Objective: To analyze the relationship between cumulative ecological risks and physical activity behaviors of junior high school students, so as to provide theoretical support for promoting the physical and mental health development of junior high school students. Methods: From March to April 2023, a multistage random cluster sampling method was used to conduct an online survey of 3 502 middle school students in Henan Province. Physical activity levels and cumulative ecological risk were measured using the Physical Activity Rating Scale-3 and the Cumulative Ecological Risk Scale. Chisquare test and multiple Logistic regression were employed to examine the distribution and influencing factors of physical exercise behaviors among different student groups. Results: Slight physical exercise had the highest proportion of physical activity in tensity among junior high school students (48.5%), with 80.4% engaging in low levels of physical activity. Only 16.8% of students exercised ≥1 time daily, and the most common frequency was 1-2 times per week (44.1%). Gender, residential area, parental education, and peer support were all significantly associated with physical activity levels among junior high school students (χ2=122.53, 6.49, 7.49, 10.17, P<0.05). Logistic regression analysis showed that higher cumulative ecological risk scores were associated with a greater likelihood of engaging in low levels of physical activity compared to high levels (OR=1.12, 95%CI=1.02-1.23, P<0.05), but no significant association was found for moderate physical activity (OR=1.08, 95%CI=0.97-1.21, P>0.05). Conclusions Junior high school students in Henan Province generally engage in insufficient physical exercise. Cumulative ecological risk negatively predicts their physical activity behaviors.

Objective:To investigate the ultrasonic characteristics of lymph node metastasis of papillary thyroid carcinoma and the predictive value of silent mating-type information regulation2 homolog1 (SIRT1) .Methods:90 PTC patients admitted from May. 2022 to May. 2023 were selected. According to the ultrasonography of patients with lymph node enlargement, hypoecho, unclear boundary, microcalcification and other conditions, the patients were divided into 26 cases in the LNM group and 64 cases without LNM. All patients underwent thyroid ultrasonography, and their serum samples were collected. Serum SIRT1 levels were detected by enzyme-linked immunosorbent assay (ELISA) double-antibody sandwich method. ROC was used to analyze the predictive value of ultrasonic characteristics and serum SIRT1 for LNM in PTC patients.Results:Compared with the group without lymph node metastasis, the proportion of patients with multiple tumor lesions ( P=0.001), tumor diameter ≥1 cm, hypoecho, unclear boundary and microcalcification was higher in the group with lymph node metastasis ( P<0.05). The serum SIRT1 level of LNM group (5.12±1.24) ng/mL was lower than that of (8.76±1.35) ng/mL in the other group ( P<0.05). ROC results showed that when the optimal cut-off value of serum SIRT1 was 7.59 ng/mL, the area under the curve was 0.78 (95% CI: 0.746- 0.835). The sensitivity and specificity were 79.43% and 71.56%, respectively. Multiple tumors, tumor diameter ≥1 cm ( P=0.018), unclear boundaries ( P=0.005), microcalcification ( P=0.001), and serum SIRT1 < 7.59 ng/mL ( P<0.001) had good clinical value in the evaluation of lymph node metastasis of papillary thyroid carcinoma, and the combined detection had a higher predictive value, with a sensitivity of 84.57%. Multivariate analysis showed that tumor boundaries were unclear ( OR=2.812, 95% CI: 1.220-6.482), microcalcification ( OR=4.145, 95% CI: 1.335-12.870), and serum SIRT1 decreased ( OR=2.399, 95% CI: 1.580-3.642) were independent risk factors for lymph node metastasis of papillary thyroid carcinoma ( P<0.05) . Conclusions:Lymph node metastasis of papillary thyroid carcinoma is characterized by unclear boundary and micro-calcification on ultrasound, and serum SIRT1 is decreased. The combined detection of ultrasound features and serum SIRT1 has a good predictive value in predicting lymph node metastasis in patients with papillary thyroid cancer.

