Publications by authors named "Yeen Huang"

21 Publications

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Corrigendum to Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey [Psychiatry Research, 288 (2020) 112954].

Psychiatry Res 2021 May 8;299:113803. Epub 2021 Apr 8.

The 6th Affiliated Hospital of Shenzhen University Health Science Center, Nanshan Hospital Affiliated to Shenzhen University, Shenzhen, 518052, People's Republic of China; Department of Rehabilitation Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, 518052, People's Republic of China. Electronic address:

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http://dx.doi.org/10.1016/j.psychres.2021.113803DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026267PMC
May 2021

Retraction notice to "Chinese mental health burden during the COVID-19 pandemic" [Asian J. Psychiatr. 51 (2020) 102052].

Asian J Psychiatr 2020 12 17;54:102482. Epub 2020 Nov 17.

Huazhong University of Science and Technology, Union Shenzhen Hospital, China. Electronic address:

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http://dx.doi.org/10.1016/j.ajp.2020.102482DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712066PMC
December 2020

Association Between Incorrect Posture and Adolescent Idiopathic Scoliosis Among Chinese Adolescents: Findings From a Large-Scale Population-Based Study.

Front Pediatr 2020 15;8:548. Epub 2020 Sep 15.

The First Affiliated Hospital of Shenzhen University, Shenzhen, China.

Adolescent idiopathic scoliosis (AIS) affects between 1 and 4% of adolescents, and severe curvature may be related to their adverse long-term outcomes. However, whether the change in body appearance is related to AIS remains largely unclear. We aimed to explore the association between incorrect posture and AIS among Chinese adolescents. Data were collected from a population-based (595,057) school scoliosis screening program in China. A sample of 3,871 adolescents was classified as cases with a diagnosed radiological lateral Cobb angle ≥10°, and 3,987 control subjects with a Cobb angle <10° were randomly selected from the screening system. Adolescents were accessed with demographic information and incorrect posture measured by visual inspection of physical signs, Adam's forward bending test (FBT), and the angle of trunk rotation (ATR). Logistic regression (LR) models were used to examine the associations. Multivariate LR showed that shoulder-height difference, scapula tilt, lumbar concave, and pelvic tilt were associated with AIS. Adolescents with angle of thoracic rotation ≥5° [adjusted odds ratio (AOR) = 5.33-14.67, < 0.001], thoracolumbar rotation ≥5° (AOR = 4.61-5.79, < 0.001), or lumbar rotation ≥5° (AOR = 7.49-7.85, < 0.001) were at especially higher risk for AIS than those with ATR <5°. Incorrect posture may be the potential risk factor for developing AIS, and ATR ≥5° was an important indicator for predicting the occurrence of scoliosis. Early monitoring of incorrect posture for school adolescents should be considered as a routine intervention to effectively identify the progress of scoliosis.
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http://dx.doi.org/10.3389/fped.2020.00548DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7522343PMC
September 2020

Predicting Adolescent Idiopathic Scoliosis among Chinese Children and Adolescents.

Biomed Res Int 2020 19;2020:1784360. Epub 2020 Jul 19.

Department of spine surgery, The First Affiliated Hospital of Shenzhen University, Number 3002, Sungang west road, Futian district, Shenzhen 518035, China.

Objective: Adolescent idiopathic scoliosis (AIS) affects 1%-4% of adolescents in the early stages of puberty, but there is still no effective prediction method. This study aimed to establish a prediction model and validated the accuracy and efficacy of this model in predicting the occurrence of AIS.

Methods: Data was collected from a population-based school scoliosis screening program for AIS in China. A sample of 884 children and adolescents with the radiological lateral Cobb angle ≥ 10° was classified as an AIS case, and 895 non-AIS subjects with a Cobb angle < 10° were randomly selected from the screening system. All selected subjects were screened by visual inspection of clinical signs, the Adam's forward-bending test (FBT), and the measurement of angle of trunk rotation (ATR). LR and receiver operating characteristic (ROC) curves were used to preliminarily screen the influential factors, and LR models with different adjusted weights were established to predict the occurrence of AIS.

