Objective The purpose of this study was to explore the family factors affecting school bullying among junior high school students, to provide a basis for the prevention of school bullying. Methods The China National Knowledge Infrastructure, VIP, Wanfang, Web of Science, and other databases were searched from inception to December 2023. Two researchers independently screened the literature, and extracted data according to predefined inclusion and exclusion criteria. After evaluation of the quality of the included literature with the Agency for Healthcare Research and Quality scale, quantitative analysis was conducted in CMA 3.3 software. Results A total of 26 studies were included, with a total sample size of 39 893. The seven family factors influencing middle school students’ bullying behavior in school were parenting style (positive parenting r=-0.164, P<0.05; negative parenting r=0.264, P<0.05), parental conflict (r=0.142, P<0.001), childhood maltreatment (r=0.275, P<0.001), family functioning (r=-0.163, P<0.05), family socioeconomic status (r=-0.076, P<0.05), parent-child attachment (r=-0.209, P<0.001), and parent-child conflict (r=0.230, P<0.001). Sensitivity analyses suggested the stability of the study results. Conclusion Bullying behavior among middle school students is closely associated with family dynamics: adolescents exposed to adverse family environments have elevated likelihood of engaging in bullying.

Objective This study was designed to analyze the dynamic characteristics and causes of accidental deaths among primary and secondary school students in Huizhou and provide reliable evidence for developing preventive strategies. Methods With the International Classification of Diseases (ICD-10) of V01-X59 series, a total of 1 206 cases were retrospectively enrolled from the Huizhou Statistical Bureau official data between 2015 and 2021. Results From 2015 to 2021, there were 1 206 deaths in Huizhou, with a mortality rate of 19.37/ 100 000. Among them, Compared with the primary school level, the accidental mortality rates at secondary school level were higher (14.93/ 100 000), with statistically significant differences (P<0.05). The main causes of accidental death were traffic accidents, drowning, and suicide, and the mortality rates of these causes were the highest at the secondary school level. Between 2015 and 2021, the mortality rates from traffic accidents showed an increasing trend, while the mortality rates from suicide and drowning showed a decreasing trend. Conclusions Secondary school students are a key population for preventing accidental deaths, especially those caused by traffic accidents. Moreover, different targeted intervention measures should be taken based on the characteristics of the primary and secondary school to reduce the occurrence of accidental death incidents.

Objective To quantify the impact of near-vision behaviors and vision environment among elementary students with electronic intelligent devices, and provide technical support for myopia prevention and control. Methods With a cluster sampling method, participants from an elementary school in Nantong city were selected to receive visual acuity test and refraction test, as well as a five-day monitoring of electronic intelligent devices (weekends included) during October to December 2023. The data on the prevalence of myopia in students, near-vision behaviors, outdoor exposure duration, and environmental light intensity were collected. The correlations of factors, such as genders, grades, and myopia status with both near-vision behaviors and vision environment were analyzed. Results The data were obtained from 343 students (91.5%) with electronic intelligent devices, including 167 myopic students (48.7%). The results revealed that the compliance rates of recommended maximum continuous near-work duration and the average outdoor exposure duration were 8.5% and 2.31%. The compliance rates of nighttime illumination were only 24.21%, while compliance rates of the average light intensity during the day were relatively high, reaching 94.52%. Data showed that only 50.14% of students could maintain a distance of 33 cm from their eyes to the books. Compared with female students, male students had shorter near-work time, longer near-work distance, and longer outdoor exposure time, with the significant differences (P<0.01). The differences in daylight and outdoor exposure duration in these grades were statistically significant (P<0.05). In the non-myopic students, there were better conditions in the some aspects, such as the maximum near-work duration (≥ 80 min), average daily duration (≥ 300 min), average near-work distance (≥ 33 cm), average light intensity (at night), and average effective outdoor exposure duration compared with the myopic students. All differences showed statistically significant (all P<0.05). Conclusions The electronic intelligent devices can quantify the near-vision behaviors and vision environment in students. It also has powerful support for the guidance of students’ near-vision behaviors.

