Objective:To explore the relationship between urinary cadmium levels and thyroid hormone levels in people aged 40-89 years old in selected areas of China.Methods:Based on the "Investigation of the Impact of Soil Quality of Agricultural Land on Human Health in Typical Areas" project from October 2019 to August 2020, a multi-stage stratified random sampling method was used to include 6 588 middle-aged and older adults aged 40-89. Demographic characteristics, dietary frequency and disease status were collected through the questionnaire and physical examination. Urinary cadmium and urinary creatinine were detected by random midstream urine. Fasting venous blood was collected for the detection of Triiodothyronine (T3) and Thyroxine (T4). The linear mixed effects model was used to explore the association of urine cadmium levels with thyroid hormone levels. Its dose-response relationship was explored by using the restricted cubic spline.Results:The age of the subjects was (63.48±12.18) years, with males accounting for 51.28%. The M ( Q 1,Q 3) of urinary cadmium level, T3 and T4 was 2.48 (1.36, 4.42) μg/g·creatinine, (1.96±0.51) nmol/L and (113.75±29.11) nmol/L, respectively. The linear mixed effects model showed that the changes of T3 and T4 were 0.027 (0.009, 0.044) nmol/L and 2.019 (1.084, 2.953) nmol/L for each one-unit increase (natural logarithm transformed) of urinary cadmium. The restricted cubic spline showed that there was a positive nonlinear association between urinary cadmium and T3 as well as T4 (all Pnonlinear<0.05). Conclusion:In selected areas of China, the urinary cadmium level of middle-aged and older adults aged 40-89 years is positively associated with T3 and T4.

Objective:To evaluate the levels and source of cadmium exposure by dietary pathway among middle-aged and elderly people ≥40 in cadmium-contaminated areas of China.Methods:A total of 7 193 people aged 40-89 years from four typical cadmium-contaminated areas in China were selected as the study subjects. Food Frequency Questionnaire (FFQ), Total Diet Study (TDS) and a 3-day-24-hour dietary recall survey were conducted. Dietary cadmium intake and food sources through dietary pathways were assessed based on cadmium content in foods, consumption amounts and intake frequencies.Results:The mean age of the participants was 63.39±12.21 years, with 50.05% being males. The average monthly dietary cadmium intake was 7.39 μg/(kg·BW). Staple foods and vegetables were the primary sources of dietary cadmium intake, accounting for 57.51% and 32.48%, respectively. The monthly dietary cadmium intake in all surveyed regions did not exceed the Provisional Tolerable Monthly Intake (PTMI) recommended by the Joint FAO/WHO Expert Committee on Food Additives (JECFA).Conclusion:The monthly dietary cadmium intake among middle-aged and elderly people in cadmium-contaminated areas of China is relatively low, with the risk remaining at an acceptable level. Staple foods and vegetables are the most significant contributors to dietary cadmium intake.

Objective:To explore the relationship between urinary cadmium levels and thyroid hormone levels in people aged 40-89 years old in selected areas of China.Methods:Based on the "Investigation of the Impact of Soil Quality of Agricultural Land on Human Health in Typical Areas" project from October 2019 to August 2020, a multi-stage stratified random sampling method was used to include 6 588 middle-aged and older adults aged 40-89. Demographic characteristics, dietary frequency and disease status were collected through the questionnaire and physical examination. Urinary cadmium and urinary creatinine were detected by random midstream urine. Fasting venous blood was collected for the detection of Triiodothyronine (T3) and Thyroxine (T4). The linear mixed effects model was used to explore the association of urine cadmium levels with thyroid hormone levels. Its dose-response relationship was explored by using the restricted cubic spline.Results:The age of the subjects was (63.48±12.18) years, with males accounting for 51.28%. The M ( Q 1,Q 3) of urinary cadmium level, T3 and T4 was 2.48 (1.36, 4.42) μg/g·creatinine, (1.96±0.51) nmol/L and (113.75±29.11) nmol/L, respectively. The linear mixed effects model showed that the changes of T3 and T4 were 0.027 (0.009, 0.044) nmol/L and 2.019 (1.084, 2.953) nmol/L for each one-unit increase (natural logarithm transformed) of urinary cadmium. The restricted cubic spline showed that there was a positive nonlinear association between urinary cadmium and T3 as well as T4 (all Pnonlinear<0.05). Conclusion:In selected areas of China, the urinary cadmium level of middle-aged and older adults aged 40-89 years is positively associated with T3 and T4.