Results: Multivariate LR and ROC curves indicated that angle of thoracic rotation (adjusted odds ratios (AOR) = 5.18 - 10.06), angle of thoracolumbar rotation (AOR = 4.67 - 7.22), angle of lumbar rotation (AOR = 6.97 - 8.09), scapular tilt (area under the curve (AUC) = 0.77, 95% CI: 0.75-0.80), shoulder-height difference, lumbar concave, and pelvic tilt were the risk predictors for AIS. LR models with different adjusted weights (by AOR, AUC, and AOR+AUC) performed similarly in predicting the occurrence of AIS compared with multivariate LR. The sensitivity (82.55%-83.27%), specificity (82.59%-83.33%), Youden's index (0.65-0.67), positive predictive value (82.85%-83.58%), negative predictive value (82.29%-83.03%), and total accuracy (82.57%-83.30%) manifested that LR could accurately identify patients with AIS.

Conclusions: LR model is a relatively high accurate and feasible method for predicting AIS. Increased performance of LR models using clinically relevant variables offers the potential to early identify high-risk groups of AIS.
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http://dx.doi.org/10.1155/2020/1784360DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387995PMC
May 2021

Mental health burden for Chinese middle school students affected by the COVID-19 pandemic.

Asian J Psychiatr 2020 Dec 20;54:102251. Epub 2020 Jun 20.

The First Affiliated Hospital of Shenzhen University, Number 3002, Sungang road, Futian district, Shenzhen, 518035, PR China; The Shenzhen Second People's Hospital, Number 3002, Sungang west road, Futian district, Shenzhen, 518035, PR China. Electronic address:

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http://dx.doi.org/10.1016/j.ajp.2020.102251DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7305706PMC
December 2020

China's experience on mental health in response to the COVID-19 pandemic.

Asian J Psychiatr 2020 Oct 12;53:102205. Epub 2020 Jun 12.

The First Affiliated Hospital of Shenzhen University, Number 3002, Sungang West Road, Futian District, Shenzhen, 518035, PR China; The Shenzhen Second People's Hospital, Number 3002, Sungang West Road, Futian District, Shenzhen, 518035, PR China. Electronic address:

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http://dx.doi.org/10.1016/j.ajp.2020.102205DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291983PMC
October 2020

Chinese mental health burden during the COVID-19 pandemic.

Asian J Psychiatr 2020 Jun 14;51:102052. Epub 2020 Apr 14.

Huazhong University of Science and Technology, Union Shenzhen Hospital, China. Electronic address:

We aimed to assess the Chinese mental health burden during the COVID-19 pandemic. Data were collected from 7,236 participants assessed with anxiety disorders, depressive symptoms, and poor sleep . The overall prevalence of anxiety disorders, depressive symptoms, sleep quality were 35.1%, 20.1%, 18.2%, respectively. Younger people reported a higher prevalence of anxiety disorders and depressive symptoms than older people (P < 0.001). Compared with other occupation, healthcare workers have the highest rate of poor sleep quality (P < 0.001). We identified a major mental health burden of the public during the COVID-19 pandemic outbreak in China. Younger people and healthcare workers were at high risk for mental illness.
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http://dx.doi.org/10.1016/j.ajp.2020.102052DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195325PMC
June 2020

Prevalence of Incorrect Posture among Children and Adolescents: Finding from a Large Population-Based Study in China.

iScience 2020 May 8;23(5):101043. Epub 2020 Apr 8.

Department of Spine Surgery, the First Affiliated Hospital of Shenzhen University, Number 3002, Sungang West Road, Futian District, Shenzhen 518035, People's Republic of China; Department of Spine Surgery, the Shenzhen Second People's Hospital, Number 3002, Sungang West Road, Futian District, Shenzhen 518035, People's Republic of China; Shenzhen Youth Spine Health Center, Number 2008, Sungang West Road, Futian District, Shenzhen 518000, People's Republic of China. Electronic address:

Evidence showed that bad posture in adulthood is often formed from the childhood, and individuals with severe incorrect posture may be associated with the progress of scoliosis. We aimed to estimate the prevalence of incorrect posture in Chinese children and adolescents and to describe the epidemiological findings stratified by the demographic characteristics. A total of 595,057 students were screened; the overall prevalence of incorrect posture in children and adolescents was 65.3%, and around 3.7% of the students were referred to radiography. Girls had a higher prevalence of incorrect posture than boys, students aged >10 years accounted for a higher rate of incorrect posture than students aged <10 years. We found that Chinese children and adolescents had a high prevalence of incorrect posture, with girls and older students being an especially high-risk group. Early interventions targeted for students with incorrect posture are urgently needed.
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http://dx.doi.org/10.1016/j.isci.2020.101043DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7178490PMC
May 2020

Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey.

