With technological advancement and the growing demand for renewable energy, research and applications of new energy materials are becoming increasingly widespread. Typical new energy materials include lithium-ion battery materials, nanomaterials, nuclear energy materials and magnetic materials, etc., each of which has special toxicological characteristics. These materials may pose potential toxicological risks in the process of resource exploitation, production, transportation, usage, recycling or disposal, which have negatively impact on human health and the ecological environment. Occupational exposure is the main route of energy materials exposure, with potential health hazards on workers during the processes of production, transportation, recycling, and disposal. Among them, the disassembled batteries in the recycling or waste disposal process requires quality control, which is the high-risk position of occupational hazards. At present, the toxicology study of typical new energy materials mainly focuses on the potential impact of lithium-ion battery materials and nanomaterials on human health and the environment, but there are still limitations and challenges. In the future, it is necessary to further strengthen the human health risk management and prevention and control of new energy materials to protect human health and sustainable development.

Objective:To investigate the clinical practicability of positive end-expiratory pressure (PEEP) titrated by lung stretch index (SI) in patients with acute respiratory distress syndrome (ARDS).Methods:A parallel randomized controlled trial was conducted. Patients with moderate to severe ARDS who required mechanical ventilation admitted to the department of critical care medicine of General Hospital of the Yangtze River Shipping from August 2022 to February 2023 were enrolled. They were randomly divide into SI guided PEEP titration group (SI group) and pressure-volume curve (P-V curve) inspiratory low inflection point (LIP) guided PEEP titration group (LIP group). All patients were ventilated in a supine position after admission, with the head of the bed raised by 30°. The primary disease was actively treated, prone position ventilation for 12 h/d, and lung protective ventilation strategies such as controlled lung expansion were used for lung recruitment. On this basis, mechanical ventilation parameters were titrated with SI in the SI group; the LIP group titrated mechanical ventilation parameters with P-V curve inspiratory LIP+2 cmH 2O (1 cmH 2O ≈ 0.098 kPa). The oxygenation index (PaO 2/FiO 2), and respiratory mechanics indicators such as lung dynamic compliance (Cdyn), peak airway pressure (Pip) were monitored before recruitment maneuver and after 1, 3, and 5 days of treatment. The therapeutic effect of the two groups was compared. Results:There were 41 patients in the SI group and 40 patients in the LIP group. There was no significant difference in general information such as gender, age, and disease type between the two groups. The mechanical ventilation time and the length of intensive care unit (ICU) stay in the SI group were significantly shorter than those in the LIP group (days: 9.47±3.36 vs. 14.68±5.52, 22.27±4.68 vs. 27.57±9.52, both P < 0.05). Although the 28-day mortality of the SI group was lower than that of the LIP group, the difference was not statistically significant [19.5% (8/41) vs. 35.0% (14/40), P > 0.05]. On the fifth day, the PaO 2/FiO 2 was higher in SI group [mmHg (1 mmHg≈0.133 kPa): 225.57±47.85 vs. 198.32±31.59, P < 0.05], the Cdyn was higher in SI group (mL/cmH 2O: 47.39±6.71 vs. 35.88±5.35, P < 0.01), the Pip was lower in SI group (mmHg: 35.85±5.77 vs. 43.87±6.68, P < 0.05). The Kaplan-Meier survival curve showed no statistically significant difference in the 28 days cumulative survival rate between the two groups (Log-Rank: χ2 = 2.348, P = 0.125). Conclusion:The application of SI titration with PEEP in the treatment of ARDS patients may improve their prognosis.