To enhance influenza prevention and control capabilities in schools, this consensus proposes a comprehensive strategy for influenza prevention and control in schools, based on domestic and international research and practices, encompassing the following key components: (1) General prevention strategy: Non-pharmaceutical interventions, including isolating sources of infection, strengthening hand hygiene, and ventilation can effectively reduce transmission in schools, requiring further implementation. (2) Vaccination campaign optimization: Annual influenza vaccination is the most cost-effective measures to protect students from influenza and severe complications, reducing school closures due to outbreaks, minimizing absenteeism, and parental work disruptions. Key strategies include policy requirements, safeguards, and advocacy to improve vaccination accessibility, and convenience for students, through optimized campus vaccination programs. (3) Addressing awareness gaps and prioritizing health campaign: Significant knowledge gaps on the threat of influenza and vaccine safety profiles are found among key stakeholders (parents, school healthcare providers, teachers, school administrators, and students), especially in rural and disadvantaged areas. Targeted health education focusing on differentiating influenza from common colds, vaccine efficacy, and daily protective measures is essential to enhance health literacy through multi-channel campaigns. (4) Strengthening organizational systems and multisectoral collaboration: School healthcare staffing should meet public health demands, with enhanced training for healthcare personnel. A collaborative framework involving schools, CDCs, and communities, health services is essential. Joint efforts by education, health, and CDC authorities are needed to formulate integrated plans, emphasizing surveillance, vaccination oversight, and building a “family-school-community-healthcare” system. (5) Policy support for influenza prevention: Comprehensive policy frameworks are critical to improving prevention efficacy in schools. (6) Contingency plan: Schools should establish emergency response plans to enforce daily health checks, symptom surveillance, ventilation, and disinfection, while standardizing management via the “two plans and nine systems” framework. This consensus emphasizes the importance of policy-driven vaccination campaigns, optimized organization and multi-dimensional health education to establish a scientific, efficient and school-based prevention system, reducing the burden of respiratory infectious diseases and safeguarding children and adolescents’ health and educational continuity.

Objective To analyze the epidemiological characteristics of infectious disease symptoms and the implementation of suspension measures in primary and secondary schools in a district of Beijing, and to provide evidence-based insights for optimizing campus infectious disease prevention strategies. Methods Between February 2023 and February 2025, data were collected from 4 186 primary and secondary school students in a district, Beijing, using a stratified random sampling method. Descriptive statistics and time series analysis were employed to examine the prevalence of symptoms across different categories, school levels, and seasons, as well as the school suspension metrics. Results Fever was the most frequently reported symptom (3 834 cases, 87.1%). Among all symptoms, school suspension measures related to herpes were the most stringent, with a weighted average suspension duration of 9.3 d and an implementation rate of 79.1%. Differences in suspension responses were observed across school levels: In primary schools, the suspension rate for fever cases was 60.5%, compared to 43.2% in secondary schools. For herpes cases, suspension rate reached 86.8% in primary schools, while secondary schools reported only 13 cases, yet related classes still maintained 10 d suspensions. Seasonally, autumn semester fever cases averaged 4.6 d suspensions, exceeding the 3.6 days observed in spring. Conclusions The predominant infectious disease symptom among primary and secondary school students is fever, with herpes posing notable seasonal risks. Primary schools emerged as key targets for prevention and control, while asymptomatic transmission in secondaryschools warrants heightened vigilance.

为贯彻落实《健康中国行动（2019 —2030年）》关于中小学生健康促进的行动，推动新时期儿童青少年健康领域学术交流和学科发展，中华预防医学会儿少卫生分会拟于2025年8月中旬在江苏省徐州市召开第十七届全国儿童青少年健康学术会议。

Objective This study investigated sleep patterns among middle school students in Nanjing and explored factors contributing to sleep disorders, to provide a basis for developing strategies to improve sleep conditions among middle school students. Methods A stratified cluster sampling method was used to conduct a questionnaire survey on sleep quality among 2 187 middle school students in Nanjing from September to November 2023. Sleep conditions were assessed to analyze the influencing factors associated with sleep disorders among middle school students. Results The detection rate of sleep disorders among middle school students in Nanjing was 11.8%; the rates were 10.9% among male and 12.9% among female students, which showed no statistically significant difference (χ2=2.056, P=0.152). The detection rates of sleep disorders were 8.3% among junior high school students, 18.6% among regular high school students, and 11.4% among vocational high school students, and showed statistically significant differences (χ2=44.856, P<0.001). Furthermore, the detection rate of sleep disorders was 6.7% in suburban students and 18.6% in urban students, which also showed a statistically significant difference (χ2=20.915, P<0.001). Multivariate logistic regression analysis identified being enrolled in a regular high school, experiencing parental physical punishment, and alcohol consumption as risk factors for sleep disorders among middle school students. In contrast, residing in suburban areas and engaging in outdoor activities for 1 hour or more were found to be protective factors against the occurrence of sleep disorders. Conclusions Sleep quality among middle school students in Nanjing is generally satisfactory but could be improved. Sleep quality is influenced by multiple factors, and targeted policies should be established to enhance students’ sleep status.

