Objective: To investigate the normal urinary manganese value in healthy adults in Guangxi, China and its distribution characteristics. Methods: From 2015 to 2016, stratified random sampling based on age and sex was performed to select 1533 healthy adults aged 18-60 years in Nanning,Liuzhou,Guilin,Hezhou,Wuzhou,Yulin,Guigang,Beihai,Qinzhou,Laibin,Hechi Nandan,Bose Jingxi,Chongzuo Daxin,and Fangchenggang.All of them had no history of occupational manganese exposure or acute or chronic liver/renal diseases and had lived in the local area for more than one year. A total of 1417 urine samples with normal specific gravity and complete data were obtained, and graphite furnace atomic absorption spectrometry was used to measure urinary manganese.The distribution characteristics of urinary manganese level were analyzed among adults with different ages,sexes,or presence or absence of smoking habits or among those who lived or did not live in the mining area. Results: The geometric mean of urinary manganese among healthy adults in Guangxi was 0.52 μg/L,and the upper limit of normal was 5.68μg/L. There was no significant difference in urinary manganese level between the healthy adults with different ages, sexes,or presence or absence of smoking habits (P>0.05).The healthy adults who lived in the mining area of nonferrous metal mines had a significantly higher geometric mean of urinary manganese than those who did not live in such areas(1.65μg/Lvs0.34μg/L,P<0.01). Conclusion The upper limit of normal of urinary manganese is 5.68 μg/L among healthy adults in Guangxi,and the healthy adults who live in the mining area of manganese mine or nonferrous metal mines have a significantly higher urinary manganese level than those who do not live in such areas.

Objective: To investigate the upper limit of the normal value of arsenic in healthy adult population in different areas of Guangxi. Methods: From 2015 to 2016, 1533 subjects from 14 counties and cities in Guangxi were collected by age, gender, stratified random sampling and questionnaire survey. 1417 urine samples with satisfactory urine quality and complete information were collected.The content of arsenic in urine was determined by atomic fluorescence spectrometry. Results: The upper limit of normal arsenic in healthy adults in guangxi was 0.053 mg/L. Male urinary arsenicP₅₀(0.011mg/L)was higher than that of the female(0.008mg/L), the difference was statistically significant(Z=5.352,P<0.01). Smoking urinary arsenicP₅₀(0.012mg/L) was higher than that of nonsmokers(0.009mg/L), the difference was statistically significant(Z=3.404,P<0.01). GroupP₅0 urine arsenic in coastal areas(0.012mg/L) the crowd was higher than that in non coastal areas(0.009mg/L), the difference was statistically significant(Z=-7.522,P<0.01). Conclusion The upper limit of normal arsenic in healthy adults in Guangxi area is 0.053mg/L,and there are differences in the levels of arsenic in healthy adults, such as different genders and regions.

Abstract The health of children and adolescents is not only related to the growth and wellbeing of individuals, but also to the construction and development of countries. This study reviewed policies that were issued by the central government since the founding of New China which focused on the prevention and treatment of common diseases among school-age children and adolescents. The results revealed that, since the founding of New China, policies for the prevention and control of common diseases among school-age children and adolescents increased in number, and they began to focus on specific rather than general health problems. A gradual emphasis was placed on the specific implementation of prevention and control measures, rather than on guiding principles. Increasingly more attention has been paid to the prevention and treatment of common diseases among school-age children and adolescents.

Objective: To construct core information about physical activities of Chinese students aged 7-18 years, so as to provide a reference for impoving the level of adolescents physical activities. Methods: Canadian 24 Hour Movement Guidelines for Children and Youth was used as a framework, the preliminary core recommendations on physical activity for Chinese students aged 7-18 years were developed based on qualitative research. Recommendations covered three scales, including physical activity, sedentary behaviour and sleep. Physical activity included four subscales of frequency, intensity, duration and type, while sedentary behaviour and sleep only included one subscale. Three rounds of consultation were conducted using Delphi method. In the second round of consultation, the results of 2014 Chinese National Surveys on Students Constitution and Health were presented to experts for reference. In the third round of consultation, experts need to rank the importance of seven items of physical fitness under the physical activity type subscale by age group through analytic hierarchy process. Results: Totally 25, 25, and 18 experts were consulted in three rounds respectively. The questionnaire response rates in 3 rounds were 100.0%, 100.0%, and 94.4%, respectively. The authority coefficients were 0.92, 0.93, and 0.91. The harmony coefficients were 0.63( χ 2=237.10, P <0.01), 0.63( χ 2= 242.60 , P <0.01), and 0.76( χ 2=97.05, P <0.01). It was recommended that students aged 7 to 18 years in China should do moderate to vigorous physical activity for a cumulative total of at least 60 minutes per day, and most of the 60 minutes or more per day should be either moderate or vigorous intensity aerobic physical activity. Of the daily physical activity, students should conduct vigorous intensity aerobic physical activity, muscle strengthening and bone strengthening physical activity on at least 3 days a week. At least 2 hours of daytime outdoor activity was recommended for primary school students and 1 hour for secondary school students. 7-12 year old students should do more physical activities that enhance flexibility, coordination and agility, while 13-18 year old students should do more physical activities that enhance strength, endurance and speed. Sedentary behaviour included one subscale, where students should reduce sedentary behaviour, break up long periods of sitting as often as possible, and limit recreational screen time and online study time. Sleep included one subscale of duration.Students should get sufficient and uninterrupted sleep per night. Conclusion The development of core recommendations on physical activity for Chinese students aged 7 to 18 might help improve physical activity levels and promote health of children and adolescents.