【Objective】 To understand the prevalence of overweight/obesity among school-age children in Pudong New Area of Shanghai, and to explore the influence of gestational weight gain and pre-pregnancy body mass index (BMI) on weight status of school-age children. 【Methods】 From November to December 2020,a stratified cluster sampling method was adopted to select first-grade students from 13 primary schools in Pudong New Area of Shanghai.After matching with the birth monitoring database, 755 students with complete birth information were selected as the study subjects.The relevant information of mothers before and during pregnancy was retrospectively collected, and the effects of pregnancy weight gain combined with pre-pregnancy BMI on overweight/obesity in school-age children were analyzed. 【Results】 1) The prevalence rates of overweight and obesity of first-grade children were 15.89% and 18.41%, respectively.2) Maternal excessive weight gain during pregnancy (OR=1.678) and overweight/obesity before pregnancy (OR=2.315,2.412) were risk factors for overweight/obesity of the offspring at school age(P<0.05).3) For mothers who were underweight before pregnancy, excessive weight gain during pregnancy was associated with overweight/obesity in school-age children in their offspring (OR=7.436, 95%CI: 1.489 - 37.143,P<0.05).4) Excessive weight gain during pregnancy combined with overweight/obesity before pregnancy significantly increased the risk of overweight/obesity in offspring (OR=3.606, 95%CI: 2.030 - 6.405, P<0.05). Mothers who gained a moderate amount of weight during pregnancy and were emaciated before pregnancy had a significantly lower risk of overweight/obesity in their school-age children (OR=0.217, 95%CI: 0.049 - 0.967, P<0.05). 【Conclusion】 Excessive weight gain during pregnancy increases the risk of overweight/obesity in school-age children in their offspring, strengthening pregnancy health education and perinatal care to help pregnant women maintain appropriate weight gain during pregnancy may be an important and novel strategy to prevent childhood obesity.

Objective To investigate the clinical efficacy and safety of 1 565 nm non-ablative fractional laser combined with topical minoxidil and oral finasteride in the treatment of patients with androgenetic alopecia(AGA).Methods Seventy-five male AGA patients with Norwood-Hamilton classification grade Ⅱ-Ⅲ,were randomly assigned into three groups:the control group 1,the control group 2 and the experimental group,with 25 cases in each group.Patients in the control group 1 received topical 5%minoxidil(1 mL,twice daily).Patients in the control group 2 were treated with both topical 5%minoxidil and oral finasteride(1 mg,once daily).Patients in the experimental group received a combined therapy of 1 565 nm non-ablative fractional laser in addition to topical 5%minoxidil and oral finasteride.Hair overall efficacy was evaluated using a 7-point rating scale after 24 weeks of treatment.Hair diameter and density were measured using a dermoscope.Patient satisfaction was assessed post-treatment,and adverse reactions were recorded.Results The overall efficacy of hair in the experimental group was superior to the control group 1 and the control group 2.There were no significant differences in hair density and hair diameter before treatment between the three groups(P＞0.05).After treatment,hair diameter and density increased in all three groups compared to baseline values(P＜0.05),and the hair diameter and hair density of the experimental group were higher than those of the control group 1 and the control group 2(P＜0.05).Patient satisfaction in the experimental group was higher than that in the control group 1 and the control group 2(P＜0.05).Patients in the experimental group experienced tolerable pain and burning sensations during laser treatment,and the symptoms were self-alleviated within a few hours.There were no serious adverse reactions reported in any group.Conclusion The combination therapy of 1 565 nm non-ablative fractional laser,5%minoxidil,and finasteride demonstrates significantly better efficacy in the treatment of AGA than minoxidil and finasteride alone drug therapy.

