Objective: To investigate the prevalence of undernutrition and its associated factors among left behind and non left behind primary and secondary school students in the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) areas of central and western China, so as to provide evidence for improving the nutritional status of children and adolescents. Methods: A survey was conducted among 123 782 students selected by random cluster sampling method in grades 3-9 from NIPRCES in central (Hebei, Shanxi, Heilongjiang, Jilin, Anhui, Jiangxi, Henan, Hunan, Hubei, and Hainan) and western (Gansu, Guangxi, Inner Mongolia, Ningxia, Tibet, Shaanxi, Guizhou, Sichuan, Xinjiang, the Xinjiang Production and Construction Corps, Yunnan, Qinghai, and Chongqing) China in 2023. Anthropometric measurements and questionnaires were used to assess nutritional and dietary status. The prevalence of undernutrition was compared between left behind and non left behind students by Chi square test, and associated factors were analyzed by three level Logistic mixed effects model. Results: The prevalence of undernutrition was 8.5% (4 326) in left behind students and 8.1% (5 905) in non left behind students. Three level Logistic mixed effect model analysis showed that whether left behind or non left behind, the undernutrition rates of primary and secondary students in western regions were higher than those of students in central regions [ OR (95% CI )=1.72(1.57-1.87),2.25(2.07- 2.43 )]; the undernutrition risk was lower for those whose fathers had a cultural level of high school or above [ OR (95% CI )=0.69(0.62-0.77),0.90(0.82-0.98)] or junior high school [ OR (95% CI )=0.72(0.66-0.79),0.92(0.85-0.99)] compared to those with primary school or below; picky eating or selective eating increased the risk of undernutrition [ OR (95% CI )=2.36(2.07-2.68),2.28(2.04-2.55)], and primary and secondary school students without nutritional content in health education classes had higher rates of undernutrition [ OR (95% CI )=1.12(1.03-1.23),1.09(1.01-1.17)](all P <0.05). Conclusion The prevalence of undernutrition is slightly higher in left behind primary and secondary students than in non left behind primary and secondary students in central and western NIPRCES areas, with variations across different characteristics.

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 understand the prevalence and related factors of depressive symptoms among primary and secondary school students in the in depth monitoring counties of China s Rural Compulsory Education Nutrition Improvement Program, so as to provide a basis for prevention and psychological intervention of depressive symptoms among children and adolescents in rural areas. Methods: In November 2022, a stratified random sampling method was adopted to collect height and weight data, basic personal and family information of 7 949 primary and secondary school students from grade three to grade nine through physical measurements and questionnaires in 56 key monitoring schools implementing the Student Nutrition Improvement Program in 7 in depth monitoring counties (Jalaid Banner in Inner Mongolia, Jinzhai County in Anhui, Mao Xian in Sichuan, Tiandeng County in Guangxi, Mian County in Shaanxi, Zhaozhou County in Heilongjiang and Youxi County in Fujian), and to obtain the information related to their depressive symptoms through the self assessment questionnaire on depression. Multivariate Logistic regression analysis was conducted to analyze the prevalence of depressive symptoms among primary and secondary school students, as well as their related factors. Results: The detection rate of depressive symptoms among primary and secondary school students in the in depth monitored counties was 23.5%. Logistic regression analysis showed that the probability of detecting depressive symptoms was higher among female students, middle school students, students whose video screen duration per day was >2 h, and students whose parents marital status was divorced or widowed ( OR =1.40, 1.64, 1.60, 1.24), and students whose sleep duration reached the recommended standard, whose parents usually accompanied them daily for time was 60-<120 min and ≥120 min, and students whose mothers literacy level was middle school graduation had lower probability of detecting depressive symptoms ( OR =0.85, 0.84, 0.71, 0.76) ( P < 0.05 ). Conclusion The detection rate of depressive symptoms among students in the in depth monitoring area is high, and targeted interventions need to be developed for students to reduce the risk of mental health problems.

