Hearing loss imposes a heavy disease burden on children and adolescents, underscoring the importance of early prevention. To understand the current situation of hearing loss and provide reference for hearing protection, this review summarizes relevant definitions, the latest grading standards, classifications, examination methods, domestic and international noise exposure limits, influencing factors and hearing protection recommendations through literature retrieval. It is found that hearing loss among children and adolescents is influenced by multiple factors, mainly otitis media and noise exposure. It is essential to enhance hearing health literacy, prioritize noise-induced hearing loss mitigation, prevent drug-induced hearing loss, conduct regular hearing tests, and treat infectious diseases promptly.

Objective To investigate the prevalence and characteristics of adverse childhood experiences (ACEs) among college students in Guangxi, and to provide a basis for promoting their mental health. Methods Students were enrolled from 12 universities of four cities in Guangxi, with a convenience sampling method. The simplified Chinese version of“ the adverse childhood experience-international questionnaire (SC-ACE-IQ) ”was used to investigate ACEs among college students through the WeChat Questionnaire Star platform. The latent class analysis (LCA) was applied to evaluate the exposure patterns of ACEs. Multifactorial logistic regression was applied to analyze the factors influencing different exposure patterns of ACEs. Results A total of 1 801 valid questionnaires were obtained from college students. The detection rate for experiencing at least one type of ACEs was 64.7%. The top three most highly detected types of ACEs were emotional neglect (40.3%), emotional abuse (25.2%), and domestic violence (23.5%). The LCA showed that the ACEs exposure patterns of college students could be categorized into 2 groups: the low ACEs exposure pattern (74.8%) and the high ACEs exposure pattern (25.2%). Logistic regression analysis revealed that non-nuclear family types increased the risk of high exposure to ACEs (OR=1.648, 95%CI:1.206-2.252), while the father’s occupation being non-farmer (OR=0.674, 95%CI:0.487-0.932), and higher levels of father’s education reduced the risk of high ACEs exposure among college students. Conclusions The detection rate of ACEs among college students in Guangxi is relatively high. Family socioeconomic level and family type are the main factors. Attention should be paid to the role of family in preventing children’s ACEs and promoting the mental health of children and adolescents.

Objective To explore the correlations between second-hand smoke exposure in indoor public places and sleep quality among adolescents and to provide scientific evidence for the implementation of relevant interventions. Methods A cross-sectional study was conducted and data were collected from the “Huantai Childhood Cardiovascular Health Cohort” during November to December in 2023. A total of 1 169 adolescents aged 12-17 were enrolled after excluding those with missing related variables. Multivariate logistic regression models were applied to examine the correlations between the frequency of second-hand smoke exposure in indoor public places and sleep quality among adolescents. Results Those with second-hand smoke exposure to 0, 1-2 and ≥ 3 days in the past 7 days, had total scores of Pittsburgh Sleep Quality Index of 3.0 (2.0, 5.0), 4.0 (3.0, 6.0) and 5.0 (3.0, 7.0), respectively. Compared with those who did not expose to second-hand smoke in indoor public places (0 day) in the past 7 days, those with an exposure duration of ≥3 days had increased odds of experiencing poor sleep quality (OR=4.19, 95% CI=2.39-7.34; P<0.001). Similar results were obtained with the sex-stratified analysis. However, the strength of the associations between the two factors was stronger among girls (OR=7.62, 95% CI=3.32-17.46; P<0.001) than among boys (OR=2.43, 95% CI=1.12-5.28; P=0.025). Analysis for 7 dimensions of sleep quality showed that second-hand smoke exposure in indoor public places was positively associated with poor subjective sleep quality, prolonged sleep latency, sleep disorders, and daytime dysfunction among adolescents. Conclusions Second-hand smoke exposure is positively associated with poor sleep quality among adolescents. Smoking bans in indoor public places should be strengthened to improve the sleep quality among adolescents.

