Objective: To analyze the trends of the frequency of meat, egg, and milk consumption among rural primary and junior high school students in central and western China covered by the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) from 2015 to 2023, so as to provide basis for formulating more targeted nutrition intervention policies and health education strategies. Methods: Using data from six rounds of monitoring and evaluation (2015-2021 and 2023), the study included 323 870 students from grade 3 to 9 across 22 provinces (autonomous regions and municipalities) in central and western China. The consumption frequencies of meat, egg, and milk over the past week were collected via questionnaires. The Cochran-Armitage trend test was used to analyze temporal trends, and multivariable Logistic regression models were employed to analyze factors associated with the frequency of meat, egg and milk consumption and to test for interaction effects between the year and gender, region, and grade level. Results: From 2015 to 2023, the proportion of students consuming meat, egg, and milk ≥1 time/day increased from 23.20 %, 10.71%, and 0.74% to 35.53%, 22.09%, and 26.63%, respectively. Trend tests indicated a significant upward trend for the daily intake of all three food categories for meat, egg and milk over the years ( Z =67.18, 64.90, 93.14, all P <0.01). Multivariable Logistic regression analysis showed that the daily meat intake was lower in the central region than in the western region ( OR=0.77, 95%CI =0.76-0.78), whereas the daily intake of eggs ( OR=1.19, 95%CI =1.17-1.22) and milk ( OR= 1.27 , 95%CI =1.24-1.29) was higher in the central region (all P <0.05). Compared with grade 3-4 students, junior high school students had lower daily intake of meat, eggs, and milk≥1 time/day ( OR =0.95, 0.77, 0.77, all P <0.05), with a declining trend as grade increased. Girls also had lower daily intake of meat, eggs, and milk ≥1 time/day than boys ( OR =0.95，0.93，0.91, all P < 0.05). Significant interactions were observed between year and region, as well as between year and grade (all P <0.05). Conclusion From 2015 to 2023, the NIPRCES improved the intake level of among rural students, but the situation of relatively insufficient intake of egg and milk among females, junior high school students and those in the western region still exists.

Objective To identify renal function and other readily accessible indicators influencing the prognosis of renal cell carcinoma (RCC) patients after nephrectomy, and to construct a prognostic prediction model based on them. Methods The clinical and pathological data of 624 RCC patients undergoing radical or partial nephrectomy in the First Hospital of Shanxi Medical University during Jan. 2013 and Dec. 2021 were retrospectively analyzed. The independent prognostic factors affecting postoperative overall survival (OS) were identified with LASSO algorithm combined with Cox regression analysis. Based on these factors, a nomogram was constructed to predict the 1-, 3-, and 5-year survival rates. The performance of the model was evaluated using the concordance index (C-index), time-dependent receiver operating characteristic (ROC) curves and the area under the curve (AUC), calibration plots, and decision curve analysis (DCA). Finally, the cutoff value of the nomogram was calculated to stratify patients into risk groups. Kaplan-Meier survival analysis with log-rank testing was performed to compare outcomes between the risk groups. Results Nine independent prognostic factors were identified, including age, smoking history, diabetes mellitus history, maximum tumor diameter, tumor subtype, N stage, Fuhrman grade, preoperative serum creatinine and cystatin C (P＜0.05). The nomogram achieved a C-index of 0.891, with time-dependent AUC of 0.920, 0.903, and 0.867 for 1-, 3-, and 5-year OS, respectively. Calibration curves showed excellent agreement with actual observations, and DCA demonstrated significant clinical net benefits across a wide threshold probability range. Using a cutoff score of 110.4, Kaplan-Meier analysis revealed statistically significant survival differences between risk groups (P＜0.001). Conclusion The proposed nomogram, incorporating renal function and other readily accessible clinical indicators, exhibits strong predictive accuracy for postoperative survival in RCC patients and may serve as a practical tool for individualized clinical decision-making.

