Objective: To explore the effect of replacing rice bowls with trays on controlling the salt intake among school aged children, providing new evidence and insights for salt reduction intervention. Methods: From April to May 2024, 373 students from grades 4-9 at a boarding school in Guizhou Province were enrolled through stratified random cluster sampling, with one intervention class and one control class per grade. During the intervention period for one month, and the types of meals provided, pricing standards, and dining procedures shall remain consistent with daily operations, the intervention group ( n =181) compartmentalized trays for lunch and dinner, while the control group ( n =192) still used a rice bowl. Pre and post intervention assessments included 24 hour urine collection, questionnaire surveys, and physical measurements. The difference in differences analysis combined with multiple linear regression was used to analyze the changes in sodium intake and to evaluate the net effect of the intervention. Results: The post intervention 24 hour sodium intake in the intervention group was ( 2 222.6 ±1 013.6) mg, an increase of 94.6 mg from baseline, with no statistically significant difference ( t=1.10, P >0.05). In contrast, the post intervention 24 hour sodium intake in the control group was (2 080.5±895.7) mg, a decrease of 190.8 mg from baseline, showing a statistically significant difference ( t=-2.39, P <0.05). The difference in differences results indicated that after adjusting the model for factors such as gender, grade and dietary behaviors affecting sodium intake, the intervention group showed a net increase of 232.5 mg [ β(95%CI )=232.5(-40.3-505.2)] in 24 hour sodium intake compared to the control group, with no statistically significant net effect ( P >0.05). Conclusions Merely changing tableware is insufficient to control children s salt intake effectively. Based on continuous practical explorations and evidence based research grounded in the nudge theory, multi dimensional measures such as salt reduction education and the construction of a supportive environment should be integrated to form an intervention system that achieves synergistic and enhanced effects.

ObjectiveTo analyze the epidemiological distribution and temporal trends of liver cancer incidence among Luzhou residents from 2016‒2022， and to provide a theoretical basis for improving liver cancer prevention and treatment strategies in Luzhou. MethodsData on liver cancer incidence among Luzhou residents from 2016 to 2022 were collected， and the incidence rate， age-specific incidence rate， and annual percentage change （APC） were calculated. A Joinpoint regression model was used to fit a time series segment to the monthly number of new cases in each district and county of Luzhou to explore the trend of liver cancer incidence rate. ResultsThe incidence rate of liver cancer in Luzhou increased from 22.96/10⁵ in 2016 to 32.31/10⁵ in 2022. The incidence rate of liver cancer in men was higher than that in women in both 2016 and 2022， and the incidence rate of liver cancer in men increased from 34.83/10⁵ in 2016 to 47.95/10⁵ in 2022， with an APC of 3.3%； the incidence rate of liver cancer in women increased from 10.50/10⁵ in 2016 to 15.95/10⁵ in 2022， with an APC of 3.0%， and the differences in the change trends were not statistically significant （P>0.05）.The incidence of liver cancer was low in the age group of 0‒<40 years from 2016 to 2022 and increased with age； the incidence of liver cancer in the age group of 55 years and above was increasing at an average annual rate of 16.4%. ConclusionThe overall incidence of liver cancer in Luzhou is on the rise， and the incidence of liver cancer in men is higher than that in women. Middle-aged and elderly men are the key population for liver cancer prevention and treatment， and liver cancer prevention and treatment should be carried out in a targeted manner， taking into account regional development differences.

Objective Build an evidence-based big data governance platform centered around intelligent Traditional Chi-nese Medicine(TCM),incorporating TCM characteristics,to promote the development of intelligent TCM healthcare,and en-hance the efficiency of medical research and practical applications..Methods We integrate hospital TCM diagnosis and treat-ment process data and other kinds of clinical data..And we employ artificial intelligence and big data technologies to effectively clean and standardize the data,among other data governance and data preparation tasks,in order to build a Chinese Medicine Clinical Data Center System.Results The platform has achieved the collection and governance of millions of real medical re-cords,providing strong support for health management and clinical research in TCM,particularly promoting research in TCM's syndrome differentiation and treatment,prescription research,and drug reactions.Conclusion By constructing a big data gov-ernance platform based on Traditional Chinese Medicine(TCM),we have achieved value-added effective management and utili-zation of TCM data,particularly enhancing the precision of TCM diagnosis and treatment and the speed of research output,thus driving the modernization process of TCM.