Objective To analyze the status and factors of milk and dairy products consumption among primary and secondary students in Beijing, so as to provide a basis for promoting the appropriate intake of milk and dairy products by students. Methods A questionnaire survey was conducted among students from 16 districts of Beijing, during September 2020 to June 2021. Students from primary and secondary schools were enrolled by a multi-stage stratified cluster sampling method. Chi-square test was applied to analyze the differences in the rate of insufficient intake of milk and dairy products between the groups, and logistic regression was employed to explore its relevant factors. Results A total of 9 959 students were enrolled, and the median daily consumption of milk and dairy products was 319.9 mL. However, 47.4% of these students failed to meet the recommended intake. Factors such as gender, grade, caregiver education, family income, accessibility of dairy products and knowledge of milk consumption were all found to significantly influence milk intake (all P<0.01). The higher risk of insufficient dairy intake was found among female students (OR=1.20, P<0.001), junior high school students (OR=1.50, P<0.001), senior high school students (OR=1.48, P<0.001), and those with limited access to milk and dairy products (OR=1.63, P<0.001). Conclusion Although the overall consumption of milk and dairy products intake among primary and secondary students shows a certain level, 47.4% of students still have insufficient intake.

Nutrition literacy encompasses the collection of knowledge and skills that enable individuals to acquire, comprehend, and process information and services of food nutrition that can be helpful for making food and nutrition decisions. It functions as a bridge connecting individuals, food, and the environment, and holds predictive value for dietary behaviors. Upon the previous studies, this review was undertaken to examine the association between nutrition literacy and dietary behaviors among school-aged children. The findings revealed that the overall nutrition literacy level among school-aged children was linked to healthy dietary behaviors, and enhancing specific facets of nutrition literacy could foster healthier food consumption patterns. Future research endeavors should delve deeper into the associations between various competencies and dietary behaviors, as well as the interplay between children’s nutrition literacy and health outcomes, to furnish scientific basis and clues for the intervention of children’s dietary behaviors and the improvement of children’s nutritional status based on nutrition education.

Objective To investigate the Knowledge, Attitudes, and Practices (KAP) characteristics of Chinese parents regarding influenza vaccination for school-aged children and the factors, and to provide a scientific basis for optimizing childhood influenza prevention and control strategies. Methods A cross-sectional study was conducted from July to December 2024 in Chengdu, Nanjing, and Wuhan. Stratified cluster sampling was used to recruit parents of elementary and secondary school students. Data on demographic characteristics, vaccine awareness, influenza prevention knowledge, protective behaviors, and health-influencing factors were collected via questionnaires. Multivariate logistic regression analysis was performed to assess KAP levels and their influencing factors. Results A total of 2 656 valid questionnaires were collected. Parents exhibited relatively high overall knowledge (94.99% compliance) and positive attitudes (96.01% compliance) regarding student influenza vaccination, but behavioral compliance was low (38.29%). Parents of junior high and high school students showed lower behavioral compliance (junior high: OR=0.56, 95%CI=0.42-0.75; senior high: OR=0.38, 95%CI=0.22-0.63), while mothers demonstrated reduced compliance (OR=0.49, 95%CI=0.24-0.99). Parents in Chengdu exhibited stronger vaccination engagement (OR=2.84, 95%CI=2.17-3.72). Additionally, parental education level, student health status, family residence location, and parental age significantly influenced KAP levels. Primary barriers to vaccination stemmed from safety concerns (45.44%), whereas drivers included protecting personal health (74.06%), school vaccination requirements (51.55%), and safeguarding family or friends (51.13%). Conclusions This multicity survey reveals that urban parents possess high influenza-related knowledge and positive attitudes but exhibit suboptimal vaccination behaviors, highlighting the complexity of translating KAP into action. Key barriers include vaccine safety concerns, older student age, and maternal roles. Future strategies should enhance school-based influenza prevention and vaccination publicity, provide clear evidence of vaccine safety, and integrate regional healthcare resources. Future strategies should prioritize school-based vaccination campaigns, evidence-based safety communication, and integrated regional healthcare resources to bridge the KAP-behavior gap, thereby enhancing influenza vaccination coverage and refining immunization policies.

