Objective: To develop and validate a health literacy assessment scale for junior high school students, providing an effective tool for evaluating and monitoring health literacy among Chinese adolescents. Methods: Based on school health education policy documents, a health literacy assessment framework was constructed, comprising five horizontal and four vertical dimensions. From May to June and August to September in 2024, the framework was refined through Delphi expert consultations and focus group discussions, leading to the development of the Health Literacy Assessment Scale for Junior High School Students. In September 2024, a convenience sample of 625 students from three junior high schools in Beijing and Tianjin completed the questionnaire. Item analysis, reliability, and validity tests were conducted to evaluate the scale. Results: The recovery rate for two rounds of expert consultation questionnaires was 100%. The expert authority coefficients ( Cr ) were 0.86 and 0.87 respectively (both >0.70), with Kendall W values of 0.34 and 0.27 ( P <0.05). The focus group discussions followed a rigorous structure, and after multiple rounds of item screening and revision, the version 3.0 of the junior high school students health literacy assessment scale was developed, comprising 57 items. Three items that failed to meet the comprehensive screening criteria were preliminarily removed, and the final scale contained 54 items. The scale demonstrated excellent reliability, with an overall Cronbach s α coefficient of 0.92 and split half reliability of 0.93. Confirmatory factor analysis [ χ 2/df =2.094, root mean square error of approximation ( RMSEA )=0.042, comparative fit index ( CFI )=0.911, Tucker Lewis index ( TLI )=0.907] indicated good model fit indices. Conclusions The preliminary development of the health literacy assessment scale for junior high school students follows a rigorous item screening process with well designed dimensions, demonstrating good reliability and validity, thus serving as an appropriate evaluation tool for adolescent health literacy.

This paper discussed the nature of ulcerative colitis， that is deficiency of the root and excess of the branch， from the theory of sweat pore， and to explore the theoretical basis and experience of treating this disease with retention enema of traditional Chinese medicine （TCM）. The main location of this disease is in the intestine. As a part of sweat pore， the intestinal sweat pore serves as the gateway for the ascending， descending， exiting and entering of qi movement in the zang fu （脏腑） organs， meridians and collaterals， as well as the channel for the transportation of qi， blood and body fluids. The constraint and closure of the intestinal sweat pore are the main pathological basis of ulcerative colitis. According to the manifestations of colonoscopy， and the different etiological factors and pathogenesis that lead to the constraint and closure of sweat pore， there should be different treatment focuses such as expelling wind to open sweat pore， clearing fire to open sweat pore， promoting blood circulation to open sweat pore， for which wind-dispersing herbs， heat-clearing herbs， and blood-activating herbs are used accordingly. The method of retention enema can directly induce Chinese medicinal herbs to the affected part， so as to diffuse and unblock the sweat pore， regulate qi and blood， and thus restore the normal function of the intestinal sweat pore.

Objective: To develop a health literacy evaluation scale for Chinese high school students, providing a tool for dynamic monitoring of health literacy among high school students and evaluating the effectiveness of health school construction. Methods: Through theoretical research, an evaluation index system for health literacy of Chinese high school students was constructed. Two rounds of Delphi expert consultations were conducted to quantitatively screen the items, and the item pool was revised based on expert opinions to compile the health literacy evaluation scale for Chinese students. Two focus group interviews were held to collect suggestions from health educators, high school teachers, and high school students regarding optimized scale length, question types, difficulty and wording of the scale. The scale was revised accordingly. A pilot survey was conducted in Beijing and Tianjin in November 2024, and the reliability and validity of the scale were evaluated based on the pilot survey data. Results: The response rate in both rounds of Delphi expert consultations was over 80%, and the expert authority coefficient was over 0.70. The expert opinions were highly concentrated, and the dispersion was small. The revised item pool based on expert opinions contained 39 items. The revised scale based on the suggestions and opinions collected from the focus group interviews had a moderate number of questions and difficulty level. The pilot survey obtained 800 valid responses, with the response rate of 89.39%. The Cronbach α coefficient of the scale was 0.911, χ 2/df =3.321, the root mean square error of approximation was 0.054, the adjusted goodness-of-fit index was 0.991 , and the factor loadings of some items were less than 0.40. Conclusion The health literacy evaluation scale for Chinese high school students demonstrates scientific rigor and practical applicability, with good internal consistency and structural validity.

