1.Analysis of knowledge, attitude, and practice levels regarding health protection against air pollution and related factors among Chinese primary school students
Chinese Journal of School Health 2026;47(7):958-961
Objective:
To assess the current status of knowledge, attitude, and practice (KAP) regarding health protection against air pollution among primary school students in China, and to analyze the impacts of fine particulate matter (PM 2.5 ) exposure, family, and individual factors on KAP levels, so as to provide empirical basis for implementing targeted interventions.
Methods:
Using stratified cluster random sampling method, a questionnaire survey was conducted among 19 297 primary school students from third to fifth grade across 30 provinces (autonomous regions and municipalities directly under the central government) in China in 2024. The questionnaire was developed based on the Technical Guidelines for the Assessment of Civic Environmental and Health Literacy (Trial), and encompasses three dimensions:knowledge, attitude, and practice. Spearman correlation analysis, Chi-square test, multivariate Logistic regression, and Bootstrap mediation effect test was applied for data analysis.
Results:
The overall mean KAP score for health protection against air pollution among primary school students was (79.73±13.53), with an adequacy rate of 80.47% ( n =15 528). The dimension scores for knowledge, attitude, and practice were (41.34±8.01, 16.43± 2.61 ), and (21.97±5.71), respectively. Knowledge was positively correlated with attitude and practice, and attitude was positively correlated with practice ( r =0.51, 0.35, 0.32, all P <0.01). Multivariate Logistic regression showed that the northeast region ( OR =2.36, 95% CI =2.02-2.75), having parents with a bachelor s degree or higher ( OR =4.76, 95% CI =2.71-8.37), living with both parents ( OR =1.33, 95% CI =1.15-1.55), being in the fifth grade ( OR =1.22, 95% CI =1.11-1.33), outdoor PM 2.5 level exceeding standard limits at the survey site ( OR =1.25, 95% CI =1.16-1.34), history of allergy ( OR =1.47, 95% CI =1.31-1.64), and wearing masks during heavily polluted weather ( OR =1.19, 95% CI =1.07-1.31) were promoting factors for KAP adequacy rate (all P <0.05). Conversely, obesity was a detrimental factor ( OR =0.78, 95% CI =0.69-0.88, all P <0.05).
Conclusions
Primary school students in China exhibit a favorable KAP level regarding health protection against air pollution, though regional, familial, and individual disparities persist. Exposure to PM 2.5 levels exceeding standard limits exerts a direct positive effect on enhancing health protection literacy. Future efforts should focus on the western region, families with lower educational attainment children to implement tailored, stratified interventions.
2.Donation-related adverse reactions and individual voluntary donation behavior following adjustments of the upper age limit for blood donation: a multicenter retrospective cohort study
Chenying WANG ; Jue WANG ; Changping LI ; Wei CHEN ; Ying LI ; Dan BAO ; Yuanqin ZHANG ; Xin ZHAO ; Jinfeng ZENG ; Yuwei HU ; Shuchang DAI ; Xiaoqiang WU ; Weimin FAN
Chinese Journal of Blood Transfusion 2026;39(9):1168-1178
Objective: To evaluate the risk of donation-related adverse reactions, donation behavior, and contributions to the blood supply among donors aged 56-65 years following extension of the upper age limit for voluntary blood donation, and to provide real-world evidence for optimizing blood donation age policies in China. Methods: A multicenter retrospective cohort was established using blood donation databases from Hainan, Shenzhen, and Jiangxi. A total of 1 180 767 donors contributing 2 020 407 whole-blood and apheresis donations were included. Donations were classified by donor age at each donation into the 18-55-year and 56-65-year groups. Generalized estimating equation (GEE) models were used to compare the risks of overall, local, and systemic donation-related adverse reactions between the two age groups. Restricted cubic spline analysis was used to assess the continuous association between donor age and the risk of overall adverse reactions. Poisson GEE models were used to compare annual donation frequency, and donation participation and contributions to the blood supply among donors aged 56-65 years were evaluated. The study was approved by the Ethics Committee of the Institute of Blood Transfusion, Chinese Academy of Medical Sciences (No.2025012) and registered with the Chinese Clinical Trial Registry (ChiCTR2500114960). Results: A total of 1 960 711 donations were included in the 18-55-year group and 59 696 in the 56-65-year group. The overall donation-related adverse reaction rates were 3.890‰and 0.704‰, respectively. Multivariable GEE analysis showed that, compared with donors aged 18-55 years, those aged 56-65 years had lower risks of overall adverse reactions (adjusted OR=0.294, 95%CI: 0.217-0.398, P<0.001) and systemic adverse reactions (adjusted OR=0.163, 95%CI: 0.101-0.263, P<0.001), whereas no statistically significant difference was observed in the risk of local adverse reactions (adjusted OR=1.337, 95%CI: 0.487-3.670, P=0.573). Donor age was nonlinearly associated with the risk of overall adverse reactions (P overall<0.001, P nonlinear<0.001), with the risk generally decreasing with increasing age between 18 and 65 years. The mean annual donation frequency was higher among donors aged 56-65 years than among those aged 18-55 years (1.63 vs 1.24 donations per year; adjusted IRR=1.34, 95%CI: 1.30-1.39, P<0.001). During the study period, donors aged 56-65 years contributed 2.95% of all donations; their whole-blood donations and whole-blood collection volume accounted for 2.36% and 2.37% of the corresponding totals, respectively. Conclusion: Under current health screening and standardized donor management, donors aged 56-65 years did not show an increased risk of short-term donation-related adverse reactions and demonstrated a higher annual donation frequency, together with a measurable contribution to the blood supply. These findings support appropriately extending the upper age limit for voluntary blood donation under strict health screening to broaden the donor pool and supplement the blood supply.
