AIM:To investigate the effects of Balanophora involucrata Hook.f.(BIH)extracts on bile acid metabolism and liver injury in mice with metabolic dysfunction-associated fatty liver disease(MAFLD)through the gut mi-crobiota-farnesoid X receptor(FXR)axis,and to explore the underlying mechanisms.METHODS:Forty C57BL mice were randomly divided into control group,MAFLD model group,medium-dose BIH group,and high-dose BIH group.The mice in control group received a regular diet,while those in other groups were fed with high-fat diet for 12 weeks to induce MAFLD.The mice in medium-and high-dose BIH groups received 0.598 and 0.299 g/kg BIH solution,respectively,while those in control and MAFLD groups received an equivalent volume of normal saline.Serum levels of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)were measured using an automatic biochemical analyzer.Liver morphology,steatosis and fibrosis were assessed by HE,oil red O and Masson staining.Levels of TC,tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in liver tissues,and bile acids in serum and ileum tissues were measured by ELISA.Protein expression of FXR and fibroblast growth factor 15(FGF15)in ileum tissues,and FXR,small heterodimer partner(SHP)and cholesterol 7α-hydroxylase(CYP7A1)in liver tissues were analyzed by Western blot.Intestinal microbiota changes were assessed by 16S rRNA gene sequencing.RESULTS:(1)The MAFLD mice exhibited increased serum TC,TG,LDL-C and bile acid levels,liver TC,TNF-α and IL-6 levels,and lipid deposition.However,BIH intervention improved these factors and increased FXR and SHP pro-teins,but decreased CYP7A1 expression in the liver.The protein levels FXR and FGF15 in the ileum were also elevated.(2)Intestinal flora analysis demonstrated that BIH intervention improved the abundance and diversity of intestinal flora in MAFLD mice.Specifically,there was an increase in Bacteroidetes/Firmicutes ratio and a decrease in Proteobacteria and Verrucomicrobia.At the genus level,abundance of Duncaniella,Muribaculum and Paramuribaculum increased,while He-licobacter decreased.CONCLUSION:Treatment with BIH regulates intestinal flora,decreases FXR levels,enhances CYP7A1 expression,promotes bile acid synthesis,reduces hepatic cholesterol accumulation,and attenuates liver steato-sis and inflammation in MAFLD mice,indicating potential therapeutic effects.

ObjectiveTo understand the experience， knowledge and attitudes of e-cigarette users in Shanghai， and to provide evidence for the development of intervention programs for e-cigarette use. MethodsThe Respondent-Driven Sampling （RDS） method was used to recruit 40 e-cigarette users for qualitative interviews from November 2020 to February 2021. NVivo （11.0） software was used to code interview records， and the thematic pattern and relationship analysis were conducted. ResultsIn terms of the reasons and user experience of e-cigarette use， most respondents used e-cigarettes for the first time after recommendation of friends； The reasons for the current use of e-cigarettes focus on the subjective feelings generated by the use of e-cigarettes （easy to use， replacing traditional tobacco， and having many flavors）. Compared with traditional tobacco use， respondents said e-cigarettes tasted good and had no physical impact （they could be used all the time without making them uncomfortable）. In terms of the awareness of e-cigarette use related knowledge， the respondents' opinions on whether e-cigarettes caused health risks were mostly based on their own experience of using them， and they said it was difficult to identify real information online. As for whether they were interested in relevant knowledge， most respondents said they wanted to learn about the professional knowledge related to e-cigarettes. Regarding the attitude related to the use of e-cigarettes， most respondents believed that e-cigarettes are addictive， e-cigarettes are not a safe alternative to traditional tobacco， ande-cigarettes couldn't help them quit smoking. Three out of ten respondents said they supported including e-cigarettes in the Regulation on Smoking Control in Public. ConclusionThere are certain characteristics of e-cigarette users' feelings， related knowledge and attitude towards e-cigarette use that should be targeted to carry out publicity， education and intervention.

