1.Association between vitamin D levels and sleep in children and adolescents
PENG Chan, LI Fan, LI Yanyan,LI Yan, XIONG Jingfan, YAO Ping
Chinese Journal of School Health 2025;46(2):239-243
Objective:
To explore the association between vitamin D levels and sleep in children and adolescents,so as to provide a reference for promoting the sleep health of children and adolescents.
Methods:
From October to December, 2021, 4 827 primary and middle school students aged 6-17 in Shenzhen were selected by multistage cluster random sampling method, and their demographic information, family background, lifestyle and sleep status were obtained by facetoface questionnaire survey, and their fasting venous blood in the morning was collected to detect the serum 25(OH)D level. The relationship between serum vitamin D level and sleep characteristics was analyzed by binary Logistic regression, and stratified analysis was carried out according to gender.
Results:
The proportion of vitamin D deficiency was 41.1%, and the proportion of sleep deficiency was 19.4%. With the increase of vitamin D level, daily sleep duration of children and adolescents tended to increase (r=0.10,P<0.01). After adjusting for covariates such as gender and age, it was found that children and adolescents with insufficient vitamin D levels were more likely to experience sleep insufficiency, social jetlag, and late sleep on weekdays, with ORs being 1.32(95%CI=1.12-1.56), 1.35(95%CI=1.19-1.54), and 1.26(95%CI=1.05-1.52)(P<0.05). Sexstratified analysis showed that, among boys, vitamin D deficiency was associated with sleep deficiency, social jetlag, and late bedtime on weekdays and weekends[OR(95%CI)=1.42(1.14-1.77),1.25(1.04-1.49),1.39(1.06-1.82),1.86(1.19-2.92),P<0.05]. In girls, however, serum vitamin D levels were only associated with social jetlag with OR being 1.47 (95%CI=1.21-1.79, P<0.05).
Conclusion
Vitamin D levels are associated with various sleep characteristics in children and adolescents, with this association being more pronounced among boys.
2.Comparison of Therapeutic Effect of Different Preparation Processes of Baihe Dihuangtang on Depressed Mice Based on Q-Marker
Yan LIU ; Jiameng LIU ; Jiahui PENG ; Dan LI ; Shengjun MA ; Jingfan YANG ; Yu FU ; Guangwei ZHU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):159-167
ObjectiveBased on modern analytical techniques and a depressed mouse model established by chronic unpredictable mild stress(CUMS), to evaluate the quality marker(Q-Marker) and pharmacodynamic difference of Baihe Dihuangtang prepared by different processes. MethodsHigh performance liquid chromatography(HPLC) was used to establish the characteristic profiles of Baihe Dihuangtang, and determine the content of Q-Marker in the samples prepared by ancient and modern processes. Seventy C57BL/6J mice were randomly divided into the normal group, model group, fluoxetine group(3 mg·kg-1), low and high dose groups of ancient process(6.5, 26 g·kg-1), and low and high dose groups of modern process(6.5, 26 g·kg-1), with 10 mice in each group. Except for the normal group, CUMS was used to induce depression in mice from the other groups for 28 d. After successful modeling, administration groups were given the corresponding drugs by gavage every day, and the normal and model groups were given an equal volume of pure water by gavage for 21 consecutive days. Change in body mass of mice was recorded, tail suspension test and open field test were used to evaluate the depressive behavior of mice, and enzyme-linked immunosorbent assay(ELISA) was employed to determine the contents of tumor necrosis factor-α(TNF-α), interleukin(IL)-1β and IL-6 in serum. ResultsCharacteristic profiles of Baihe Dihuangtang prepared by the two processes were established, the similarity between the two was 0.951, and 8 characteristic peaks were recognized with the reference peak of regaloside A. The results of quantitative analysis showed that the Q-Marker content was similar in Baihe Dihuangtang prepared by ancient and modern processes. The results of pharmacodynamics showed that, compared with the normal group, the model group showed increased immobility time in the tail suspension test, reduced total movement distance in the open field test, and elevated IL-1β, IL-6 and TNF-α levels in the serum(P<0.01). Compared with the model group, the behavioral indicators of mice in the Baihe Dihuangtang treatment group were significantly improved in terms of tail suspension time and open field exercise, and the levels of IL-1β, IL-6 and TNF-α in serum were significantly reduced(P<0.05, P<0.01). Baihe Dihuangtang prepared by the two processes both had antidepressant effects, and the difference between the two was not statistically significant in improving depressive symptoms. ConclusionQ-Marker of Baihe Dihuangtang prepared by modern and ancient methods are equivalent in content, and the pharmacological effects are consistent, indicating that dried Lilii Bulbus can replace fresh products in the preparation of Baihe Dihuangtang. This study provides a scientific basis for the development of new drugs of Baihe Dihuangtang and a reference for its rational application and clinical use.