Psychiatry Res 2020 06 12;288:112954. Epub 2020 Apr 12.

The 6th Affiliated Hospital of Shenzhen University Health Science Center, Nanshan Hospital Affiliated to Shenzhen University, Shenzhen, 518052, People's Republic of China; Department of Rehabilitation Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, 518052, People's Republic of China. Electronic address:

China has been severely affected by Coronavirus Disease 2019(COVID-19) since December, 2019. We aimed to assess the mental health burden of Chinese public during the outbreak, and to explore the potential influence factors. Using a web-based cross-sectional survey, we collected data from 7,236 self-selected volunteers assessed with demographic information, COVID-19 related knowledge, generalized anxiety disorder (GAD), depressive symptoms, and sleep quality. The overall prevalence of GAD, depressive symptoms, and sleep quality of the public were 35.1%, 20.1%, and 18.2%, respectively. Younger people reported a significantly higher prevalence of GAD and depressive symptoms than older people. Compared with other occupational group, healthcare workers were more likely to have poor sleep quality. Multivariate logistic regression showed that age (< 35 years) and time spent focusing on the COVID-19 (≥ 3 hours per day) were associated with GAD, and healthcare workers were at high risk for poor sleep quality. Our study identified a major mental health burden of the public during the COVID-19 outbreak. Younger people, people spending too much time thinking about the outbreak, and healthcare workers were at high risk of mental illness. Continuous surveillance of the psychological consequences for outbreaks should become routine as part of preparedness efforts worldwide.
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http://dx.doi.org/10.1016/j.psychres.2020.112954DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152913PMC
June 2020

China urgently needs a nationwide scoliosis screening system.

Acta Paediatr 2020 11 14;109(11):2416-2417. Epub 2020 May 14.

Department of Spine Surgery, the First Affiliated Hospital of Shenzhen University, Shenzhen, China.

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http://dx.doi.org/10.1111/apa.15326DOI Listing
November 2020

Mental health burden for the public affected by the COVID-19 outbreak in China: Who will be the high-risk group?

Psychol Health Med 2021 01 14;26(1):23-34. Epub 2020 Apr 14.

The 6th Affiliated Hospital of Shenzhen University Health Science Center, Nanshan Hospital Affiliated to Shenzhen University Shenzhen , Shenzhen, People's Republic of China.

In December, 2019, an outbreak of respiratory illness caused by Coronavirus disease 2019 (COVID-19) emerged in Wuhan, China and spread rapidly to other parts of China and around the world. We aimed to identify high-risk groups whose mental health conditions were vulnerable to the COVID-19 outbreak. Data were collected from 7,236 self-selected participants measured by anxiety symptoms, depressive symptoms, and sleep quality. The overall prevalence of anxiety symptoms, depressive symptoms, and poor sleep quality were 35.1%, 20.1%, and 18.2%, respectively. People aged < 35 years reported a higher prevalence of anxiety symptoms and depressive symptoms than people aged ≥ 35 years. Healthcare workers have the highest rate of poor sleep compared to other occupations. Healthcare workers/younger people who spent a high level of time (≥ 3 hours/day) had a particular higher prevalence of anxiety symptoms than in those who spent less time (< 1 hours/day and 1-2 hours/day) on the outbreak. During the COVID-19 outbreak, healthcare workers and younger people were at an especially high-risk of displaying psychological impact when they spent too much time thinking about the outbreak. Continuous monitoring of the psychological consequences for high-risk population should become routine as part of targeted interventions during times of crisis.I.
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http://dx.doi.org/10.1080/13548506.2020.1754438DOI Listing
January 2021

Gender differences in the associations between types of childhood maltreatment and sleep disturbance among Chinese adolescents.

J Affect Disord 2020 03 22;265:595-602. Epub 2019 Nov 22.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, China. Electronic address:

Background: To explore the association between different types of childhood maltreatment and sleep disturbance among Chinese adolescents, with a particular focus on gender differences.

Methods: A cross-sectional study was conducted in 7 randomly selected provinces of China via the 2015 School-Based Chinese Adolescents Health Survey. Questionnaires from 153,547 students were completed and were eligible for this study. The Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI) and Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess sleep disturbance and childhood maltreatment, respectively.

