Objective To investigate the impact of dietary protein intake on the prevalence of type 2 diabetes in adult residents, and to provide a reference for formulating diabetes prevention and control measures. Methods The research was based on cross-sectional survey data from the Nutrition and Health Follow-up Study of Chinese Residents in Chongqing (2021). Energy and nutrient intake was calculated in combination with the Chinese food composition table. Multivariate logistic regression was used to analyze the association between dietary protein and diabetes, and then restricted cubic spline regression (RCS) was used to analyze the dose-response relationship between dietary protein intake and the development of diabetes. Results Among the 1 415 adult residents, dietary intake of total protein, animal protein, and plant protein was 69.69g/d, 26.26g/d, and 43.43g/d, respectively. The ratio of protein to energy supply was 14.31%, and the prevalence of diabetes was 18.02%. Comparing with the residents in the first percentile of total dietary protein intake, the multivariable-adjusted odds ratios of those in the second and third percentile were 1.754 and 2.453 respectively. Comparing the residents in the third percentile with those in the first percentile, the multivariable-adjusted odds ratios of diabetes were 1.592 for protein energy supply ratio, and 1.558 for animal protein intake. Conclusion High protein intake, high protein energy supply ratio and high animal protein intake may increase the risk of diabetes, and different types of protein may have different effects on diabetes.

Objective To investigate the distribution of virulence genes of Klebsiella pneumoniae(KPN)and to evaluate the diagnostic efficacy of peg-344 for hypervirulent strains.Methods KPN isolates were col-lected from January to December in 2023 in Xuanwu Hospital,Capital Medical University.Whonet5.6 was used to analyze the distribution and drug resistance of bacterial strains.Toxicity testing included wire string test,PCR amplification of virulence genes(peg-344,rmpA,iutA,iroB),K1 and K2 capsule serotypes,serum resistance test,and diagnostic efficacy of detection was analyzed by using receiver operating characteristic curve.Results A total of 122 KPN isolates were collected,including 45(36.9%)sensitive strains,20(16.4%)extended-spectrum β-lactamase positive strains,and 57(46.7%)carbapenem-resistant Klebsiella pneumoniae strains.The specimens were mainly isolated from sputum,urine,and blood,and mainly came from Department of Urology,Department of Neurology,Intensive Care Unit,and Department of Neurosurgery.The positive rate of string test was 27.9%.PCR detected K1(12.3%),K2(8.2%),peg-344(62.3%),rmpA(60.7%),and iutA(73.8%),but the iroB result was negative,and strains with multiple virulence genes accounted for 63.1%.The results of the serum resistance test showed that 43.5%,31.1%,and 25.4%of the samples were at levels 1-2,3-4,and 5-6,respectively.peg-344 had the largest area under the curve for diagnosing the hy-pervirulent strains,followed by peg-344+iutA and peg-344+rmpA.Conclusion KPN is widely distributed in the hospital,and there are a variety of virulence genes.peg-344 has clinical value in distinguishing low viru-lence from high virulence in KPN.

Objective To investigate the incidence of central obesity and characteristics and changing trend of macronutrient energy supply in adult residents of Chongqing, and to analyze the relationship between carbohydrate energy supply and central obesity. Methods Using the longitudinal tracking data of China Health and Nutrition Survey project, combined with China food composition table , the energy and nutrient intake and macronutrient energy supply ratio were calculated. The association between carbohydrate energy supply and central obesity was analyzed by multi-level statistical model. Results In 2011, 2015 and 2018, the carbohydrate supply ratio of adult residents in Chongqing was 43.02%, 46.52%, and 46.07%, respectively, and the difference was statistically significant (F=18.699, P<0.001). The overweight rates in 2011, 2015, and 2018 were 29.2%, 36.7%, and 37.8%, while the obesity rates were 12.2%, 13.5%, and 19.5%, respectively, with statistically significant differences (χ²=41.416, P<0.001). The central obesity rates were 51.5%, 57.2%, and 62.8%, respectively (χ²=21.008, P<0.001). The carbohydrate supply ratio was positively correlated with waist circumference. Compared to the population with a carbohydrate to energy ratio of <55%, the risk of central obesity in the population with a carbohydrate to energy ratio of ≥ 65% was 1.63 times higher. Conclusion The ratio of carbohydrate to energy supply of adult residents in Chongqing has slightly increased. Rates of overweight, obesity and central obesity are on the rise. A high carbohydrate to energy supply ratio may be a risk factor for central obesity.

