ObjectiveTo investigate the current status of emergency management for severe mental disorders in Shanghai, and to provide countermeasures and suggestions for the establishment of a sound emergency management system for severe mental disorders and the enhancement of emergency management capability. MethodsA questionnaire survey and qualitative interviews were used to conduct an investigation into the emergency management in 17 district-level mental illness prevention and control institutions in Shanghai, which includes the basic situation of emergency management for severe mental disorders, the construction of emergency response teams and personnel, emergency preparedness drills and training, emergency management plans and rules and regulations, and problems encountered in emergency management. ResultsIn terms of emergency management mechanism and basic situation, resources such as personnel allocation, security funds and green channel were well equipped in each district-level mental illness prevention and control institution in Shanghai. However, the equipment of some hardware facilities was still insufficient to some extent. Therefore, further improvement on the emergency management mechanism for severe mental disorders was needed. With regard to the construction of emergency team and personnel allocation, the majority were those aged between 35‒<45 years old, with a bachelor’s degree, and more than 10 years of working experience. For example, 90.27% staff in district-level mental illness prevention and control institution had a bachelor’s degree or above, which was higher than that among the staff in community-level (73.60%); staff majored in clinical medicine in district-level institution accounted for the proportion at 52.71%, higher than that among the staff in community-level (28.86%); 57.24% staff in district-level institution had an intermediate professional title, higher than that among the staff in community-level (42.28%); and 69.90% staff in district-level institution had more than 10 years of working experience, higher than that among the staff in community-level (43.62%). In the aspect of emergency drills and training, all district-level mental illness prevention and control institutions in Shanghai had a high demand for emergency training, and the weak aspects mainly focused on lack of emergency service protocols, skills of addressing technical challenges, and construction of effectiveness evaluation system. Moreover, the teaching methods were primarily centered on case analysis, simulation drills, interactive discussions, and so forth. Concerning emergency management plans and rules and regulations, all districts in Shanghai had relatively established well-developed systems for emergency response plans, emergency response leadership groups, and emergency response operational task forces for severe mental disorders. About half of the institutions had established other rules and regulations related to emergency management of severe mental disorders in addition to emergency plans. ConclusionShanghai has initially established an emergency management system for severe mental disorders, but it is still fragile in specialized training for emergency management of severe mental disorders, construction of emergency management mechanisms, and the building-up of grassroots emergency teams. Further priorities should include strengthening emergency management training, enhancing the construction of emergency management personnel teams, and gradually establishing a more comprehensive and integrated emergency management mechanism for severe mental disorders.

Objective: To explore the association between mental health and muscle strength among Chinese adolescents aged 13- 18, providing a theoretical foundation and intervention strategies for mental health promotion. Methods: Data were obtained from the 2019 Chinese National Survey on Students Constitution and Health, including 98 631 Chinese adolescents aged 13- 18. Psychological distress was assessed by using the Kessler Psychological Distress Scale (K10), and mental well being was measured with the Warwick-Edinburgh Mental Well being Scale (WEMWBS). Based on the gender and age specific Z scores of various test items [grip strength, standing long jump, pull ups (for males), and sit ups (for females)], muscle strength index (MSI) was constructed to evaluate the comprehensive level of muscle strength in adolescents. According to the Dual factor Model (DFM) of mental health, participants were categorized into four groups:troubled, symptomatic but content, vulnerable, and complete mental health. Gender differences were analyzed by using Chi-square tests, trends were tested with Cochran-Armitage tests, and multinomial Logistic regression models were applied to assess associations between muscle strength and mental health among adolescents. Results: In 2019, 37.4% of Chinese adolescents aged 13-18 were reported of high mental distress, and 59.9% were reported of low mental well being. Boys had significantly lower rates of high mental distress (35.3%) and low mental well being (55.6%) compared to girls (39.4%, 64.3%), and the differences were of statistical significance ( χ 2=176.13, 780.42, both P <0.05). In 2019, the rate of complete mental health among adolescents showed a downward trend with increasing age ( χ 2 trend = 258.47) and a gradual upward trend with increasing muscle strength levels ( χ 2 trend =123.14)，and both boys and girls exhibited similar trends ( χ 2 trend =103.83, 168.46; 57.00 , 67.34) (all P <0.05). The results of the unordered multiclass Logistic regression model showed that after controlling for confounding factors such as age and gender, when the completely pathological group as a reference, for every 1 unit increase in MSI in adolescents, the likelihood of being in a completely mental health state increased by 29% ( OR = 1.29); for every unit increase in the Z-score for pull ups, the likelihood of being in a completely mental health state increased by 6% ( OR =1.06) among boys; for every 1 unit increase in sit up Z score, the likelihood of being in a completely mental health state increased by 19% ( OR =1.19) among girls (all P <0.05). Conclusions The mental health status of Chinese adolescents is not good enough. Muscle strength is positively associated with mental health.

