ObjectiveTo analyze the hygienic status of tableware cleaning and disinfection in 41 catering facilities of Shanghai in 2020, to identify its influencing factors, so as to propose evidence-based improvements for future scientific supervision. MethodsA field survey was conducted on the cleaning and disinfection methods of tableware in 41 catering establishments in Shanghai. A total of 180 tableware samples were collected and tested for four indicators, including free residual chlorine, anionic synthetic detergent residues, coliforms, and total number of bacterial colonies. The results were classified and statistically analyzed based on the type of catering establishment, tableware material, tableware function, and cleaning and disinfection methods. ResultsThe tableware passed the tests for coliforms and free residual chlorine. The qualification rate for anionic synthetic detergent residues was 48.89% (88/180), with an average of 0.02 mg per 100 cm² and a maximum of0.25 mg per 100 cm² (This unit complied with the requirements of national standardard: GB 14934—2016). Based on the type of catering enterprises, large restaurants had the lowest qualification rate for anionic synthetic detergent residues in tableware at 46.15%. In terms of the function of tableware, chopsticks had the lowest qualification rate for anionic synthetic detergent residues at 26.32%. The detection rate of total number of bacterial colonies in tableware was 42.22% (76/180), with an average of 0.5 log₁₀ (CFU·mL⁻¹) and a maximum of 3.4 log₁₀ (CFU·mL⁻¹). Among them, medium-sized restaurants had the highest detection rate of total number of bacterial colonies in tableware at 47.73% (21/44). ConclusionThe qualification rate of anionic synthetic detergent residues in tableware is relatively low.It is recommended to strengthen research on the occurrence patterns of unqualified tableware and establish early warning values for the qualification rate of anionic synthetic detergent residues, enhance law enforcement inspections on relevant catering establishments, guide enterprises to fulfill their main responsibilities, and improve the quality and safety of tableware.

Objective:This study utilizes data from the 2021 Chinese Longitudinal Healthy Longevity and Happy Family Survey(CLHLS-HF)to examine the current status of Long-Term Care Insurance(LTCI)implementation and to identify the factors influencing whether disabled elderly individuals receive formal care services.The study aims to provide policy recommendations to enhance the effectiveness and equity of the system.Methods:In this cross-sectional study, a sample of 1 447 older participants with dependency, residing in LTCI pilot areas and meeting the inclusion criteria from the 2021 CLHLS-HF, was selected.Chi-square tests and binary logistic regression analyses were employed to explore the factors influencing the receipt of formal care by dependent older individuals.Results:Among the 1 447 participants, there were 496 males with an average age of 92 years(SD 9)and 951 females with an average age of 95 years(SD 9). Of these, 701 received formal care.The logistic regression analysis revealed that factors influencing the receipt of formal care included urban residence( OR=2.237, 95% CI: 1.675-2.987, P<0.001), residing in the eastern region( OR=2.907, 95% CI: 1.747-4.837, P<0.001), living in the western region( OR=3.132, 95% CI: 1.816-5.501, P<0.001), having no children( OR=2.478, 95% CI: 1.108-5.540, P=0.027), and the degree of disability, with severe disability being more likely to receive care compared to mild( OR=0.497, 95% CI: 0.388-0.637, P<0.001)and moderate disabilities( OR=0.589, 95% CI: 0.433-0.801, P=0.001). Conclusions:Dependent older individuals in the eastern and western regions, particularly those without children or with severe disabilities, are more likely to receive formal care through the LTCI system.However, there are substantial inequities in LTCI coverage among individuals with varying degrees of disability.To enhance the effectiveness of the LTCI system, greater efforts should be directed towards economically disadvantaged regions and older individuals with mild to moderate disabilities, thereby ensuring better protection for the disabled population.

Mental health inequality is a major manifestation of health inequality in the psychological dimension,and it has become a realistic problem to challenge common social progress.The aim of this study is to review the domestic and international research on the measurement and decomposition of mental health inequality.The authors mainly discussed 3 aspects:socio-economic and demographic inequalities in mental health,and the impact of acute major infectious diseases on mental health inequality.They also summarized the commonly used indicators and research methods.This paper reviews the selection of data indicators,research subjects,and research perspectives,so as to provide evidence for further research on mental health inequality in China.

