Objective: To explore the isotemporal substitution effects among different intensities of physical activity within a 10 minute recess period on the mental health of junior high school students, aiming to provide evidence based references for targeted practical interventions. Methods: From May to November 2024, a total of 845 junior high school students from Tianjin,Taiyuan and L Liang in Shaanxi Province,Puyang in Henan Province,Xi an in Shaanxi Province,Quzhou in Zhejiang Province,and Chaoyang in Liaoning Province were selected by using a combination of stratified random sampling and convenience sampling. ActiGraph wGT3X-BT accelerometers was used to measure physical activity during a 10 minute recess period. Mental health status was assessed with the Depression Anxiety Stress Scale (DASS-21). An isotemporal substitution model was constructed in 1 minute increments to predict the effects of substituting different physical activity behaviors on students mental health. Results: During recess, sedentary behavior (SB) was predominant among junior high school students, with an average duration of [7.08(5.85,7.98)] minutes, while moderate to vigorous physical activity (MVPA) accounted for the shortest duration at [0.42(0.21,0.85)] minutes. There were statistically significant differences in MVPA,LPA and SB time between students of different genders and grades( Z/H =-9.08,-8.34,-9.51;84.87,126.82,135.27,all P <0.01). Isotemporal substitution analysis, adjusted for gender and age, showed that replacing 1 minute of SB with 1 minute of MVPA significantly improved anxiety levels ( β =-0.29, 95% CI =-0.53 to -0.04) and overall mental health ( β =-0.72, 95% CI =-1.39 to -0.04), with both results reaching statistical significance (both P <0.05). No significant effects were observed for other substitution patterns (both P >0.05). Conclusions Substituting SB with MVPA during a 10 minute recess period exerts a positive impact on the mental health of junior high school students. It is recommended to optimize the daily recess activity structure in schools to enhance students mental well being.

Objective: To investigate the current status of milk tea consumption and its association with psychological distress among college students, so as to provide theoretial support for promoting the mental health of college students. Methods: From September to November 2023, a convenience sampling method was used to select 15 440 college students aged 17-24 from seven universities in Shanghai, Jiangxi, Hubei, and Shanxi. A self designed questionnaire and the Kessler Psychological Distress Scale were used to assess milk tea consumption and psychological distress, respectively. The Mantel-Haenszel test was employed to analyze the trend of psychological distress at different levels of milk tea consumption. Binary Logistic regression analysis was used to determine the association between milk tea consumption and psychological distress, and the restricted cubic spline method was applied to explore the nonlinear relationship between milk tea consumption and symptoms of psychological distress. Results: The detection rate of psychological distress among college students was 59.6%. Univariate analysis indicated a significant trend association between milk tea consumption frequency ( χ 2 trend =42.33) and milk tea intake level ( χ 2 trend = 5.17 ) with psychological distress ( P <0.05). Binary Logistic regression models showed a positive association between different levels of milk tea consumption frequency and psychological distress [1-3 times (mild to moderate distress, OR =1.20,1.41), 4-5 times (mild to severe distress, OR =2.80,5.44,4.12), and ≥6 times (severe distress, OR =8.04); and milk tea intake level: 1-1 500 mL (severe distress, OR =1.35), >1 500- <3 000 mL (mild to moderate distress, OR =1.21, 1.35), ≥3 000 mL (mild to severe distress, OR =1.33,1.71,1.29)] ( P <0.05 ). The restricted cubic spline model showed a nonlinear association between milk tea intake and the risk of psychological distress ( F = 107.34 , P non linear <0.01, P overall <0.01). Conclusions High frequency and high volume milk tea consumption are associated with an increased risk of psychological distress among college students. Reducing the consumption behavior of college students milk tea is helpful to improve mental health.