On May 25, 2024, Shanghai Municipal Administration for Market Regulation released Shanghai local standard Requirements for Outdoor Smoking Areas Setting Up and Management (DB 31/T 1482‒2024) (hereinafter referred to as Standard), which scheduled for official implementation from September 1, 2024. This article provided an interpretation of the key provisions in the Standard, with a particular emphasis on the scope of application, establishment and management requirements. In addition, the significance and potential difficulties and challenges during subsequent implementation of the Standard was summarized and outlined simultaneously, so as to provide a guarantee for users to fully comprehend and effectively implement the Standard.

Objective To understand the status quo of nutrition working ability in primary medical and health institutions of Chongqing City.Methods Three primary medical institutions were randomly extracted from each of 39 districts and counties of Chongqing City,and Primary Nutrition Service Capacity Survey Form and Nutrition Work Capacity Survey System were adopted to conduct the questionnaire survey.Then the sur-vey results were analyzed.Results A total of 117 primary medical institutions were surveyed,in which 86 in-stitutions(73.50％)undertook the nutritional work.The number of engaging the nutrition full-time work in the units was 0(0,0).Among the nutritional staff,the age in 164 persons was 30-＜40 years old,accounting for 48.38％,180 persons(53.10％)had the primary title,232 persons(68.44％)had the bachelor degree,287 persons(84.66％)had the medical related background,but only 2 persons had the nutritional related profes-sional background.There were 57(48.72％),75(64.10％),77(65.81％)primary medical institutions in carry-ing out the nutrition and health management of pregnant women,children aged 0-6 years old and elderly peo-ple,34 institutions(29.10％)in carrying out nutritional monitoring,and 17 institutions(14.50％)had the clinical nutrition work ability.Compared with the villages and towns,the proportion of urban area primary medical institutions in carrying out the blood routine items in children aged 0-6 years old,hemoglobin,blood routine and urine routine items in elderly people was higher,the number of published popular science works on nutrition was more,and the differences were statistically significant(P＜0.05).Conclusion The nutrition work system of primary medi-cal institutions in Chongqing City is temporarily imperfect,the specialized persons still lack and the nutritional health service level needs to be further strengthened.

Objective To determine the levels of arsenic in food in Chongqing city,and to assess the levels of dietary arsenic exposure and the associated potential health risks in residents of Chongqing city.Methods By using the monitoring data on arsenic levels in food in Chongqing between 2018 and 2023 in combination with the local dietary survey data for Chongqing from the 2018 China Nutrition and Health Survey Program,and adopting the 2-dimensional Monte Carlo simulation,we made an estimate of the dietary arsenic exposure levels of Chongqing residents.The margin of exposure(MOE)method was applied to assess both non-carcinogenic risks(skin damage)and carcinogenic risks(lung cancer and urinary system cancers)associated with dietary intake of arsenic.Results Out of 4900 food samples,the detection rate of arsenic was 36.40％,with the average levels ranging from the median bound(MB)of 0.020 7 to the upper bound(UB)of 0.023 4 mg/kg.The highest average levels were found in rice and its products,with an MB of 0.0981 and a UB of 0.098 5 mg/kg.The daily average exposure to inorganic arsenic for residents of different ages,sexes,and places of residence was highest in individuals aged 3 to 6,with an MB of 1.046 μg/(kg·d)and a UB of 1.116 μg/(kg·d),and lowest among individuals aged 60 and older.Arsenic exposure was higher in males than that in females and higher in people living in rural areas compared to those in urban areas.In terms of non-carcinogenic risks,the MOE values for inorganic arsenic were always higher than 1 in various populations.As for carcinogenic risks,the MOE values were all less than 100 in various populations.Rice and its products were the main source of dietary arsenic exposure in Chongqing,accounting for 69.97％to 74.37％of the total exposure.Conclusion The non-carcinogenic risk caused by dietary arsenic exposure in Chongqing is relatively low,but there may be a certain level of carcinogenic risk.Continued attentions should be given to dietary arsenic exposure levels in young children.