Objective:To explore the efficacy and surgical seletion or timing for elderly patients(≥85 years) with inguinal hernia.Methods:A retrospective analysis was conducted on clinical data of 323 patients aged ≥ 85 years who underwent surgical treatment for inguinal hernia admitted to the Department of General Surgery of East China Hospital Affiliated to Fudan University from Jan 2020 to Dec 2024.There were 308 males (95.36%) and 15 females (4.64%), with an average age of (87.83 ± 1.91) years. The ASA classification included 15 cases of grade Ⅰ, 209 cases of grade Ⅱ, 97 cases of grade Ⅲ, and 2 cases of grade Ⅳ.Results:Among the 323 patients, there were 20 bilateral hernia cases and 303 unilateral cases. Ninety-seven cases were of scrotal hernia. Surgical methods included 11 TAPP cases, 10 TEP cases, 297 Lichtenstein cases, 3 open suture repair and 2 laparoscopic suture repair. Four cases underwent intestinal resection and in two cases enterostomy was performed. The median follow-up after surgery was 3 months. Hernia recurrence was found in 2 cases, seroma in 14 cases, chronic pain in 2 cases, SSI in 11 cases, intestinal obstruction in 1 case, urinary retention in 3 cases, pulmonary infection in 9 cases, urinary tract infection in 2 cases, cardiovascular and cerebrovascular accidents in 2 cases. The incidence of postoperative complications in the emergency group was significantly higher than that in the elective group. Three deaths occurred within 30 days after surgery, all of which were in the emergency group.Conclusions:Selective inguinal hernia repair is safe and effective for over 85 year old patients with inguinal hernia. The incidence of emergency surgical complications and mortality is significantly increased. Lichtenstein surgery under local anesthesia or regional block anesthesia is the preferred method.

Objective:This study utilizes data from the 2021 Chinese Longitudinal Healthy Longevity and Happy Family Survey(CLHLS-HF)to examine the current status of Long-Term Care Insurance(LTCI)implementation and to identify the factors influencing whether disabled elderly individuals receive formal care services.The study aims to provide policy recommendations to enhance the effectiveness and equity of the system.Methods:In this cross-sectional study, a sample of 1 447 older participants with dependency, residing in LTCI pilot areas and meeting the inclusion criteria from the 2021 CLHLS-HF, was selected.Chi-square tests and binary logistic regression analyses were employed to explore the factors influencing the receipt of formal care by dependent older individuals.Results:Among the 1 447 participants, there were 496 males with an average age of 92 years(SD 9)and 951 females with an average age of 95 years(SD 9). Of these, 701 received formal care.The logistic regression analysis revealed that factors influencing the receipt of formal care included urban residence( OR=2.237, 95% CI: 1.675-2.987, P<0.001), residing in the eastern region( OR=2.907, 95% CI: 1.747-4.837, P<0.001), living in the western region( OR=3.132, 95% CI: 1.816-5.501, P<0.001), having no children( OR=2.478, 95% CI: 1.108-5.540, P=0.027), and the degree of disability, with severe disability being more likely to receive care compared to mild( OR=0.497, 95% CI: 0.388-0.637, P<0.001)and moderate disabilities( OR=0.589, 95% CI: 0.433-0.801, P=0.001). Conclusions:Dependent older individuals in the eastern and western regions, particularly those without children or with severe disabilities, are more likely to receive formal care through the LTCI system.However, there are substantial inequities in LTCI coverage among individuals with varying degrees of disability.To enhance the effectiveness of the LTCI system, greater efforts should be directed towards economically disadvantaged regions and older individuals with mild to moderate disabilities, thereby ensuring better protection for the disabled population.

