Objective: To explore the associations of moderate to vigorous intensity physical activity (MVPA) and sedentary behavior (SB) among primary and secondary school students and their parents, so as to provide a scientific basis for formulating targeted physical activity promotion strategies for children and adolescents. Methods: From 2021 to 2022, basic information and 24 h movement behaviors of 2 484 pairs of students and their parents were collected from five primary and secondary schools in Haizhu District, Guangzhou City, with a convenient sampling combining with cluster sampling method. Component regression models were constructed to analyze the relationship between parental MVPA, SB and primary and secondary school students MVPA and SB, and a component isochronous substitution model was used to explore the effects of mutual substitution between parental MVPA, residual components (time use components other than SB during the 24 h period), and SB on the behavioral activities of MVPA and SB in primary and secondary school students. Results: Parental MVPA and SB of students in grade 1 to 3 were positively correlated with both students MVPA and SB ( β=0.06, 0.12, P <0.01). The component isochronous substitution model showed that substituting 10 and 20 minutes of MVPA for SB by parents in grade 1 to 3 was associated with an increase in MVPA of students, and substituting 10 and 20 minutes of residual ingredients for SB was associated with a decrease in SB of students, with mean changes of 0.8 (95% CI =0.4-1.2) and 1.4 (95% CI =0.7-2.2) and -1.4 (95% CI =-1.7 to -1.1) and -2.9 (95% CI =-3.4 to -2.3)( P <0.05). No statistically significant associations were observed between parents of students in grades 4 to 6 and 7 to 9 and students physical activity and sedentary behaviour ( P >0.05). Conclusions Parents of students in grades 1 to 3 increases MVPA and decrease SB are beneficial to increase MVPA and decrease SB of students. Parents could promote physical activity among primary and secondary school students, and the intervention gateway should be advanced, with the low grades as the optimal intervention period.

OBJECTIVES: To explore the value of serum cystatin C (CysC) levels in evaluating renal prognosis in IgA nephropathy (IgAN) patients. METHODS: We retrospectively collected the clinical data of IgAN patients diagnosed by renal biopsy at Guangdong Provincial People's Hospital from January, 2014 to December, 2018. Based on baseline serum CysC levels, the patients were divided into high serum CysC (>1.03 mg/L) group and normal serum CysC (≤1.03 mg/L) group. The composite endpoint for poor renal prognosis was defined as ≥50% decline in estimated glomerular filtration rate (eGFR) and/or progression to end-stage renal disease (ESRD). Lasso regression, multivariate Cox regression and Kaplan-Meier survival analysis were used to identify the risk factors and compare renal survival rates between the two groups. Smooth curves fitting and threshold effect analysis were used to explore the relationship between serum CysC levels and the outcomes. A nomogram model was constructed and its predictive performance was evaluated using concordance index, calibration curve, receiver operating characteristic (ROC) curve and the area under curve (AUC). RESULTS: A total of 356 IgAN patients were enrolled, who were followed up for 4.65±0.93 years. The composite endpoint occurred in 74 patients. High serum CysC was identified as an independent risk factor for poor renal prognosis in IgAN (HR=2.142, 95% CI 1.222 to 3.755), and the patients with high serum CysC levels had a lower renal survival rate (Log-rank χ²=47.970, P<0.001). In patients with serum CysC below 2.12 mg/L, a higher CysC level was associated with an increased risk of poor renal prognosis (β=3.487, 95% CI: 2.561-4.413, P<0.001), while above this level, the increase of the risk was not significant (β=0.676, 95% CI: -0.642-1.995, P=0.315). The nomogram model based on serum CysC and 3 other independent risk factors demonstrated good internal validity with a concordance index of 0.873 (95% CI: 0.839-0.907) and an AUC of 0.909 (95% CI: 0.873-0.945). CONCLUSIONS Serum CysC levels are associated with renal prognosis in IgAN patients, and high serum CysC an independent risk factor for poor renal prognosis.
Humans ; Glomerulonephritis, IGA/diagnosis* ; Cystatin C/blood* ; Prognosis ; Risk Factors ; Retrospective Studies ; Glomerular Filtration Rate ; Kidney Failure, Chronic ; Male ; Female ; Adult ; Nomograms ; Middle Aged