Objective To understand the current situation and factors of milk-related knowledge among primary and secondary students’ family caregivers in Beijing, so as to provide scientific basis for ensuring the growth and development of students and enhancing the level of milk-related knowledge of their family caregivers. Methods Family caregivers from 16 districts, whose children are in grade 3 to 12, were surveyed by questionnaires from September to December 2020. The current situation of milk-related knowledge among the family caregivers was analyzed. The binary logistic regression model was adopted to analyze the factors of the milk-related knowledge levels among caregivers. Results The mean score of milk-related knowledge among caregivers was 11.03 ± 2.32, with a compliance rate of 40.12%. Logistic regression analysis revealed that female caregivers; those aged ≤35 years, 35-45 years; those with educational level of high school/secondary vocational school/technical school, junior college/vocational college, as well as bachelor’s degree or above; and those from families with an annual per-capita income of 40 000-69 999 yuan, and≥70 000 yuan demonstrated a significantly higher likelihood of compliance with milk-related knowledge (all P<0.05). Conclusions The compliance rate of milk-related knowledge among primary and secondary students’ primary caregivers in Beijing requires to be improved. The focus should be on popularizing basic knowledge, such as the recommended amount of milk consumption and how to identify dairy products in the “Chinese Dietary Guidelines for School aged Children” among caregivers. In particular, efforts should be strengthened to popularize milk-related knowledge among caregivers who are middle-aged, have low educational level, and come from low-income families.

Objective To analyze the poor vision situation among primary and secondary students in Yicheng, and provide support and suggestions for students’ vision improvement, based on the current empirical evidences. Methods With the stratified cluster sampling method, the visual acuity screening in students aged 6-18 was conducted in Yicheng (Zhumadian City), during February to June 2023. The detection rates of poor vision in students were compared among different grades and genders. Results A total of 26 000 students were detected, including 20 198 students (77.68%) with poor vision. Among them, 8 953 elementary students were detected, covering 6 100 (68.13%) with poor vision; 8 674 middle school students were detected, encompassing 6 940 (80.01%) with poor vision; 8 373 high school students were detected, spanning 7 158 (85.49%) with poor vision. The differences were statistically significant among school students in these grades (χ2=792.346, P<0.001). The detection rates of students (grade 1-12) with poor vision were 64.21%, 66.15%, 67.05%, 68.04%, 70.19%, 73.21%, 77.97%, 79.52%, 82.58%, 84.00%, 86.08% and 86.39%, respectively. The results showed that the detection rates of poor vision increased with the elevation of grade levels. Of the 13 103 male students detected, 9 457 (72.17%) had poor vision. Among 12 897 female students, 9 759 (75.67%) had poor vision. The differences between male students and female students with poor vision were statistically significant (χ2=41.157, P<0.001). There were significant differences in the detection rate of poor vision between male students and female students in all grades (χ2=14.131, P<0.001; χ2=11.692, P<0.001, χ2=14.682, P<0.001). Conclusion The issue of poor vision among students in Yicheng District, Zhumadian City is rather severe. Notably, the detection rate of poor vision exhibits a significant upward trend with the elevation of grade levels.

Objective This study was aimed at understanding spinal curvature prevalence and associated factors among middle school students in Liangxi District, to provide a reference for preventive measures and interventions for spinal curvature in children and adolescents. Methods From November to December 2022, students in seventh grade to senior 3 (including those in vocational high school) in Liangxi District, Wuxi City were selected through a stratified cluster random sampling method. Spinal curvature assessment and a questionnaire survey were conducted. Results A total of 1 232 secondary school students from five schools were selected. The detection rate of spinal curvature was 3.33% (41 cases). The detection rate in girls was 4.98%, a value 1.75% higher than that in boys (χ2=10.028, P<0.01). The detection rate in students at ordinary high schools was 4.89%, a value higher than that in students at vocational high schools (2.87%) and junior high schools (2.01%) (χ2=6.549, P<0.05). The detection rate in malnourished students was 9.09%, a value higher than that in non-malnourished students (3.06%) (χ2=5.943, P<0.05). Multivariate logistic regression analysis indicated that female sex (OR=3.791, 95%CI: 1.797-7.998), attending an ordinary high school (OR=2.537, 95%CI: 1.162-5.538), and malnutrition (OR=4.631, 95%CI: 1.590-13.485) were risk factors for spinal curvature. Conclusions The detection rate of spinal curvature among middle school students in Liangxi District was relatively high. Closer attention must be paid to students at ordinary high schools and girls with malnutrition.