Results: The prevalence of sleep disturbance among adolescents in China was 21.6%. A significantly increased risk of sleep disturbance was associated with physical abuse (aOR=1.22, 95% CI=1.21-1.24), emotional abuse (aOR=1.15, 95% CI=1.14-1.15), sexual abuse (aOR=1.16, 95% CI=1.15-1.18), physical neglect (aOR=1.04, 95% CI=1.03-1.05), and emotional neglect (aOR=1.03, 95% CI=1.02-1.03). A significant dose-response relationship was found between cumulative childhood maltreatment experiences and sleep disturbance. The interaction terms (between physical abuse/emotional abuse/sexual abuse/physical neglect/emotional neglect/number of childhood traumas and gender) were significantly associated with sleep disturbance. Further stratification analyses by gender showed that girls who reported experiencing one or more of these five types of childhood maltreatment had a higher risk of sleep disturbance than boys.

Limitations: The study only included school students, and the cross-sectional design limited our ability to make causal inferences.

Conclusions: The study findings suggest that childhood maltreatment increases the risk of sleep disturbance in adolescents. Furthermore, exposure to single and multiple types of childhood maltreatment predicts lower sleep quality in girls.
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http://dx.doi.org/10.1016/j.jad.2019.11.099DOI Listing
March 2020

Gender differences in the associations between types of childhood maltreatment and sleep disturbance among Chinese adolescents.

J Affect Disord 2020 03 22;265:595-602. Epub 2019 Nov 22.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, China. Electronic address:

Background: To explore the association between different types of childhood maltreatment and sleep disturbance among Chinese adolescents, with a particular focus on gender differences.

Methods: A cross-sectional study was conducted in 7 randomly selected provinces of China via the 2015 School-Based Chinese Adolescents Health Survey. Questionnaires from 153,547 students were completed and were eligible for this study. The Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI) and Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess sleep disturbance and childhood maltreatment, respectively.

Results: The prevalence of sleep disturbance among adolescents in China was 21.6%. A significantly increased risk of sleep disturbance was associated with physical abuse (aOR=1.22, 95% CI=1.21-1.24), emotional abuse (aOR=1.15, 95% CI=1.14-1.15), sexual abuse (aOR=1.16, 95% CI=1.15-1.18), physical neglect (aOR=1.04, 95% CI=1.03-1.05), and emotional neglect (aOR=1.03, 95% CI=1.02-1.03). A significant dose-response relationship was found between cumulative childhood maltreatment experiences and sleep disturbance. The interaction terms (between physical abuse/emotional abuse/sexual abuse/physical neglect/emotional neglect/number of childhood traumas and gender) were significantly associated with sleep disturbance. Further stratification analyses by gender showed that girls who reported experiencing one or more of these five types of childhood maltreatment had a higher risk of sleep disturbance than boys.

Limitations: The study only included school students, and the cross-sectional design limited our ability to make causal inferences.

Conclusions: The study findings suggest that childhood maltreatment increases the risk of sleep disturbance in adolescents. Furthermore, exposure to single and multiple types of childhood maltreatment predicts lower sleep quality in girls.
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http://dx.doi.org/10.1016/j.jad.2019.11.099DOI Listing
March 2020

Gender differences in the associations between types of childhood maltreatment and sleep disturbance among Chinese adolescents.

J Affect Disord 2020 03 22;265:595-602. Epub 2019 Nov 22.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, China. Electronic address:

Background: To explore the association between different types of childhood maltreatment and sleep disturbance among Chinese adolescents, with a particular focus on gender differences.

Methods: A cross-sectional study was conducted in 7 randomly selected provinces of China via the 2015 School-Based Chinese Adolescents Health Survey. Questionnaires from 153,547 students were completed and were eligible for this study. The Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI) and Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess sleep disturbance and childhood maltreatment, respectively.