Objective:To explore the efficacy and surgical seletion or timing for elderly patients(≥85 years) with inguinal hernia.Methods:A retrospective analysis was conducted on clinical data of 323 patients aged ≥ 85 years who underwent surgical treatment for inguinal hernia admitted to the Department of General Surgery of East China Hospital Affiliated to Fudan University from Jan 2020 to Dec 2024.There were 308 males (95.36%) and 15 females (4.64%), with an average age of (87.83 ± 1.91) years. The ASA classification included 15 cases of grade Ⅰ, 209 cases of grade Ⅱ, 97 cases of grade Ⅲ, and 2 cases of grade Ⅳ.Results:Among the 323 patients, there were 20 bilateral hernia cases and 303 unilateral cases. Ninety-seven cases were of scrotal hernia. Surgical methods included 11 TAPP cases, 10 TEP cases, 297 Lichtenstein cases, 3 open suture repair and 2 laparoscopic suture repair. Four cases underwent intestinal resection and in two cases enterostomy was performed. The median follow-up after surgery was 3 months. Hernia recurrence was found in 2 cases, seroma in 14 cases, chronic pain in 2 cases, SSI in 11 cases, intestinal obstruction in 1 case, urinary retention in 3 cases, pulmonary infection in 9 cases, urinary tract infection in 2 cases, cardiovascular and cerebrovascular accidents in 2 cases. The incidence of postoperative complications in the emergency group was significantly higher than that in the elective group. Three deaths occurred within 30 days after surgery, all of which were in the emergency group.Conclusions:Selective inguinal hernia repair is safe and effective for over 85 year old patients with inguinal hernia. The incidence of emergency surgical complications and mortality is significantly increased. Lichtenstein surgery under local anesthesia or regional block anesthesia is the preferred method.

Objective:To analyze the risk factors for 6-month prognosis of traumatic spinal cord injury (TSCI).Methods:A retrospective analysis was conducted of the 133 patients with TSCI who had been admitted to Department of Orthopaedics, The First Hospital Affiliated to Jinan University from January 2017 to August 2021. The patients with TSCI were categorized into an improved group ( n=82) and a non-improved group ( n=51) according to the improvements in the American Spinal Injury Association (ASIA) grading between admission and 6 months after injury. To identify the risk factors that might affect the prognosis of TSCI patients at 6 months after injury, univariate and logistic regression analyses were conducted of indicators such as gender, age, length of MRI spinal cord signal change, maximum canal compromise (MCC), maximum spinal cord compression (MSCC), brain and spinal cord injury center(BASIC)score, neutrophil-to-lymphocyte ratio (NLR) within 3 days after injury, ASIA grading within 3 days after injury, mean arterial pressure (MAP) at 3 days after operation, and presence of complications. Results:The univariate analysis showed significant differences between the improved and non-improved groups in length of MRI spinal cord signal change, MCC, MSCC, BASIC, NLR within 3 days after injury, ASIA grading within 3 days after injury, MAP at 3 days after operation, and presence of complications (all P<0.05). The logistic regression analysis showed that NLR ( OR=0.463, 95% CI: 0.287 to 0.748, P=0.002) and ASIA grading ( OR=11.684, 95% CI: 1.684 to 81.086, P=0.013) within 3 days after injury, as well as MAP at 3 days after operation ( OR=2.224, 95% CI: 1.306 to 3.787, P=0.003), were risk factors affecting the 6-month prognosis in TSCI patients. Conclusion:The NLR and ASIA grading within 3 days after injury, and MAP at 3 days after operation are risk factors that may affect the prognosis of TSCI patients at 6 months after injury.

ObjectiveTo investigate the pollution level of deoxynivalenol （DON） in wheat flour and its products sold in Shanghai， and to assess the health risks of DON exposure for residents in Shanghai who ingested DON from wheat flour and its products. MethodsRisk monitoring data of DON in wheat flour and its products sold in Shanghai from 2017 to 2021 were combined with the consumption data of wheat flour and its products by Shanghai residents. A probabilistic assessment method was used to assess dietary exposure of DON in wheat flour and its products. ResultsThe overall detection rate of DON in wheat flour and its products was 77.3% （1 041/1 347）， with a mean concentration of 226.3 μg·kg^-1， P₅₀ of 130.0 μg·kg^-1 and a maximum value of 3 080.0 μg·kg^-1. The mean daily exposure and 95th percentile daily exposure （by body weight） of DON from wheat flour and its products in Shanghai residents were 0.279 μg·kg^-1 and 1.146 μg·kg， accounting for 27.9% and 114.6% of the daily tolerable intake of DON TDI， 1 μg·kg， respectively. The probability assessment results indicated that 6.1% of the whole population in Shanghai had DON exposure exceeding the TDI value. Among them， 12.8% of the population aged 6 years old and below， 16.4% of the population aged between 7 and 17 years old， 3.9% of the population aged between 18 and 59 years old and 3.2% of the population aged 60 years old and above exceeded the TDI value for daily DON exposure through wheat flour and its products. ConclusionCertain populations in Shanghai may face certain health risks from daily DON intake wheat flour and its products. Special attention should be paid to the health risk of daily DON exposure through wheat flour and its products for individuals age below 18 years old .

