Objective: To explore the current status and influencing factors of eating behaviors in adolescents, so as to provide a theoretical foundation for health promotion education among adolescents. Methods: Based on the database from Survey of Chinese Family Health Index (2021), by a random number table method, 1 065 teenagers were selected from the provincial capitals of 22 provinces and 5 autonomous regions in China, as well as 4 municipalities directly under the central government. A general characteristic questionnaire, Patient Health Questionnaire-9 (PHQ-9), Short Form of the Family Health Scale (FHS-SF), 10-item Short Version of the Big Five Personality(BFP-10), Content-based Media Exposure Scale (CM-E) and Sakata Eating Behavior Scale Short Form(EBS-SF) were used to collect information. Multivariate stepwise linear regression analysis was employed to identify and analyze related factors of eating behaviors among adolescents. Receiver operating characteristic was used to validate the predictive ability of the EBS-SF score for overweight and obesity among adolescents. Results: The average scores of BFI-10,C-ME, FHS-SF, PHQ-9 and EBS-SF were (33.08±4.64)(19.20±4.55)(38.48±6.65)(6.09±5.63)(16.75±4.36), respectively. Multivariate linear regression showed that family type (other types), agreeableness, conscientiousness, family health and depression were the main related factors of EBS-SF scores among adolescents( B =2.61,-0.42,0.20,-0.11,0.23, P <0.05).The analysis of receiver operating characteristic curve showed that the EBS-SF scores had a good ability in predicting obesity among male adolescents ( AUC= 0.73, P <0.01). Conclusions Family type, big five personality, family health,depression are the related factors of eating behaviors among adolescents. EBS-SF scores are predictive of obesity in adolescents, which would provide a new perspective for promoting healthy eating habits among adolescents.

The development of longitudinal cohorts has made the identification and surveillance of multiple biological markers and behavioral factors which influence disease course or health status become possible. However, traditional statistical methods typically use univariate longitudinal data for research, failing to fully exploit the information from multivariate longitudinal data. The group-based multi-trajectory model (GBMTM) emerged as a method to study the developmental trajectory of multivariate data in recent years. GBMTM has distinct advantages in analyzing multivariate longitudinal data by identifying potential subgroups of populations following similar trajectories by multiple indicators that influence the outcome of interest. In this study, we introduced the application of GBMTM by explaining the fundamental principles and using the data from a health management study in the elderly by using smart wearing equipment to investigate the relationship between multiple life-related variables and hypertension to promote the wider use of GBMTM in longitudinal cohort studies.

Objective To investigate the factors involved in the development of thyroid nodules and the correlation between homocysteine(Hcy)and albumin-globulin ratio(AGR)and thyroid autoantibodies in adults.Methods As a retrospective study,a total of 1 427 people who received physical examination at the Second Hospital Affilia-ted to Hebei North College from October 2019 to August 2020 and the clinical data of the subjects who fulfilled the criteria of NAR were selected for analysis by simple random sampling.All of subjects underwent thyroid color ultrasound scanning and were divided into a control group(without thyroid nodules,n=52)and an observation group(with thyroid nodules,n=48).The general clinical data of the two study groups were compared,and the correlation between Hey and AGR and thyroid autoantibodies was analyzed.Confunding factors affecting the inci-dence of thyroid nodules were screened using multifactorial unconditional logistic regression analysis.Results The observation group showed statistically significant differences in gender,age,diastolic blood pressure,systolic blood pressure,Hey,AGR,TGAb,and TPOAb as compared to the control group(P＜0.05);Using adult Hcy as the dependent variable and Spearman's correlation analysis of AGR,TGAb and TPOAb,adult Hcy was nega-tively correlated with AGR(r=-0.384,P＜0.05)and TGAb and TPOAb were positively correlated(r=0.218,0.224,P＜0.05);Using age,sex,diastolic blood pressure,systolic blood pressure,Hcy,AGR TGAb and TPOAb as independent variables and thyroid nodules as dependent variables,a multifactor logistic regression analysis was performed in 100 subjects who experienced physical check.The analysis showed that age ≥40 years and female were relevant factors for the development of thyroid nodules factors(P＜0.05),Hcy,AGR,TGAb and TPOAb were correlated with thyroid nodules(P＜0.05).Conclusions Thyroid nodules are more common in middle-aged women,and there is a correlation between Hcy,AGR,TGAb,and TPOAb levels and thyroid nod-ules.Regular thyroid screening examination should be carried out based on the above indicators.

