Objective: To examine the developmental trajectory of fine motor ability in schoolage children with attention deficit hyperactivity disorder (ADHD) for two years, so as to provide scientific evidence to promote motor development in ADHD children. Methods: From April to June 2019, 31 children aged 6-8 years old were selected from a public elementary school. They were diagnosed with ADHD by two psychiatric professionals according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria. Additionally, 31 typical developmental children, matched for age, sex and IQ with the ADHD group, were recruited as the control group. Fine motor ability was assessed with tasks of hand manual dexterity in Movement Assessment Battery for Children-2 (MACB-2), and a followup assessment was conducted from April to June 2021. The development changes of fine motor ability between two groups of children were compared by using t test and repeated measures analysis of variance. Results: Between baseline and followup periods after two years, the total score of hand fine motor in the ADHD group did not show significant improvement (7.4±3.0, 8.0±3.4; t=-1.05, P>0.05), while there was a small effect size improvement in typically developing control group (9.5±2.1, 10.5±2.4; t=-2.12, effect size=0.38, P<0.05). Followup after two years, coin/peg throwing scores with dominant hand improved between ADHD group and control group (7.0±3.3, 9.5±3.2; 8.4±2.8, 11.6±1.6) (t=-3.74, -6.33, P<0.01; effect size=0.67, 1.14), with a smaller improvement in the ADHD group. The score for threading beads/threads decreased in between ADHD group and control group (7.9±2.4, 5.8±3.1; 9.2±1.1, 8.2±1.9) (t=3.89, 2.78, P<0.01; effect size=0.70, 0.50), with a greater decrease in the ADHD group. Conclusions The development speed of fine motor ability in children with ADHD aged 6-8 is slow and continues to lag behind normal developmental children. Fine motor development in children with ADHD should be closely monitored, and targeted interventions should be implemented when necessary.

Objective:To summarize the best evidence for non-pharmacological interventions for postoperative pain in patients undergoing abdominal surgery, so as to provide reference for alleviating postoperative pain in patients.Methods:UpToDate, BMJ Best Practice, PubMed, Embase, Web of Science, Guidelines International Network and other databases and professional association websites were searched for guidelines, clinical decisions, evidence summaries, systematic reviews, expert consensus and randomized controlled trials on non-pharmacological interventions for postoperative pain in patients undergoing abdominal surgery. The search period was from the establishment of the databases to December 30, 2022.Results:A total of 17 articles were included, including three clinical decision-making, four guidelines, six systematic evaluations, two expert consensus, one randomized controlled trial and one quasi-randomized cotrolled trial. A total of 30 pieces of evidence were summarized from six aspects, such as basic principles of non-pharmacological intervention, evaluation and planning, physical intervention, psychological intervention, other forms of intervention, health education and follow-up.Conclusions:The best evidence for non-pharmacological intervention in postoperative pain in patients undergoing abdominal surgery can provide a basis for clinical medical staff to conduct non-pharmacological intervention.

Objective To explore the impact of exercise intervention on the reading abilities of chil-dren with Chinese developmental dyslexia(CDD).Methods Twenty-seven CDD children were recruited from patients of Peking University Sixth Hospital,and randomly divided into a CDD exercise interven-tion group of 14 and a CDD control group of 13.Another 14 age-matched normal children were select-ed into a normal control group.All groups kept daily physical activities in school,while the CDD ex-ercise intervention group additionally underwent 8-week individualized gross and fine motor interven-tion.The literacy,reading fluency and reading comprehension of all groups were evaluated by using"Elementary School Students'Literacy Test and Evaluation Scale",one-minute word reading and ele-mentary school students'reading ability assessment.Results Before the intervention,there were no sig-nificant differences between the exercise intervention and control groups in the literacy level,reading fluency,and reading comprehension(P>0.05),which were all significantly lower than the normal con-trol group(P<0.05).However,after the intervention,significant improvement was observed in the aver-age literacy level,reading fluency,and reading comprehension of the CDD exercise intervention group,and the literacy and reading fluency of the CDD control group,as well as the average literacy level and reading comprehension of the normal control group.Moreover,there were no significant differ-ences between the CDD exercise intervention and control groups in the average literacy level and read-ing fluency score(P>0.05),both significantly lower than the normal control group(P<0.05).Mean-while,the reading comprehension score of the CDD exercise intervention group was significantly higher than the CDD control group(P<0.05),but significantly lower than the normal control group(P<0.05).Conclusion Eight-week targeted gross and fine motor intervention can effectively improve reading abili-ty of DD children,especially their reading comprehension.