Objective: To investigate the intake of liquid dairy products and identify its influencing factors among the fourth grade students in Nanjing City. Methods: The fourth grade students were selected as the study subjects in Nanjing City using a multi-stage random cluster sampling method in September 2020. Their general information, frequency of liquid dairy product intake one week prior to survey and mean intake amount per time were collected. According to the 2016 Dietary Guidelines for Chinese Residents, weekly intake of liquid dairy products of 2 100 g and greater was defined eligible. Factors affecting the frequency and amount of liquid dairy product intake were identified using multivariable logistic regression analysis. Results: A total of 2 268 questionnaires were allocated and 2 216 valid questionnaires were recovered, with an effective recovery rate of 97.71%. The respondents included 1 199 boys ( 54.11% ) and 1 017 girls ( 45.89% ). The frequency of liquid dairy product intake was (6.41±4.86) times per week, and the median intake amount was 1 250.00 g per week (interquartile range, 1 750.00 g per week). There were 607 students ( 27.39% ) consuming liquid dairy products of 2 100 g and greater a week, and 1 016 students ( 45.85% ) consumed liquid dairy products for 7 times and more a week. Multivariable logistic regression analysis showed that living in urban areas ( OR=1.204, 95%CI: 1.005-1.443 ), knowing nutrition labels ( OR=1.221, 95%CI: 1.021-1.460 ), periodical measurement of body weight (OR=1.486, 95%CI: 1.098-2.011) and restricted intake of sugar-containing drinks ( OR=1.264, 95%CI: 1.005-1.590 ) facilitated the intake of liquid dairy products for 7 times and more a week, and students with periodical measurement of body weight were more likely to consume liquid dairy products for 2 100 g and greater a week ( OR=1.821, 95%CI: 1.240-2.676 ). Conclusions Inadequate intake of liquid dairy products is found among the fourth grade students in Nanjing City. Residence, awareness of nutrition labels, periodical measurement of body weight, and parental restriction of sugar-containing drink intake affect the intake of liquid dairy products.

Objective:To evaluate the effect of oral iodized oil pills on iodine nutrition and thyroid function of pregnant women in Xinjiang Uygur Autonomous Region (Xinjiang).Methods:From May to July 2017, one county was selected from Ili Prefecture without taking iodized oil pills, Aksu Prefecture taking iodized oil pills once a year, and Kashgar Prefecture taking iodized oil pills twice a year in Xinjiang as survey sites, respectively; 100 pregnant women (evenly distributed in early, middle and late pregnancy) were selected from each survey county, the general data, urine and blood samples were collected, and urinary iodine and thyroid function indicators [free triiodothyronine (FT 3), free thyroxine (FT 4), thyrotropin (TSH), anti thyroglobulin antibody (TgAb), and anti thyroid peroxidase antibody (TPOAb)] were tested. Results:A total of 308 pregnant women were investigated, and 289 were finally included in the analysis, with an average age of 25 years; the body mass index (BMI) was (22.69 ± 3.07) kg/m 2. The occupation distribution was mainly farmer, accounting for 93.77% (271/289); most of them had junior high school education or below, accounting for 71.97% (208/289). The median urinary iodine of early, middle and late pregnant women in Kashgar Prefecture was 712.87, 604.50 and 656.23 μg/L, respectively, which were in iodine excess state. The iodine nutrition level of early pregnant women in Ili Prefecture and Aksu Prefecture was in iodine super suitability state, and the iodine nutrition level of middle and late pregnant women was in the iodine suitability state. The difference of median urinary iodine in early, middle and late pregnancy women between different regions was statistically significant ( Z = 53.02, 49.60, 44.66, P < 0.001). In addition, the urinary iodine of women in Kashgar Prefecture during each pregnancy period was significantly higher than that in Ili Prefecture and Aksu Prefecture ( P < 0.05). There were statistically significant differences in the levels of FT 3 among women in early pregnancy, FT 4 and TSH among women in middle pregnancy between different regions ( F = 4.59, 10.92, Z = 8.61, P < 0.05 or < 0.001). Among them, the level of FT 3 in early pregnancy in Kashgar Prefecture was lower than that in Ili Prefecture ( P < 0.05); the level of FT 4 in Kashgar Prefecture during middle pregnancy was higher than that in Ili Prefecture, and the level of TSH was lower than that in Ili Prefecture ( P < 0.05). There was no significant difference in TgAb positive rate, TPOAb positive rate and double antibody positive rate of early, middle and late pregnant women between different regions ( P > 0.05). The detection rates of hypothyroxinemia in early pregnant women in Ili Prefecture, Aksu Prefecture and Kashgar Prefecture were 13.9% (5/36), 3.2% (1/31) and 0 (0/33), respectively, and there was a statistically significant difference between different regions ( P = 0.036). The detection rates of subclinical hyperthyroidism in middle pregnant women were 0 (0/35), 0 (0/40), 17.6% (6/34), respectively, and there was a statistically significant difference between different regions ( P = 0.001). Conclusions:The results of urinary iodine in the three regions are in line with the iodine nutrition distribution under their respective iodine supplement strategies. Pregnant women in Kashgar Prefecture present iodine excess status after taking iodized oil pills; at the same time, the serum FT 3, FT 4 and TSH levels of pregnant women in Kashgar Prefecture are affected by iodine nutrition levels. Although it is scientific and effective to implement the intensified iodine supplement measures for pregnant women, it is still necessary to further study the suitability of oral iodine oil pills to ensure that pregnant women are at an suitability iodine nutrition level.

