ObjectiveTo investigate the cadmium contamination levels in commercially available foods in Jinhua City, to assess the dietary cadmium exposure risk among Jinhua residents, and to provide a scientific basis for optimizing dietary recommendations and managing cadmium exposure risks. MethodsFrom 2013 to 2024, a total of 4 434 samples of 15 categories of commercially available foods from the Jinhua Food Safety Risk Monitoring System, including rice, milled and processed grains, fresh vegetables 1 (leafy vegetables, celery, and daylily flowers), fresh vegetables 2 (legume vegetables, root and tuber vegetables, and stem vegetables other than celery) , fresh vegetables 3 (all vegetables other than fresh vegetables 1 and fresh vegetables 2), fresh fruits, legumes and legume products, nuts and seeds, meat and meat products (excluding livestock and poultry offal and products made from them), eggs and egg products, milk and dairy products, fish, crustaceans (excluding sea crabs and mantis shrimp), sea crabs and mantis shrimp, and other aquatic products (bivalves, gastropods, cephalopods, and echinoderms), were collected from 9 counties (cities and districts) in Jinhua City to assess their cadmium contamination levels. Combining these results with data from the 2023 Jinhua City Resident Nutrition Surveillance Survey, the health risks associated with dietary cadmium exposure among residents of different ages and genders in Jinhua City were assessed according to the provisional tolerable monthly intake (PTMI, 25 μg·kg^-1) and margins of safety (MOS) recommended by the Joint FAO/WHO Expert Committee on Food Additives (JECFA). A MOS > 1 indicated that the risk of dietary cadmium exposure for residents was at an acceptable level，whereas a MOS ≤ 1 indicated that the risk of dietary cadmium exposure for residents was relatively high. ResultsThe cadmium detection rate in food was 73.55% (3 261/4 434), with 4.06% (180/4 434) of samples exceeding the limit. Foods with higher cadmium detection rates were in sea crabs and mantis shrimp (98.59%), fresh vegetables 1 (94.92%), and rice (87.93%). The median cadmium concentration was 0.010 mg·kg^-1. Food categories with higher cadmium concentrations included sea crabs and mantis shrimp (0.644 mg·kg^-1), rice (0.032 mg·kg^-1), and fresh vegetables 1 (0.020 mg·kg^-1). A total of 2 092 individuals were included in the population nutrition surveillance survey, and the average daily per capita food consumption was 887.97 g·d^-1, consisting of fresh vegetables (342.17 g·d^-1), meat and meat products (141.29 g·d^-1), and rice (110.70 g·d^-1). The 50th and 95th percentiles of cadmium mass fractions were used to define general and high exposure levels for assessing resident exposure risk. When assigning a value of 0 and the limit of detection (LOD) value to the contamination levels of undetected samples, at the general exposure level, the monthly average cadmium exposure for the residents was 5.08 and 5.15 μg·kg^-1 (based on body weight; same below), with MOS values of 4.92 and 4.85; the range of average cadmium exposure across different age and gender groups was 3.91‒6.70 and 3.97‒6.80 μg·kg^-1, with all MOS values >1, indicating that the dietary cadmium exposure risk for the residents was at an acceptable level. At the high exposure level, the average cadmium exposure for the residents was 36.02 μg·kg⁻¹, with an MOS value of 0.69; the average cadmium exposure levels for different age and gender groups ranged from 27.68 to 48.37 μg·kg⁻¹, with MOS values ranging from 0.52 to 0.90, all of which were <1; indicating that the dietary cadmium exposure risk for residents was relatively high. Dietary cadmium exposure among minors aged 6‒17 years in Jinhua City was higher than that among adults, and dietary cadmium exposure among females was higher than that among males. Rice and fresh vegetables were the major foods contributing to dietary cadmium exposure among residents in Jinhua City, each accounting for more than 30% of the total exposure contribution. ConclusionCommercially available foods in Jinhua City exhibit varying degrees of cadmium contamination, with higher levels primarily found in aquatic products such as sea crabs and mantis shrimp, fresh vegetables such as leafy greens, celery, and daylily flowers, as well as rice. The dietary cadmium exposure risk for residents of Jinhua City is at an acceptable level under general exposure conditions but poses a health risk under high exposure conditions. Monitoring of cadmium in relevant foods should be strengthened, and dietary guidance should be provided to high-risk groups including minors aged 6‒17 years and women.