Objective: To investigate the relationship between fine motor skills and executive function in school aged boys with attention deficit hyperactivity disorder (ADHD) aged 6-10 years, so as to provide a reference for promoting executive function. Methods: From November 2022 to May 2021,65 boys with ADHD were recruited from a tertiary hospital in Beijing and a public elementary school in Beijing, and 65 boys with typical development according to age and sex were recruited as controls. Children s fine motor skills were assessed using the movement assessment battery for children, second version (MABC-2), and children s inhibitory control, working memory, and cognitive flexibility were assessed using the Stroop color word test (SCWT), Rey osterrich complex figure test (ROCFT) and trail making test (TMT), respectively. Independent samples t-tests were used to analyze the differences between the two groups, and Pearson correlation analysis and stratified regression analysis were used to explore the relationship between fine motor skills and executive functioning in boys with ADHD. Results: In the fine motor skills test, boys with ADHD scored significantly lower (8.68±3.62) than control boys (11.22±2.27)( t =4.80, P <0.05); in the executive function test, the results of SCWT, ROCFT, and TMT tests were significantly worse in boys with ADHD than in normal boys ( t =-4.53-4.42, P < 0.05). Correlation analysis showed that the fine motor skill scores of boys with ADHD were negatively correlated with the number of word sense errors ( r =-0.35) and color errors ( r =-0.42), and positively correlated with memory scores for delayed structure ( r =0.30) and detail ( r =0.25), which were negatively correlated with TMT-A ( r =-0.34),TMT-B reaction time ( r =-0.26), number of errors ( r =-0.43) ( P <0.05). Stratified regression analysis showed that fine motor skill scores of boys with ADHD were predictive of test results for inhibitory control, working memory and cognitive flexibility, with explanatory rates of 15%, 7%, and 19%, respectively. Conclusion Fine motor skills in boys with ADHD are correlated with executive functions, and fine motor skills could predict inhibitory control, working memory and cognitive flexibility to some extent. The development of fine motor skills in boy with ADHD could promote their executive functions.

Objective: To analyze the epidemiological characteristics of coronavirus disease 2019 (COVID-19) local infections in Zhejiang Province during the period between March and May, 2022, so as to provide the evidence for COVID-19 control. Methods: The individual investigation data and field epidemiological investigation data of local COVID-19 cases in Zhejiang Province from March to May 2022 were extracted from the National Diseases Prevention and Control Information System of China. The temporal, spatial and population distribution, identification and booster vaccination of local COVID-19 cases were analyzed using a descriptive epidemiological method. Factors affecting the severity of clinical symptoms were identified among local COVID-19 cases using a multivariable logistic regression model. Results: A total of 289 local COVID-19 epidemics occurred in Zhejiang Province from March to May 2022, and all infections were caused by the Omicron variant. A total of 1 598 local COVID-19 infections were reported, including 672 confirmed cases (42.05%) and 926 asymptomatic cases (57.95%), and the 672 confirmed case included 614 mild cases (91.37%), 58 normal cases (8.63%), while no severe, critically ill or dead cases were reported. The mean duration of COVID-zero community, mean duration of COVID-19 epidemics and mean length to COVID-19 peak calculated according to 7 epidemics with 50 and more cases were (6.14±1.07), (13.43±4.39), (3.00±1.63) d, respectively. COVID-19 infection was predominantly detected in centralized quarantine sites (1 105 cases, 69.15%), and 843 cases completed booster immunization of COVID-19 vaccines (52.75%). Multivariable logistic regression analysis showed that age (with ages of 60 years and older as the reference, age of 6 to 17 years, OR=0.111, 95%CI: 0.024-0.508; age of 18 to 44 years, OR=0.341, 95%CI: 0.163-0.713) and booster COVID-19 vaccination (OR=0.219, 95%CI: 0.117-0.410) were protective factors for developing more severe clinical symptoms following COVID-19 infections. Conclusions All local COVID-19 infections were caused by Omicron variant in Zhejiang Province during the period between March and May 2022, and all cases had mild clinical symptoms. Preschool children, middle-aged and elderly residents and individuals that did not complete booster COVID-19 vaccination may had relatively more severe clinical symptoms following COVID-19 infections.