Objective: To analyze the association between the occurrence of menarche and the exposure to artificial light at night (ALAN) in female Han nationality girls aged 9-18 in China, so as to provide a reference for the research on the disturbance mechanism of ALAN on puberty, as well as provide a scientific evidence for controlling ALAN and making public sanitary policy. Methods: A total of 74 483 Han girls aged 9-18 with complete records of menarche, height, and weight were included in the 2014 Chinese National Surveys on Students Constitution and Health. Pearson correlation was used to explore the correlation between the incidence of menarche and the exposure to artificial light at night in 11-year-old Han girls, and the third quantiles of the area covered by outdoor night lights (0.16, 0.60) and the third quantiles of the average night light intensity [0.97, 5.91 nw/(sr ·cm) 2] were used respectively to divide the study subjects into 3 groups, and the multifactor Logistic regression model was used to analyze the effect of artificial light at night exposure on menarche. Results: In 2014, the median age of menarche of Chinese Han girls was 12.18 years old, and the incidence of menarche in the 11-year-old group was 26.31%. After controlling for body mass index, local population and the logarithmic values of per capita GDP, the incidence of menarche of 11-year-old Han girls was positively correlated with the local outdoor average night light coverage area ratio and the night average light intensity logarithmic adjustment value( r =0.29, 0.30, P <0.05).The higher the local outdoor night light coverage area ratio ( OR =1.28, 1.52) and the average night light intensity ( OR =1.47, 1.58), the higher the incidence of menarche in 11-year-old Han girls( P <0.05). Conclusion There is a positive correlation between artificial light at night exposure and the menarche rate of 11-year-old Han girls. Research on artificial light at night exposure may provide scientific evidence on puberty onset and its effects on population health.

Objective: To analyze physical fitness and health status and gender differences of middle school students among 5 minorities (Mongolian, Hui, Uyghur, Zhuang and Korean), and to provide the theoretical basis for the strategy formulation. Methods: The present data came from 3 waves of Chinese National Survey on Students Constitution and Health (2010, 2014, and 2019). According to National Standards for Students Physical Health (2014 Revision), excellent, and excellent good physical fitness and health status were defined. Cochran Armitage test was used to examine the trends of physical fitness and health status. Chi square test and Logistic regression were used to analyze the difference of physical fitness and health status by sex and survey year. Results: From 2010 to 2019, the excellent physical fitness and health status rate of Mongolian, Hui, Uyghur, Zhuang and Korean students increased from 1.8%, 0.7%, 0.3%, 0.5% and 1.3% to 4.3%, 2.8%, 1.2%, 1.3% and 3.5%, respectively. The excellent good physical fitness and health status rate of Mongolian, Hui, Uyghur and Zhuang students increased from 12.9%, 8.0%, 7.2 % and 8.4% to 24.7%, 20.1%, 12.6% and 19.8%( Z =6.15，6.71，4.12，3.06，5.26；11.88，13.42，6.70，11.08， P <0.05), respectively. In 2019, students aged 13 to 15 years showed higher proportion of excellent/excellent good physical fitness and health status than that of students aged 16 to 18. Boys were more likely to be in excellent/excellent good physical fitness and health status than girls from 2010 to 2019. The sex difference in excellent/excellent good physical fitness and health status narrowed during 2010 and 2019. Conclusion Physical fitness and health status of minority students improved while sex difference narrowed during last decade, but there is still a long way to reach the goal proposed by China. Targeted intervention should be proposed to promote physical fitness and health status in accordance with the developmental characteristics, especially for girls and students aged 16 to 18 years.

BACKGROUND: Non-transport unintentional injuries (NTUIs) are major public concerns, especially among children and adolescents in low- and middle-income countries. With environmental and cognitive changes, a recent systematic description of global trends and regional differences concerning NTUIs is urgently needed for the global agenda of relevant policy-making and intervention target findings. METHODS: We used mortality, population, and socio-demographic-index (SDI) data from Global Burden of Disease 2019 to analyze the trends of NTUIs mortality. We applied the slope index of inequality (SII) and relative index of inequality (RII) to measure the absolute and relative inequality between countries and territories. The concentration curve and concentration index (CI) were also used to measure the inequality. We conducted a sensitivity analysis to make our findings credible. RESULTS: In 2019, there were 205,000 deaths due to NTUIs among children and adolescents aged 5 to 24 years, which decreased from 375,000 in 1990. In 2019, the age-standardized mortality rate (ASMR) was 8.13 per 100,000, ranging from the lowest in the Netherlands (0.90 per 100,000) to the highest in the Solomon Islands (29.34 per 100,000). The low-middle SDI group had the highest ASMR of NTUIs, while the low SDI group had the slowest decrease. After excluding the death caused by "exposure to forces of nature" and "other unintentional injuries", drowning accounted for the most deaths in almost every SDI group, gender, and age group, but the major causes of death varied in different subgroups. For example, animal contact was a major cause in low and low-middle SDI groups but less in high SDI groups, while high and high-middle SDI groups had a higher proportion of deaths for foreign body and poisonings. The SII showed a declining trend, but the RII and CI did not, which might indicate that inequality was persistent. Similar results were found in the sensitivity analysis. CONCLUSIONS Despite the declining trend of the mortality rate and the narrowing gap between countries, there were still a large number of children and adolescents dying from NTUIs, and those experiencing social-economic disadvantages remained at high mortality. Embedding the prevention of NTUIs into sustainable development goals might contribute to the progress of reducing death and inequalities, which ensures that no one is left behind.
Global Burden of Disease