Objective: To evaluate the dietary quality among residents aged 18-79 years in Jinhua City, Zhejiang Province using Dietary Balance Index (DBI_22), so as to provide evidence for improving residents' nutritional status and formulating targeted nutritional intervention measures. Methods: From July to October in 2023-2024, a multi-stage random sampling method was employed to select residents aged 18-79 years in Jinhua City as survey subjects. Demographic information was collected through questionnaire survey. Dietary intake was investigated using 3 d 24 h dietary recall method. The DBI_22 higher bound score (DBI_HBS), lower bound score (DBI_LBS), and Dietary Quality Distance (DBI_DQD) were calculated to evaluate dietary quality. Dietary patterns were determined based on DBI_HBS and DBI_LBS scores. Results: A total of 3 284 residents were surveyed, with an average age of (52.81±14.93) years. There were 1 590 males (48.42%) and 1 694 females (51.58%). There were 857 urban residents (26.10%) and 2 427 rural residents (73.90%). The DBI_HBS was (13.85±4.91) points, with low excessive intake accounting for 61.18%; the DBI_LBS was (20.05±5.62) points, with low insufficient intake accounting for 74.54%; the DBI_DQD was (33.90±7.75) points, with low and moderate dietary imbalance accounting for 49.73% and 46.99%, respectively. Males, residents aged 60-79 years, and rural residents had higher DBI_DQD scores, indicating dietary imbalance. Insufficient intake was reported by 84.81% of residents for fruits, 96.56% for milk, and 55.09% for legumes. Excessive consumption was observed in 80.36% for poultry/meat and 39.74% for salt. Among the six identified dietary patterns, pattern A was optimal and adopted by 518 residents (15.77%), while patterns D and E had the highest participation rates, with 1 045 (31.82%) and 1 037 (31.58%) residents, respectively. Conclusions The dietary intake among residents in Jinhua City is characterized by both insufficient intake and excessive intake. Males, residents aged 60-79 years, and rural residents are key populations with dietary imbalance. The main dietary patterns are characterized by insufficient intake of fruits, milk, and legumes, and excessive intake of poultry/meat and salt.

Objective To investigate the intervention efficacy of best possible self (BPS)on the mental health of new recruits (including state optimism and pessimism,perceived stress and subjective well-being).Methods A non-randomized controlled trial was conducted on 212 new recruits subjected with cluster sampling from an army unit in a training base for new recruits in September 2023.Based on their organizational structure,they were divided into a study group (n=100,receiving BPS intervention 15 min/d,for 2 consecutive weeks)and a control group[n=112,typical day (TD)intervention,15 min/d,same period].Future Expectancy Scale (FEX),Chinese Perceived Stress Scale (CPSS),Positive and Negative Affect Scale (PANAS ) and Satisfaction with Life Scale (SWLS ) were used to measure the 2 groups of participants at T0 (baseline),T1 (end of the first week of intervention),T2 (end of the second week of intervention)and T3 (1 week after the end of intervention)in order to evaluate the intervention efficacy on above mentioned mental health indicators.Results There were no significant differences in demographic and baseline psychological variables listed above between the 2 groups.However,as the training progressed,obvious differences were observed in the training effects on state pessimism,perceived stress and subjective well-being (including affective and cognitive well-being)between them.When compared with the baseline data (T0),the study group had notably reduced state pessimism (P<0.01)and elevated affective (P<0.001) and cognitive well-being (P<0.001)during T1 and T3,and decreased perceived stress at T1 (P<0.05)and T3 (P<0.001).However,no such changes of above indicators were observed in the control group before and after training.Conclusion A 2-week BPS intervention can effectively reduce state pessimism and perceived stress,promote subjective well-being,and improve mental health in new recruits during new recruit training.

Objective To explore the effects of expressive writing on repetitive negative thinking(RNT)and anxiety and depression in new recruits,and to compare the effectiveness of different writing intervals on the training effects.Methods A total of 262 new recruits of a troop were sampled using cluster sampling and then divided into 3 groups based on their own organizational company.There were 2 groups receiving RNT-focused expressive writing,including 6-week group(n=90),once a week for 6 consecutive weeks,and 6-day group(n=83)once a day for 6 consecutive days,as well as a control group without any intervention(control group,n=89).Perseverative Thinking Questionnaire(PTQ),Self-Rating Depression Scale(SDS),and Self-Rating Anxiety Scale(SAS)were used to survey all participants at following 3 time points:before intervention(T0),at the end of intervention(T1)and 1 month after intervention(T2).Results There were no significant differences in demographic information and psychological indicators among the 3 groups before the intervention.After intervention,the scores of RNT,depression,and anxiety were significantly lower in the 6-week group at T1 and T2 than the baseline levels(T0)(P＜0.01).The 6-day group showed a tendency of increasing and then decreasing in the 3 scores,the scores of RNT and depression were significantly higher at T1 than T0(P＜0.01),then all 3 scores fell back at T2,and the scores of depression and anxiety at T2 were significantly lower than at T0(P＜0.01).No significant changes were observed in these psychological indicators in the control group before and after training.Conclusion RNT-focused expressive writing for 6 weeks can reduce RNT and relieve emotions such as depression and anxiety in new recruits,but similar effects are not observed in the 6-day consecutive writing program.So,we recommend a 6-week writing intervention to promote mental health in new recruits.