Objective To analyze the epidemiological patterns of campus infectious diseases in northern China and their factors, and to propose targeted prevention and control strategies for improving school health management system in China. Methods Based on the monitoring data of common diseases and health-related factors among students in Inner Mongolia Autonomous Region from 2021 to 2023, covering 12 leagues and cities and 103 counties (cities, districts), descriptive analysis, chi-square tests, and Wilcoxon rank-sum tests were performed to quantify the associations between health resource allocation (funding, personnel), multi-departmental collaboration policies, and infectious disease reporting rates. Results From 2021 to 2023, tuberculosis exhibited the highest reported incidence rate among Class A and B infectious diseases, followed by brucellosis and viral hepatitis. Within Class C diseases, influenza demonstrated the highest reporting rate, with hand-foot-mouth disease (HFMD) and mumps ranking closely (both>70%). Notable upward trends were observed for pertussis and HFMD (32.1% increase). Correlation analysis further revealed that the total workforce in health administrative departments was inversely correlated with reporting rates of tuberculosis (P=0.041) and brucellosis (P=0.007). School healthcare personnel density significantly correlated with influenza (P=0.006) and syphilis (P=0.001) reporting rates. Among policy-related factors, only syphilis reporting rates were negatively associated with joint interdepartmental policy issuance (P=0.012). Conclusions The prevention and control of campus infectious diseases in northern China requires attention to regional characteristics and resource allocation efficiency. Recommendations include enhancing classroom air quality monitoring, refining vaccination services, and prioritizing brucellosis health education in pastoral areas.

Objective To analyze the epidemiological characteristics of infectious disease outbreaks in primary and secondary schools and childcare institutions of Peixian, and to provide future references for prevention and control of infectious diseases in schools. Methods Data were collected via the sub-systems of “Public Health Emergency Management Information and China Influenza Surveillance Information” of the China Disease Prevention and Control Information System. Health emergencies and influenza outbreaks in primary and secondary schools and childcare institutions reported in Peixian from 2013 to2023 were included. Epidemiological characteristics of common infectious diseases outbreaks in schools were analyzed with the descriptive epidemiology. Results From 2013 to 2023, a total of 43 outbreaks of common infectious diseases were reported in Peixian, with 12 cases of general events, 31 cases of unrated events (all influenza events) involving 80 690 children. A sum of 934 cases was identified with the incidence of 1.16%, including influenza (36 cases), chickenpox (3 cases), mumps (2 cases), hand, foot, and mouth disease (1 case). Forty-three outbreaks of infectious diseases were found in primary schools (26 cases), middle schools (13 cases), and kindergartens (4 cases). Meanwhile, the distributions of these outbreaks varied in both the urban areas, with 11 cases, and rural areas, with 32 cases, with the incidence of 0.71%, 1.65%, respectively. The difference was significant (χ2=264.272, P<0.001). The incidence of the infectious diseases peaked in these months, such as March to June and from October of one year to January of the following year. Conclusions The common outbreaks of infectious diseases in Peixian are mainly unrated events and general events, with influenza as the main disease. The distributions of outbreaks are seasonal and bimodal. Targeted preventive measures should be taken timely to control the outbreaks of infectious diseases in schools and childcare institutions.

Objective To understand the health status of college students in Guangzhou, and to provide evidence for college health management. Methods A statistical analysis was conducted on the physical examination results of 9 705 freshmen who enrolled at the university from 2020 to 2023, mainly focused on the differences in the prevalence of abnormal results by year and gender. Results There were 9 016 students (92.9 %) with abnormal physical examination results. The prevalence rates of poor vision from 2020 to 2022 were 83.1%, 78.2% and 70.7%, respectively,showing a decreasing trend year by year (χ2=180.29, P<0.05). The prevalence rates of poor vision rebounded in 2023 (84.63%), showing no differences compared with those in 2020 (83.1%) (P>0.05). In 2022 and 2023, there was no significant difference in the prevalence rates of abnormal liver function (15.3%, 16.8%), abnormal renal function (55.6%,57.9%), anemia (2.4%, 2.1%), hyperglycemia (0.6%, 0.7%) and abnormal weight (47.3%, 49.6%) between the two groups (P>0.05). However, these prevalence rates showed statistical differences compared with the copying indicators from 2020 to 2021 (P<0.05). The prevalence rates of hypertension (12.7%) and abnormal electrocardiogram (9.5%) in 2023 were statistically different from those in other years (P<0.05). The prevalence rates of hypertension (13.6%), abnormal electrocardiogram (6.4%), abnormal liver function, and abnormal kidney function (17.6%, 61.7% ) and abnormal weight (65%) in male students were higher than those in female students (P<0.05). The prevalence rates of poor vision (83.3%) and anemia (6.5%) in female students were higher than those in male students (P<0.05). There was no statistically significant difference in the prevalence rates of hyperglycemia between male- and female-students (P>0.05). The prevalence rates of hypertension, abnormal liver function, abnormal kidney function, and high blood glucose showed an increasing trend year by year (P<0.05), while the prevalence rates of anemia and abnormal weight showed a decreasing trend year by year (P<0.05). Conclusions The prevalence rates of abnormal physical examination results of freshmen is relatively high. There are differences in different years and genders regarding poor eyesight, hypertension, abnormal electrocardiogram results, abnormal liver and kidney function, anemia, and abnormal body weight. The university should strengthen health management and formulate targeted intervention measures.