Objective: To analyze the features of unhealthy lifestyle patterns among primary and secondary school students in the nutrition improvement program for rural compulsory education students (NIPRCES) areas in China in 2021 and 2023, so as to provide data support for lifestyle promotion and healthy development among primary and secondary school students. Methods: Adopting a cluster random sampling method, data on primary and secondary students aged 7-15 years from nutrition and health surveillance of China NIPRCES in 2021 and 2023 were collected. The prevalence of unhealthy lifestyles among primary and secondary students such as physical inactivity, outdoor inactivity, excessive screen time, and sleep deprivation by gender, school section, urban/rural, and region were analyzed. The reporting rates of the above indicators among primary and secondary students were compared by Chi-square test. Results: In 2021 and 2023, the rates of moderate to vigorous physical inactivity among primary and secondary school students were 79.2% and 80.4%, the rates of outdoor inactivity were 42.8% and 49.3%, the rates of excessive video time were 2.6% and 2.9%, the rates of sleep deprivation were 32.9% and 22.6%, and the differences were statistically significant( χ 2=51.86,1 071.48,18.36,3 296.99, P <0.05). In 2023, the rate of outdoor inactivity for primary and secondary students increased by 6.5 percentage points compared with 2021, and the rate of sleep deprivation decreased by 10.3 percentage points compared with that in 2021. In 2021 and 2023, the reporting rates of moderate to vigorous physical inactivity, outdoor inactivity, and sleep deprivation among girls and junior high school students were higher than those among boys ( χ 2=174.41,180.11; 175.75, 85.46 ;92.22,151.35) and elementary school students ( χ 2=136.64,5.75; 40.55,4.71;162.80,3 291.61); the reporting rates of moderate to vigorous physical inactivity( χ 2=194.43,118.60) and sleep deprivation ( χ 2=969.66,983.72) among urban students were higher than those among rural students; the reporting rates of excessive video time for boys and junior high school students were higher than those for girls ( χ 2=103.62,84.85) and elementary school students ( χ 2=810.09,626.51)( P <0.05). From a regional distribution perspective, the reporting rates of moderato to vigorous physical inactivity, outdoor inactivity, and excessive video time among primary and seconday school students in the central and western regions were lower than those in the eastern region ( χ 2= 663.44,302.78; 356.97,82.10;50.89,81.83) ( P <0.05). Conclusions Unhealthy lifestyles remain prevalent among primary and secondary students in NIPRCES areas of China. These findings underscore the need to strengthen policy implementation for promoting healthy lifestyles among primary and secondary school students.

Objective To understand the potential types and influencing factors of motor system symp-toms in breast cancer patients with endocrine therapy.Methods The convenience sampling method was used to select 505 breast cancer patients with endocrine therapy in a class 3A hospital of Zhejiang Province from January 2021 to August 2023 as the research subjects.The self-designed general information questionnaire and the motor system subscale in the Breast Cancer Endocrine Symptom Assessment Scale were used to investi-gate the patients,and the latent profile analysis(LPA)was performed.The t test,x2 test and rank sum test were adopted to conduct the univariate analysis on the influencing factors of different latent categories.The variables with statistical significance in the single factor analysis adopted the binary logistic regression for con-ducting multivariate analysis.Results A total of 553 questionnaires were distributed,and 505 valid question-naires were recovered with an effective recovery rate of 91.32％.The research subjects conducted LPA.The motor system symptoms could be divided into the two potential categories of the pain and stiffness group(n=116)and slight influence group(n=389).The binary logistic regression results showed that the medication time and medication type were the potential category factors affecting the motor system symptoms(P＜0.05).Conclusion There are classification characteristics of motor system symptoms in breast cancer patients with endocrine therapy.The medical and nursing staff should early identify the patients with pain and stiffness,and understand the symptoms of motor system and clinical detection results at regular intervals.