Objectives:To compare the diagnostic efficacy of non-ST-segment elevation myocardial infarction (NSTEMI) and the predictive value for major adverse cardiovascular events (MACE) of the 0/3-hour algorithm for high-sensitivity cardiac troponin (hs-cTn) recommended by the 2015 European Society of Cardiology (ESC) guidelines for the management of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and the 2021 "Chinese Expert Consensus on Laboratory Testing and Clinical Application of Cardiac Troponin" in suspected acute coronary syndrome (ACS) patients in the Chinese population. Methods:This is a multicenter prospective observational study,including 1527 patients with suspected ACS from three clinical centers from January 2017 to September 2020.Plasma hs-cTnI levels were measured using the ARCHITECT assay at the time of presentation and 3 hours later in patients with suspected ACS (test determination).Clinical judgment (independent clinical judgment by cardiac experts,independent of the test results) was used as the gold standard to compare the sensitivity,specificity,and consistency of the two diagnostic algorithms,and to analyze their predictive value for MACE at 30 days and 180 days.MACE in this study was defined as a composite event of cardiovascular death,myocardial infarction,and unplanned coronary revascularization. Results:According to clinical judgment,there were 400 patients with NSTEMI and 1127 patients without NSTEMI.The 0/3-hour algorithm recommended by the 2021 Chinese Expert Consensus showed higher sensitivity in diagnosing NSTEMI than the 2015 ESC guidelines (91.50％[95％ CI:88.32％-94.04％]vs.87.75％[95％ CI:84.13％-90.80％]),but slightly lower specificity (93.88％[95％ CI:92.32％-95.21％]vs.95.56％[95％ CI:94.19％-96.69％]),with both differences being statistically significant (both P<0.001).In the follow-up at 30 days and 180 days,the incidence of MACE in patients diagnosed with NSTEMI by both algorithms was higher than in those without NSTEMI (P<0.001).The incidence of MACE at 30 days and 180 days for the group excluded from the diagnosis of NSTEMI by 2015 ESC guidelines was 0.19％ and 1.120％,respectively,and for the NSTEMI group was 2.89％ and 3.68％,respectively;for the group excluded from NSTEMI by the 2021 Chinese Expert Consensus,the incidence was 0.096％ and 0.770％,respectively,and for the NSTEMI group was 2.91％ and 4.36％,respectively.Cox analysis showed that the HR ratio for MACE at 180 days in the NSTEMI group diagnosed by both algorithms was 3.418 and 5.892,respectively,significantly higher than the group excluded from NSTEMI. Conclusions:The 0/3-hour algorithm recommended by the 2021 Chinese Expert Consensus has superior diagnostic sensitivity compared to the 2015 ESC NSTE-ACS guidelines,at the cost of slightly lower specificity.Both algorithms can effectively predict MACE within 180 days,but based on the data from this study,the algorithm recommended by the 2021 Chinese Expert Consensus is more sensitive in predicting the risk of MACE,and patients excluded from the diagnosis of NSTEMI by this method have a lower incidence of MACE,suggesting that its application in clinical practice may be more helpful in terms of long-term safe management of patients.

Objective:To explore the predictive value of single high-sensitivity cardiac troponin I (hs-cTnI) concentration of 30-day cardiovascular adverse events in patients with suspected acute coronary syndrome (ACS).Methods:This is a multicenter, prospective and observational clinical study. Patients with suspected ACS who were admitted into the emergency department of Fuwai Hospital, the First Affiliated Hospital of Sun Yat-sen University and Nanjing First Hospital from January 2017 to September 2020 were enrolled. hs-cTnI result at the time of visit was obtained from patients with suspected ACS. Patients were followed up for 30 days and patients were divided into no events group and events group according to the presence or absence of 30-day cardiovascular adverse events (acute myocardial infarction (including index), unplanned revascularization and cardiovascular death). The predictive value of single Hs-cTnI at different concentration thresholds on the adverse event was evaluated in terms of sensitivity, negative predictive value (NPV) and 95% confidence interval ( CI). The best threshold was defined as: missed diagnosis rate <2% and NPV >99%. Patients were sub-grouped according to the confounders of hs-cTnI (sex, age, chest pain duration, estimated glomerular filtration rate), and Chi-square test was used to compare sensitivity and NPV among various subgroups. Results:A total of 1 461 patients were included. Among them, 387 patients (26.5%) had 30-day adverse cardiovascular events and 1 074 patients (73.5%) had no adverse cardiovascular events. Mean age was (62±12) years old and 905 were males (61.9%). When the concentration of hs-cTnI was less than 2 ng/L (limit of detection), the missed diagnosis rate of 30-day cardiovascular adverse events was 0.8% (3/387), the sensitivity was 99.2% (95% CI 97.6%-99.8%), and NPV was 98.7% (95% CI 96.0%-99.7%). When hs-cTnI concentration was less than 6 ng/L, the missed diagnosis rate was 1.8%, the sensitivity was 98.2% (95% CI 96.1%-99.2%), and NPV was 99.0% (95% CI 97.9%-99.6%). Subgroup analysis showed that the sensitivity and NPV of single hs-cTnI concentration <6 ng/L for 30-day cardiovascular adverse events were lower in patients with chest pain less than 3 h than those with chest pain time>3 hours ( P<0.05). Conclusions:Single hs-cTnI concentration less than 6 ng/L can predict the risk of 30-day cardiovascular adverse events in suspected ACS patients, but continuous monitoring is recommended for patients with chest pain onset≤3 hours.

