Objective To learn the epidemiological characteristics of male homosexual transmission of Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) among young students in Liaoning Province, so as to provide a scientific basis for reducing the risk of HIV infection among young students and formulating targeted prevention and control measures. Methods Through the "China Disease Prevention and Control Information System", HIV/AIDS information of students aged 15-24 years for the period from January 1, 2015 to December 31, 2024 in Liaoning Province was collected. Epidemiological analyses were conducted on the male-to-male sexual transmission of HIV/AIDS among young male students, and the trend of change can be analyzed based on the Annual Percent Change (APC) and the Average Annual Percent Change (AAPC). Results From 2015 to 2024, a total of 916 new cases of HIV/AIDS among male students aged 15-24 years through homosexual transmission were reported in Liaoning Province. The number of reported cases decreased overall each year (AAPC=-9.11%,P<0.001). The main reporting cities were Shenyang with 315 cases (34.4%) and Dalian with 304 cases (33.2%). The majority of these cases were aged 19-24 (718 cases, 78.4%), Han ethnicity (756 cases, 82.5%) and associate degree or above (772 cases, 84.3%). With the increase in years, the proportion of cases in the 15-<19 ages group showed an upward trend (χ2trend=5.836, Ptrend=0.016; AAPC=5.54%, P=0.062). The proportion of patients with four or more same-sex sexual partners showed a monotonically decreasing trend (χ2trend=27.249, Ptrend<0.001; AAPC=-8.73%, P=0.013). The proportion of cases detected through testing and counseling showed an upward trend from 2015 to 2017 (APC=25.74%, P<0.01), but a downward trend from 2017 to 2021 (APC=-16.70%, P<0.001). The proportion of patients from Sexually Transmitted Disease (STD) clinics showed a downward trend from 2015 to 2017 (APC=-30.09%, P<0.001), but an upward trend from 2017 to 2020 (APC=44.43%, P<0.001). The proportion of patients from other medical visits (AAPC=13.19%, P<0.01) and other sources (AAPC=-10.28%, P<0.01) showed a monotonically increasing and decreasing trend, respectively. Conclusions From 2015 to 2024, the reported cases of HIV/AIDS transmitted through male-to-male sexual contact among young students in Liaoning Province showed a general decline, and the composition characteristics changed. The proportion of young students in the younger age group increased, indicating that further efforts are needed to strengthen health education on AIDS prevention for young students of this age group. The proportion of HIV/AIDS detected in patients visiting STD clinics and other medical institutions increased, suggesting that the detection efforts in key medical institutions such as STD clinics should be strengthened. At the same time, it is necessary to pay closer attention to changes in the source of samples and make targeted adjustments to the key areas of AIDS prevention and control.

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 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 explore the characteristics and trends of mortality among primary and secondary school students in Wulong from 2015 to 2024, and to provide a scientific basis for implementing effective interventions to reduce mortality. Methods Data on deaths occurring between January 1, 2015, and December 31, 2024, were retrieved from the mortality surveillance system. Descriptive analysis, χ2 test, and Joinpoint regression analysis were employed to examine mortality patterns among students aged 6-18 years, including gender-, age group-, and cause-specific mortality rates, monthly distribution of deaths, and the Average Annual Percentage Change (AAPC). Results The average mortality rate among students aged 6-18 years in Wulong (2015-2024) was 25.40 per 100 000, with boys showing significantly higher rates (29.80/100 000) than girls (20.74/100 000) (χ2=4.040, P=0.044). Injury-related mortality (16.48/100 000) exceeded disease-related mortality (8.93/100 000) (χ2=9.820, P=0.002). The highest mortality rate was observed in the 15-18-year age group (36.27/100 000), while the lowest was in the 6-<10-year age group (19.30/100 000). Annual mortality rates fluctuated during 2015-2024, with an AAPC of -4.27%, though the trend was not statistically significant. Among injury-related deaths, drowning was the leading cause (mortality rate: 7.32 per 100 000), with male drowning mortality (10.68 per 100 000) being 2.83 times that of females (3.77 per 100 000). The leading disease-related cause of death was malignant tumors (2.72 per 100 000). The highest proportional mortality occurred in January, July, and November, accounting for 45.05% of all deaths. Conclusions Injuries, particularly drowning, were the leading causes of death among students aged 6-18 years in Wulong. Prevention efforts should prioritize drowning control through enhanced safety measures along water bodies and targeted water safety education for students. Parents should strengthen supervision, while relevant authorities should promote life-value education and increase awareness of healthy living and safety precautions among students.

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 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.

