Objective To analyze the main abnormal health indicators in the admission physical examination of college freshmen and their health status, and to provide basis for enhancing health education and medical security. Methods A total of 6 875 enrolled freshmen from a university in September 2024 underwent admission physical examinations. Data of students’ body height, body mass, blood pressure, heart rate, blood routine, and biochemical tests were collected and their physical examination results were analyzed. Statistical comparisons were performed to evaluate differences of detection rates of overweight/obesity, abnormal liver function, anemia, and hyperlipidemia across genders and academic categories, and weight groups. Results The detection rates ranked as follows: overweight/obesity (12.26%), abnormal liver function (6.14%), anemia (4.84%), hypercholesterolemia (2.67%), hypertriglyceridemia (1.57%), elevated creatinine (1.44%), hypertension (1.13%), abnormal electrocardiogram (0.90%), and hyperglycemia (0.87%). The detection rates of overweight/obesity, abnormal liver function, hypercholesterolemia, hypertriglyceridemia, hypertension, abnormal electrocardiogram, and hyperglycemia were significantly higher in male students than those in female students (P<0.05). The detection rate of anemia was significantly higher in female students than that in male students (P<0.05). The detection rates of overweight/obesity, hypertension, and abnormal electrocardiogram were significantly higher in undergraduates than those in postgraduates (P<0.05). The detection rates of hypercholesterolemia and hypertriglyceridemia were significantly higher in postgraduates than those in undergraduates (P<0.05). The detection rates of abnormal liver function, hypercholesterolemia, hypertriglyceridemia, hypertension, and hyperglycemia were significantly higher in the overweight/obesity group than in the normal weight group (P<0.05). Conclusions The results in this university exhibited notable prevalence of nutritional, metabolic, and cardiovascular abnormalities among students. The metabolic problems including abnormal liver function, hyperlipidemia are serious among male students, especially for overweight/obesity group, while the anaemia emerges as a critical issue among female students. Targeted interventions should prioritize weight management, metabolic monitoring, and gender-specific health strategies.

Objective To investigate the relationship between cyberbullying and suicidal ideation in college students, and explore the mediating role of rumination and the regulatory effect of uncertain psychological stress, and to provide scientific basis for prevention and intervention of suicidal ideation in this population. Methods A convenience sampling method was used to survey on the cyberbullying experiences, rumination, suicidal ideation, and uncertain psychological stress among undergraduate students in 12 full-time ordinary universities in Xuzhou during September to October 2023. A latent variable structural equation model was constructed to analyze the mediating effects and moderating effects. Results Significant differences in suicidal ideation scores were observed across gender, sexual orientation, and annual family income (P<0.01). Significant positive correlations were found among cyberbullying, rumination, and suicidal ideation. The latent variable structural equation modeling demonstrated significant direct effects of cyberbullying on both suicidal ideation (β=0.428, P<0.05) and rumination (β=0.579, P<0.05). Rumination mediated the relationship between cyberbullying and suicidal ideation (indirect effect β=0.183, P<0.01), accounting for 30% of the total effect. Uncertain psychological stress significantly moderated this mediation model (P<0.01), with the cyberbullying-suicidal ideation association being stronger under high stress conditions (β=0.366, P<0.001) than under low stress conditions (β=0.247, P<0.001). Conclusions Both cyberbullying and rumination significantly predict suicidal ideation, with rumination functioning as a partial mediator. Uncertain psychological stress moderates this relationship, demonstrating that the associations between cyberbullying and suicidal ideation strengthens with increasing stress levels. Therefore, targeted interventions for cyberbullied college students should prioritize rumination reduction while implementing stress management training to mitigate uncertain psychological stress, which is crucial for preventing suicidal ideation development.

Objective To investigate the associations between hobbies/interests and mental health issues, including depression, anxiety, and stress among adolescents in Fujian. Methods A cross-sectional survey was conducted using a multi-stage stratified cluster random sampling method to examine their hobbies/interests as well as mental health issues including depression, anxiety, and stress in Fujian. The χ2 tests were utilized to compare the distribution differences in depression, anxiety, and stress, while logistic regression analysis was applied to explore the associations between hobbies/interests and depression/anxiety. Results A questionnaire survey was conducted among 58 174 students from 110 secondary schools across 55 counties (cities, districts) in 6 prefecture-level cities of Fujian. Among them, 33 972 (58.4%) were junior high school students and 24 202 (41.6%) were senior high school students. The results showed that 18.5% of the students exhibited varying levels of depressive symptoms, while 21.9% reported varying levels of anxiety symptoms. Regression analysis indicated that having positive and beneficial hobbies served as protective factors against depression (OR= 0.756, 95%CI: 0.711-0.803), anxiety (OR=0.730, 95%CI: 0.689-0.774) and stress (OR=0.680, 95%CI:0.626-0.739). Conclusions Engaging in hobbies and interests is correlated with adolescent depression, anxiety, and stress, among other psychological conditions. Schools can help safeguard and enhance students’ mental health by fostering positive and beneficial interests.