Objective: To explore the relationship between family structure with adolescents physical and mental health, and to provide a reference for promoting healthy development of adolescents in the family with particular structure. Methods: The stratified random sampling method was used to select 3 941 middle school students aged 13 to 18 years in Shangrao City of Jiangxi Province. Self designed questionnaire, Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Scale (GAD-7) were used to assess family structure, depressive symptoms and anxiety symptoms, participants were divided into underweight or overweight and obesity according to screening for underweight of school age children and screening for overweight and obesity of school age children. Results: The proportion of adolescents with special family structure was 7.0%. Univariate analysis showed that underweight rate of adolescents with divorced parents (31.2%) was higher than that of adolescents whose parents were still married (25.3%) ( χ 2= 3.55 , P <0.05), the detection rate of depressive symptoms in adolescents with special family structure(40.9%) was higher than that in adolescents with typical family structure(34.5%) ( χ 2=4.60, P <0.05). Multivariate analysis showed that the risk of depressive symptoms in adolescents with special family structure was 1.41 times higher than that in adolescents with typical family structure( 95% CI= 1.02-1.79, P <0.05). Conclusion No significant relationships between special family structure with underweight, overweight and obesity, and anxiety symptoms of adolescents are observed,however,special family structures are associated with increased risk of depressive symptoms in adolescents.

In order to investigate the apoptosis triggered by porcine circovirus type 2 (PCV2) in lymphocytes and the underlying mechanism, the levels of apoptosis and the expression levels of miRNA were examined by flow cytometry, Western blotting and real-time PCR (qPCR). The mimics or inhibitors of miR-125a-5p, an apoptosis-related miRNA, were transfected into PK-15 cells, and the apoptosis rate was examined upon overexpression or inhibition of mir-125a-5p. The target gene of mir-125a-5p was predicted by bioinformatics method, and the regulation of mir-125a-5p on the target gene was analyzed by luciferase reporter assay. The expressions of Bcl-2, Bax, cytochrome C and caspase-3 were detected by Western blotting. The results showed that exosomes secreted by PK-15 cells infected with PCV2 significantly increased the lymphocyte apoptosis rate, which was dose-dependent in certain concentration range. The expression of miR-125a-5p was dramatically increased. The apoptosis rate was increased significantly in the cells transfected with miR-125a-5p. It was predicted that there were binding sites of miR-125a-5p at Bcl-2 3'UTR by TargetScan. The luciferase activity of wild-type pmir-Bcl-2 3'UTR was inhibited significantly by miR-125a-5p mimics, but that of mutant pmir-Bcl-2 3'UTR was not changed. By Western blotting, Bcl-2 was reduced significantly, while Bax, cytochrome C and caspase-3 increased significantly, and the ratio of Bcl-2/Bax was significantly decreased. These results showed that PCV2 up-regulated the expression of miR-125a-5p through exosomes, then inhibited the expression of Bcl-2 at both mRNA and protein level, activated mitochondrial apoptosis pathway and induced apoptosis in lymphocytes.
3' Untranslated Regions ; Animals ; Apoptosis/genetics* ; Caspase 3/genetics* ; Cell Proliferation/genetics* ; Circovirus/genetics* ; Cytochromes c/genetics* ; Luciferases/genetics* ; Lymphocytes/metabolism* ; MicroRNAs/metabolism* ; Swine ; bcl-2-Associated X Protein/genetics*

Objective: To analyze the relationship between school bullying and parent child separation of left behind children, and to provide a theoretical basis for preventing and controlling school bullying of left behind children. Methods: A total of 4 945 children aged 7 to 18 in Shangrao City were selected by stratified cluster random sampling to complete the Chinese version of the School Bullying Experience Questionnaire(C-SBEQ), and the differences of school bullying between left behind and non left behind children were compared. The parent child separation data of 1 791 left behind children was obtained by self designed questionnaire, and the influence of parent child separation characteristics on school bullying of left behind children was analyzed by binary Logistic regression. Results: The rates of school bullying, bully victimization and perpetration of left behind children were 21.3%, 18.3% and 3.0% respectively, which were higher than those of non left behind children(15.4%, 12.7%, 2.7%). And there were statistical significance in the detection rates of school bullying among left behind children in different schooling stages( χ 2=9.82, P < 0.05), the detection rates ranked as follows:21.4% in primary school, 18.9% in junior high school and 14.7% in senior high school. The rate of bullying perpetration among left behind children was significantly higher in boys (4.8%) than in girls (1.0%)( χ 2= 14.69, P <0.05). The rate bully victimization among former left behind children (children with left behind experience) in the younger than 7 years group ( 20.3 %) was higher than that in the older than 7 years group(13.4%)( χ 2=4.79, P =0.03). There was no significant differences in the detection rate of bullying perpetration among the left behind children with different parent child separation experiences ( P >0.05). Control schooling stages, Logistic regression analysis showed that taking former school age left behind children as reference, bully victimization risk of former pre school left behind children was 1.64 times( OR=1.64, 95%CI= 1.04 -2.59, P <0.05). Conclusion School bullying of left behind children is more severce than that of non left behind children. Early occurrence of parent child separation is associated with higher risk of bullying victimization among left behind children.