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 understand the awareness and vaccination intentions regarding the Human Papilloma Virus (HPV) vaccine among college students in China from 2014 to 2024, and to provide a basis for targeted measures to reduce the disease burden of cervical cancer. Methods A systematic search was conducted on academic resource platforms, including CNKI, Wanfang Database, VIP Journal Network, Supranet E-books, and PubMed from 2014 to 2024 to collect research literature on HPV vaccine awareness and vaccination intentions among college students. Meta-analysis was performed using RevMan 5.4 software based on the data of the eligible studies. Results A total of 18 studies meeting the criteria were included in this study, including 18 articles on HPV vaccine awareness and 17 articles on HPV vaccination intentions. The Meta-analysis results showed that the combined awareness rate of the HPV vaccine was 48% (95%CI: 38% - 59%), and the combined vaccination intention rate was 57% (95%CI: 47% - 68%). Conclusions The current college student population in China exhibits a relatively low level of awareness regarding HPV vaccines but a relatively high vaccination intention. It is recommended to systematically advance HPV prevention and control efforts in colleges and universities from four aspects: health education, service optimization, policy support, and gender perspectives.

Objective To analyze the factors influencing HIV-related knowledge awareness and casual sexual behaviors among young students in Chongqing from 2020 to 2024 based on the sentinel surveillance data, and to provide a reference for formulating the HIV prevention and control measures for young students in Chongqing. Methods Continuous cross-sectional surveys were conducted from 2020 to 2024.A multi-stage stratified sampling method was used to select young students in Chongqing for anonymous questionnaire surveys, collecting socio-demographic information, HIV knowledge, and sexual behavior data. Logistic regression analysis was applied to identify influencing factors associated with casual sexual behaviors. Results A total of 10 410 participants were surveyed from 2020 to 2024.The majority were young students aged 20-24 years, registered locally, and of Han ethnicity. Approximately 40% of the surveyed subjects were freshmen each year. The sample was primarily composed of undergraduates and postsecondary specialized college students. The awareness rate of HIV-related knowledge among young students ranged from 91.9% to 97.1% during the study period. The proportion of students engaging in casual sexual behaviors in the past year decreased from 18.4% in 2020 to 13.0% in 2024.Multivariate analysis showed that, compared to male students, females were less likely to engage in casual sexual behaviors (aOR=0.31, 95%CI: 0.21-0.42). Compared to the 22-year-old and above age group, students aged 18-<22 years had a lower risk of engaging in casual sexual behaviors (aOR=0.41, 95%CI: 0.27-0.63; aOR=0.53, 95%CI: 0.37-0.77). Students with HIV-related knowledge had a lower risk of engaging in casual sexual behaviors (aOR=0.32, 95%CI: 0.21-0.50). Compared to freshmen, students in other grades were more likely to use condoms during casual sexual behaviors (aOR=2.87, 95%CI: 1.32-6.47). Students with HIV knowledge were more likely to use condoms compared to those without (aOR=3.45, 95%CI: 1.35-8.62). Conclusions The overall awareness rates of HIV-related knowledge among young students in Chongqing remain relatively high from 2020 to 2024, but the HIV-related knowledge structure is uneven. The incidence of casual sexual behaviors reveal no significant decline, and gaps in condom use persist. Male gender, aged 22 years and above, and lack of HIV knowledge are the risk factors for engaging in casual sexual behaviors. Freshmen and students lacking HIV knowledge are more likely to engage in unprotected casual sexual behaviors. It is recommended to strengthen behavioral interventions for key populations such as male students and freshmen, and to improve educational approaches to facilitate the translation of protective knowledge into practice.

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 influenza vaccination coverage and the occurrence of post-vaccination adverse reactions among children aged 6 months to 15 years in Xuzhou from 2019 to 2024, and to provide a reference basis for the development of influenza vaccination. Methods Influenza vaccination data (2019-2024) and suspected Adverse Events Following Immunization (AEFI) reports were sourced from the “Jiangsu Comprehensive Immunization Service Management Information System” and “China Disease Prevention and Control Information System”, respectively. The vaccination coverage and AEFI situation were analyzed. Joinpoint regression analysis was applied to model the trend in vaccination rates. Results From 2019 to 2024, a total of 245 892 children aged 6 months to 15 years received 301 576 doses of influenza vaccinations in Xuzhou, with an average annual vaccination rate of 2.08% (range:0.87%-3.13% annually). No significant temporal trend was observed (AAPC=20.832%, 95%CI: -0.114-46.166, P=0.051). The vaccination rate of girls was higher than that of boys, with a statistically significant difference (χ2=511.51, P<0.01). The vaccination rates for the age groups of 6 months to <3 years, 3 to <6 years, 6 to <12 years, and 12 to 15 years were 6.41%, 4.43%, 1.25%, and 0.27%, respectively. The different age groups demonstrated a declining trend in vaccination rates (χ2trend=218 537.02, P<0.01), showing statistically significant differences annually (all P<0.01). Geographic disparities showed significant differences (all P<0.01): 3.01% (urban districts), 1.43% (county-level cities), and 1.63% (counties). A total of 189 AEFI cases were reported, with an overall incidence rate of 62.67 per 100 000 doses. Among these, 185 cases were general reactions accounting for 97.88%. The incidence was highest in the 6 months to <3 years age group (73.72 per 100 000 doses), followed by the 3 to <6 years age group (72.58 per 100 000 doses). Conclusions The influenza vaccination rate is relatively low among children aged 6 months to 15 years in Xuzhou, and AEFI monitoring indicates a favorable safety profile for the influenza vaccine. It is necessary to strengthen the popularization of science, actively lead the parents to pay attention to influenza vaccination, and improve the influenza vaccination rate of children to achieve the effect of influenza epidemic prevention and control.

