1.Association between mental health and muscle strength among Chinese adolescents aged 13-18
Chinese Journal of School Health 2025;46(9):1232-1236
Objective:
To explore the association between mental health and muscle strength among Chinese adolescents aged 13- 18, providing a theoretical foundation and intervention strategies for mental health promotion.
Methods:
Data were obtained from the 2019 Chinese National Survey on Students Constitution and Health, including 98 631 Chinese adolescents aged 13- 18. Psychological distress was assessed by using the Kessler Psychological Distress Scale (K10), and mental well being was measured with the Warwick-Edinburgh Mental Well being Scale (WEMWBS). Based on the gender and age specific Z scores of various test items [grip strength, standing long jump, pull ups (for males), and sit ups (for females)], muscle strength index (MSI) was constructed to evaluate the comprehensive level of muscle strength in adolescents. According to the Dual factor Model (DFM) of mental health, participants were categorized into four groups:troubled, symptomatic but content, vulnerable, and complete mental health. Gender differences were analyzed by using Chi-square tests, trends were tested with Cochran-Armitage tests, and multinomial Logistic regression models were applied to assess associations between muscle strength and mental health among adolescents.
Results:
In 2019, 37.4% of Chinese adolescents aged 13-18 were reported of high mental distress, and 59.9% were reported of low mental well being. Boys had significantly lower rates of high mental distress (35.3%) and low mental well being (55.6%) compared to girls (39.4%, 64.3%), and the differences were of statistical significance ( χ 2=176.13, 780.42, both P <0.05). In 2019, the rate of complete mental health among adolescents showed a downward trend with increasing age ( χ 2 trend = 258.47) and a gradual upward trend with increasing muscle strength levels ( χ 2 trend =123.14),and both boys and girls exhibited similar trends ( χ 2 trend =103.83, 168.46; 57.00 , 67.34) (all P <0.05). The results of the unordered multiclass Logistic regression model showed that after controlling for confounding factors such as age and gender, when the completely pathological group as a reference, for every 1 unit increase in MSI in adolescents, the likelihood of being in a completely mental health state increased by 29% ( OR = 1.29); for every unit increase in the Z-score for pull ups, the likelihood of being in a completely mental health state increased by 6% ( OR =1.06) among boys; for every 1 unit increase in sit up Z score, the likelihood of being in a completely mental health state increased by 19% ( OR =1.19) among girls (all P <0.05).
Conclusions
The mental health status of Chinese adolescents is not good enough. Muscle strength is positively associated with mental health.
2.Traditional Chinese Medicine Regulates Oxidative Stress-related Signaling Pathways to Prevent and Treat Bronchial Asthma: A Review
Xuyang ZHENG ; Zhenhui SHU ; Yi LI ; Ziyue QU ; Weilin LI ; Kexin MA ; Junsheng SHA ; Limin ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(18):260-269
Bronchial asthma (asthma for short) is a common clinical respiratory disease mainly characterized by chronic airway inflammation, with complicated pathogenesis and a long treatment cycle. It is lingering and difficult to be cured, and lack specific drugs. Oxidative stress is a new focus in the research on the pathogenesis of asthma and a potential key target for the treatment. Under physiological conditions, the oxidative and antioxidative systems in the body are in a dynamic balance, and the two antagonize each other to maintain normal life activities. In the case of asthma attack, oxidation products such as reactive oxygen species (ROS), malondialdehyde (MDA), and nitric oxide (NO) are produced excessively, while the content of antioxidants such as superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) is reduced. As a result, the oxidation exceeds the removal of oxidation products, which aggravates oxidative stress. In addition, the overproduction of ROS activates oxidative stress-related signaling pathways to produce pro-inflammatory factors, exacerbating inflammation, which leads to lung and airway tissue damage. In recent years, traditional Chinese medicine has garnering increasing attention because of the unique advantages in the treatment of asthma, especially in regulating redox balance, alleviating oxidative stress in asthma patients, and reducing inflammation. On the one hand, by inhibiting the mitogen-activated protein kinase (MAPK) and transcription factor (NF)-κB signaling pathways, traditional Chinese medicine can reduce the content of oxidation products and pro-inflammatory factors from the source. On the other hand, by activating the nuclear factor-erythroid 2-related factor 2 (NrF2) signaling pathway, traditional Chinese medicine can elevate the levels of antioxidant enzymes and enhance the antioxidant system to neutralize the excessive accumulation of oxidation products. Therefore, the adjustment of redox balance state by traditional Chinese medicine may be a new means and a new direction for the prevention and treatment of asthma in the future. This paper summarizes the oxidative stress-related pathways in the pathogenesis of asthma and reviews the latest research progress in the regulation of oxidative stress-related pathways by Chinese medicine extracts and prescriptions in the treatment of asthma, with a view to providing a fuller, more solid, and more scientific theoretical basis for the clinical and basic research on the prevention and treatment of asthma by traditional Chinese medicine.