3.Comparison of Therapeutic Effect of Different Preparation Processes of Baihe Dihuangtang on Depressed Mice Based on Q-Marker
Yan LIU ; Jiameng LIU ; Jiahui PENG ; Dan LI ; Shengjun MA ; Jingfan YANG ; Yu FU ; Guangwei ZHU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):159-167
ObjectiveBased on modern analytical techniques and a depressed mouse model established by chronic unpredictable mild stress(CUMS), to evaluate the quality marker(Q-Marker) and pharmacodynamic difference of Baihe Dihuangtang prepared by different processes. MethodsHigh performance liquid chromatography(HPLC) was used to establish the characteristic profiles of Baihe Dihuangtang, and determine the content of Q-Marker in the samples prepared by ancient and modern processes. Seventy C57BL/6J mice were randomly divided into the normal group, model group, fluoxetine group(3 mg·kg-1), low and high dose groups of ancient process(6.5, 26 g·kg-1), and low and high dose groups of modern process(6.5, 26 g·kg-1), with 10 mice in each group. Except for the normal group, CUMS was used to induce depression in mice from the other groups for 28 d. After successful modeling, administration groups were given the corresponding drugs by gavage every day, and the normal and model groups were given an equal volume of pure water by gavage for 21 consecutive days. Change in body mass of mice was recorded, tail suspension test and open field test were used to evaluate the depressive behavior of mice, and enzyme-linked immunosorbent assay(ELISA) was employed to determine the contents of tumor necrosis factor-α(TNF-α), interleukin(IL)-1β and IL-6 in serum. ResultsCharacteristic profiles of Baihe Dihuangtang prepared by the two processes were established, the similarity between the two was 0.951, and 8 characteristic peaks were recognized with the reference peak of regaloside A. The results of quantitative analysis showed that the Q-Marker content was similar in Baihe Dihuangtang prepared by ancient and modern processes. The results of pharmacodynamics showed that, compared with the normal group, the model group showed increased immobility time in the tail suspension test, reduced total movement distance in the open field test, and elevated IL-1β, IL-6 and TNF-α levels in the serum(P<0.01). Compared with the model group, the behavioral indicators of mice in the Baihe Dihuangtang treatment group were significantly improved in terms of tail suspension time and open field exercise, and the levels of IL-1β, IL-6 and TNF-α in serum were significantly reduced(P<0.05, P<0.01). Baihe Dihuangtang prepared by the two processes both had antidepressant effects, and the difference between the two was not statistically significant in improving depressive symptoms. ConclusionQ-Marker of Baihe Dihuangtang prepared by modern and ancient methods are equivalent in content, and the pharmacological effects are consistent, indicating that dried Lilii Bulbus can replace fresh products in the preparation of Baihe Dihuangtang. This study provides a scientific basis for the development of new drugs of Baihe Dihuangtang and a reference for its rational application and clinical use.