Objective To investigate the prevalence and changing trends of myopia and high myopia among children and adolescents in Sichuan from 2021 to 2024, and to provide a basis for policy formulation. Methods From 2021 to 2024, 183 districts (counties) in 21 cities (prefectures) of Sichuan were designated as monitoring sites. Nine schools (kindergartens, primary and secondary schools) were selected in each district, and seven in each county, with a stratified cluster sampling method. At least 80 students from each grade of each school were enrolled for vision screening. The myopia and high myopia rate were analyzed using Chi-square tests for changing trend. Results During this period, the detection rates of myopia among children and adolescents in Sichuan were 51.4%, 47.8%, 47.4%, and 46.7%, respectively, showing a significant downward trend (χ2=1 294.893, P<0.001), with an average annual percent change range of -1.6. The detection rates of high myopia were 4.8%, 4.4%, 3.8%, and 3.9%, respectively, showing a downward trend (χ2=413.033, P<0.001), with an average annual percent change range of -0.3. In both genders, stratified analysis revealed consistent downward trends of myopia (Male: χ2=604.863, P<0.001; Female: χ2=711.790, P<0.001), with an average annual percent change range of -1.5 and -1.6, and girls exhibited higher myopia rate than that among boys in each year (χ2=1 004.078, 1 321.610, 1 244.378, 1 307.335, all P<0.001), as well as the high myopia (Male: χ2=149.029, P<0.001;Female: χ2=272.354, P<0.001), with an average annual percent change range of -0.2 and -0.4, and girls exhibited higher high myopia rate than that among boys in each year (χ2=71.301, 69.574, 54.266, 31.521, all P<0.001). Stratified analysis by educational stage showed that the detection rate of myopia in preschool, primary school and junior high school stages showed a downward trend (χ2=181.504, 186.019, 224.029, all P<0.001), while it showed an increasing trend in the senior high school (χ2=204.661, P<0.001). The average annual percent changes were -1.4,-0.8,-1.2 and +1.0, respectively. The detection rates of high myopia in preschool, primary school, and junior high school showed a fluctuating downward trend (χ2=6.779, 27.538, 52.228, all P<0.01), with an average annual percent change range of -0.02, -0.02, -0.17, respectively, while no statistically significant differences were observed in the senior high schools (χ2=0.114, P=0.736). Conclusion Although overall myopia prevalence in Sichuan’s children and adolescents has declined, the rising trend among senior high school students warrants urgent attention.

Objective To understand the mental health status and influencing factors of college students during the normalized COVID-19 prevention and control period. Methods From March to May 2024, a cross-sectional survey was conducted using a stratified cluster sampling method among students from four universities in Xuzhou. A self-designed questionnaire, combined with the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) was used to collect data. Univariate and multivariate ordinal logistic regression were applied to identify influencing factors. Results A total of 789 valid questionnaires were collected. Of the respondents, 27.5% and 37.77% exhibited varying degrees of anxiety and depression, respectively. Urban residence (OR=0.656, 95%CI：0.469-0.918) and medical major (OR=0.677, 95%CI：0.484-0.948) were protective factors against anxiety, while having sequelae (OR=2.069, 95%CI：1.411-3.034) and holding negative attitudes (OR=2.277, 95%CI：1.623-3.196) were risk factors. Similarly, medical major (OR=0.659, 95%CI：0.482-0.901) was a protective factor against depression, whereas sequelae (OR=1.539, 95%CI：1.103-2.147) and holding negative attitudes (OR=2.010, 95%CI：1.478-2.729) were risk factors. Conclusions A certain proportion of college students experience anxiety and depression. Particular attention should be paid to the psychological status of students who are non-medical majors, from rural areas, have sequelae, or hold negative attitudes.

Objective To explore the characteristics of dietary and physical activity behavioral patterns among senior primary school students in Shanghai and their associations with prevalence of overweight and obesity, and to provide evidence for targeted intervention strategies. Methods A total of 5 781 students (grade 4-5) from 32 schools in 16 districts of Shanghai were enrolled from September to November 2023, with a stratified random cluster sampling method. Dietary and physical activity behavior patterns, as well as demographic characteristics were collected through questionnaires. Height and weight were measured through physical examinations. Students were classified into 4 groups based on BMI: underweight, normal weight, overweight, and obesity. Latent class analysis (LCA) was used to identify different dietary and physical activity behavioral patterns. Multivariate logistic regression was used to analyze the associations between dietary and physical activity patterns and prevalence of overweight and obesity. Results The prevalence of overweight and obesity among senior primary school students in Shanghai was 37.54% (overweight 16.97%, obesity 20.57%), with a higher prevalence among boys and students whose parents had lower educational attainment. Through LCA, students were divided into four groups of dietary and physical activity behavioral patterns. Compared with “healthy group”, the “high-energy food and low-activity” group, characterized by higher comsumption of sugar-sweetened beverages and fried foods and lower physical activity levels, exhibited a higher risk of overweight and obesity (OR=1.43, 95%CI: 1.19~1.72). Conclusion Unhealthy dietary and physical activity behavioral patterns significantly increase the risk of overweight and obesity among senior primary school students.

