Objective: To analyze the influence of stress and psychological resilience on the dietary behavior of middle school students so as to privide a basis for the development of policies and interventions aimed at improving middle school students dietary behavior. Methods: A total of 8 874 middle school students in Shanghai were surveyed using stratified cluster random sampling method from November 2019 to January 2020. The questionnaire included general information, dietary behavior, Perceived Stress Scale (PSS-10) and Connor-Davidson Resilience Scale (CD-RISC-10). Factor analysis was used to analyze the dietary behavior model. Logistic regression model was used to explore the correlation between stress, psychological resilience and dietary behavior in adolescents. Besides, a structural equation model was established to analyze the mediating effect of psychological resilience on stress and dietary behavior. Results: The total score of psychological resilience among middle school students was (27.99±9.83), and the total score of stress was (25.56±7.06). Factor analysis categorized dietary behavior into two types: the high energy dietary behavior and balanced dietary behavior. High energy dietary behavior exhibited statistically significant differences across genders and schooling stage ( χ 2=41.37, 204.03), while balanced dietary behavior showed statistically significant differences across schooling stage and socioeconomic status ( χ 2=130.23, 96.53) (all P <0.01). Logistic regression analysis showed that adolescents with moderate and high stress levels had an increased risks of high energy dietary behavior ( OR=1.25, 95%CI =1.12-1.39; OR=1.58, 95% CI = 1.39-1.79) and a reduced likelihood of reduced balanced dietary behavior ( OR=0.73, 95%CI =0.65-0.81; OR=0.53, 95%CI =0.47-0.60); adolescents with high levels of psychological resilience had a decreased risk of highenergy dietary behavior ( OR= 0.73 , 95%CI =0.65-0.83), and those with moderate and high resilience levels showed improved balanced dietary behavior ( OR= 1.45 , 95%CI =1.29-1.62; OR=2.50, 95%CI =2.21-2.84) (all P <0.01). The mediating effect of psychological resilience between stress and high energy dietary behavior or balanced dietary behavior accounted for 15.61% and 56.10% of the total effects, respectively. Conclusions Stress and psychological resilience are the influencing factors of dietary behavior in middle school students. Psychological resilience have a partial mediating effect between stress and high energy dietary behavior or balanced dietary behavior.

Animals ; Macaca mulatta ; Optic Disk ; Glaucoma ; Craniocerebral Trauma ; Intraocular Pressure ; Low Tension Glaucoma

Humans ; Vascular Stiffness ; Coal Mining ; Occupational Diseases/epidemiology* ; Risk Factors ; Coal ; Miners

Objective:To analyze and summarize the medical security situation of the snowmobile,sled,and steel frame snowmobile tracks at the National Sliding Centre,and to provide experience for future event hosting and medical security work for mass ice and snow sports.Methods:Retrospective analysis of injuries and treatment of athletes participating in the International Training Week and World Cup for Ski,Sled,and Steel Frame Ski from October to November 2021(hereinafter referred to as"Inter-national Training Week"),as well as the Ski,Sled,and Steel Frame Ski events at the Beijing Winter Olympics in February 2022(hereinafter referred to as the"Beijing Winter Olympics").We referred to and drew on the"Medical Security Standards for Winter Snow Sports"to develop specific classification standards for analyzing injured areas,types of injuries,and accident locations.Results:A total of 743 athletes participated in the International Training Week and the Beijing Winter Olympics.During the com-petition,there were 58 incidents of overturning,prying,and collision,of which 28(28 athletes)were in-jured,accounting for 48.3％of the total accidents and 3.8％of the total number of athletes.Among them,there were 9 males(32.1％)and 19 females(67.9％),with an average age of(26.3±4.7)years.Among the 28 injured athletes,20 cases(71.4％)received on-site treatment for Class Ⅰ injuries,while 8 cases(28.6％)had more severe injuries,including Class Ⅱ injuries(7 cases)and Class Ⅲ injuries(1 case),which were referred to designated hospitals for further treatment.Among the 28 injured athletes,3 cases(10.7％)experienced multiple injuries,including 2 cases of 2 injuries and 1 case of 3 injuries.The most common injuries were in the ankle and toes(10/32,31.3％).Out of 28 injured athletes,one(3.6％)experienced two types of injuries simultaneously,with joint and/or ligament injuries being the most common(11/29,37.9％).The most accident prone point on the track was the ninth curve(18/58,31.0％).Conclusion:Through the analysis and summary of medical security work,it can provide better experience and reference for the future development of snowmobile,sled,and steel frame snowmobile sports in China,making the National Snowy and Ski Center truly a sustainable Olympic heritage.

