Objective: To retrospectively analyze the efficacy and prognostic factors of postoperative intensity modulated radiotherapy for grade Ⅱ gliomas. Methods: Retrospective analysis was conducted on patients with postoperative grade Ⅱ glioma in our hospital from Jan. 2010 to Dec. 2018. The primary endpoint was progression-free survival, and the secondary endpoint was overall survival. Correlative analyses of prognosis by age, gender, initial resection status, the maximum diameter of the lesions, bi-hemisphere, astrocytoma, chemoradiation, adjuvant chemotherapy were conducted. Results: A total of 109 cases with grade Ⅱ glioma were enrolled. The follow-up rate was 91.75%, including 10 cases dead and 27 relapsed. There were 24 cases (88.9%) of in-field failure, and 3 cases (11.1%) of out-field failure. 14 cases of recurrence occurred in 81 cases of total resection group, accounting for 17.3%, and 13 in 28 cases of subtotal resection group, accounting for 46.4%. The recurrence rate in the subtotal resection group was significantly higher than that in the total resection group (χ ²=9.484, P<0.05). The 1-, 2-, 3-, 4- and 5-year progression-free survival rates were 92.5%, 86.0%, 80.6%, 77.5% and 66.8%, respectively. The 2-, 3-, 4- and 5-year overall survival rates were 97.2%, 90.8%, 87.7% and 84.5%, respectively. Multivariate analysis showed that patients with subtotal resection(HR=3.608, P<0.05) and bi-hemisphere(HR=3.183, P<0.05)were significantly correlated with the progression free survival. Conclusions Postoperative intensity modulated radiotherapy for grade Ⅱ gliomas can achieve a better PFS. Recurrence in the radiation field is the main failure mode. Initial resection status and bi-hemisphere of tumor are important influential factors for PFS of grade Ⅱ gliomas patients.

Objectives: To investigate the total fluids intake among college students in spring from Hebei. Methods: In March 2017, the subjects were recruited in a college in Baoding, Hebei Province. 156 students completed the investigation. Total drinking fluids was assessed by 7-day 24-hour fluid intake questionnaire, with a quantitative tool. The water from food was assessed by duplicate portion method. The sources of total fluids intake among subjects were analysed. Results: The age of subjects was (19.8±1.1) years old, including 80 male students. The median amounts of total fluids intake, total drinking fluids and water from food were 2 324, 1 135 and 1 174 ml, respectively. The proportions of total drinking fluids and water from food in total fluids intake were 51%±9% and 49%±10%. Only 19.9% (n=31) and 18.6% (n=29) of college students had adequate total fluids intake and total drinking fluids, according to the recommendation of China. The median amounts of total fluids intake, total drinking fluids and water from food were 3 210, 1 860 and 1 093 ml/d, respectively. The proportion of total drinking fluids in total fluids intake was 61%±7%, which were all higher than those who did not reach the recommended intake (2 158, 1 000, 1 149 ml/d; drinking fluids accounting for 46%±8% of total fluids intake) (P<0.05). Conclusion The amounts of total fluids intake and total drinking fluids of college students in Hebei Province are lower than the recommended intake in China. The contributions of total drinking fluids and water from food to total fluids intake were nearly same.

Objective: To investigate the food source of water of college students from Hebei Province in spring. Methods: In March 2017, the subjects were recruited in a college in Baoding, Hebei Province. 156 students completed the investigation. All foods were collected for 3 consecutive days using duplicate portion study combined with weighing method to test the water content of various foods. To analyze the water content of the food and calculate the proportion to the total amount of food water intake, the edible parts of each meal were divided into staple food, dishes, porridge, soup and snacks. Body mass index (BMI) was grouped according to quartiles, and the differences in food intake and food water sources among subjects of different genders and BMI were compared. Results: The age of subjects was (19.8±1.1) years old, including 80 male students. The median intake of staple food, dishes, porridge, soup and snacks per day was 562 g, 743 g, 111 g, 102 g and 0 g, respectively. The median intake of water from staple food, dishes, porridge, soup and snacks per day was 301 ml/d, 620 ml/d, 97 ml/d, 93 ml/d and 0 ml/d, respectively. The median ratio of water intake to total food water intake of staple food, dishes, porridge, soup and snacks was 27%, 53%, 8%, 8% and 0%, respectively. The median intake of water from staple food and dishes in male students was significantly higher than that of female students (P<0.05). The amount of water intake from porridge of female students was significantly higher than that of male students (P<0.05). There was no significant difference in the water intake from soup and snacks between different genders. There was no significant difference in food intake and food water sources among college students with different BMI (P>0.05). Conclusion The food source of water of college students from Hebei Province in spring is mainly based on dishes and staple foods. The food source of water for boys and girls is different.

