Objective: To examine the prevalence of e-cigarette use and associated factors among primary and secondary school students in Pudong New Area, Shanghai, and to explore the pathways linking harm perception of e-cigarettes, interpersonal social influence, and attitudes toward e-cigarette use with experimentation behavior, in order to provide scientific basis for further optimizing the prevention and control strategies of e-cigarette among adolescents. Methods: From September to October 2025, a multi stage cluster random sampling method was used to select 5 144 primary and secondary school students aged 8-19 years from 47 primary and secondary schools in Pudong New Area, Shanghai, to conduct an anonymous questionnaire survey. The questionnaire collected information on e-cigarette use, harm perception of e-cigarette, interpersonal social influence, and attitudes toward e-cigarette use. The Chi-square test was applied to analyze the differences in cigarette and e-cigarette use behavior among primary and secondary school students with different demographic characteristics. Structural equation modeling (SEM) was constructed using Mplus 8.3 software, and the bootstrap method was utilized to test the mediating effects. Results: The reported rates of cigarette experimentation, e-cigarette experimentation, and current e-cigarette use among primary and secondary school students were 1.85%, 2.10%, and 0.70%, respectively. Higher reporting rates of e-cigarette experimentation were observed among boys (2.82%), secondary school students aged 16-19 (3.39%), senior high school students (3.05%), and those with weekly pocket money >100 yuan ( 6.11% ) ( χ 2=11.67, 8.61, 8.00, 54.18, all P <0.05). Structural pathway analysis results demonstrated that e-cigarette harm perception positively predicted interpersonal social influence ( β =0.61) and e-cigarette use attitude ( β = 0.53 ), and interpersonal social influence ( β =0.65) and e-cigarette use attitude ( β =0.25) further promoted e-cigarette experimentation behavior among primary and secondary school students (all P <0.01), with interpersonal social influence playing a major mediating role (indirect effect=0.40). Conclusions E-cigarette experimentation behavior among primary and secondary school students in Pudong New Area is jointly influenced by multiple psychosocial factors. Intervention strategies should strengthen interpersonal social factors such as family and peers on the basis of health education, thereby constructing a comprehensive prevention and control strategy for e-cigarette use among primary and secondary school students.

Background As a pillar industry in China, the manufacturing sector has a high incidence of non-fatal occupational injuries. The factors influencing non-fatal occupational injuries in this industry are closely related at various levels, including individual, equipment, environment, and management, making the analysis of these influencing factors complex. Objective To identify influencing factors of non-fatal occupational injuries among manufacturing workers, providing a basis for targeted interventions and surveillance. Methods A total of 2243 frontline workers from cable and shipbuilding enterprises were selected as study subjects to investigate the incidence of non-fatal occupational injuries and collect information at four levels: individual, equipment, management, and environment in past 12 months. Data balancing was performed using resampling, and LASSO regression was used to select factors of non-fatal occupational injuries. The influence degree and type of variables were judged based on the magnitude of the estimated coefficients of each variable, where variables with estimated coefficients > 0 are risk factors, and those <0 are protective factors. The area under the receiver operating characteristic (ROC)curve (AUC) was used to test the performance of the model, with an AUC value > 0.7 indicating good model performance. Results Among the 2243 frontline workers, males accounted for 77.7% (1742 out of 2243), with the main age range being 40-49 years old, representing 29.5% (661 out of 2243), 82.7% of the workers (1854 out of 2243) were married, and 55.6% (1248 out of 2243) had a junior middle school education level. The average monthly income for 51.0% (1144 out of 2243) of the workers was between 5000 and 6999 Chinese Yuan. The incidence of non-fatal occupational injuries among the manufacturing workers was 8.4% (189/2243) in the past 12 months. Among the 22 factors associated with the occurrence of non-fatal occupational injuries (P<0.05), 10 were individual-level factors, including gender, smoking, alcohol consumption, colleague relationships, average exercise duration, job burnout, work fatigue, musculoskeletal disorders, cardiovascular diseases, and neurological and sensory organ diseases; 3 were equipment-level factors, including equipment operability, hazardous workpieces, and safety hazards; 5 were environmental-level factors, including low temperatures, special operations, noise, workspace size, and dirty and disorderly environment; and 4 were management-level factors, including daily working hours, weekly working days, overtime, and pre-job technical training. The AUC value of the LASSO regression model was 0.704 and the final model retained a total of 10 variables. Among them, there were 7 risk factors for non-fatal occupational injuries (coefficient > 0), including safety hazards, musculoskeletal disorders, dangerous workpieces, job burnout, dirty and disorderly environment, smoking, and male gender; and 3 protective factors (coefficient < 0), including pre-job technical training, good colleague relationship, and long working days per week. Conclusion Manufacturing enterprises need to focus on the incidence of non-fatal occupational injuries and conduct targeted interventions for non-fatal occupational injuries by controlling potential safety hazards, providing pre-job technical training, reducing dangerous workpieces, rectifying working environment, and reasonably arranging working hours.

