Objective: To investigate the correlation between social jetlag and psychological behavior in upper primary school students,so as to provide reference for sleep health promotion in primary school students. Methods: From April to June 2024, a survey was conducted among 4 341 fourth and fifth grade students from 9 public primary schools in a district in Beijing. Sleep patterns were assessed using a self designed questionnaire, while psychological behavior was evaluated using the Strengths and Difficulties Questionnaire (SDQ)(parent version). A generalized estimating equation (GEE) model was used to examine the association between different levels of social jetlag and psychological behavior problem scores in primary school students. Results: The proportions of students with social jetlag of <1.0, 1.0-<2.0, and ≥2.0 h were 57.6%, 30.6%, and 11.8%, respectively. The GEE model analysis found that after adjusting for covariates, compared with primary school students with social jetlag of <1.0 h, those with 1.0 -<2.0 and ≥2.0 h had higher scores for internalizing behavior problems [ β (95% CI ) =0.23(0.05-0.41)，0.28(0.02-0.54), P < 0.01]. Primary school students with ≥2.0 h of social jetlag had higher scores for externalizing behavior problems [ β (95% CI )=0.42 (0.13-0.71)， P <0.01]. Among boys and primary school students with an average nighttime sleep duration of ≥9 h, comparied with social jetlag of <1.0 h,those with sucial jetlag 1.0-<2.0 h had higher scores on internalizing and externalizing behavior problems[ β (95% CI )=0.32(0.07-0.56),0.51 (0.11-0.90), 0.26 (0.06-0.46)，0.58 (0.25-0.91), P <0.05]. Conclusions Greater social jetlag may be a risk factor for internalizing and externalizing behavior problems in upper primary school students. Reducing social jetlag may help decrease the occurrence of psychological behavior problems in primary school students.

OBJECTIVE To study the improvement effect and mechanism of Shengmai powder on heart failure （HF） mice with qi-yin deficiency. METHODS The mice were randomly divided into blank group （water）， model group （water）， Shengmai powder low-， medium-， and high-dose groups [2.61， 5.22 and 10.44 g/kg （based on crude drug dosage）] and positive control group （metoprolol， 30 mg/kg）， with 10 mice in each group. Except for the blank group， all other groups were subcutaneously injected with D-galactose， and a qi-yin deficiency HF mice model was established by continuous food restriction and weight-bearing swimming. At the same time of modeling， the corresponding medicine/water was gavaged once a day for five weeks. The general state of mice was recorded and the traditional Chinese medicine （TCM） syndrome score was evaluated. Behavioral experiments were conducted to investigate the total distance of open field action， the percentage of immobility time， and the swimming exhaustion time of mice. The contents of aspartate transaminase （AST）， creatine kinase （CK） and lactate dehydrogenase （LDH） in the serum of mice were detected； cardiac function indexes [heart rate， left ventricular ejection fraction （LVEF）， left ventricular end systolic diameter （LVESD）， left ventricular end diastolic diameter （LVEDD）， left ventricular mass index and whole heart mass index] were all detected； the histopathological morphology of mice myocardium was observed； the level of cardiomyocyte apoptosis in mice was detected； mRNA expression levels of B-cell lymphoma 2 （Bcl-2）， Bcl-2 associated X protein （Bax）， and Cleaved-caspase-3 in myocardial tissue of mice were detected； the phosphorylation levels of sarcoplasmic reticulum calcium regulatory related proteins [ryanodine receptor 2 （RyR2） and phospholamban （PLB）] in myocardial tissue of mice were detected. RESULTS Compared with the blank group， the body weight， total distance of open field action， swimming exhaustion time， LVEF， LVEDD， Bcl-2 mRNA expression level in myocardial tissue and PLB protein phosphorylation level in the model group were significantly reduced/shortened （P＜0.05）； TCM syndrome score， the percentage of immobility time， heart rate， LVESD， left ventricular mass index， whole heart mass index， cardiomyocyte apoptosis rate， the contents of CK， LDH and AST in serum， mRNA expression levels of Cleaved-caspase-3 and Bax and the phosphorylation level of RyR2 protein in myocardial tissue were significantly increased （P＜0.05）； there were inflammatory cell infiltration， disordered cell arrangement and obvious myocardial interstitial fibrosis in myocardial tissue. After the intervention of Shengmai powder， most of the above quantitative indexes in mice were significantly reversed （P＜0.05）， the inflammatory cell infiltration in myocardial tissue was reduced， and the degree of fibrosis was significantly reduced. CONCLUSIONS Shengmai powder can improve cardiac function， reduce the level of cardiomyocyte apoptosis and myocardial fibrosis in HF mice with qi-yin deficiency. Its mechanism may be related to the regulation of the expression of sarcoplasmic reticulum calcium regulation related proteins.