4.The Development and Weight Assignment of the Diagnostic Scale of Turbid Toxin Syndrome: Based on Delphi and Hierarchical Analysis Process
Xiaoyu LIU ; Zhihua LIU ; Jingfan LI ; Runze LI ; Yuman WANG ; Binqing XUE ; Xinqian ZHANG ; Qian YANG ; Yanru DU
Journal of Traditional Chinese Medicine 2024;65(7):684-690
ObjectiveTo construct traditional Chinese medicine (TCM) diagnostic scale of turbid toxin syndrome in order to provide corresponding reference for the standardization of TCM syndromes and studies. MethodsWe systematically searched the Chinese Medical Dictionary (CMD), China Knowledge Network (CNKI), Wanfang Data Knowledge Service Platform (WF) and VIP database for TCM classics and modern literature on turbid toxin syndrome, and initially screened the four diagnosis information of turbid toxin syndrome, established a pool of information entries, and conducted a cross-sectional clinical survey. Discrete trend method, correlation coefficient method, Cronbach's coefficient method, and factor analysis method were applied to objectively screen the entries. The diagnostic scale of turbid toxin syndrome were constructed through three rounds of Delphi method expert survey to determine the scale entries, using hierarchical analysis to get the judgement matrix scores and relative weight of each entry, after passing consistency test and then isometric expansion of the relative weight of the entries to get the weight of each entry and assign the value. ResultsA total of 35 articles were included, 45 entries were obtained after the initial screening. After the clinical investigation, 12 entries were not suitable by the discrete trend method, 23 entries not suitable by correlation coefficient method, 13 entries by the internal consistency screening were removed with the Cronbach's alpha coefficient rising, and 10 entries not suitable by the factor analysis method. Twenty-two entries were retained after objective screening by the combined use of the four statistical methods. The positive coefficients of experts in the three rounds of Delphi method of expert consultation were 96.67%, the coefficients of expert authority were 0.834, 0.856, and 0.867, and the coefficients of co-ordination were 0.126, 0.326, and 0.312, respectively. After consulting with clinical experts, and three rounds of Delphi method survey and hierarchical analysis method weight assignment, the diagnostic scale entries of turbid toxin syndrome were finally established. Primary symptoms: dark red or purple and dusky tongue, yellowish greasy or dry coating (10 points); sticky and unpleasant stools (8 points); disharmony of tastes including halitosis, sticky and greasy taste in the mouth, dry mouth and bitter taste in the mouth (6 points); unfavourable or yellowish or red urination (5 points); and dark complexion (4 points). Secondary symptoms: heavy body (3 points); dizziness (3 points); profuse, sticky, foul-smelling secretions (2 points); wiry and slippery, or slippery, or slippery and rapid pulse (2 points); feeling of hardness in the abdomen (1 point). ConclusionUsing Delphi method combined with the hierarchical analysis method, combining qualitative and quantitative study, a diagnostic scale of turbid toxin syndrome was initially developed.
5.Current situation of primary and secondary school students health services in community health service organizations in Shenzhen
LU Wenlong, LIN Bingliang, XUAN Peng, LI Yan, WEN Erya, LAN Lina, XIONG Jingfan
Chinese Journal of School Health 2024;45(12):1699-1703
Objective:
To understand and assess the current situation of primary and secondary school students health services in community health service organizations in Shenzhen, so as to provide a basis for upgrading the capacity of health services.
Methods:
A total of 684 community health service organizations and 587 part time health vice principals in the Shenzhen City were selected for the study in June 2022, and the special questionnaire surveys regarding primary and secondary school students health service capacity and the community health service organizations and part time health vice principals performance ability were administered in Shenzhen. SPSS 26.0 software was used for a descriptive analysis.
Results:
The staffing rate of general practitioners or clinical physicians in Shenzhen s community health service organizations was 99.9%, 67.1% of community health service organizations established counterpart collaborative relationships with schools, 50.8% of community health service organizations provided diagnostic and treatment services for students, 24.8% of community health service organizations provided health check up services for students, 85.2% of community health service organizations provided health guidance to schools, and 94.3% of community health service organizations had a part time vice principal of health with a score of (7.63±1.59) in the self assessment of their ability to carry out their duties, and space constraints and shortage of nursing were the main problems in promoting student medical check ups in the community health service organizations.
Conclusions
The community health service organizations in Shenzhen suffer from inadequate medical service resources and inadequate training for professional staff, resulting in low service capacity for providing physical examinations and health management for primary and secondary school students. There is a need to further promote the integrated development of education and health, and continuously enhance service capabilities, to promote the orderly development of student health work.