Background Excessive intake of sugar-sweetened beverages (SSBs) is harmful to health. In recent decades, the consumption of SSBs by Chinese residents has increased rapidly, increasing the risk of death and burden of disease. Objective To analyze the knowledge level and influencing factors of SSBs for Chinese residents aged 18-64 years in 2021. Methods A multi-stage cluster random sampling approach was used to conduct a questionnaire survey among residents aged 18-64 years in 302 survey sites across the country in 2021, and 98567 valid questionnaires were obtained. Four questions are about SSBs among the questionnaire's 5 dimensions. Respondents who answered 3 or more questions correctly were considered to have a basic understanding of SSBs. Frequency and weighted proportion were used for description. With individual as level 1 and resident council (village council) as level 2, a two-level logistic regression model was applied to examine the influencing factors. A null model was used to determine whether the two-level logistic regression model was appropriate. Results The knowledge awareness rate of SSBs was 57.0% among the Chinese residents aged 18-64 years in 2021. The knowledge point with the lowest correct rate was "It is best to consume no more than 25 grams of added sugar per day" (22.6%), while the one with the highest correct rate was "Excessive intake of SSBs can increase the risk of obesity and diabetes" (81.1%). The results of the null model showed that SSBs knowledge level had a clustering effect at resident council (village council) level (t=25.00, P<0.0001), so a two-level model fit better than a one-level model. The results of the two-level logistic model revealed that residents who were female (OR=1.14, 95%CI: 1.11, 1.18) or working in medical and health (OR=1.36, 95%CI: 1.27, 1.45) and education institutions (OR=1.16, 95%CI: 1.07, 1.24) had a higher knowledge level compared to males or residents of other occupations. The knowledge level was lower among residents in central (OR=0.87, 95%CI: 0.77, 0.97) and western (OR=0.85, 95%CI: 0.75, 0.94) areas than in eastern areas. Those with chronic diseases (OR=0.81, 95%CI: 0.78, 0.84) and who did not know if they had a chronic disease (OR=0.75, 95%CI: 0.72, 0.78) had a lower knowledge level than those without chronic diseases. Compared with 18-24 years, the knowledge level was higher in ages 35-44 years (OR=1.07, 95%CI: 1.02, 1.12) and lower in ages 55-64 years (OR=0.92, 95%CI: 0.86, 0.97), and not different from the ages 25-34 years and 45-54 years. The knowledge level increased with the level of education, the trend was statistically significant (P＜0.001). Conclusion Only about half of Chinese adults aged 18-64 years had a basic understanding of SSBs in 2021. The awareness rate of added sugar intake was low in particular. The knowledge levels of male, central and western, or less educated populations were even lower. Awareness of the negative health outcomes of SSBs was high among the population.