Background Diseases severely affect the efficiency of workers. Comorbidity refers to the coexistence of two or more chronic diseases or health problems in the same individual. Previous studies have primarily focused on occupational injuries caused by environmental exposures, while the analysis of the epidemiological characteristics of self-reported diseases and occupational injuries among manufacturing workers has been insufficient. Objective To analyze the distribution of self-reported diseases and occupational injuries among manufacturing workers, the strength of correlation between different diseases, and common disease combinations, and to preliminarily explore the relationship between self-reported diseases and occupational injuries. Methods A cross-sectional survey was conducted to investigate the occupational injuries of 2382 workers in 2 manufacturing enterprises over the past year, and 2355 questionnaires were valid after cleaning. The questionnaire included three parts: basic information, occupational injury occurrence, and disease prevalence. The self-reported diseases diagnosed by physicians included musculoskeletal diseases, cardiovascular diseases, respiratory diseases, mental health problems, neurological and sensory organ diseases, digestive organ diseases, reproductive and urinary organ diseases, skin diseases, tumors, endocrine and metabolic system diseases, blood diseases and birth defects, a total of 11 types. Log-binomial model was used to calculate the prevalence ratio (PR) value of the association between different diseases, and UpSet diagram was used to present the disease combination pattern. Results In total, 40.2% (946/2355) of the study participants reported at least one disease, while 8.6% (203/2355), 5.2% (122/2355), and 5.9% (140/2355) reported having two, three, and four or more diseases, respectively. A higher prevalence was observed for musculoskeletal diseases, neurological and sensory organ diseases, digestive organ diseases, and skin diseases, which accounted for 18.0% (423/2355), 13.8% (324/2355), 9.3% (218/2355), and 9.1% (214/2355), respectively. Workers with musculoskeletal disorders, cardiovascular diseases, or neurological and sensory organ diseases reported significantly higher incidence of occupational injuries compared with workers without the corresponding diseases (P<0.001, P=0.041, and P=0.006, respectively). Musculoskeletal diseases were strongly associated with comorbidities of neurological and sensory organ diseases (PR values were 1.86 and 1.98, respectively), and the other patters were musculoskeletal diseases and digestive organ diseases (PR and OR values were 1.57 and 2.35, respectively), and musculoskeletal diseases and cardiovascular diseases (PR and OR values were 1.46 and 2.22, respectively). The largest binomial comorbidity group involved musculoskeletal diseases and neurological and sensory organ diseases, accounting for 5.4% (25/465) of the comorbid workers. Conclusion Among the self-reported diseases of manufacturing workers, musculoskeletal diseases, neurological and sensory organ diseases, digestive organ diseases, and skin diseases are more common. Musculoskeletal diseases and neurological and sensory organ diseases are the most common in all comorbidities. Musculoskeletal diseases, cardiovascular diseases, and neurological and sensory organ diseases are associated with occupational injuries. In the prevention and control of occupational injuries, joint prevention strategies targeting multiple diseases should be strengthened.