3.Status and pathways of factors influencing physical activity time among elementary and junior high school students in Beijing
Shan CAI ; Yihang ZHANG ; Ziyue CHEN ; Yunfei LIU ; Jiajia DANG ; Di SHI ; Jiaxin LI ; Tianyu HUANG ; Jun MA ; Yi SONG
Journal of Peking University(Health Sciences) 2024;56(3):403-410
Objective:To describe the current distribution of daily physical activity time among ele-mentary and junior high school students in Beijing,and to analyze the influencing factors and pathways at the individual,family,school and community levels.Methods:Data were drawn upon from a cross-sectional investigation in Beijing in 2023,and a total of 3 157 elementary and junior high school students were included in the final analysis.Questionnaire was used to collect data on basic characteristics,over-all and in-school physical activity time per day,the number of sports mastered,perceived physical activi-ty benefits and barriers scales,perceived family,school,and community physical activity supportive en-vironment scales.Log-binomial regression model was used to analyze the associations between physical activity time and influencing factors,and structural equation modeling was used for the path analysis of the influencing factors.Results:The reported rates of ≥ 2 hours of overall physical activity per day and≥1 hour of physical activity in school per day among elementary and junior high school students in Beijing in 2023 were 33.1%and 64.8%,respectively.The associations between the number of sports mastered by students and the reported rate of ≥2 hours of overall physical activity per day showed a typical dose-response relationship(P-trend<0.001).The perceived physical activity benefits-to-barriers ratio(PR=1.24,95%CI:1.20-1.28),scores of perceived family,school,and community physical acti-vity supportive environment scales were all positively associated with the reported rate of≥2 hours of overall physical activity per day(PR=1.51,95%CI:1.38-1.66;PR=1.50,95%CI:1.37-1.64;PR=1.21,95%CI:1.16-1.27).The structural equation modeling showed that the number of sports mastered by the students(β=0.11,P<0.001),perceived physical activity benefits-to-barriers ratios(β=0.15,P<0.001),and scores of supportive environment scales consisting of family,school,and community(β=0.13,P<0.001)were associated with the reported rates of ≥2 hours of overall physi-cal activity per day directly.In addition,the scores of supportive environment scales could indirectly in-fluence the reported rates of ≥2 hours of overall physical activity per day by influencing the number of sports mastered by the students(β=0.21,P<0.001)and the perceived physical activity benefits-to-barriers ratio(β=0.56,P<0.001),while the number of sports mastered by the students could indi-rectly influence the reported rates of ≥2 hours of overall physical activity per day by influencing the per-ceived physical activity benefits-to-barriers ratios(β=0.05,P=0.003).The influencing factors and pathways of the reported rates of ≥ 1 hour of physical activity in school per day were similar with those of the reported rates of ≥2 hours of overall physical activity per day described above.Conclusion:The dai-ly physical activity time among elementary and junior high school students in Beijing in 2023 fell short of meeting the national requirement.There was a need to build a supportive environment consisting of fami-ly,school,and community for physical activity,to promote the students'sports skills,to establish the idea of independent physical activity,and to ensure that primary and secondary school students were given one hour of physical activity time every day,both inside and outside the school.