Objective To investigate the effect of cardiac function and renal function on early neurological function recovery of acute stroke patients.Methods Hospitalized acute stroke patients from January 2010 to May 2018 were recruited in the Department of Neurology,Peking University First Hospital,who were divided into two groups according to the modified Rankin Scale (mRS) score at discharge,good recovery (mRS score ≤2) and poor recovery (mRS score ＞2).The clinical characteristics,laboratory and echocardiography data were collected respectively.All cases were classified according to Trial of Org 10 172 in Acute Stroke Treatment (TOAST) criteria.Estimated glomerular filtration rate (eGFR) was calculated by chronic kidney disease epidemiology collaboration equation in renal function assessment,and cardiac function was calculated by left ventricular ejection fraction (LVFF) and E-wave/A-wave ratio (E/A).Multivariate Logistic regression analysis and stratified analysis were performed to explore the effects of cardiac and renal function and interactions on stroke patients.Results A total of 517 patients with acute stroke were enrolled in this study,23.4％ (121/517) of which presented with chronic kidney disease.Poor recovery was aggravated with the progression of eGFR stage in patients with acute stroke (x2=14.627,P=0.001).Compared with the good recovery group,LVEF and E/A were significantly lower in the poor recovery group,while left atrium diameter ((3.87±0.52) cm vs (3.77±0.49) cm,t=-2.139,P=0.033),interventricular septum thickness ((1.10±0.19) cm vs (1.04±0.16) cm,t=-4.056,P=0.000),left ventricular posterior wall thickness ((1.00±0.13) cm vs (0.98±0.13) cm,t=-2.190,P=0.029) and left ventricular mass index ((102.03±25.73) g/m2 vs (94.94±23.63) g/m2,t=-3.145,P=0.002) were significantly higher in the poor recovery group.Stratified analysis showed that the rate of poor recovery increased with the decrease of eGFR at different levels of LVEF and E/A.Compared with patients of normal renal function and mild impairment of renal function or with patients of high third tertile of LVEF,chronic kidney disease significantly increased the rate of poor recovery in patients with low third tertile of LVEF,while the rate of poor recovery was not significantly different in patients with chronic kidney disease among third tertile of E/A.The levels of eGFR and LVEF in different stroke subtypes were significantly different (F=7.433,P=0.000;F=2.617,P=0.034).The eGFR and LVEF levels of the cardioembolism (CE) group were the lowest compared with other subtypes of stroke.The eGFR levels in the CE group were significantly lower than that in other subtypes except the large artery atherosclerosis group,and the LVEF level was significantly lower in the CE group compared to the small artery occlusion group.Multivariate Logistic regression analysis revealed that eGFR (OR=0.866,95％CI 0.760-0.987,P=0.031),LVEF (OR=0.798,95％CI 0.688-0.925,P=0.003),E/A (OR=0.136,95％CI 0.034-0.548,P=0.005) and eGFR by LVEF (OR=1.002,95％CI 1.000-1.004,P=0.022) were significantly associated with early functional outcome in patients with acute stroke after adjusting for relevant clinical confounders (all P＜0.05).Conclusions Renal function,cardiac systolic and diastolic function were associated with the early functional recovery in patients with acute stroke.Moreover,cardiac systolic dysfunction and renal dysfunction interacted significantly with the early neurological function recovery in patients with acute stroke.

Objective To evaluate the disinfect effects of glutaraldehyde, ortho-phthalaldehyde ( OPA ) and peracetic acid on gastroscopy disinfection. Methods Relevant literature from PubMed, Cochrane Library, web of science, Embase, CNKI, CBM, VIP were retrieved to collect the randomized controlled trials on disinfection by glutaraldehyde, OPA and peracetic acid on gastroscope. Literature was selected according to the inclusion and exclusion criteria. The RevMan 5. 3. 4. 0 statistic software was used to extract data and a meta-analysis was performed. Results A total of 18 RCT were included. There were significant differences in the disinfect effects between the OPA group and the glutaraldehyde group ( OR=2. 02, 95％CI:1. 88-1. 27, P<0. 00001), and between the peracetic acid group and the glutaraldehyde group ( OR = 2. 79, 95％CI:1. 52-5. 11, P = 0. 0009 ) . There were no significant differences in the disinfection effect between the OPA group and peracetic acid group ( OR=1. 30,95％CI:0. 62-2. 73, P=0. 49) . Conclusion The disinfect effects of OPA and peracetic acid are similar, which are superior to glutaraldehyde. Compared with OPA and glutaraldehyde, peracetic acid is a better choice considering its good disinfect effect and low cost.