Objective: To investigate the characteristics of schizophrenic patients using long-acting antipsychotic medications, so as to provide the basis for applicable population of long-acting antipsychotic medications. Methods: Data of schizophrenic patients using long-acting antipsychotic medications in Shanghai City from June 2020 to June 2022 were collected through Shanghai Mental Health Information Management System, and demographic characteristics, illness and medication use of patients were descriptively analyzed. Results: A total of 2 684 schizophrenic patients using long-acting antipsychotic medications were included in the study, had a mean age of (46.92±12.39) years, with 1 246 males (46.42%) and 1 438 females (53.58%). There were 1 397 unemployed cases, accounting for 52.05%; 1 429 cases with an educational level in junior high school or below, accounting for 53.24%; 1 301 unmarried cases, accounting for 48.47%; 832 cases in poverty, accounting for 31.00%. The caregivers of patients were mainly their parents, with 1 507 cases accounting for 56.15%. The courses of illness were mainly ≤10 years and >10-20 years, with 860 cases each, both accounting for 32.04%; 1 963 cases with incomplete self-awareness, accounting for 73.14%; 1 570 cases hospitalized at least once, accounting for 58.49%. There were 2 486 cases with continuous medication, accounting for 92.62%. The main method of taking medication was given by others, with 1 947 cases accounting for 72.54%. The medication adherence was mainly taking medication on time and in the right amount, with 2 437 cases accounting for 90.80%. Conclusion The main characteristics of schizophrenic patients using long-acting antipsychotic medications are young, unmarried, and unemployed adults, with incomplete self-awareness, continuous medication and medication given by others.

With the acceleration of urbanization, urban rail transit systems have become one of the most important modes of transportation in modern cities. Urban rail transit systems operate in enclosed or semi-enclosed environments, characterized by poor air circulation and high passenger flow. During the period of high incidence of respiratory infectious diseases in autumn and winter, air quality and pathogenic microorganism monitoring in public places have attracted much attention. This article provided a detailed introduction to air pollutants and their sources related to urban rail transit, including chemical pollutants, such as particulate matter and gaseous pollutants, and microbial aerosols. Based on identified air pollutants related to urban rail transit, this paper reviewed the research progress on air quality monitoring technologies for chemical pollution factors and microbial aerosols. Finally, a summary of the health effects of chemical pollutants and microbial aerosols was provided, along with suggestions for monitoring and improving air quality tailored to the characteristics of urban rail transit systems. Through a review of previous studies, carrying out research on air quality monitoring technologies and associated health effects related to urban rail transit is of great significance and values for air quality management, urban development, and public health.

Objective To explore the clinical characteristics and treatment scheme of patients with spinal infection caused by Prevotella intermedia(P.intermedia).Methods Clinical diagnosis and treatment processes of a patient with spinal infection caused by P.intermedia admitted to the spinal surgery department of a hospital were summa-rized,and relevant literature was retrieved from database for reviewing.Results The patient,a 50 year old male,was admitted to the hospital due to"lumbago pain complicated with pain in double lower extremities for 2 months".The lesion tissue was taken for metagenomic next-generation sequencing(mNGS)detection,which detected P.in-termedia,and the patient was diagnosed with P.intermedia spondylitis.After treatments with open lesion clea-rance,tube rinsing+autologous bone transplantation fusion internal fixation,intravenous drip of ceftriaxone sodium and metronidazole,as well as metronidazole rinsing,infection was under control.A total of 16 available papers were retrieved,together with this case,a total of 17 patients were included,with 7 males and 10 females.The main risk factors were diabetes and history of corticosteroid use(35.3％).The most common invasion sites were lumbar ver-tebra(n=12)and thoracic vertebra(n=6).13 cases were positive for pathogen culture,3 cases were positive for molecular detection,and 1 case was positive for staining microscopy.17 patients received anti-anaerobic bacteria treatment,with 14 cases receiving combined surgical treatment.One case died,with a mortality of 5.9％;5 cases had partial neurological impairment,with a disability rate of 29.4％.The survival rate of patients who received treatment of anti-anaerobic bacteria combined with surgery was 92.8％,3 patients only with anti-anaerobic bacteria treatment but without surgery were all cured.Conclusion P.intermedia is an opportunistic pathogeanic bacteria which often causes infection in immunocomprised individuals and is prone to be misdiagnosed.It is recommended to perform mNGS detection to identify the pathogen as early as possible and seize the opportunity for treatment to reduce mortality.