Objective To investigate the associations between gut microbiota and the secondhand smoke-related obesity among children and adolescents, to identify specific bacterial genera/species related to both secondhand smoke exposure and obesity, and to reveal the gut microbiota mechanisms underlying the association between secondhand smoke exposure and obesity among children and adolescents. Methods Based on data from the “Huantai Childhood Cardiovascular Health Cohort Study” in 2021, a total of 44 obese children and 44 age- and gender-matched normal-weight children were randomly enrolled. The questionnaire surveys, physical measurements, and biological sample collection were applied. After log-transforming the gut microbiota data, multivariate linear regression models and logistic regression models were used to assess the associations between the gut microbiota and secondhand smoke-related obesity and its related indicators. Results After controlling for confounders, genera (such as UBA1819, UCG-005, Holdemania, Eisenbergiella, unclassified_ f_Eggerthellaceae, and Tyzzerella), specific species (such as uncultured_organism_g__UBA1819, unclassified_g__UCG-005, uncultured_bacterium_g__Holdemania, etc.), and OTUs belonging to the genera Butyricicoccus, Coprococcus, Eisenbergiella, Alistipes, and Ruminococcaceae were all associated with secondhand smoke exposure and related indicators of childhood obesity (all P<0.05). Moreover, these secondhand smoke-related bacterial genera had a high ability in identifying childhood obesity (AUC: 0.79-0.83). Conclusion Specific gut microbiota is associated with both secondhand smoke exposure and obesity or its related indicators, suggesting that gut microbiota homeostasis may play an important role in the association between secondhand smoke exposure and childhood obesity.

Perfluoroalkyl and polyfluoroalkyl substances (PFAS), as environmentally persistent pollutants, have emerged as critical global public health concerns due to their widespeard exposure and health hazards. This review systematically summarizes recent advances in PFAS exposure pathways, internal exposure biomarkers, and multi-system toxicological effects. Environmental monitoring data revealed that PFAS are prevalent in aqueous environments, food matrcies, indoor dust, and other media through industrial emissions, with short-chain and fluoroether alternatives showing significant increases. Human biomonitoring indicated that serum Perfluorooctanesulfonic acid and Perfluorooctanoic acid are primary exposure biomarkers, while urine and breast milk effectively reflect internal exposure levels, with children exhibiting higher exposure levels than adults. Epidemiological and toxicological studies demonstrated associations between PFAS exposure and liver injury, cardiovascular diseases, reproductive dysfunction, immune suppression, and neurological permeability. Existing evidence suggested that health risks of PFAS alternatives still required long-term assessments. Future research should prioritize source regulation, longitudinal cohort studies, and targeted prevention strategies to mitigate PFAS-related health impacts with scientific evidences.

Objective To investigate the effectiveness of influenza vaccine among school-age students, and provide scientific data for influenza prevention and control in schools. Methods A total of 9 506 students aged 3-17 years were enrolled via the “School Registration System”. Students’ influenza vaccination records for autumn and winter in 2022 were collected through the “Zhejiang Provincial Immunization Program Information System”. The influenza diagnosis information was obtained through the “Chinese Center for Disease Control and Prevention Information System”. The epidemiological analysis was carried out on the influenza vaccination and incidence. The influenza incidence among different age groups and the influenza incidence between vaccinated and unvaccinated groups were compared. The influenza vaccine effectiveness and its index were calculated. Results In the autumn of 2022, a total of 9 506 students received vaccinations, achieving a vaccination rate of 11.32%. Concurrently, the influenza incidence was 7.25%. The influenza incidence peaked (10.82%) in the group (aged 3-5 years), showing a downward trend with the increase of age (χ2=1 572.98, P<0.001). The incidence was 3.53% in the vaccinated groups and 7.73% in the unvaccinated groups, with statistically significant difference (χ2=220.275, P<0.001). The rate of influenza vaccine effectiveness was 54.33% (51.11%-60.90%). In the group (aged 3-5 years), the influenza vaccine effectiveness was the weakest. and it advanced with the increase of age, reaching a steady condition after 12 years old. After receiving the vaccine, the incidence of influnce outbreaks in school decreased by 77.22% compared to 2019. Conclusions The incidence of influenza in schools is quite high, especially in kindergarten and primary school. The influenza vaccine shows favorable effectiveness among school-age students, so it is recommended to vaccinate as early as possible in epidemic season.

Objective To explore the characteristics of hospitalized injury cases among primary and secondary school students in Laishan District from 2021 to 2024, and to provide a basis for formulating injury prevention and control policies and measures for targeted population. Methods Data of hospitalized injury cases of primary and secondary school students from 2021 to 2024 from Shandong “Injury hospitalization Information Management” subsystem were collected. Descriptive statistical analysis was conducted on demographics (gender, age), injury causes, times, location, nature, body parts affected, outcomes, hospitalization duration, and costs. Results A total of 1 264 cases (6.3% of all injury hospitalizations) were included, with a male-to-female ratio of 2.48∶1. The highest proportion occurred in the 6-11 age group (43.67%). Accidental injuries predominated (98.90%), primarily falls (71.30%), traffic accidents (11.24%), and sports/recreational injuries (5.06%). Blunt force injuries (84.25%) were the most common mechanism. Temporal analysis revealed a summer peak (32.91%) and daily peaks at 8:00-10:00 AM and 14:00-17:00 PM. Injuries primarily occurred in schools (35.36%), residences (31.41%), and roads/streets (19.54%). The upper (52.77%) and lower limbs (35.84%) were the most frequently injured, with fractures (72.15%) being the predominant injury type. The median hospitalization duration was 7 days (5-14), and median cost was 14 100 CNY (8 800-20 100 CNY), totaling 19.1672 million CNY. Conclusions Hospitalized injuries among primary and secondary school students in Laishan District exhibit distinct gender and spatiotemporal characteristics, with males at higher risks and falls and traffic accidents as leading causes. It is necessary to establish a four-dimensional prevention and control system targeting time, location, population, and mechanisms to mitigate these risks.