Results: The prevalence of sleep disturbance among adolescents in China was 21.6%. A significantly increased risk of sleep disturbance was associated with physical abuse (aOR=1.22, 95% CI=1.21-1.24), emotional abuse (aOR=1.15, 95% CI=1.14-1.15), sexual abuse (aOR=1.16, 95% CI=1.15-1.18), physical neglect (aOR=1.04, 95% CI=1.03-1.05), and emotional neglect (aOR=1.03, 95% CI=1.02-1.03). A significant dose-response relationship was found between cumulative childhood maltreatment experiences and sleep disturbance. The interaction terms (between physical abuse/emotional abuse/sexual abuse/physical neglect/emotional neglect/number of childhood traumas and gender) were significantly associated with sleep disturbance. Further stratification analyses by gender showed that girls who reported experiencing one or more of these five types of childhood maltreatment had a higher risk of sleep disturbance than boys.

Limitations: The study only included school students, and the cross-sectional design limited our ability to make causal inferences.

Conclusions: The study findings suggest that childhood maltreatment increases the risk of sleep disturbance in adolescents. Furthermore, exposure to single and multiple types of childhood maltreatment predicts lower sleep quality in girls.
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http://dx.doi.org/10.1016/j.jad.2019.11.099DOI Listing
March 2020

Gender differences in the associations between types of childhood maltreatment and sleep disturbance among Chinese adolescents.

J Affect Disord 2020 03 22;265:595-602. Epub 2019 Nov 22.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, China. Electronic address:

Background: To explore the association between different types of childhood maltreatment and sleep disturbance among Chinese adolescents, with a particular focus on gender differences.

Methods: A cross-sectional study was conducted in 7 randomly selected provinces of China via the 2015 School-Based Chinese Adolescents Health Survey. Questionnaires from 153,547 students were completed and were eligible for this study. The Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI) and Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess sleep disturbance and childhood maltreatment, respectively.

Results: The prevalence of sleep disturbance among adolescents in China was 21.6%. A significantly increased risk of sleep disturbance was associated with physical abuse (aOR=1.22, 95% CI=1.21-1.24), emotional abuse (aOR=1.15, 95% CI=1.14-1.15), sexual abuse (aOR=1.16, 95% CI=1.15-1.18), physical neglect (aOR=1.04, 95% CI=1.03-1.05), and emotional neglect (aOR=1.03, 95% CI=1.02-1.03). A significant dose-response relationship was found between cumulative childhood maltreatment experiences and sleep disturbance. The interaction terms (between physical abuse/emotional abuse/sexual abuse/physical neglect/emotional neglect/number of childhood traumas and gender) were significantly associated with sleep disturbance. Further stratification analyses by gender showed that girls who reported experiencing one or more of these five types of childhood maltreatment had a higher risk of sleep disturbance than boys.

Limitations: The study only included school students, and the cross-sectional design limited our ability to make causal inferences.

Conclusions: The study findings suggest that childhood maltreatment increases the risk of sleep disturbance in adolescents. Furthermore, exposure to single and multiple types of childhood maltreatment predicts lower sleep quality in girls.
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http://dx.doi.org/10.1016/j.jad.2019.11.099DOI Listing
March 2020

Gender differences in the associations between types of childhood maltreatment and sleep disturbance among Chinese adolescents.

J Affect Disord 2020 03 22;265:595-602. Epub 2019 Nov 22.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, China. Electronic address:

Background: To explore the association between different types of childhood maltreatment and sleep disturbance among Chinese adolescents, with a particular focus on gender differences.

Methods: A cross-sectional study was conducted in 7 randomly selected provinces of China via the 2015 School-Based Chinese Adolescents Health Survey. Questionnaires from 153,547 students were completed and were eligible for this study. The Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI) and Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess sleep disturbance and childhood maltreatment, respectively.

Results: The prevalence of sleep disturbance among adolescents in China was 21.6%. A significantly increased risk of sleep disturbance was associated with physical abuse (aOR=1.22, 95% CI=1.21-1.24), emotional abuse (aOR=1.15, 95% CI=1.14-1.15), sexual abuse (aOR=1.16, 95% CI=1.15-1.18), physical neglect (aOR=1.04, 95% CI=1.03-1.05), and emotional neglect (aOR=1.03, 95% CI=1.02-1.03). A significant dose-response relationship was found between cumulative childhood maltreatment experiences and sleep disturbance. The interaction terms (between physical abuse/emotional abuse/sexual abuse/physical neglect/emotional neglect/number of childhood traumas and gender) were significantly associated with sleep disturbance. Further stratification analyses by gender showed that girls who reported experiencing one or more of these five types of childhood maltreatment had a higher risk of sleep disturbance than boys.