The objective of this study is to assess the current status of vaccination against respiratory disease among the elderly aged ≥60 and analyze the factors influencing vaccination rates at both service provider and recipient levels in Zhejiang Province. Using a stratified random sampling method, a questionnaire survey was conducted from September 2022 to January 2023 among elderly people aged ≥60 in 30 townships/streets in Zhejiang Province, as well as immunization planning staff at the provincial, municipal, county/district, and township/street levels. Logistic regression models were used to analyze the factors related to vaccination among elderly people in Zhejiang Province. Based on the Zhejiang Provincial Comprehensive Management Information System for Vaccine and Vaccination, the systematic coverage rates of influenza vaccine and pneumonia vaccine for the elderly were 21.76% and 4.57%, respectively. Multivariate logistic regression analysis indicated that advanced age ( OR=1.74, 95% CI: 1.51-1.99), knowing that influenza is more severe than the common cold ( OR=1.67, 95% CI: 1.37-2.04) and having heard of the influenza vaccine ( OR=9.78, 95% CI: 7.03-13.59) were motivating factors for elderly to receive influenza vaccines. Advanced age ( OR=1.71, 95% CI: 1.43-2.06), knowing the serious consequences of pneumonia in the elderly ( OR=1.93, 95% CI: 1.47-2.55) and knowing that pneumonia vaccines can prevent pneumonia ( OR=6.36, 95% CI: 4.84-8.36) were motivating factors for elderly to receive pneumonia vaccines. Zhejiang Immunization Program staff believed that the main reasons why the elderly aged ≥60 would not be vaccinated against influenza or pneumonia were that they felt they would not get sick (55.52% and 56.35% respectively), it would not be serious if get sick (47.73% and 37.46% respectively), lacking trust in vaccine efficacy and safety (38.31% and 43.69% respectively). Vaccination rates for influenza and pneumonia vaccines among the elderly aged ≥60 in Zhejiang Province are suboptimal. Advanced age, awareness of the severity of respiratory diseases and awareness of vaccines against such diseases are related factors for elderly individuals to receive influenza and pneumonia vaccines.

The objective of this study is to assess the current status of vaccination against respiratory disease among the elderly aged ≥60 and analyze the factors influencing vaccination rates at both service provider and recipient levels in Zhejiang Province. Using a stratified random sampling method, a questionnaire survey was conducted from September 2022 to January 2023 among elderly people aged ≥60 in 30 townships/streets in Zhejiang Province, as well as immunization planning staff at the provincial, municipal, county/district, and township/street levels. Logistic regression models were used to analyze the factors related to vaccination among elderly people in Zhejiang Province. Based on the Zhejiang Provincial Comprehensive Management Information System for Vaccine and Vaccination, the systematic coverage rates of influenza vaccine and pneumonia vaccine for the elderly were 21.76% and 4.57%, respectively. Multivariate logistic regression analysis indicated that advanced age ( OR=1.74, 95% CI: 1.51-1.99), knowing that influenza is more severe than the common cold ( OR=1.67, 95% CI: 1.37-2.04) and having heard of the influenza vaccine ( OR=9.78, 95% CI: 7.03-13.59) were motivating factors for elderly to receive influenza vaccines. Advanced age ( OR=1.71, 95% CI: 1.43-2.06), knowing the serious consequences of pneumonia in the elderly ( OR=1.93, 95% CI: 1.47-2.55) and knowing that pneumonia vaccines can prevent pneumonia ( OR=6.36, 95% CI: 4.84-8.36) were motivating factors for elderly to receive pneumonia vaccines. Zhejiang Immunization Program staff believed that the main reasons why the elderly aged ≥60 would not be vaccinated against influenza or pneumonia were that they felt they would not get sick (55.52% and 56.35% respectively), it would not be serious if get sick (47.73% and 37.46% respectively), lacking trust in vaccine efficacy and safety (38.31% and 43.69% respectively). Vaccination rates for influenza and pneumonia vaccines among the elderly aged ≥60 in Zhejiang Province are suboptimal. Advanced age, awareness of the severity of respiratory diseases and awareness of vaccines against such diseases are related factors for elderly individuals to receive influenza and pneumonia vaccines.