Objective To learn the current situation of sleep insufficiency and related influencing factors among senior-high school students in Shanghai, and to provide a basis for developing the corresponding intervention strategies. Methods Using multi-stage randomized cluster sampling, students from two senior-high schools in each of the 16 districts in Shanghai were enrolled in 2023.Students were surveyed with questionnaire of “2023 Shanghai Students’ Common Diseases and Health Factors Monitoring and Intervention” program. Data on students’ sleep time, academic performance, and family economic status were collected. Results A total of 8 779 valid samples were taken, among which 96.5% of the students suffered from sleep insufficiency. The prevalence of sleep insufficiency was lower in male students than female students (95.4% vs. 97.7%, χ2=33.554, P<0.05). Multivariate logistic regression analysis showed that in male students, students with excellent academic performance, those with outdoor activity time <1 h, and no daily use of mobile electronic devices as the reference group, respectively. The following group had a higher risk of sleep insufficiency: In female students (OR=1.781, 95%CI: 1.370-2.316), students with moderate to high academic achievement (OR=1.644, 95%CI: 1.083-2.494), those with outdoor activity time of 1- <2 h (OR=2.725, 95%CI: 2.013-3.688), 2- <3 h (OR=1.721, 95%CI: 1.154-2.566), ≥3 h (OR=1.541, 95%CI: 1.039-2.286), and those with daily use of mobile electronic devices (OR=2.969, 95%CI: 2.319-3.800). Conclusions Sleep insufficiency is a severe issue among high school students in Shanghai, with gender, academic performance, outdoors duration, and daily use of electronic devices being the main influencing factors. Schools, and students should take appropriate measures to improve the sleep insufficiency.

Objective To explore the association between recent life stress events, health literacy and depression/anxiety symptoms among college students, and to provide basis for the prevention and control of depression and anxiety symptoms in college students. Methods A total of 7 617 freshmen from two universities in Jiangsu and Anhui were enrolled with a cluster sampling method. Recent life stress events, health literacy and depression/anxiety were evaluated by the Adolescent Life Events Self-Assessment Scale (ASLEC), the Chinese Adolescent Interactive Health Literacy Questionnaire (CAIHLQ), the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder Scale (GAD-7). Spearman correlation and hierarchical regression were conducted to explore variable relationships. Results The detection rates of depression and anxiety symptoms among college students were 49.9% and 34.9%, respectively. Correlation analysis revealed that recent life stress events were positively correlated with depressive and anxiety symptoms (r=0.62, 0.59, both P<0.001), while health literacy was negatively correlated with both (r=-0.42, -0.37, both P<0.001). Hierarchical regression analysis indicated that the interaction term between life stress events and health literacy had a significant negative predictive effect on depression and anxiety symptoms (β=-0.33, -0.40, both P<0.001). Conclusion Recent life stress events are risk factors for depression and anxiety, and health literacy can mitigate the adverse impact of recent life stress events on depression and anxiety in college students.

Objective To learn the nutritional status and influencing factors of secondary school students in Shanghai, and to provide a basis for the scientific prevention and control strategies. Methods A cross-sectional study design employing multistage cluster random sampling, students from 2 junior schools, 2 high schools, and 1 vocational high school from 16 districts in Shanghai were selected from September to November 2023.Questionnaires were surveyed with the project of “Monitoring and Intervention of Common Diseases and Factors Affecting the Health of Students in Shanghai in 2023” (Partial), which was combined with the physical examinations to collect information on basic information, dietary and exercise behaviors, smoking and drinking behaviors, height and weight. The chi-square test was used for univariate analysis, and the multivariate logistic regression model was used to identify the independent influencing factor on the nutritional status of secondary school students. Results A total of 21 435 valid samples were enrolled, and the detection rates of wasting, overweight, and obesity among secondary school students in Shanghai were 6.97%, 17.80%, and 17.81%, respectively. Significant differences in nutritional status were observed by different genders (χ2=962.20, P<0.001) and school stages (χ2=44.56, P<0.001). Multivariate logistic regression analysis showed that females had lower risks of wasting (OR=0.53, 95%CI:0.48-0.60), overweight (OR=0.47, 95%CI:0.43-0.51), and obesity (OR=0.34, 95%CI:0.32-0.37) compared to males. High school students had a higher risk of wasting than junior high school students (OR=1.35, 95%CI:1.19-1.52). Compared to never drinking sugary beverages in the past 7 days, sugary beverages were a risk factor for obesity in secondary school students both <1 time/day (OR=1.17, 95%CI:1.03-1.32) and≥1 time/day (OR=1.24, 95%CI:1.07-1.44). Compared with no fresh fruit consumption per day, 1 kind/day (OR=1.36, 95%CI:1.01-1.84) and ≥3 kinds/day (OR=1.44, 95%CI:1.05-1.98) had a higher risk of wasting. The 2 kinds/day of fresh fruit increases the risk of overweight (OR=1.25, 95%CI:1.01-1.53). The≥3 kinds/day of fresh fruit consumption was a common risk factor for overweight (OR=1.25, 95%CI:1.00-1.56) and obesity (OR=1.26, 95%CI:1.02-1.56). The risk of wasting was low (OR=0.71, 95%CI:0.57-0.89) for≥1 kind/day dairy consumption in the past 7 days compared to no daily dairy consumption. Compared with no moderate-intensity exercise in the past 7 days, the risk of wasting was lower for 1 to 4 days/week (OR=0.81, 95%CI: 0.70-0.94) and≥4 days/week (OR=0.61, 95%CI: 0.52-0.72) of moderate-intensity exercise; and the risk of obesity was lower for≥4 days/week of moderate-intensity exercise (OR=0.81, 95%CI: 0.72-0.91). Secondary school students who do not drink alcohol have a higher risk of weight loss (OR=1.19, 95%CI: 1.03~1.38) and a lower risk of obesity (OR=0.84, 95%CI: 0.77~0.93). Conclusions Undernutrition and overnutrition coexist in Shanghai secondary school students, in which overweight and obesity are prominent. The nutritional status of this population is correlated with dietary and exercise behavioral habits, and targeted interventions should be taken to effectively improve adolescent nutritional health.