3.Application progress of Yttrium-90 microsphere selective internal radiation therapy on metastatic liver cancer
Guanxiang ZHUO ; Linhe GAN ; Jinfeng LIAN ; Yilin WANG
Chinese Journal of Clinical Medicine 2025;32(1):15-23
Yttrium-90 microsphere selective internal radiation therapy (90Y-SIRT) has been widely used in the treatment of malignant liver cancers, and its safety and efficacy have been fully validated. As an important local therapeutic method, 90Y-SIRT has been utilized for the treatment of multiple metastatic liver cancers in many cancer diagnosis and treatment centers at home and abroad, demonstrating significant therapeutic potential. This article reviews the basic principle, development history, indications and contraindications of 90Y microsphere, as well as the specific applications in treatment of different types of metastatic liver cancers, aiming to provide references for further research and optimization of treatment strategies.
4.A prediction model for high-risk cardiovascular disease among residents aged 35 to 75 years
ZHOU Guoying ; XING Lili ; SU Ying ; LIU Hongjie ; LIU He ; WANG Di ; XUE Jinfeng ; DAI Wei ; WANG Jing ; YANG Xinghua
Journal of Preventive Medicine 2025;37(1):12-16
Objective:
To establish a prediction model for high-risk cardiovascular disease (CVD) among residents aged 35 to 75 years, so as to provide the basis for improving CVD prevention and control measures.
Methods:
Permanent residents aged 35 to 75 years were selected from Dongcheng District, Beijing Municipality using the stratified random sampling method from 2018 to 2023. Demographic information, lifestyle, waist circumference and blood biochemical indicators were collected through questionnaire surveys, physical examinations and laboratory tests. Influencing factors for high-risk CVD among residents aged 35 to 75 years were identified using a multivariable logistic regression model, and a prediction model for high-risk CVD was established. The predictive effect was evaluated using the receiver operating characteristic (ROC) curve.
Results:
A total of 6 968 individuals were surveyed, including 2 821 males (40.49%) and 4 147 females (59.51%), and had a mean age of (59.92±9.33) years. There were 1 155 high-risk CVD population, with a detection rate of 16.58%. Multivariable logistic regression analysis showed that gender, age, smoking, central obesity, systolic blood pressure, fasting blood glucose, triglyceride and low-density lipoprotein cholesterol were influencing factors for high-risk CVD among residents aged 35 to 75 years (all P<0.05). The area under the ROC curve of the established prediction model was 0.849 (95%CI: 0.834-0.863), with a sensitivity of 0.693 and a specificity of 0.863, indicating good discrimination.
Conclusion
The model constructed by eight factors including demographic characteristics, lifestyle and blood biochemical indicators has good predictive value for high-risk CVD among residents aged 35 to 75 years.