OBJECTIVE To investigate the synergistic effect and mechanism of curcumin （CUR） combined with zerumbone （ZER） on the biological behavior of non-small cell lung cancer （NSCLC） A549 cells. METHODS CCK-8 method and Gin’s formula were used to screen the optimal concentration combination for synergistic effect after the combination of CUR and ZER. The cells were divided into blank group， CUR group， ZER group， and CUR+ZER group. Flow cytometry was used to evaluate cell apoptosis， and clone formation experiment was used to evaluate cell proliferation ability， scratch experiment and Transwell migration experiment were used to evaluate cell migration ability， and Transwell invasion experiment was used to evaluate cell invasion ability. Western blot assay was used to detect the protein expressions of phosphorylated phosphatidylinositol-3-kinase （p- PI3K）， phosphorylated protein kinase B （p-Akt）， and vascular endothelial growth factor A （VEGF-A）. RESULTS The half inhibitory concentrations of CUR and ZER on A549 cells were approximately 16 and 12 μmol/L， respectively； the drug combination of CUR 8 μmol/L+ZER 6 μmol/L had the highest efficiency enhancement index， with the cell proliferation inhibition rate of （77.41±4.16）%， indicating the most significant synergistic effect. Compared with the CUR and ZER groups， the cell apoptosis rate in the CUR+ZER group was significantly increased （P＜0.01）， while the cell clone formation rate， cell migration rate， the number of migrating cells， the number of invading cells， and relative expression levels of p-PI3K， p-Akt， and VEGF-A proteins in the cells were significantly reduced （P＜0.05 or P＜0.01）. CONCLUSIONS The combination of CUR and ZER has a synergistic effect， significantly promoting the apoptosis of NSCLC cells， and inhibiting cell proliferation， migration， and invasion. Its potential mechanism may be closely related to the inhibition of the PI3K/Akt signaling pathway， thereby down-regulating the protein expression of VEGF-A.

OBJECTIVE To establish an HPLC method for determination of the related substances in papaverine hydrochloride. METHODS NanoChrom ChromCore 120 C8 column was used; the mobile phase A consisted of 3.4 g·L−1 potassium dihydrogen phosphate aqueous solution, adjust pH to 3.5 with phosphoric acid-acetonitrile(90∶10), the mobile phase B was methanol, with gradient elution at the flow rate of 0.8 mL·min−1; the detection wavelength was 238 nm; the column temperature was 50 ℃. RESULTS The minimum separation between the main component and each impurity was >1.5; Papaverine and its thirteen impurities showed a good linear relationship in the self-concentration range(r>0.999); and the average recoveries were 93.1%−101.2% with RSDs of 2.3%−8.1%. CONCLUSION The method is accurate, sensitive and reliable, which is suitable for the determination of related substances in papaverine hydrochloride.

Objective To investigate the predictive value of serum lipoprotein-associated phospho-lipase A2(Lp-PLA2)for long-term prognosis of elderly patients with stable coronary heart dis-ease(CHD).Methods A retrospective trial was conducted on 198 patients with stable CHD ad-mitted to our hospital from January 2016 to December 2018.All of them were followed up for 5 years,and divided into adverse cardiovascular event group(n=42)and control group(n=156)according to whether adverse cardiovascular events occurred during follow-up.Clinical features and Lp-PLA2 level were compared between the two groups.The predictive value of Lp-PLA2 for adverse cardiovascular events was analyzed in elderly patients with stable CHD within 5 years.Re-sults The adverse cardiovascular event group had significantly older age(74.95±7.02 vs 70.17±6.30 years,P=0.000),larger proportions of diabetes(54.76％vs 27.56％,P=0.001),of coronary artery stenosis ≥75％(69.05％vs 47.44％,P=0.013)and of left ventricular ejection fraction(LVEF)＜50％(50.00％vs 28.21％,P=0.008),and higher Lp-PLA2 level(478.38±187.54 U/L vs 308.17±126.73 U/L,P=0.000)when compared with the control group.The AUC value of age and Lp-PLA2 was 0.683(95％CI:0.590--0.776,P＜0.001)and 0.763(95％CI:0.677--0.848,P=0.763),respectively,in predicting the long-term prognosis in elderly patients with stable CHD.Multivariate logistic regression analysis showed that age,diabetes,coronary artery stenosis ≥75％,LVEF＜50％and Lp-PLA2 were independent influencing factors for adverse cardiovascular events within 5 years in elderly patients with stable CHD(P＜0.05,P＜0.01).Con-clusion Increased Lp-PLA2 level is associated with adverse cardiovascular events within 5 years in patients with stable CHD.