Objective:To investigate the influencing factors of thyroid volume in school-age children aged 8 - 10 years in Xinjiang Uygur Autonomous Region (Xinjiang for short).Methods:In 2020, counties (cities, districts) were taken as the units in the whole region of Xinjiang. Each county (city, district) was divided into 5 sampling areas according to the orientation of east, west, south, north, and middle, one township/street was selected from each area, and one primary school was selected from each township/street, 40 non-boarding children aged 8 - 10 years were selected from each primary school as the investigation subjects. Height and weight of children were measured, and body mass index (BMI) and body surface area were calculated; 24 h mixed urine samples of children and household edible salt samples were collected to detect the contents of urinary iodine and salt iodine; thyroid volume of children was measured by B-ultrasonography. Pearson correlation analysis was used to analyze the correlation between thyroid volume and age, height, weight, body surface area, BMI, urinary iodine content, and salt iodine content. Univariate and multiple linear regression analyses were used to evaluate the correlation variables affecting thyroid volume.Results:A total of 18 334 children aged 8 - 10 years were investigated. The median urinary iodine was 237.88 μg/L. There were 132 children with goiter, and the rate of goiter was 0.72%. Of these, 9 249 (50.45%) were girls and 9 085 (49.55%) were boys. Girls' thyroid volume was positively correlated with age, height, weight, body surface area, BMI, urinary iodine content, and salt iodine content ( r = 0.125, 0.135, 0.167, 0.167, 0.154, 0.031, 0.019, P < 0.05); boys' thyroid volume was positively correlated with age, height, weight, body surface area, and BMI ( r = 0.132, 0.326, 0.156, 0.149, 0.146, P < 0.05), and there was no correlation with urinary iodine content and salt iodine content ( r = 0.019, 0.017, P > 0.05). Univariate linear regression analysis showed that age, height, weight, BMI, body surface area and urinary iodine content were the influencing factors of thyroid volume ( t = 14.92, 12.54, 20.98, 17.98, 20.25, 4.28, P < 0.01). Further multiple linear regression analysis showed that age, BMI, body surface area and urinary iodine content had significant independent effects on thyroid volume ( t = 9.61, 8.57, 7.76, 4.89, P < 0.01), the coefficient of determination ( R2) of the model was 0.278 2. According to the regression coefficient (β), the body surface area (β = 0.522 6) had the greatest influence on thyroid volume. Conclusions:The iodine nutrition of children aged 8 - 10 years in Xinjiang is sufficient. Thyroid volume is affected by age, BMI, body surface area and urinary iodine content.