Objective : To investigate risk factors related to coronary artery lesion( CAL) in children with Kawasaki disease． Methods : Retrospective analysis was conducted on clinical data of 144 children with Kawasaki disease. The cases were divided into two groups according to whether they had CAL or not．There were 50 children in CAL group and 94 children in non-coronary artery lesion(NCAL) group．The clinical and laboratory indicators in the two groups were analyzed and compared，and the diagnostic efficacy of these indicators for Kawasaki disease combined with CAL was analyzed by drawing the receiver operating characteristic (ROC) curve. Results : There was no statistical significant difference in age，gender，duration of fever，use time of immunoglobulin，erythrocyte sedimentation rate，C-reactive protein，serum amyloid A，N-terminal pro brain natriuretic peptide，white blood cell，hemoglobin and platelet between the two groups (P＞0. 05) ．In CAL group，the serum levels of 25-( OH) D3 and albumin were lower，while the levels of alanine transaminase，interleukin-6 and procalcitonin were higher than those in NCAL group (P＜0. 05) ．Multivariate logistic regression analysis showed that the levels of serum 25-( OH) D3 ( OR = 0. 984，95% CI:0. 974 ～0. 995) ，albumin ( OR = 0. 857，95% CI:0. 771－0. 951) ，alanine transaminase ( OR = 1. 011，95% CI : 1. 005 －1. 017) and interleukin-6 ( OR = 1. 002，95% CI : 1. 000 －1. 005 ) were significantly related with coronary artery lesion in children with kawasaki disease (P＜0. 05) ．The levels of 25-( OH) D3 ，albumin，alanine transaminase and interleukin-6 in serum had diagnostic value for Kawasaki disease combined with CAL，and the area under the curve (AUC) were 0. 660，0. 652，0. 711，and 0. 700，respectively．The AUC of combined diagnosis of four indicators was 0. 816 ． Conclution Decrease of serum 25-( OH) D3 and albumin levels，increase of serum interleukin-6 and alanine transaminase levels in children with Kawasaki disease are risk factors for CAL ，combined detection on these multi-indicators have diagnostic value for Kawasaki disease combined with CAL.

Objective:To investigate the effect of functional movement assessment on the recurrence of patients with ankylosing spondylitis (AS) after treat-to-target therapy.Methods:The clinical data of 61 patients with AS in Chengdu were collected including clinical symptoms and AS disease activity (ASDAS). After 24 weeks adalimumab treatment, motor function score of AS patients(ASDAS<1.3) was assessed by functional movement screen (FMS), then adalimumab was discontinued and the rest of the concurrent drugs were continued until the disease relapse or up to 1 year. The data of the two groups were compared using t-test analysis and Cox proportionate hazard model. Results:① The recurrence rate of patients with AS after treat-to-target therapy within 1 year follow-up was 57.4%; ② The recurrence group was younger [(27±7) vs (31±6), t=5.96, P=0.02], the ASADAS value was at the high end when adalimumab was withdrawal [(1.29±0.07) vs (0.87±0.16), t=177.31, P<0.01], and the FMS value was lower after treat-to-target [(12.9±2.7) vs (16.2±1.9), t=29.23, P<0.01], The time to reaching the treatment target was longer [(2.9±1.2) month vs (1.7±0.6) month, t=19.89, P<0.01] than the stable group; ③ The cut-off value of the FMS test of AS patients after treat-to-target therapy was 14.25 (sensitivity was 84.6%, specificity was 80%) . The time to treat-to-target was a risk factor for recurrence ( RR=2.285, P<0.05), and the FMS value after treat-to-target was a protective factor ( RR=0.625, P<0.05). Conclusion:After discontinuing the adalimumab, about half of the patients relapse. The time reaching the treatment target and the FMS value after treat-to-target therapy are the risk factors for disease recurrence.

Objective:To establish a new nurse standardized training management index system based on training transfer theory, and to provide reference for objective evaluation of standardized training management for new nurses.Methods:From August 2020 to April 2021, guided by the theory of training transfer, the standardized training management indexs for new nurses were preliminarily drawn up through literature review, semi-structured interviews. The Delphi method was used to conduct two rounds of expert consultation.Results:The effective questionnaire recovery rate of the two rounds of expert consultation was 92.00% (23/25) and 95.65% (22/23), respectively. The expert authority coefficients were 0.904 and 0.905, respectively. Kendall′s harmony coefficients were 0.228 and 0.250, respectively, both P<0.01. The final index system of standardized training management for new nurses based on training transfer theory included 4 first-level indexes, 14 second-level indexes and 59 third-level indexes. Conclusions:The new nurse standardized training management index system based on training transfer theory is scientific and reliable. It provides a tool for evaluating standardized training management of new nurses and a reference for perfecting the training management system of new nurses.