Objective This study was designed to investigate the occurrence, the composition of patients’ medical expenses and factors of non-traumatic spinal diseases among patients (children and adolescents) in a tertiary hospital of Xuzhou. Additionally, it aimed to provide references for the prevention and treatment of these types of disease, as well as the management of medical expenses. Methods With a cluster sampling method, a retrospective study was conducted to collect the homepage information of medical records of inpatients (children and adolescents) with non-traumatic spinal diseases in a tertiary hospital of Xuzhou from 2019 to 2023, including basic information, diagnostic reports, medical history and treatment, and personal medical expenses etc. The disease types, composition of medical expenses and factors of inpatients with non-traumatic spinal disease were analyzed. Results A total of 242 cases were enrolled, including lumbar disc herniation (139 cases), lumbar spinal stenosis (21 cases), torticollis (16 cases), scoliosis (14 cases), spondylitis (8 cases), and others(44 cases), among which lumbar disc herniation accounted for the highest proportion (57.44%). There were significant differences in different types of disease in different age groups (χ2=4.566, P=0.033). The material costs peaked (66.14%) in the total medical expenses of inpatients (children and adolescents) with non-traumatic spinal diseases. The multivariate Logistic analysis showed that the inpatients with an increase in age (OR=2.192,95%CI : 1.167-4.118) and the extension ofhospital stays (OR=2.859, 95%CI : 1.578-5.182) had higher medical expenses; while those who received non-surgical treatment (OR=0.157,95%CI :0.065-0.381) and whose treatment outcome was uncured (OR=0.514,95%CI :0.275-0.962) had lower medical expenses. Conclusions For the control of patients’ medical expenses with non-traumatic spinal diseases, emphasis ought to be laid on the older patients who may need surgical intervention. In terms of disease types, particular focus should be placed on the adolescent patients with lumbar disc herniation. Regarding the composition of the medical expenses, the supervision of medical consumables should be strengthened.

Objective To investigate the prevalence and incidence of co-occurrence of myopia and obesity among school-age children, and their influencing factors in Shanghai, and to provide scientific evidence for developing coordinated prevention strategies. Methods Data from the control group of the Shanghai Time Outside to Reduce Myopia Trial (STORM) were collected. During October and November 2016, a multistage random cluster sampling method was employed to recruit first- and second-grade students from eight schools in eight districts in Shanghai. After a three-year follow-up, a tota1 of 1 600 students with complete data were included in the final analysis. Questionnaires, physical examinations, and ophthalmic assessments were conducted at both baseline and follow-up. Univariate analysis and ordinal logistic regression were used to identify factors associated with the co-occurrence of myopia and obesity. Results At baseline, the prevalence of co-occurred myopia and obesity was 2.56% (41/1 600), increased to 18.13% (290/1 600) at follow-up. Among 905 healthy children at baseline, 6.08% (55/905) developed co-occurred myopia and obesity during follow-up. Multivariate analysis showed that longer outdoor time after school (OR=0.99, P=0.02) and living in suburban areas (OR=0.54, P<0.01) were associated with a lower risk, while having both parents with myopia significantly increased the risk (OR=1.69, P<0.01). Conclusions The co-occurrence of myopia and obesity in school-aged children and adolescents is an emerging public health concern. Both behavioral and environmental factors contribute to its development. Early identification of high-risk populations and integrated interventions targeting shared risk factors are essential for coordinated prevention of these chronic conditions.

