To investigate the trends and influencing factors of vitamin D nutritional status among primary and secondary school students in Guizhou Province from 2012 to 2023, providing scientific basis for formulating nutritional improvement measures.

A multi-stage cluster sampling method was adopted to select one primary and one secondary school from each of the survey sites implementing the “Nutrition Improvement Program for Rural Compulsory Education Students” in Guizhou Province. A total of 9 830 students were surveyed with questionnaires and had their blood samples tested.The prevalence rates of each year were standardized using the population age structure of 2023. The Mann-Whitney U test was used to compare the differences in vitamin D levels between different genders, and the Kruskal-Wallis H test was used to compare the differences among different age groups. The Bonferroni method was used to correct the significance level for two-group comparisons. The Spearman rank correlation analysis was used to test the trend of vitamin D levels over the years. The quantile regression model was used to examine whether there were differences in the trend of vitamin D levels among different subgroups.

Vitamin D levels among primary and secondary school students in Guizhou Province fluctuated between 2012 and 2023, but showed an overall upward trend (r_s=0.048, P<0.001), rising from 21.1 ng/ml in 2012 to 22.6 ng/ml in 2023.The vitamin D levels of males were consistently higher than those of females (P<0.05). With increasing age, vitamin D levels showed a downward trend(P<0.05). Except for 2015, the serum 25(OH)D concentrations of the 12-14 and 15-17 age groups were lower than those of the 6-8 age group. The prevalence of vitamin D deficiency (VDD) and vitamin D inadequacy (VDI) was consistently higher in females than in males. The prevalence of VDD and VDI in each age group fluctuated, and in 2023, the prevalence of VDD and VDI in each age group was lower than in 2012. The quantile regression model results indicated that the rate of improvement in vitamin D levels over time was significantly slower in males than in females (β=-0.118, P=0.016). The average annual improvement rate in vitamin D levels was significantly higher in the 6-8 age group than in the 15-17 age group(β=0.261, P<0.001).

The prevalence of VDD and VDI among primary and secondary school students in Guizhou Province remains at a relatively high level. Specifically, targeted nutritional intervention strategies should be developed for females and older males to improve their vitamin D nutritional status.

To investigate the awareness rate and influencing factor of weight management knowledge, and the prevalence of abnormal body mass index (BMI) among junior high school students in Yinchuan, analyze the correlation between weight management knowledge awareness and abnormal BMI, and provide a theoretical basis for the implementation of weight-related health education among children and adolescents.

Between March 12 and April 26, 2025, a multi-stage stratified cluster random sampling method was employed to recruit 2 485 students from Grade 7 to Grade 9 across 9 junior high schools in Yinchuan as study participants. A self-developed structured questionnaire was administered to assess participants’awareness of comprehensive weight management knowledge (including nutrition, physical activity, etc.) and its associated influencing factors. Abnormal BMI was screened using a bioelectrical impedance analysis (BIA) body composition analyzer. In accordance with the national standards Screening for Malnutrition in School-age Children and Adolescents (WS/T456-2014)and Screening for Overweight and Obesity in School-age Children and Adolescents (WS/T586-2018) issued by the National Health and Family Planning Commission of China, students with emaciation, overweight, or obesity were classified by gender and age.

The overall awareness rate of weight management knowledge among junior high school students in Yinchuan was 57.34%. The highest awareness rate was observed in the dimension of “prevention cognition” (51.75%), while the lowest was in “scientific weight control” (35.57%). No statistically significant difference was detected across different grades (P>0.05),whereas the awareness rate among female students was significantly higher than that among male students (P<0.05).Multivariable logistic regression analysis revealed that female gender (OR=0.53), Grade 9 enrollment (OR=1.21), urban residency (OR=0.78), being an only child (OR=1.31), parental education level of college or above (OR=1.18), cohabitation with parents (OR=2.21), normal guardian weight (OR=0.84), school-based health education implementation (OR=1.33), and teacher-delivered weight management knowledge (OR=2.61) were significant influencing factors of weight management knowledge awareness among junior high school students (all P<0.05). The prevalence of abnormal BMI among the study population was 29.86%, with emaciation, overweight, and obesity accounting for 8.09%, 14.29%, and 7.48% of the total sample, respectively.The awareness rate of weight management knowledge was significantly negatively correlated with emaciation (r=-0.712),overweight (r=-0.723), and obesity (r=-0.756), with all P<0.05.

