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.

Background The high work intensity and possible subsequently increased susceptibility to occupational hazards of calcium carbide plants may lead to hypertension in workers, but there are few studies on the relationship between occupational hazard exposure and hypertension in workers involving the production process of calcium carbide. Objective To explore the influence of occupational hazards on the incidence of hypertension in calcium carbide plants. Methods Using historical cohort design, the employees of a calcium carbide factory in the western part of Inner Mongolia Autonomous Region were selected as research subjects. According to the pre-determined inclusion and exclusion criteria, the study population comprised an exposure group of 377 employees (including furnace workers, inspection workers, and maintenance workers) exposed to dust, noise & carbon monoxide, and a control group of 388 employees (including central control workers, electricians, and administrative personnel) without above-mentioned exposure. The total sample size was 765 participants. The follow-up period was from April 2011 to October 2022, and the study endpoint was defined as the conclusion of the follow-up period or diagnosed hypertension in annual occupational health examination. Information on general demographic characteristics, living habits, and work status was collected from all study subjects. Cox proportional hazards regression model was used to analyze the association between occupational hazard exposure and the risk of hypertension among the calcium carbide plant employees. Results The average age, mean systolic and diastolic blood pressure, proportion of males, smoking rate, and alcohol consumption rate in the exposure group were higher than those in the control group (P<0.05). Compared to baseline, both systolic and diastolic blood pressure levels increased in the exposure group and the control group at the end of the follow-up (P<0.05). At the end of the follow-up, the average differences between systolic/ diastolic blood pressure and baseline values in the exposure group were higher than those in the control group (P<0.05). During the follow-up period, a total of 223 cases of hypertension occurred, with a total follow-up of 2785 person-years, resulting in an incidence density of 8007.18 per 100000 person-years, an average age of onset of (35.90±8.22) years, and an average working age of onset of (2.69±1.97) years. The incidence density in the exposure group was 128.71% higher than that in the control group, and the risk of hypertension in the exposure group was 2.115 times that of the control group. The risk of hypertension was 2.199 times higher for men than for women, 1.344 times higher for those aged 30 and above than for those under 30, 1.546 times higher for smokers than for non-smokers, and 1.750 times higher for drinking workers than for non-drinking ones. The results of Cox proportional hazards regression modeling indicated that the hazard ratio (95%CI) of hypertension among the employees exposed to dust, noise, and carbon monoxide was 2.254 (1.703, 2.982), 1.594 (1.107, 2.295), and 1.567 (1.079, 2.274), respectively, when different covariates (gender, age, smoking, and alcohol consumption) were included. The results of Log-rank test showed that there were statistically significant differences in the distribution of disease-free survival between the exposure group and the control group (P<0.05). Conclusion Occupational exposures to dust, noise, and carbon monoxide may increase the risk of hypertension among calcium carbide plant workers.

Objective To evaluate the protective effect of radiation protection safety education (RPSE) on patients with differentiated thyroid carcinoma (DTC) undergoing iodine-131 (¹³¹I) treatment. Methods The DTC patients who undergo ¹³¹I treatment were divided into the control group and the RPSE group using the convenience sampling method, with 142 patients in each group. Patients in the control group received routine health education, while the RPSE group received routine health education combined with RPSE. Dose equivalent rate (DER) on pillows, bed sheets, quilt covers, and household waste of patients were compared between the two groups upon discharge. Results The median (M) DERs of patients' pillows, bed sheets, quilt covers and household waste were 3.86, 3.63, 3.91 and 56.59 times higher in the control group compared with the environmental background level, respectively. The M DERs of patients' pillows, bed sheets, quilt covers were 2.23, 2.18, and 2.55 times higher in the RPSE group compared with the environmental background level, while the M DER of household waste was equivalent to the environmental background level. The DERs of patients' pillows, bed sheets, quilt covers, and household waste in the RPSE group were significantly lower than those in the control group (all P<0.001). The DERs of the above four items were lower in both male and female patients in RPSE group compared with same-gender patients in the control group (all P<0.001). The patients' DERs of the above indicators had no significant difference among different gender in both control group and RPSE group (all P>0.05), except for higher DER of household waste in female patients than that of male patients in the control group (P<0.05). There were no significant differences in the DERs of pillows, bed sheets, quilt covers, and household waste across subgroups, where patients received different treatment doses, of both the control group and the RPSE group (all P>0.05). Conclusion RPSE for DTC patients treated with ¹³¹I, reduces the DERs of pillows, bed sheets, quilt covers, and particularly household waste.

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.

Objective To evaluate the characteristics of dose distribution of neuronal networks in vitro on microelectrode arrays(MEAs)under 2.6 GHz radiofrequency(RF)exposure.Methods The MEAs were coupled with a real-time RF exposure setup,and electromagnetic simulation software was used to calculate the RF dose absorbed in cultured neuronal networks.A fiber-optic temperature probe was used for experimental validation and monitoring of the cell temperature during RF exposure.The MEAs were used to record the electrical activity of neurons.Results For an input power of 1 W,a specific absorption rate(SAR)level of(15.51±2.48)W/kg was calculated,and the variability of the SAR distribution was 16%.In our experimental system,the temperature elevation of neurons was up to 0.15℃for an SAR of 4 W/kg RF exposure.Conclusion The exposure device can provide high SAR efficiency and uniformity in the 2.6 GHz band,which is suitable for studying the real-time effects of RF fields on the electrical activity of neuronal networks in the 5G network band.

Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.

ObjectiveTo determine the antibody levels of varicella-zoster virus （VZV） in healthy individuals aged 1 to 30 years in Songjiang District of Shanghai， and to provide evidence for further development of varicella immunization strategies for healthy population. MethodsSix village committees were selected in Songjiang District through multi-stage stratified random sampling method from July to September 2022. Healthy individuals aged 1 to 30 years old in these villages were recruited and 3‒5 mL of venous blood was collected. Anti-VZV IgG antibody was tested by ELISA. Positive rate of anti-VZV IgG antibody and geometric mean concentration （GMC） were determined. ResultsA total of 315 healthy individuals aged （10.97±8.38） years were included in this study， of which 165 were males aged （11.00±8.52） years and 150 were females aged （10.96±8.25） years. Blood samples were collected and tested for anti-VZV IgG antibody， with the overall positive rate of 55.24% （174/315）. The GMC was calculated to be 99.73 mIU·mL^-1， with the GMC in those tested positive for anti-VZV IgG antibody of 413.11 mIU·mL^-1. The positive rate of anti-VZV IgG antibody and GMCs across age groups ranged between 13.33%‒86.67% and 16.36‒355.14 mIU·mL^-1， respectively. The highest GMC was found in the group of 20‒30 years old （355.14 mIU·mL^-1）， followed by 132.41 mIU·mL^-1 in the group of 5‒ years old and 138.12 mIU·mL^-1 in the group of 15‒ years old. Moreover， the positive rate was 38.47% in the group with 1-dose varicella vaccine and 63.49% in the group with 2 doses， while the GMC were 53.28 mIU·mL^-1 and 130.79 mIU·mL^-1 in these two groups， respectively. Multivariable analysis revealed that occupation was a risk factor associated with anti-VZV IgG antibody （OR=2.540）. Stratified analysis by varicella immunization history showed that among 2-dose vaccination group， time interval since the last dose was a protective factor （OR=0.315）. ConclusionsThe overall positive rate of anti-VZV IgG antibody in healthy population in Songjiang District of Shanghai remains low. The 2-dose varicella vaccination should be strengthened to improve the coverage in susceptible population.

Dementia in traditional Chinese medicine （TCM） mainly presents amnesia and dullness. Alzheimer's disease and vascular dementia belong to the category of dementia in TCM. These progressive neurological diseases have a complex etiology and a long course， and the drugs that can reverse the disease course remain to be developed. Therefore， early intervention plays a vital role in delaying the disease progression. Apathy refers to a lack of motivation that leads to the attenuation or disappearance of goal-directed behaviors， cognitive functions， and emotional responses. Clinical studies have suggested that apathy exists in the early stage of a variety of neurodegenerative diseases， being one of the key symptoms to the early diagnosis of dementia. The severity of apathy is related to the severity of dementia. Therefore， early diagnosis and treatment of apathy are of great significance to the prevention and treatment of dementia. The preclinical research on apathy in dementia is still in its infancy， and the systematic evaluation method has not been prescribed. The clinical diagnosis and treatment are also in the exploratory stage， and the complex pathophysiological mechanisms of apathy and dementia development have not been fully elucidated. This article reviews the research progress of apathy in dementia， the apathetic behaviors of dementia animal models， the behaviors of patients with apathy， and the treatment methods in recent years and summarizes the research status of apathy in dementia. This review aims to provide a theoretical basis for exploring the behavior of apathy in dementia and conducting preclinical research and evaluation of the pathogenesis and to lay a foundation for the treatment of apathy in dementia.

Objective To evaluate both the causal relationship between plasma metabolites and the risk of knee osteoarthritis(KOA)and the potential mediating or masking effect of immune cells using Mendelian randomization(MR)systems.Methods The GWAS data on 1400 plasma metabolites,731 immune cell traits and KOA was retrieved from the genome-wide association study(GWAS)database.Two-way MR analysis was used to evaluate the causal relationship between plasma metabolism and KOA.Two-step mediation MR analysis was conducted to evaluate immune cell traits that might have mediating or masking effects.Results After sensitivity analysis and screening,65 plasma metabolites and 35 immune cell traits were found to have causal relationships with KOA(P＜0.05).Mediation analysis found that CD45RA+CD28-CD8br％CD8br had a mediating effect in the causal relationship between three metabolites(2-hydroxyhi-ppurate,X-07765,X-23739)and the risk of KOA.2-hydroxyhippurate(salicylic acid)exerted a masking effect,and the effect ratio was 0.0412.Conclusion A variety of plasma metabolites and immune cell traits are causally related to KOA,which should not be regarded as a simple degenerative joint disease.The protective effect of salicylic acid against KOA may be weakened by its role in inducing the differentiation of Treg cells,which is worthy of more studies.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.