Objective To preliminarily develop a health literacy assessment tool covering all educational stages of primary and secondary schools and to test its reliability and validity, providing a reliable basis for the scientific evaluation of students’ health literacy levels. Methods A preliminary indicator system was constructed through systematic literature and policy review. Following revisions based on two rounds of expert consultation, an indicator system was formed covering five grade levels, 6 domains, 26 indicators, and either 36 or 66 items. Based on this system, four parallel questionnaires (A/B/C/D versions) were developed for each grade level. In October 2024, a pilot assessment was conducted using convenience sampling among primary and secondary school students in Zhongshan City. Reliability was assessed using Cronbach’s α coefficient, split-half reliability, and test-retest reliability. Validity was assessed using content validity and confirmatory factor analysis. Results The positive coefficient for both rounds of expert consultation was 100% and the expert authority coefficient was>0.7. The Kendall’s W coefficient in the second-round expert consultation was statistically significant (P<0.05). The pilot assessment showed that the mean scores for the four parallel questionnaires across the five grade levels were 82.66±9.76, 82.54±6.99, 83.64±7.30, 73.86±10.46, and 81.92±7.84 points, respectively. No statistically significant differences were found among the four questionnaires within each grade level (P>0.05). Regarding reliability, the questionnaire Cronbach’s α coefficient (0.871-0.960), split-half reliability (0.841-0.921), and test-retest reliability (0.637-0.818) all met acceptable standards. For validity, content validity correlations were significant. Confirmatory factor analysis indicated acceptable χ2/df and RMSEA values, but CFI and TLI did not reach 0.9. Conclusion The preliminarily developed overall health literacy scale for primary and secondary school students demonstrates good reliability, while its structural validity requires further improvement.

Objective To investigate the health literacy level and its influencing factors among secondary school students in Guangdong Province, and to provide a scientific basis for targeted health education interventions. Methods From October to November 2022, a total of 18 230 secondary school students in Guangdong Province were selected using a multistage stratified cluster random sampling method for a health literacy survey. The possession rates of overall and six-dimensional health literacy (growth and development & adolescent health-care, healthy behaviors and lifestyles, disease prevention, mental health, safety emergency &risk avoidance, medical knowledge & rational medical health-care) were calculated and compared among students with different characteristics. Multivariate logistic regression was employed to identify the independent influencing factors related to students’ health literacy. Results The overall possession rates of health literacy among secondary school students in Guangdong Province was 28.8%. The possession rates of six-dimensional health literacy, from high to low, were safety emergency & risk avoidance (63.2%), healthy behaviors and lifestyles (44.4%), disease prevention (43.0%), mental health (41.9%), growth and development & adolescent health-care (19.9%), and medical knowledge & rational medical health-care (9.1%). Multivariate logistic regression analysis showed that being in senior high school, female gender, being an only child, parental education level of junior college/bachelor’s degree or above, and receiving health education ≥3 times per month were positively correlated with the overall health literacy level of secondary school students (P<0.05). Schools located in non-Pearl River Delta regions (Eastern, Western, and Northern Guangdong), vocational school students, and daily use of mobile electronic devices for more than 4 hours were negatively correlated with the overall health literacy level of secondary school students (P<0.05). Conclusions The overall health literacy level among secondary school students in Guangdong Province is suboptimal and unevenly distributed across dimensions, influenced by multiple factors at the individual, family, and school levels. It is recommended that relevant authorities strengthen education in underdeveloped areas, such as growth and development & adolescent health-care, and medical knowledge & rational medical health-care, and formulate differentiated intervention strategies guided by the aforementioned influencing factors.