4.Interpretation of the 2023 updated guidelines for the use of ERAS in gynecologic oncology patients
Feifei MA ; Xianling FENG ; Changyong YANG ; Yang BAI ; Ziyue SHI
Chinese Journal of Modern Nursing 2024;30(20):2661-2666
Enhanced Recovery After Surgery (ERAS) is a standardized perioperative care plan aimed at optimizing perioperative management through a series of evidence-based interventions. In recent years, guidelines related to ERAS in gynecologic oncology have been successively updated. The International ERAS Society published guidelines on the application of ERAS in gynecologic oncology in 2016 and 2019. With the advancement of evidence-based research, these guidelines were further updated in 2023. This paper interprets the key points of the 2023 updated guidelines for the use of ERAS in gynecologic oncology patients, aiming to enhance perioperative management.
5.Comorbidity of myopia and obesity and the moderating role of lifestyle among primary and secondary school students in Inner Mongolia Autonomous Region in 2021
Chinese Journal of School Health 2023;44(9):1299-1303
Objective:
To describe the current status of the prevalence of co-morbid myopia and obesity among 7-18 years students in the Inner Mongolia Autonomous Region in 2021 and to analyze the moderating effect of lifestyle in this association ,so as to provide scientific basis for the establishment of the mechanism of Co-morbidity,Shared Etiology,and Shared Prevention of common diseases in children and adolescents.
Methods:
A total of 139 630 primary and secondary school students aged 7-18 years from Inner Mongolia Autonomous Region were selected by stratified random cluster sampling method in September,2021. Myopia was determined using distance visual acuity examination and refractive error examination, and obesity was determined according to the BMI classification criteria for overweight, obesity screening of Chinese school age children and adolescents. Used a questionnaire, healthy lifestyles were determined according to the American Heart Association s Healthy Lifestyle Score by totaling the six scores for smoking, alcohol consumption, diet, exercise, screen time, and sleep duration.The χ 2 test was used to compare the association between group differences in the co-morbidity rate of myopia and obesity. The multivariable Logistic regression model was used to explore the influencing factors of the co-morbidity of myopia and obesity, and the stratified analysis was used to analyze the moderating effect of lifestyles on the prevalence of the co-morbidity.
Results:
The prevalence of myopia and obesity co-morbidity among students aged 7-18 years old in the Inner Mongolia Autonmous Region in 2021 was 13.7%, higher among boys than girls ( 15.5 % vs. 11.8%), higher among those aged 10-12 years old than 7-9,13-15,and 16-18 years old (14.7%,13.7%, 13.3%, 12.0%), higher among other ethnic minorities than Han Chinese and Mongolians (15.3%, 14.0%, 12.5%), higher in urban areas than that in suburban areas(15.3%, 13.0%), and middle economic level tracts were higher than poor and good tracts (14.8%, 12.9 %, 12.6%) ( χ 2=392.37,115.73,62.80,119.02,121.60, P <0.05). Multivariable Logistic regression modeling showed that unhealthy lifestyles ( OR=1.24, 95%CI=1.19-1.29 ) and middle level of lifestyle score ( OR=1.15, 95%CI=1.10-1.19 ) students had higher prevalence of co-morbidity, and the results were statistically significant among both boys and girls, the age groups of 10- 12, 13-15, and 16-18 years old, as well as the Han and Mongolian ethnic groups (all P <0.05).
Conclusion
In 2021, the current situation of myopia and obesity co-morbidity and unhealthy lifestyles among primary and secondary school students in the Inner Mongolia Autonomous Region are not optimistic.