Hospital culture plays an important role in the orderly operation of large shelter hospitals as well as epidemic prevention and control.From April to May 2022, the shelter hospital of the National Convention and Exhibition Center(Shanghai) had created the large shelter hospital culture co-built by doctors and patients with a greater sense of belonging by taking measures such as joint party building between doctors and patients, giving play to the vanguard force of party members, carrying out various forms of cultural, sports and science popularization activities, encouraging enthusiastic patients to participate in activity planning, focusing on key groups, formulating shelter " residents convention", and so on. These measures ultimately formed cultural adaptation, cultural synchronization and cultural shaping, which were conducive to enhancing the empathy of doctors and patients, improving the effectiveness of medical implementation, and promoting the standardization of shelter management system. This harmonious, warm and autonomous culture co-built by doctors and patients effectively ensures the safe and orderly operation of the shelter hospital, and provides reference for the construction of the cultural system of large shelter hospitals in China.

Objective: To analyze the correlation between behavior and lifestyle factors and anxiety symptoms of left-behind children, and to provide evidence for mental health intervention of left-behind children. Methods: 1 188 children aged from 13 to 18 (617 non-left-behind children and 571 left-behind children) in B County of Shangrao City, Jiangxi Province were evaluated with Generalized Anxiety Disorder Scale (GAD-7). Meanwhile, physical activity, TV watching time, computer usage time, dietary behavior, sleep and other behavioral lifestyle factors of left-behind children were investigated by questionnaire. Results: The detection rate of anxiety among left-behind children (66.0%) was higher than that of non-left-behind children (60.5%). The detection rates of mild, moderate, and severe anxiety were 26.3%, 15.4% and 24.3%, respectively. Under the condition of controlling age and gender, Logistic regression analysis showed that left-behind childrens anxiety symptoms and computer usage time>3 h/d (mild anxiety, OR=3.00, 95%CI=1.27-4.16; moderate anxiety, OR=4.09, 95%CI=1.55-10.78; severe anxiety, OR=3.44, 95%CI=1.46-8.11), mobile phone usage time >3 h/d (mild anxiety, OR=4.93, 95%CI=2.71-8.94; moderate anxiety, OR=5.93, 95%CI=2.98-11.79; severe anxiety, OR=7.11, 95%CI=3.85-13.15), skipping breakfast behavior (moderate anxiety, often skipping, OR=6.09, 95%CI=1.59-23.36; severe anxiety, often skipping, OR=5.49, 95%CI =1.68-7.97, sometimes eat breakfast, OR=2.68, 95%CI=1.10-6.53) was positively correlated; with appropriate sleeping time (moderate anxiety, OR=0.28, 95%CI=0.13-0.60) was negatively correlated. Conclusion The unhealthy behavior and lifestyle of left-behind children may be a potential risk factor for anxiety symptoms.

Objective: To investigate the correlation between takeaway food consumption and poor sleep status of college students in Jiangxi Province, to provide a theoretical basis for poor sleep prevention and intervention among college students. Methods: A total of 2 610 college students were selected from a university in Shangrao City, Jiangxi Province by cluster stratified random sampling in May of 2018. The frequency and type of takeaway food consumption, sleep quality and drowsiness were investigated. Results: The detection rate of takeaway food consumption behavior(≥4 times in a week) for college students was 74.8%. The detection rates of poor sleep quality and drowsiness were 17.0% and 18.3%, respectively. The difference of sleep quality was statistically significant with sex, college, different self rated family conditions, study burden, physical activity level, depression and daily smoking ( χ 2=4.33，8.67，23.14，39.03，12.89，313.37，15.23， P <0.05). There were statistically significant differences between drowsiness and college, grade, learning burden, physical activity and depression ( χ 2=12.81，6.57，20.61，8.42，228.06， P <0.05). Logistic regression analysis showed that takeaway consumption (≥4 times in a week) had statistical significance with poor sleep quality and drowsiness ( P <0.05). Conclusion College students takeaway consumption (≥4 times in a week) of rice noodles, malatang, fragrant pot hot pot increase the risk of poor sleep. It is suggested that schools should strengthen nutrition and health education for college students.