Objective To analyze the influencing factors of myopia among primary and secondary school students in Yancheng City, construct a myopia risk prediction tool based on the random forest model, and to provide a scientific basis for formulating targeted intervention strategies. Methods Based on the physical examination and questionnaire survey data of 13 235 primary and secondary school students in Yancheng in 2023, univariate analysis was applied to screen significant influencing factors. The random forest model was then employed to rank the importance of variables, and the model performance was evaluated using the ROC curve. Results The detection rate of myopia among primary and secondary school students in Yancheng was 77.8%. The ranking results of the importance of each variable in the random forest model were as follows: Age, school stage, duration of doing homework or reading/writing after school, whether parents have myopia, mother’s education level, reading or using electronic screens while lying or prostrate, duration of outdoor activities during the day in the past week, father’s education level, frequency of moderate-to-high-intensity exercise per day during holidays, reading or using electronic screens while walking or riding in a vehicle, number of times sugar-sweetened beverages were consumed in the past 7 days, turning off the lights when using electronic screens after dark, number of times fried foods were eaten in the past 7 days, gender, urban/rural residence, whether parents restrict watching TV or playing computer, daily sleep duration, location of activities during break time, and frequency of eye exercises per day. The area under the ROC curve of the random forest model was 0.679 2, with a 1-specificity of 42.40% and a sensitivity of 67.35%. Conclusions Myopia among primary and secondary school students is jointly influenced by genetic, behavioral, and family environmental factors, requiring comprehensive interventions. The random forest model has certain value in predicting myopia risk, but its discriminatory ability is limited. Future studies need to optimize the model and expand the sample size to improve the predictive efficacy.

Objective To investigate the prevalence and influencing factors of scoliosis among school-aged adolescents in Jiayuguan, and to provide references for formulating disease intervention measures. Method From July to September 2024, a random cluster sampling method was used to select 1 500 middle school students in Jiayuguan City. A three-step combined screening method was employed: visual forward bend test, trunk rotation measurement, and X-ray examination. Additionally, questionnaires were filled out, and multiple logistic regression analysis was conducted to explore the influencing factors of scoliosis under different exposure patterns. Results The detection rate of scoliosis among 1 500 middle school students was 6.13%, with 4.1% in junior high school students and 7.6% in senior high school students, and the difference was statistically significant (χ2=7.888, P=0.005). Multivariate logistic regression analysis showed that the risk factors for scoliosis included watching videos for more than 2 hours per day (OR=13.964, 95%CI:3.936-49.542), insufficient physical education classes (OR=4.691, 95%CI:1.992-11.047), lack of regular rotation of classroom seats (OR=3.556, 95%CI:1.159-10.913), poor standing posture (OR=11.699, 95%CI:1.726-79.285), poor sitting posture (OR=20.492, 95%CI:3.428-122.483), outdoor activity time less than 1 hour per day (OR=12.853, 95%CI:1.451-113.833), bad backpacking habits (OR=8.942, 95%CI:3.497-22.862), and family history of scoliosis (OR=4.258, 95%CI:1.674-10.832, all P<0.05). Conclusion Middle school students' scoliosis should be given priority. Efforts should be made to correct poor sitting and standing postures, strengthen early screening and intervention for individuals with a positive family history, increase outdoor exercise duration and frequency, and reduce video viewing time.

Objective To analyze the awareness status of nutritional health knowledge and its influencing factors among high school students in Jining City, and to provide a scientific basis for further strengthening nutritional health education for high school students. Methods In 2024, 2 725 high school students were selected by a stratified random cluster sampling method. The Nutritional Health Knowledge Questionnaire for School-Age Children (High School Version) was employed to investigate the basic information, nutritional health knowledge, attitudes, and behaviors. Binary logistic regression was used to analyze the associated factors. Results The nutritional health knowledge score of high school students in Jining City was (65.52±13.09) points, with an awareness rate of 25.03%. The correct rate was highest for dietary habits (78%) and lowest for dietary recommendations (48%). The awareness rates were 26.1% for male students and 24% for female students. Statistically significant differences in awareness rates were found among different grades (χ2=35.74, P<0.05), boarding status (χ2=23.49, P<0.05), whether having meals at school (χ2=10.48, P<0.05), parents’ education levels (father:χ2=31.41, mother: χ2=14.93, both P<0.05), parents’ occupations (father: χ2=102.54, mother: χ2=100.10, both P<0.05), weekly breakfast consumption (χ2=25.18, P<0.05), and daily outdoor activity time (χ2=25.61, P<0.05). Multivariate regression analysis showed that students who did not board at school (OR=1.52), did not have meals at school (OR=1.55), whose fathers had a college/vocational college education (OR=2.33), whose mothers worked in other health-related industries (OR=2.02), and who engaged in 90-120 minutes of outdoor activity daily (OR=1.85) had relatively better awareness of nutritional health knowledge. Conclusions The awareness rate of nutritional health knowledge among high school students in Jining City still has significant room for improvement, particularly in the area of dietary recommendations. The awareness status was associated with boarding status, whether having meals at school, weekly breakfast consumption, and outdoor activity time. Targeted measures should be effectively implemented to improve the nutritional knowledge awareness rate among high school students.