Objectives: To investigate the total fluids intake, volume of urine and hydration status among college students from Hebei Province in spring. Methods: In March 2017, the subjects were recruited in a college in Baoding, Hebei Province. 156 students completed the investigation. Total drinking fluids was assessed by 7-day 24-hour fluid intake questionnaire, with a quantitative tool. The water from food was assessed by the duplicate portion method. The urine samples of 24-hour was collected for 3 consecutive days, and the volume, osmolality, pH and specific gravity of urine were measured. Hydration status was grouped to three types according to the urine osmolality (mOsm/kg), namely, optimal hydration (urine osmolality ≤500), middle hydration (500< urine osmolality ≥800) and dehydration (urine osmolality >800), and the differences among subjects in different genders and hydration statuses were compared. Results: The age of all subjects was (19.8±1.1) years old, including 80 male students. The median amounts of total fluids intake, total drinking fluids, water from food and urine volume were 2 324, 1 135, 1 174 and 1 279 ml/d, respectively. The volume of urine among males was 1 272 ml/d, which was not significantly different from that of females (1 304 ml/d) (P>0.05). The osmolality and specific gravity of urine among males were 688 mOsm/kg and 1.017, which were higher than those of females (493 mOsm/kg, 1.014) (P<0.05). But the pH of males was 6.6±0.3, which was lower than that of females (6.7±0.3) (P<0.05). Only 37.2% (n=58) of college students were in optimal hydration status. The median of the amount of total drinking fluids among subjects in optimal hydration status was 301, 448 ml/d higher than that in middle hydration status and dehydration, respectively (P<0.05). The proportion of females in optimal hydration status was 51.3% (n=39), which was higher than that of males 23.8% (n=19) (P<0.05). Conclusion Large proportion of college students in Hebei had lower total drinking fluids than the recommended intake of China, and the volume of urine was equal to the amount of total drinking fluids among the college students. Only 37.2% of college students were in optimal hydration status, and the proportion of female college students in optimal hydration status was larger than that of males.

At present, methods of water-intake survey include government, industry, sector statistics data, dietary survey (24 hours dietary recall, dietary record and food frequency questionnaire), fluid intake survey (retrospective fluid-intake questionnaire, 1-5 days 24 hours fluid-intake survey, 7 days 24 hours fluid-intake record), weighing method with the food composition table, weighing method, duplicate portion method and chemical analysis, and so on. The method of 7 days 24 hours fluid-intake record is an internationally recognized and authoritative method for fluid-intake survey with the highest accuracy, which can reflect the differences of fluid intake between working and non-working days, and can obtain detailed data on behaviors and patterns of fluid water, such as the time, types and places of fluid intake. The method of combining weighing method, duplicate portion method and chemical analysis is used to analyze water intake from food with the highest accuracy, which can be used in an extensive range of population and areas, but with high cost and complex operating steps. It is of great practical significance to compare and evaluate the advantages and disadvantages of different methods about water-intake survey, which will be helpful for researchers to choose appropriate methods for water-intake survey to obtain accurate and representative data in various areas, different population, and complex circumstances.

Objective: To understand snack food consumption among students of grade four and grade five in six cities of China, and to provide evidence for conducting nutritional education and making intervention strategies. Methods: A multi-stage stratified cluster random sampling method was used to select 12 197 primary school students in grade four and grade five from 72 primary schools in Beijing,Guangzhou,Nanjing,Chongqing,Jinan,Harbin. All the participants were administered with a self-administered questionnaire survey on dietary behaviors. Results: The proportion of pupils who consumed snack food at home, school and elsewhere was 96.4%, 59.4% and 75.5% respectively. The most popular snacks at home were fruits & vegetables, milk, cereals (72.0%, 71.1%, 68.6%), the most popular snacks at school were fruits & vegetables, milk, cereals (30.0%, 28.2%, 23.8%), the most popular snacks in other places were sugars, cereals and beverages (36.6%, 36.2%, 35.7%). The top five reasons for snack food was being delicious, healthy/nutritious, clean, choices of peers and family members (68.5%, 49.3%, 42.2%, 24.7%, 17.8%, respectively). Conclusion Snack food consumption is popular among primary students, most of which are unhealthy. Nutrition education for students and parents should be encouraged to promote students to consume snacks reasonably and develop healthy eating behaviors.

Objective: To understand the status on beverages consumption among grade 4 and grade 5 primary school students in six cities of China, and to provide evidence for nutrition education and intervention strategies. Methods: A multi-stage stratified cluster random sampling method was used to select 12 197 grade 4 and grade 5 primary school students from 72 primary schools in Beijing, Guangzhou, Nanjing, Chongqing, Jinan and Harbin. All the participants were investigated with a self-administered questionnaire survey of dietary behaviors. Results: The proportion of students who consumed beverages at home, school and elsewhere was 92.5%, 51.4% and 70.6% respectively. The most popular beverages at home were milk, fruit & vegetable drinks, tea drinks (69.4%, 46.6%, 39.6%); the most popular beverages at school were milk, fruit & vegetable drinks, tea drinks (30.5%, 13.0%, 12.7%) while the most popular beverages in other places were milk, tea drinks, fruit & vegetable drinks(37.4%, 29.6%, 28.1%). The top five reasons for choosing beverages were taste delicious, healthy & nutritious, clean, choice of peers and family members(72.3%, 50.8%, 38.4%, 21.9%, 21.6%, respectively). Conclusion Consumption of drinking beverages is popular among students, most of which are unhealthy. Therefore, nutrition education for students and parents should be encouraged aiming to help students choose healthy drinks and eating behaviors.

