To introduce and analyze guideline terminology related to clinical question formulation, evidence retrieval and appraisal, and recommendation development.

Objective: To explore the effect of the comprehensive intervention on overweight and obesity among middle school students at the population level (health education lecture and official account push) and individual level (personalized dietary guidance), so as to provide a reference for preventing and controlling their overweight and obesity. Methods: Three junior high schools and three senior high schools were randomly selected in Guangzhou in 2018 by convenience sampling. Through physical examination, 1 457 overweight and obese students aged from 12 to 18 years old were screened. Intervention was administered through "Student Personalized Dietary Guidance" manual, health tweets on the official accounts, and health education lectures from September 2018 to December 2019. The Chi square test was used to compare the difference in overweight and obesity constituent ratio between the two groups before and after the intervention. And intervention effect was evaluated by analyzing the number needed to treated(NTT). Results: The proportion of overweight before the intervention was 66.71% (972/1 457), and decreased to 59.92% (873/1 457) after the intervention; the proportion of obesity before the intervention was 33.29% (485/1 457), which decreased to 26.63% (388/1 457) after the intervention. Among obese students, the smallest NNT was seen in the girl group aged 12-13 years (NNT=2.6, 95% CI =1.9-4.1), while the largest NNT in the boy group aged 14-18 years (NNT=5.9, 95% CI =4.7-8.1). The NNT of the girls aged 12-13 years was the smallest (NNT=2.7, 95% CI =2.2-3.5), and the NNT of the boys aged 14-18 years was the largest (NNT=7.4, 95% CI =6.0-9.7). Conclusion Health education at population level (health education lectures, official account push) with individual level (personalized dietary guidance) can effectively intervene overweight and obesity among middle school students in Guangzhou.

Objective:To evaluate the consistency of individual iodine nutrition levels by serum iodine, plasma iodine and whole blood iodine, and to provide reference for iodine-related epidemiological investigation.Methods:Healthy adults aged 18 - 59 years were recruited from the Research Center of Environment and Health in Water Source Area of South-to-North Water Diversion of Hubei University of Medicine. Whole blood sample was collected and serum and plasma were separated. The content of iodine in serum, plasma and whole blood was determined by inductively coupled plasma mass spectrometry (ICP-MS), and the linear relationship, precision and accuracy of the standard curve of the detection method were evaluated. The difference of three kinds of blood iodine levels was analyzed by variance analysis of compatibility group design, and Passing-Bablok regression and Bland-Altman plot were used to evaluate the consistency between serum iodine and plasma iodine.Results:The linear range of iodine in serum, plasma and whole blood was 0.0 - 25.0 μg/L, and the correlation coefficients ( R2) were all > 0.999. The relative standard deviation of 8 mixed blood samples ranged from 1.9% to 4.3% ( n = 6), and the determination results of blood iodine certified standard substances were all within the reference range. The recovery rate of the added standard ranged from 99% to 106%. The iodine levels in serum, plasma and whole blood of 50 volunteers were (57.31 ± 8.06), (57.49 ± 8.50) and (33.89 ± 5.40) μg/L, respectively, and there was no statistically significant difference between serum iodine and plasma iodine ( P = 0.904). The results of Passing-Bablok regression showed that there was no statistically significant difference in bias between serum iodine and plasma iodine ( P = 0.538). The Bland-Altman plot indicated that the difference between serum iodine and plasma iodine was within the consistency limit. Conclusion:The results of plasma iodine and serum iodine are in good agreement, and plasma iodine can be used as an evaluation index of individual iodine nutrition level. But there is no consistency between whole blood iodine and serum iodine.

【Objective】 To investigate the effects of total flavone of oldenlandia diffusa (FOD) on the proliferation and apoptosis of hepatocellular carcinoma (HCC) stem cells sorted from Huh7. 【Methods】 Human HCC cell lines Huh7 was cultured in vitro; CD133 positive (CD133⁺) stem cells in Huh7 cell line were sorted by flow cytometry, and stem cell markers such as Nanog, Oct4 and Sox2 were tested by Western blotting. CD133⁺-Huh7 was stimulated by different concentrations (0 μg/mL, 50 μg/mL, 100 μg/mL and 400 μg/mL) of FOD for different time (24 h, 48 h, 72 h and 96 h). CCK8 and plate cell cloning assay were used to detect the effect of FOD on CD133⁺-Huh7 proliferation while Annexin V-PE/7-AAD was used to detect the effect of FOD on CD133⁺-Huh7 apoptosis. Western blotting was used to detect the protein expressions of protein 53 (P53), factor associated suicide-Fas-associating protein with a novel death domain (Fas-FADD), B-cell lymphoma-2 (Bcl-2), Cleaved-Caspase3, and Bcl-2 associated X protein (Bax). 【Results】 More than 95% of stem cells were purified for further experiments. Cell proliferation of CD133⁺-Huh7 was significantly inhibited by FOD, with the significant suppression at the concentration of 100 μg/mL for 72 h compared with negative control group (P<0.05). The apoptosis rate was significantly upregulated than that in the negative control group (P<0.05). The protein expression of Bcl2 decreased while Bax and Cleaved-Caspae3 increased via FAS/FADDD and P53 axis. 【Conclusion】 FOD can significantly inhibit the proliferation and promote the apoptosis of CD133⁺-Huh7.