Objective: To explore the lipid-lowering effect and potential mechanism of the couplet medicines of Flastem Milkvetch Seed and Tribulus terrestris on hyperlipidemia rats. Methods: Forty-eight Sprague-Dawley rats were randomly divided into 6 groups, normal control group, high-fat model group, simvastatin group, Tribulus terrestris group, Flastem Milkvetch Seed group, and couplet medicines of Flastem Milkvetch Seed and Tribulus terrestris group, with 8 rats in each group. The normal control group was fed with basal diet, and the other groups were fed with high-fat diet to establish a hyperlipidemia rat model. At the same time, different group rats were treated with different drug respectively. 6 weeks later, the body weight and visceral index of the rats were measured. Levels of serum cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were detected by automatic biochemical analyzer. The mRNA and protein expression of HMG coenzyme A reductase (HMGCR), cholesterol 7-alpha hydroxy-lase (CYP7A1) and low density lipoprotein receptor (LDL-R) were detected by RT-PCR and western blot. Results: Compared with model group, the serum levels of TC, TG, and LDL-C were significantly decreased in all Chinese medicine groups, and the serum level of HDL-C was significantly increased in Flastem Milkvetch Seed group and couplet medicines of Flastem Milkvetch Seed and Tribulus terrestris group. Moreover, the mRNA and protein expression of HMGCR, CYP7A1, and LDL-R in rat liver also significantly increased in all Chinese medicine treatment groups. And couplet medicines of Flastem Milkvetch Seed and Tribulus terrestris group shows more significantly effect. Conclusion: Couplet medicines of Flastem Milkvetch Seed and Tribulus terrestris significantly regulate the serum lipid levels on hyperlipidemia rat model, and its mechanism may be related to the regulating expressions of HMGCR, CYP7A1, LDL-R gene.

Objective To probe to the status of clinical practice experience among student nurse about rotation training. Methods A qualitative phenomenological methodology was used in the study and semi-structured in-depth interviews were conducted among 20 students. The data were transcribed, collated, summarized and analyzed by content analysis. Results Through careful analysis and distillation, five themes were identified including clinical teaching affected the aspiration of nursing students to nursing work, medical and nursing level affected nursing students career planning, nursing labor intensity impacted on nursing students practice motivation, life details influenced nursing students internship experience, and male students suffered discrimination because of gender. Conclusions During clinical teaching of nursing students, we should strengthen the head nurse′s role and teaching faculty training, arrange the internship rotation plan reasonably, create a good learning atmosphere, provide care and support for male nursing students.

Objective To study the influence of hierarchical model on the professional attitude and quality improvement of nurses and supply references for the apphcation of hierarchical model.Methods 310 nurses were divided into the control group(158 cases)and the practice group(152 cgses).The practice group adopted hierarchical model while the control group did not.Investigation was carried out in 15 aspects such as training requirement,choosing of nursing posts and departure intention,etc.Results The nursing teaching pest and nursing management post in the aspect of post requirement between the two groups had no statistical difference(P＞0.05),but statistical difference existed in other items(P＜0.05).In the aspect of training requirement evident difference existed in two groups(P＜0.05).Conclusion Application of hierarchical model proved to be a pivotal method to improve the professional passion and loyalty of nurses.

Objective To discuss the variance of working expectation values and actual satisfaction degree in nursing college graduates from various aspects and evaluate their actual career mentality.Methods We investigated the working expectation values and actual satisfaction degree in nursing college graduates who graduated from Chengde medical college in 2004 and 2005.Results The working expectation values and actual satisfaction degree had statistical difference in 5 aspects(P<0.05).We subsequently compared the expectation values between each two groups and drew out the conclusion that these nursing graduates had great requirement of being understood and respected.Conclusion The nursing graduates had higher working expectation values and lower satisfaction degree.They paid more attention to be understood and respected and were in great need of emotional support and mental satisfaction.Hospital administrators should help them accurately orient theirselves,establish career development plan,attach importanee to their mental requirement and adopt effective measures to improve their satisfaction degree and promote the healthy growth of nursing college graduates.