Objective: To analyze epidemiological characteristics of campus bullying among primary and middle school students in central China to explore its relation with mental health problems, and to provide a reference for the campus bullying prevention. Methods: Stratified cluster sampling method was used to select primary and middle school 10 581 students from Anyang, Nanyang and Xinxiang cities of Henan Province, Middle School Students Mental Health Scale and the Self designed Scale of Adolescent Bullying Behavior were used to analyze the relationship between mental health problems with campus bullying behavior. Results: The total report rate of bullying penetrator was 12.5% among students in the three cities. Among primary and middle school students with mental health problems such as hostility, interpersonal stress, academic pressure and emotional imbalance, the detection rate of bullying behavior was 24.2%, 20.3%, 19.4% and 20.1%, respectively. The results of multivariate analysis showed that hostility symptoms ( OR =3.78, 95% CI =1.71-8.32), interpersonal stress ( OR =3.50, 95% CI = 1.62 -7.57), academic pressure ( OR = 1.62 , 95% CI =1.21-2.16) and emotional imbalance ( OR =2.80, 95% CI =1.41-5.56) showed a significant impact on campus bullying ( P <0.05). Conclusion Mental health problems of primary and middle school students are closely related to the occurrence of bullying behavior. It is necessary to pay attention to the mental health education of bullies and intervene bullying behaviors from the source.

Objective: To analyze the characteristics of imported coronavirus disease 2019 ( COVID-19 ) cases from abroad to Zhejiang Province,so as to provide basis for improving the prevention and control of COVID-19 imported epidemic. Methods: The imported COVID-19 cases reported by Zhejiang Province from September 1, 2020 to January 28, 2021 were extracted from the National Diseases Prevention and Control Information System.The case information were checked with the field epidemiological investigation reports. A descriptive analysis was adopted for the epidemiological characteristics of the imported COVID-19 cases,including time,spatial and population distribution,import source, etc. Results: Zhejiang Province reported 136 cases of COVID-19 from abroad from September 1, 2020 to January 28, 2021, with 38 confirmed cases ( 27.94% ) and 98 asymptomatic cases ( 72.06% ). No deaths and related local cases were reported. A total of 10 confirmed cases and 58 asymptomatic cases were positive for nucleic acid tests at the port of entry, 7 cases were positive after the medical observation period, and the other cases were positive during the medical observation period. Cases were reported in each month. The age of the cases was mainly 20 to 39 years old, accounting for 61.03% (83 cases). The occupations were mainly business services, accounting for 33.09% ( 45 cases ). The 136 imported cases came from 32 countries, among which 26 cases came from Philippines. Most of the imported cases enter China through Hangzhou, Ningbo and Shanghai. Conclusions The imported epidemic situation in Zhejiang Province is sporadic, with large proportion of asymptomatic infections. The imported cases are mainly business service providers and come from Philippines. Therefore, measures such as nucleic acid tests and isolation of entry personnel at ports should be strengthened to prevent the spread of the local epidemic caused by imported cases.

Background: The influencing factors of diabetic kidney disease (DKD) in Chinese patients with type 2 diabetes mellitus (T2DM) were explored to develop and validate a DKD diagnostic tool based on nomogram approach for patients with T2DM. Methods: A total of 2,163 in-hospital patients with diabetes diagnosed from March 2015 to March 2017 were enrolled. Specified logistic regression models were used to screen the factors and establish four different diagnostic tools based on nomogram according to the final included variables. Discrimination and calibration were used to assess the performance of screening tools. Results: Among the 2,163 participants with diabetes (1,227 men and 949 women), 313 patients (194 men and 120 women) were diagnosed with DKD. Four different screening equations (full model, laboratory-based model 1 [LBM1], laboratory-based model 2 [LBM2], and simplified model) showed good discriminations and calibrations. The C-indexes were 0.8450 (95% confidence interval [CI], 0.8202 to 0.8690) for full model, 0.8149 (95% CI, 0.7892 to 0.8405) for LBM1, 0.8171 (95% CI, 0.7912 to 0.8430) for LBM2, and 0.8083 (95% CI, 0.7824 to 0.8342) for simplified model. According to Hosmer-Lemeshow goodness-of-fit test, good agreement between the predicted and observed DKD events in patients with diabetes was observed for full model (χ2=3.2756, P=0.9159), LBM1 (χ2=7.749, P=0.4584), LBM2 (χ2=10.023, P=0.2634), and simplified model (χ2=12.294, P=0.1387). Conclusion LBM1, LBM2, and simplified model exhibited excellent predictive performance and availability and could be recommended for screening DKD cases among Chinese patients with diabetes.