Objective:To evaluate the levels and source of cadmium exposure by dietary pathway among middle-aged and elderly people ≥40 in cadmium-contaminated areas of China.Methods:A total of 7 193 people aged 40-89 years from four typical cadmium-contaminated areas in China were selected as the study subjects. Food Frequency Questionnaire (FFQ), Total Diet Study (TDS) and a 3-day-24-hour dietary recall survey were conducted. Dietary cadmium intake and food sources through dietary pathways were assessed based on cadmium content in foods, consumption amounts and intake frequencies.Results:The mean age of the participants was 63.39±12.21 years, with 50.05% being males. The average monthly dietary cadmium intake was 7.39 μg/(kg·BW). Staple foods and vegetables were the primary sources of dietary cadmium intake, accounting for 57.51% and 32.48%, respectively. The monthly dietary cadmium intake in all surveyed regions did not exceed the Provisional Tolerable Monthly Intake (PTMI) recommended by the Joint FAO/WHO Expert Committee on Food Additives (JECFA).Conclusion:The monthly dietary cadmium intake among middle-aged and elderly people in cadmium-contaminated areas of China is relatively low, with the risk remaining at an acceptable level. Staple foods and vegetables are the most significant contributors to dietary cadmium intake.

Objective:To investigate the association of urinary cadmium levels with peripheral leukocyte classification counts among middle-aged and older adults aged 40 to 89 years in selected areas of China.Methods:The research was based on the survey of the impact of soil quality of agricultural land on human health in typical areas conducted in 2019-2020. A total of 5 600 middle-aged and older adults aged 40 to 89 years were included by using a multi-stage stratified random sampling method. Baseline characteristics of the subjects were collected and physical examinations were performed. Random midstream urine was collected to measure urinary cadmium and urinary creatinine and fasting venous blood was collected to measure the leukocyte count, neutrophil count, lymphocyte count, monocyte count and eosinophil count. The linear mixed effect model was used to analyse the association of urinary cadmium levels with leukocyte classification counts, and the dose-response relationship between them was analyzed by using the restricted cubic spline (RCS) function.Results:The age of the subjects was (63.17±12.02) years; 2 851 (50.91%) were males; and the M ( Q 1, Q 3) of urinary creatinine-corrected urinary cadmium levels was 2.69 (1.52, 4.69) μg/g·creatinine. After adjusting for confounding factors, the results of linear mixed effects model analysis showed that for each 1-unit increase in urinary creatinine-corrected urinary cadmium level, the percentage change [% (95% CI)] of leukocyte count and lymphocyte count was -1.70% (-2.61%, -0.79%) and -1.57% (-2.86%, -0.26%), respectively. RCS function showed a negative linear relationship between urinary creatinine-corrected urinary cadmium levels and leukocyte counts and lymphocyte counts, respectively (all Pnon-linear>0.05). Conclusion:Urinary cadmium levels are negatively associated with leukocyte count and lymphocyte count among middle-aged and older adults aged 40 to 89 years in selected areas of China.

Objective:To investigate the association of urinary cadmium levels with peripheral leukocyte classification counts among middle-aged and older adults aged 40 to 89 years in selected areas of China.Methods:The research was based on the survey of the impact of soil quality of agricultural land on human health in typical areas conducted in 2019-2020. A total of 5 600 middle-aged and older adults aged 40 to 89 years were included by using a multi-stage stratified random sampling method. Baseline characteristics of the subjects were collected and physical examinations were performed. Random midstream urine was collected to measure urinary cadmium and urinary creatinine and fasting venous blood was collected to measure the leukocyte count, neutrophil count, lymphocyte count, monocyte count and eosinophil count. The linear mixed effect model was used to analyse the association of urinary cadmium levels with leukocyte classification counts, and the dose-response relationship between them was analyzed by using the restricted cubic spline (RCS) function.Results:The age of the subjects was (63.17±12.02) years; 2 851 (50.91%) were males; and the M ( Q 1, Q 3) of urinary creatinine-corrected urinary cadmium levels was 2.69 (1.52, 4.69) μg/g·creatinine. After adjusting for confounding factors, the results of linear mixed effects model analysis showed that for each 1-unit increase in urinary creatinine-corrected urinary cadmium level, the percentage change [% (95% CI)] of leukocyte count and lymphocyte count was -1.70% (-2.61%, -0.79%) and -1.57% (-2.86%, -0.26%), respectively. RCS function showed a negative linear relationship between urinary creatinine-corrected urinary cadmium levels and leukocyte counts and lymphocyte counts, respectively (all Pnon-linear>0.05). Conclusion:Urinary cadmium levels are negatively associated with leukocyte count and lymphocyte count among middle-aged and older adults aged 40 to 89 years in selected areas of China.