Objective:To estimate the iodine nutrition level of pregnant women and children in Xinjiang.Methods:Using cluster random sampling method, from March to September in 2018, in the whole district, county (city, district) was treated as a unit to conduct sampling; each county (city, district) was divided into five areas (east, west, south, north, middle), 40 children aged 8 - 10 and 20 pregnant women in each area were randomly selected, salt samples and urine samples were collected to measure iodine content, and B-ultrasound method was used to detect thyroid volume in children.Results:Among 94 counties (cities, districts), 18 859 salt samples were collected from children and 9 070 salt samples from pregnant women. The median salt iodine (interquartile range) for children was 26.65 (23.70, 29.80) mg/kg, and the median salt iodine (interquartile range) for pregnant women was 26.60 (23.80, 29.80) mg/kg. Totally 17 736 qualified iodized salt samples and 109 non-iodized salt samples consumed by children were tested, the coverage rate of iodized salt was 99.42% (18 750/18 859), qualified rate of iodized salt was 94.59% (17 736/18 750), the consumption rate of qualified iodized salt was 94.05% (17 736/18 859), and the non-iodized salt rate was 0.58% (109/18 859). Totally 8 533 qualified iodized salt samples and 57 non-iodized salt samples consumed by pregnant women were tested, the coverage rate of iodized salt was 99.37% (9 013/9 070), the qualified rate of iodized salt was 94.67% (8 533/9 013), the consumption rate of qualified iodized salt was 94.08% (8 533/9 070), and the non-iodized salt rate was 0.63% (57/9 070). Twelve counties (cities, districts) had a consumption rate of qualified iodized salt lower than 90% for children, and 14 counties (cities, districts) had a consumption rate of qualified iodized salt lower than 90% for pregnant women. Totally 18 862 8 - 10 years old children's urine samples were detected, median urinary iodine was 227.0 μg/L, no county (city, district) was found with median urinary iodine < 100 μg/L. A total of 9 070 pregnant women's urine samples were detected, median urinary iodine was 182.0 μg/L, and 23 counties (cities, districts) had a median urinary iodine less than 150 μg/L. B ultrasound was used to detect thyroid volume in 18 787 children aged 8 - 10 years, 231 children had goiter, and the goiter rate was 1.23%, ranged from 0 to 12.05%, and 2 counties (cities, districts) had goiter rate > 5%.Conclusions:There are still some areas in Xinjiang with the consumption rate of qualified iodized salt < 90%. Children's iodine nutrition is greater than the appropriate amount (200 - 299 μg/L), pregnant women's iodine nutrition is appropriate (150 - 249 μg/L), and children's goiter rate generally meets national elimination and control standards (< 5%). Monitoring of iodized salt should be strengthened, and iodine nutrition levels in children and pregnant women should be continuously monitored.

Objective:To understand the iodine nutritional status of pregnant women in the early, middle and late pregnancy in historical iodine deficiency areas (South Xinjiang) and non historical iodine deficiency areas (North Xinjiang) in Xinjiang, so as to provide scientific basis for the prevention and control of iodine deficiency disorders in pregnant women and the formulation of appropriate prevention and control measures.Methods:From March to June 2019, using cluster yandom sampling, each county (city, district, county for short) in the whole region was divided into five sampling areas according to the east, west, south, north and middle direction. Twenty pregnant women were selected from each area, and the iodine content was determined by taking household salt samples and random urine samples.Results:A total of 9 461 salt samples were collected from pregnant women's families in 96 counties, of which 9 099 were qualified iodized salts, 22 were non iodized salts, the rate of non iodized salt was 0.23%, the coverage rate of iodized salts was 99.77% (9 439/9 461), the consumption rate of qualified iodized salts was 96.17% (9 099/9 461), and the median of salt iodine was 27.42 mg/kg. A total of 9 456 urine samples of pregnant women were tested. The median of urinary iodine was 187.30 μg/L, ranging from 0.30 to 1 300.00 μg/L. The median of urinary iodine of pregnant women in 12 counties (North Xinjiang) was < 150 μg/L. The medians of urinary iodine of pregnant women in the early, middle and late pregnancy in historical iodine deficiency areas were 215.85, 208.10 and 196.60 μg/L, respectively, while that in the non historical iodine deficiency areas were 179.10, 180.70 and 179.15 μg/L, respectively, the differences were statistically significant ( P < 0.01). There was a significant difference in the urinary iodine content of pregnant women in the early, middle and late pregnancy in historical iodine deficiency areas ( H = 8.85, P < 0.05), but there was no significant difference in the non historical iodine deficiency areas ( H = 0.28, P > 0.05). Conclusions:Some pregnant women in North Xinjiang are in iodine deficiency. The contents of urinary iodine in the early, middle and late pregnancy in historical iodine deficiency areas are higher than those in non historical iodine deficiency areas. The distribution of urinary iodine in the early, middle and late pregnancy of pregnant women in the historical iodine deficiency areas is different.

Objective: To investigate the influencing factors of smoking tendency of adolescents and to analyze the influence of e-cigarette on smoking tendency of teenagers and the possible interaction, to provide evidence for tobacco control measures. Methods: Stratified multistage cluster probability sampling method was used to select 6 178 students from junior middle school, high school and vocational high school students in Shanghai for questionnaire survey from September to October 2019. Students with smoking tendency were taken as case group, adolescents with same sex and similar age(within 1 year) were mathed in 1∶3 ratio. A total of 631 adolescents with smoking tendency and 1 870 non-smoking tendency were included in the study. Conditional Logistic regression was used to analyze the influencing factors and possible interactions. Results: After adjusting gender, age and other covariates, conditional Logistic analysis results showed that the smoking tendency of middle school students was associated with factors such as their friends smoking, trying cigarettes and trying e-cigarettes. The OR value and 95%CI were 3.26(2.47-4.29), 5.90(3.76-9.24), and 3.28(2.11-5.10), respectively. The interaction analysis results showed that the OR value and 95%CI of the multiplying interaction between friends smoking and trying e-cigarettes, trying smoking and trying e-cigarettes were 8.62(4.90-15.17) and 12.01(6.02-23.95), respectively. There was no additive interaction. Conclusion Tobacco control interventions, such as e-cigarette harm publicity and peer education, can help to change teenagers smoking tendency and further reduce their tobacco use rate.

