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Article History

Received: 2 October 2024

Accepted: 24 February 2026

First Online: 14 March 2026

Competing interests

: The authors declare no competing interests.

: The ethical approval was obtained from the Medical Ethics Committee of Xi’an TCM Hospital of Encephalopathy (NO 西脑伦理2017-01) dated by (1/6/2017). All research activities, including study design and data collection methods were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

: Written informed consent was meticulously obtained from all participants and their parents prior to any data collection, specifically between April 20 and May 5, 2019. Before participation, all participants and their parents were comprehensively briefed about the purpose and procedures of the study, the confidentiality of their responses, the absence of risk in the study, and their right to withdraw at any time without any consequences. Participants were explicitly informed that involvement was entirely voluntary, withdrawal was permitted at any time without penalty, and data would be used anonymously for scientific purposes only. Participants and their parents could raise any questions or concerns before, during or after the study. Only upon confirming their full understanding and voluntary agreement did they sign the informed consent form. All collected data were anonymized to protect participant identity and ensure confidentiality.