Objective To develop a standardized and clinically feasible semi-structured play-based assessment protocol for the Childhood Autism Rating Scale (CARS) tailored to the psychological and behavioral characteristics of Chinese children and outpatient practice settings, and to validate its reliability and validity in children with Autism Spectrum Disorder (ASD). Methods Based on the diagnostic criteria for ASD outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and the assessment items of CARS, core play-based evaluation dimensions were identified. Game types, toy selections, and operational protocols were designed with reference to play-setting guidelines and the Autism Diagnostic Observation Schedule (ADOS). Content validity was assessed via expert panel reviews. From September 2020 to December 2024, 713 ASD children aged 2-6 years were recruited across five clinical centers to evaluate the reliability and validity of the developed semi-structured play-based CARS protocol. Results The semi-structured play-based assessment protocol was established under the iterative reviews by 10 experts. The results demonstrated a good internal consistency (Cronbach’s α=0.73) and inter-rater reliability (Kappa=0.85). Kruskal-Wallis tests revealed statistically significant differences in CARS total scores across diagnostic severity levels (P<0.05). Conclusion The semi-structured play-based CARS protocol exhibits strong reliability and validity for ASD assessment in clinical settings, supporting its broader implementation in practice.

Objective To analyze the epidemiological characteristics, development trends, and influencing factors of injury-related behaviors among primary and secondary school students in Liaoning from 2020 to 2023, and to provide scientific strategies and basis for the further prevention and control of injury-related behaviors. Methods A multi-stage stratified cluster sampling approach was employed to investigate the prevalence of injury-related behaviors among students enrolled in Liaoning during 2020 to 2023.Rigorous analyses were carried out for the distribution characteristics, development trends, and the influencing factors. Results From 2020 to 2023, the overall reporting rate of injury-related behaviors among primary and secondary school students in Liaoning was 24.5%. The reporting rate of daily unintentional injuries was 16.9% (including 16.0% for walking violations and 0.9% for non-safe swimming). The reporting rate of family bullying/violence, serious injuries, school bullying was 9.0%, 2.2%, and 1.3%, respectively. Multivariate analysis revealed that for serious injuries, rural areas (OR=0.92, 95%CI: 0.87-0.98, P=0.010) and female (OR=0.59, 95%CI: 0.55-0.62, P<0.001) were protective factors, while higher grades (junior high school: OR=1.16, 95%CI: 1.08-1.25, P<0.001; senior high school: OR=1.65,95%CI: 1.52-1.78, P<0.001) were identified as risk factors. Regarding school bullying, female (OR=0.71, 95%CI: 0.66-0.77, P<0.001) and non-boarders (OR=0.74, 95%CI: 0.67-0.82, P<0.001) were protective factors, while higher grades (junior high school: OR=1.2, 95%CI: 1.13-1.38, P<0.001; senior high school: OR=1.43, 95%CI: 1.29-1.59, P<0.001) were risk factors. For walking violations, female (OR=0.84, 95%CI: 0.82-0.86, P<0.001) was a protective factor, while non-boarders (OR=1.20, 95%CI: 1.15-1.24, P<0.001) and higher grades (junior high school: OR=1.16, 95%CI: 1.13-1.20, P<0.001; senior high school: OR=1.30,95%CI: 1.26-1.34, P<0.001) were risk factors. For non-safe swimming, female (OR=0.66, 95%CI: 0.60-0.72, P<0.001), non-boarders (OR=0.66, 95%CI: 0.58-0.75, P<0.001), and junior high school (OR=0.87, 95%CI: 0.78-0.98, P=0.017) were protective factors. For family bullying/violence, female (OR=0.82, 95%CI: 0.79-0.84, P<0.001) and higher grades (junior high school: OR=0.78,95%CI: 0.76-0.81, P<0.001; senior high school: OR=0.40, 95%CI: 0.39-0.42, P<0.001) were protective factors, while non-boarders (OR=1.46,95%CI: 1.38-1.55, P<0.001) was a risk factor. Conclusions Injury-related behaviors among students in Liaoning showed a downward trend from 2020 to 2023.Males, urban areas, and primary schools were the primary at-risk groups, with daily unintentional injuries being the most prevalent. In response to the factors influencing the prevalence of these injuries, corresponding prevention, control, and intervention measures should be prioritized to safeguard the healthy growth of students.