Objective:To integrate the best evidence of non-drug intervention of urinary incontinence in elderly women and to formulate practical recommendations.Methods:In this systematic review study, using “elderly woman”,“urinary incontinence”,“bladder training”,“pelvic floor muscle training”,“enuresis”,“leakage of urine” as the key words, the 6S evidence resource pyramid model was used to search in British Medical Journal best practice, Uptodate, World Health Organization, Guidelines International Network, National Institute for Health and Care Excellence, Chinese Medical Association, Scottish Intercollegiate Guideline Network, Registered Nurses Association of Ontario, Cochrane Library, The Joanna Briggs Institute (JBI), New Zealand Guidelines Group, Polish Society of Gynecologists and Obstetricians, PubMed, Embase, Medline, Web of Science, SinoMed, China National Knowledge Infrastructure, WanFang Data, etc. The evidence retrieved included evidence-based knowledge base resources, clinical practice guidelines, expert consensus, systematic review, etc. Data were retrieved from January 1, 2017 to May 1, 2022, and collated from May 2, 2022 to May 25, 2022. Two researchers independently evaluated the quality of literature and extracted data using the AGREE Ⅱ and JBI evidence-based health care center assessment tools. The JBI evidence-based health care center′s evidence pre-rating system and evidence recommendation rating system were applied to rank the evidence; and under the guidance of the evidence structure of JBI, the strength of evidence recommendation was determined and the best evidence was extracted and summarized in combination with the study group discussion and expert opinion.Results:A total of 9 articles were retrieved, including 7 guidelines and 2 systematic reviews; and 6 guidelines were classified as Grade A and 1 as grade B; both 2 systematic reviews were rated as Grade A; 84% (27/32) of the items were evaluated as “Yes”. Evidence were summarized as 34 pieces of best evidence from 6 dimensions, including “overall recommendation, evaluation of type and degree of urinary incontinence, lifestyle change, behavioral therapy, prevention of precipitating factors, intervention in special population”; the flow chart of screening, evaluation, special symptoms, life style and behavior therapy was combed, and the practical suggestions were formed.Conclusions:The overall quality of the literature on non-drug intervention of urinary incontinence in elderly women is high, and the level of evidence is high. Early identification of urinary incontinence types and assessment of disease severity, lifestyle changes, avoidance of predisposing factors and behavioral therapy are the key to non-drug treatment of urinary incontinence in those patients.

Objective:To investigate the relationship between intracranial arterial remodeling and imaging markers in patients with cerebral small vessel disease (CSVD).Methods:One hundred and fifty-six patients with CSVD who were admitted to the Department of Neurology of the Second Affiliated Hospital of Zhengzhou University or the Public People′s Hospital of Xinzheng from January 2020 to May 2022 were selected, and their brain artery remodeling (BAR) score was calculated. The patients with BAR score≤-1 standard deviation (SD) were defined as individuals with constrictive remodeling of intracranial arteries, and the patients with BAR score≥1 SD were defined as individuals with dilated remodeling of intracranial arteries. Imaging markers of CSVD [white matter hyperintensities (WMHs), lacune, cerebral microbleeds, enlarged perivascular spaces, and cerebral atrophy] were quantified, total CSVD load was calculated and patients were divided into low load group (0-2 points, n=91) and high load group (3-4 points, n=65) according to the total CSVD load scores. The correlation between intracranial artery remodeling and various imaging markers of CSVD and total load was analyzed by using univariate analysis and binary Logistic regression analysis. A nomogram prediction model was established and a receiver operating characteristic curve (ROC) was drawn to assess the predictive value of intracranial artery remodeling on high total CSVD load. Results:Dilated intracranial arterial remodeling was an independent influence factor on severe WMHs ( OR=3.66, 95% CI 1.38-9.72, P=0.009), lacune ( OR=3.78, 95% CI 1.17-12.19, P=0.026), cerebral atrophy ( OR=3.11, 95% CI=1.10-8.81, P=0.033), and high total CSVD load ( OR=6.66, 95% CI=2.14-20.77, P=0.001). Age was an independent influencing factor for high total CSVD load ( OR=1.12, 95% CI 1.07-1.16, P<0.01). A nomogram prediction model for high total CSVD load with age and BAR score≥1 SD as dependent variables had a good effect (C-index=0.826) and calibration ( P=0.024). The best cut-off point of ROC curve was 0.50, with an area under the curve of 0.83 (95% CI 0.76-0.89, P<0.01), the sensitivity and specificity of 0.72 and 0.82. Conclusions:Patients with dilated intracranial arterial remodeling may have a heavier CSVD load. Dilated intracranial arterial remodeling may serve as a new biomarker for assessing CSVD, but the mechanism of the association needs further study.