6.Effects of conditioned medium of alveolar epithelial cells on vascular endothelial cell damage
Jingfan YANG ; Haibo LI ; Yanqin QIN ; Jiansheng LI
Chinese Critical Care Medicine 2024;36(2):160-165
Objective:To observe the effect of lipopolysaccharide (LPS) induced conditioned medium of alveolar epithelial cells on the inflammatory response and cell damage of vascular endothelial cells, and explore its mechanism.Methods:The LPS induced type Ⅱ alveolar epithelial cells (A549) conditioned medium was used as a stimulus to induce human umbilical vein endothelial cells (HUVEC) damage. The cell counting kit-8 (CCK-8) was used to detect the effect of 0% (blank group), 12.5%, 25%, 50%, 75% and 100% A549 cell conditioned medium cultured for 6, 12, 24 and 48 hours on the cell viability of HUVEC. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)] and vasoactive substances [vascular endothelial growth factor (VEGF), endothelin-1 (ET-1)] in the supernatant. Phalloidin staining was used to observe the effects of A549 cells conditioned medium on cell morphology. The expressions of protein kinase B/nuclear factor-κB (AKT/NF-κB) pathway in HUVEC induced by conditioned medium was detected by Western blotting.Results:Compared with the blank group, A549 cells conditioned medium with concentrations of 12.5%, 25%, and 50% had no significant effects on cell viability of HUVEC after 6, 12, and 24 hours, but the activity of HUVEC decreased significantly after 48 hours. Therefore, 12.5%, 25%, 50% A549 cell conditioned medium stimulated for 24 hours was selected as the induction condition for follow-up experiments. Compared with the blank group, the level of IL-6 was significantly increased in 12.5% and 50% conditioned medium groups (ng/L: 2?438.95±64.89, 3?036.41±96.69 vs. 1?736.75±20.99, both P < 0.05), the level of TNF-α was significantly increased in 12.5% and 25% conditioned medium groups (ng/L: 174.08±11.09, 81.37±8.17 vs. 50.03±0.26, both P < 0.01), the levels of VEGF and ET-1 were significantly increased in 12.5%, 25% and 50% conditioned medium groups [VEGF (ng/L): 173.60±41.44, 192.49±12.38, 318.89±27.90 vs. 66.68±19.65; ET-1 (ng/L): 54.88±1.37, 36.69±0.29, 24.07±0.73 vs. 10.67±0.25, all P < 0.01]. Phalloidin staining showed that HUVEC induced by 25% A549 cells conditioned medium were irregular in shape, uneven in size, disordered in arrangement, widened in gap, dense and unclear in microfilament structure and serrated in cell membrane. Furthermore, the average fluorescence intensity of 25% conditioned medium group significantly increased compared to the blank group (67?205.60±3?430.40 vs. 56?272.67±7?650.95, P < 0.05). Western blotting showed that compared with the blank group, the expression of HUVEC cells phosphonated inhibitor α of NF-κB (p-IκBα) was significantly decreased in the 12.5%, 25%, and 50% conditioned medium groups (p-IκBα/IκBα: 0.38±0.08, 0.67±0.12, 0.31±0.07 vs. 1.00±0.00, all P < 0.01), the expressions of phosphonated-AKT (p-AKT) and VEGF were significantly increased (p-AKT/AKT: 1.50±0.18, 1.42±0.27, 1.61±0.14 vs. 1.00±0.00, VEGF/GAPDH: 1.37±0.10, 1.53±0.22, 1.40±0.12 vs. 1.00±0.00, all P < 0.05), the expression of phosphonated NF-κB p65 (p-P65) was significantly increased in the 25% conditioned medium group (p-P65/P65: 1.45±0.14 vs. 1.00±0.00, P < 0.05). Conclusion:LPS induced conditional culture medium of alveolar epithelial cells induced endothelial cell damage via activating AKT/NF-κB pathway.