Objective To evaluate the applicability of the comprehensive index method for assessing occupational health risks on chemical hazards in key work sites of a metal product enterprise. Methods A metal product enterprise in Beijing City was chosen as the research subject using the convenience sampling method. Occupational health investigations and chemical hazard monitoring were conducted at four work sites: grinding machine operation, welding, cutting, and painting. The comprehensive index method was used to determine the risk levels of chemical hazards. Results The grinding dust in the grinding machine operation work site was assessed as moderate risk. The nitrogen oxides and ozone in the welding (southeast) work sites were assessed as moderate risk. The nitrogen oxides ozone and welding fumes in the welding (northwest) and cutting work site were assessed as moderate risk. Benzene in the painting work site was assessed as moderate risk. All chemical hazards in other work sites were determined to pose low risks. Co-exposures to nitrogen oxides and ozone in the two welding work sites and cutting work site were classified as moderate risk. Co-exposure to ethylbenzene, xylene, methanol, ethyl acetate, and butyl acetate in the painting work site also posed moderate risk, while the co-exposure to toluene and methanol in the painting work site was assessed as low risk. Conclusion The comprehensive index method could be used for the occupational health risk assessment in the metal product enterprise. The enterprise should strengthen hazard control measures for exposure to grinding dust, welding fumes, nitrogen oxides, ozone, and benzene, and closely monitor the health risks associated with co-exposures of chemical hazards.

Objective To investigate the correlation between serum Sortilin(SORT)and insulin-like growth factor 1(IGF-1)levels and the occurrence and prognosis of cardiovascular disease(CVD)in maintenance hemodialysis(MHD)patients with end-stage renal disease(ESRD).Methods Eighty-four MHD patients with ESRD diagnosed and treated in the First People's Hospital of Kunshan from February 2017 to February 2018 were selected as the MHD group.With 5 years of follow-up,the MHD group was divided into the CVD group(n=35)and the non-CVD group(n=49)according to whether they had concurrent CVD,while 60 healthy individuals who underwent physical examination during the same period were used as the control group.Enzyme-linked immunosorbent assay was used to detect serum SORT and IGF-1 levels.Multivariate logistic regression analysis was conducted to investigate the influencing factors of CVD in MHD patients with ESRD.The predictive value of serum SORT and IGF-1 for CVD in MHD patients with ESRD was analyzed by the receiver operating characteristic curve.The correlation between serum SORT and IGF-1 levels and the survival rate of MHD patients with ESRD was analyzed by Kaplan-Meier survival analysis.Results Compared to the control group,the MHD group had higher serum SORT level(413.37±55.41 ng/L vs 81.27±24.69 ng/L)and lower serum IGF-1 level(117.64±18.42 μg/L vs 421.34±14.58 μg/L),with significant differences(t=43.416,106.122,all P＜0.001).The age,dialysis time,and serum SORT level(488.73±55.41ng/L vs 359.54±58.29ng/L)of patients in the CVD group were higher than those in the non-CVD group,while serum IGF-1 level(88.25±17.92 μg/L vs 138.63±19.55μg/L)was lower than that of the non-CVD group,with significant differences(t=2.896,2.588,10.221,12.050,all P＜0.05).Age(OR=1.548,P＜0.001),dialysis time(OR=1.616,P＜0.001)and serum SORT(OR=1.353,P＜0.001)were independent risk factors for CVD in MHD patients,while serum IGF-1(OR=0.742,P=0.000)was a protective factor for CVD in MHD patients.The area under the curve(95％CI)of the combined serum SORT and IGF-1 test for predicting concomitant CVD in MHD patients was 0.931(95％CI:0.895～0.961),which was greater than that of the single detection[0.843(0.810～0.889),0.887(0.833～0.921)],and the differences were statistically significant(Z=5.117,4.895,all P＜0.001).The five-year cumulative survival rate of MHD patients in the SORT high expression group(48.39％)was lower than that in the low expression group(84.81％),while the five-year cumulative survival rate of MHD patients in the IGF-1 low expression group(51.52％)was lower than that in the high expression group(84.31％),and the differences were significant(Log-Rank x2=18.670,8.900,all P＜0.01).Conclusion The serum SORT levels increased while IGF-1 levels decreased in MHD patients.The combined detection of the two has high predictive value for the occurrence of CVD in MHD patients with ESRD,which is associated with poor survival prognosis in MHD patients with ESRD.

