Objective: To investigate the association between plant-based diet and different types of obesity, so as to provide references for obesity prevention. Methods: Residents aged 35-75 years from 33 counties (cities, districts) in Zhejiang Province were selected as study subjects using a multistage stratified random sampling method between April and December 2024. Demographic information and living behaviors were collected using questionnaire surveys. Height, weight and waist circumference were measured, and body mass index (BMI) was calculated. BMI ≥28.0 kg/m2 was defined as obesity, waist circumference ≥90 cm in males or ≥85 cm in females was defined as central obesity, and individual with obesity who also had central obesity was defined as having compound obesity. Food intake over a 3-day period was collected using the consecutive 3-day 24-hour dietary recall method. The plant diet index (PDI), healthful plant diet index (HPDI), and unhealthful plant diet index (UPDI) were calculated, and categorized into quintiles (Q1-Q5) based on their distribution. Association between the PDI, PDI, UPDI and different types of obesity were analyzed using multivariable logistic regression models. Results: A total of 4 882 individuals were surveyed, including 2 233 males (45.74%) and 2 649 females (54.26%). The average age was (55.42±12.14) years. There were 537 individuals of obesity, 1 718 individuals of central obesity, and 500 individuals of compound obesity, with detection rates of 11.00%, 35.19%, and 10.24%, respectively. Multivariable logistic regression analysis showed that, after adjusting for demographic information and living behaviors, compared with Q1 group, HPDI Q5 group showed a 29.6% lower risk of obesity (OR=0.704, 95%CI: 0.525-0.943) and a 32.1% lower risk of compound obesity (OR=0.679, 95%CI: 0.502-0.918). Conversely, the UPDI Q5 group exhibited a 39.5% higher risk of obesity (OR=1.395, 95%CI: 1.032-1.886) and a 39.8% higher risk of compound obesity (OR=1.398, 95%CI: 1.025-1.907). No statistically significant association was found between PDI and obesity, central obesity, and compound obesity (all P>0.05). As HPDI increased, the risks of obesity and compound obesity showed decreasing trends; as UPDI increased, the risks of obesity and compound obesity showed increasing trends (all Ptrend<0.05). Conclusion A healthful plant-based diet is associated with reduced risks of obesity and compound obesity, while an unhealthful plant-based diet is associated with increased risks of obesity and compound obesity.

Background China is a major coal producer and consumer country in the world. Coal workers' pneumoconiosis (CWP) is a primary factor endangering the occupational health of coal miners. Research on the disease burden of CWP and its changing trend is significant for disease prevention & control and associated policies. Objective To analyze the disease burden of CWP in China from 1990 to 2021 and its changing trend, and predict the disease burden from 2022 to 2035. Methods Using the Global Burden of Disease Study (GBD) database of 2021, numbers ofincident cases, prevalent cases, deaths, and disability-adjusted life years (DALYs) as well as crude and age-standardized rates of CWP in China were retrieved. Linear regression model was used to calculate the estimated annual percentage change (EAPC) of the age-standardized rates. Joinpoint regression model was used to analyze the temporal trend of disease burden and the disease burden of different sexes and age groups, and Bayesian age-period-cohort (BAPC) model was used to forecast the trend of CWP disease burden. Results In 1990, the incident, prevalent, and deaths cases of CWP in China were 3266, 18872, and 1561, respectively, and the DALYs of CWP were 44614.718 person-years. In 2021, the incident, prevalent, and deaths cases of CWP were 3446, 23975, and 1229, respectively, and the DALYs of CWP were 29610.754 person-years. From 1990 to 2021, the age-standardized incidence, prevalence, mortality, and DALYs rates of CWP in China all showed a downward trend, with the EAPCs of −3.121%, −2.532%, −4.018%, and −4.268%, respectively. The disease burden of CWP in China was mainly concentrated in the male population. The annual average percent change analysis indicated that each standardized rate showed a fluctuating downward trend in different periods. The BAPC model showed that from 2022 to 2035, the age-standardized rates of CWP in China would continue to decline steadily. In 2035, the age-standardized incidence, prevalence, mortality, and DALYs rates of CWP would be reduced to 0.10 per 100000, 0.74 per 100000, 0.03 per 100000, and 0.74 per 100000, respectively. Conclusion The disease burden contributed by CWP in China generally show a downward trend from 1990 to 2021, and it is expected that the age-standardized rates will continue to decline steadily from 2022 to 2035.

