Objective: To evaluate the effects of a home-school collaborative intervention on improving sugar sweetened beverages (SSBs) consumption behaviors among primary school students in grades 3 to 5 in Chengdu, so as to provide evidence for SSBs prevention and control strategies among primary school students. Methods: Using a stratified cluster random sampling method, a total of 2 006 students in grades 3 to 5 from 4 primary schools in Chengdu were enrolled from October to December 2024, including an intervention group ( n =769) and a control group ( n =1 237). The control group received routine psychological counseling, while the intervention group received a comprehensive home-school collaborative intervention integrating time perspective cultivation and family functioning improvement. A two level linear mixed effects model was used to analyze the net intervention effect, and the EBICglasso algorithm was used to construct variable association networks to identify core intervention targets. Results: After adjusting for confounders and clustering effects, the intervention significantly reduced the weekly frequency of SSBs consumption (decreased from baseline by 1.29 in the intervention group, 95% CI =-1.84 to -0.73; by 0.84 in the control group, 95% CI =-1.21 to -0.46; interaction P =0.01, Cohen s d=-0.16), improved SSBs consumption behavioral intention (decreased from baseline by 0.62 in the intervention group, 95% CI =-1.26 to -0.02; by 0.14 in the control group, 95% CI =-0.57 to 0.29; interaction P =0.02, Cohen s d =-0.15) and increased family functioning level (increased from baseline by 0.34 in the intervention group, 95% CI =-0.16 to 0.85; decreased by 0.08 in the control group, 95% CI =-0.42 to 0.25; interaction P =0.01, Cohen s d =0.17). A permutation test with 1 000 iterations showed no statistically significant difference in global network strength between the two groups ( P =0.19), whereas the differences in overall network structure and maximum edge weight were both statistically significant (all P <0.05), with present hedonistic time perspective, SSBs consumption attitude and behavioral intention identified as the core intervention targets. Conclusion The comprehensive home-school collaborative intervention effectively reduces SSB consumption frequency among primary school students and improves behavioral intention and family functioning.

Objective To investigate the longitudinal relationship between sleep duration(SD)and positive youth development(PYD)among primary and secondary school students in Chengdu city using a cross-lagged model,and to provide scientific evidence for enhancing sleep management practices for students.Methods A total of 4061 students of grades 3 through 9 from the Chengdu Child Positive Development Cohort were included in this three-wave longitudinal study.There was a one-year interval between one survey and the following round of survey,and the time points for the baseline,12-month follow-up,and 24-month follow-up surveys were designated T0,T1,and T2.The PYD of the participants was assessed using the Chinese version of the Positive Youth Development Scale.The demographic data and the average daily SD over the past month were collected.Spearman correlation analysis was performed to examine the associations between SD and PYD,and a cross-lagged model was used to investigate the longitudinal relationship between them.Results The average daily SD for the 3 rounds of surveys conducted at T0,T1,and T2 was 9.00(8.04,10.00)hours,10.44(9.67,11.11)hours,and 10.39(9.83,11.00)hours,respectively,while the PYD scores were 5.30(4.73,5.71),5.27(4.73,5.73),and 5.39(4.89,5.77),respectively.Statistical significance was found in the differences of SD and PYD scores across the 3 rounds(P＜0.05).Spearman correlation analysis revealed synchronous correlations between SD and PYD at all three time points(r=0.10 at T0,r=0.18 at T1,and r=0.21 at T2,P＜0.05)and significant lagged correlations(e.g.,r=0.10 for T1-PYD and T2-SD,and likewise,significant correlation was found for the 3 other cross-lagged paths).The cross-lagged model demonstrated that PYD at T0 and T1 positively predicted SD at T1 and T2,respectively(β0-1=0.116[95％CI,0.083-0.150],β1-2=0.097(95％CI,0.067-0.127),P＜0.05),and that SD at T0 and T1 also positively predicted PYD at T1 and T2(β0-1=0.028[95％CI,0-0.056],β1-2=0.042[95％CI,0.010-0.074],P＜0.05).According to these findings,a bidirectional predictive relationship between SD and PYD across different time points was observed in primary and secondary school students.Furthermore,PYD demonstrated better performance for predicting SD than SD did for PYD.Subgroup analysis by sex confirmed the robustness of the predictive power of PYD for SD.Conclusion This study reveals a positive bidirectional predictive relationship between SD and PYD among primary and secondary school students,suggesting that higher levels of PYD may contribute to adequate sleep.These findings provide critical scientific evidence for schools and families to strengthen sleep management and promote the holistic development and well-being of adolescents.