The overall awareness rate of weight management knowledge among junior high school students in Yinchuan is relatively low, while the prevalence of abnormal BMI is notably high. A significant negative correlation exists between weight management knowledge awareness and abnormal BMI, which warrants serious attention.

To explore the chain mediation role of social withdrawal and self-esteem in the relationship between childhood trauma and depression among junior high school students, to inform youth mental health interventions.

From June to August 2025, a stratified sampling survey was conducted among 2 630 students from five junior high schools in Tai’an, Shandong. Core variables were assessed using the social withdrawal dimension of the Youth Self-Report, the Self-Esteem Scale, the Childhood Trauma Questionnaire, and the Depression Screening Questionnaire. Pearson correlation tested associations among variables. Multiple linear regression tested effects on depression. Mediation models with bootstrapping tested the chain mediation of social withdrawal and self-esteem.

All trauma dimensions were positively related to social withdrawal and depression, and negatively to self-esteem. Social withdrawal was negatively related to self-esteem and positively to depression. Self-esteem was negatively related to depression. Further analysis showed that all trauma dimensions directly predicted higher depression (β=0.335, 0.113, 0.237, 0.152, 0.175; all P<0.001), and indirectly predicted higher depression via social withdrawal (β=0.196, 0.110, 0.172, 0.138, 0.176; Boot 95% CI excluded 0) and via the chain “trauma →social withdrawal → low self-esteem → depression” (β=0.020, 0.010, 0.025, 0.014, 0.026; Boot 95% CI excluded 0). Self-esteem also significantly mediated the associations between emotional abuse, emotional neglect, physical neglect, and depression (β=0.021, 0.037, 0.025; Boot 95% CI excluded 0).

Social withdrawal and low self-esteem play a chain mediation role in the relationship between childhood trauma and depression among junior high school students. Timely interrupting risk factors and developing protective factors are crucial for improving the mental health of adolescents.

To explore the reference values of percentage body fat (PBF) for obesity screening in children and adolescents, in order to provide a reference for the development of rapid assessment tools for obesity among primary and secondary school students, and the promotion of obesity screening work among children and adolescents.

A stratified cluster sampling method was used to include subjects from Putuo District, Shanghai in September 2024. Basic information and anthropometric data were collected from 2 270 primary and secondary school students. The χ² test and rank-sum test were used for data analysis with SPSS 29.0. Fitted curves were used to analyze the trend of PBF across sex and age, and optimal cut-points for obesity screening were determined by plotting receiver operating characteristic (ROC) curves.

The students were aged 7-17 years, with a mean age of 11.85±3.10 years. The detection rate of simple obesity was 16.8%, and the rate of central obesity was 22.1%. With increasing age, PBF in boys first increased and then decreased, whereas that in girls showed a general upward trend. Sex differences in PBF emerged after the age of 10 years (P<0.05). ROC curve analysis showed that the model fitting values were all >0.5, and the AUCs of PBF for obesity screening exceeded 0.900 across sex and age groups, with both sensitivity and specificity generally >80%.

PBF is highly valuable as an obesity screening indicator and can accurately and intuitively reflect body fat content and its changes in children.

To investigate the prevalence of dental caries among primary and secondary school students in an ethnic minority region of Sichuan, and to examine the relationship between dental caries and nutritional status, with the aim of providing a foundation for effective prevention and control strategies for dental caries in ethnic minority areas.

A stratified cluster random sampling method was employed to select 13 899 primary and secondary school students from this ethnic minority region for inclusion in the study. Comprehensive oral and physical examinations were conducted, along with the administration of questionnaires. The χ² test was utilized to compare differences, while logistic regression analysis was performed to investigate the association between dental caries and nutritional status.