Objective: The study aimed to analyze the association between different types of obesity and dyslipidemia among rural primary and middle school students in Zhejiang Province, so as to inform strategies for prevention and control of childhood obesity and hyperlipidemia. Methods: As part of Nutrition Improvement Programme for Rural Compulsory Education Students, 1 244 participants were selected by stratified cluster random sampling in 5 counties of Zhejiang Province during September to December 2021. Physical examination, detection of blood lipid and questionnaire survey were conducted. The Chi -square test and Logistic regression analyses were used to assess the association between different types of obesity and dyslipidemia. Results: The prevalence rates of overweight, obesity, abdominal obesity, and hyperlipidemia were 15.11%, 12.46%, 17.60%, and 21.78%. Obesity and abdominal obesity were correlated to high risk of high triglycerides ( OR =3.97, 95% CI =2.54-6.20; OR =4.45, 95% CI =2.95- 6.72 )( P <0.05). Compared with the non overweight and obese group with normal waist circumference,the overweight and obesity group were correlated to high risk of high cholesterol ( OR=2.53, 95%CI =1.45-4.42, P <0.05). Abdominal overweight or obese group had the highest risk for dyslipidemia and triglycerides ( OR =1.82, 95% CI =1.33-2.48; OR =3.64, 95% CI =2.45-5.43) ( P < 0.05). Conclusions The prevalence rates of overweight, obesity, abdominal obesity, and hyperlipidemia are relatively high in rural primary and middle school students of Nutrition Improvement Programme for Rural Compulsory Education Students in Zhejiang Province. Abdominal obesity is a more important risk factor for hyperlipidemia. Waist circumference should be the focus of considerable attention.

Objective: To understand current status and related factors of breakfast among primary and secondary school students in Zhejiang Province, so as to provide a scientific basis for improving breakfast habits of primary and secondary school students. Methods: During May to November of 2023, 33 326 students from grade four to six of primary schools and grade one to two of secondary schools were selected from 90 counties and cities in Zhejiang Province by using the stratified cluster random sampling method. General information and breakfast consumption were collected by questionnaire. Multivariate Logistic regression was used to analyze the related factors of breakfast. Results: About 81.29% of the primary and secondary school students reported regular breakfast consumption. The rate of regular breakfast consumption was higher on the school days (92.23%) than on the weekends (85.17%), and higher in primary school students (85.83%) compared to secondary school students (74.71%), with statistically significant differences ( χ 2=827.42, 655.03, P <0.01). About 49.19% of primary and secondary school students had their breakfast within 10 minutes or less, and 83.30% of primary and secondary school students had 3-5 food groups for breakfast. The proportions of students who consumed cereals and potatoes, milk, and eggs were respectively 18.76%, 28.85%, 14.63%. About 22.84%, 28.00 %, 32.60% and 32.23% of the students had no meat, soybeans, vegetables and fruits in their breakfast. The results of multivariate Logistic regression analysis showed that girls, rural area, secondary school, place of living (dormitory, others), migrant parent (one or both outside the hometown), late bedtime (22:00-22:59, 23:00 and later) and late wake up time (9:00 and later) on the weekends were positively correlated with no having breakfast every day ( OR=1.22, 1.40, 1.46, 1.20, 1.20, 1.34, 1.36, 1.41 , 3.51, 2.32, P <0.05). The time of physical activity per day (30-<60, 60-<90, 90-120, >120 min), bedtime (21:00-21:59, 22:00-22:59) and wake up time (6:00-6:59, 7:00-7:59) on school days were negatively correlated with no having breakfast every day ( OR=0.75, 0.64, 0.67, 0.64, 0.77, 0.82, 0.75, 0.67, P <0.05). Conclusions There is a considerable number of primary and secondary school students with irregular breakfast consumption, which are related to multiple factors. Therefore, it is necessary to strengthen nutrition education and improve the behavior of breakfast for primary and secondary school students.

