Objective: To understand the allocation of health staff and clinics in primary and secondary schools in Guangdong Province, so as to provide a reference for school health construction. Methods: In December 2020, a total of 17 205 primary and secondary schools in 21 cities in Guangdong Province were investigated by combining document verification and on site surveys. The allocation of health staff and clinics in different cities and types of schools was analyzed using SPSS 25.0 software. Results: The proportion of schools in Guangdong Province that met the national standard for school health staff ratio was 37.7%. Among different types of schools, the lowest ratio was found in nine year schools (33.1%), while the highest was in twelve year schools (61.3%). Among the 17 205 schools in the province, 12.6% had clinics with an area of >40 m 2, and 6.9% with occupational licenses for medical institutions. The proportion of full time health staff was 39.1%. Among all school health staffs, the proportions of permanent staff, temporary staff, and appointed staff were 47.5%, 29.0% and 23.6%, respectively. The rate of school health staff with professional qualifications was 44.9%, while 48.3% had graduated from medical related majors, and 20.9% held a bachelor s degree or higher as their first degree. There were differences among various types of schools, with primary schools having the lowest health staff configuration and professional level (24.0% and 35.7%, respectively). Conclusions There are still issues of insufficient staff and low professional level in health staff and establishment of clinics in primary and secondary schools in Guangdong Province, and the allocation is uneven across different types of schools. The allocation of clinics in the province is still in urgent need of improvement.

Objective To investigate the reasons for the inconsistent results between the vertical auto profile(VAP)method and bio-chemical homogeneous phase(BHP)method in detecting plasma low-density lipoprotein cholesterol(LDL-C),and provide experimen-tal basis for the accurate and quantitative detection of plasma LDL-C levels.Methods A total of 360 plasma samples from diabetes mellitus patients combined with carotid plaque admitted to the Department of Endocrinology of Ningbo Yinzhou Hospital of Traditional Chinese Medicine during January,2022 and January,2023 were collected.The LDL-C levels of these samples were detected by the VAP method and BHP method,respectively.The VAP method uses software to automatically calculate the area under the LDL-C curve after centrifugation of the sample as the LDL-C level(LDL-CVAP)and the BHP method directly detects the LDL-C level(LDL-CBHP)by the special surfactant method.360 samples were divided into the consistent group(group A)and inconsistent group(group B)ac-cording to the relative deviation between the LDL-CBHP and LDL-CVAP methods.Group B was further divided into the LDL-CBHP on the high side group(Group B1)and LDL-CBHP on the low side group(Group B2).Groups B1 and B2 were divided into B1-1,B1-2,B1-3 and B2-1 groups based on the degree of relative deviation.The percentages of samples and levels of lipoprotein a cholesterol[Lp(a)-C],intermediate-density lipoprotein cholesterol(IDL-C),Lp(a)-C and IDL-C[Lp(a)-C+IDL-C],very low-density lipo-protein cholesterol(VLDL-C),total cholesterol(TC)and total triglyceride(TG)in each group were compared.Results The LDL-CBHP levels of 360 samples were significantly higher than that of LDL-CVAP(P＜0.01).The percentage of samples in group B was significantly higher than that in group A,and that of group B1 was significantly higher than that of group B2(P＜0.05).The levels of Lp(a)-C,IDL-C and Lp(a)-C+IDL-C in groups B1-1,B1-2,and B1-3 were significantly higher than those in group A(P＜0.01).The relative deviation between LDL-CBHP and LDL-CVAP in 360 samples was significantly positively correlated with the levels of Lp(a)-C,IDL-C,and Lp(a)-C+IDL-C(P＜0.01).The maximum correlation coefficient was found in Lp(a)-C+IDL-C.Conclusion The results of plasma LDL-C in diabetes mellitus patients combined with carotid plaque detected by the BHP method are significantly different from those detected by the VAP method,which mainly shows that the results of the BHP method are on the high side.The higher the level of plasma Lp(a)-C+IDL-C,the greater the relative deviation between the BHP method and VAP method.The reason for the high results of LDL-C detected by the BHP method may be related to the fact that LDL-CBHP contains irremovable Lp(a)-C and cholesterol carried by IDL-C.The VAP method can be used as an accurate method for detecting real LDL-C without Lp(a)-C and IDL-C.