Objective To investigate the effects of probiotics combined with sacubitril valsartan and amiodarone on short-term and long-term efficacy of patients with atrial fibrillation after radiofrequency ablation. Methods A total of 90 patients with atrial fibrillation after radiofrequency ablation in the First Hospital of Zhangjiakou City from June 2021 to June 2022 were selected and randomly divided into three groups, with 30 cases in each group. Control group was treated with amiodarone, sacubitril valsartan group was treated with amiodarone and sacubitril valsartan, and probiotics group was treated with probiotics, amiodarone and sacubitril valsartan. The recurrence situation, atrial structure indexes[left atrial diameter (LAD), left ventricular ejection fraction (LVEF), left ventricular end systolic volume index (LVESVI), left atrial volume (LAV), left ventricular end diastolic volume index (LVEDVI)], myocardial fibrosis indexes[galactin-3 (Gal-3), soluble growth stimulation expression gene 2 protein (sST2)], inflammatory response indexes[intercellular adhesion molecule-1 (ICAM-1), C reactive protein (CRP), interleukin-6 (IL-6)], neuroendocrine hormone indexes[aldosterone, norepinephrine (NE), angiotensin Ⅱ (AngⅡ)], metabolites of gut microbiota[total bile acids, trimethylamine oxide (TMAO)] and incidence of adverse events were compared among the three groups. Results At 12 months after treatment, the recurrence rate of the probiotics group was significantly lower than that of the sacubitril valsartan group and the control group (P < 0.05); after 3, 6 and 12 months of treatment, the LAD, LAV, LVESVI, LVEDVI, sST2 and Gal-3 in the probiotics group were significantly lower than those in the sacubitril valsartan group and the control group (P < 0.05), and these indexes in the sacubitril valsartan group were also significantly lower than those in the control group (P < 0.05); after 3, 6 and 12 months of treatment, the LVEF of the probiotics group was significantly higher than that of the sacubitril valsartan group and the control group (P < 0.05), and the LVEF of the sacubitril valsartan group was also significantly higher than that of the control group (P < 0.05); after 3, 6 and 12 months of treatment, the CRP, IL-6, ICAM-1, NE, aldosterone and AngⅡ in the probiotics group were significantly lower than those in the sacubitril valsartan group and the control group, and these indexes in the sacubitril valsartan group were also significantly lower than those in the control group (P < 0.05); after 3, 6 and 12 months of treatment, the TMAO and total bile acids in the probiotics group were significantly lower than those in the control group and the sacubitril valsartan group (P < 0.05); there was no significant difference in the incidence of adverse events among the three groups (P>0.05). Conclusion Probiotics combined with sacubitril valsartan and amiodarone can improve atrial structure after radiofrequency ablation of atrial fibrillation, inhibit myocardial fibrosis, reduce inflammatory response, regulate neuroendocrine hormones and metabolites of gut microbiota, prevent long-term recurrence of atrial fibrillation, and have a high safety.

Objective: To analyze the total fluids intake and sources of college students from Hebei in spring and summer, and to provide a scientific reference for appropriate fluids intake in different seasons. Methods: Subjects were recruited in a university in Baoding, Hebei Province, and investigations were conducted in April and June 2021. The number of people who completed both spring and summer investigations was 80. Quantitative instruments and 7 day 24 h Fluid Intake Questionnaire were used to investigate the total drinking fluids, and it was recorded for 7 consecutive days in spring and summer respectively. The duplicate portion method was used to investigate the water from food. The total fluids intake and sources among subjects were analyzed in spring and summer. Results: There was no statistical significance between the total drinking fluids and total fluids intake between spring and summer [1 141(715), 1 176(649)mL/d, (2 496±604)(2 458±554)mL/d] ( F=1.86, 0.59, P >0.05). Spring showed significantly higher water from food compared with summer [(1 318±274)(1 217±302)mL/d]( F=16.63, P <0.05). The proportions of total drinking fluids and water from food in spring were 46% and 54%, respectively, and both were 50% in summer, the differences were statistically significant ( F=12.97, 12.97, P <0.05). There were differences in total fluids intake,total drinking fluids and water from food of different genders in earch season ( t/Z =4.75, -3.63, 3.44; 4.80, -2.91, 4.01, P <0.05). There were differences in total water intake, total drinking fluids, the proportions of total drinking fluids and water from food of different BMI groups in each season ( F/H =8.08, 16.65, 3.03, 3.03; 7.11,17.97, 4.52, 4.52, P <0.05). In spring, only 13.8% of subjects achieved the recommended total drinking fluids of China, compared with 18.8% in summer. In spring and summer, the total fluids intake, total drinking fluids, the proportions of total drinking fluids in the group achieved the recommendation were all higher than those who did not reach the recommendation ( t/Z =6.64, -5.19, 5.79; 8.12, -5.97, 5.70, P <0.05). Conclusion Season is a factor that affects total fluids intake, and it should be taken into account when setting the recommendation on adequate water intake.