Limitations: The study only included school students, and the cross-sectional design limited our ability to make causal inferences.

Conclusions: The study findings suggest that childhood maltreatment increases the risk of sleep disturbance in adolescents. Furthermore, exposure to single and multiple types of childhood maltreatment predicts lower sleep quality in girls.
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http://dx.doi.org/10.1016/j.jad.2019.11.099DOI Listing
March 2020

The mediating effects of depressive symptoms on the association of childhood maltreatment with non-medical use of prescription drugs.

J Affect Disord 2018 03 26;229:14-21. Epub 2017 Dec 26.

Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China. Electronic address:

Background: Childhood maltreatment might increase the risk of subsequent drug use behavior, and depressive symptoms have been reported to be associated both childhood maltreatment and non-medical use of prescription drugs (NMUPD). This large-scale study aimed to test the mediating effects of depressive symptoms on the association of childhood maltreatment with NMUPD among Chinese adolescents.

Methods: A secondary analysis of the cross-sectional data collected from 7th to 12th graders who were sampled using a multistage, stratified cluster, random sampling method in the 2015 School-based Chinese Adolescents Health Survey. There were 24,457 students who were invited to participate and 23,039 students' questionnaires were completed and qualified for our survey (response rate: 94.2%).

Results: In the adjusted models without mediation, the results showed that students who reported that they had experienced emotional abuse were at a higher risk of past year use and past month use of opioids (past year: Adjusted OR [AOR] = 1.07, 95% CI = 1.05-1.10; past month: AOR = 1.08, 95% CI = 1.06-1.10) and sedatives (past year: AOR = 1.06, 95% CI = 1.03-1.08; past month: AOR = 1.15, 95% CI = 1.13-1.16). The results of mediation analyses demonstrated that there were significant standardized indirect effects of emotional abuse on opioids use and sedatives use through depressive symptoms, respectively (P < 0.001).

Limitations: Our study sample only included school students, and causal inference could not be examined due to the cross-sectional design.

Conclusions: Depressive symptoms play a significant mediator role on the association of childhood maltreatment with NMUPD. Interventions targeted at adolescents who are involved in NMUPD should pay attention to their histories of childhood maltreatment.
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http://dx.doi.org/10.1016/j.jad.2017.12.029DOI Listing
March 2018

Is sexual minority status associated with poor sleep quality among adolescents? Analysis of a national cross-sectional survey in Chinese adolescents.

BMJ Open 2017 12 26;7(12):e017067. Epub 2017 Dec 26.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.

Objectives: Recent studies have suggested that sexual minorities are more likely to have poor sleep quality. This study aims to explore sleep quality among sexual minority adolescents and examines the association between sexual minority status and sleep quality.

Design: Cross-sectional survey.

Setting: A total of 506 high schools in seven Chinese provinces.

Participants: A total of 150 822 students in grades 7-12 completed the questionnaires, and 123 459 students who reported being aware of their sexual orientation were included in analyses.

Main Outcome Measures: The Pittsburgh Sleep Quality Index, sexual attraction and school bullying victimisation.

Results: Of the 123 459 students who were analysed, 5.00% self-reported as sexual minorities. Only 26.67% of sexual minority students slept 8 or more hours/day, which is less than their heterosexual peers (35.70%; χ=130.04, P<0.001). Of the total sample, 22.41% of the students reported poor sleep quality, and this prevalence was significantly higher in sexual minority students than in heterosexual students (32.56% vs 21.87%; χ=281.70, P<0.001). After controlling for social demographics, lifestyle and depressive symptoms, sexual minority students had higher odds of poor sleep quality (adjusted OR=1.41, 95% CI 1.31 to 1.51) than their heterosexual peers. The indirect effect of school bullying victimisation (standardised β estimate=0.007, 95% CI 0.006 to 0.009) was significant, indicating that school bullying victimisation partially mediated the association between sexual minority status and sleep quality.

Conclusions: Our study suggested that poor sleep quality was common in sexual minority adolescents, and more attention should be paid to sleep problems in this population. Conducting interventions to reduce school bullying behaviours is an important step to improving sleep quality in sexual minority adolescents. Further, studies are warranted that focus on the risk factors and mechanisms of and interventions for sleep problems in sexual minority adolescents.
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http://dx.doi.org/10.1136/bmjopen-2017-017067DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770949PMC
December 2017

Sexual attraction and the nonmedical use of opioids and sedative drugs among Chinese adolescents.

