Comorbidity symptoms of anxiety and depression disorders (CAD) is common among adolescents and threaten the health and safety of adolescents. This study estimated the prevalence of CAD and examined its relative important influencing factors for formulating targeted intervention programs. Data were from the National Student Common Disease and Risk Factors Surveillance program in Shaanxi province, Northwestern China in 2023. Anxiety and depressive symptoms were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and the Center for Epidemiologic Studies Depression Scale (CES-D) respectively. An Extreme Gradient Boosting algorithm (XGBoost) model combined with Shapley additive explanations (SHAP) was applied to explore the relative predictive contribution of behavioral factors by school grade. A total of 94 472 students were included, in whom 15 113 (16.00%) had CAD, and the prevalence of CAD in senior high school students (22.08%) was higher than junior high students (12.01%). There was a gender specific difference in the prevalence of CAD, the proportion of CAD in boys was lower than in girl in junior high school (10.22% vs. 13.87%) and senior high school (20.45% vs. 23.64%). The all health-risk behaviors included in this study can influence the CAD among students, but there importance varied with gender and academic stage. The top three contributing factors were unhealthy diet, internet addiction and bully in junior high school boys. The top three contributing factors were unhealthy diet, internet addiction and sleep deprivation in junior high school girls. The top three contributing factors were sleep deprivation, internet addiction and unhealthy diet in both senior high school boys and girls. CAD is common among adolescents in Shaanxi Province, the prevalence of CAD increased with academic stage, while the junior high school students also screen-positive for CAD risk. The prevalence of CAD both in junior high school and senior high school students was mainly related to unhealthy life behaviors, such as unhealthy diet, internet addiction and sleep deprivation, and bully. Integrating behavioral risk surveillance with adolescent mental health services may help improve early identification and targeted intervention.

Background Comorbidity of anxiety and depression disorders (CAD) is common among adolescents and threaten the health and safety of adolescents. This study estimated the prevalence of CAD and examined its relative important influencing factors for formulating targeted intervention programs. Methods Data were from the National Student Common Disease and Risk Factors Surveillance program in Shaanxi province, Northwestern China in 2023. Anxiety and depressive symptoms were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and the Center for Epidemiologic Studies Depression Scale (CES-D) respectively. An Extreme Gradient Boosting algorithm (XGBoost) model combined with Shapley additive explanations (SHAP) was applied to explore the relative predictive contribution of behavioral factors by school grade. Results A total of 94 472 students were included, in whom 15 113 (16.00%) had CAD, and the prevalence of CAD in senior high school students (23.64%) higher than junior high students (12.01%). There was a gender specific difference in the prevalence of CAD, the proportion of CAD in boys was lower than in girl in junior high school (10.22% vs. 13.87%) and senior high school (20.45% vs. 23.64%). The health-risk behaviors included in this study can all influence the occurrence of CAD among students, but there importance varied with gender and academic stage. The top three contributing factors were unhealthy diet, internet addition and bully in junior high school boys. The top three contributing factors were unhealthy diet, internet addition and sleep deprivation in junior high school girls. The top three contributing factors were sleep deprivation, internet addition and unhealthy diet in both senior high school boys and girls. Conclusion CAD is common among adolescents in Shaanxi Province, the prevalence of CAD increased with academic stage, while the junior high school students also have CAD risk. The prevalence of CAD both in junior high school and senior high school students was mainly related to unhealthy life behaviors, such as unhealthy diet, internet addition and sleep deprivation, and bully.

This study aimed to examine the prevalence and epidemiological characteristics of hypertension among children and adolescents aged 7-17 years in Shaanxi Province using three hypertension guidelines for children and adolescents. Data from the 2023 Shaanxi Student's Health Surveillance Survey were used. Hypertension was defined according to three references, namely, the 2018 National Health Commission of the China (NHCC) pediatric blood pressure reference, the 2017 American Academy of Pediatrics (AAP) clinical practice guidelines, and the 2016 European Society of Hypertension guidelines (ESH). A log-binomial regression model was applied to assess the associations between hypertension and possible risk factors. A total of 220,497 students with an average age of 11.73 years were included in the analysis. The prevalence of hypertension was 11.73%, 15.75% and 10.04% according to the NHCC, AAP and ESH guidelines, respectively. All three guidelines suggest that children who were overweight or obese or who lived in rural areas had significantly greater odds of having hypertension, and central and southern Shaanxi students had significantly lower odds of having hypertension. All three guidelines show that hypertension in children and adolescents seems to be a serious health problem in Shaanxi Province as well as in Northwestern China; thus, policymakers and public health practitioners should take immediate action to address the already established modifiable risk factors.