Objective To investigate the status and influencing factors of overweight and obesity among primary and secondary school students in Pudong New Area of Shanghai, and to provide reference for formulating obesity-related intervention strategies for school-age children. Methods Stratified cluster random sampling method was used to conduct a questionnaire survey among primary and secondary school students in Pudong New Area. The overweight and obesity rate was calculated according to the Chinese health industry standard, and the risk factors of overweight and obesity in children and adolescents of different school age groups were analyzed by logistic regression. Results The overweight and obesity rate (25.3%) of primary and secondary school students in Pudong New Area exceeded the national average level. In primary school group, male, sleep time ≥ 8h per day, water intake ≥ 1200 mL per day, and the presence of mobile food stalls around the school were the risk factors for overweight and obesity. Daily extracurricular exercise time of 30 minutes to 2 hours was a protective factor. In junior high school group, male and electronic product use time of ≥ 2h per day were the risk factors for overweight and obesity. The daily extracurricular exercise time of 1 to 2 hours was a protective factor. In high school group, drinking water ≥1200mL per day was a risk factor for overweight and obesity. Eating breakfast every day for the past week was a protective factor. Conclusion Group intervention targeting overweight and obese school-age children, while changing corresponding unhealthy habits according to different school age groups, is crucial for weight loss in school-age children.

OBJECTIVE To explore the possible molecular mechanism through which amygdala cell adhesion molecule-1(CADM1)is involved in acute sleep deprivation-induced anxiety.METHODS Sixteen 8-week-old C57BL/6J mice were randomly divided into the control group and para-chlorophe-nylalanine(PCPA)-induced acute sleep deprivation experimental group.The PCPA mice were intraperi-toneally injected with PCPA suspension(at a dose of 300 mg?kg-1)between 8∶00 and 9∶00 am for 2 consecutive days while the control mice were injected with the same dose of normal saline.The sleep latency and sleep duration of mice were detected via the righting reflex test.Anxiety-like behaviors were detected by the open field test and elevated plus maze test.The expression level of CADM1 in the mouse amygdala was detected by Western Blot and Immunofluorescence staining.The GeneNet-work database was used to analyze the association between Cadm1 genes and other genes in the mouse amygdala.The key candidate regulatory genes were screened,and the Cadm1-anxiety behavior phenotype network was constructed.The mRNA expression levels of the key candidate regulatory genes were analyzed via qPCR analysis.RESULTS Compared with the control mice,the sleep latency of PCPA mice was significantly prolonged(P<0.01)while the sleep duration was significantly shortened(P<0.01).The activity time and distance of PCPA mice in the open field center were significantly shorter than those of the control group(P<0.05).The elevated plus maze experiment showed that the percentage of the number of times PCPA mice entered the open arm and the percentage of residence time in the open arm were significantly lower than those of the control group(P<0.05).Western Blot and immuno-fluorescence staining showed that the expression of CADM1 protein in the amygdala from PCPA mice was down-regulated compared with the control mice(P<0.05).Based on gene-behavioral association network analysis,Cadm1 was significantly associated with 25 anxiety-like behavior-related genes.The enrichment analysis of Cadm1 co-expression genes showed that Cadm1 was associated with γ-amino-butyric acid GABAergic synaptic pathway(P=4.31e-09),and that the key genes were huntingtin associ-ated protein 1(Hap1)(r=0.705,P=1.09e-08)、inositol 1,4,5-triphosphate receptor type 1(Itpr1)(r=-0.751,P=3.34e-10)、gamma-aminobutyric acid type A receptor subunit delta(Gabrd)(r=-0.836,P=3.93e-14)、γ-aminobutyric acid A receptor β1 subunit gene(Gabrb1)(r=0.732,P=1.50e-09)and adrenoceptor alpha 2A(Adra2a)(r=0.759,P=1.73e-10).The results of qPCR analysis showed that the mRNA levels of Hap1(P<0.05)、Gabrb1 and Adra2a were significantly up-regulated(P<0.01)while those of Itpr1 and Gabrd were significantly down-regulated(P<0.01).CONCLUSION Acute sleep deprivation leads to down-regulation of Cadm1 expression in the amygdala,and induces anxiety-like behaviors by affecting the expression of GABAergic synaptic signaling pathways Hap1,Gabrb1,Adra2a,Itpr1 and Gabrd.