Objective:To analyze the selection of outcome indicators for randomized controlled trials (RCT) on exercise rehabilitation in patients with atrial fibrillation (AF), promote the construction of the core outcome set and provide reference for the research design of subsequent RCT.Methods:The RCT literature related to exercise rehabilitation of patients with atrial fibrillation was systematically searched from CNKI, Wanfang, VIP, PubMed, Web of Science, Embase and Cochrane Library databases, and the search period was from establishment of the databases until July 31, 2023. After literature screening, Cochrane Risk of Bias Assessment Tool was used for quality evaluation, information extraction, classification of outcome indicators, frequency of use statistics, analysis and extraction of current shortcomings in the selection of outcome indicators, and corresponding suggestions were proposed.Results:A total of 32 articles were included, and 19 RCT were evaluated twice for outcome measures. The number of outcome measures ranged from 2 to 17, with 10 RCT setting outcome measures according to primary and secondary criteria and 6 RCT setting safety outcome measures. A total of 96 outcome indicators were extracted in this study, total 266 frequency, which could be divided into 4 categories, such as safety evaluation (18 times), clinical response (75 times), patient-reported outcomes (68 times) and laboratory and other examination (105 times) .Conclusions:Existing RCT outcome indicators of exercise rehabilitation in patients with atrial fibrillation emphasize the changes in subjective feelings and objective indicators of individuals, covering four aspects such as the physical condition, exercise ability, quality of life and psychological status of individuals. However, there is a lack of uniform standards and the safety evaluation indicators are fewer. The categories of exercise rehabilitation indicators for atrial fibrillation patients extracted in this paper can provide a reference for the design of future RCT studies and promote the generation of higher quality evidence-based medical evidence.

Objective:To explore the effect of music therapy in patients with post-stroke cognitive impairment (PSCI) based on Meta-analysis.Methods:The randomized controlled trial (RCT) on the effect of music therapy in PSCI patients was searched through computer on China National Knowledge Infrastructure, WanFang, VIP, PubMed, Embase, Web of Science, and Cochrane Library. Researchers screened articles according to inclusion and exclusion criteria, evaluated quality, and extracted data. Meta-analysis of the data was conducted using RevMan 5.4 software. The search period was from the establishment of the database to April 6, 2022.Results:A total of 19 RCTs were included, including 1 496 study subjects. The results showed that music therapy could improve cognitive function [ SMD=1.31, 95% CI (1.00, 1.62), P<0.01], increase ability of daily living [ SMD=1.19, 95% CI (0.41, 1.96), P<0.05], relieve anxiety [ SMD=-1.38, 95% CI (-1.88, -0.88), P<0.01], and depression [ SMD=-2.40, 95% CI (-3.73, -1.07), P<0.01]in PSCI patients. Conclusions:Existing evidence suggests that music therapy has a certain improvement effect on the cognitive function of PSCI patients, and can enhance their ability of daily living, reduce negative emotions such as anxiety and depression.

Objective:To determine the risk factors of perioperative cerebral oxygen supply and utilization and cerebral activity in newborns with congenital heart disease(CHD).Methods:In this prospective cohort study, NIRS and amplitude integrated EEG(aEEG) performed before and after surgery were used to assess cerebral oxygen supply and utilization and cerebral activity in these newborns. Cerebral tissue oxygenation index(TOI) and fractional tissue oxygen extraction(FTOE) measured from NIRS for each patient were compared to background pattern and SWC of aEEG before and after surgery. Analysis included clinical characteristics and explore the risk factors of TOI, FTOE.Results:90 CHD newborns were obtained. Pre- and postoperative TOI were 0.56±0.05 and 0.59±0.03, both of them were lower than the average for normal newborns( P<0.05). Pre- and postoperative FTOE were 0.36±0.07 and 0.39±0.04. TOI and FTOE were significantly improved after surgery( P<0.05). There was negative correlation between the TOI improvement after surgery and SpO 2 of right upper limb( β: -0.202). Patient with Respiratory support before surgery had lower preoperative TOI levels( β: -0.879). Preoperative SpO 2 was higher, then preoperative TOI was also higher( β: 0.214). The postoperative FTOE of who had lower amplitude showed by aEEG was significantly lower( P<0.05). The postoperative TOI of who had immature SWC was lower than mature SWC( P<0.05). Delayed chest closure was a risk factor for postoperative death. Conclusion:TOI in children with CHD improved significantly after operative, especially in patient with cyanosis CHD. Preoperative TOI is positively related to SpO 2. It’s positive correlation between cerebral activity and cerebral oxygen utilization. The patient who has immature SWC showed lower cerebral oxygen supply. Monitoring cerebral activity and oxygenation may be useful in perioperative management and cerebral protection of newborns with CHD.