Objective: To investigate students’ satisfaction on school feeding program in 8 cities in China, and to provide the basis for improving school feeding management and lunch quality. Methods: Multi-stage random cluster sampling method was used to randomly select the second, fifth and eighth-grade students from 67 primary and middle schools in 8 cities including Beijing, Shanghai, Harbin, Shijiazhuang, Guangzhou, Changsha, Bengbu and Pinghu. Results: A total of 15 475 students participated in the survey, 15 170(98.0%) of which were valid questionnaires. A total of 13 297(87.7%) students had lunch in school. Twenty-six(38.8%), 14(20.9%) and 27(40.3%) schools served lunch by self-run canteens, custody canteens, and food delivery companies respectively. Twenty-one schools provided milk or yogurt for lunch, accounting for 31.3%. The reported rates of very satisfied, satisfied, moderate, dissatisfied, and extremely dissatisfied among students were 40.8%, 28.1%, 20.1%, 7.3%, and 3.6%, respectively. The satisfaction rate of the eighth-grade students was lower than that of the second-and fifth-grade(56.9% vs 77.1% vs 73.5%). The satisfaction rate among students from schools with self-run canteen was higher than that of custody canteens and food delivery companies(73.8% vs 60.5% vs 66.2%). The satisfaction rate of school lunch is highest in dining surrounding (75.3%), followed by amount of meals(71.6%), food hygiene(71.1%), food combination(65.4%), and the appearance of the food(60.5%), and food taste(55.9%). Conclusion The satisfaction rate of students for school lunch was acceptable. The food taste is the main factor for students’ dissatisfaction. Schools should be encouraged to provide lunch in the self-run canteens with tasty food while meeting the nutritional standard.

Objective: To understand rural students’ perception and satisfaction of the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES), and to provide basis for promoting students’ participation in the school feeding program and improving the acceptability of school feeding. Methods: In 3 national pilot counties and 2 local pilot counties of NIPRCES, 1 middle school and 1 primary school were randomly selected. Two classes of 2 364 students from grade 4 to grade 9 were randomly selected and investigated with questionnaires. Results: Students were aware of the policy, with 78.9% of the students reported to be familiar with NIPRCES. The awareness rate of students at the national pilot areas was higher than that in local pilot areas(P<0.05). Students showed positive attitude towards NIPRCES. The median score of students’ understandings of the influence of NIPRCES was 20.0 (18.0, 20.0) points. Students in national pilot areas showed a more positive attitude toward the program than those in local pilot areas(P<0.05). Moderate satisfaction was reported in school feeding, 78.7% of students thought that school provided adequate amount of food, and 60.9% of the students enjoyed the food very much. The main reasons for leftovers were too much in amount(27.4%), repetition of food types (22.8%) and food aversions(9.2%). Conclusion Students are quite aware of NIPRCES and show moderate satisfaction in school feeding. The awareness and satisfaction are relatively higher among students in national pilot areas than those in local pilot areas. Health promoting schools should be established and students and parents should be advocated to take part in the program, health education need to be promoted in schools. Experiences sharing between different places could help improve the quality and acceptability of school feeding program.

Objective: To understand nutrition knowledge,related attitude and behavior among primary students in six cities of China, and to provide evidence for nutrition education and intervention strategies. Methods: A multi-stage stratified cluster random sampling method was used to select 12 197 grade 4 and grade 5 primary school students from 72 primary schools in 6 cities of China, whom were administered with a questionnaire survey on nutrition knowledge, practice and practice. Results: Average nutritional knowledge was relatively low (12.0±6.4), practice score was moderate(11.4±2.4), while nutritional attitude was relatively high(17.0±2.4). The nutritional KAP scores of girls were higher than those of boys; the nutritional knowledge and practice scores of urban students were higher than those of suburban students; the nutritional knowledge score of fifth-grade students was higher than that of fourth-grade students(P<0.05). The overall nutritional knowledge awareness rate was 26.1%, with the highest in knowledge of whole grains(73.9%). About 83.5% of the students held positive nutritional attitude, 97.6% considered nutritional knowledge important. The overall rate of healthy eating behavior of students was 88.1%. Most students had breakfast almost every day(88.5%). About 34.9%, 38.0%,46.1% and 50.5% were reported of rarely consumption in snacks, fast food and drinks. Students in urban area and grade 5 were more likely have breakfast. Girls reported higher rates of having breastfast and low consumption of snack food and beverage while boys reported higher consumption of fast food. Students from suburban areas reported high consumption of western fast food but lower beverage(P<0.05). The score of students’ nutritional knowledge was positively correlated to attitude, so as attitude and practice(P<0.05). Conclusion Insufficient nutritional knowledge and unhealthy dietary behavior is observed in primary school students in China. Nutritional K-A-P varies in students with different gender, area and grade. Specific nutritional education in school-setting should be developed accordingly to culture healthy lifestyle among primary school students.