Objective:To investigate the expression levels, correlation, and diagnostic efficacy of peripheral blood CD8 +T lymphocyte subsets and different immune checkpoint markers in patients with Brucellosis. Method:A case-control study was conducted on 32 patients with acute phase brucellosis (27 males and 5 females, aged 36 (30, 43) years), 38 patients with chronic phase brucellosis (30 males and 8 females, aged 40 (32, 48) years), and 30 healthy controls (24 males and 6 females, aged 39 (32, 46) years), who underwent physical examination at Xinjiang Uygur Autonomous Region People′s Hospital from February 1, 2021 to December 31, 2023. All subjects had fasting blood sampling once in the morning. Flow cytometry was used to detect the proportion of peripheral blood lymphocyte subsets, the expression levels of CD8 +T lymphocyte surface programmed cell death receptor-1 (PD-1), T lymphocyte immunoglobulin receptor with Ig and ITIM domains (TIGIT), T cell immunoglobulin and mucin domain containing protein 3 (TIM-3), perforin and granzyme B. The changes in these indicators during the acute and chronic phases of the disease were observed, and correlation analysis was performed using Spearman′s method. Receiver Operating Characteristic Curve (ROC) analysis is used to evaluate the diagnostic value of immunological indicators with differences in acute and chronic brucellosis. Results:CD3 +T lymphocyte in the chronic group (70.71%±8.78%) is significantly lower than that in the healthy control group (74.65%±7.31%) ( P<0.05), and CD4 +T lymphocyte in the acute phase group (39.52%±5.85%) is also lower than that in the healthy control group (45.10%±5.18%) ( P<0.01); while CD8 +T lymphocyte in the acute group (31.73%±5.87%) is significantly higher than that in the chronic phase group (26.75%±4.71%) ( P<0.001). There was a statistically significant difference ( P<0.001) in CD8+CD28 -T lymphocyte among the acute group (69.85% (58.62%, 78.55%)), chronic group (86.46% (73.30%, 92.52%)) and healthy control group (25.39% (20.60%,32.90%)), when compared pairwise. The expression levels of immune checkpoint PD-1, TIGIT, and TIM-3 on the surface of CD8 +T lymphocytes were higher in both the acute and chronic groups than in the healthy control group ( P<0.001). The expression level of perforin secreted by CD8 +T lymphocytes in the acute and chronic groups was lower than that in the healthy control group ( P<0.05), while the expression level of granzyme B in the acute and chronic groups was higher than that in the healthy control group ( P<0.01). The proportion of CD8 +CD28 -T lymphocytes in brucellosis patients was positively correlated with the expression levels of TIGIT and TIM-3 ( r=0.624, 0.406, P<0.001). The ROC curve combined with the proportion of CD8 +CD28 -T lymphocytes and the proportion of TIGIT on the surface of CD8 +T lymphocytes can distinguish acute and chronic brucellosis. The Area Under Curve (AUC) is 0.973, which has certain implications for clinical differentiation of patients with acute and chronic diseases. Conclusion:The CD8 +T lymphocyte subsets in patients with brucellosis exhibit dynamic changes, accompanied by changes in relevant immune checkpoint molecules, and can regulate the activation and inhibition of the immune status of brucellosis patients. The synergistic effect of CD8 +CD28 -T cells and TIGIT/TIM-3 may be a key mechanism of driving chronicity, and their combined diagnosis can serve as a clinical staging marker.

Objective To construct and preliminary verify a postoperative pulmonary rehabilitation nursing programme for children with double lung transplantation,aiming to promote early recovery and provide references for clinical nursing practice.Methods A convenience sampling approach was employed to select 25 cases pediatric patients who underwent bilateral lung transplantation at a tertiary teaching hospital in Hangzhou between January 2020 and September 2024,and they were divided into an experimental group and a control group according to the time of admission to the hospital.The experimental group received the newly developed post-transplant rehabilitation nursing program,which encompassed fluid management,mechanical ventilation,sequential oxygen therapy,pulmonary function training,exercise management,and process facilitation.In contrast,the control group received the standard post-lung transplantation rehabilitation protocol.Key outcomes,including mechanical ventilation duration,ICU stay,total hospitalization time,activity level,pulmonary function,incidence of adverse events and rehabilitation adherence,were compared between the 2 groups.Results Finally,24 cases completed the study,including 11 cases in the experimental group and 13 cases in the control group.After the intervention,the experimental group exhibited significantly shorter mechanical ventilation time compared to it in the control group(P=0.009).Additionally,at discharge,the intervention group demonstrated higher activity levels and better rehabilitation compliance(P＜0.05).Conclusion The pulmonary rehabilitation nursing program for children with double lung transplantation is scientifically sound,safe,and feasible.The implementation of this program is beneficial for the early discontinuation of mechanical ventilation,improving postoperative mobility,and enhancing compliance with pulmonary rehabilitation.