Objective To compare the clinical efficacy and safety of transarterial chemoembolization(TACE)plus apatinib(Apa)and camrelizumab(Cam)and TACE plus Apa in treating CNLC stage Ⅲ hepatocellular carcinoma(HCC).Methods A total of 54 patients in Affiliated Yancheng No.1 People's Hospital,School of Medicine,Nanjing University with CNLC stage Ⅲ HCC were enrolled in this study.The patients were divided into triple treatment group(n=25,receiving TACE plus Apa and Cam)and dual treatment group(n=29,receiving TACE plus Apa).The overall survival(OS)and progression-free survival(PFS)were compared between the two groups.Univariate analysis and multivariate analysis were used to determine the independent influencing factors for OS and PFS.The target immunotherapy-related adverse reactions(TRAE)were analyzed.Results The median OS and PFS in the triple treatment group were 23.2 months and 10.9 months respectively,which were higher than 15.2 months and 5.8 months respectively in the dual treatment group(both P＜0.001).Multivariate analysis indicated that the therapeutic regimen and the type of portal vein tumor thrombosis(PVTT)were the independent factors affecting OS,while only the therapeutic regimen was the independent factor affecting PFS.The incidence of≥grade Ⅲ TRAE in the triple treatment group and the dual treatment group was 20％(5/25)and 17.2％(5/29)respectively,the difference between the two groups was not statistically significant(P＞0.05).Conclusion For the treatment of patients with CNLC stage Ⅲ HCC,TACE plus Apa and Cam is superior to TACE plus Apa in OS and PFS,and the type of PVTT and the therapeutic regimen are the independent prognostic factors associated with patient's survival.

OBJECTIVE To explore the possible molecular mechanism through which amygdala cell adhesion molecule-1(CADM1)is involved in acute sleep deprivation-induced anxiety.METHODS Sixteen 8-week-old C57BL/6J mice were randomly divided into the control group and para-chlorophe-nylalanine(PCPA)-induced acute sleep deprivation experimental group.The PCPA mice were intraperi-toneally injected with PCPA suspension(at a dose of 300 mg?kg-1)between 8∶00 and 9∶00 am for 2 consecutive days while the control mice were injected with the same dose of normal saline.The sleep latency and sleep duration of mice were detected via the righting reflex test.Anxiety-like behaviors were detected by the open field test and elevated plus maze test.The expression level of CADM1 in the mouse amygdala was detected by Western Blot and Immunofluorescence staining.The GeneNet-work database was used to analyze the association between Cadm1 genes and other genes in the mouse amygdala.The key candidate regulatory genes were screened,and the Cadm1-anxiety behavior phenotype network was constructed.The mRNA expression levels of the key candidate regulatory genes were analyzed via qPCR analysis.RESULTS Compared with the control mice,the sleep latency of PCPA mice was significantly prolonged(P<0.01)while the sleep duration was significantly shortened(P<0.01).The activity time and distance of PCPA mice in the open field center were significantly shorter than those of the control group(P<0.05).The elevated plus maze experiment showed that the percentage of the number of times PCPA mice entered the open arm and the percentage of residence time in the open arm were significantly lower than those of the control group(P<0.05).Western Blot and immuno-fluorescence staining showed that the expression of CADM1 protein in the amygdala from PCPA mice was down-regulated compared with the control mice(P<0.05).Based on gene-behavioral association network analysis,Cadm1 was significantly associated with 25 anxiety-like behavior-related genes.The enrichment analysis of Cadm1 co-expression genes showed that Cadm1 was associated with γ-amino-butyric acid GABAergic synaptic pathway(P=4.31e-09),and that the key genes were huntingtin associ-ated protein 1(Hap1)(r=0.705,P=1.09e-08)、inositol 1,4,5-triphosphate receptor type 1(Itpr1)(r=-0.751,P=3.34e-10)、gamma-aminobutyric acid type A receptor subunit delta(Gabrd)(r=-0.836,P=3.93e-14)、γ-aminobutyric acid A receptor β1 subunit gene(Gabrb1)(r=0.732,P=1.50e-09)and adrenoceptor alpha 2A(Adra2a)(r=0.759,P=1.73e-10).The results of qPCR analysis showed that the mRNA levels of Hap1(P<0.05)、Gabrb1 and Adra2a were significantly up-regulated(P<0.01)while those of Itpr1 and Gabrd were significantly down-regulated(P<0.01).CONCLUSION Acute sleep deprivation leads to down-regulation of Cadm1 expression in the amygdala,and induces anxiety-like behaviors by affecting the expression of GABAergic synaptic signaling pathways Hap1,Gabrb1,Adra2a,Itpr1 and Gabrd.

