Objective: To evaluate the comprehensive intervention effect of lunch for primary and secondary school students in Minhang District, so as to provide a theoretical and practical basis for lunch intervention in school. Methods: From October to December 2023, a convenience sampling method was used to select 1 937 students from one primary and secondary school in Minhang District.A comprehensive intervention measure focusing on "reducing oil and salt" for lunch recipe optimization and nutrition education was carried out, and a questionnaire survey was conducted to evaluate the intervention effect three months later. Chi square test and Wilcoxon rank test were used to compare the data before and after the intervention. Results: After intervention, the use of cooking oil and salt, the supply of protein and fat in primary and secondary school lunches were reduced, and had no obvious impact on energy and other major nutrients. After intervention, compared to before intervention, the proportion of primary school students who felt that lunch was greasy decreased (8.9%, 6.2%, χ 2=4.35), and the proportion of primary and secondary school students who felt that lunch were delicious decreased significantly (33.2%, 23.2%; 63.9%, 53.5%, χ 2=26.39, 17.52) ( P < 0.05 ). Secondary school students also felt reduced variety of food ingredients (46.9%, 38.3%, χ 2=16.05, P <0.05). In addition, after intervention, the total surplus rate of primary school students meals decreased (7.4%, 4.4%, χ 2=5.73), mainly reflected in the decrease of the surplus rate of staple foods (7.1%, 2.4%, χ 2=17.39), while the surplus rate of vegetable dishes increased ( 16.0 %, 21.2%, χ 2=6.01) ( P <0.05). Although there was no significant change in the total surplus rate of meals for secondary school students, the surplus rate of staple foods decreased (12.9%, 5.4%, χ 2=33.52), while the surplus rates of meat and vegetable dishes increased (11.2%, 26.9%; 17.5%, 33.2%, χ 2=74.26, 61.88) ( P <0.05). After intervention, there was no statistically significant difference in the overweight and obesity rates of primary school students ( χ 2=0.11,0.43) and secondary school students ( χ 2=0.01,0.00) compared to before intervention( P >0.05). After intervention, the lung capacity of primary school students [1 564 (1 269,1 890) mL] and sitting forward flexion [11.3 (7.6, 15.2) cm] increased compared to before intervention [1 522 (1 259, 1 819 ) mL, 10.5 (6.3, 13.5) cm] ( Z =2.20, 4.68, P <0.01), but there was no statistically significant difference in lung capacity and sitting forward flexion of secondary school students before and after intervention ( Z =-0.46, -0.08, P >0.05). Conclusion The comprehensive intervention of school lunch has promoted a significant decrease in the use of oil and salt in lunch and improved the quality of recipes, and has a positive impact on the situation of leftover lunch and the health of students to a certain extent.

ObjectiveTo understand the visual environment sanitation in primary and secondary school classrooms in Minhang District， Shanghai， and to investigate the factors affecting the decline in students’ visual acuity. MethodsIn 2020， among all the primary and secondary schools in Minhang District， according to different types of classroom structures， levels， orientations， unilateral lighting， and bilateral lighting， a total of 20 231 students from 674 classrooms in primary and secondary schools were selected through stratified cluster sampling. Each monitored classroom was regarded as a research unit， and the naked eye vision of students was tested using a standard logarithmic vision chart during the 2020 and 2021 academic years. The change in average visual acuity between the two measurements was taken as the dependent variable， and the visual environment indices were considered as independent variables. The relationship between classroom visual environment indices and the decline in students’ naked eye vision was analyzed. ResultsThe qualification rates for per capita classroom area， window to floor area ratio， average illuminance of the blackboard， uniformity of blackboard illuminance， average illuminance of the desks， uniformity of desk illuminance， lighting coefficient of classroom， blackboard reflection ratio， back wall reflection ratio， and distance between lamps and desks were 79.53%， 88.58%， 46.74%， 70.33%，64.69%， 80.86%， 71.81%， 20.30%， 1.63%， and 97.53%， respectively. The average naked eye vision of primary and secondary school students in the 2020 academic year was 4.75±0.37 （right eye） and 4.76±0.37 （left eye）， while in the 2021 academic year， it was 4.70±0.39 （right eye） and 4.71±0.38 （left eye）. There was a significant decrease in the naked eye vision of primary and secondary school students in the 2021 academic year compared to that of 2020 （P<0.05）. Univariate linear regression analysis showed a significant correlation between grade， average illuminance of the blackboard， average illuminance of the desks， uniformity of desk illuminance， lighting coefficient， and distance between lamps and desks， and the decline of students’ naked eye vision within one academic year （P<0.05）. After adjusting for grade， multiple linear regression analysis revealed a significant correlation between the average illuminance of the blackboard， uniformity of desk illuminance， lighting coefficient， and distance between lamps and desks， and the decline of students’ naked eye vision within one academic year （P<0.05）. Higher average illuminance of the blackboard， uniformity of desk illuminance， lighting coefficient， and distance between lamps and desks were protective factors for naked eye vision. ConclusionThe visual environment of primary and secondary school classrooms in Minhang District is a matter of concern. Average illuminance of the blackboard， uniformity of desk illuminance， lighting coefficient， and distance between lamps and desks are related to the degree of visual impairment in students over a year.