Pathological insulin resistance (IR) is closely related to gestational diabetes mellitus (GDM) and adverse pregnancy outcomes in women with GDM. Increasing studies have investigated the efficacy of IR indices, such as quantitative insulin sensitivity index, homeostasis model assessment of insulin resistance, triglyceride-glucose index and sex hormone-binding globulin, in predicting GDM and related complications in recent years. This article reviews the research progress in the above topics.

Objective:To identify the risk factors for simple congenital ptosis.Methods:A case-control study was performed.A total of 106 children diagnosed with simple congenital ptosis at the Second Affiliated Hospital of Zhejiang University School of Medicine from October 2018 to January 2021 were recruited as a case group, and 106 sex-matched children without congenital abnormalities were enrolled as a control group at the same period.Ophthalmic examinations, including interpalpebral fissure height and margin reex distance 1, were performed on all participants.A questionnaire survey was administered to their mothers.The questionnaire included demographic information, prenatal maternal diseases, medical treatments and environmental exposures during pregnancy.Univariate analysis was used to compare the differences in variables between the case and control groups.Variables with P<0.20 were retained for multivariate logistic regression analysis to identify the risk factors for simple congenital ptosis.The goodness of fit of the model was evaluated by the Hosmer-Lemeshow test, and collinearity was assessed by the variance inflation factor (VIF). This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine (No.2019-136). The method and purpose of the study were fully explained to the children's guardians and written informed consent was obtained. Results:Comparisons of gestational age <37 weeks, birth order ≥2, maternal age, antibiotic use in the first trimester, paternal smoking ≥half a pack per day, and prenatal maternal passive smoking between the two groups were all with P<0.20.Multivariate logistic regression analysis showed that gestational age <37 weeks (odds ratio [ OR]=4.58; 95% confidence interval [ CI]: 1.24-16.85), paternal smoking ≥half a pack per day ( OR=2.28; 95% CI: 1.22-4.28) and prenatal maternal passive smoking ( OR=3.13; 95% CI: 1.16-8.41) were risk factors for simple congenital ptosis.No significant collinearity was found among these identified factors (all VIF<5). Conclusions:Preterm birth, paternal smoking, and prenatal maternal passive smoking are risk factors for simple congenital ptosis.