Background: The influencing factors of diabetic kidney disease (DKD) in Chinese patients with type 2 diabetes mellitus (T2DM) were explored to develop and validate a DKD diagnostic tool based on nomogram approach for patients with T2DM. Methods: A total of 2,163 in-hospital patients with diabetes diagnosed from March 2015 to March 2017 were enrolled. Specified logistic regression models were used to screen the factors and establish four different diagnostic tools based on nomogram according to the final included variables. Discrimination and calibration were used to assess the performance of screening tools. Results: Among the 2,163 participants with diabetes (1,227 men and 949 women), 313 patients (194 men and 120 women) were diagnosed with DKD. Four different screening equations (full model, laboratory-based model 1 [LBM1], laboratory-based model 2 [LBM2], and simplified model) showed good discriminations and calibrations. The C-indexes were 0.8450 (95% confidence interval [CI], 0.8202 to 0.8690) for full model, 0.8149 (95% CI, 0.7892 to 0.8405) for LBM1, 0.8171 (95% CI, 0.7912 to 0.8430) for LBM2, and 0.8083 (95% CI, 0.7824 to 0.8342) for simplified model. According to Hosmer-Lemeshow goodness-of-fit test, good agreement between the predicted and observed DKD events in patients with diabetes was observed for full model (χ2=3.2756, P=0.9159), LBM1 (χ2=7.749, P=0.4584), LBM2 (χ2=10.023, P=0.2634), and simplified model (χ2=12.294, P=0.1387). Conclusion LBM1, LBM2, and simplified model exhibited excellent predictive performance and availability and could be recommended for screening DKD cases among Chinese patients with diabetes.

Objective: To learn the epidemiological characteristics of imported coronavirus disease 2019（COVID-19）cases from abroad to Zhejiang Province reported from March 1 to April 7,2020,so as to provide basis for improving the prevention and control of COVID-19 imported epidemic. Methods: The imported COVID-19 cases and related local cases reported in Zhejiang Province from March 1 to April 7 were extracted from the National Diseases Prevention and Control Information System and were checked with the epidemiological investigation reports. A descriptive analysis was adopted for the epidemiological characteristics of imported COVID-19 cases,including time,spatial and population distribution,clinical classification,country of origin and contact history of related local cases. Results: The first imported COVID-19 case was reported on March 1. By April 7,totally 91 imported cases were reported,including 48（52.75%）confirmed cases and 43（47.25%）asymptomatic cases. In terms of clinical classification,there were 32（66.67%）ordinary cases and 16（33.33%）mild cases;no severe,critical or dead cases were reported. The symptoms of 41 confirmed cases came out after entry. The median time between entry and onset was 3 days,and the intervals of 4 cases were 14 days or over. All the 11 cities in Zhejiang Province had imported cases,among which Lishui and Wenzhou reported 24（26.37%）and 21（23.08%）cases. Of all the imported cases,81（89.01%）aged from 10 to 49 years;31（34.07%）were overseas students,21（23.08%）were business people and 19（20.88%）were catering staff;69（75.82%） came from European countries such as Italy,UK and Spain. In addition,a local case on the same flight with a imported case was reported on March 26. Conclusions The imported COVID-19 cases of Zhejiang Province were relatively young,most were asymptomatic or ordinary cases. They were mainly overseas students,business people and catering staff,from European countries such as Italy,UK and Spain,to Lishui and Wenzhou. Strict control measures should be done in entry quarantine,transfer and isolation to prevent local transmission caused by imported cases.