6.A monitoring aid for movement disorder rehabilitation
Yu JIA ; Pengfei LI ; Ziyue MA ; Linlin WANG ; Juan DENG ; Hong WANG ; Hong SHA
International Journal of Biomedical Engineering 2023;46(1):30-35
Objective:To design a motor impairment rehabilitation monitoring aid for the assessment of motor impairment in patients who do not have or have difficulty walking independently.Methods:An assistive device vehicle was designed, equipped with an accelerometer and a six-dimensional force sensor. The normal walking (NW) group and abnormal walking group were set up, in which the abnormal walking group included moderate abnormal walking (MA) group, moderate abnormal walking with the aid of the assistive vehicle (MA-V) group, severe abnormal walking (SA) group, and severe abnormal walking with the aid of the assistive vehicle (SA-V) group. In the MA-V group, the range of knee movement was adjusted from 0 to 30°, and in the SA group, the knee joint was completely unbending. The gait cycles, peak and mean acceleration values of the right and left legs were evaluated by accelerometers, and changes in the upper limb forces were assessed by six-dimensional force transducers.Results:For the moderate impairment group, the difference in gait cycle between the MA and MA-V groups was not statistically significant ( P>0.05), and the gait cycle in the MA-V group was slightly greater than that in the MA group. For the severe injury group, the gait cycle of the SA-V group was lower than that of the SA group, and the difference was statistically significant ( P<0.01). For all abnormal groups, the mean and peak acceleration of the left leg were greater than that of the right leg, and the difference between the peak acceleration of the left leg and that of the right leg was statistically significant ( P<0.05). In the abnormal walking pattern, the mean (absolute) value of the left hand force was greater than that of the right hand, especially in the Z-axis. The standard deviations of the combined forces on the left side for the NW, MA-V, and SA-V groups were 2.759, 8.297, and 13.118 N, respectively. The SA-V group had the highest dispersion in the force scatter plot, while the NW group had a better concentration. Conclusions:An assistive vehicle equipped with an accelerometer and a six-dimensional force sensor was designed to help physicians in the assessment and rehabilitation of motor disorders.
7.Association between residual cholesterol and the risk of subclinical renal damage
Xi ZHANG ; Zejiaxin NIU ; Guilin HU ; Mingfei DU ; Ting ZOU ; Xiaoyu ZHANG ; Lan WANG ; Chao CHU ; Yueyuan LIAO ; Qiong MA ; Dan WANG ; Keke WANG ; Hao JIA ; Chen CHEN ; Yu YAN ; Yue SUN ; Tongshuai GUO ; Jie ZHANG ; Weihua GAO ; Ziyue MAN ; Ke GAO ; Wenjing LUO ; Jianjun MU ; Yang WANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2023;44(1):6-13
【Objective】 Dyslipidemia has shown to be associated with cardiovascular, metabolic and renal diseases. This study aimed to investigate the association between residual cholesterol and the risk of subclinical renal damage (SRD). 【Methods】 A total of 2 342 participants were recruited from the previously established Hanzhong Adolescent Hypertension Study cohort. According to estimated glomerular filtration rate(eGFR) and urinary albumin-to-creatine ratio(uACR), the subjects were divided into SRD group and non-SRD group. The associations of residual cholesterol with eGFR, uACR, and the risk of SRD were analyzed by multiple linear and Logistic regression analyses. 【Results】 Residual cholesterol was positively correlated with uACR(r=0.081, P<0.001) but negatively correlated with eGFR (r=-0.091, P<0.001). Multiple linear regression analysis revealed that residual cholesterol was an influencing factor of uACR (β=0.075, P<0.001) and eGFR (β=-0.027, P<0.001) after adjustment for gender, age, smoke, alcohol, exercise, BMI, hypertension, diabetes and serum uric acid. In addition, Logistic regression analysis revealed that residual cholesterol was significantly associated with the risk of SRD independently of potential confounders [OR(95% CI)=1.387 (1.113-1.728), P<0.001]. Further subgroup analysis showed that residual cholesterol was significantly associated with the risk of SRD in women but not in men. 【Conclusion】 Residual cholesterol is a contributing factor in the risk of subclinical renal damage with gender-specific association.