Objective To evaluate the roles of telomerase,interferon-γ(IFN-γ),adenosine deaminase(ADA)and T cell spot test(T-SPOT.TB)in the diagnosis of tuberculous and malignant pleural effusion.Methods Forty patients with early tuberculous pleurisy(tuberculosis group)and 40 patients with malignant pleural effusion(tumor group)were enrolled.Pleural effusion and fasting blood were extracted before treatment.The activity of telomerase and the concentration of IFN-γ were detected by enzyme-linked immunosorbent assay.The activity of ADA was detected by colorimetric analysis.The positive rate of T-SPOT.TB was detected by Elispot spot counting.Results Telomerase activity in the tuberculosis group was significantly lower than that in the tumor group([1.46±0.73]×10-3 nmol/L vs.[3.34±1.72]×10-3 nmol/L,P<0.01).The concentration of IFN-γ was(137.44±38.93)U/L and(27.94±8.46)U/L in the tuberculosis group and tumor group,respectively;ADA content was(68.42±9.58)U/L and(15.39±4.43)U/L.There were significant differences in IFN-γ and ADA between the 2 group(P<0.01).IFN-γ concentration,ADA activity and the positive rate of T-SPOT.TB in the tuberculosis group were significantly higher than those in the tumor group(P<0.01).The sensitivity and specificity of combined detection of telomerase,IFN-γ,ADA and T-SPOT.TB in differentiating tuberculous and malignant pleural effusion were 0.974 and 0.974,respectively.Conclusion The combined detection of telomerase,IFN-γ,ADA and T-SPOT.TB has important value in differential diagnosis of tuberculosis and malignant pleural effusion.

Humans ; Asthma/drug therapy* ; Biological Therapy

Objective:To understand the coronavirus disease 2019(COVID-19)prevention and control work and the problems and difficulties faced by non-government primary medical institutions in China during the epidemic period.Methods:A survey on the coronavirus disease 2019(COVID-19)prevention and control work of non-government primary medical institutions was conducted on April 14 to 21, 2020 with the self-designed questionnaire. The questionnaire contained three parts: the first part was basic information of medical staff in non-government primary medical institutions, including position and institutional information; the second part was the status quo of non-government primary medical institutions participating in the prevention and control of COVID-19, including the specific work and difficulties faced by the responders during the epidemic period; and the third part was the prevention and control effect of COVID-19 in the responders′ institutions, including whether there were confirmed cases and infected medical staff. An online invitation was issued among the members of General Practice Branch of Chinese Non-government Medical Institution Association. The invited participants included the heads, general practitioners and other medical personnel of the non-government primary medical institutions the invited participants voluntarily scanned the online two-dimensional code to fill in.Results:A total of 761 individuals in primary health institutions from 20 provinces, municipalities and autonomous regions in China participated in the survey. There were 290 (38.1%) men and 471 (61.9%) women with age of 40(32, 48) years; 83.0% (632/761) had worked for more than 5 years; 33.8% (257/761) owned primary professional titles and 33.0% (251/761) owned intermediate titles. Among all participants 28.5% (217/761) were general practitioners, 26.9% (205/761) were institutions/department managers, 14.6% (111/761) were specialists and 40.3% (307/761) were other related personnel. A total of 549 institutions continued to operate during the epidemic period and 96.5% (530/549) participated in the work related to the prevention and control of the epidemic, including prescreening and triage, health consultation, follow-up of suspected patients, donation, quarantine of suspected cases, follow-up of close contacts/discharged patients, diagnosis and treatment of patients with new coronavirus pneumonia. 44.7% (340/761) of respondents participated in the epidemic prevention as front-line staff and directly contacted patients/suspected patients, and 63.1% (480/761) participated in the epidemic prevention work of primary medical institutions, including clinical outpatient service, prescreening triage and screening. The working sites were not limited to the institutions, but also other sites including high-speed railway station. The 97.8% (744/761) responders expressed their willingness to participate in epidemic prevention work under the unified leadership and command of the state. The 63.9% (486/761) of the responders were worried about the lack of protective equipments and measures, and 90.4% (688/761) respondents showed that they needed medical supplies (protective equipment: masks, goggles, protective gowns, etc.).Conclusion:The participation of non-government primary medical institutions and their staff in COVID-19 infection prevention and control is a key component of the epidemic prevention process.