Objective To investigate the factors of poor vision among junior-high school students in Xinbei, and to provide references for the development of scientific prevention and control measures. Methods A total of 1 986 students from three junior high schools in Xinbei, Changzhou, were randomly surveyed with a clustered sampling method. Information of their baselines, visual acuity, and refractive status was collected. Both the single factor and multi factor analysis were applied to analyze the results. Results A total of 1 934 final survey questionnaires were collected, with 1 129 male students (58.38%) and 805 female students (41.62%). The average age of the surveyed junior high school students was (14.18±0.81) years old. Univariate analysis indicated that there were statistically significant differences (all P<0.05) in the gender ratio, grades, family history of myopia, continuous near vision behaviors, and daily outdoor exposure between junior-high school students with normal vision and those with poor vision. The logistic multivariate analysis showed that gender, grade, family history of myopia, continuous near vision behavior and daily outdoor exposure were the factors of poor vision among junior high school students (all P<0.05). The proportion of emmetropia, hyperopia, and high myopia among different grades showed statistically significant differences (all P<0.05). Data of astigmatism, mild myopia, and moderate myopia among different grades showed no statistically significant differences (P>0.05). The proportion of male students with emmetropia, hyperopia, and astigmatism was significantly higher than that of female students (all P<0.05). The proportion of moderate and high myopia in male students was significantly lower than that in female students (both P<0.05). There was no statistically significant difference in the proportion of mild myopia between male students and female students (P>0.05). Conclusions The detection rate of abnormal vision among junior high school students in Xinbei District, Changzhou, is significantly high, and myopia is a serious issue. Therefore, it is crucial to strengthen the prevention and control of myopia among junior high school students.

Clavicular fracture is a common type of fracture, and its clinical manifestations after occurrence include focal edema, pain, deformity, subcutaneous ecchymosis, and bony crepitus. However, in the case of the non-displaced broken ends following the fracture, the clinical manifestations are often atypical, thereby increasing the likelihood of misdiagnosis. This paper discusses a case of painless clavicular fracture in an adolescent, and summarizes its diagnosis and treatment through case review, aiming to reduce the likelihood of misdiagnosis in clinical application.

Objective To analyze the efficacy of Holter electrocardiogram combined with treadmill exercise test in diagnosing myocardial ischemia and coronary heart disease. Methods From January 2021 to June 2022, 163 patients with suspected coronary heart disease were selected from the Second People’s Hospital of Pingdingshan City. All participants underwent treadmill exercise tests, Holter electrocardiograms, and coronary angiography (CAG). Results The frequency of myocardial ischemia episodes, the magnitude of ST-segment depression, and the duration of ST-segment depression detected by a combination of dynamic electrocardiography (Holter monitoring) and treadmill exercise test in coronary heart disease patients were all higher than those detected by the treadmill exercise test alone. The specificity, sensitivity, and accuracy of diagnosing myocardial ischemia in coronary heart disease using the combination of dynamic electrocardiography and treadmill exercise test were also significantly higher than using the treadmill exercise test alone, with statistically significant differences (all P<0.05). Conclusion The combination of dynamic electrocardiography (Holter monitoring) and treadmill exercise test can more effectively diagnose myocardial ischemia in patients with coronary heart disease.

Objective To compare the differences in the positive rates of influenza among children aged 0-14 in Dingxi from 2022 to 2023, and to analyze the risk factors for influenza infection and severe cases in the area. Methods Based on the influenza surveillance data of children aged 0-14 in the hospital from 2022 to 2023, children aged 0-14 with influenza virus infection who were hospitalized in Dingxi People’s Hospital were enrolled as the case group (n=236), while children of the same age group with non-influenza infection who received health checkups were selected as the control group (n=100). The case group was divided into the mild group (n=152) and the severe group (n=84) based on the severity of the disease. Stepwise logistic regression analysis was applied to explore the risk factors for influenza infection and severe cases. Results The positive rates of influenza among children aged 0-14 from 2022 to 2023 were 11.14% and 14.47%, respectively, and the difference was statistically significant (χ2=4.127, P=0.042). The dominant types of influenza were the Victoria and seasonal H3. Stepwise logistic regression analysis showed that a history of COVID-19 infection and respiratory disease were the risk factors for influenza infection (P<0.05). The long duration of fever, white blood cell count, neutrophil count, neutrophil-to-lymphocyte ratio, and comorbid pneumonia were all the risk factors for severe cases (P<0.05). Conclusions Victoria and seasonal H3 types are the dominant types of influenza in 2022-2023. The history of COVID-19 infection and respiratory disease are the risk factors for influenza infection. Meanwhile, long duration of fever, white blood cell count, neutrophil count, neutrophil-to-lymphocyte ratio, and combined pneumonia are the risk factors for severe cases.