8.Association of genetic variants in NEDD4L with blood pressure responses to dietary salt and potassium intake
Zejiaxin NIU ; Mingfei DU ; Guilin HU ; Xi ZHANG ; Dan WANG ; Lan WANG ; Wenjing LUO ; Mingke CHANG ; Ting ZOU ; Xiaoyu ZHANG ; Yu YAN ; Chao CHU ; Yueyuan LIAO ; Qiong MA ; Keke WANG ; Hao JIA ; Chen CHEN ; Yue SUN ; Tongshuai GUO ; Jie ZHANG ; Weihua GAO ; Ziyue MAN ; Ke GAO ; Jianjun MU ; Yang WANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2023;44(1):30-37
【Objective】 4-like protein with down-regulated expression and development in neural precursor cells (NEDD4L) plays an important role in blood pressure (BP) regulation and sodium homeostasis by regulating epithelial sodium channel protein. In this study, we aimed to explore the relationship of NEDD4L gene polymorphisms with BP responses to sodium and potassium intake. 【Methods】 In 2004, 514 subjects from 124 families in Meixian County, Shaanxi Province, were recruited to establish a salt-sensitive hypertension study cohort. All the subjects received a 3-day baseline survey, a 7-day low-salt diet, a 7-day high-salt diet, and finally a 7-day high-salt and potassium supplementation. Their BP was measured and peripheral blood samples were collected at different intervention periods. The 14 gene polymorphisms of NEDD4L gene were genotyped and analyzed by MassARRAY platform. 【Results】 BP decreased on a low-salt diet, and significantly increased on a high-salt diet, and decreased again after potassium supplementation. NEDD4L SNPs rs74408486 were significantly associated with systolic BP, diastolic BP and mean arterial pressure responses to the low-salt diet. SNPs rs292449 and rs2288775 were significantly associated with pulse pressure response to the high-salt diet. In addition, SNPs rs563283 and rs292449 were significantly associated with diastolic BP, mean arterial pressure, and pulse pressure responses to high-salt and potassium supplementation diet. 【Conclusion】 NEDD4L gene polymorphisms were significantly associated with BP responses to sodium and potassium intake, suggesting that NEDD4L gene may be involved in the development of salt sensitivity and potassium sensitivity.
9.Association of genetic variants in uromodulin with blood pressure responses to dietary salt and potassium intake
Yan WU ; Mingfei DU ; Xi ZHANG ; Lan WANG ; Guilin HU ; Zejiaxin NIU ; Ting ZOU ; Xiaoyu ZHANG ; Chao CHU ; Yueyuan LIAO ; Qiong MA ; Dan WANG ; Keke WANG ; Hao JIA ; Chen CHEN ; Yu YAN ; Yue SUN ; Tongshuai GUO ; Jie ZHANG ; Weihua GAO ; Ziyue MAN ; Ke GAO ; Wenjing LUO ; Jianjun MU ; Yang WANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2023;44(1):38-45
【Objective】 Based on our previously established salt-sensitive hypertension cohort, we aimed to examine the association of genetic variants in uromodulin with blood pressure(BP) responses to dietary interventions of sodium and potassium intake. 【Methods】 In 2004, 514 subjects from 124 families in Mei County, Shaanxi Province, were recruited to establish the salt-sensitive hypertension study cohort. Among them, 333 non-parent subjects were selected and sequentially maintained on a normal-diet for 3 days, low-salt diet for 7 days, then a high-salt diet for 7 days and a high-salt diet with potassium supplementation for another 7 days. Thirteen single nucleotide polymorphisms(SNPs) in the uromodulin gene were genotyped on the MassARRAY platform. 【Results】 BP levels decreased from the baseline to low-salt diet, increased from low-salt to high-salt diet, and decreased again from the high-salt diet to the high-salt plus potassium supplementation intervention. SNPs rs77875418 and rs4997081 of the uromodulin gene were significantly associated with diastolic BP(DBP) and mean arterial pressure(MAP) responses to high-salt diet. In addition, SNPs rs77875418, rs79245268, rs4293393, rs6497476, rs4997081, rs13333226, and rs12917707 were significantly associated with systolic BP(SBP), DBP, and MAP responses to high-salt diet with potassium supplementation. 【Conclusion】 Genetic variants in uromodulin gene are significantly associated with BP responses to sodium and potassium supplementation, suggesting that uromodulin may be mechanistically involved in BP sodium-sensitivity and potassium-sensitivity.