Objective: To gain a better understanding of the emotional and behavioral problems associated determinants of primary and middle school students from Guangdong Province during the COVID-19 pandemic, so as to provide a basis for developing targeted intervention strategies. Methods: Using the method of convenience sampling, an online questionnaire survey was carried out among primary and middle school students from Guangzhou, Zhanjiang and Zhongshan from March to April 2020. The emotional and behavioral problems of primary and middle school students were assessed using the Conners Parental Symptoms Questionnaire(PSQ), and a self compiled questionnaire was used to collect basic information related to the primary and middle school students and the influencing factors of emotional and behavioral problems. A total of 7 755 valid questionnaires were retrieved and statistically analyzed using the chi square test and multivariate Logistic regression. Results: The detection rate of emotional and behavioral problems among children and adolescents aged 6 to 17-years-old in Guangdong Province was 14.8%; that was 21.0%, 14.4%, 7.3 %, and 10.1% in lower primary school students, upper primary school students, junior high school students, and high school students, respectively. The detection rate of the psychosomatic and hyperactivity index in boys was higher than that observed in girls, and the detection rate of anxiety in boys was lower than that observed in girls( P <0.05). There were statistically significant differences in emotional and behavioral problems in children in different grades( P <0.05). The results of the regression analysis showed that male students were at risk of psychosomatic ( OR= 1.37 , 95%CI =1.04-1.82) and hyperactivity disorders( OR=1.58, 95%CI =1.21-2.06), whereas the male gender was a protective factor for anxiety( OR=0.50, 95%CI =0.39-0.64). Grades were identified as the influencing factors of all of the factors related to emotional and behavioral problems. Students who reported excessive screen time and insufficient sleep were more likely to experience emotional and behavioral problems. Conclusion The detection rate of emotional and behavioral problems among primary and middle school students in Guangdong Province during the COVID-19 epidemic was high, which was associated with sex, grade, screen time and sleep. It is necessary to develop and implement targeted intervention measures.

Objective: To investigate the association between sedentary bouts and cardiovascular disease (CVD) risk factors, and to provide a reference for controlling and reducing the incidence of CVD in children. Methods: Cluster random sampling was used to select 356 students from five primary schools in Guangzhou. Sedentary behavior and physical activity were assessed using ActiGraph GT3X accelerometers, which were worn for 7 consecutive days. According to the sedentary bout duration of each participant, sedentary time was classified into categories of 1-<5, 5-<10, 10-<15, 15-<20 and ≥20 min bouts. Physical examinations were carried out to identify cardiometabolic risk factors. Multivariate linear regression was performed to analyze the relationship between sedentary bouts and CVD risk factors. Results: After adjusting for confounding factors, the time accumulated in sedentary bouts of 5-<10, 10-<15, 15-<20 min in duration were positively associated with higher cardiometabolic risk scores ( B =1.24， 2.01 ，2.40), negatively associated with lower HDL ( B =-0.13，-0.21，-0.27). The time accumulated in sedentary bouts of 1-<5, 5-<10 , 10-<15, 15-<20 min in duration were positively associated with BMI levels ( B =1.07，1.89，2.86，3.65), and waist circumference ( B =2.79，4.81，8.04，10.14)( P <0.05). Conclusion These results suggested that sedentary bouts of 5-<20 min were associated with an unfavorable cardiometabolic risk profile. Our finding suggests no more than 20 min accumulated sedentary time for children.

Objective: To examine the association of sedentary behaviors with visual acuity among primary school children, and to provide a reference basis for the prevention and control of poor vision. Methods: Using stratified random cluster sampling method, a total of 4 969 students in grade 1-4 were selected from 5 primary schools in Guangzhou in 2017, and then were followed up in 2019. A validated questionnaire was used to collect data on children s sedentary behaviors, including doing homework, watching TV, playing computer/video games, and taking the bus/car between home and school. Visual acuity was measured in the baseline and the follow up using a 5 m standard logarithmic visual acuity chart. Multiple linear regression and Logistic regression were conducted to analyze the relationship between sedentary behaviors and visual changes. Results: The two year cumulative incidence of poor vision was 48.74%. Homework time was inversely associated with visual acuity of left eye( β=-0.012, 95%CI =-0.023- -0.002 ). Homework time was positively correlated with poor vision( OR =1.16, 95% CI =1.05-1.27). However, total sedentary time, screen time and bus/car time were not statistically associated with changes in visual acuity( P >0.05). Conclusion Increased homework time was associated with poorer vision in primary school students. Interventions to reduce the academic burden should be taken.