Abstract Improving health literacy can effectively reduce the risk of health risk behaviors and adverse health outcomes in children and adolescents. Global research on health literacy of children and adolescents has been increasing in recent years. The paper reviews the existing research and proposes that there is no universal definition and connotation of health literacy for children and adolescents, most of the studies use or make some revisions on the definition of adult health literacy in child and adolescent health literacy, failing to consider developmental characteristics and unique health needs of children and adolescents. Moreover, the assessment index system and instruments are diversified, making the research findings from different studies difficult to compare, and to obtain consistent and reliable conclusions. Future endeavors are encoouraged to expand health literacy researches and to update more comprehensive and practical definition, and to develop a standardized assessment instrument that can be validated in Chinese culture.

Abstract Subjective social status and life skill level are important influencing factors of adolescent health risk behaviors, and they interact with each other and jointly act on adolescent health risk behaviors, which make the mechanism of adolescent health risk behaviors become more diverse and complex. The current paper reviews the correlations among subjective social status, life skill level and adolescent health risk behaviors, in order to explore the joint influence of subjective social status and life skill level on adolescent health risk behaviors, then provides future directions for exploring possible mechanisms, and proposes recommendations for effective prevention strategies of adolescent health risk behaviors.

Objective:To retrospectively construct competency-based portfolios for medical students to analyze the factors influencing competency self-assessment, and to explore an approach to efficient portfolio construction.Methods:The participants were randomly selected among medical graduates of 2015 in Shantou University Medical College. Through records collection and an online questionnaire survey, portfolios were built for the participants based on their development data during eight years from college entrance, college education, to post-graduation medical education. The correlation between variables was determined using Kendall's tau-b correlation coefficients. The inter-group differences were analyzed using the Mann-Whitney U test. Results:A total of 126 usable questionnaires for effective developmental portfolios were collected. There were a total of 208 indicators collected, including 79 questionnaire indicators (including 36 for competency self-assessment). The reliability coefficient (Cronbach's α) of the questionnaire was 0.984. The factors related to competency self-assessment were identified. Conclusion:This study provides a basis for the implementation of portfolio assessment, which can promote students' self-assessment and competency development. Optimizing the indicator system, building an online platform, increasing participants' participation motivation, and emphasizing self-reflection and feedback will help improve the efficiency of developmental portfolio construction and its performance.

Objective: To preliminarily develop the Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students, as an important measuring tool for assessment of comprehensive abilities in infectious disease prevention of Chinese middle school students. Methods: The basic dimensional framework and item pool were established by literature review in the view of public health. Then Delphi method was used to modify the framework and item pool to scale 1.0. Panel discussion in middle school students was used to adjust the expression and structure of scale 1.0, turning it into scale 2.0. With the confirmation of theory experts subjects, the scale was preliminarily developed. Results: Literature review suggested that the basic dimension framework included five longitudinal dimensions and seven horizontal dimensions. According to Delphi method ( n =18), the Kendall s coefficient of concordance ( W ) of the scale was equal to 0.14 ( P <0.01), the average importance, proportion of full marks, coefficient of variation and weight coefficient of all dimensions and items met the inclusion criteria. According to panel discussion, the scale was finally adjusted into scale 2.0 with 53 items. Conclusion This study preliminarily established the Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students, which might be applied in both scientific research and practical use.