Objective: To investigate the prevalence of work-related musculoskeletal disorders (WMSDs) and influencing factors among vegetable greenhouse workers, so as to provide insights into relevant intervention measurements. Methods: Workers from 4 vegetable greenhouse villages were sampled in the suburbs of Xining City using a cluster sampling method from March to April 2023. Participants' demographic information, characteristics of greenhouse operation and prevalence of WMSDs were collected using questionnaire surveys. Factors affecting the prevalence of WMSDs among vegetable greenhouse workers were identified using a multivariable logistic regression model. Results: A total of 550 questionnaires were distributed, and 518 valid questionnaires were recovered, with an effective response rate of 94.18%. There were 264 males (50.97%) and 254 females (49.03%), and 269 participants (51.93%) aged 50 years and older. The prevalence of WMSDs among vegetable greenhouse workers was 40.93% (212 cases). Waist, neck and back were mainly affected, with 185 (35.71%), 157 (30.31%), and 153 (29.54%) cases, respectively. Multivariable logistic regression analysis showed that workers who smoke (OR=2.406, 95%CI: 1.133-5.110), worked 8 hours and longer per day (OR=6.618, 95%CI: 3.492-12.542) and lift heavy loads of about 20 kg (OR=1.770, 95%CI: 1.013-3.092) had a higher risk of WMSDs. Conclusions WMSDs occurred in 40.93% of vegetable greenhouse workers in Xining City, and waist, neck and back were mainly affected. Smoking, working duration and lifting heavy loads may influence the prevalence of WMSDs among vegetable greenhouse workers in Xining City.

BACKGROUND: Dual regimen dolutegravir (DTG) plus lamivudine (3TC) has demonstrated non-inferior efficacy compared to DTG-based three-drug regimens (3DRs), yet directly comparative data regarding the efficacy and safety of DTG + 3TC and bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) for therapy-naïve people with human immunodeficiency virus (HIV)-1 (PWH) are still limited. We aimed to assess the antiviral potency and safety profiles of DTG + 3TC vs. B/F/TAF based on antiretroviral therapy (ART)-naïve PWH in China. METHODS: This retrospective multicenter study enrolled PWH initiating ART with DTG + 3TC or B/F/TAF from 2020 to 2022 in Guangdong and Guangxi. We analyzed response rates based on target not detected (TND) status using intention-to-treat (ITT) analysis. Subgroups were formed based on baseline viral load (VL) (<100,000 vs . ≥100,000 copies/mL) and CD4 + cell count (<200 vs . ≥200 cell/µL). Median time to TND VL was assessed by Kaplan-Meier method. We also measured changes from baseline in CD4 + cell counts, CD4/CD8 ratio, lipid parameters, weight, creatinine (Cr), estimated glomerular filtration rate (eGFR), and drug-related adverse effects (DRAEs). RESULTS: We enrolled 280 participants, including 137 (48.9%) on DTG + 3TC and 143 (51.1%) on B/F/TAF. At week 48, 96.4% (132/137) on DTG+3TC and 100% (143/143) on B/F/TAF achieved TND ( P = 0.064). At week 12, TND responses were higher with B/F/TAF (78.3% [112/143]) than DTG+3TC (30.7% [42/137]) ( P <0.001). This trend held across subgroups. B/F/TAF achieved TND faster (12 weeks) than DTG+3TC (24 weeks) ( P <0.001). No differences were seen in CD4 + cell count and CD4/CD8 ratio, except in the high-VL subgroup, where B/F/TAF showed better recovery. DRAEs were significantly lower with B/F/TAF (4.9% [7/143]) than with DTG + 3TC (13.1% [18/137]) ( P = 0.016). Lipid parameters, body weight, and Cr increased in both groups over 48 weeks, with DTG+3TC showing a more favorable effect on triglycerides, high-density lipoprotein (HDL) cholesterol, and weight gain. CONCLUSIONS In this real-life study, B/F/TAF led to a faster viral decline and fewer DRAEs compared to DTG+3TC. No significant difference was observed in the TND rate at week 48, regardless of baseline VL and CD4 + cell count. CD4 + recovery was superior for B/F/TAF in participants with high VL. The DTG + 3TC regimen had less impact on metabolic changes than B/F/TAF.
Adult ; Humans ; Anti-HIV Agents/therapeutic use* ; China ; Emtricitabine/pharmacology* ; HIV Infections/drug therapy* ; HIV-1 ; Lamivudine/pharmacology* ; Lipids ; Retrospective Studies