: To investigate the current status of online classes, screen time and its influencing factors among primary school students in Guangdong during the 2019 novel coronavirus pandemic. Methods: Using the convenience sampling method, a total of 5 266 pupils aged 6-12-years-old from Guangzhou, Zhanjiang, and Zhongshan participated in the online questionnaire. ANOVA or chi square tests were performed to compare differences in online classes and screen time between grades, and multinomial Logistic regression was performed to analyze the correlates of recreational screen time. Results: The prevalence of prolonged recreational screen time was 42.2% and 55.2% on weekdays and weekends, respectively. Recreational screen time increased by 40.31 min/d on weekdays and 33.07 min/d on weekends, compared to usual school semesters. The average duration of an online class was (26.07±9.62) min, which totaled (110.41±51.98)min per day. Sex, grade, being the only child, and parents education levels were identified as the influencing factors of prolonged recreational screen time. Children who practiced moderate levels (weekdays: OR =1.27; weekends: OR =1.40; P <0.05) or lower levels of physical activity (weekdays: OR =1.86; weekend: OR =1.84; P < 0.05 ) were at a higher risk of prolonged recreational screen time than those who practiced more vigorous physical activity. Children whose parents limited their screen time to a moderate (weekdays: OR=1.61, P <0.05) or lower level (weekdays: OR=1.32, P < 0.05 ) had a higher risk of prolonged recreational screen time than those with a higher frequency. Children with parents recreational screen time ≥ 2 h/d had a higher risk of prolonged recreational screen time than the reference group; children who exhibited moderate to vigorous levels of physical activity <1 h/d (weekdays: OR=1.31, P <0.05), and those used electronic devices for learning 1-2 h/d (weekdays: OR =2.65; weekend: OR =2.65; P <0.05) or for ≥2 h/d (weekdays: OR =4.05, weekend: OR=5.24, P < 0.05 ) were at a higher risk of prolonged recreational screen time than the reference group. Conclusion During the COVID-19 pandemic, the level of screen time among children in Guangdong was high. Behavioral monitoring and targeted interventions are needed to promote children s health.

Objective: To investigate the associations between early life factors and the incidence of overweight and obesity and to provide a reference for childhood overweight and obesity prevention. Methods: A total of 5 172 children aged 6-11 years from 5 primary schools in Guangzhou were enrolled using stratified random cluster sampling method. After two years follow up, 3 315 children were included in the final analysis. Questionnaire was used to collect children s early life factors. Height and weight were measured objectively at baseline and follow up. Results: The incidence of overweight and obesity was 8.7% in children. After adjustment for confounders, results from the Logistic regression analysis showed that maternal pre pregnancy underweight was negatively associated with the incidence of childhood overweight and obesity( OR=0.54, 95%CI =0.38-0.76)( P <0.05). While excessive gestational weight gain during pregnancy( OR=1.55, 95%CI =1.14-2.10) and caesarean section ( OR=1.30, 95%CI =1.00-1.68) were positively associated with the incidence of childhood overweight and obesity( P <0.05). Conclusion Both excess gestational weight gain and caesarean section would increase the risk of the overweight and obesity of their offspring, while maternal pre pregnancy underweight would reduce the risk of childhood overweight and obesity.

Objective:The purpose of this study is to analyze the surveillance data of the Integrated HCV surveillance in Shanghai and provide a scientific basis for HCV's elimination strategies.Methods:Descriptive statistical analysis and multivariate logistic regression analysis were performed using the multi-dimension results of the Integrated HCV surveillance in Shanghai from 2014 to 2019. Data related to reported HCV cases, HCV gene subtypes surveillance, HCV behavioral risk factors surveillance and HCV-antibody testing results of the community-based general population and high-risk/key populations.Results:The reported incidence rate of acute hepatitis C in Shanghai decreased from 2014 to 2019 ( Z=-4.07, P<0.01); meanwhile, the reported incidence rate of chronic hepatitis C met an upward trend ( Z=10.26, P<0.01), with an annual average, reported incidence rates of 0.18 per 100 000 and 8.60 per 100 000, respectively. Seven hundred forty-four blood samples were subtyped with 16 subtypes from 4 genotypes (GT1, GT2, GT3, and GT6). Among above, 1b (324 cases, 43.55%), 3a (121 cases, 16.26%), 3b (111 cases, 14.92%) and 6a (47 cases, 6.32%) were the principal subtypes. The composition of genotypes varied with decreased 1b and increased 3b and 6a. The major risk factors for HCV infection were blood transfusion ( OR=4.18, 95% CI: 2.79-6.27), surgery ( OR=1.63, 95% CI: 1.26-2.12), sharing syringe ( OR=4.18, 95% CI: 2.75-6.34), pedicure ( OR=2.01, 95% CI: 1.54-2.62), sharing razors ( OR=4.09, 95% CI:1.24-13.51), and unsafe beauty practices ( OR=3.15, 95% CI: 2.13-4.65). HCV antibody screening of 11 groups of high-risk/key populations showed that drug users had the highest HCV-antibody positive rate of 18.81% (1 008/5 358). The anti-HCV positive rate of the general population was 0.16% (7/4 268), which was significantly lower than that of high-risk/key populations from the same year, 2.50%(501/20 002) ( χ2=94.04, P<0.01). Conclusions:Shanghai is a low-endemic area of HCV. Constantly carrying out integrated surveillance and analysis is of great value for early identification of HCV infected people and its risk factors, timely adjustment of prevention and control strategies, and eliminating the public health threat of HCV.