ObjectiveTo investigate the general situation of defect of vertebral column among primary and middle school students in Minhang District of Shanghai and analyze the related factors， to provide a scientific basis for prevention and treatment. MethodsFrom September to October 2022， a total of 5 715 students were selected from two primary schools， two middle schools， and two high schools in Minhang District for physical examinations and screening for defect of vertebral column. ResultsTotally 219 students had defect of vertebral column， accounting for 3.83% of the sampled population. Anteroposterior spinal abnormalities were found in 4 individuals， accounting for 0.07%， and 218 students had scoliosis， accounting for 3.81%. The detection rate of defect of vertebral column was higher in girls （6.27%） than that in boys （1.51%）， and higher in high school students （10.74%） than in primary school students （1.31%） and middle school students （10.97%）. Students who are mildly underweight （5.95%） and who are moderately to severely underweight （7.46%） had a higher detection rate of defect of vertebral column than those with normal weight （4.54%）， overweight （2.83%）， and obesity （1.60%）. The detection rate among students with poor vision （4.32%） was significantly higher than those with normal vision （2.24%）， with all differences statistically significant （all P<0.05）. ConclusionThe positive rate of defect of vertebral column in primary and middle school students in Minhang District， Shanghai is nearly 4%， with most cases being scoliosis. Factors such as being female， increasing age， being underweight， and poor vision are associated with a higher probability of detecting defect of vertebral column.

Objective:To study the risk model of medical equipment maintenance and repair based on system dynamics,and to solve the problems of frequent risk of corruption,high transaction prices and low procurement timeliness in the process of medical equipment maintenance and repair.Methods:The risk matrix was formed by analyzing the procurement risk of medical equipment maintenance and warranty,and the risk matrix was drawn.The system dynamics model was constructed around the price risk,schedule risk and corruption risk of medical equipment maintenance procurement,and the causal relationship and feedback effect between the risk influencing factors of medical equipment maintenance procurement were revealed through the construction of causality diagram and stock flow diagram.The risk change effects of the PLA General Hospital's application of the system dynamics-based medical equipment maintenance and procurement risk model in practice in 2022 was compared.Results:After the application of risk management control based on system dynamics model,the increase of procurement price risk decreased from 0.54 before control to 0.27,the increase of corruption risk decreased from 0.27 before control to 0.05,and the increase of schedule risk decreased slowly.After lowering the risk threshold,the increase of price risk and price risk decrease significantly.When the risk threshold was reduced from 60 to 40,the project success rate was increased by 6.52%and the rate of doubts and complaints decreased by 6.61%.Conclusion:The medical equipment maintenance risk model based on system dynamics strictly manages the procurement demand side,implements price limit and price review management,and can effectively eliminate the corruption risk and schedule risk derived from price risk by optimizing the procurement method,building the negotiation price limit model and improving the price review and pricing mechanism.

Objective To investigate the impacts of tanshinone ⅡA(Tan ⅡA)on lipopolysaccharide(LPS)induced proliferation and apoptosis of dental pulp stem cells by regulating the fatty acid synthase(Fas)/fatty acid synthase ligand(FasL)signaling pathway.Methods Identification of human pulp stem cells(hDPSCs)isolated from the third molar of 18～20 years old patients requiring orthodontics.Lps-induced hDPSCs were treated with low,medium and high doses of Tan ⅡA,and then human recombinant FasL protein(rh FasL)was used to intervene the LPS-induced hDPSCs after high dose Tan ⅡA.Proliferation and apoptosis of hDPSCs,levels of tumor necrosis factor-α(TNF-α)and interleukin(IL)-6 in hDPSCs supernatant,proliferating cell nuclear antigen(PCNA),Cleaved aspartate-specific cysteine proteinase-3(Cleaved Caspase-3),Fas,FasL protein expression were detected.Results hDPSCs were successfully isolated.In a dose-dependent manner,Tan ⅡA promoted LPS-induced proliferation,inhibited apoptosis,up-regulated PCNA protein expression,and inhibited TNF-α,IL-6 level,Cleaved Caspase-3,Fas,and FasL protein expression.The effect of rh FasL on LPS-induced dental pulp stem cells was opposite to the above indexes(P<0.05).rh FasL attenuates the effect of high-dose Tan ⅡA on pro-liferation and apoptosis of LPS-induced dental pulp stem cells.Conclusion Tan ⅡA may promote LPS induced hDPSCs proliferation and inhibit apoptosis by inhibiting the Fas/FasL signaling pathway.