ObjectiveTo assess the health risk of dietary exposure to nonylphenol in infants aged 0-36 months through infant formula in Shanghai. MethodsA monitoring of nonylphenol pollution in infant formula was conducted in 2022. A total of 90 samples were obtained from maternal and infant stores， supermarkets， and online stores in Shanghai. Based on the daily consumption data of infant formula， a point assessment method was used to assess the dietary exposure to nonylphenol in infant formula. ResultsThe prevalence of nonylphenol in infant formula retailed in Shanghai was 95.6% （86/90）. The amount of nonylphenol varied from non-detected to 22.70 μg·kg^-1， with the mean value of 8.47 μg·kg^-1 and the P₅₀ value of 7.77 μg·kg^-1. The mean daily nonylphenol exposure （estimated by body weight） from infant formula in infants aged 0-6 months， 7-12 months and 13-36 months in Shanghai was 0.091， 0.068 and 0.054 μg·kg^-1， respectively； furthermore， the P₉₅ value of daily exposure （by body weight） was 0.228， 0.152 and 0.119 μg·kg^-1， respectively. These amounts were much lower than the tolerable daily intake （TDI） of nonylphenol （by body weight 5 μg·kg^-1）. ConclusionThe health risk of daliy nonylphenol intake from infant formula remains low among infants aged 0-36 months in Shanghai.

Objective:To explore the clinical efficacy of adult donor dual kidney transplantation.Methods:Retrospective analysis of case data of 13 adult donor kidney dual kidney transplantation (DKT) performed in the The Second Xiangya Hospital of Central South University from September 2016 to December 2020. For 13 donors, the average age and BMI were (53.5±12.4)years and (24.3±2.8) kg/m 2, respectively. Their mean Serum creatinine (SCr) at admission and before procurement was (132.9±54.1)and (228.7±112.4)μmol/L, respectively. 3 of them had diabetes mellitus history, and 8 had hypertension history. 11 met the United Network for Organ Sharing (UNOS) DKT criteria and 6 met Remuzzi score DKT criteria. For 13 recipients, the average age and BMI were (39.3±8.9)years and (20.2±2.4)kg/m 2, respectively. All of them received ABO blood type-matched kidney transplants. 2 of them had their grafts transplanted in the bilateral iliac. In 12 cases, the grafts filled rapidly and urinated immediately when opening blood flow. In 1 case, the grafts were dark in color and vascular showed weak pulsation after opening blood flow. The time to recovery of perioperative graft function (from the day of surgery to the natural reduction of SCr to the normal range 44-133μmol/L), the occurrence of delayed graft function (DGF), acute rejection (AR), ureteral and surgical incision complications, as well as the recipients’ final follow-up SCr, eGFR, urinary protein, and grafts outcome were observed. Risk factors affecting outcomes were assessed by univariate logistic regression analysis. Results:The SCr dropped to the normal range at discharge in 10 recipients, and the average recovery time was (13.8±13.0) days. In other 3 cases SCr at discharge were 300.0, 149.0, 152.5μmol/L. 4 cases had DGF, 4 had AR, 1 experienced urinary fistula, and 1 experienced incisional dehiscence, which were treated with anti-rejection, J-tube implantation, continuous catheterization to maintain bladder void, secondary suturing, respectively. The follow-up time ranged from 4 to 54 months, with a median of 28(15.5, 31.0) months. At the final follow-up time, 10 cases had good graft function, 2 suffered impaired kidney function, and 1 experienced graft failure. The average SCr and eGFR except for graft failure patient were (144.2±101.3)μmol/L and (52.9±21.2)ml/min, respectively. 4 had positive urine protein. Univariate logistic regression analysis showed that donor age, BMI, history of diabetes mellitus and hypertension, and SCr were not significantly correlated with recipients’ DGF and graft impairment ( P>0.05), and due to the small sample size, multifactorial logistic regression analysis was not performed. Conclusion:The short to medium-term effects of adult donor DKT coule be safe and feasible.