Objective To analyse the trend and epidemiological characteristics of tuberculosis cases in schools from 2012 to 2022, and to provide reference for the prevention and control of tuberculosis outbreaks in schools. Methods Tuberculosis cases among students in “Nanchang were enrolled via the National Tuberculosis Information Management System”. The χ2 test, ANOVA, and spatio-temporal analysis were used to analyse the epidemiological characteristics. Results A total of 2 429 tuberculosis cases among students were recorded in Nanchang from 2012 to 2022, with the average annual registered prevalence rate of 14.86/100 000, showing overall wave-like variations. The prevalence among male students was higher than that of female students (P<0.01). The age of onset was concentrated in the range of 15-20, while the incidence of tuberculosis outbreaks mainly peaked in both spring and autumn. There were statistically differences in the proportion of tuberculosis cases among students across different regions (χ2=614.16, P<0.01). The proportion was the highest in the Honggutan District, at 11.55%, while those in Nanchang County and Anyi County were relatively lower, at 2.41% and 1.61% respectively. Conclusions The prevalence of tuberculosis in schools in Nanchang is in a critical situation, with obvious differences in gender and regions. Therefore, prevention and control work should be strengthened among key populations and high-prevalence.

Objective To analyze the epidemiological characteristics of reported hand-foot-mouth disease cases in Chengguan District, Lhasa, and to provide a basis for scientific prevention and control strategies. Methods Data of hand-foot-mouth disease were collected between 2020 and 2024 from the “Infectious Disease Reporting Information Management System” in Chengguan District. The χ2 tests were used for comparisons between groups. Results A total of 3 322 hand-foot-mouth disease cases were reported, with an annual incidence of 146.84/100 000. Males (1 856 cases) were more frequently affected than females (1 466 cases), with a higher annual incidence rate in males (153.67/ 100 000 vs 139.02/100 000, χ2=8.234, P=0.004). Preschool children (1 820, 54.79%) and children ≤5 years old (2 491, 74.98%) were the main affected groups, showing decreasing incidence in older age groups. Bimodal distribution pattern were observed in 2021 and 2024, while unimodal peaks occurred in other years, with overall peaks in May-July and September-November. A total of 212 cases were confirmed through laboratory tests, accounting for 6.38%, including 88 Cox A16-positive (41.51%), 64 other enteroviruses-positive (30.19%), and 60 EV71-positive (28.30%) cases. Conclusions Hand-foot-mouth disease in Chengguan District predominantly affects children≤5 years old, with distinct seasonal peaks in spring/summer and autumn. The proportion of laboratory-confirmed cases is relatively low. Strategies should prioritize high-risk seasons, intensify preschool institution monitoring, promote vaccination in infants, and strengthen enterovirus type-specific tracking.

Objective To analyze the epidemiological characteristics of tuberculosis and the awareness of core information among students in Zibo, and to provide basis for evaluating the effect of tuberculosis prevention and control in schools and formulating more effective measures. Methods The data of cases records were obtained from “China Information System for Disease Control and Prevention” during 2018 to 2023. A total of 2 858 students from 71 classes of 18 schools were enrolled and surveyed with multi-stage stratified cluster sampling method. The results of awareness were analyzed by descriptive epidemiological methods. Curve regression trend test was adopted to analyze annual trends of tuberculosis incidence. Both the χ2-test and Fisher’s exact probability method were applied to analyze the intergroups differences in both the patients’ source and the awareness of core information. Results A total of 427 cases among primary, secondary, and tertiary students, as well as college students, were registered as tuberculosis patients in Zibo, with an average annual prevalence of 9.24/100 000, showing a trend of first rising and then falling (F=47.843, P=0.041). The gender ratio of men and women was 1.41∶1, and patients aged 15 years or older accounted for 95.32%. The incidence peaked in both July and May. Patients sourced from tracking and referral accounted for 88.29%, and the proportion of tracking increased year by year (F=13.165, P=0.022). The total awareness rate of the five core information for tuberculosis prevention was 93.74%, and the full awareness rate was 76.22%. Students of 22.60% were aware of 3-4 items, and 1.18% were aware of less than 3 items. The total awareness rate and the full awareness rate of students among college (χ2=12.153,13.749, P<0.001), non-boarding schools (χ2=15.451,23.414, P<0.001) and from other provinces (χ2=26.390, 20.513, P<0.001) were relatively high. Conclusions The tuberculosis epidemic among students in Zibo is at a low incidence level, and the awareness of core information on tuberculosis prevention and control is relatively good. But the implementation quality of routine prevention and control measures, such as health education and physical examination still needs to be improved. Special attention should be paid to students aged 15 and above and those in boarding school students.