Objective To explore the value of Chinese thyroid imaging reporting and data system(C-TIRADS)combined with intranodular and perinodular stiffness for distinguishing benign and malignant thyroid nodules.Methods Data of routine ultrasound and ultrasonic shear wave elastography(SWE)in 117 patients with thyroid nodules confirmed by fine needle aspiration cytology(FNAC)and/or surgical pathology were retrospectively analyzed.The nodules were classified according to C-TIRADS and SWE parameters of nodules and surrounding 2 mm glands measured with SWE technique,including Young's modulus of thyroid nodules(E)and perinodular glandular(Eshell)(the maximum[Emax/Eshellmax],the mean[Emean/Eshellmean]and the minimum[Emin/Eshellmin]as well as standard deviation[ESD/EshellSD]values).Then receiver operating characteristic(ROC)curve was drawn,and area under the curve(AUC)was calculated to assess the efficacy of C-TIRADS,SWE and the combination for differentiating benign and malignant thyroid nodules.Results Totally 117 thyroid nodules of 117 patients were enrolled,including 50 benign and 67 malignant ones.SWE parameters of malignant thyroid nodules were higher than those of benign ones(all P＜0.001).AUC of C-TIRADS for differentiating benign and malignant thyroid nodules was 0.736,with sensitivity of 79.10％,specificity of 68.00％and accuracy of 74.36％.AUC of Emax,Emean,Emin and ESD was 0.816,0.752,0.664 and 0.705,respectively,of Emax was the highest.AUC of Eshellmax,Eshellmean,Eshellmin and EshellSD was 0.834,0.804,0.693 and 0.697,respectively,of Eshellmax was the highest,which was not statistically difference with that of Emax(Z=1.044,P=0.297).AUC of C-TIRADS+Emax and C-TIRADS+Eshellmax was 0.835 and 0.843,respectively,being not significantly different(Z=0.574,P=0.566)but higher than that of C-TIRADS(AUC=0.736,Z=2.510,2.230,both P＜0.05),with diagnostic specificity and accuracy both higher than those of C-TIRADS(all P＜0.05).Conclusion C-TIRADS combined with intranodular and perinodular stiffness could be used to effectively distinguish benign and malignant thyroid nodules,which might improve diagnostic efficiency of C-TIRDAS.

Objective To investigate the effects of different fractions of inspired oxygen administered during general anesthesia on post-operative recovery in patients undergoing laparoscopic hernia repair and hysterectomy in a sub-plateau region.Methods Clinical data of 111 patients undergoing laparoscopic hernia repair and hysterectomy under general anesthesia were collected from the People's Hospital of Datong Hui and Tu Autonomous County between April 2022 and November 2023.Based on the concentration of inhaled oxygen during general anesthesia,patients were randomly divided into three groups:100%oxygen(n=36),80%oxygen(n=38),and 60%oxygen(n=37).Respiratory-related parameters,including arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),and oxygenation index(OI),were compared among the three groups before anesthesia induction,30 min after pneumoperito-neum,and 1 d after surgery.Postoperative pulmonary complications,incision infections,first gastrointestinal exhaust time,and length of hospitalization were recorded.Postoperative delirium and cognitive function were also assessed.Results At 30 min after pneumoperi-toneum induction,the OI in the 60%oxygen group was higher than that in the 100%oxygen group(P=0.009),whereas there was no sta-tistical difference in OI between the 80%oxygen and 100%oxygen groups(P>0.05).PaO2 and OI were lower(P<0.05)and PaCO2 was higher(P<0.05)in all groups on the 1st day after surgery than before the induction of anesthesia.PaO2 and OI were higher in the 80%oxygen group than in the 100%oxygen group(all P<0.05).PaO2 and OI were higher in the 60%oxygen group than in the 100%oxygen and 80%oxygen groups(all P<0.05).PaCO2 was lower in the 60%oxygen group than in the 100%oxygen group(P<0.001).The first gastrointestinal exhaust time was shorter in the 60%oxygen group than in the 100%oxygen group(P=0.019).No postoperative incision infections were observed in any of the three groups,and there were no statistically significant differences in the incidence of postoperative pulmonary complications,length of hospitalization,incidence of postoperative delirium,and cognitive dysfunction among the three groups(all P>0.05).Conclusion During general anesthesia for patients undergoing laparoscopic hernia repair and hysterectomy in a sub-pla-teau region,appropriately reducing the concentration of inspired oxygen(60%)is beneficial for postoperative respiratory and gastrointes-tinal function recovery without increasing the incidence of incision infections,postoperative delirium,and cognitive dysfunction.