Objective To observe the changes of invariant natural killer T(iNK T)cells in visceral adipose tissue and blood lipids of high-fat diet-fed mice,and to analyze the correlation between iNK T cells and lipid metabolism.Methods Fifty-two C57BL/6 mice were selected as the high-fat diet group,and 51 C57BL/6 mice as the normal control group.The high-fat diet intervention lasted for 12 weeks.At weeks 1,4,8,and 12,the epididymal and perirenal fats of mice in both groups were collected and weighed to record the visceral fat mass(VFM),and the changes in body fat content(BFC)were calculated.Flow cytometry and laser scanning confocal microscopy were used to detect the changes of invariant natural killer T(iNK T)cells in visceral adipose tissue.An automatic biochemical analyzer was used to measure the lipid levels in mice,and the correlations of iNKT cells in visceral adipose tissue with VFM,BFC,and serum lipid levels were analyzed.Results At 12 weeks after high-fat diet feeding,the body weight,VFM,BFC,serum total cholesterol(TC),triglyceride(TG)and high-density lipoprotein cholesterol(HDL-C)increased significantly,while the content of invariant natural killer T(iNK T)cells in visceral adipose tissue decreased obviously in the high-fat diet group,as compared with the control group(P＜0.01).The iNKT cell number in visceral adipose tissue of mice was negatively correlated with VFM,BFC,serum HDL-C and serum TG(r=-0.293,-0.289,-0.337,-0.199,P＜0.05),and was not correlated with serum TC and LDL-C(r=-0.122,-0.082,P＞0.05).Conclution VFM is increased and iNK T cell number is decreased in in adipose tissue of high-fat diet-fed mice.The number of iNK T cells is negatively correlated with VFM,BFC,serum HDL-C and TG.

Objective: To analyze the association of eating dining locations and their association with nutritional status among Chinese children aged 6-17 years,so as to provide reference for guiding children s reasonable diet. Methods: Stratified random cluster sampling was used to select children aged 6 to 17 years from 28 cities and rural areas of 14 provinces in East, North, Central, South, Southwest, Northwest, Northeast of China, and a total of 52 535 children were included in the study from 2019 to 2021. Information including dining locations, demographic characteristics, dietary intakes and physical activity were collected through a questionnaire survey. Fasting body height and weight were measured in the morning. Unordered multiclass Logistic regression analysis was conducted to assess the relationship between dining locations and nutritional status in children. Results: Regarding children s dining locations, 66.3% ate breakfast at home,25.8% ate breakfast at school,7.9% ate breakfast outside (small dining tables, restaurants, stalls, etc.); 67.7% ate dinner at home,29.0% ate dinner at school,3.3% ate dinner outside; and 63.6% ate lunch at school,30.8% ate lunch at home,5.7% ate lunch outside. The prevalence rates of overweight/obesity and undernutrition were 28.6% and 9.3%, respectively. The adjusted multiclass Logistic regression analysis (controlling for age, region, parental education, household income, total energy intake, and moderate-to-vigorous physical activity) demonstrated that, compared to eating at home, school based breakfast and dinner consumption was associated with significantly lower overweight/obesity risks for both genders (boys: breakfast OR =0.70, 95% CI =0.65-0.75; dinner OR =0.80, 95% CI = 0.74- 0.86; girls: breakfast OR = 0.89 , 95% CI = 0.82-0.96; dinner OR =0.88, 95% CI =0.81-0.95), whereas eating lunch away from home significantly increased overweight/obesity risks (boys: OR =1.32, 95% CI =1.17-1.48; girls: OR =1.43, 95% CI =1.26- 1.62 ), with all associations being statistically significant ( P <0.05). After adjusting for confounding factors, boys who ate breakfast away from home showed a significantly reduced risk of undernutrition ( OR =0.80,95% CI =0.66-0.97), while those consuming lunch away from home had an increased risk ( OR =1.26, 95% CI =1.01-1.57) ( P <0.05). Conclusions The choice of dining locations for children is becoming more diverse, and a relatively high proportion of children eat meals outside the home and at school. Eating out have a higher risk of malnutrition for children. School feeding may be beneficial to children s physical health.

Objective:Based on the theory of behavioral economics,it analyzed the causes of behavioral biases in the utilization of traditional Chinese medicine health management services for the elderly and proposes strategies for optimizing their active utilization behavior,providing reference for enhancing traditional Chinese medicine health management services.Methods:Qualitative interviews were conducted to collect the elderly's perceptions and utilization behaviors of traditional Chinese medicine health management services.The prospect theory,nudge theory,and assistance theory of behavioral economics were used to analyze the behavioral biases in the elderly's decision-making process of utilization of traditional Chinese medicine health management services and to propose targeted optimization strategies.Results:The elderly's limited rationality was affected by the influence of information and uncertainty,leading to anchoring effects in the initial impression and overconfidence effects in self-health.When making decisions,the elderly were influenced by the herding effect of group conformity,and loss aversion and preference structure also constrained their active utilization of traditional Chinese medicine health management services.The time discounting of traditional Chinese medicine health management outcomes leaded the elderly to have a preference for intertemporal choices.Conclusion:It is needed to build a supportive social environment to adjust the cognitive biases of the elderly;establish standardized social systems to highlight the positive effects of framing;enhance the health literacy of traditional Chinese medicine to facilitate rational decision-making.