Objective:To learn about the current status of iodine nutrition of key populations in Shiyan City, Hubei Province, and to provide basis for guiding key populations to supplement iodine scientifically.Methods:According to the requirements of the "National Iodine Deficiency Disorders Surveillance Program (2016 Edition)", pregnant women and school-age children aged 8 - 10 (age balanced, half male and half female) in 8 counties (cities, districts) under the jurisdiction of Shiyan City, Hubei Province were selected from 2017 to 2020. Their household edible salt samples and urine samples were collected to detect salt iodine and urinary iodine contents, respectively. At the same time, the thyroid gland of children was examined by B-ultrasonic and the goiter rate was calculated.Results:In total, 3 198 household edible salt samples of pregnant women were tested, the median salt iodine was 23.7 mg/kg, the coverage rate of iodized salt was 99.9% (3 196/3 198), the qualified rate of iodized salt was 96.0% (3 068/3 196), and the consumption rate of qualified iodized salt was 95.9% (3 068/3 198). Totally 2 898 urine samples of pregnant women were tested, and the median urinary iodine was 198.2 μg/L. In total, 6 363 household edible salt samples of children were tested, the median salt iodine was 23.8 mg/kg, the coverage rate of iodized salt was 99.8% (6 352/6 363), the qualified rate of iodized salt was 95.5% (6 067/6 352), and the consumption rate of qualified iodized salt was 95.3% (6 067/6 363). Totally 5 764 urine samples of children were tested, and the median urinary iodine was 259.8 μg/L. Totally 2 188 children were examined, and the goiter rate was 0.4% (9/2 188).Conclusions:From 2017 to 2020, the coverage rates of iodized salt (≥95%), consumption rates of qualified iodized salt ( > 90%) of key populations and the goiter rate of children ( < 5%) in Shiyan City of Hubei Province are in line with the national standards for eliminating iodine deficiency disorders. Pregnant women are generally at an appropriate level of iodine (150 - 249 μg/L) and children are generally at the super appropriate level of iodine (200 - 299 μg/L). It is necessary to continue to strengthen the monitoring of iodine nutrition in key populations and implement the strategy of "adjusting measures to local conditions, classified guidance and scientific iodine supplementation".

Objective: To explore the association between maternal pre pregnancy and pre delivery overweight with overweight and obesity among offspring during adolescence in Guangzhou, and to provide evidence for child obesity prevention. Methods: Based on the routine physical examination of primary and secondary school students in Guangzhou, random sampling was used to 6 middle schools and questionnaire survey was conducted among 3 384 students and their parents. Students with overweight and obesity were included in the case group, and the other students were included in the control group. Propensity Score Matching (PSM) was adopted to reduce selection bias. Logistic regression model and χ 2 test were used to analyze the data before and after PSM. Results: The result of univariate analysis showed that there were statistically significant differences between overweight/obese group and the control group by gender, schooling stage (middle and high schools), picky eater, family history of obesity, family monthly income, delivery mode, high birthweight, and gestational weight gain before PSM( χ 2=42.38, 10.64, 14.47, 26.85, 10.58, 13.59 , 15.53, 20.64, P <0.05). After PSM, results showed that there were no statistically significant differences between overweight/obese group and the control group in middle and high schools, and mother delivery mode( P >0.05). Logistic regression analysis showed that the risk of overweight and obesity of maternal pre pregnancy on adolescent offspring was 1.54 times higher than control group (95% CI =1.01-2.36) before PSM, and the overweight and obesity of maternal predelivery also increased the risk of overweight and obesity of adolescent offspring( OR=2.35, 95%CI =1.67-3.31). After PSM, maternal overweight and obesity pre pregnancy ( OR=2.17, 95%CI =1.41-3.34) and maternal overweight and obesity pre delivery( OR=2.99, 95%CI =2.08-4.31) significantly increased the risk of overweight and obesity in adolescent offspring. Conclusion Maternal overweight and obesity pre pregnancy and pre delivery are associated with increased risk of overweight and obesity in adolescent offspring.