Background The prevalence of malnutrition in older adults is high. Early use of appropriate screening scales for malnutrition risk and early intervention can effectively improve life quality of the elderly in communities. Objective To evaluate the risk of malnutrition among the community-dwelling elderly in a district of Shanghai and explore its influencing factors. Methods From October to December 2021, a total of 960 seniors aged 65 years and above in community committees (villages) of Minhang District were selected by stratified random sampling. Trained investigators conducted one-to-one interviews with included seniors using questionnaires. The questionnaires included the Geriatric Depression Scale (GDS), the Activity of Daily Living Scale (ADL), and the malnutrition risk assessment for elderly adults. Height, weight, waist circumference, and calf circumference were measured. Chi-square test and logistic regression were used to analyze potential influencing factors of malnutrition in the elderly. Results Among the 960 community-dwelling seniors of Minhang District, 13 (1.35%) were malnourished and 311 (32.40%) were at the risk of malnutrition. There were statistically significant differences in nutritional status across different categories of age, sex, monthly family income, education level, marital status, waist circumference, dental health status, activity of daily living, nutrition knowledge, suffering from chronic diseases, having > 3 chronic diseases, taking > 3 long-term prescriptions, depression symptoms, sleeping duration, daily outdoor activity time, number of daily food species (milk/soy products/fish/meat/poultry/eggs), daily intake of vegetables and fruits, daily consumption of cooking oil, frequency of physical exercise, frequency of smoking, and living alone (P < 0.05). The logistic regression analysis results showed that poor dental conditions, insufficient daily intake of milk/soy products/fish/meat/poultry/eggs (<3 kinds), insufficient daily intake of vegetables and fruits (<500 g), excessive daily consumption of cooking oil (>25 g), insufficient daily outdoor activities (<1 h·d⁻¹), living alone, low educational level (primary school and below), suffering from chronic diseases, having > 3 chronic diseases, taking > 3 long-term prescriptions, and being single/widowed/divorced were the main risk factors for nutritional abnormalities in the elderly (P< 0.05). Conclusion The elderly in Minhang District of Shanghai have a high malnutrition risk, and their nutritional status is affected by multiple factors, including poor dental status, irrational dietary structure, insufficient time for outdoor activities, suffering from chronic diseases, having > 3 chronic diseases, taking > 3 long-term prescriptions, low educational level, living alone, and being single/widowed/divorced.

Objective:To study the respiratory morbidity and the risk factors of respiratory complications in late-preterm infants.Methods:The data of 959 late-preterm infants in 21 hospitals in Beijing from October 2015 to April 2016 were collected.These infants were divided into the respiratory morbidity group (237 cases) and the control group (722 cases) according to whether they had short-term respiratory morbidity after birth.Clinical data of the two groups were compared.Results:Among the 959 late-preterm babies, 530 were male and 429 were female.Two hundred and thirty-seven cases (24.7%) developed short-term respiratory morbidity after birth.Infectious pneumonia developed in the most cases (81 cases, 8.4%), followed by transient tachypnea (65 cases, 6.8%), amniotic fluid aspiration (51 cases, 5.3%), and respiratory distress syndrome (24 cases, 2.5%) successively.All the infants recovered and discharged.There were no differences between gender and maternal age between 2 groups (all P>0.05). Compared with the control group, more late-preterm infants were delivered by cesarean section (73.4% vs.59.7%, χ2=14.43, P<0.001) and the 1-minute Apgar score was lower [(9.41±1.66) scores vs.(9.83±0.53) scores, t=5.40, P<0.001] in the respiratory morbidity group.The differences were statistically significant.There were more cases with maternal complications in the respiratory morbidity group that in the control group (66.7% vs.58.6%, χ2=4.877, P=0.027), but no difference in various complications between 2 groups was observed ( P>0.05). In the respiratory morbidity group, the most frequent complications were maternal hypertension and preeclampsia (27.8% vs.22.6%, χ2=2.728, P=0.099). There were no differences between 2 groups in gestational age, birth weight and birth length (all P>0.05). There were more infants small for gestational age and large for gestational age in the respiratory morbidity group than in the control group (18.8% vs.14.1%, 6.3% vs.2.4%, χ2=8.960, P=0.011). The duration of hospitalization of the respiratory morbidity group was significantly longer than that of the control group [(9.00±4.42) d vs.(6.82±4.19) d, t=6.676, P<0.001] since the infants with respiratory morbidity needed to be hospita-lized. Conclusions:Respiratory diseases occur in about 1/4 of late-preterm infants.Infants who are delivered by cesarean section and whose mothers are complicated with the maternal hypertension and preeclampsia should be monitored closely.Respiratory support should be provided for infants not appropriate for gestational age who are more likely to suffer from respiratory diseases, so that they can successfully pass through the transition period.