Objective: To investigate the coverage of enterovirus 71 (EV71) vaccine among children born between 2018 and 2021 in Ningbo City, Zhejiang Province, so as to provide insights into formulating EV71 vaccination strategy. Methods: Data pertaining to demography and EV71 vaccination among children born between 2018 and 2021 in Ningbo City were obtained from the Zhejiang Immunization Information Management System, and the coverage of vaccination, full-dose vaccination and timely vaccination of EV71 vaccine were analyzed. Results: Totally 416 176 children were born between 2018 and 2021, including 216 977 boys (52.14%) and 199 199 girls (47.86%). The coverage rates of vaccination, full-dose vaccination and timely vaccination was 61.50%, 58.70% and 32.53%, respectively. The coverage rates of vaccination, full-dose vaccination and timely vaccination among local children (71.43%, 70.04% and 40.24%) were higher than those among migrant children (54.05%, 50.18% and 26.73%; P<0.05). The coverage rates of vaccination, full-dose vaccination and timely vaccination among urban children (67.72%, 65.06% and 40.37%) were higher than those among rural children (54.11%, 51.14% and 23.21%; P<0.05). The coverage rates of vaccination were 54.98%, 61.24%, 65.10% and 66.72%, the coverage rates of full-dose vaccination were 52.16%, 58.72%, 62.44% and 63.39%, and the coverage rates of timely vaccination were 22.47%, 25.86%, 39.14% and 48.03% by the born year from 2018 to 2021, all showing increasing trends year by year (P<0.05). Conclusion The coverage of vaccination, full-dose vaccination and timely vaccination of EV71 vaccine appears a tendency towards a rise among the 2018-2021 birth cohorts in Ningbo City, while the coverage of timely vaccination need to be improved. Health education for EV71 vaccination should be enhanced for rural and migrant children.

Objective: To investigate immune responses to influenza virus infections and the immunogenicity of trivalent split-virus influenza vaccine among elderly populations in Jiangbei District, Ningbo City, so as to provide the support for promoting influenza vaccination among elderly populations. Methods: The elderly populations at ages of 60 years and older were recruited in Jiangbei District of Ningbo City from September to November, 2020, and the participants were assigned to the vaccination group and the control group according to vaccination intention. The titers of haemagglutination inhibition ( HI ) antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were measured using the micro HI test prior to vaccination and 30 days post-vaccination, and the protective rate, geometric mean titer ( GMT ) and seroconversion rate of antibodies were analyzed before and after vaccination. Results: There were 290 participants in the vaccination group, including 132 men (45.52% ), and 290 controls, including 132 men ( 45.52% ). There were no significant differences between the vaccination group and the control group in terms of the protective rate or GMT of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV prior to vaccination ( P>0.05 ). Following vaccination, the protective rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were 98.62%, 94.14% and 88.28%, and the GMT of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV increased by 9.26, 6.19 and 10.09 folds, while the seroconversion rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were 78.62%, 68.28% and 71.38%, respectively. The protective rates, GMT and seroconversion rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were all significantly greater in the vaccination group than in the control group post-vaccination ( P<0.05 ). A lower increase was seen in the GMT of antibodies against the influenza virus BV among residents at ages of 80 years and older (increase by 7.91 folds) than among residents at ages of 70 to 79 years ( increase by 12.53 folds ) and 60 to 69 years (increase by 13.32 folds) in the vaccination group post-vaccination ( P<0.05 ), and the seroconversion rate of antibodies against the influenza virus BV was significantly lower in residents at ages of 80 years and older ( 62.57% ) than in those at ages of 70 to 79 years ( 83.33% ) ( P<0.05 ), while the positive conversion rate of antibodies against the influenza virus A ( H3N2 ) was significantly lower in residents at ages of 80 years and older ( 62.57% ) than in those at ages of 60 to 69 years ( 91.30% ) ( P<0.05 ). Conclusions Low-level immune responses are detected to antibodies against influenza virus A ( H3N2 ) and BV among elderly populations in Jiangbei District of Ningbo City, and trivalent split-virus influenza vaccine shows a high immunogenicity among elder populations. An emphases on improvements in coverage of influenza vaccination among elderly populations at ages of 60 to 69 years, and development of influenza vaccines with a higher protective efficacy for residents at ages of 80 years and older are recommended.