Objective To investigate the effect of narrative education on emotional and clinical ability of baccalaureate nursing students practicing in ICU. Methods A total of 42 baccalaureate nursing students practicing in ICU between January 2016 and September 2016 were treated as the control group and received traditional teaching, their counterparts practicing in ICU between October 2016 and June 2017 were served as the observation group (41 cases) and subject to narrative education. The Self-rating Anxiety Scale(SAS),the Self-rating Depression Scale(SDS) were filled out by both groups before and after practicing in ICU, and assessed the comprehensive ability after ICU practice. Results The scores of SAS and SDS after practicing were (49.47 ± 12.37),(50.25 ± 11.86)points in the observation group and (54.32 ± 12.51), (55.79 ± 11.34) points in the control group, and the difference was significant(t=10.822, 12.310, P<0.05). The total scores and personal quality, theoretical knowledge level, clinical nursing ability, judgment thinking ability, communication and cooperation ability was (88.45 ± 13.54), (23.21 ± 4.73), (18.42±3.45), (17.91±3.62), (8.56±0.83), (8.34±0.67) points in the observation group , and (73.13± 11.35), (19.13±4.52), (15.45±3.21), (15.76±3.54), (6.17±0.19), (5.17±0.18) points in the control group, and the difference was significant (t=3.226-8.665, P<0.05 or 0.01). Conlusions The narration education can reduce the psychological burden of baccalaureate nursing students practicing in ICU and can improve the comprehensive ability of them.

Objective To study the effect of body weight management on community residents with over-weight or obesity.Methods Chronic Disease Management Information System was used to establish personal health profile for 10 560 individuals with over-weight or obesity(4660 men and 5900 women,average age 58±12 years).Guide for individualized food intake,physical activity were given to these participants for an average of 9±6 months (range,1 to 32 months) with a following up.The change of body weight before and after the intervention was nalyzed.Statistical software(SPSS 12.0) wag used for the data analysis,the frequencies,rate and trend were analysised by the chi-square test,the means in quatitaitve data was analyzed by the paired t-test.P valuse for statistiacal significance is set for 0.05.Results A total of 9848 participants showed no change in body weight,although weight decrease or increase was seen in 499 and 213,respectively.Before and after the intervention,the proportion of weight remained,decrease or increase among over-weisht + central obesity individuals was 92.3%(6290/6817),5.9%(403/6817) and 1.8% (124/6817);95.5%(2888/3024),2.8%(84/3024) and 1.7%(52/3024) among the simple overweight or obesity group;and 93.2%(670/719),1.7%(12/719)and 5.1%(37/719) among the simple central obesity group,separately.Conclusions Body-weight management among central obesity individuals with over weight in communities is a more effective way of in terms of individule intervention than those individuals only with single over-weight,obesity or central obesity status.

Objectives To develop a measurement for obesity assessment which could be used as a simple tool of risk screening. Methods The data of National Nutrition and Health Survey ( 2002 ) were used to analyze the relationship between body mass index ( BMI ), waist circumference (WC) and chronic diseases, based on which chronic disease index ( CRI ) was established. Receiver operating characteristic curve (ROC) was used to determine the cut-off of CRI and to compare the predictive effectiveness of CRI,BMI and WC on chronic diseases. The kappa test was chosen to estimate the consistency of different cut-off of CRI with BMI and WC. The odds ratios of chronic diseases in different cut-offs of CRI were calculated by multiple Logistic regression analysis. Results CRI was calculated as CRI = BMI + 3.5 WC. In ROC curve,the cut-off of CRI was 300. The predictive effectiveness of CRI was higher than that of BMI and WC. CRI at 300 showed the best consistency with 24 kg/m2 BMI and 85 cm WC (P <0. 05 ). In comparison with CRI <300,the risk of chronic diseases was significantly increased with an increase of 20 U CRI. Conclusion CRI shows good predietive effectiveness and could be used to identify those with higher risk of chronic diseases.

Objective To analyze the dietary behavior and blood lipid profiles of the local elderly Tibetans and Han people living in Tibet and in Beijing,and to advise some steps to promote the health of local elderly Tibetans.Methods We collected the data of diet and blood lipids of the local Tibetan and Han people living in Tibet and in Beijing aged over 35 yrs by the method of migration epidemiology.Results The diet pattern of Tibetan was high intakes of coarse grains(219.8?123.3 g/day),meat(226.2?210.1 g/day),and wine(580.8?1 049.0 g/day),but low intakes of fresh vegetable & fruits(217.8?160.4 g/day).The prevalence of hypertriglyceridemia(5.0%) and low high-density lipoprotein cholesterol(3.1%) of Tibetan was lower than that of other two groups(elderly Han people in Tibet 22.5% and 10.7%;elderly Han people living in Beijing 14.7% and 8.4%,all P