7.Research progress on the role of N6-methyladenosine methylation in the pathogenesis and development of respiratory diseases
Haibo LI ; Jingfan YANG ; Yanqin QIN ; Jiansheng LI
Chinese Critical Care Medicine 2024;36(3):303-307
N6-methyladenosine (m6A) is one of the most common post-transcriptional modifications of eukaryotic mRNA. The m6A modification accelerates mRNA metabolism and translation, and plays an important role in cell differentiation, embryonic development and stress response. As a reversible epigenetic modification, m6A modification plays an important role in many physiological and pathological processes. The m6A modification is closely related to the occurrence and progression of respiratory diseases, and the m6A modification regulatory factor may be a potential target for regulating respiratory diseases. This article reviews the role of m6A modification in the development of respiratory diseases such as lung cancer, acute lung injury (ALI), asthma, pulmonary fibrosis, and chronic obstructive pulmonary disease (COPD). The purpose of m6A modification is to provide a reference for the pathogenesis of respiratory diseases and the study of targets.
8.Research Progress and Quality Marker Prediction of Famous Classical Formula Baihe Dihuangtang
Yan LIU ; Jiameng LIU ; Dan LI ; Bo SUN ; Jingfan YANG ; Yu FU ; Shengjun MA ; Guangwei ZHU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(18):235-242
Baihe Dihuangtang is a famous classical formula that has been respected by physicians in the past and is still used today. It was first recorded in ZHANG Zhongjing's Synopsis of the Golden Chamber, and is composed of Lilii Bulbus and Rehmanniae Radix juice. This paper systematically reviewed the research progress of historical evolution, pharmacological activities and clinical applications of Baihe Dihuangtang in recent years, and found that there was no major changes in the composition, decoction method and indications of this formula since the Han dynasty. According to the herbal textual research, the fleshy scaly leaves of Lilium brownii var. viridulum should be selected for Lilii Bulbus in this formula, and the tuberous roots of Rehmannia glutinosa were selected for Rehmanniae Radix. According to the dosage conversion of ancient and modern times, the dosage is 245 g of fresh Lilii Bulbus and 400 g of fresh Rehmanniae Radix, and the ratio of their juice is 1∶1. Its efficacy is to nourish Yin and clear heat, and to tonify the heart and lungs, which is used to treat the heart and lung Yin deficiency syndrome of lily disease. Modern pharmacological studies have shown that the research on the pharmacological effects of Baihe Dihuangtang mainly focuses on anti-depressant, anti-anxiety, improving insomnia and regulating metabolism, and it is mostly used clinically for neurological disorders such as depression, anxiety and insomnia. The quality marker(Q-Marker) of Baihe Dihuangtang were predicted according to the principles of ingredient specificity, component validity, component measurability, formula compatibility, and quality transmissibility and traceability, and it was determined that catalpol, rhmannioside D, regaloside A, regaloside B, regaloside C, and acteoside could be selected as potential Q-Markers of Baihe Dihuangtang, which could provide scientific reference for the establishment of the quality control system and the development of compound preparation of this famous classical formula.