Objective:To investigate the immune effects of Clostridium difficile toxoid B (CdtB) vaccine formulated with different mucosal adjuvants through microneedle immunization, and to provide ideas for the prevention and treatment of Clostridium difficile infection. Methods:CdtB vaccine was prepared with purified Clostridium difficile toxin B(TcdB) after formaldehyde detoxification. Female BALB/c mice were immunized with different doses of vaccine alone or in combination with mucosal adjuvants. The titers of specific serum IgG and fecal IgA were detected at 0 d, 7 d, 14 d, 28 d and 42 d after immunization. The protective effects of CdtB vaccine were evaluated by cell neutralization assay and Clostridium difficile challenge infection. Results:(1) With the increase of immune dose, the mice immunized with CdtB vaccine alone by microneedle not only produced better serum specific IgG, but also had higher level of IgA in feces. (2) When the mice were immunized with CdtB vaccine containing LT or CTB adjuvant by microneedle, the trend of serum specific IgG titer in each group increased with the increase of immune dose, especially in the group containing LT adjuvant. There were significant differences in the trend of specific IgA titer in feces between the adjuvant groups and the group without adjuvant, but the adjuvant effect was not obvious. (3) No significant difference in serum IgG titer was observed between the mice immunized with 10 μg CdtB by microneedle or intraperitoneal injection, but microneedle immunization significantly increased fecal IgA level. (4) The neutralization titers of specific antibodies in mouse serum after immunization and the test results of challenge protection in mice confirmed that the use of CdtB vaccine had certain protective effects.Conclusions:CdtB vaccine had better immune effects in mice through microneedle immunization, but the adjuvant effects of LT and CTB were not significant.

Objective To evaluate the malnutrition status and analyze the changing trends of nutritional status among primary and middle school students in poor rural areas of Chongqing from 2013 to 2019, and to provide scientific bases for formulating measures to improve students' nutrition status. Methods In 12 poor rural areas in Chongqing, a random sampling was adopted. At least 10% of elementary and middle schools were randomly selected in each area each year. At least 40 students were sampled in each grade to measure their height and weight. The nutritional status of the students was evaluated and the changing trend of nutritional status in the five years from 2013 to 2019 was analyzed. Results From 2013 to 2019, the prevalence rate of malnutrition showed a downward trend. The prevalence rate of malnutrition of boys was higher than that of girls. The prevalence rate of growth retardation decreased more significantly than that of emaciation. Conclusion The status of malnutrition among students in poor areas of Chongqing had been improved, but had not been eliminated yet. Further attention should be paid to the changes of students' nutritional status and timely measures should be taken to improve the students' nutritional and health status.

Objective: To examine the vitamin A status of children and adolescents aged between 6-17 years old in Chongqing, and to analyze the influencing factors of vitamin A deficiency, providing a scientific basis for nutritional improvement measures. Methods: From 2016 to 2017, a multi-stage random sampling method was used to select approximately 1 508 children and adolescents aged between 6-17 years old from three rural and three urban locations in Chongqing. This study carried out a questionnaire survey and laboratory testing, and the statistical analysis was performed using SPSS version 25.0. Results: The mean vitamin A level was (1.45±0.42)μmol/L, while the prevalence of vitamin A deficiency and the subclinical deficiency rate were 0.46% and 13.46%, respectively. The binary Logistic regression analysis revealed that the following factors were associated with a lower risk of vitamin A deficiency:overweight and obese students(OR=0.51); students whose mothers had a high school education or above(OR=0.35, P=0.01); students from big cities; and higher quartile albumin levels (Q 3 and Q 4). Students who did not eat meat each day(OR=2.05), students aged 6-8 years old, and students with C-reactive protein in the third (OR=2.12) and fourth (OR=4.54) higher quartiles were at a higher risk of vitamin A deficiency. Conclusion The subclinical vitamin A deficiency rate was relatively high among children aged 6-17 years old in Chongqing. Measures including nutritional education, reasonable diets, and nutritionally fortified food or fortifiers should be used when necessary.

Objective: To understand the status of vitamin D deficiency and high blood pressure in primary and middle school students aged 7 to 17 years old in Chongqing, and to explore the correlation between vitamin D deficiency and high blood pressure in children and adolescents. Methods: From 2016 to 2017, a total of 1 360 primary and middle school students, aged 7 to 17 years old, were selected from three rural and three urban sites in Chongqing using multistage stratified random sampling. This study carried out a questionnaire survey, and participants underwent a physical examination which included blood pressure and serum vitamin D assessments. Results: The deficiency and insufficiency rates of vitamin D were 9.71%, and 62.57%, respectively. The high blood pressure rate was 25.88%. Multivariate Logistic regression analysis showed that after adjusting for age, economic status, waist circumference, BMI classification, and family history of hypertension, the risk of hypertension was 1.42 times that of the normal group (P<0.05), and the risk of high systolic blood pressure was 1.59 times that of the normal group (P<0.05). Conclusion The deficiency and insufficiency rate of vitamin D among children and adolescents aged 7 to 17 years old in Chongqing was high, and the phenomenon of high blood pressure was prominent. Students with vitamin D deficiency and insufficiency were more likely to have high blood pressure.