Objective:To investigate the effect of acupoint stimulation assisted anesthesia on the agitation during recovery and the levels of serum opioids (Opiorphin) and amyloid A (SAA) in elderly patients after hip fracture surgery.Methods:Eighty-six older patients who underwent hip fracture surgery in Shaoxing Second Hospital from February 2020 to September 2021 were randomly divided into the routine group and the research group, each with 43 patients. They were given acupoint sham stimulation and acupoint stimulation respectively, and the general indexes of the two groups, recovery quality, cognitive function and changes in serum Opiorphin and SAA levels were compared.Results:There were no differences in operation time, anesthesia time, recovery time and intraoperative blood transfusion between the two groups ( P>0.05). The dosage of remifentanil in the research group was significantly lower than that in the routine group: (270.64 ± 17.62) μg vs. (291.82 ± 23.34) μg, P<0.05. The incidence of agitation during the recovery period in the research group was significantly lower than that in the routine group: 13.95% (6/43) vs. 48.84% (21/43), P<0.05. The mini-mental state examination (MMSE) scores in the research group at 12, 24 and 48 h after operation were significantly higher than those in the routine group: (22.80 ± 2.04) scores vs. (19.31 ± 3.61) scores, (24.92 ± 2.44) scores vs. (21.49 ± 3.58) scores, (26.73 ± 2.57) scores vs. (24.23 ± 3.95) scores, there were statistical differences ( P<0.05). The serum Opiorphin level at 24 h after operation in the research group was higher than that in the routine group: (32.74 ± 8.57) mg/L vs. (25.40 ± 6.36) mg/L; and the SAA level was lower than that in the routine group: (157.36 ± 10.24) mg/L vs. (204.37 ± 15.56) mg/L, there were statistical differences ( P<0.05). Conclusions:Acupoint stimulation adjuvant anesthesia can reduce the occurrence of agitation during the recovery period of elderly patients with hip fracture, reduce the dosage of anesthetics, reduce postoperative cognitive impairment, regulate serum Opiorphin and SAA levels, and help early postoperative recovery.

Objective : To investigate the status and influencing factors of self-management behaviors among pregnant women with gestational diabetes mellitus (GDM), so as to provide insights into health management of GDM. Methods: GDM patients admitted to Medical Community General Hospital of Shaoxing Second Hospital were sampled from January to June 2023, and basic characteristics were collected using questionnaire surveys, including age, parity, education level and gestational age. The self-management behaviors were evaluated among GDM patients using the self-management behavior scale, and the social support level was evaluated using the social support scale, while the modes of coping with diseases were identified using the medical coping modes questionnaire (MCMQ). Factors affecting the self-management behaviors were identified among GDM patients using a multiple linear regression model. Results: A total of 120 GDM patients were enrolled, with a mean age of (27.58±3.73) years and gestational age of (22.16±5.82) weeks. The score for self-management behaviors was (118.19±24.86) points among GDM patients, including 15 cases with good self-management behaviors (12.50%), 61 cases with moderate behaviors (50.83%) and 44 cases with poor behaviors (36.67%). Multiple linear regression analysis showed that educational level (high school: β'=0.168; junior college and above: β'=0.187), per capita monthly household income (≥5 000 Yuan, β'=0.305), health education for GDM (β'=0.087), coping mode (avoidance: β'=0.168; acceptance: β'=0.375) and social support level (general: β'=0.184; high: β'=0.429) were factors affecting self-management behaviors among GDM patients. Conclusion The self-management behaviors of GDM patients are associated with educational level, per capita monthly household income, health education for GDM, coping mode and social support level.

Solitary fibroma often occurs in the pleura, but rarely outside the pleura. Extrapleural solitary fibroma has atypical clinical symptoms and difficult imaging diagnosis. Here, we report a case of solitary fibroma recurred and metastasized to the bladder after pelvic surgery. He was treated with palliative resection in our hospital. The patient died of systemic metastasis 3 years after operation.