Objective:To compare the diagnostic efficacy of 18F-prostate specific membrane antigen (PSMA)-1007 PET/CT and mpMRI in the diagnosis of pelvic lymph node metastasis of prostate cancer (PCa). Methods:The clinical data of 30 patients who underwent 18F-PSMA-1007 PET/CT and mpMRI examinations in Sichuan Cancer Hospital from November 2018 to April 2021 were analyzed. The average age was (68.4±6.4) years old. The preoperative total PSA was 45.70(16.07, 100.00)ng/ml. Among 30 patients, 14 cases were found lymph node positive by PET/CT and 7 cases were found lymph node positive by mpMRI.Combined with the two preoperative imaging methods and the patient's PSA level, there was 1 patient in stage T 1, 20 patients in stage T 2, 6 patients in stage T 3, and 3 patients in stage T 4. Twenty-nine cases were classified as high risk group and one case was in moderate risk group.All 30 patients underwent laparoscopic radical prostatectomy and enlarged pelvic lymph node dissection (ePLND). According to the postoperative pathological results, the sensitivity, specificity, positive predictive value and negative predictive value of the two imaging techniques for the diagnosis of PCa pelvic lymph node metastasis were calculated, and the consistency of the two imaging techniques for the postoperative pathological results was observed by Kappa test. Results:All the 30 patients were confirmed to be PCa by postoperative pathology, among which 10 patients were positive for pelvic lymph node biopsy. The sensitivity, specificity, positive predictive value and negative predictive value of 18F-PSMA-1007 PET/CT for pelvic lymph node metastasis were 100.0% (10/10), 80.0% (16/20), 71.4%(10/14) and 100.0%(16/16) respectively, and Kappa value was 0.727. The sensitivity and specificity of mpMRI were 70.0% (7/10) and 100.0% (20/20), the positive and negative predictive values were 100.0% (7/7) and 87.0%(20/23)respectively, and the Kappa value was 0.757. The P values of sensitivity, specificity, positive predictive value and negative predictive value between the two imaging methods were 0.18, 0.07, 0.30, <0.01, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of 18F-PSMA-1007 PET/CT in diagnosing the number of pelvic lymph node metastasis were 100%(28/28), 98.2% (373/380), 80.0% (28/35) and 100.0%(373/373), respectively. The sensitivity, specificity, positive predictive value and negative predictive value of mpMRI in diagnosing the number of pelvic lymph node metastasis were 78.6% (22/28), 100.0% (380/380), 100.0% (22/22) and 98.4%(380/386), respectively. The P values of the sensitivity, specificity, positive predictive value and negative predictive value of lymph node detection by the two imaging methods were all <0.01, and the differences were statistically significant. Conclusions:The sensitivity and negative predictive value of 18F-PSMA-1007 PET/CT for the detection of positive lymph node were higher than mpMRI. The specificity and positive predictive value of mpMRI in detecting positive lymph node metastasis were higher than 18F-PSMA-1007 PET/CT examination.

Objective: To understand comprehensive sexuality education knowledge among junior high school students in China, and to analyze relevant influencing factors to provide scientific basis for the implementation of school based sexuality education or comprehensive sexuality education in the future. Methods: By using convenient sampling method, a cross sectional survey was conducted among 4 545 students at grade 1 to grade 3 from junior middle schools in Beijing, Liaoning, Sichuan, Chongqing, Yunnan, Henan, using an online electronic questionnaire during September to October 2021. The questionnaire included general demographic information, subjective social status, sex education received at home and school, bullying, as well as knowledge, attitude, practice and needs towards comprehensive sexuality education. Results: The average score of the comprehensive sexuality education knowledge was (12.21±3.10) points, which was converted to (71.82±18.21) points based on the percentage based system. The scores varied by grade, sex and sexuality education setting, significantly higher in grade 3 students (12.69±2.99), girls (12.28±3.01) ( P < 0.01), and students who have received sex education at home (12.67±2.88) and students who received sex education at school (12.63±2.91), as well as those who had actively searched for sex information online had a higher score (12.71±2.94) ( t =35.10, 28.78, 10.55, P <0.01).Further analysis using multiple linear regression and Logistic regression, "whether you have received sex education at home" "whether you have received sex education at school" "whether you have searched the Internet actively" and "whether it is necessary to carry out comprehensive sex education" are still correlated with the score of comprehensive sex education knowledge; "self reported bullying" was still associated with "subjective social status" score, correct rate of question 2, and "shyness and inferiority toward the development of secondary sexual characteristics" ( P <0.01). Conclusion The current comprehensive sexuality education knowledge among junior high school students needs to be improved. The level of implementation of sexuality education in different settings varies, but the implementation of sexuality education in schools can help improve students comprehensive sexuality education knowledge level.