Objective:To investigate the application of multiscale low-rank plus sparsity (MLRS) modeling in fast ultra-high-field intracranial 4D Flow imaging.Methods:Ten healthy volunteers, 5 males and 5 females, aged 23-35 (29±4) years old, recruited from October 2022 to January 2023 at Huashan Hospital of Fudan University, were prospectively collected. A MLRS model acceleration algorithm was proposed according to the characteristics of 4D Flow data based on the multiscale low-rank (MLR) model. Firstly, full sampling brain 4D Flow scans were performed on healthy volunteers using 7.0 T MR, and the acquired data were under-sampled with Gaussian distributions at different acceleration rates (R of 4, 8, 12, and 16, respectively). The root mean square error (RMSE) and peak signal-to-noise ratio (PSNR) of the compressed sensing algorithm (CS), low-rank plus sparse algorithm (L+S), MLR, and MLRS model were calculated at different acceleration rates, with fully sampled data as reference. And the comparison of models was performed using the paired-samples t-test or Wilcoxon signed rank test. Pearson′s test was used to assess the correlation between hemodynamic parameters of the 4 algorithms and the fully sampled reference values at different acceleration rates, and the correlation coefficients were compared using Wilcoxon signed rank test. Results:The RMSE under the same acceleration rates was MLRS, MLR, L+S, and CS models in ascending order, and the RMSE of the MLRS model was significantly lower than that of the MLR, L+S, and CS models ( P<0.05); the PSNR was MLRS, MLR, L+S, and CS models in descending order, and the PSNR of the MLRS model was significantly higher than that of the MLR, L+S, and CS model ( P<0.05). The correlation coefficients between the blood flow velocity measured by the MLRS model and the reference value were significantly higher than those of the MLR, L+S, and CS models for different acceleration rates ( P<0.05). Conclusion:The proposed MLRS algorithm is capable of accelerating ultra-high-field 4D Flow MR imaging of the brain while guaranteeing the image quality, and the MLRS model has higher reconstruction accuracy compared with conventional acceleration models at the same acceleration rate.

The unique characteristics of the tumor microenvironment (TME) could be exploited to develop antitumor nanomedicine strategies. However, in many cases, the actual therapeutic effect is far from reaching our expectations due to the notable tumor heterogeneity. Given the amplified characteristics of TME regulated by vascular disrupting agents (VDAs), nanomedicines may achieve unexpected improved efficacy. Herein, we fabricate platelet membrane-fusogenic liposomes (PML/DP&PPa), namely "platesomes", which actively load the hypoxia-activated pro-prodrug DMG-PR104A (DP) and physically encapsulate the photosensitizer pyropheophorbide a (PPa). Considering the different stages of tumor vascular collapse and shutdown induced by a VDA combretastatin-A4 phosphate (CA4P), PML/DP&PPa is injected 3 h after intraperitoneal administration of CA4P. First, CA4P-mediated tumor hemorrhage amplifies the enhanced permeation and retention (EPR) effect, and the platesome-biological targeting further promotes the tumor accumulation of PML/DP&PPa. Besides, CA4P-induced vascular occlusion inhibits oxygen supply, followed by photodynamic therapy-caused acute tumor hypoxia. This prolonged extreme hypoxia contributes to the complete activation of DP and then high inhibitory effect on tumor growth and metastasis. Thus, such a combining strategy of artificially-regulated TME and bio-inspired platesomes pronouncedly improves tumor drug delivery and boosts tumor hypoxia-selective activation, and provides a preferable solution to high-efficiency cancer therapy.