Drug Alcohol Depend 2018 02 15;183:169-175. Epub 2017 Dec 15.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, China. Electronic address:

Objective: The nonmedical use of prescription drugs (NMUPD) is attracting public attention. We aimed to explore the association between sexual attraction and NMUPD among Chinese adolescents.

Method: A school-based survey was conducted in seven Chinese provinces, and a multi-stage stratified cluster sampling method was used in this study. A total of 150,822 students from seven Chinese provinces completed the questionnaire; the response rate was 95.93%. All data were collected between November 2014 and January 2015.

Results: Overall, 8.8%, 4.4%, and 2.2% of the students reported lifetime, past-year, and past-month NMUPD, respectively. Compared with heterosexual students (8.2%), sexual minority and unsure students were more likely to report lifetime NMUPD (14.4% and 10.0%, respectively; χ = 244.34, P < 0.001). In addition, sexual minority and unsure students were more likely to admit past-year and past-month use of NMUPD. After adjusting for social demographics and lifestyle covariates, sexual minority and unsure students were at an increased risk of lifetime NMUPD (adjusted odds ratio [AOR] = 1.68, 95% confidence interval [CI] = 1.54-1.83 and AOR = 1.33, 95% CI = 1.26-1.41, respectively).

Conclusions: Our study suggested that sexual minority and unsure adolescents have a higher risk of NMUPD. Moreover, our study suggested that sexual minority and unsure students are more likely to both try and continue to use prescription drugs. Further studies focusing on the mechanism of substance abuse and appropriate interventions among sexual minority and unsure adolescents are warranted.
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http://dx.doi.org/10.1016/j.drugalcdep.2017.10.038DOI Listing
February 2018

[Mitochondrial injury in enterovirus 71-infected Vero cells and its mechanism].

Nan Fang Yi Ke Da Xue Xue Bao 2015 Jun;35(6):857-61

Department of Pathology, School of Basic Medical Sciences, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China. E-mail:

Objective: To investigate the mitochondrial injury in enterovirus 71 (EV71)-infected Vero cells and explore the possible mechanism.

Methods: A clinical isolate of EV71 was inoculated to Vero cells and the EV71 antigen was detected by immunofluorescence assay. The morphological changes of Vero cells were observed using optical microscopy and transmission electron microscopy. The diameter and area density of the viral particles and the ratio and area density of vacuolated mitochondria in the cells were measured on the ultrastructural images.

Results: EV71-infected Vero cells underwent obvious changes and to a spherical morphology followed by cell death EV71 particles were detected in the cytoplasm by immunofluorescence. Ultrastructurally, the infected cells contained a large number of viral particles in the cytoplasm, with a clustered distribution and lattice-like arrangement. The diameter of the particles were 16.3 nm and the mean area density was 38.3%. Most of the mitochondria presented with swelling, vacuoles and degeneration. The ratio of the vacuolated mitochondria was 90.9% with a mean area density of 89.2%. Viral particles were also found in some mitochondria.

Conclusion: EV71 proliferates in the cytoplasm and invades the mitochondria of infected Vero cells leading to mitochondrial injury and cell death, suggesting that mitochondria are the targets for EV71 infection.
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June 2015

An enterovirus 71 strain causes skeletal muscle damage in infected mice.

Int J Clin Exp Pathol 2015 1;8(4):3460-8. Epub 2015 Apr 1.

Department of Pathology, School of Basic Medical Sciences, Southern Medical University Tonghe, Guangzhou, China.

Objective: To study the target organs for enterovirus 71 (EV71) in infected suckling mice.

Methods: 5-day-old BALB/c suckling mice were infected with an EV71 strain. Tissues of the infected mice were processed for histopathological examination, including immunohistochemistry, in situ hybridization, ultrastructural observation.

Results: Some mice developed limb paralysis, trouble walking and loss of balance. Results of the histopathological study showed that a large amount of EV71 existed in the skeletal muscle tissues, accounting for the damage of the skeletal muscles.

Conclusion: The EV71 clinical isolate used in this study presented evident myotropism. Skeletal muscles are important target organs for EV71 in the infected suckling mice. To clarify the relationship between EV71 infection and muscle diseases may contribute to a better understanding of the pathogenesis of EV71.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4466917PMC
April 2017