Objective To investigate and evaluate the prevalence of myopia and its influencing factors among primary and secondary school students in Suqian from 2019 to 2023, and to provide a reference for further formulating strategies and measures for prevention and control of myopia. Methods In 2019, 12 schools were selected with a stratified random cluster sampling method. The visual acuity tests and refractive examinations among primary and secondary school students were measured for 5 consecutive years to analyze the detection of myopia. A questionnaire survey was conducted among students in grade four and above, and the logistic regression analysis model was used to analyze the influencing factors of student myopia. Results A total of 4 314, 4 179, 4 063, 4 053, and 4 192 students were enrolled in the five surveys, respectively. From 2019 to 2023, the overall detection rate of myopia among students in Suqian showed an upward trend, standing at 50.46%, 55.52%, 60.57%, 55.54% and 60.47%, respectively. Moreover, the myopia detection rate among girls was higher than that of in boys each year (all P<0.05). Multivariate Logistic regression analysis showed that the main risk factors affecting myopia were female gender (OR=1.397, 95%CI: 1.293-1.150), higher grades [(junior high school (OR=3.816, 95%CI:3.486-4.177); senior high school (OR=8.231, 95%CI:7.234-9.364); vocational high school (OR=2.287, 95%CI:1.948-2.686)], parental reminders about proper reading posture (OR=1.206, 95%CI:1.101-1.321), prolonged exposure to sunlight while reading or using screens (OR=1.156, 95%CI: 1.038-1.287), lying or prone positions during screen time (OR=1.165, 95%CI:1.042-1.303), extended close-up visual tasks [30-60 minutes (OR=1.223, 95%CI:1.096-1.365); 1-2 hours (OR=1.190, 95%CI:1.056-1.342); 2-3 hours (OR=1.381, 95%CI:1.155-1.650); ≥ 3 hours (OR=1.264, 95%CI:1.087-1.470)], and parental myopia status [paternal only (OR=1.700, 95%CI:1.510-1.915); maternal only (OR=1.846, 95%CI:1.627-2.096); both parents (OR=2.212, 95%CI:1.861-2.628)]. Conclusion The myopia detection rate among primary and secondary school students in Suqian is relatively high, showing an overall upward trend. Effective intervention measures should be taken targeting the main influencing factors of student myopia to control the prevalence and development of myopia.

Objective To analyze the reported incidence of pulmonary Tuberculosis (TB) among undergraduates at a university in Beijing over the past 10 years, and to provide an objective basis for the scientific prevention and control of TB on campus. Methods A total of 118 834 undergraduate students from 2015 to 2024 at a university in Beijing were enrolled. The TB case reports from the past decade were collected and reviewed. A cluster sampling method was employed, and descriptive statistics and difference tests were conducted on the collected data. Results From 2015 to 2024, a total of 97 confirmed pulmonary TB cases were identified among undergraduate students at the university, with an average annual incidence rate of 81.63 per 100 000. The reported incidence of TB showed a downward trend (χ2= 27.84, P= 0.001). The average annual reported incidence rate was higher in male students (95.93 per 100 000) than in female students (53.02 per 100 000), lower in Han students (73.39 per 100 000) than in ethnic minority students (132.24 per 100 000), and lower in urban students (49.96 per 100 000) than in non-urban students (96.53 per 100 000); the differences were all statistically significant (P<0.05). Most TB cases (63.92%, 62/97) were detected during the September entrance physical examination and close-contact screening. The incidence rate among first-year undergraduates (111.45 per 100 000) was higher than that among second- to fourth-year students (51.61 per 100 000). Conclusions The findings indicate that active pulmonary TB is more frequently detected during entrance physical examinations and close-contact screenings among freshmen. Therefore, strict screening measures should be implemented for entrance examinations and close contacts, and diverse forms of health education should be strengthened. Routine monitoring and screening should be emphasized, with particular attention paid to high-risk populations. A multi-sector, coordinated prevention and control approach should be adopted to reduce the transmission of TB on campus.

Objective To compare the intervention effects of expressive drawing courses and traditional mental health education courses in alleviating depressive symptoms and enhancing self-acceptance levels among college freshmen. Methods Using a cluster randomized controlled trial design, 16 administrative classes of first-year undergraduate students at a university were randomly divided into an experimental group (8 classes, n=280) and a control group (8 classes, n=272). The experimental group received a 12-week expressive drawing course, while the control group continued with the traditional mental health education courses. The primary outcome measures were the Self-Rating Depression Scale (SDS) scores and the Self-Acceptance Questionnaire (SAQ) scores, assessed at baseline and the 12th week post-intervention. Independent samples t-tests were used for baseline homogeneity comparisons. Mixed-design analysis of variance was employed to examine the interaction effects of group and measurement time on SDS and SAQ scores to evaluate the intervention effects. Results No statistically significant differences were found in demographic characteristics and depressive symptoms between the experimental and control groups (all P>0.05). However, the self-acceptance level in the experimental group was lower than that in the control group (35.73±4.68 vs 37.36±4.44, t=-4.190, P<0.001). Repeated-measures analysis of variance revealed significant interaction effects of group and time on both SDS and SAQ scores (both P<0.05). Simple effect analysis indicated that the experimental group exhibited a significant decrease in SDS scores (ΔM=-4.40, ηp2=0.092) and a significant increase in SAQ scores (ΔM=3.45, ηp2=0.161), whereas no significant changes were observed in the control group. Conclusions Expressive drawing can effectively alleviate depressive symptoms and enhance self-acceptance levels among college freshmen.