In 2024, the caries rate of primary and secondary school students in an ethnic minority area in Sichuan was 74.17%, and 77.63%, 74.29%, and 57.26% for Tibetans, Qiangs, and Han Chinese, respectively. Statistically significant differences were observed in caries rates based on various factors, including gender (χ²=170.20, P<0.001), ethnicity (χ²=364.64, P<0.001), school segment (χ²=93.77, P<0.001),topography (χ²=675.45, P<0.001), overweight and obesity status (χ²=106.85, P<0.001), as well as daily milk consumption (χ²=22.49, P<0.001) among students. The difference in caries rates among students of different ages was statistically significant (χ²=174.82, P<0.001). Overweight and obesity were protective factors for caries among primary and secondary school students in an ethnic minority area of Sichuan (OR=0.696, 0.587, respectively, both P-values<0.001).

The caries rate of primary and secondary school students in an ethnic minority area in Sichuan is high, and overweight and obesity are closely related to caries. It is recommended that an integrated intervention system addressing “environment-nutrition-behavior” be established to prevent dental caries effectively while safeguarding students’ oral health.

To explore the impact of collaborative intervention by village doctors and village cadres on the knowledge, attitudes, and testing behaviors regarding HIV/AIDS among middle-aged and elderly high-risk populations in rural areas.

Using purposive sampling, 64 middle-aged and elderly individuals with high-risk characteristics for HIV/AIDS in M Village, Luzhou City, were selected as study subjects. A self-controlled before-and-after study design was adopted, and a collaborative intervention model involving village doctors and village cadres was implemented. The subjects underwent a 3-week (once a week, totaling 3 sessions) intensive educational intervention followed by a 4-week maintenance intervention. At five time points, including baseline (T0), after one intervention (T1), after two interventions (T2), after three interventions (T3), and after the maintenance phase (T4), the following indicators were assessed: HIV/AIDS knowledge awareness rate, discriminatory attitudes, condom use self-efficacy, HIV self-testing willingness, and testing behaviors.

After the intervention, the study subjects showed improvements in their awareness of HIV/AIDS knowledge, discriminatory attitudes, self-efficacy in condom use, willingness for HIV self-testing, and testing behaviors (all P<0.05). The intervention demonstrated cumulative effects, with all indicators in T3 reaching optimal levels and remaining stable in T4 (P<0.05).

Collaborative intervention by village doctors and village cadres can effectively enhance the knowledge level of HIV/AIDS, self-efficacy of condom use,reduce discriminatory attitudes towards HIV/AIDS, and promote testing behaviors among middle-aged and elderly high-risk populations in rural areas.

To explore the diagnosis related group(DRG) grouping model of traditional Chinese medicine diseases and syndromes under the mode of traditional Chinese medicine disease and syndrome and Western medicine diagnosis, and provide references for relevant medical insurance departments to improve DRG of Zhejiang Province(ZJ-DRG) scheme and enhance its applicability in traditional Chinese medical institutions.

Discharged patients, from 2020 to 2023, in a tertiary TCM hospital of Zhejiang were selected, and their medical record homepage and the DRG grouping data were collected. Hemorrhoids(ICD-10 code: I84.0-I84.9) were selected as the target disease type for dominant diseases in traditional Chinese medicine. A multilayer perceptron (MLP) neural network and K-prototypes clustering algorithm were used to screen categorical node variables, and decision tree model was used to group hemorrhoids inpatients. The between-group heterogeneity and within-group homogeneity of the established model were evaluated through the coefficient of variation (CV) and the reduction in variance (RIV).

The 4 663 hemorrhoids inpatients in this study were divided into 6 DRGs according to the ZJ-DRG scheme, and the heterogeneity between these groups (RIV: 1.92%) and the homogeneity within these groups (CV: 9.34%-26.29%) were moderate. Through the K-P clustering algorithm based on “Primary diagnosis-Primary symptom-Main Surgery or procedure”, 10 DRGs were formed, with the RIV increasing to 9.05% and the CV ranging between 17.14% and 22.99%. By further integrating traditional Chinese medicine specific indicators and complications, under the decision tree model (CRT algorithm), the RIV increased to 34.59%.

The constructed DRGs grouping model of traditional Chinese medicine diseases and syndromes has improved grouping efficiency and enhanced the heterogeneity between these groups. It can provide a reference for establishing a hierarchical and segmented disease group incentive mechanism for target dominant diseases in traditional Chinese Medicine.