Objective:To investigate the current status and influencing factors of stroke patients.Methods:Using stratified sampling method, 458 stroke patients was investigated for the health behavior from October to December, 2015. Based on PROCEDE-PROCEED model, logistic regression analysis was conducted with the health behavior level of the subjects as the dependent variable, and the characteristic factors in the chi-square test as the independent variables to analyze the factors which influence the health behavior level of stroke patients from predisposing factors, enabling factors and reinforcing factors.Results:The health behavior score of stroke patients was (14.5±3.9), which was at medium level. The score of each dimension was nutrition (0.80±0.25), disease management (0.60±0.26), interpersonal relationship (0.57±0.33), and medication compliance (0.49±0.41). The multiple logistic regression analysis showed that the predisposition factors including age ( OR=2.03, 95% CI=1.08-3.80) and history of hypertension( OR=2.35, 95%=1.16-4.76), the enabling factors including the allocation of social resources ( OR=1.73, 95% CI=0.89-3.36), and the reinforcing factors including family support ( OR=2.03, 95% CI=0.99-4.17) were important factors which affect the health behavior of stroke patients. Conclusion:The health behavior level of stroke patients need to be improved. The relevant community resource allocation system continuously, and focus on the impact of family environment and particularly the elderly and patients with a history of hypertension should be attentioned when improving the health behavior of patients.

Objective:To investigate the present situation of unintended pregnancy within two years postpartum and its influencing factors in China.Methods:Participants who delivered a live birth at 60 hospitals in 15 provinces in the eastern, central and western regions of China during July 2015 to June 2016 were interviewed by using structured questionnaire. Information on occurrence of unintended pregnancy within 2 years after delivery, postpartum contraceptive use, sexual resumption, breastfeeding, and women′s socio-demographic characteristics, and so on, were collected. Life-table analysis, cluster log-rank tests and a 2-level Cox regression model were used for data analysis.Results:A total of 18 045 postpartum women were investigated. The cumulative 1- and 2-year unintended pregnancy rates after delivery were 5.3% (95% CI: 4.5%－6.1%) and 13.1% (95% CI: 11.3%－14.8%), respectively. Cox regression model analysis showed that the risk of unintended pregnancy within 2 years postpartum were increased in younger women, ethnic minorities, women with abortion history, and those who had a vaginal delivery with short lactation time and late postpartum contraceptive initiation (all P<0.01). The risk of postpartum unintended pregnancy was not associated with geographic regions and hospitals where women gave a birth (all P>0.05). Conclusions:In China, the risk of unintended pregnancy within 2 years after delivery is relatively high. Service institutions and service providers should improve the quality of postpartum family planning services, promote the use of high effect contraceptive methods, and educate women to use a method at the time of their sexual resumption or even before.

Objective:To investigate the correlation between serum procalcitonin (PCT) level and intracranial atherosclerotic burden (ICASB) in patients with ischemic stroke.Methods:From January 2019 to December 2020, consecutive patients with acute ischemic stroke admitted to the Department of Neurology, Jiangsu Provincial Second Chinese Medicine Hospital were enrolled. Chemiluminescence immunoassay was used to detect serum PCT levels, and ICASB was evaluated based on the results of cranial magnetic resonance angiography. Univariate analysis was used to determine the baseline data among the different ICASB score groups. Then the independent correlation between serum PCT level and ICASB was determined by the ordinal logistic regression analysis. At the same time, the correlation between serum PCT level and ICASB was determined by the linear regression analysis. Results:A total of 291 patients with acute ischemic stroke were enrolled, including 161 male (55.3%), aged 64.5±8.4 years; median serum PCT level was 0.053 μg/L. According to the ICASB score, the patients were divided into 0 group ( n=155, 53.3%), 1-3 group ( n=95, 32.6%) and >3 group ( n=41, 14.1%). Univariate analysis showed that the age, serum homocysteine and PCT level, as well as the proportion of diabetes were significantly higher in the higher ICASB score group, while the proportion of the patients with atrial fibrillation was significantly lower (all P<0.05). Ordinal multivariable logistic regression analysis showed that higher serum PCT level was an independent factor for higher ICASB score (the 4 th quartile vs. the 1 st quartile: odds ratio, 2.015, 95% confidence interval 1.052-3.927; P=0.043). Multiple linear regression analysis showed that the serum PCT level was positively correlated with the ICASB score ( r=0.253, P=0.001). Conclusion:The serum PCT level is correlated with ICASB.