Objective To investigate and analyze the current situation of nuclear technology utilization and radiation workers' occupational health management in non-medical institutions in Huai'an City, and to strengthen the prevention and control of occupational radiation diseases. Methods 37 non-medical institutions of nuclear technology utilization in Huai'an City were surveyed by questionnaire, including radioisotope and radiation apparatus, personal dose monitoring of radiation workers, implementation of occupational health examination, protective equipment, etc. Results The industry covers manufacturing industry, transportation, warehousing and postal industry, scientific research and technical service industry, residential service, repair and other service industries, 0 class I radiation device, 15 class II radiation devices, 67 class III radiation devices; 0 class I and II radiation sources, 1 class III radiation device, 16 class IV radiation sources, 51 class V radiation sources, 1 unsealed radioactive material Class B workplace; 493 radiation workers, 90.5% with certificates, 85.4% with personal dose monitoring rate, rate of 37.8% with radiation protection monitoring equipment, and 68.0% with occupational health examination rate. It has 13 institutions equipped with personal protective equipment, 23 with dose alarming devices and 14 with radiation protection monitors. 30 radiation workplace tests have been carried out in the past two years. Conclusion The occupational health management of radiation workers in non-medical institutions is weak. At present, the responsibility of occupational health supervision has been assigned to the health department. Therefore, the health administrative department should strengthen the supervision of non-medical nuclear technology utilization institutions and improve the emergency mechanism of radiation emergencies in Huai'an city.

Objective:To analyze the clinical characteristics and prognosis of pregnant women with hemorrhagic fever with renal syndrome (HFRS).Methods:A total of 11 pregnant women with HFRS admitted to The Second Affiliated Hospital of Xi′an Jiaotong University (four cases), The Second Affiliated Hospital of Air Force Medical University (four cases), The First Affiliated Hospital of Xi′an Jiaotong University (one case) and Central Hospital of Xianyang City (two cases) between November 2009 and February 2019 were included as the study group, and 24 age-matched non-pregnant women with HFRS were selected as the control group. The age, complications, clinical classification and laboratory indexes of the two groups were analyzed retrospectively, and the clinical outcomes of pregnant women and their fetuses in the study group were followed up. The data between two groups were compared using Mann-Whitney U test or chi-square test. Results:Patients in the study and control groups were 29 (22, 33) and 32 (24, 37) years old, respectively. Seven of 11 patients in study group were severe and critical cases, which was significantly higher than that in the control group (16.7%(4/24), χ2=7.722, P=0.015). In the study group, 10 patients had hypervolemic syndrome, 10 patients had pulmonary edema and six patients had overlapping hypotension shock phase and oliguria phase, which were all higher than those in the control group ((2/24, 8.3%), (2/24, 8.3%) and (2/24, 8.3%), respectively; χ2=22.828, 22.828 and 9.135, respectively, all P<0.01). Compared with the control group, the pregnant patients in study group had a higher urea nitrogen maximum and serum creatinine maximum, and the differences were both statistically significant ( Z=-2.453 and -2.336, respectively, both P<0.05), while they had a lower serum albumin minimum, hemoglobin maximum and hemoglobin minimum, and the differences were all statistically significant ( Z=-3.742, -3.350 and -4.034, respectively, all P<0.01). All pregnant women with HFRS recovered. Nine pregnant women gave birth to nine healthy infants. All of them received breastfeeding and the feeding duration were more than six months. No abnormal growth and development were found during an average follow-up of three years. Conclusions:Pregnancy can aggravate the severity of HFRS, and pregnant women have higher risk of the multiple stages overlap and the complications such as hypervolemic syndrome and acute pulmonary edema. After recovery from HFRS, mother may carry to full-term pregnancy.

Peptide inhibition of the interactions of the tumor suppressor protein P53 with its negative regulators MDM2 and MDMX activates P53