Objective To investigate the current status of overweight and obesity and analyze its related influencing factor among primary and secondary school students in Shanghai, and to provide a scientific basis for the education departments, health institutions, and school administrators to formulate targeted and effective intervention strategies. Methods A multi-stage cluster sampling method was adopted among 41 451 students from 118 primary and secondary schools in Shanghai. Height and weight measurements were conducted by trained professionals to calculate BMI, with overweight and obesity defined according to standards. A questionnaire survey was conducted to assess school health work. Chi-square tests and bivariate logistic regression analysis were performed to analyze associations between school health work and overweight and obesity among students. Results The overall detection rate of overweight and obesity among primary and secondary school students in Shanghai is 34.2%. The results showed that the absence of psychological counseling services (OR=1.35, 95%CI: 1.18-1.55), lack of overweight and obesity prevention initiatives (OR=1.16, 95%CI:1.08-1.25), insufficient physical education class (OR=1.17, 95%CI:1.02-1.34), and infrequent school sports events (OR=1.07, 95%CI:1.02-1.12) were risk factors for students’ overweight and obesity. Conclusions Multiple school health-related factors are significantly associated with the risk of overweight and obesity among primary and secondary school students in Shanghai. It is necessary to implement targeted measures for different factors, the school environment should be optimized to reduce the prevalence of overweight and obesity among students and promote their healthy growth.

Objective To investigate the growth levels and patterns of vital capacity among primary and secondary school students aged 6-17 years in Changzhou in 2024, and to establish growth curves and percentile reference values of vital capacity in healthy children and adolescents. Methods In 2024, a total of 13 276 primary and secondary school students in Changzhou were enrolled to measure the vital capacity, with a stratified random cluster sampling method. Correlations between vital capacity and age were analyzed by Spearman’s rank correlation. Gender differences of vital capacity across different age groups were analyzed by t-test or Wilcoxon rank sum tests. The LMS method was employed to build percentile reference values and growth curves of vital capacity by gender and age, and comparisons were made with data from other regions. Results The measured P50 values of vital capacity for boys and girls aged 6-17 in Changzhou ranged from 1 068.50 to 4 286.00 mL and 996.00 to 2 984.00 mL, respectively. Vital capacity increased with age in both genders (all P<0.01). Vital capacity in boys was higher than that in girls across all age groups (all P<0.01). The constructed growth curves of vital capacity for boys and girls had similar shapes, showing gender differences. The peak growth period of vital capacity occurred at 12-14 years in boys and 9-11 years in girls. Conclusion The percentile curves and reference values of vital capacity constructed by LMS method in this study can provide reference for evaluating the growth levels of vital capacity among healthy children and adolescents in Changzhou.

Objective To investigate the current status of influenza vaccination and the monitoring of Adverse Events Following Immunization (AEFI) after vaccination in Fuzhou from 2021 to 2023, and to provide a scientific basis for influenza prevention and control and optimization of immunization strategies. Methods Data of influenza vaccination from the Fujian Provincial Immunization Program Information Management System (2021-2023), and AEFI case information reported after influenza vaccination in the National Immunization Program Information System were collected. The population data from the same period, a statistical analysis was conducted for influenza vaccination rate and AEFI reporting incidence rate in Fuzhou City. Results From 2021-2023, the average reported influenza vaccination rate of population was 1.86%, showing an upward trend year by year (χ²=28 327.63, P<0.05). During the three years, the average vaccination rate was the highest in Taijiang District (4.82%) , while the lowest was in Minqing County (1.12%). The vaccination rate in different age groups exhibited significant significance (χ²=1 726 452.40, P<0.05), with the highest rate in the 6 months to <3 years old group, followed by the 3 to <7 years old group, and the lowest in the 18 to <60 years old group. Totaling 60 AEFI cases were reported during 2021-2023, with the majority being general reactions (98.3%). The AEFI reporting incidence rates in all counties (cities/districts) remained at a relatively low level (1.35/10 000 doses), with no statistically significant differences among 12 counties/city/districts (χ²=15.72, P=0.15). The reported incidence of AEFI showed an upward trend year by year(χ²=6.74, P<0.05). Conclusion The influenza vaccination rate in 2021-2023 in Fuzhou was low, showing a slow upward trend, and the AEFI reporting incidence rate of the vaccine was low.

Objective To learn the prevalence and influencing factors of scoliosis, myopia, and their comorbidity among primary and secondary school students of Nantong in 2024, and to provide reference for formulating scientific and effective prevention and control measures. Methods From September to November 2024, a stratified random cluster sampling method was used to select 15 179 primary and secondary school students from 7 districts in Nantong for screening scoliosis and myopia. A questionnaire survey was conducted on 11 292 students in grade 4 and above. A total of 11 171 valid questionnaires were collected, with an effective recovery rate of 98.9%. The χ2 test was applied to compare the differences between the groups of scoliosis, myopia and their comorbidity. Multivariate logistic regression was applied to analyze the influencing factors of scoliosis, myopia, and their comorbidity. Results In 2024, the detection rates of scoliosis, myopia, and their comorbidity were 3.81%, 68.36%, and 3.16%, respectively. The comorbidity rate of senior high school students (8.18%) was higher than that of junior high school students (3.79%) and primary school students (0.06%) (χ2= 60.52, 423.67, 126.65, all P<0.001). Multivariate logistic regression analysis showed that an increase in school stage (junior high school, OR=2.02, 95%CI: 1.55-2.64; senior high school, OR=1.93, 95%CI: 1.27-2.95), as well as daily indoor sedentary time > 8 hours in the past week (OR=1.33, 95%CI: 1.01-1.75) increased the risk of scoliosis, myopia, and their comorbidity among primary and secondary school students. Meanwhile, daily daytime outdoor activity time > 2 hours in the past week (OR=0.65, 95%CI: 0.45-0.94) and average daily sleep duration > 8 hours (OR=0.49, 95%CI: 0.36-0.62) reduced the comorbidity risk. Conclusion The prevalence of scoliosis, myopia, and their comorbidity among primary and secondary school students in Nantong is relatively serious. An increase in school stage and sedentary sitting are the risk factors of comorbidity, and sleep for more than 8 hours per day is the protective factor. Further measures should be taken to reduce the academic burden on students, encourage students to increase their weekly outdoor activities, reduce indoor sedentary time, and ensure sufficient sleep time, thereby preventing the occurrence and progression of scoliosis, myopia, and their comorbidity.