Objective To explore the expression levels and clinical significance of serum Gasdermin D(GS-DMD)and angiotensin converting enzyme 2(ACE2)in children with Kawasaki disease(KD).Methods A to-tal of 90 children with KD treated in the hospital from January 2020 to January 2022 were collected as KD group.According to whether the children with KD had coronary artery lesions(CAL),the KD group was di-vided into CAL group(32 cases)and non-CAL group(58 cases),and 50 children with fever due to acute re-spiratory infection admitted to the hospital during the same period were selected as fever control group.An-other 50 children with oblique inguinal hernia who underwent elective surgery in the same period were selected as the control group.Serum GSDMD and ACE2 levels were detected by enzyme-linked immunosorbent assay.The correlation between serum GSDMD,ACE2 and clinical indicators was analyzed by Pearson correlation.Multivariate Logisitic regression was used to analyze the influencing factors of CAL occurrence in KD pa-tients.The diagnostic value of serum GSDMD and ACE2 for CAL in children with KD was analyzed by receiv-er operating characteristic(ROC)curve.Results The serum GSDMD and ACE2 levels in KD group were higher than those in fever control group and control group,and the differences were statistically significant(all P＜0.05).Compared with the non-CAL group,the fever duration,gamma globulin treatment time,erythro-cyte sedimentation rate,platelet count,C reactive protein,GSDMD and ACE2 levels of KD children in the CAL group were significantly higher,while the blood sodium and albumin were significantly lower,with statistical significance(all P＜0.05).The results of Pearson correlation analysis showed that serum GSDMD and ACE2 levels in KD group were positively correlated with fever duration,gamma globulin treatment time,erythrocyte sedimentation rate,platelet count and C reactive protein(all P＜0.05),and negatively correlated with blood sodium and albumin(all P＜0.05).Multivariate Logistic regression analysis showed that the increase of ser-um GSDMD and ACE2 was an independent risk factor for the development of CAL in KD children.ROC curve analysis results showed that the area under the curve(AUC)and 95％CI of the combined detection of serum GSDMD and ACE2 for CAL in KD children were 0.918(0.868-0.949).The AUC and 95％CI of serum GS-DMD and ACE2 were significantly higher than that of serum GSDMD and ACE2[0.838(0.789-0.887)and 0.865(0.811-0.912),respectively],and the differences were statistically significant(Z=5.116,4.217,all P＜0.05).Conclusion The combined detection of serum GSDMD and ACE2 has high diagnostic value for CAL in children with KD.

Objective:To investigate the risk factors for nonunion after surgery for femoral shaft fractures in order to reduce them.Methods:The clinical data were retrospectively analyzed of the 804 patients with femoral shaft fracture who had been treated from January 2014 to December 2020 at Department of Orthopaedics, Xijing Hospital. There were 575 males and 229 females, aged from 18 to 96 years (average, 43.7 years). The patients were divided into 2 groups according to whether nonunion had occurred after surgery: a nonunion group of 112 cases and a fracture healing group of 692 cases. The preoperative general data, such as age, gender and fracture type, as well as intraoperative and postoperative data, such as operation time, internal fixation method, reduction method and internal fixation failure, were compared between the 2 groups. Items with P<0.05 were included in the multivariate logistic regression analysis to identify the risk factors for nonunion. Results:There were statistically significant differences between the nonunion group and the fracture healing group in smoking history, drinking history, injury mechanism, injury type, multiple injuries, fracture AO classification, fixation method, internal fixation failure, postoperative infection and use of non-steroid anti-inflammtory drugs ( P<0.05). Multivariate logistic regression analysis showed that smoking ( OR=3.261, 95% CI: 2.072 to 5.133, P<0.001), high energy injury ( OR=2.010, 95% CI: 1.085 to 3.722, P=0.026), multiple injuries ( OR=3.354, 95% CI: 1.985 to 5.669, P<0.001), AO type 32-C fracture (type 32-C fracture used as a reference, P=0.034), internal fixation failure ( OR=3.517, 95% CI: 1.806 to 6.849, P<0.001), external stent fixation (external stent fixation used as a reference, P=0.009) were the risk factors for nonunion after femoral shaft fractures. Conclusions:After surgery for patients with femoral shaft fracture, special attention should be paid to those with a smoking habit, high-energy injury, multiple injuries, AO type 32-C fracture, external stent fixation or a failed internal fixation, because they are high-risk groups prone to postoperative nonunion.