Objective To investigate the value of ultrasound and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of mass-type autoimmune pancreatitis (AIP) and pancreatic ductal adenocarcinoma (PDAC). Methods A retrospective analysis was performed for the clinical data, ultrasound findings, and CEUS findings of 11 patients with mass-type AIP who were diagnosed in Tangshan Workers' Hospital from January 2015 to December 2020, and their characteristic manifestations were analyzed and compared with the data of 23 patients with PDCA. The chi-square test was used for comparison of categorical data between two groups. Results For the 11 patients with mass-type AIP, CEUS had a diagnostic accuracy of 63.64%, and all of these patients had hypoechoic single lesions; the patients with clear boundaries, regular morphology, pancreatic duct dilatation or cutoff, and blood flow signal accounted for 54.55%, 63.64%, 18.18%, and 36.36%, respectively, while in the PDCA group, such patients accounted for 30.43%, 34.78%, 78.26%, and 21.74%, respectively, and there was a significant difference in the presence or absence of pancreatic duct dilatation or cutoff between the two groups( χ 2 =11.089, P < 0.05), with no significant differences in the other indices (all P > 0.05). For the 11 patients with mass-type AIP, CEUS showed that 7 patients (63.64%) had hyperenhancement and 4 (36.36%) had iso-enhancement in the arterial phase, and 5 patients (45.45%) had hyperenhancement in the arterial phase and 6 (54.55%) had iso-enhancement in the venous phase; for the 23 patients with PDCA, 22 (95.65%) had hypoenhancement of lesions in both arterial and venous phases, and there were significant differences in the enhancement pattern in arterial and venous phases between the two groups ( χ 2 =30.345 and 30.084, both P < 0.05). Conclusion The enhancement pattern of CEUS and the presence or absence of pancreatic duct dilatation or cutoff have a relatively high value in the differential diagnosis of mass-type AIP and PDCA.

This paper reviews the status quo of recent years’ research on autophagy and damage of chondrocytes in Kashin-Beck disease （KBD） and osteoarthritis （OA）. PI3K/AKT signaling pathway and mTOR regulate the autophagy activity of chondrocytes. PI3K/AKT signaling pathway can promote the proliferation of chondrocytes and cause their damage by inhibiting their autophagy activity. This might play an important role in the occurrence and progression of bone and joint diseases such as KBD and OA， and provide scientific basis for revealing the pathogenesis and treatment plan of them.

Objective: To investigate lunch supply of public primary school canteens in Zhejiang Province, and to provide a basis for the scientific guidance of school lunch. Methods: During May to Jun. and Sept. to Oct. in 2019, lunch food supply was weighed and recorded and the number of diners in 44 public primary school canteens were summarized. Each investigation lasted for one week. Results: Food was mainly based on the taste of the students (40.91%) in the school canteen. About 45.45% of the schools referred to the Nutrition Guidelines of School Meals for students meals when making recipes in the school canteen. The supplies of cereals, vegetables, fruits, livestock and poultry meat, fish and shrimp, eggs, milk, soybean nuts, vegetable oil and salt were 109.05, 118.01, 0, 63.96, 9.25, 11.31, 0, 10.68, 10.47, 2.54 g. The supply of vegetable oil was basically the same as the recommended amount ( P >0.05). The supplies of energy, protein, calcium, iron, zinc, vitamin A, vitamin B 1, vitamin B 2, vitamin C, dietary fiber were 820.84 kcal, 32.79 g, 164.18 mg, 7.84 mg, 4.71 mg, 23.07 μgRAE, 0.41 mg, 0.35 mg, 20.47 mg, 2.34 g, 37.56% of energy from fat and 48.47% of energy from carbohydrate. The supply of vitamin B 1 was basically the same as the recommended amount ( P >0.05). There were no significant differences in all kinds of food and nutrients between urban and rural primary schools ( P >0.05). Conclusion Lunch supply is not optimistic in public primary school canteens in Zhejiang Province, with unreasonable structure and fails to agree with current nutritional recommendations. It is suggested that the scientific guidance of students meals should be carried out according to the survey results combined with the characteristics of local diet.

Chondroitin sulfate (CS) is a sulfurated glycosaminoglycan, a major component of the extracellular matrix, widely distributed in skin, cartilage and vascular tissue. CS plays an important role in the physiological state regulation of articular cartilage, which affects tensile strength and elasticity of tissues by influencing aggrecan. Previous studies have shown that CS sulfate modification may be related to the growth and development disorders of cartilage tissue and the occurrence of osteoarticular diseases. At the same time, CS is also a common joint supplement, often used in the treatment of osteoarthritis and Kashin-Beck disease. In this paper, the research progress of CS sulfate modification characteristics in Kashin-Beck disease and osteoarthritis and the application of the preparation in the treatment of Kashin-Beck disease and osteoarthritis are reviewed, aiming to provide help for the investigation of the etiology of Kashin-Beck disease and the treatment of osteoarthritis and Kashin-Beck disease.