Objective To explore the association between weekly Physical Education (PE) class frequency and depressive symptoms among middle school students, and to inform the development of evidence-based policies for promoting adolescent mental health. Methods A stratified random cluster sampling method was employed to survey 71 987 junior and senior high school students in Hubei Province in October 2022. Depressive symptoms were assessed using the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regression and Restricted Cubic Spline (RCS) models were employed to analyze associations, with subgroup analyses stratified by gender, grade level, and sleep duration. Results Among the participants, a total of 22 579 (31.3%) were detected with depressive symptoms. Compared with students attending 1 PE class per week, those attending 2, 3, or more classes per week showed 11% (OR=0.89, 95% CI: 0.86-0.93);15% (OR=0.85, 95% CI: 0.80-0.89);12% (OR=0.88, 95% CI: 0.81-0.96) reductions in depressive symptom risk, respectively. There was a nonlinear dose-response relationship between weekly PE class frequency and depressive symptoms (χ2=33.78, P<0.01). Stratified analyses revealed that attending ≥2 PE classes per week was associated with reduced depressive symptom risk across subgroups stratified by gender, school stage, and sleep duration. Conclusions The frequency of weekly PE classes (≥2 sessions/week) is nonlinearly associated with depressive symptoms in middle school students. Policy interventions optimizing PE curriculum scheduling may serve as a feasible strategy for adolescent depression prevention.

Objective To investigate the current status of screened myopia (referred to as myopia) in lower-grade primary school students in Miluo, Hunan and analyze its association with dietary food groups, and to provide scientific evidence for myopia prevention and control among primary school students. Methods A cluster random sampling method was used to select six primary schools in Miluo City, Hunan Province, in September 2024. Uncorrected visual acuity and refractive error were examined in 789 first- and second-grade students without cycloplegia. Dietary intake and diversity were assessed using the Chinese Dietary Quality Questionnaire, and physical activity was evaluated using the International Physical Activity Questionnaire-Short Form. The myopia rate was calculated, and logistic regression models were used to explore the association between myopia and dietary food groups. Results Among the 789 first- and second-grade students, 157 were diagnosed with myopia, yielding a myopia detection rate of 19.90%. The myopia rates for boys and girls were 21.17% and 18.26%, respectively, with no statistically significant difference (P>0.05). Compared with the normal vision group, myopic students had a lower proportion of poultry and fish and seafood intake (P<0.05). Multivariate logistic regression analysis showed that poultry intake was a protective factor for myopia (OR= 0.57, 95%CI: 0.36-0.90), while intake of unprocessed red meat (non-ruminant) was a risk factor for myopia (OR= 2.03, 95%CI: 1.14-3.59). Conclusions Myopia is a serious issue among lower-grade primary school students in Miluo City. Intake of poultry food might be a protective factor against myopia in primary school students, while intake of non-ruminant meat could be a risk factor.

Objective To investigate the depression, anxiety, and stress status among students in Guangzhou’s technical school, and provide references for technical school to carry out psychological intervention among students. Methods A stratified random cluster sampling method was applied to select 2 087 students from 10 technical schools of Guangzhou in October 2022.The questionnaire survey was conducted using the depression-anxiety-stress scale (DASS-21). The survey focused on the depression, anxiety, and stress status and the influencing factors among students in the past week. Results The scores of depression, anxiety, and stress among technical school students were 2(0.00, 6.00), 2(0.00, 6.00) and 2(0.00, 10.00), respectively. The detection rates of depression, anxiety, and stress were 18.5%, 21.08%, and 10.21%, respectively. The logistic regression analysis showed that students with monthly disposable expenses≥2 000 yuan, those from poor or fair family atmosphere and smokers exhibited higher levels of depression (OR=1.172, 2.741, 1.448, and 1.388, respectively). Similarly, students from poor or fair family atmosphere and smokers had higher anxiety levels (OR = 4.670, 1.877 and 2.037, respectively), as did those with monthly disposable income≥2 000 yuan, poor or fair family atmosphere, and smokers (OR=1.516, 5.406, 1.755, and 2.177, respectively). Third-year students showed lower stress levels (OR=0.625). Conclusions The detection rates of depression and stress among students in technical schools of Guangzhou are relatively low, while the detection rate of anxiety is relatively high. Psychological interventions for these students should prioritize groups such as those from urban areas, families with poor family atmosphere, those with higher monthly disposable income, and smokers.