Objective:To explore the effect of ultrasound-guided erector spinal plane block (ESPB) combined with hyperbaric oxygen (HBO) in patients with post-herpetic neuralgia (PHN).Methods:A total of 86 patients with PHN admitted to No.988 Hospital of CPLA from January 2017 to August 2019 were selected as the research subjects and equally divided into two groups by the random number table method. The patients in the control group received ultrasound-guided ESPB therapy, while the patients in the observation group received HBO therapy on the second day after ultrasound-guided ESPB. The pain severity (VAS scores), levels of inflammatory factors, and treatment effectiveness were compared between the two groups.Results:After treatment, the VAS scores of the patients in both two group were significantly lower than those before treatment; the differences of pain severities between the two groups were also statistically significant; the VAS scores of the observation group were lower than those of the control group; all the differences were statistically significant ( P<0.05). After 3 weeks of treatment, the levels of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), and preprocalcitonin (PCT) in the two groups were all lower than those before treatment; the levels of those inflammatory factors in the observation group were lower than those of the control group; all the differences were statistically significant ( P<0.05). The effective rates of the observation group and the control group were 83.72% and 74.42% respectively, with statistically significant difference ( P<0.05). Conclusion:Ultrasound-guided ESPB combined with HBO therapy can better relieve the pain, reduce inflammation, and ensure treatment efficiency for patients with PHN. It is clinically worthy of promotion.

Objective:To investigate the effect of proprioceptive exercise therapy combined with hyperbaric oxygen on the postoperative rehabilitation of patients with knee cruciate ligament injuries.Methods:A total of 44 patients with knee cruciate ligament injuries who received surgical treatment in No.988 Hospital of CPLA from January 2017 to October 2019 were evenly divided into observation group and control group (22 cases for each group) by random number table method. The patients in the control group were given the conventional rehabilitation treatment after surgery, while the patients in the observation group were additionally treated with proprioceptive exercise therapy combined with hyperbaric oxygen. Both groups received treatments for 2 weeks. The visual analogue scales (VAS) scores of pains were compared between the two groups before treatment, after one-week treatment, and after two-week treatment. The flexor/extensor peak torque ratios and limb symmetry were compared between the two groups before and after treatment. The clinical treatment effects of the knee cruciate ligament injuries and postoperative life quality were compared between the two groups.Results:The VAS scores of the observation group after one-week and two-week treatment were 2.11±0.45 and 1.02±0.07 respectively. The corresponding scores in the control group were 5.46±1.04 and 3.48±0.75 respectively, and the differences between the two groups after one-week and two-week treatment were statistically significant ( P<0.05). After two weeks of treatment, the difference of peak torque ratios of the flexor/extensor between the observation group [(84.95±7.71)%] and the control group [(73.65±8.11)%] was statistically significant ( P<0.05); the difference of limb symmetry ratio between the observation group [(88.96±10.22)%] and the control group [(75.60±9.08)%] was statistically significant ( P<0.05); the difference of total effective rate between the observation group (86.36%, 19/22) and the control group (63.64%, 14/22) was statistically significant ( P<0.05). The difference of scores of Medical Outcomes Study Short-Form 36 (SF-36) on life quality between the observation group (92.81±11.53) and the control group (85.60±12.34) was statistically significant ( P<0.01). Conclusion:Proprioceptive exercise therapy combined with hyperbaric oxygen on the postoperative patients with cruciate ligament injuries of the knee can enhance clinical effect, reduce the pain level of patients, and improve ligament function, hence achieve better quality of life.

Objective:To explore the effect of ultrasound-guided erector spinal plane block (ESPB) combined with hyperbaric oxygen (HBO) in patients with post-herpetic neuralgia (PHN).Methods:A total of 86 patients with PHN admitted to No.988 Hospital of CPLA from January 2017 to August 2019 were selected as the research subjects and equally divided into two groups by the random number table method. The patients in the control group received ultrasound-guided ESPB therapy, while the patients in the observation group received HBO therapy on the second day after ultrasound-guided ESPB. The pain severity (VAS scores), levels of inflammatory factors, and treatment effectiveness were compared between the two groups.Results:After treatment, the VAS scores of the patients in both two group were significantly lower than those before treatment; the differences of pain severities between the two groups were also statistically significant; the VAS scores of the observation group were lower than those of the control group; all the differences were statistically significant ( P<0.05). After 3 weeks of treatment, the levels of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), and preprocalcitonin (PCT) in the two groups were all lower than those before treatment; the levels of those inflammatory factors in the observation group were lower than those of the control group; all the differences were statistically significant ( P<0.05). The effective rates of the observation group and the control group were 83.72% and 74.42% respectively, with statistically significant difference ( P<0.05). Conclusion:Ultrasound-guided ESPB combined with HBO therapy can better relieve the pain, reduce inflammation, and ensure treatment efficiency for patients with PHN. It is clinically worthy of promotion.