Objective To construct and validate a clinical prediction model for delayed extubation undergoing non-emergency major surgery based on the random forest algorithm.Methods Clinical data of 7 528 patients undergoing non-emergency major surgery under general anesthesia from January 2018 to De-cember 2022 were retrospectively collected.The patients were divided into two groups according to whether extubation was performed within 2 hours after surgery:non-delayed extubation group(≤2 hours)and de-layed extubation group(＞2 hours).All the patients were randomly divided into a training set and a valida-tion set in a ratio of 7 ∶ 3.The predictive factors for delayed extubation after surgery were screened through LASSO regression and Logistic regression.The random forest model was established and verified by random forest algorithm.Results There were 123 patients(1.6%)experienced delayed extubation after surgery.ASA physical status,department,intraoperative use of flurbiprofen ester,dexmedetomidine,glucocorticoid,hypocalcemia,severe anemia,intraoperative blood transfusion,and airway spasm were identified as inde-pendent predictive factors for delayed extubation.The area under curve(AUC)value of the random forest prediction model in the validation set was0.751(95%CI0.742-0.778),and the sensitivity was98.1%,and the specificity was 41.9%.Conclusion The predictive model of delayed extubation undergoing non-e-mergency major surgery based on random forest algorithm has a good predictive value,which may be helpful to prevent delayed extubation undergoing non-emergency major surgery.

Objective: To compare the effectiveness of qualitative and quantitative fecal immunochemical tests (FIT) in identifying colorectal cancer, so as to provide insights into perfecting screening strategies for colorectal cancer. Methods: Participants in the Colorectal Cancer Screening Program for Key Populations in Zhejiang Province from May 2020 to December 2021 were recruited, and their demographic information, lifestyle and disease history were collected through a questionnaire survey. Qualitative or quantitative FIT along with a questionnaire-based risk assessment were employed as the initial screening tests. Individuals who were positive in any FIT or had high-risk assessment results were required to attend a subsequent colonoscopy examination. The positive rate, detection rate of colorectal cancer, positive predictive value and number of colonoscopies required were compared between qualitative and quantitative FITs, and stratified analyses by gender and age were conducted. Results: Totally 4 099 769 participants were included. The qualitative FIT group included 3 574 917 individuals, yielding a positive rate of 11.35%, a detection rate of 1.19%, a positive predictive value of 0.48% and 83.84 colonoscopies required to detect one cancer case. The quantitative FIT group involved 524 852 individuals, yielding a positive rate of 6.70%, a detection rate of 2.31%, a positive predictive value of 1.01% and 43.23 colonoscopies required to detect one cancer case. The quantitative FIT group showed significantly higher detection rate of colorectal cancer, higher positive predictive value and less number of colonoscopies required compared to the qualitative FIT group (all P<0.05). The same results were obtained after stratification by gender and age. Conclusion Compared to qualitative FIT, quantitative FIT improves the detection of colorectal cancer and reduces the workload of colonoscopy examinations, making it more suitable for colorectal cancer screening in large-scale populations.