Objective To analyze the influencing factors of suicidal behavior in patients with Bipolar Disorder (BD) in China, with a meta-analysis method. Methods Eight databases (PubMed/MedLine, Embase, Cochrane, Web of Science, Google Scholar, China National Knowledge Infrastructure (CNKI), Wanfang Medical Network, VIP Journals) were retrieved from the inception to June 4, 2025. Fourteen eligible studies with Chinese BD patients involving 6 431 participants were included. Both Review Manager 5.4 software and Stata 18.0 software were performed to analyze the associations between suicidal behavior and the potential influencing factors in BD patients, such as gender, age, family history or previous history of mental illness, history of depression, mixed episodes, typical initial symptoms, and typical suicidal concepts or previous attempted suicide behaviors. The sources of heterogeneity were explored. Results The influences of gender, history of depression, mixed episodes, typical suicidal concepts or previous attempted suicide behaviors on the suicidal behaviors of patients were statistically significant (P<0.05). Female patients (OR=1.738), those with a family history or past history of mental illness (OR=1.501), those with a history of depression (OR=1.981), those with mixed episodes (OR=2.864), those with typical initial symptoms (OR=2.025), and those with typical suicidal ideas or past attempted suicide behaviors (OR=4.064) exhibited higher risks of suicide. The heterogeneity results indicated substantial heterogeneity for age, family history or past history of mental illness, history of depression, typical initial symptoms, typical suicidal concepts or previous attempted suicide behaviors (P<0.001). The subgroup analysis showed that the effects of each influencing factor in different subgroups were not statistically significant (P>0.05). Conclusion BD patients who are female, with a family history or past history of mental illness, a history of depression, mixed episodes, typical initial symptoms, typical suicidal ideas or previous attempted suicide behaviors have a relatively higher risk of suicidal behavior.

Objective To systematically evaluate the prevalence of Premenstrual Syndrome (PMS) among female college students in China, and to provide evidence for developing targeted health promotion strategies in universities. Methods We systematically searched databases such as CNKI, VIP, Wanfang, PubMed, and Web of Science from inception until December 2024. Following literature screening, data extraction, and quality assessment, a Meta-analysis was performed using Stata 17.0 software. Results A total of 15 cross-sectional studies involving 9 367 participants were enrolled. The Meta-analysis results showed that the combined detection rate of PMS among female college students in China was 49.6% (95%CI：44.7%-54.5%), with detection rates of mild, moderate, and severe symptoms being 27.2%, 17.6%, and 3.4%, respectively. Subgroup analysis indicated that the prevalence of PMS after 2020 (59.5%) was significantly higher than that before the COVID-19 pandemic (47.5%) (P<0.05), while no statistically significant difference was observed between northern and southern regions (P> 0.05). Conclusions The prevalence of PMS among female college students in China is high, and the COVID-19 pandemic may have increased the risk. This study suggests that reproductive health issues in this population should be prioritized, with personalized health management strategies provided based on symptom severity. Additionally, efforts should focus on enhancing psychological resilience and systemic health support to address major public health emergencies.

Objective To understand the current status of myopia among children and adolescents in Taizhou in 2024, and to provide a scientific basis for myopia prevention and control. Methods A stratified random cluster sampling method was used to conduct distance visual acuity examination and refractive testing among children and adolescents in 48 schools (kindergartens) in Taizhou City in 2024, and data were analyzed for myopia detection status and severity. Results A total of 13 950 children and adolescents were surveyed, and 8 745 were diagnosed with myopia, corresponding to an overall prevalence of 62.69%. The prevalence of myopia was significantly higher in girls (64.04%) than in boys (61.45%), and higher in urban areas (66.14%) than in suburban areas (58.33%) (both P<0.05). The prevalence of myopia in kindergartens, primary schools, junior high schools, senior high schools, and vocational high schools was 9.20%, 46.03%, 85.02%, 93.09%, and 87.01%, respectively. For both boys and girls, the prevalence of myopia demonstrated a significant upward trend with grade progression (both P<0.001). The prevalence of mild, moderate, and severe myopia in kindergarten was 8.92%, 0.19%, and 0.09% in kindergarten; in primary school, 32.33%, 11.73%, and 1.24%; in junior high school, 32.06%, 41.76%, and 10.24%; and in senior high school, 22.04%, 49.45%, and 20.82%. A significant trend of increasing myopia severity with advancing educational stage was observed (χ2 trend=1 560.214, P<0.001). Conclusions The myopia situation among children and adolescents in Taizhou is relatively severe, with myopia rates increasing with educational stage and severity worsening. Scientific protective measures should be taken to prevent myopia in younger children and delay the progression from mild to moderate or severe myopia.