Objective:To investigate the effect of proprioceptive exercise therapy combined with hyperbaric oxygen on the postoperative rehabilitation of patients with knee cruciate ligament injuries.Methods:A total of 44 patients with knee cruciate ligament injuries who received surgical treatment in No.988 Hospital of CPLA from January 2017 to October 2019 were evenly divided into observation group and control group (22 cases for each group) by random number table method. The patients in the control group were given the conventional rehabilitation treatment after surgery, while the patients in the observation group were additionally treated with proprioceptive exercise therapy combined with hyperbaric oxygen. Both groups received treatments for 2 weeks. The visual analogue scales (VAS) scores of pains were compared between the two groups before treatment, after one-week treatment, and after two-week treatment. The flexor/extensor peak torque ratios and limb symmetry were compared between the two groups before and after treatment. The clinical treatment effects of the knee cruciate ligament injuries and postoperative life quality were compared between the two groups.Results:The VAS scores of the observation group after one-week and two-week treatment were 2.11±0.45 and 1.02±0.07 respectively. The corresponding scores in the control group were 5.46±1.04 and 3.48±0.75 respectively, and the differences between the two groups after one-week and two-week treatment were statistically significant ( P<0.05). After two weeks of treatment, the difference of peak torque ratios of the flexor/extensor between the observation group [(84.95±7.71)%] and the control group [(73.65±8.11)%] was statistically significant ( P<0.05); the difference of limb symmetry ratio between the observation group [(88.96±10.22)%] and the control group [(75.60±9.08)%] was statistically significant ( P<0.05); the difference of total effective rate between the observation group (86.36%, 19/22) and the control group (63.64%, 14/22) was statistically significant ( P<0.05). The difference of scores of Medical Outcomes Study Short-Form 36 (SF-36) on life quality between the observation group (92.81±11.53) and the control group (85.60±12.34) was statistically significant ( P<0.01). Conclusion:Proprioceptive exercise therapy combined with hyperbaric oxygen on the postoperative patients with cruciate ligament injuries of the knee can enhance clinical effect, reduce the pain level of patients, and improve ligament function, hence achieve better quality of life.

Objective To summary the clinical experience of ECMO for failure to separate from bypass after arterial switch operation of TGA.Methods 8 TGA patients (6 boys and 2 girls,aged 1 day to 3.5 years and weighing 2.7-11.0 kg,3 VSD intact and 5 with VSD,others complicated malformation including COA,left ventricular outtract stenosis) were treated with VA ECMO owing to failure to separate from bypass caused by low output syndrome after ASO between July 2007 and June 2016.We collected the medical records and analyzed the indication,management and complication of ECMO for this patient population.There were two stages of ECMO supporting for low output after ASO,The first stage was to improve tissue perfusion and correct inner environment by high flow supporting,and the second stage was ventricular function training.ECMO was weaned when the blood pressure was more than 60 mmHg and the difference value of systolic pressure and diastolic pressure was 15-20 mmHg under medium dose inotropics supporting.Volume infusion was limited strictly during ECMO.Results The running time were 22-300 h.5 patients were weaned from ECMO successfully and 4 patients discharged to home.The long-term follow-up of echocardiography indicated normal cardiac function in 3 patients.1 older child had left cardiac failure again after weaning from ECMO 12 days later;he was supported by LVAD subsequently.LVAD was weaned after 236h supporting,unfortunately,He died from cardiac failure 50 days after LVAD weaning.3 patients could not wean from ECMO and died.The main complications were bleeding and pericardial tamponade.Conclusion VA ECMO was effective treatment for failure to separate from bypass after switch operation of TGA.The high mortality was seen in patients with intramural coronary arterial.The myocardial structure perhaps changed secondary in older TGA children,ECMO and LVAD can be used as short-term circulatory transition to artificial heart or transplant.Bleeding was the main complication of this population;surgical hemostasis and accurate coagulation management were the guarantee for successful ECMO running.

Objective To explore the impacts of Danhong injection on physiological and biochemical indicators in malnourished mice at physiological low doses, evaluate its safety, and test the practical value of safety re-evaluation of Traditional Chinese Medicinal ( TCM) injections. Methods A total of 32 ICR mice during growth period were selected to set up corn deficient nutrition mice model. Mice were assigned into the normal control group (given 0. 9% saline), Danhong injection at low, medium and high dosages (0. 2, 0. 4 and 0. 6 mL) groups (n=8 in each group);Mice were administered with respective medications intraperitoneally for 7 consecutive days. Blood samples were taken and mice were executed on the 8th day. All 9 kinds of organ or tissue were obtained completely, to measure related physiological and serum biochemical parameters. The safety of Danhong injection was evaluated by using Benefit and Damage Index - General Score ( BDI-GS ) system. Results The Danhong injection showed only slight damages on major organs or tissues, the BDI values were all above 0. 85, and the GS values were all above 9. 0;BDI values for Danhong injection at different dosages were all above 1. 0 for spleen and pancreas, showing better replenishing and healthy effects, and the differences were of statistical significance compared with the normal control group (P<0. 05 or P<0. 01). Meanwhile, it exerted obviously hypoglycemic effect. Conclusion Danhong injection is of rather low risk under physiological dosages, and therefore is safe to use. The mal-nutrition model combined with the BDI-GS system may be developed as a novel approach for safety re-evaluation of TCM injection in clinic.