Objective To analyze the willingness of school health personnel to engage and control human papillomavirus (HPV) and to explore the factors influencing student’ guardians in vaccination decision-making, and to provide scientific basis for optimizing school-based HPV prevention strategies and enhancing vaccination coverage. Methods Based on the 2024 Key Population Research Project on Prevention and Control of Infectious Diseases in Schools, questionnaires were conducted among 2 875 school health personnel from 13 provinces and 2 733 student guardians from four of these provinces. Descriptive analyses included t-tests for age comparisons across groups and chi-square tests for categorical variables such as gender, region, and educational level. Multivariate Logistic regression analysis was performed to identify influencing factors, and Cochran’s Q test was used to evaluate multiple reasons behind guardians’ decisions regarding their daughters’ HPV vaccination. Results Among school health personnel, the top three channels for acquiring HPV prevention and vaccination knowledge were district health commissions/education commissions/CDC official WeChat accounts (86.5%), schools (61.8%), and district women’s federations’ official WeChat accounts (42.1%). For parents, the primary sources were schools (68.8%), district health commissions/education commissions/CDC official WeChat accounts (54.8%), and integrated media (35.6%). A total of 88.9% of school health personnel correctly identified the optimal HPV vaccination age as “9-45 years, preferably before first sexual intercourse”, compared to 64.6% of female guardians and 57.9% of male guardians of daughters, with statistically significant differences (P<0.05). Additionally, 54.2% of school health personnel deemed HPV vaccination necessary for boys, whereas only 24.9% of male guardians held the same view. Factors significantly associated with school health personnel’s willingness to conduct HPV-related health education included being female (OR=0.439, P<0.001), residing in central China (OR=0.707, P=0.046, with western China as the reference), and awareness of the optimal vaccination age (OR=1.718, P=0.005). Among the 1 314 surveyed female guardians, child age (OR=1.757, P<0.001), residence in central China (OR=0.511, P<0.001), and knowledge of the optimal vaccination age (OR=1.646, P<0.001) were key factors influencing decisions regarding their daughters’ HPV vaccination. Among parents of girls having received the HPV vaccine (398, 30.3%), the top two reasons for vaccination were (1) HPV vaccine can prevent diseases related to HPV infection (response rate 34.6%) and (2) it can prevent cervical cancer (response rate 32.5%). The two reasons for not getting vaccinated (916, 69.7%) that had the highest prevalence and response rates were (1) children can rely on their own immunity and do not need to be vaccinated (response rate 11.6%) and (2) the HPV vaccine is ineffective in preventing cervical cancer (response rate 11.5%). Conclusions School health personnel’s willingness to prevent and control HPV is influenced by gender, region, and knowledge, while parents’ vaccination decisions are influenced by their children’s age, region, and knowledge of the vaccine. It is necessary to strengthen school health education, optimize information transmission channels, and enhance parents’ trust in the vaccine, so as to promote the transformation of HPV prevention and control from “cognitive recognition” to “behavioural internalization”, thereby increasing vaccination rates and improving HPV prevention and control strategies in schools.

Objective To explore the current status of hyperopic reserve and its associations with lutein and zeaxanthin intake in preschool children, and to provide a foundation for future nutrition-based interventions and preventive strategies against insufficient hyperopia reserve. Methods A cross-sectional study was conducted from October 2024 using random cluster sampling. A total of 524 children aged 3-6 years from six kindergartens in Gulou District, Nanjing, were enrolled. Hyperopic reserve was assessed via cycloplegic refraction using the Welch Allyn SPOT Vision Screener. Serum lutein concentrations were measured by high-performance liquid chromatography (HPLC). Multivariate logistic regression analyzed associations between lutein/zeaxanthin intake and hyperopic reserve status. Results The prevalence of insufficient hyperopic reserve was 14.5% (72/497), with no significant gender difference (12.9% in boys vs. 16.3% in girls). After adjusting for parental myopia and vitamin A supplementation, children with combined lutein + zeaxanthin supplementation exhibited a 4.01-fold higher odds of adequate hyperopic reserve compared to non-supplement users (OR=4.01, 95% CI: 1.33 ~ 14.27, P=0.03). Conclusion The prevalence of insufficient hyperopic reserve among preschool children in Gulou District of Nanjing is 14.5%, which is relatively low, but it still needs attention.