Objective To analyze sexual behavior characteristics, HIV prevention knowledge acquisition, and HIV testing status among college students in Jiamusi City, Heilongjiang Province, and explore the influencing factors of HIV testing among those with sexual behavior, and to provide a scientific basis for locally formulating targeted prevention and control strategies. Methods An online questionnaire survey was conducted among students at three universities in Jiamusi City using a convenience sampling method between May and July 2023.The survey covers students’ demographic information, sexual behavior characteristics, acquisition of AIDS prevention knowledge, and HIV testing status. Descriptive analyses were performed with medians and interquartile ranges, frequencies, and proportions. Differences among groups were assessed using the chi-square test, and the influencing factors of HIV testing among those with sexual behaviors were analyzed using a binary logistic regression model. Results A total of 17 368 valid questionnaires were included. Among them, 10.14% of students reported a history of sexual behaviors, and the overall AIDS knowledge awareness rate was 90.43%. Among the 1 761 students who self-reported a history of sexual behaviors, 26.40% had engaged in unsafe sexual behaviors in the past year. The awareness rate of AIDS knowledge was 88.98%. The proportion of those who received HIV testing in the past year was 36.17%. Multivariate analysis revealed that among students with sexual behaviors, male students had an adjusted OR of 1.56 (95%CI: 1.23-1.96) for receiving HIV testing within the past year compared with female students. Compared to third-year students and above, first- and second-year students had ORs of 1.67 (95%CI: 1.29-2.17) and 1.34 (95%CI: 1.02-1.76), respectively, for receiving HIV testing within the past year. Compared with those who had engaged in unsafe sexual behaviors in the past year, those who did not had an OR of 1.58 (95%CI: 1.25-2.01) for receiving HIV testing in the past year. Compared with those who did not consider AIDS frightening, those who considered AIDS frightening had an OR of 2.22 (95%CI: 1.80-2.75) for receiving HIV testing in the past year. Compared with those who did not perceive themselves at risk of infection, those who self-assessed as at risk had an OR of 2.61 (95%CI: 1.94-3.51) for receiving HIV testing in the past year. Conclusions College students in Jiamusi had a relatively high level of HIV knowledge awareness and HIV testing acceptance. However, the proportion of unsafe sexual behaviors remains prevalent. It is recommended to strengthen targeted interventions for high-risk subgroups, enhance risk perception, and promote regular testing among high-risk populations.

Objective To investigate the screening status of myopia and the impact of reading-writing habits on myopia among third- to fourth-graders in Yangpu, Shanghai, and to provide evidence for formulating corresponding myopia prevention and control measures. Methods In 2023, a cross-sectional study with stratified random cluster sampling was conducted among 2 242 third- and fourth-graders from 10 primary schools in Yangpu. Visual acuity and non-cycloplegic refraction examinations were performed, and questionnaires on reading and writing habits were completed by students and their parents. Logistic regression analysis was used to assess the influence of reading and writing habits on myopia. Results The screening myopia prevalence among third- and fourth-graders in Yangpu was 36.93%. The screening myopia prevalence was higher in girls than in boys (χ2=7.934, P=0.005), and higher in fourth graders than in third graders (χ2=28.251, P<0.001). Myopia prevalence increased with age (χ2trend=25.578, P<0.001), showing statistically significant differences. Logistic regression analysis indicated that being female (OR=1.223, 95%CI:1.020-1.466) and reading with the eyes-book distance<30 cm (OR=1.597, 95%CI:1.327-1.915) were risk factors for myopia. Having a father without myopia (OR=0.475, 95%CI:0.393-0.574), mother without myopia (OR=0.677, 95%CI:0.563-0.813), grandfather without myopia (OR=0.713, 95%CI:0.536-0.950), and having learned the correct pen-holding posture (OR=0.608, 95%CI:0.478-0.774) were protective factors against myopia. Conclusions This study found that the screening myopia prevalence among third- to fourth-graders in Yangpu, Shanghai remains at a relatively high level. Myopia is susceptible to the effects of factors such as gender, age, parental myopia status, eye-book distance, and whether students have mastered the correct pen-holding posture. Therefore, targeted intervention measures should be implemented for myopia prevention and control in this targeted population.