Objective To investigate the monitoring results of vaccination coverage of the 2023 National Immunization Program (NIP) in Zhumadian, and to evaluate the monitoring quality of vaccination coverage in Zhumadian. Methods Data of the NIP’s vaccination coverage in Zhumadian were collected via the “Henan Provincial Immunization Planning Information Management System”. The estimated vaccination coverage, differences (D), ratios (R), and dropout rates were calculated for evaluation. Results The data completeness and timeliness of the 2023 report on the NIP vaccination coverage were both recorded (100.00%). The reported vaccination coverage of the NIP vaccines across the city ranged from 93.10% to 98.24%, while the estimated vaccination coverage was between 69.89% and 90.92%. The D-value evaluation of HepB in Zhumadian was suspicious, while the remaining 7 D-value evaluations were all unreliable. The R-value evaluation of R1(3MMR1/PV1-3), R2(DTP2/PV3), R3(MMR1/JE1), and R4(DTP4/HepA) was considered reliable, while R5(DT/MenA+C2) was considered suspicious. The dropout rate of hepatitis B vaccine, poliomyelitis vaccine and DPT vaccine was evaluated as reasonable. Conclusions In 2023, the reported vaccination coverage of NIP vaccine in Zhumadian is at a relatively high level. However, there is an issue of low reliability in the vaccination coverage reports. It is necessary to further improve the quality of the monitoring report of NIP vaccine vaccination coverage in Zhumadian City.

Objective To investigate the current status of hypertension prevalence, awareness, and control among permanent residents in Baoying County and analyze the factors, and to provide references for the prevention and treatment of hypertension. Methods Based on the 2019 Chronic Diseases and Sociodemographic Factors Survey in Baoying, a cross-sectional study was conducted. A total of 9 970 permanent residents aged 15 and above in Baoying were enrolled with a multi-stage sampling method. Both questionnaire surveys and physical measurements were carried out by trained investigators, with 9 770 people actually finished the questionnaire survey and physical examination. A total of 9 764 valid questionnaires were collected. Statistical analysis was performed using SPSS 20 software. Differences between groups were analyzed using the χ2 test. Trends and factors were analyzed using the trend χ2 test and a multivariate logistic regression model, respectively. Results The prevalence of hypertension among the surveyed residents was 35.19% (3 436 individuals), with a standardized rate of 18.61%. The prevalence was higher among males than that among females (χ2=4.84, P=0.028). The awareness and control rates among hypertensive people were 75.29% (2 587 individuals) and 46.07% (1 583 individuals), respectively, with standardized rates of 55.56% and 27.56%, respectively. The multivariate logistic regression model revealed that being aged ≥35 years (OR=3.13-6.25), overweight (OR=1.85) and obesity (OR=2.98), alcohol consumption (OR=1.52), smoking (OR=1.13), and having other chronic conditions (OR=2.55) were risk factors for hypertension, while higher levels of education (OR=0.44-0.77) were the protective factors. Higher awareness rates of hypertension were observed among those aged ≥35 years (OR=2.87-3.90), overweight (OR=1.50) and obese individuals (OR=1.64), and those with other chronic conditions (OR=2.07). The blood pressure control rate was higher in the 65-year-old group (OR=3.84), but lower among overweight (OR=0.86) and obese individuals (OR=0.72). Conclusions The hypertension prevention and control situation among permanent residents in Baoying County remains severe. There aredifferences in the prevalence, awareness, and control among populations with different characteristics. Further efforts are needed to strengthen personalized promotional interventions.