Objective:To investigate the effect of situational simulation drill in nurses training on prevention and treatment of venous thromboembolism (VTE).Methods:Totally 120 nurses in 1-3 years from a tertiary general hospital were selected to participate in the training for prevention and treatment of venous thromboembolism. They were divided into intervention group and control group according to the number of single and double packet ward. A total of 62 nurses in the single wards were selected as the intervention group, and a total of 58 nurses in the double wards were selected as the control group. The control group and the intervention group were trained on the prevention and treatment of venous thromboembolism by traditional teaching method and scenario simulation drill, and the effect was evaluated by Kirkpatrick Model.Results:After training, intervention group training object theory examination score, operation assessment score, clinical nursing work assessment score, and nurses ability to scale score (83.79±6.85), (87.00±4.57), (7.90±0.62), (79.03±8.24) respectively, were higher than the control group (80.67±7.90), (84.02±4.70), (7.21±0.72), (70.86±11.59), the score comparison difference was statistically significant ( t values were -3.660-5.670, P < 0.05); The satisfaction of the training object to the teaching plan, teaching content and teaching form in the intervention group was 88.71% (55/62), 87.10% (54/62) and 87.10% (54/62), which were all higher than the control group 74.14% (43/58), 72.41% (42/58) and 68.97% (40/58), with statistically significant differences ( χ2 values were 4.250, 4.038, 5.804, P<0.05). Conclusion:The application of situational simulation drill in the nursing training of prevention and treatment of VTE is helpful to improve the theoretical skills and clinical work ability of nurses in the prevention and treatment of VTE, and to increase the satisfaction of nurses with the training.

Objective:To explore the abnormal sensory manifestations of children with autism spectrum disorder (ASD).Methods:A total of 269 ASD children with sensory symptoms (ASD toddler group: under 3 years old( n=110), and ASD preschool children: 3-6 years old( n=159)) were investigated by self-made children's sensory abnormality questionnaire, and 175 typically developing(TD) children were compared.SPSS 26.0 software was used for statistical analysis, including descriptive statistics, t test and χ 2 test. Results:The incidence of sensory abnormalities in ASD group was 95.17%, which was higher than that in TD group (78.86%; χ 2=28.224, P<0.001), and the incidence of multiple sensory domain symptoms in ASD group was 84.77%, which was higher than that in TD group (63.77%; χ 2= 22.608, P<0.001). The incidence of sensory symptoms in ASD toddler group was 98.18%, which was not statistically different from that in TD toddler group (92.59%)(χ 2=3.210, P=0.073). The incidence of multiple sensory domain symptoms in ASD toddler group was higher (85.19%), which was statistically different from that in TD toddler group (66.00%)(χ 2=7.613, P=0.006). In the four items of sensory symptoms (auditory hyperresponsiveness, auditory sensory seeking, tactile hyperresponsiveness and tactile sensory seeking), the proportion of moderate to severe of the first three items in ASD group were 66.67%, 72.08% and 61.54%, which were higher than those in TD group (46.81%, 56.36% and 38.46%)(χ 2= 9.652, P=0.002, χ 2= 7.822, P=0.005, χ 2= 4.631, P=0.031), but the proportion of moderate to severe of four items in ASD toddler group were not statistically different from that in TD toddler group at all ( P>0.05). The incidence of functional impairment caused by four items of sensory symptoms in ASD group (68.55%, 65.99%, 63.25% and 48.87%) was higher than those in TD group (45.74%, 28.18%, 26.92% and 27.12%) (χ 2= 12.814, P<0.001; χ 2= 40.456, P<0.001; χ 2= 11.429, P=0.001; χ 2= 7.930, P=0.005). The incidence of functional impairment caused by auditory sensory seeking and tactile hyperresponsiveness in ASD toddler group (57.65% and 55.56%) was higher than that in TD toddler group (31.58% and 0) and the incidence of the other two symptoms in these two groups were not statistically different.There was no statistical difference in the incidence of sensory symptoms between ASD toddler group and ASD preschool group, neither the incidence of multiple sensory domain symptoms ( P>0.05). Conclusion:Sensory abnormalities are common in autistic children, and most of them involve two or more sensory domains. Attention should be paid to the occurrence, quantity, degree and functional impairment of their symptoms.