Objective:To describe the population and area distribution differences in the prevalence of urinary incontinence in middle-aged and elderly adults in 10 areas in China.Methods:A total of 24 913 participants aged 45-95 years who completed the third resurvey of China Kadoorie Biobank during 2020-2021 were included. The prevalence of urinary incontinence was assessed by an interviewer-administered questionnaire, and urinary incontinence was classified as only stress urinary incontinence, only urgency urinary incontinence and mixed urinary incontinence. The prevalence of urinary incontinence and its subtypes were reported by sex, age and area, and the severity of urinary incontinence and treatment were described.Results:The average age of the participants was (65.4±9.1) years. According to the seventh national census data in 2020, the age-standardized prevalence rates of urinary incontinence was 25.4% in women and 7.0% in men. The age-standardized prevalence rates of only stress, only urgency and mixed incontinence were 1.7%, 4.2% and 1.2% in men and 13.5%, 5.8% and 6.1% in women, respectively. The prevalence rates of urinary incontinence and all subtypes in men and the prevalence of urinary incontinence and all subtypes except only stress urinary incontinence in women all increased with age ( P<0.001). After adjusting for age, the prevalence of urinary incontinence in both men and women were higher in rural area than in urban area ( P<0.001). The treatment rates in men and women with urinary incontinence were 15.4% and 8.5%, respectively. Conclusions:The prevalence of urinary incontinence was high in middle-aged and elderly adults in China, and the prevalence rate was higher in women than in men, but the treatment rate of urinary incontinence was low.

Objective In the context of expanding in size and improving the quality of medical consumables,the"one product,one policy"approach has brought challenges to the management of consumables in public hospitals.This study investi-gated the potential management problems in the process of centralized procurement with volume of medical consumables in a pub-lic tertiary hospital in Guangdong Province,and accordingly worked out the corresponding management countermeasures and then assessed their implementation effects.Methods The fishbone diagrams was applied to systematically analyze the potential prob-lems in the implementation process of centralized procurement with volume of medical consumables.Targeted measures were worked out from May to July 2023 in the hospital.The time series data of centralized procurement of coronary stents,pacemak-ers,tubular/end-to-end anastomoses,and spinal products from December 2022 to December 2023 were analyzed.Changes in the monthly implementation rate and contract completion volume pre-and post-intervention were measured to evaluate the effectiveness of the intervention.Results The fishbone diagrams analysis revealed that the primary factors impeding procurement implementa-tion were internal system flaws,personnel management inadequacy,supply issues,and an absence of an information system.Post-intervention,the monthly implementation rate(t=-4.19,P＜0.05)and contract completion(t=-2.38,P＜0.05)significantly improved.Conclusion The implementation of intervention management for centralized procurement with volume of medical consumables can effectively promote the related implementation effect in the department.In the context of centralized pro-curement,clinical and health management personnel need to bolster their professionalism to ensure the procurement management efficiency and quality.It is crucial to deepen policy understanding and implementation,enhance production and distribution process supervision and disciplinary mechanisms,ensure multi-departmental coordination for supply security,and improve hospi-tal information systems and procurement platforms.

Objective To evaluate the short-term efficacy of Huoxue Xiaozhong Powder(i.e.,Shuangbai San)for the treatment of patients with mild-to-moderate knee osteoarthritis(KOA)of qi stagnation and blood stasis syndrome.Methods Sixty patients with mild-to-moderate KOA of qi stagnation and blood stasis syndrome were randomly divided into the treatment group and the control group,with 30 cases in each group.The treatment group was treated with external application of Huoxue Xiaozhong Powder,and the control group was treated with external application of Voltaren(diclofenac diethylamide emulsion).Both groups were treated for one week as a course.The changes of visual analogue scale(VAS)score,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score and erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)level and synovial thickness under ultrasound in the two groups before and after treatment were observed.Moreover,the clinical efficacy and safety of the two groups were evaluated.Results(1)After one week of treatment,the total effective rate of the treatment group was 93.33%(28/30),and that of the control group was 73.33%(22/30).The intergroup comparison(tested by rank sum test)showed that the clinical efficacy of the treatment group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the VAS score,WOMAC score,ESR,CRP level and synovial thickness under ultrasound in the two groups were significantly improved compared with those before treatment(P＜0.01),and the treatment group had stronger effect on the improvement of VAS score,WOMAC score,ESR,CRP level and synovial thickness under ultrasound than the control group(P＜0.01).(3)During treatment,no obvious adverse reactions such as skin redness,swelling and itching occurred in the two groups of patients,which had a high safety.Conclusion For the patients with mild-to-moderate KOA of qi stagnation and blood stasis syndrome,the use of Huoxue Xiaozhong Powder for external treatment alone can also achieve good short-term clinical effects,which can effectively alleviate the symptoms of pain,and reduce the levels of inflammatory indicators and synovial thickness.

Objective To investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]