OBJECTIVE： To systematically review the efficacy and safety of colesevelam hydrochloride combined with other hypoglycemic drugs in the treatment of T2DM， and to provide evidence-based reference for clinical treatment of T2DM. METHODS： Retrieved from PubMed， Embase， Medline， Cochrane Library， CJFD， VIP and Wanfang database during database establishement-Jul. 2019， randomized controlled trials （RCT） about the efficacy and safety of colesevelam hydrochloride combined with other hypoglycemic drugs （trial group） vs. placebo or other hypoglycemic drugs （control group） in the treatment of T2DM were collected. After extracting data from clinical studies that met the inclusion criteria， the quality of the studies was evaluated by Cochrane System Evaluator Manual 5.1.0. Meta-analysis was conducted by using Rev Man 5.3 statistical software in respects of the levels HbA1c， FPG， LDL-C， the incidence of total ADR， incidence of hypoglycemia and incidence of gastrointestinal ADR. RESULTS： A total of 11 RCTs were included， involving 2 625 patients. Results of Meta-analysis showed that HbA1c levels [MD＝－0.37， 95％CI（－0.51， －0.22），P＜0.001]， FPG level [MD＝－0.47， 95％CI（－0.88， －0.07）， P＝0.02] and LDL-C level [MD＝－0.38， 95％CI（－0.49， －0.28）， P＜0.001] in trial group were significantly lower than control group， with statistical significance. In terms of safety， the incidence of total ADR [OR＝1.24， 95％CI（1.06， 1.45）， P＝0.007] and gastrointestinal ADR [OR＝1.78，95％CI（1.05， 3.02），P＝0.03] in trial group were significantly higher than control group， with statistical significance. There was no significant difference in the incidence of hypoglycemia [OR＝1.03， 95％CI（0.62，1.72），P＝0.90]. CONCLUSIONS： Colesevelam hydrochloride combined with other hypoglycemic drugs can effectively reduce the levels of HbA1c， FPG and LDL-C in T2DM patients， but attention should be paid to the occurrence of gastrointestinal ADR.

Objective To understand the levels of water fluoride,tea fluorosis and the severity of drinking tea type of endemic fluorosis in Xinjiang from 2014 to 2016,and to provide a basis for making prevention and control measures.Methods In 2014-2016,a cross-sectional study was conducted to select six counties with serious fluorosis in Xinjiang as monitor counties,one diseased township was selected from five directions including east,south,west,north and center in each county,one village was selected in each township,and 10 families were selected to investigate the situation of brick tea drinking.Drinking water and brick tea samples were collected for detection of fluorine content,and epidemiological methods were used to analyze the prevalence of dental fluorosis and skeletal fluorosis.Results In 2014-2016,resident population per capita brick tea consumptions were 3.9-4.4 kg,per capita brick tea fluorine intakes were 4.6-6.1 mg,and the mean of tea fluorine was 433.1,385.2,432.7 mg/kg,respectively,the differences were not statistically significant (F =0.33,P ＞ 0.05);the means of water fluorine were 0.06-1.26 mg/L,and they were 0.38,0.37,0.33 mg/L,respectively,the differences were not statistically significant (F =2.64,P ＞ 0.05).The survey results showed that dental fluorosis of children aged 8-12 was 243 in three years,with a detection rate of 4.47％ (243/5 442) and the range of 0.08-0.14,which was negative.The skeletal fluorosis of adults aged 36-45 was 25 in 2015,with a detection rate of 2.75％ (25/910).Conclusions The fluorine content of some tea in drinking tea type of endemic fluorosis areas in Xinjiang is high,and the fluorine content of some water samples has exceed the standard of drinking water type disease area (1.2 mg/L).The prevalences of dental fluorosis and skeletal fluorosis are acceptable;it is recommended to maintain the previous prevention and control policies and to further monitor the tea market.