10.Prevalence of psychological distress among Chinese children and adolescents aged 9-18 years
Ziyue CHEN ; Shan CAI ; Ning MA ; Yihang ZHANG ; Yi ZHANG ; Jianuo JIANG ; Yunfei LIU ; Jiajia DANG ; Panliang ZHONG ; Di SHI ; Yanhui DONG ; Guangrong ZHU ; Jun MA ; Yi SONG
Chinese Journal of Epidemiology 2023;44(10):1537-1544
Objective:To describe the prevalence of psychological distress and to analyze its influencing factors among Chinese children and adolescents aged 9-18 years in 2019.Methods:Data was from the 2019 Chinese National Survey on Students' Constitution and Health, and 148 892 children and adolescents were included. Psychological distress was measured using the Kessler Psychological Distress Scale (K10): scores ≤19 were defined as no psychological distress, scores between 20-24 were defined as mild psychological distress, scores between 25-29 were defined as moderate psychological distress, and scores ≥30 were defined as severe psychological distress (moderate to severe psychological distress were defined as high psychological distress). The ANOVA, t test, and χ2 test were used to compare the differences in K10 scores and high psychological distress rates among children and adolescents with different characteristics. The ANOVA and trend χ2 test were used to analyze the trends. Modified-Poisson regression models were used to determine influencing factors of high psychological distress. Results:The K10 scores for Chinese children and adolescents aged 9-18 years in 2019 was 21.5±9.2, and their rate of high psychological distress was 31.6%. The rates of high psychological distress among children and adolescents aged 9-12, 13-15, and 16-18 years were 22.3%, 35.9%, and 38.8%. K10 scores and rates of high psychological distress showed an increasing trend as age increased (trends test all P<0.001). K10 scores and rates of high psychological distress were higher among children and adolescents who were older, female, rural, in areas with medium to low GDP per capita level, and with lower parental education (all P<0.001). Multifactorial modified-Poisson regression analysis showed that children and adolescents aged 13-15 years, 16-18 years, female, rural, and in areas with low to moderate GDP per capita level were at higher risk of high psychological distress (all P<0.05), with a OR (95% CI) of 1.55 (1.52-1.58), 1.66 (1.63-1.69), 1.07 (1.05-1.09), 1.02 (1.01-1.04), 1.10 (1.07-1.12). Children and adolescents in areas with medium to high GDP per capita level, whose father had a secondary or high school degree, whose father had a college degree or above, whose mother had a secondary or high school degree, and whose mother had a college degree or above were at lower risk of high psychological distress (all P<0.05), with a OR (95% CI) of 0.96 (0.94-0.98), 0.92 (0.90-0.93), 0.84 (0.82-0.86), 0.95 (0.93-0.97), 0.86 (0.83-0.88). Conclusions:The prevalence of psychological distress was high among Chinese children and adolescents aged 9-18 years in 2019, which is a vital problem. Mental health interventions need to be implemented among children and adolescents that were older, girls, rural, live in areas with lower economic levels, and whose parents have a lower education level.


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