Objective To explore the associations between dietary patterns and stress, anxiety, and depression among undergraduates and to provide reference for promoting mental health in this targeted population. Methods Using the convenience sampling method, from February to May in 2024, the Depression-Anxiety-Stress Scale (DASS) and a Semi-quantitative Food Frequency Questionnaire were used to collect data on stress, anxiety, depression, and dietary intake among undergraduates at a medical university in Ningxia. Factor analysis was used to extract dietary patterns, and logistic regression was performed to analyze the associations between different dietary patterns and stress, anxiety, and depression. Results A total of 250 undergraduates were surveyed, with a mean age of (20.58 ± 1.68) years; 38.40% were male, 64.00% had normal BMI, 40.40% were sophomores, 86.80% were enrolled in medical majors, 77.20% were non-only children, mean nighttime sleep duration was (7.34±0.96) hours, and mean weekly exercise time was (9.38±9.33) hours. The detection rates of stress, anxiety, and depressive symptoms were 19.60%, 41.60%, and 29.50%, respectively. Six dietary patterns were identified: “staple food-dominant pattern” “balanced pattern” “meat-alcohol-beverage pattern” “processed food pattern” “mushroom-vegetable pattern” and “offal-potato pattern.” After adjusting for confounders, the “meat-alcohol-beverage pattern” was positively associated with stress (OR=5.27, 95%CI: 1.97-14.12), anxiety (OR=2.25, 95%CI: 1.05-4.81), and depression (OR=2.95, 95%CI: 1.35-6.46). The “processed food pattern” was positively associated with anxiety (OR=3.33, 95%CI: 1.53-7.27) and depression (OR=4.02, 95%CI: 1.72-9.39). The “mushroom-vegetable pattern” was negatively associated with anxiety (OR=0.44, 95%CI: 0.21-0.84). The Q3 level of the “staple food-dominant pattern” was negatively associated with stress (OR=0.24, 95%CI: 0.09-0.68) and anxiety (OR=0.38, 95%CI: 0.17-0.83). Both the Q2 level (OR=0.35, 95%CI: 0.15-0.79) and Q3 level (OR=0.25, 95%CI: 0.11-0.60) of the “staple food-dominant pattern” were negatively associated with depression. Conclusions The meat-alcohol-beverage pattern and processed food pattern are risk factors for stress, anxiety, and depression among undergraduates, whereas the mushroom-vegetable pattern and appropriate staple food-dominant pattern are protective factors. Attention to dietary patterns may be an effective approach to promoting mental health in undergraduates.

Objective To analyze the status and influencing factors of cigarette smoking initiation among secondary school students in Nanping, and to provide a scientific basis for targeted cigarette control interventions among students. Methods From August to October 2023, students from six junior- and senior-high schools in Nanping were enrolled with a multi-stage stratified random cluster sampling method and surveyed with questionnaires, covering topics such as smoking behaviors and secondhand smoke exposure. Statistical software SPSS 19.0 was conducted for univariate and binary logistic regression analyses on the influencing factors of students’ cigarette smoking initiation. Results A total of 828 secondary school students were surveyed. The cigarette smoking initiation rate of secondary school students in Nanping was 16.91% (140/828), with boys (20.56%) higher than that of girls (11.45%). The cigarette smoking initiation rate in junior-, senior-, and vocational- high school students was 13.20%, 16.67% and 29.60%, respectively, while the rates were 13.62% for students under 16 years old and 21.73% for those aged 16 years and older, showing statistically significant differences (all P<0.05). Multivariate logistic regression analysis showed that vocational high school (OR=2.35, 95%CI:1.33-4.16), secondhand smoke exposure in indoor public places other than the home (OR=1.79, 95%CI:1.14-2.79), having seen someone smoking in the movie or video within 30 d (OR=1.67, 95%CI:1.07-2.62), having close friend smoking (OR=3.58, 95%CI:2.26-5.67), having teachers who smoke (OR=2.21, 95%CI:1.31-3.74), believing that smoking makes young people more attractive (OR=2.37, 95%CI:1.04-5.40), and believing that they will use tobacco within the coming year (OR=5.66, 95%CI:1.42-22.52) were risk factors for cigarette smoking initiation among secondary school students (P<0.05). Believing that smoking makes young people less attractive (OR=0.61, 95%CI:0.38-0.97), believing that quitting smoking is definitely difficult (OR=0.60, 95%CI:0.37-0.99), and feeling more uncomfortable smoking in social situations (OR=0.55, 95%CI:0.33-0.93) were factors that reduced the risk of cigarette smoking initiation among secondary school students (P<0.05). Conclusions The rate of smoking initiation among secondary school students in Nanping is relatively high in Fujian, which is influenced by factors such as the type of school and secondhand smoking exposure. Targeted measures need to be taken to strengthen tobacco control health education and to guide secondary school students to establish a correct perception of staying away from tobacco.

Objective To understand the associations between blood pressure levels and age, puberty development stage, and nutritional status among primary and secondary students in Shanghai in 2023, and to provide scientific basis for initiating early prevention and control strategies for elevated blood pressure in students. Methods A total of 36 733 primary and secondary school students in Shanghai from September to November 2023 were enrolled with a multi-stage cluster sampling method. Physical examinations were performed to analyze the blood pressure levels and nutritional status. Logistic regression analysis was used to explore the associations between blood pressure and age, puberty development, and nutritional status. Results The detection rate of normal-high and elevated blood pressure among primary and secondary school students in Shanghai was 16.74% and 15.25%, respectively, with both rates being higher in boys than in girls. The detection rate of normal-high and elevated blood pressure in 17-year-old boys were the highest (34.8% and 22.5%), while the detection rates in girls at 13-14 years old were the highest (12.7%, 18.5%), respectively. There were statistically significant differences (all P<0.001) in the detection rates of normal-high blood pressure and elevated blood pressure among students of different genders, nutritional status, and puberty stages. Multivariate analysis showed that underweight students had a lower probability of developing elevated blood pressure (P<0.05), while the risk of normal-high blood pressure and elevated blood pressure in overweight and obese students was 1.79-4.86 times that of normal-weight students (P<0.001). The risk of normal-high blood pressure and elevated blood pressure in puberty-stage students was 1.75-2.71 times that of pre-puberty groups (P<0.001). Conclusions The problem of elevated blood pressure among primary and secondary school students in Shanghai is particularly prominent, especially among puberty-stage and obese students. We should continue to strengthen blood pressure monitoring and implement interventions through various comprehensive measures to reduce the risk of elevated blood pressure in students.