Objective To investigate the effect of the endoscopic surveillance system in irrigating fluid absorption and bleeding during transurethral resection of the prostate.Methods In vitro trials,we simulated the fluid absorption and bleeding in the operation by using self-developed endoscopic surveillance system from January 2013 to June 2013.Continuous irrigation of 5 ％ mannitol solution,we extracted 5 times irrigating fluid (each time 100 ml and a total of 500 ml) in the process of irrigation and recorded absorption measurements of every time extraction rinses.At the same time,we dripped human whole blood 5 times(each time 5 ml and a total of 25 ml) in the process of irrigation and recorded the bleeding measurements.The above process was repeated three times to detect the accuracy and consistency of the endoscopic surveillance system.In clinical trials,50 cases of BPH were monitored in surgery and the biochemical index,hemodynamics,irrigating fluid absorption and bleeding were compared from October 2016 to April 2017.The included criteria contained as follow:the age of patients should be more than 50 years.The transabdominal ultrasound showed that the volume of prostate should be more than 60 ml.The maximal uroflowmetry should be less than 15ml/s.The IPSS scores should be more than 8.Based on the operative time,two groups (＜60 min and ≥ 60 min) were classified.Results We developed the endoscopic surveillance system which is original in the world.In vitro trials,the average irrigating fluid were (100.60 ± 2.07) ml,(201.00±3.39) ml,(302.00±4.67) ml,(403.60±4.39) ml and (502.40 ±7.57) ml;and the average bleeding were (5.06 ± 0.11) ml,(10.10 ± 0.16) ml,(15.04 ± 0.15) ml,(20.06 ± 0.11) ml and (25.10 ± 0.16) ml.No significant difference was observed in all groups (P ＞ 0.05).In clinical trials,we compared some preoperative and postoperative indexes.The average blood oxygen saturation were (94.46 ± 2.49) ％ and (92.39 ± 2.77) ％ (P ＜ 0.01),the average Serum sodium ion concentration were (141.05 ± 2.52) mmol/L and (138.06 ± 4.27) mmol/L(P ＜ 0.01),the average HGB were (143.50 ± 13.43) g/L and (137.04 ± 14.25) g/L(P ＜ 0.01).The average HCT were (42.05 ± 4.09) ％ and (137.04 ± 14.25) ％ (P ＜ 0.01).The average HR were (77.9 ± 7.6) beats per minute and (77.93 ± 6.93) beats per minute (P＞0.05).The MAP were (90.32 ± 9.75) mmHg and (91.07±8.96)mmHg(P＞0.05).The average serum potassium ion concentration were (4.13 ± 0.53) mmol/L and (4.09 ± 0.37) mmol/L (P ＞ 0.05).The average irrigating fluid absorption of the group less than 60 minutes and the group equal or more than 60 minutes were (401.83 ± 279.23) ml and (885.25 ± 367.68) ml (P ＜ 0.01).The average blood loss were (64.10 ±47.47) ml and (158.40 ± 65.22) ml(P ＜0.01).The preoperative and postoperative hemodynamic,blood biochemical and hematology showed difference in our trials.Irrigating fluid absorption and blood loss were positively associated with operation time.Conclusions The endoscopic surveillance system was safety and accuracy.It can offer real-time monitoring data and alarm mechanism for the surgeons that possibly improve operation safety.

Objective To investigate the efficacy of dexmedetomidine-assisted topical anesthesia in patients undergoing bronchoalveolar lavage ( BAL). Methods Twenty-four ASA Ⅱ or Ⅲ patients in ICU, aged 24-64 yr, weighing 50-80 kg, scheduled for BAL, were randomly divided into 2 groups ( n = 12 each) : topical anesthesia group (group A) , topical anesthesia + dexmedetomidine group (group B) . In group A, 0.9% normal saline 5 ml was injected intravenously 30 min before operation, 2% lidocaine 5-10 ml was given via a tracheal tube or cannula 5 min before operation and then an increment of 2% lidocaine 5 ml was given using fibreoptic bronchoscope every 15-30 min as required (the total amount was within 20 ml) . In group B, dexmedetomidine 0.5-1.0 μg/kg was injected (time of injection≥ 10 min) followed by infusion at 0.1-0.5 μg·kg-1 ·h-1 and the topical anesthesia was performed as the method described in group A. The time of lavage, adverse reactions and adverse cardiovascular events were recorded. Blood samples were taken 20 min before lavage, 20 min after the start of lavage and 20 min after the end of lavage (T1-3 ) for determination of the concentrations of plasma catecholamine and serum cortisol. Results The incidences of adverse reactions and adverse cardiovascular events were significantly lower and the operation time was significantly shorter in group B than in group A ( P < 0.05). The concentrations of plasma catecholamine and serum cortisol were significantly higher at T2，3 in group A, while lower at T2，3 in group B than at T1 ( P < 0.05) . The concentrations of plasma catecholamine and serum cortisol were significantly lower in group B than in group A ( P < 0.05). Conclusion Dexmedetomidine-assisted topical anesthesia can be used safely and effectively in BAL.