Objective:To explore the differences of immune reconstitution between peripheral blood stem cell transplantation and umbilical cord blood transplantation.Methods:A total of 300 patients (aged 18 (8, 33), 163 males and 137 females) with malignant hematological diseases who received allogeneic hematopoietic stem cell transplantation in the First Affiliated Hospital of University of Science and Technology of China from January 2018 to March 2020 were enrolled in this study, including 255 cases of umbilical cord blood transplantation and 45 cases of peripheral blood stem cell transplantation. Multicolor flow cytometry was applied to analyze lymphocyte subsets of the percentages and absolute counts in the two donor types and peripheral blood of patients after receiving hematopoietic stem cell transplantation. The differences between the two grafts were compared, and the lymphocyte subsets results were evaluated at 1, 2, 3, 4, 6, 9, 12, and 18 months after transplantation. 18-month disease-free survival (DFS) within the 300 patients under the two transplantation types were retrospectively analyzed.Results:1. The proportion of NKT cells in peripheral blood group was significantly higher than that in cord blood group (2.79% vs 0.24%, P<0.001). 2. The proportion of helper T cells in the UCBT group was higher than that in the PBSCT group, as well as the counts 6 months after transplantation ( P<0.05). 3. The proportion of NK1 cells (3 rd to 9 th month) and count (4 th to 12 th month) in UCBT group were significantly higher than those in PBSCT group ( P<0.05). 4. NKT cells in the UCBT group were lower than those in the PBSCT group (proportion and count) throughout the monitoring process ( P≤0.001). 5. The proportion of DNT cells (within 1 year) and count (within 6 months) in the UCBT group were significantly lower than those in the PBSCT group ( P<0.05). Conclusions:Compared with the peripheral blood stem cell transplantation group, the umbilical cord blood transplantation patients had a faster rate of lymphocyte reconstitution, and patients received umbilical cord blood transplantation had a stronger ability of immune reconstitution and could achieve long-term hematopoiesis.

ObjectiveTo understand the status and relationship between social support level and Internet addiction among left-behind middle school students， so as to provide references for the targeted intervention and risk reduction of Internet addiction. MethodsStratified cluster random sampling method was used to recruit 3 532 middle school students from six middle schools in a county of Southeast Chongqing， including 1 945 （55.07%） left-behind students and 1 587 （44.93%） non-left behind students. All the selected students were assessed using self-designed general situation questionnaire， Diagnostic Scale of Internet Addiction for Middle School Students （DSIA-MSS） and Adolescent Social Support Rating Scale （ASSRS）， then the trend test was performed on relationships of social support to Internet addiction. Results① The detection rate of Internet addiction in the left behind group was higher than that in the non-left behind group （22.98% vs. 16.13%， χ²=25.732， P<0.01）. ② ASSRS score in the left behind group was lower than that in the non-left behind group ［（66.81±15.92） vs. （68.19±16.18）， t=2.544， P=0.011］. ③ Among three different living states of students （non-left behind， one-parent working outside， both-parents working outside）， the detection rate of Internet addiction demonstrated significant differences among students with different social support levels （χ²=35.220， 37.662， 31.434， P<0.01）. ④ A "dose-effect" relationship of social support to Internet addiction was found， indicating that students with higher social support levels suffered a lower risk of Internet addiction （P<0.01）. ConclusionLeft-behind middle school students develop a prominent problem of Internet addiction， which is closely related to their social support level， and the two aspects display a negative "dose-effect" relationship.

Objective: To evaluate and describe the changes of core muscle groups based on DAVID spine biomechanics training system in ankylosing spondylitis (AS) patients. Methods: The clinical data of 100 patients of AS and 31 healthy controls were collected. Clinical symptoms, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis function index (BASFI), Bath ankylosing spondylitis measurement index (BASMI), ankylosing spondylitis disease activity (ASDAS), and simultaneous detection of DAVID spine biomechanics training system, simple core muscle fitness test: Eight-grade abdominal bridge, PLANK exercise (flat support), Abdominal static muscle endurance test, Back static muscle endurance test were compared using t-test analysis and spearman correlation analysis. Results: ① Between AS and healthy male control o group, there were significant differences of spinal mobility in forward flexion, right rotation, left rotation (42±13 vs 48±1, 52±14 vs 69±12, 52±13 vs 58±11; all P values <0.05); and significant differences of spinal muscle strength in forward bending force, right rotation force, left rotation force, right bending force (103±42 vs 146±17, 87±34 vs 104±13, 80±35 vs 101±13, 161±55 vs 186±19; all P values <0.05), and significant differences in the left/right rotational force (1.17±0.21 vs 1.02±0.111, P<0.05) of spine balance strength comparison.② Between AS and healthy controls of female group, there were differences in forward bending force (49±23 vs 77±10, P<0.05) of spinal muscle strength; and significant differences in forward bending/backward extension strength, left and right rotation strength (0.32±0.11 vs 0.58±0.21, 1.29±0.21 vs1.03±0.11, all P values <0.05) of spine balance strength; ③ In AS group, the spinal mobility was correlated with age (Rear extension r=-0.28, right flexion r=-0.268, left flexion r=-0.404, right rotation r=-0.367, left rotation r=-0.235; all P values <0.05), course of disease (Rear extension r=-0.354, forward flexion r=-0.283, right flexion r=-0.204, left flexion r=-0.284, right rotation r=-0.339, left rotation r=-0.23; all P values <0.05), body mass index (BMI) (Rear extension r=-0.23, forward flexion r=-0.288, right flexion r=-0.22, left flexion r=-0.201, right rotation r=-0.26, left rotation r=-0.29; all P values <0.05), sacroiliac joint stage(Rear extension r=-0.375, forward flexion r=-0.446, right flexion r=-0.331, left flexion r=-0.367, right rotation r=-0.368, left rotation r=-0.314; all P values <0.05) and BASDAI (Rear extension r=-0.381, forward flexion r=-0.374; all P values <0.05). Spinal muscle strength was correlated with gender (Posterior extensor force r=0.344, flexor force r=0.507, right rotation force r=0.376, left rotation force r=0.399, right flexion force r=0.433, left flexion force r=0.445; all P values <0.05); the left/right spine rotation strength was correlated with gender (r=0.271, P<0.05). ④ In the simple core muscle fitness test, eight-grade abdominal bridge was correlated with spinal muscle strength (Rear extension force r=0.234, right rotation r=0.290, left rotation r=0.219, right flexion r=0.35, left flexion r=0.327; all P values <0.05); PLANK exercise was correlated with spinal muscle strength (Rear extension force r=0.234, right rotation r=0.290, left rotation r=0.219, right flexion r=0.35, left flexion r=0.327; all P values <0.05); abdominal static muscle endurance test was correlated with forward flexion strength (r=0.341, P<0.05); back static muscle endurance test was correlated with spinal mobility (Rear extension r=0.262, forward flexion r=0.23, right rotation r=0.455, left rotation r=0.426, right flexion r=0.387, left flexion r=0.46; all P values <0.05); correlated with spine strength (right flexion r=0.256, left flexion r=0.272; all P values <0.05). Conclusion Compared with healthy people, AS patients have decreased activity, strength and balance of spinal core muscle. There are significant decline in spinal mobility and muscle strength of male AS patients and muscle imbalance of female AS patients. Simple core muscle fitness test could be used in clinic to measure the changes of AS patients'core muscle group.