Objective To learn the epidemiological characteristics and associated factors of Spinal Curvature Abnormalities (SCA) among primary and secondary school students in Shanghai, and to provide evidence for targeted regional prevention and control strategies. Methods A multistage random cluster sampling method was employed to select students from 16 districts in Shanghai for SCA. Diagnosis was conducted in accordance with the Technical Guidelines for the Prevention and Control of Spinal Curvature Abnormalities in Children and Adolescents (GB/T 16133—2014). Data on physical examinations and behavioral habits were investigated. Statistical analysis was conducted using SPSS 21.0, with the chi-square tests and logistic regression models for correlation analysis. Results A total of 30 192 valid samples were included in this study, with 741 SCA cases detected, yielding an overall detection rate of 2.45%. The prevalence was higher in females (2.66%) than in males (2.27%), and significantly elevated among senior high school students (3.80%) compared to elementary (0.81%) and junior high students (2.09%). Urban students exhibited a higher prevalence (2.72%) than suburban (2.24%). Multivariate analysis indicated that urban residence (OR=1.23, 95%CI: 1.06–1.43), female (OR=1.18, 95%CI: 1.02-1.36), high school stage (OR=4.12, 95%CI: 3.11-5.45), and underweight status (OR=1.26, 95%CI: 1.07-1.48) were independent risk factors (all P<0.05). Conclusions The prevalence of SCA among primary and secondary school students in Shanghai cannot be overlooked, with significant associations observed across school stages, gender, residential areas, and underweight status. It is recommended to enhance early screening initiatives and strengthen diagnostic follow-up and early interventions for screen-positive students, thereby reducing the incidence of SCA.

Objective To explore the correlations among psychological help-seeking, adverse childhood experiences, and smartphone addiction in medical students, and to provide empirical evidence for students’ mental health research for the targeted population. Methods A stratified cluster sampling was used to conduct a questionnaire survey from April to June 2024 among 704 medical students in a medical university in Ganzhou City. Data were collected with the Attitude Toward Seeking Professional Psychological Help Short Form (ATSPPH-SF), Adverse Childhood Experiences Questionnaire, and the Propensity to Mobile Phone Addiction Scale for College Students (MPATS). Results There was a positive correlation between adverse childhood experiences and smartphone addiction (r=0.239, P<0.01). Psychological help-seeking attitudes among medical students showed significant negative correlations with both adverse childhood experiences (r=-0.175, P<0.01) and smartphone addiction (r=-0.276, P<0.01). The mediating effect of smartphone addiction accounted for 22.195% of the total effect [effect value=-0.182, 95%CI(-0.274, -0.105)], and adverse childhood experiences could negatively predict medical students’professional psychological help-seeking attitudes and indirectly affect the attitudes through smartphone addiction. Conclusions Smartphone addiction partially mediates the impact of professional help-seeking attitudes and adverse childhood experiences. It is recommended that universities should prioritize individualized strategies and implement targeted interventions.

Objective To investigate the current status of myopia and the trends in refractive error among primary and secondary school students in Yancheng, Jiangsu, and to provide references for myopia prevention and control. Methods From 2019 to 2023, a cluster sampling method was adopted to select 33 923 students who had participated in vision examinations for four consecutive years for a myopia follow-up survey. A myopia tracking survey was conducted to calculate the myopia detection rates in different age groups and to analyze the changes in spherical equivalent (SE) and the severity of myopia across these age groups. Results The myopia detection rates among the 33 923 students from 2019 to 2023 were 48.03%, 61.62%, 69.63%, and 76.45%, respectively (P<0.001). The rates for male students were 45.90%, 58.87%, 66.59%, and 73.40%, while those for female students were 50.42%, 64.70%, 73.03%, and 79.87%. In the initial age group of 6-8 years, the myopia detection rates in the 2022-2023 academic year were 4.57 times (age 6), 3.35 times (age 7), and 2.49 times (age 8) those of the 2019-2020 academic year. In the initial age group of 6-11 years, the high myopia detection rates in the 2022-2023 academic year were at least four times those of the 2019-2020 academic year. Students aged 6-9 years exhibited the fastest progression of myopia, with the most rapid progression observed in 8-year-old students, whose SE increased annually by -0.49 D (right eye) and -0.47 D (left eye), and in 9-year-old students, whose SE increased annually by -0.49 D (right eye) and -0.45 D (left eye). Conclusion The progression of myopia among students aged 6-9 has significantly accelerated, highlighting the need for increased attention to the critical window period for myopia prevention and control in this age group.