Objective To investigate the application of arterial spin labeling (ASL) perfusion imaging in ischemic white matter hyperintensity at double post-labeling delay (PLD) time of 1.5s and 2.5s. Methods A retrospective analysis was conducted on 130 patients in Jiaozuo People’s Hospital from January 2020 to December 2023. These patients had complete imaging data of MRI non-contrast scan, ASL (PLD=1.5 s) and ASL (PLD=2.5 s), presented with clinical symptoms of cerebral ischemia, as well as showed punctate hyperintense signals in the cerebral matter on the T2FLAIR sequence. A total of 308 lesions in these patients were identified. The normal brain tissue on the contralateral side of the lesions was selected as the control group. The minimum cerebral blood flow (CBFmin) in the lesion area and the contralateral normal area was respectively measured at the workstation, and the differences between the groups and the sensitivity of each examination method were compared. Results There was a significant difference between the CBFmin value in the lesion area and the CBFmin value in the contralateral normal area , when the PLD was 1.5 s (Z=-8.191, P<0.001). There was a significant difference in the CBFmin value between the lesion area and the contralateral normal area when the PLD was 2.5 s (Z=-11.722, P<0.001). The detection rates of hypoperfusion lesions were 69.8%, 83.4%, 93.8%, respectively, showing significant differences, when PLD=1.5 s, PLD=2.5 s, and PLD=1.5 s combined with 2.5 s (χ2=61.559, P<0.001). Conclusions Double PLD scans are helpful to enhance the detection rate of hypoperfusion lesions. The detection rate of PLD=2.5 s was higher than that of PLD=1.5 s.

Objective To analyze the trend of polycyclic aromatic hydrocarbons (PAHs) in air haze (PM2.5) of Zibo, the sources of pollutants and the carcinogenic risks to human health through the monitoring data. Methods From 2021 to 2023, 16 kinds of PAHs in the air were collected by glass fiber filter at two fixed monitoring sites in District A and District B of Zibo every month. The concentration of 16 kinds of PAHs was determined by high-performance liquid chromatography for data analysis. Results Through the analysis of 504 samples, the annual average concentrations were 12.67 ng/m3, 11.36 ng/m3 and 10.97 ng/m3, respectively in District A, while 15.54 ng/m3, 15.27 ng/m3 and 13.49 ng/m3, respectively in the District B. The concentration of PAHs showed an increasing trend in every winter. The incremental lifetime cancer risk (ILCR) of the children group in the two districts (District A: (3.77~6.57) × 10-7, District B: (4.84~7.36) × 10-7) was lower than that of the adult group (District A: (5.26~9.16)× 10-7, District B: (6.75~10.3)×10-7). In 2021, the ILCR of the adult group in the District B was higher than the threshold of 1.0×10-6, while the values of both groups were lower the threshold of 1.0×10-6 during the rest of the time. The main sources of PAHs in the area were the combustion of gasoline, coal and biomass. Conclusions The air PAHs pollution in Zibo is showing a decreasing trend year by year. The concentration of benzopyrene is relatively high, and there are an obvious changes between the heating season and the non-heating season. ILCR showed that PAHs in the air of this area only posed potential carcinogenic risk in the adult group in District B in 2021, and the carcinogenic risk to humans was negligible for the rest of the time.

Objective To investigate and analyze a case of coupled death in a child with Severe Combined ImmunoDeficiency Disease (SCID) after vaccination with BCG vaccine,and summarize the experience of prevention and treatment work. Methods Collect relevant information on the patient’s medical visit,vaccine the vaccinators and the vaccine recipients, and organize an investigation and diagnosis of abnormal reactions to vaccination. Results Children with immunodeficiency were not screened in a timely manner to detect and avoid vaccination with BCG vaccine;Early symptoms of SCID in pediatric patients have not been taken seriously;commercial supplementary insurance for vaccination provides compensation to a certain extent. Conclusions Early detection of neonatal immunodeficiency during BCG vaccination is crucial; we need to strengthen the proactive follow-up work after neonatal BCG vaccination; developing safer BCG vaccines. At the same time, we will increase the promotion of commercial supplementary insurance for suspected adverse reactions to vaccination (AEFI) and improve the compensation process.

The capability-opportunity-motivation behavior (COM-B) model provides a systematic lens to dissect the multidimensional factors influencing self-management in gastroesophageal reflux disease patients. This framework posits that behaviour change requires synergistic interactions among three core components of capability, opportunity, and motivation. Capability-related factors included physiology, knowledge, psychology, lifestyle and medication compliance, etc. Opportunity-related factors included economic culture, social support, life pressure and healthcare accessibility, etc. Motivation-related factors included disease experience, self-efficacy, while these are the two key factors for stimulating the motivation of self-management. Therefore, this COM-B-driven analysis proposes strategies to enhance capacity, stimulate motivation, and create optimization opportunities for more future precise support.