To construct a TOPSIS-RSR-Markov chain model to comprehensively evaluate the current situation of traditional Chinese medicine service ability in Shanxi Province and predict the dynamic evolution trend.

Based on the data of public traditional Chinese medicine hospitals in 11 prefecture-level cities in Shanxi Province from 2021 to 2023, an evaluation system containing two first-class and ten second-class indicators was constructed. TOPSIS method and RSR method were used to rank the ability, and Markov model was used to predict the change trend from 2024 to 2025.

TOPSIS showed that Yuncheng (C=0.88), Jinzhong (C=0.75), Taiyuan (C=0.75) ranked the top three, and Shuozhou (C=0.10) ranked the bottom. The RSR method ranked Taiyuan (RSR=0.818) and Changzhi (RSR=0.75) in the highest grade. The two methods were moderately consistent (Spearman r=0.56). Markov prediction showed that the short-term capacity differentiation, the head agglomeration effect was enhanced, and some low- and medium-level cities were at risk of being downgraded. The proportion of low-level cities was stable at 25%. Sensitivity analysis confirmed that the core conclusions were robust, optimistic and structural optimization scenarios could increase the proportion of high-level cities, and pessimistic scenarios exacerbated the Matthew effect.

The service ability of traditional Chinese medicine in Shanxi Province is characterized by “dynamic evolution in gradient differentiation”. It is necessary to implement the differentiation strategy of “leading by the head city-breakthrough by the central city-bottom out by the tail city” to accelerate the development of traditional Chinese medicine in Shanxi Province.

To develop a scientific and systematic evaluation indicator system for the operation of the Health Vice Principal Program, addressing the current lack of standardized assessment tools for evaluating its effectiveness, and to provide a basis for objectively measuring and continuously improving the program.

An initial pool of items for the operation of the Health Vice Principal Program was constructed using literature research, questionnaire surveys, and expert interviews. Two rounds of expert consultations were conducted using the Delphi method to refine the indicator system based on expert feedback.The analytic hierarchy process was applied to determine the weights of indicators at all levels.

A comprehensive evaluation indicator system for the operation of the Health Vice Principal Program was successfully established, consisting of 5 first-level indicators, 19 second-level indicators, and 57 third-level indicators.

The construction process of this indicator system is scientific and reliable, demonstrating a high degree of expert consensus and consistency. It provides a practical and quantitative measurement tool for systematically evaluating the effectiveness of the Health Vice Principal Program, thereby promoting the standardization and high-quality development of school health work.

To analyze the influence of family structure on health literacy of prevention and treatment of infectious diseases among female residents in Qingdao, in order to provide scientific basis for formulating and improving health intervention strategies for infectious disease prevention.

This study conducted a multi-stage stratified random sampling survey among female permanent residents aged 15-69 in Qingdao in 2022. A logistic regression model was used to analyze its influencing factors, and subsequently, a decision tree algorithm was employed to establish a predictive model to identify key stratification variables.

Multivariable logistic regression model showed that after adjusting urban or rural areas, household registration, age, educational level, marital status, occupation and other factors, the health literacy of prevention and control of infectious diseases among women with 2 family members and 3 or more family members were higher than those living alone (OR=1.528, 95% CI: 1.512-1.545; OR=1.514, 95% CI: 1.499-1.530), women who did not care for or raise minors had a lower level of infectious disease prevention and control health literacy (OR=0.890, 95% CI: 0.886-0.895). The chi-squared automatic interaction detector(CHAID) decision tree model screened six significant factors influencing female residents’ infectious disease prevention and control, which were educational level, urban or rural areas, occupation, family size, whether caring for minors and age. Among women with low education level, those living alone in rural areas and those raising minors in urban areas had lower health literacy in the prevention and treatment of infectious diseases.

Whether live alone or raise minors affects female residents’ infectious disease prevention and control. We suggest to focus on women living alone and low-education women living in urban areas who are caring for or raising minors, so as to promote the overall improvement of female health literacy in the prevention and control of infectious diseases.