5.Lasso-Logistic regression analysis and construction and validation of a nomogram prediction model for hepatic encephalopathy after transjugular intrahepatic portosystemic shunt
Peng CHANG ; Pengfei XUE ; Chengxi GUO ; Yaopu WANG ; Bo WANG ; Kai ZHAO ; Jinfeng XUE
Journal of Clinical Medicine in Practice 2025;29(7):19-25
Objective To analyze the influencing factors of hepatic encephalopathy(HE)after transjugular intrahepatic portosystemic shunt(TIPS)and construct a nomogram prediction model based on these factors.Methods A total of 290 patients with cirrhotic portal hypertensive variceal gastrointestinal bleeding in the Yuncheng Central Hospital Affiliated to Shanxi Medical University from January 2019 to December 2023 were selected and randomly divided into training set of 145 cases and validation set of 145 cases.All patients underwent TIPS treatment,and the incidence of HE within 3 months after TIPS was recorded.In the training set,patients were divided into HE group(n=42)and non-HE group(n=103)based on the occurrence of HE.Clinical materials were compared between the two groups,and Lasso-Logistic regression analysis was applied to explore the influencing factors of HE after TIPS.A nomogram prediction model was constructed based on the influencing factors and validated in both the training set and the validation set for its clinical value in predicting HE after TIPS.Results The overall incidence of HE was 29.31%,with incidence rates of 28.97%and 29.66%respectively in the training set and the validation set.In the training set,the HE group had significantly higher age,C grading of preoperative Child-Pugh ratio,diabetes mellitus ratio,total bilirubin(TBIL),prothrombin time(PT),serum sodium,serum creatinine,interleukin-6(IL-6),interleukin-18(IL-18),blood ammonia,monocyte chemotactic protein-1(MCP-1),postoperative portal venous pressure,and intestinal flora disturbance ratio when compared to the non-HE group,while the preoperative glial fibrillary acidic protein(GFAP)level was significantly lower in the HE group(P<0.05).Lasso-Logistic regression analysis showed that preoperative C grading of Child-Pugh grading,diabetes mellitus,TBIL,PT,IL-6,IL-18,blood ammonia,GFAP,MCP-1 level,and postoperative intestinal flora disturbance were influencing factors for HE after TIPS(P<0.05).A nomogram prediction model was constructed based on ten influencing factors selected by Lasso-Logistic regression analysis.The area under the curve(AUC)of this model for predicting HE after TIPS was 0.933(95%CI,0.889 to 0.976)in the training set and 0.944(95%CI,0.893 to 0.995)in the valida-tion set,with good consistency between the model's prediction and actual observation.Conclusion The nomogram prediction model for HE after TIPS,constructed based on the influencing factors selected by Lasso-Logistic regression analysis,has high predictive efficacy and accuracy.
6.Cost-utility analysis of HIV screening in blood donors using a decision-tree Markov model
Liqin HUANG ; Lilin WANG ; Linfen WU ; Jiahui ZUO ; Jinfeng ZENG
Chinese Journal of Blood Transfusion 2025;38(7):958-963
Objective: To develop a comprehensive health economics evaluation model for HIV blood screening using Markov modeling, so as to evaluate the quality-of-life adjustment years (QALYs) gained by transfusion recipients after implementation of blood HIV screening. Methods: Shenzhen Blood Center was selected as the validation case for model development. Based on historical HIV screening data of Shenzhen Blood Center and published literature, the health economics evaluation of donor HIV screening was performed using cost-utility analysis. The single factor sensitivity analysis was performed on parameters in the model. Results: 3.09 QALYs were gained for each transfusion recipient prevented from HIV infection. During 2020-2023, donor HIV screening at Shenzhen Blood Center saved 506.76 QALYs, and each QALY saved 182 900 yuan. Conclusion: From the perspective of long-term benefit of transfusion recipients, HIV screening of blood donors demonstrates high health and economic value.
7.Evaluation of donor ALT screening strategies based on random sampling simulation with large sample sizes
Liqin HUANG ; Yuanye XUE ; Le CHANG ; Lunan WANG ; Jinfeng ZENG
Chinese Journal of Blood Transfusion 2025;38(8):1094-1100
Objective: To comprehensively evaluate the current alanine aminotransferase (ALT) screening strategies and provide a basis for their optimization. Methods: ALT test results of 21 345 blood samples were collected from 33 blood collection institutions. Multiple probability distribution functions were employed to fit the data, and the akaike information criterion (AIC) was used to determine the optimal fitting model. Based on this model, 1 million random samplings were conducted to simulate the final ALT test results of blood donors under different ALT screening strategies, eligibility criteria, and pre-donation ALT detection deviations. A decision tree was subsequently constructed for health economic analysis. Results: The log-normal distribution with a mean of 2.96 and a variance of 0.65 provided the best fit for the data. When the eligibility criteria was 50 U/L and the pre-donation detection deviation was ±20%, not conducting pre-donation testing increased blood donation by 1.14%. When the pre-donation detection deviation was ±20% and the eligibility criteria was raised from 50 U/L to 100 U/L, conducting and not conducting pre-donation testing increased blood donation by 7.59% and 6.60%, respectively. With a eligibility criteria of 50 U/L and a pre-donation detection deviation of ±20%, 1.14% of eligible blood donors would be disqualified from donating blood. Health economic analysis showed that when the eligibility criteria was adjusted to 56 U/L or higher, not conducting pre-donation ALT testing was the dominant strategy; under other conditions, conducting pre-donation testing was the dominant strategy. Conclusion: The selection of ALT testing strategies is a complex process influenced by multiple factors, and it is necessary to adopt an appropriate ALT screening strategy based on specific testing circumstances.