BACKGROUND: Numerous studies have concentrated on high-dose radiation exposed accidentally or through therapy, and few involve low-dose occupational exposure, to investigate the correlation between low-dose ionizing radiation and changing hematological parameters among medical workers. METHODS: Using a prospective cohort study design, we collected health examination reports and personal dose monitoring data from medical workers and used Poisson regression and restricted cubic spline models to assess the correlation between changing hematological parameters and cumulative radiation dose and determine the dose-response relationship. RESULTS: We observed that changing platelet of 1265 medical workers followed up was statistically different among the cumulative dose groups (P = 0.010). Although the linear trend tested was not statistically significant (P CONCLUSION We concluded that although the exposure dose was below the limit, medical workers exposed to low-dose ionizing radiation for a short period of time might have increased first and then decreased platelets, and there was a dose-response relationship between the cumulative radiation dose and platelets changing.
Adult ; Aged ; Blood Platelets/radiation effects* ; Female ; Health Personnel/statistics & numerical data* ; Humans ; Male ; Middle Aged ; Occupational Exposure/adverse effects* ; Prospective Studies ; Radiation Dosage ; Radiation Exposure/adverse effects* ; Radiation, Ionizing ; Young Adult

Objective:To explore application value of logotherapy-based intervention on palliative care for middle aged patients with advanced lung cancer, in order to provide reference for assistant of their hospice.Methods:Totally, 72 middle aged patients with advanced lung cancer from October 2018 to April 2019 in the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Chest Hospital were divided into experimental group and control group according to the patients enrolled time, with 36 cases in each group. The patients in the control group recieved routine nursing, the experimental group carried out 3 times of logotherapy based on the routine nursing. Before and after intervention, the effects was assessed by Functional Assessment of Cancer Therapy-General (FACT-G), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp-12) and Hospital Anxiety and Depression Scale (HADS), respectively.Results:There was no significant difference in FACT-G, FACIT-Sp-12, HADS before intervention between the two groups( P>0.05). After intervention, the sociafamily condition, emotional condition demension scores and total scores in FACT-G were (12.75±3.55), (13.41±2.61), (43.31±4.23) points, the belief, meaning, peace demension scores as well as total scores in FACIT-Sp-12 were (11.78±1.58), (11.06±2.27), (10.19±2.33), (33.03±3.46) points in the experimental group, significantly higher than those in the control group (10.88±3.12), (11.45±3.06), (38.82±5.06), (9.73±1.39), (9.67±1.73), (8.70±2.24), (28.09±2.89) points ( t values were 2.260-6.259, P<0.05), the anxiety, depression subscale and total HADS scores were (9.19±2.36), (8.56±1.98), (17.75±3.12) points in the experimental group, significantly lower than those in the control group (10.42±1.84), (9.97±2.19), (20.39±2.50) points, the differences were statistically significant (t values were 2.352-3.776, P<0.05). Conclusions:Logotherapy-based intervention can promote quality of life and spiritual comfort and allivate nagetive emotion of middle aged patients with advanced lung cancer.

Objective: To investigate the distribution and drug resistance situation of staphylococcus aureus (SA) and methicillin-resistant staphylococcus aureus (MRSA) from the classroom environments in primary schools of Guangzhou. Methods: The air and the surfaces of door handles, desks, chairs, light switches and floor were sampled in the classrooms of 8 primary schools selected through stratified clustering method in Guangzhou from May to June, 2016. SA and MRSA were isolated and identified, and drug sensitivity tests were conducted. Results: A total of 760 samples were collected, the detection rate of SA and MRSA were 8.8% and 4.2%, respectively. There were statistically significant differences in the detection rate of staphylococcus aureus among different sampling sites(P<0.01).Detection of SA and MRSA on the floor,light’s witches and surface of deskes was both above 6.0%. The multiple drug resistance rate of MRSA was up to 100.0%, and the main resistance mode was Penicillin-Erythromycin-Rifampin-Tetracycline-Teicolanin. Conclusion MRSA can be detected in air, door handles, desk surface, chair surface, light switch and floor of primary schools. Relevant administration departments should pay attention to the environments health of Guangzhou primary schools.

Objective: To investigate the antibiotic resistance spectrum and genetic characteristics of multidrug-resistant Staphylococcus aureus(MDRSA) nasal isolate among primary school students, and to provide a scientific basis for the prevention and control of masal MDRSA resistance and the selection of clincal drugs in children. Methods: Antibiotic susceptibility experiments were performed on all SA isolates of 1 705 primary school students from 8 primary schools in Guangzhou selected by using multistage cluster stratified sampling method. MDRSA antibiotic susceptibility spectrum was analyzed, and the resistant, virulence and immune evasion cluster(IEC) genes detected by polymerase chain reaction(PCR). Results: The prevalence of MDRSA nasal carriage was 20.76%(354/1 705), and the proportion of multidrug resistance among SA isolates was 96.20%(354/368). The predominant resistant antibiotics of MDRSA isolates were penicillin(99.72%), erythromycin(96.33%), clindamycin(90.96%) and teicoplanin(90.11%). Notably, 240(67.80%, 240/354) MDRSA isolates were resistant to more than six antimicrobial categories. And the predominant detection rates of resistant genes were BlaZ(92.66%), Tet(M)(49.72%), virulence genes Tst(25.42%) and IEC genes Sak(92.09%), Hlb(61.58%). Conclusion We found high prevalence of nasal colonization MDRSA from healthy children. Moreover, MDRSA isolates has a high resistant rate to multiple antibiotics, and the proportion of resistant to ≥6 antimicrobial categories is high.