In this article,the content of radiation physics in the ICRU report No.89 were interpreted in details,aiming to provide reference in the radiation physics for radiologists performing brachytherapy for cervical cancer patients.

Objective To investigate the risk factors of hyperbilirubinemia in late preterm infants. Methods The clinical data of 815 late preterm infants (449 males and 366 females) from 25 hospitals in Beijing were collected from October 2015 to April 2016, including 340 cases(41.7％) with hyperbilirubinemia (hyperbilirubinemia group), and 475 cases without hyperbilirubinemia (control group). The clinical data of two groups were compared, and the maternal factors influencing hyperbilirubinemia in late preterm infants were analyzed with logistic regression. Results There were no significant differences in gender ratio (M:F 1.39 vs. 1.12, t=1.811,P=0.172)and birth weight[(2502.6±439.6)g vs. (2470.2±402.9)g,χ2=2.330,P=0.127)]between two groups. The incidence rates of hyperbilirubinemia in infants of 34 wks, 35 wks and 36 wks of gestational age were 22.9％(87/174), 35％(119/300) and 42.1％(143/341) respectively (χ2=1.218,P=0.544). The multivariate logistic regression analysis indicated that the maternal age(OR=1.044,95％ CI:1.010-1.080,P=0.011)was independent risk factor and multiple births(OR=1.365,95％CI:0.989-1.883,P=0.048), premature rupture of membranes(OR=2.350,95％ CI:1.440-3.833,P=0.001), cesarean section(OR=1.540,95％CI:0.588-4.031,P=0.014)were risk factors for hyperbilirubinemia in late preterm infants. Conclusions The incidence of hyperbilirubinemia in late preterm infants is relatively high. Maternal age, multiple births, premature rupture of membranes and cesarean section are risk maternal factors related to hyperbilirubinemia in late preterm infants.

Objective To evaluate the efficacy of Ganoderma lucidum preparation on the behaviors,biochemistry,and autoimmunity parameters of mouse models of APP/PS-1 double transgenic Alzheimer's disease(AD).Methods A total of 44 4-month-old APP/PS-1 double transgenic AD mice were randomly divided into AD model group,Aricept group,Ganoderma lucidum middle-dose(LZ-M)group,and Ganoderma lucidum high-dose(LZ-H)group,with 11 mice in each group.In addition,10 4-month-old C57BL/6 mice were used as the control group.Water maze test was conducted to observe the behavior changes,and the protein expressions in brain tissues were detected by Western blot analysis.The autoimmune indicators were detected by indirect immunofluorescence method.Results In the navigation experiment,the time of finding the platform was gradually shortened since the 2day in the control,LZ-H,and LZ-M groups,and the time of searching the platform in the AD model group gradually increased.On the 5day,the time of finding platform was significantly shorter in control group (t=5.607,P=0.000) and LZ-H group(t=2.750,P=0.010)than AD model group.In the space exploration experiment,the number of crossing the target platform(t=2.452,P=0.025)and the residence time in the target quadrant(t=2.530,P=0.020)in AD model group mice was significantly smaller/shorter than those in control group;in addition,the number of crossing the target platform in the AD model group was significantly smaller than that in LZ-H group(t=2.317,P=0.030)and LZ-M group(t=2.443,P=0.030),while the residence time in target quadrant decreased significantly(t=2.770,P=0.020)compared with LZ-H group;the number of crossing through the target platform quadrant(t=2.493,P=0.022)and residence time in the target quadrant(t=2.683,P=0.015)in LZ-H group were significantly higher than in Aricept group.Western blot analysis showed that the expression of ApoA1 in the brain tissues of mice in LZ-H and LZ-M groups were significantly higher than those in AD model group(P<0.01,P<0.05);Aβ-40 expression in LZ-H group was significantly lower than that in AD model group(P<0.05);the expressions of Syt1,ApoE,and ABCA1 in brain tissues of mice in LZ-H group were significantly higher than those in model group(P<0.01,P<0.05).The plasma IgG level in Aricept group(t=30.945,P=0.000),LZ-M group(t=25.639,P=0.000)and LZ-H group(t=4.689,P=0.001)were significantly higher than that in the control group.Conclusion Ganoderma lucidum preparation can improve behavior disorders of AD model mice,promote the expressions of ApoA1,ApoE and Syt1,inhibit the expression of Aβ-40 protein,and improve the autoimmune function.