Objective To observe the changes of invariant natural killer T(iNK T)cells in visceral adipose tissue and blood lipids of high-fat diet-fed mice,and to analyze the correlation between iNK T cells and lipid metabolism.Methods Fifty-two C57BL/6 mice were selected as the high-fat diet group,and 51 C57BL/6 mice as the normal control group.The high-fat diet intervention lasted for 12 weeks.At weeks 1,4,8,and 12,the epididymal and perirenal fats of mice in both groups were collected and weighed to record the visceral fat mass(VFM),and the changes in body fat content(BFC)were calculated.Flow cytometry and laser scanning confocal microscopy were used to detect the changes of invariant natural killer T(iNK T)cells in visceral adipose tissue.An automatic biochemical analyzer was used to measure the lipid levels in mice,and the correlations of iNKT cells in visceral adipose tissue with VFM,BFC,and serum lipid levels were analyzed.Results At 12 weeks after high-fat diet feeding,the body weight,VFM,BFC,serum total cholesterol(TC),triglyceride(TG)and high-density lipoprotein cholesterol(HDL-C)increased significantly,while the content of invariant natural killer T(iNK T)cells in visceral adipose tissue decreased obviously in the high-fat diet group,as compared with the control group(P＜0.01).The iNKT cell number in visceral adipose tissue of mice was negatively correlated with VFM,BFC,serum HDL-C and serum TG(r=-0.293,-0.289,-0.337,-0.199,P＜0.05),and was not correlated with serum TC and LDL-C(r=-0.122,-0.082,P＞0.05).Conclution VFM is increased and iNK T cell number is decreased in in adipose tissue of high-fat diet-fed mice.The number of iNK T cells is negatively correlated with VFM,BFC,serum HDL-C and TG.

Objective:To explore the prevalence and associated factors of anxiety symptoms among the work-ing population in Shandong Province.Methods:Multi-stage stratified cluster sampling method was used to recruit 172 396 working individuals aged 18 years or older from various cities of Shandong Province.Participants complete-da demographic questionnaire covering gender,age,education,lifestyle factors,etc.Anxiety symptoms and occupa-tional burnout were assessed with the Self-Rating Scale for Anxiety(SAS)and Burnout Scale(MBI-GS).Corre-lates were analyzed using multifactor logistic regression.Results:The prevalence of anxiety symptoms was 17.0％(25 991/152 759).Multivariate logistic regression analysis indicated that female(OR=1.17),primary education or below(OR=1.58),divorced(OR=1.24),previous drinking habit(OR=1.23),smoking habit(OR=1.20),poor physical health(OR=24.85),and experiencing burnout(OR=5.48)were risk factors for anxiety symptoms(P＜0.05).Conclusion:The prevalence rate of anxiety is relatively high in working population in Shandong Prov-ince,and anxiety is mainly associated with gender,education level,marital status,smoking,alcohol consumption,physical health status and burnout.

Objective:Based on the theory of behavioral economics,it analyzed the causes of behavioral biases in the utilization of traditional Chinese medicine health management services for the elderly and proposes strategies for optimizing their active utilization behavior,providing reference for enhancing traditional Chinese medicine health management services.Methods:Qualitative interviews were conducted to collect the elderly's perceptions and utilization behaviors of traditional Chinese medicine health management services.The prospect theory,nudge theory,and assistance theory of behavioral economics were used to analyze the behavioral biases in the elderly's decision-making process of utilization of traditional Chinese medicine health management services and to propose targeted optimization strategies.Results:The elderly's limited rationality was affected by the influence of information and uncertainty,leading to anchoring effects in the initial impression and overconfidence effects in self-health.When making decisions,the elderly were influenced by the herding effect of group conformity,and loss aversion and preference structure also constrained their active utilization of traditional Chinese medicine health management services.The time discounting of traditional Chinese medicine health management outcomes leaded the elderly to have a preference for intertemporal choices.Conclusion:It is needed to build a supportive social environment to adjust the cognitive biases of the elderly;establish standardized social systems to highlight the positive effects of framing;enhance the health literacy of traditional Chinese medicine to facilitate rational decision-making.