Objective: To understand the current situation regarding sex education in home and school settings in China, and to provide a scientific basis for more effective family and school sex education. Methods: Using a convenient sampling method, a crosssectional survey of students from grade 7 to grade 9 in Beijing, Liaoning, Sichuan, Chongqing, Yunnan and Henan was carried out from September to December 2021. The questionnaire covered general demographic information, sex education at home and school, and the status of comprehensive sexuality education. Finally, 4 109 valid questionnaires were collected. Results: A total of 760(18.50%) middle school students had not received any form of sex education, 923(22.46%) had only received sex education at school, 299(7.28%) had only received sex education at home, and 2 127 (51.76%) had received sex education at home and at school. The scores related to junior middle school students knowledge of comprehensive sexuality education was (12.43±2.89) points, the attitude score was (47.86±5.31) points, the behavior score was (40.44±5.18) points, and the comprehensive level score was (82.02±9.01) points. Junior middle school students who received sex education at home and in school had the highest comprehensive level of sex education( P <0.01). Junior middle school students who only received sex education at school had a higher comprehensive sexuality education knowledge level than those who only received sex education at home( P < 0.01 ). The level of comprehensive sexuality education behavior among junior middle school students who only received family sex education was significantly higher than among those who only received sex education at school( P <0.01). Conclusion Receiving sex education in both home and school settings can effectively improve the comprehensive sexuality education competency among junior middle school students. School based sex education should be further implemented in the future and family sex education should be encouraged.

Objective? To explore the effect of standardized psychological intervention on quality of life in patients with medium or advanced cancer. Methods? By convenience sampling, a total of 60 patients with medium or advanced cancer were selected and divided into control group (n=30) and observation group (n=30) according to random number table, the patients were numbered based on their order of admission. The control group received supportive nursing intervention while the observation group received the standardized psychological intervention. The Quality of Life Core Questionnaire was used before and after the intervention to evaluate the life quality of the two groups. During the research process, 9 cases were lost in the observation group and the rest 21 cases were enrolled into the study while 10 cases were lost in the control group with 20 cases left. Results? Before intervention, the overall cognitive function and quality of life of the observation group were different with statistical significance (P＜0.05), and there were no statistical differences in the rest dimensions between the two groups (P＞ 0.05). After intervention,the observation group scored differently from the control group in the dimensions of emotional function, cognitive function,overall quality of life, pain symptoms,Insomnia symptoms, and loss of appetite with statistical significance (P＜ 0.05). The observation group scored higher than the control group in emotional function and overall quality of life, but lower than the control group in cognitive function, pain symptoms, insomnia symptoms and loss of appetite. The differences of scores before and after intervention between the two groups in emotional function, pain symptoms, nausea and vomiting, insomnia symptoms and loss of appetite, constipation symptoms and diarrhea symptoms were statistically significant (P＜ 0.05). After intervention, the observation group showed improvement in terms of the symptoms including emotional function, pain, nausea and vomiting, insomnia and loss of appetite. Conclusions The adoption of the standardized psychological intervention for patients with medium or advanced cancer could improve their negative emotions, enhance their confidence in treatment, and improve their quality of life.