Objective:To explore the cause and treatment of chylothorax after surgery for congenital heart disease(CHD) in newborns.Methods:A retrospective analysis was made to the clinical data of 49 newborns with chylothorax after surgery for CHD within the period from January 2009 to December 2019. These newborns were aged from from 1 day to 28 days with the weight from 2.0 kg to 4.1 kg. The complete transposition of great arteries was performed in 13 cases, coarctation of the aorta/ interruption of the aortic arch in 13 case, right ventricular outflow tract reconstruction/ Blalock-Taussing shunt in 9 cases, total anomalous pulmonary venous connection in 8 cases, ventricular septal defect repair and atrial septal defect repair in 4 cases, ligation of patent ductus arteriosus in 1 case and persisten truncus arteriosus in 1 case. Chylothorax occurred in the right in 19 cases, left side in 20 cases, bilateral in 9 cases and the pericardium in 1 case. The diagnosis was made at the time from 1 day to 22 days after the surgery with an average of 8 days.Results:43 patients were cured(87.75%), 41 cases(83.67%) were cured with diet and support therapy, the course lasted from 4 days to 65 days with an average of 11 days; 1 cases, because of the poor effect of diet and support therapy, was given pleural injection of high-sugar combined with octreotide treatment; 1 case received thoracic duct ligation as the conservative therapy was ineffective; 6 cases of death due to heart failure/ severe pulmonary hypertension after operation, and parents gave up.Conclusion:Individualization conservative therapy is the first choice for chylothorax, while timely surgery can raise the survival rate and save the hospitalization time and the cost.

Objective:To summarize and analyze the efficacy, experience and follow-up results of 300 cases of transposition of the great arteries (TGA) intervened by arterial switch operation.Methods:It was a retrospective, single-center study involving 300 TGA patients intervened by arterial switch operation between January 2010 and December 2017 in Guangdong Provincial People′s Hospital.Their clinical data were retrospectively analyzed.There were 236 male patients and 64 females.Among them, 128 cases (42.7%) were TGA with ventricular septal defect (TGA/VSD), and 172 cases (57.3%) were TGA with intact ventricular septal defect (TGA/IVS). The mean age and weight at operation were (23.8±39.2) cases days, and (3.5±0.8) kg, respectively.There were 193 cases (64.3%) with usual coronary artery patterns, and 107 cases (35.7%) with unusual coronary artery patterns.Among the 107 cases with unusual coronary artery patterns, 21 cases (7.0%) were involved with the intramural coronary artery, and 17 (5.7%) presented the single-ostium coronary pattern.Non normal distribution data were used the Mann- Whitney U test.Categorical measures were compared by Chi- square test or Fisher′ s exact test.Survival probability and freedom from events were calculated by the Kaplan-Meier method, and difference in survival probability by the Log Rank test. Results:All patients were successfully intervened by arterial switch operation, 73.3% of patients with TGA/IVS underwent the surgery within 3 weeks after birth, and 85.9% of patients with TGA/VSD underwent surgery within 3 months.The mean cardiopulmonary bypass time and aortic occlusion time were (193±68) min, and (122±39) min, respectively.Twenty-five patients (8.3%) died in hospital.Thirty cases had low cardiac output syndrome, 1 implanted with a permanent pacemaker due to complete atrioventricular block.A total of 254 patients were followed up for 1 month to 10 years.Three patients with single-ostium coronary pattern died at the follow-up period.The 5-year and 10-year survival rates were both 90.7%.During the follow-up, 49 cases (49/254 cases, 19.3%) had pulmonary artery stenosis, 66 cases (66/254 cases, 26.0%) had aortic valve regurgitation, 47 cases (47/254 cases, 18.5%) had pulmonary valve regurgitation, and 4 (4/254 cases, 1.6%) had aortic anastomotic stenosis.Among the 21 patients (21/254 cases, 8.3%) requiring reintervention, 17 patients (17/254 cases, 6.7%) underwent a total of 18 reinterventions, including 12 interventions of pulmonary artery plasty, 4 of percutaneous balloon pulmonary valvuloplasty, 1 of aortic reconstruction at anastomosis and 1 of pacemaker exchange due to battery exhaustion.Conclusions:Arterial switch operation is the optimal treatment for TGA.The long-term follow-up results of arterial switch operation are satisfactory in TGA children, with a low risk of long-term reoperation.

Objective:To explore the effect of inpatient palliative care in patients with end-stage heart failure.Methods:From July 2019 to January 2021, convenience sampling was used to select 97 patients with end-stage heart failure admitted to the Cardiovascular Department of Henan Provincial Chest Hospital as the research subject. The patients were divided into the control group ( n=48) and the observation group ( n=49) with the random number table. The control group conducted routine nursing, and the observation group carried out inpatient palliative care on this basis. The 21-Item Depression Anxiety Stress Scale (DASS-21) , General Self-efficacy Scale (GSES) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) were used to compare the adverse psychological state, self-efficacy and quality of life of the two groups of patients. Results:Before intervention, there were no significant differences in DASS-21, MLHFQ and GSES scores between the two groups ( P>0.05) . After intervention, the DASS-21 and MLHFQ scores of the observation group were lower than those of the control group, and the GSES score was higher than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Inpatient palliative care can effectively relieve the adverse psychological state of patients with end-stage heart failure and improve their self-efficacy and quality of life.

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.