Objective To analyze the epidemiological characteristics, pathogenetic features, and spatiotemporal clustering patterns of other infectious diarrhea in children under 10 years old in Xuzhou from 2018 to 2024, and to provide references for the prevention and control of diarrheal diseases. Methods Data on age, sex, occupation, onset date, pathogen types, and demographic characteristics of other infectious diarrhea cases in children under 10 years old in Xuzhou City from 2018 to 2024 were collected from the Chinese Center for Disease Control and Prevention Information System. Descriptive epidemiological methods and chi-square tests were used to analyze the incidence trends, seasonal variations, regional distribution characteristics, and pathogen spectrum composition of other infectious diarrhea in children under 10 years old in Xuzhou City. ArcGIS 10.8 software was performed for visualization, and GeoDa 1.14 software was employed for spatial autocorrelation analysis to assess spatial clustering. Results From 2018 to 2024, a total of 11 014 cases of other infectious diarrhea in children under 10 years old were reported in Xuzhou, with an average annual incidence rate of 127.07 per 100 000. The peak incidence period was mainly in the winter and spring seasons each year. The male-to-female ratio was 1.37∶1. There were cases in all age groups, with the highest proportion of 91.47% in the 0-5 years age group, and the incidence of disease in the population was dominated by children in the diaspora, accounting for 85.85%. Among the 2 279 cases with pathogenic diagnosis, the ratio of viral infection was the highest (98.88%), which was mainly rotavirus (71.08%). Global autocorrelation Moran’s I was 0.264 (P<0.05) for average annual incidence. LISA clustering map showed that the “high-high” clustering areas during 2018-2024 were mainly distributed in Gulou District, Quanshan District, and Yunlong District, while the “high-low” clustering areas during 2023-2024 were mainly distributed in Xinyi. Conclusions The incidence of other infectious diarrhea in children under 10 years old in Xuzhou City demonstrates an overall upward trend from 2018 to 2024, with distinct seasonal and population distribution characteristics. The primary pathogen is rotavirus, and the geographic distribution of cases concentrates in the central and northeastern regions. Health education for high-risk populations should be strengthened before the high-incidence seasons, and particular attention should be given to rotavirus vaccination and scientific prevention and control measures for infants and young children.

Objective To understand the sexual behavior characteristics before diagnosis of young student HIV-infected individuals transmitted through homosexual transmission in Shandong, and to explore the related characteristics of those with bisexual behavior, and to provide a basis for formulating targeted publicity and intervention measures. Methods Convenience sampling was used to select HIV-infected young students transmitted through homosexual transmission from 2021 to 2022 in Shandong as the research subjects. Their sexual behavior characteristics before diagnosis were investigated. A multivariate logistic regression model was used to analyze the related characteristics of cases with bisexual behavior. Results A total of 180 cases were surveyed, of whom 12.2% had engaged in bisexual sexual behavior. Multivariate logistic regression results showed that compared with cases detected through outreach activities and voluntary blood donation, cases detected through voluntary counseling and testing (OR=0.131, 95%CI: 0.035-0.483) and medical institutions (OR=0.202, 95%CI: 0.051-0.796) had a lower proportion of engaging in bisexual behavior. Cases seeking homosexual partners through offline venues, such as parks/bars had a higher proportion of engaging in bisexual behavior (OR=8.176, 95%CI: 2.419-27.638) than those seeking homosexual partners online via the internet. Conclusion Targeted education and intervention measures should be strengthened for young students in bars, parks, and other offline places, to control the spread of HIV/AIDS among young students.

Objective Dental caries is a common multifactorial disease among children, severely affecting oral health. With the acceleration of urbanization, the scale of rural left-behind children has been expanding. Due to the absence of parent-child relationships and lack of oral health knowledge, dental caries among left-behind children has attracted widespread social attention. This study aimed to comprehensively understand the current status of dental caries prevalence among rural left-behind children in China and provide scientific strategies for improving their oral health. Methods A systematic search was conducted in Chinese databases (CNKI, Wangfang Data, VIP) and English databases (PubMed, Medline) for studies on dental caries prevalence among left-behind children. Meta-analysis was performed on the included literature data. Results A total of 16 studies were included, involving 7 458 participants, of whom 4 366 had dental caries. The overall prevalence of dental caries among left-behind children was 63.5% (95%CI: 51.9%-75.1%). Subgroup analysis showed that the pooled prevalence of dental caries was higher in female left-behind children than in males, at 62.4% (95%CI: 43.1%-81.8%) and 58.3% (95%CI: 39.4%-77.2%), respectively. The prevalence in preschool left-behind children was higher than that in school-aged children, at 70.1% (95%CI: 50.2%-90.0%) and 55.1% (95%CI: 42.8%-67.3%), respectively. The prevalence in South China was significantly higher than that in East China, Central China, and Southwest China, at 67.5% (95%CI: 48.8%-86.2%). Conclusions The prevalence of dental caries among rural left-behind children in China is relatively high, with significant differences in prevalence across gender, age, and region. Targeted oral health education and preventive measures should be strengthened for left-behind children with different characteristics. Due to the limited information on family and other basic factors mentioned in the included studies, future high-quality cross-sectional studies on influencing factors are needed.