目的 了解2020年陕西省中小学生近视现状及影响因素,为中小学生近视防治提供科学依据.方法 于2020年10-11月,采用分层整群抽样方法选择陕西省10个地市的小学四至六年级、初中和高中学生31 780人为研究对象,进行问卷调查、远视力检查和屈光检查.采用SPSS 18.0软件进行x2检验和多因素logistic回归分析.结果 陕西省中小学生近视检出率为69.12％.多因素logistic回归分析结果显示,女生(OR=1.448)、学校类型(与小学相比,初中OR=2.364,普通高中 OR=5.636,职业高中OR=1.850)、课后读写时间≥1h(与＜1 h 相比,1～＜2 h OR=1.130,2～＜3 hOR=1.136,≥3 h OR=1.196)、视屏时间≥1h(与＜1 h 相比,1～＜2h OR=1.167,2～＜3 h OR=1.152,≥3 h OR=1.235)、父母一方近视(OR=1.738)和双方均近视(OR=2.689)、视力检查次数(与不检查视力相比,检查1～2次OR=1.181,检查≥3次OR=1.104)与中小学生近视高风险相关,均有统计学意义(P＜0.05,P＜0.01),郊县(OR=0.891)、做眼保健操(OR=0.791)、在户外进行课间休息(OR=0.938)、眼睛与书本距离≥33 cm(OR=0.830)、家长限制看电子产品时间(OR=0.913)与中小学生近视低风险相关,均有统计学意义(P＜0.01).结论 陕西省中小学生近视率相对较高,防控形势十分严峻.应重点关注女生、城区、高年级、视屏时间及课后读写时间过长、父母近视的中小学生视力情况.

OBJECTIVE:To investigate the dietary patterns related to depressive symptoms based on reduced rank regression in people aged 55 and above in 4 provinces of China and the degree of association between this dietary pattern and depressive symptoms.METHODS:Stratified, multi-stage, cluster and random sampling method was used to collect personal information such as demographic characteristics, behavioral lifestyles, disease history and medicine use in Chinese aged 55 and above who participated in the baseline survey of "Community-based Cohort Study on Nervous System Diseases" project conducted in 2018 and 2019 in Hebei, Zhejiang, Shaanxi and Hunan Provinces. Food frequency questionnaire was used to obtain dietary data. Depressive symptom was assessed by geriatric depression scale with a cut-off of 11. Participants who have incomplete demographic information, dietary data or scores of geriatric depression scale, and those whose intake frequency of each food-group >99. 5% were excluded. A total of 11 497 participants, 43. 1% of whom were male, were involved in this study with average age of(67. 3±7. 6) years. The reduced rank regression method was used to extract depressive symptoms-related dietary patterns by gender, and the degree of association between dietary patterns and depressive symptom was analyzed by logistic regression.RESULTS:Among males, the depressive symptoms-related dietary pattern was characterized by the higher intake frequency of fried flour-made food, meat, processed meat, animal offal, and preserved eggs, and the lower intake frequency of liquid milk/milk power/cheese, fresh eggs(except preserved eggs) and nut. Among females, the depressive symptoms-related dietary pattern was characterized by the higher intake frequency of fried flour-made food, meat, processed meat, animal offal and preserved eggs, and the lower intake frequency of coarse cereals, fruits, liquid milk/milk power/cheese and fresh eggs(except preserved eggs). The highest quartile group of the dietary pattern score had a significantly higher risk of depressive symptom than the lowest quartile group(OR=3. 498, 95% CI 2. 624-4. 663, P<0. 001 for males; OR=3. 853, 95% CI 3. 002-4. 944, P<0. 001 for females).CONCLUSION:The depressive symptoms-related dietary pattern is characterized by the higher intake frequency of fried flour-made food, meat, processed meat, animal offal and preserved eggs, and the lower intake frequency of liquid milk/milk power/cheese and fresh eggs(except preserved eggs) in the Chinese aged 55 and above. The score of this dietary pattern is significantly positively correlated with depressive symptom.