9.Screening status of warning signs for mental and behavioral development and influencing factors of infants and young children in poverty eliminated regions of Henan province
Shuaiqi LI ; Sheju CHEN ; Shuaibing WANG ; Dong WANG ; Linbin JIA ; Weijia ZHAO ; Jingfan XU ; Jing WANG ; Wei CHEN
Chinese Journal of Pediatrics 2024;62(10):969-974
Objectives:To investigate the screening status of warning signs for mental and behavioral development (WS) and influencing factors of infants and young children (IYC) in poverty eliminated regions of Henan Province.Methods:This study was a cross-sectional study. A total of 15 680 IYC aged 6-23 months from 51 poverty eliminated counties in Henan province from June to September of 2023 were selected through a multi-stage random sampling method. IYC′s early warning signs were screened using the WS checklist (WSC). Children′s socio-demographic characteristics, maternal information, birth status, and illness conditions such as fever and diarrhea within 2 weeks were measured through a uniformly designed questionnaire. All participants also received the measurement of height, weight, and hemoglobin concentration level. Logistic regression model was used to explore the influencing factors of positive WSC and conducted sensitivity analyses.Results:Among the sample of 15 680 IYC, there were 8 462 boys (53.97%) and 7 218 girls (49.03%), with their age of (15±5) months. A total of 291 (1.86%) IYC were positive in WSC. Parenting risk ( OR=5.07, 95% CI 3.93-6.52, P<0.001) and preterm birth ( OR=1.63, 95% CI 1.06-2.52, P=0.027) were both positively associated with the odds of WSC′s positivity. Being girls ( OR=0.66, 95% CI 0.52-0.85, P=0.001), age (12-17 months, OR=0.47, 95% CI 0.35-0.62, P<0.001; 18-23 months, OR=0.40, 95% CI 0.30-0.54, P<0.001), and maternal educational level (junior high school, OR=0.46, 95% CI 0.32-0.66, P<0.001; senior high school or vocational high school, OR=0.35, 95% CI 0.23-0.56, P<0.001; college and above, OR=0.36, 95% CI 0.23-0.57, P<0.001) were all negatively associated with the risk of WSC′s positivity. Sensitivity analyses demonstrated that, after excluding anemic children, the association between preterm birth and WSC′s positivity was not significant ( OR=1.54, 95% CI 0.95-2.49, P=0.081). Despite this situation, being girls, age and maternal educational level were still negatively associated with the odds of WSC′s positivity (all P<0.05); preterm birth, parenting risk were remained positive associated with the risk of WSC′s positivity (all P<0.05) either by excluding children with protein-energy malnutrition or 2-week morbidity, or using prevalence ratio instead of OR. Conclusions:Among the IYC in poverty eliminated regions of Henan Province, the risk of positivity of WSC was higher for those IYC with parenting risk, preterm birth, boys, younger age, and lower maternal education level. These influencing factors, such as gender, age, preterm birth, parenting risk and maternal educational level, were in certain stability across different IYC characteristics and estimation models.
10.Sugar sweetened beverages knowledge and associated factors among primary and middle school students in Shenzhen
ZHANG Shuangxia, LI Yanyan, XIONG Jingfan, LI Yan, YAO Ping
Chinese Journal of School Health 2023;44(5):691-695
Objective:
To explore the status of sugar sweetened beverages(SSBs) and its associated factors among primary and middle school students in Shenzhen, providing reference for nutrition and health education.
Methods:
A random number table and convenience sampling method was used to select 40 135 primary and middle school students aged 6-18 years in Shenzhen. Data was collected to investigate their SSBs knowledge and associated factors.
Results:
The proportion of SSBs knowledge score less than 60 points, between 60-79 points and 80-100 points were 5.6%, 41.9% and 52.4%. Multivariate analysis showed that age(4-6 grade, junior middle and high school), gender(female), parents education(high school or vocational schools, colleges and universities as bachelors, masters or doctors), students pay attention to the ingredient list (seldom, none), parental dissuasion or reward behavior (only forced dissuasion, giving no dissuasion, occasional reward, no reward), and the storing beverages at home (seldom, none) were associated with total SSBs knowledge score and milk containing beverage knowledge score ( β =-0.79,-1.19,-1.74,0.58, 1.20 ,1.81,2.98,3.13,2.70,4.85,6.34,6.41,-0.99,-0.78,-1.81,-2.40,5.85,6.26,0.61,1.92, P <0.05). Age(4-6 grade, junior middle and high school), gender(female), father s education background(with colleges and universities as bachelor, masters or doctors), mother s education background(high schools or vocational schools, colleges and universities as bachelors, masters or doctors), parents dissuation behaviors(giving no dissuation), parents rewarding behavior(seldom, none), storing beverages at home(seldom, none) were associated with the total SSBs knowledge score and milk containing beverage knowledge score( β =-0.68, -0.92 ,-0.49,0.26,0.51,1.05,1.09,0.90,1.93,2.62,2.55,-0.68,0.93,1.13,0.21,0.92, P <0.05).
Conclusion
Primary and middle school students have moderate to high level of SSBs knowledge. It is necessary for students and their parents to learn more SSBs related nutrition healthy knowledge, and to reduce home availability of SSBs.


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