Objective To evaluate glucose metabolism in elderly inpatients with primary hypertension. Methods Based on the results of the oral glucose tolerance test (OGTT) ,130 elderly patients with primary hypertension were divided into the normal glucose tolerance (NGT )group ,the impaired fast glucose(IFG)group ,the impaired glucose tolerance(IGT)group and the type 2 diabetes mellitus (T2DM )group.Clinical characteristics and morbidity were compared among the groups. Results Among patients with grade 1 ,2 or 3 hypertension ,14(32.6％ ) ,9(20.5％ )and 7(16.3％ )had NGT ,3(7.0％ ) ,5(11.4％ )and 4(9.3％ )had IFG ,16(37.2％ ) ,18(40.8％ )and 19(44.2％ )had IGT , and 10 (23.2％ ) ,12 (27.3％ ) and 13 (30.2％ ) had T2DM ,respectively.Moreover ,there was a significant difference in levels of 2 hours postprandial blood glucose between patients with grade 1 hypertension and those with grade 3 hypertension in the T2DM group(P< 0.05). Conclusions Abnormal glucose metabolism and diabetes mellitus are highly prevalent in elderly inpatients with essential hypertension.

Objective: The serotype screening of Shigella flexneri from 1934 to 1965 preserved by the National Center for Medical Culture Collections was carried out, and the molecular characteristics of the serotype conversion strains were studied. Methods: Serotyping of Shigella flexneri in this study was conducted by slide agglutination and multiplex PCR, respectively. The gtrⅡ gene sequence alignment and pulsed field gel electrophoresis typing were performed on the serotype conversion strains. Results: Among the 255 strains of Shigella flexneri preserved in CMCC (B) from 1934 to 1965, 79 were carrying gtrⅡ gene, of which 19 strains and 1 strain were agglutinated with the Y serotype and X serotype, respectively, and furthermore, the multiplex PCR assays results showed serotypes 2a and 2b, respectively, and the strains were considered to have serotype conversion. The 20 strains carrying the gtrⅡ gene showed multiple nucleotide mutations. Besides 3 strains of 3 amino acid mutations, the amino acid sequences of the other 17 strains showed a stop codon in advance, resulting in functional inactivation of gtrⅡ. PFGE analysis revealed that the similarity between the serotype Y strain carrying the gtrⅡ gene and the serotype 2a strain was 75.8%-100%, and the similarity between the serotype X strain carrying the gtrⅡ gene and the serotype 2b strain was 81.6%-100%. Conclusion Mutations in the gtrⅡ gene are more complicated in serotype-transforming Shigella flexneri serotype Y or X strains. Molecular typing suggests that the serotype-transforming Shigella flexneri serotype Y or X strains may be derived from the Shigella flexneri serotype 2a or 2b, and advance the serotype conversion to 1949.