OBJECTIVE:To establish a method for analysis of 25-hydroxylvitamin D_2(25(OH)D_2), 25-hydroxylvitamin D_3(25(OH)D_3)and vitamin K_1 in serum by ultra-performance liquid chromatography tandem mass spectrometry(UPLC-MS/MS), which can be applied in diagnosis of vitamin deficiency and estimation on the nutritional status of people.METHODS:Serum samples mixed with d_6-25(OH)D_3, d_7-vitamin K_1(internal standard)were precipitated with acetonitrile and extracted with n-hexane. The sample solution was separated using BEH C_(18) column(2. 1 mm×100 mm, 1. 7 μm) with gradient elution using methanol-water containing 0. 1% formic acid as mobile phase. The target molecule was detected in positive electrospray ionization(ESI~+) and multiple reaction monitoring.RESULTS:The concentration of 25(OH)D_2, 25(OH)D_3 and vitamin K_1 showed good linearity in the range 5. 0-75. 0 ng/mL, 2. 0-81. 5 ng/mL and 0. 3-12. 0 ng/mL, respectively, with the correlation coefficients greater than 0. 995. The limits of detection(LOD) of 25(OH)D_2, 25(OH)D_3 and vitamin K_1 were 1, 0. 25 and 0. 1 ng/mL, and the limits of quantification(LOQ) for 25(OH)D_2, 25(OH)D_3 and vitamin K_1were 3, 0. 75 and 0. 3 ng/mL, respectively. The recoveries of three levels in the matrix were 98. 5%-104. 3%, the relative standard deviation(RSD) were all less than 5. 0%(n=6).CONCLUSION:An UPLC-MS/MS method for analysis of 25(OH)D_2, 25(OH)D_3 and vitamin K_1 in serum is sensitive, rapid, accurate and suitable for the nutritional surveillance of vitamin D and K_1 in the population.

目的 了解陕西省农村地区中小学生维生素D营养状况,评估国家“农村义务教育学生营养改善计划”(简称“计划”)的实施效果,为合理补充维生素D提供科学依据. 方法 采用多阶段分层整群抽样,抽取2015-2017年陕西省参加“计划”的横山区、长武县、勉县中小学学生,采集空腹静脉血,对血清25-羟基维生素D(25-hydroxyvitamin D,25-(OH) D)进行测量,计算维生素D缺乏率、亚临床缺乏率,并进行分析评价. 结果 2015-2017年监测学生血清25-(OH)D为(22.21-±9.04) ng/ml,维生素D缺乏率、亚临床缺乏率分别为4.39％,41.95％;男生和女生血清25-(OH)D平均水平为(23.42±9.32)ng/ml和(20.94±8.56)ng/ml,差异有统计学意义(t=7.537,P＜0.001),小学生高于初中生(归15.644,P＜0.001),陕北＞关中＞陕南(F=90.810,P＜0.001);维生素D缺乏率、亚临床缺乏率,女生＞男生(x2=47.665,P＜0.001),初中生＞小学生(x2=146.965,P＜0.001),陕南＞关中＞陕北(x2=219.214,P＜0.001),2015年、2016年＞2017年(x2=382.476,P＜0.001).结论 自“计划”实施以来,学生维生素D营养缺乏有所改善,但仍不容乐观,仍有部分处于亚临床缺乏状态,应引起重视,加大营养改善力度.

OBJECTIVE To establish a method for the simultaneous and rapid determination of vitamin A and vitamin E of different configurations in human serum by high performance liquid chromatography(HPLC) with multi-wavelength fluorescence detector. METHODS The serum was mixed after adding internal standard, and acetonitrile was added for protein precipitation. The mixture was centrifuged after extraction with n-hexane. The n-hexane layer was dried by N_2 flow, the residue was dissolved with methanol. The HPLC system was consisted of WATERS Symmetry C_(18) column(4. 6 mm × 250 mm, 5 μm) and the mobile phase was methanol. The column temperature was 30 ℃ and fluorescence detector with online wavelength conversion method was carried out for the quantitative detection. RESULTS The liner range of determination of vitamin A, α-vitamin E, β-vitamin E and δ-vitamin E were 0. 050-2. 0 μg/mL, 0. 50-50 μg/mL, 0. 050-5. 0 μg/mL and 0. 050-5. 0 μg/mL, respectively(r≥0. 996). The minimum detection limits of the method for vitamin A and vitamin E were all 0. 02 μg/mL. The intraday and interday relative standard deviations(RSDs) were less than 3% at high, medium and low concentrations. The recoveries of the samples at the three concentrations were 91. 2%-107. 5%, and the RSDs were less than 10%. CONCLUSION This method is simple and accurate, with higher sensitivity than using UV detector and can be used for the simultaneous determination of vitamin A and vitamin E of different configurations in serum, and is suitable for rapid detection of batch serum samples.