8.Analysis on the current situation and prospect of chemiluminescence technology in blood screening
Jinfeng ZENG ; Haobiao WANG ; Yingnan DANG ; Liqin HUANG
Chinese Journal of Blood Transfusion 2025;38(8):1120-1126
Chemiluminescence immunoassay (CLIA), a non-radioactive immunoassay technology that has developed rapidly over the past three decades, has increasingly demonstrated its application value in blood screening due to its advantages such as high sensitivity, high specificity, rapid detection, and high degree of automation. This article systematically reviews the application status, technical characteristics, differences from traditional methods, influencing factors for promotion and application of CLIA in blood screening at home and abroad, and looks forward to its development prospects. Countries such as the United States, Germany, and Japan have widely adopted CLIA in the screening of pathogens like HBV, HCV, and HIV, predominantly using "1 CLIA test + 1 nucleic acid testing (NAT) test" model. Some regions have also expanded testing items to include anti-HBc and HTLV. In China, enzyme-linked immunosorbent assay (ELISA) combined with NAT remains the primary method. CLIA is still in the stage of detection performance comparison. However, domestic reagents have gradually been approved, and more enterprises are accelerating their layout in this field. CLIA is superior to ELISA in terms of sensitivity, detection range, and automation adaptability, which can reduce missed detection and shorten the window period. But it is limited by factors such as high cost, closed system characteristics, and domestic batch release supervision. In the future, CLIA is expected to complement existing technologies, expand the detection of emerging and re-emerging pathogens, and combine with fully automated assembly lines to improve screening quality, providing more comprehensive protection for clinical blood transfusion safety.
9.Cost-utility analysis of HIV screening in blood donors using a decision-tree Markov model
Liqin HUANG ; Lilin WANG ; Linfen WU ; Jiahui ZUO ; Jinfeng ZENG
Chinese Journal of Blood Transfusion 2025;38(7):958-963
Objective: To develop a comprehensive health economics evaluation model for HIV blood screening using Markov modeling, so as to evaluate the quality-of-life adjustment years (QALYs) gained by transfusion recipients after implementation of blood HIV screening. Methods: Shenzhen Blood Center was selected as the validation case for model development. Based on historical HIV screening data of Shenzhen Blood Center and published literature, the health economics evaluation of donor HIV screening was performed using cost-utility analysis. The single factor sensitivity analysis was performed on parameters in the model. Results: 3.09 QALYs were gained for each transfusion recipient prevented from HIV infection. During 2020-2023, donor HIV screening at Shenzhen Blood Center saved 506.76 QALYs, and each QALY saved 182 900 yuan. Conclusion: From the perspective of long-term benefit of transfusion recipients, HIV screening of blood donors demonstrates high health and economic value.
10.A case of abdominal multiple cystic echinococcosis and its pathogenic molecular biology identification
CHEN Yixiong ; WANG Ziqi ; LIU Jinfeng
China Tropical Medicine 2025;25(2):217-
Objective To identify the clinical characteristics of a case of abdominal multiple cystic echinococcosis in Shenzhen City, Guangdong Province, and to characterize the molecular biology of pathogen, in order to provide a basis for control and prevention of echinococcosis. Methods Clinical and epidemiological data of 1 case of echinococcosis in Shenzhen City in January 2024 were collected. The pathological sections of the cyst tissue removed by surgery were examined by microscopy after staining. Nucleic acids were extracted from cyst tissue samples, and the ND1 and Cox1 gene sequences were amplified and sequenced by PCR. Sequence comparison and phylogenetic tree analysis were performed using Mega X, BLAST and other software. Results The patient, male, 29 years old, a resident of Nyerong County, Nagqu City, Xizang Autonomous Region, had a history of exposure to domestic dogs and hepatic echinococcosis. Imaging showed abdominal multiple placeholder, consider echinococcosis recurrence; 12 pieces of cystic lesions from different parts of the abdominal cavity were surgically removed, and the pathological sections of cystic tissues showed cuticle layer, germinal layer, protoscolex of echinococcosis. PCR amplification of the specific genes ND1 and Cox1 were positive, and the amplified fragments were about 510 bp and 285 bp, respectively. Sequence comparison and phylogenetic tree analysis results showed that the homology between the sequences in this study and the ND1 gene of Echinococcus granulosus type G1 (JX217890.1, Qinghai), and Cox1 gene (MH050610.1, Xizang) in the GenBank database was 99%. It is closely related to the epidemic strains of Echinococcus granulosus in Xizang, Qinghai and Xinjiang in the phylogenetic tree, and is in the same evolutionary branch (type G1). Conclusion The patient was an imported case of abdominal multiple cystic echinococcosis, and the genotype was G1, with a high probability that the infection originated in Xizang. It is recommended to enhance the surveillance and management of echinococcosis in non-endemic areas, and to strengthen the inspection and quarantine of livestock and agricultural by-products imported from endemic areas to prevent the spread of echinococcosis.


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