ObjectiveTo analyze the temporal distribution characteristics of crisis calls and eight major counseling issues to the Shanghai mental health hotline, and to provide recommendations for improving hotline management. MethodsDescriptive statistics were used to analyze 1 106 crisis calls and the calls of eight major counseling issues to the Shanghai mental health hotline across months, time periods and weeks from October 2021 to September 2023, and the chi-square test was used to analyze whether there was any difference in the distribution of 1 106 crisis calls and the calls of eight major counseling issues across months, time periods and weeks. ResultsThere were significant differences in the number of crises calls across different months (χ²=87.816, P<0.05), time periods (χ²=161.848, P<0.05), and weekly distributions (χ²=63.329, P<0.05). The highest number of calls occurred in September, while January had the lowest. The peak call times were between 18:00‒20:00, with the fewest calls occurring between 3:00‒5:00. The day of the week with the highest number of calls was Saturday, while Wednesday had the lowest. Among the different types of counselling issues in crisis calls, the highest number of calls were related to mental disorders, while the fewest calls were related to COVID-19. ConclusionCrisis calls to the Shanghai mental health hotline are concentrated at specific times, indicating that relevant organizations should optimize resource allocation based on this time distribution.

ObjectiveTo investigate the status of liver function abnormalities in patients with severe mental disorder (SMD) in Shanghai community, to explore the related factors to abnormal liver function in patients with SMD, and to analyze the effects of the types of mental disorders and medication status on liver function abnormalities. MethodsThe patients with SMD in Jinshan District, Minhang District, Hongkou District and Xuhui District of Shanghai were selected as the research subjects. Questionnaire survey, physical examination and laboratory tests were conducted to obtain their demographic characteristics and liver function indicators such as alanine aminotransferase (ALT) and total bilirubin (TBil). The types of mental disorders and medication status of patients in Jinshan District were also investigated. Abnormalities in liver function were determined by abnormalities in either ALT or TBil. Binary logistic regression analysis was used for multivariate analysis of the status of abnormal liver function, and the effects of mental disorder types and medication status on liver function were analyzed, simultaneously. ResultsA total of 7 251 patients with SMD were finally included into this study, and the rate of liver function abnormality was 22.7%, of which 694 cases (9.6%) had ALT abnormality and 1 084 cases (14.9%) had TBil abnormality. Univariate analysis showed that the rate of liver function abnormalities was higher in males than that in females (χ²=45.026, P<0.001), higher in suburbs than that in urban areas (χ²=25.317, P<0.001), higher in those with higher BMI than in those with lower BMI (χ²=63.748, P<0.001), higher in those with elevated blood pressure (BP) than in those without elevated BP (χ²=24.774, P<0.001), higher in those with elevated blood glucose than in those without elevated blood glucose (χ²=43.345, P<0.001), higher in those with abnormal triglyceride (TG) than in those with normal TG (χ²=15.551,P<0.001), and higher in those with abnormal total cholesterol (TC) than in those with normal TC (χ²=10.962, P=0.001). Multivariate analysis showed that the rate of abnormal liver function was higher in males than that in females (OR=1.53, 95%CI: 1.36‒1.73), higher in suburbs than that in urban areas (OR=1.43, 95%CI: 1.21‒1.70), higher in those with overweight than in those with normal BMI (OR=1.16, 95%CI: 1.01‒1.33), higher in those with obesity than in those with those with normal BMI (OR=1.61, 95%CI: 1.36‒1.91), higher in those with elevated blood glucose than in those without elevated blood glucose (OR=1.39, 95%CI: 1.23‒1.58), and higher in those with abnormal TC than in those with normal TC (OR=1.36, 95%CI: 1.13‒1.65).The difference in the rate of ALT abnormalities among the SMD patients in Jinshan District with different medication status was statistically significant (χ²=21.928, P<0.001). Whereas, the differences in the effects of the types of mental disorders and medication status on the status of liver function abnormalities were not statistically significant(P>0.05). ConclusionThe detection rate of liver function abnormalities in community-based SMD patients in Shanghai is high, and male, suburban, and accompanied by elevated BMI, BP, blood glucose, and TC are risk factors for liver function abnormalities in patients with SMD. Primary healthcare providers should pay more attention to the liver function of patients with SMD and initiate targeted and tailored prevention, detection and treatment measures.

Objective To evaluate the effects of high-fat diet on the pharmacokinetics of metronidazole in Chinese healthy adult subjects.Methods This program is designed according to a single-center,randomized,open,single-dose trial.Forty-seven healthy subjects were assigned to receive single dose of metronidazole tablets 200 mg in either fasting and high-fat diet state,and blood samples were taken at different time points,respectively.The concentrations of metronidazole in plasma were determined by high performance liquid chromatography-mass spectromentry.Results The main pharmacokinetic parameters of metronidazole in fasting state and high-fat diet state were as follows:Cmax were(4 799.13±1 195.32)and(4 044.17±773.98)ng·mL-1;tmax were 1.00 and 2.25 h;t1/2 were(9.11±1.73)and(9.37±1.79)h;AUC0_t were(5.59±1.19)x 104 and(5.51±1.18)x 104 ng·mL-1·h;AUC0_∞ were(5.79±1.33)x 104 and(5.74±1.32)× 104 ng·mL-1·h.Compared to the fasting state,the tmaxof the drug taken after a high fat diet was delayed by 1.25 h(P＜0.01),Cmax,AUC0_t,AUC0-∞ were less or decreased in different degrees,but the effects were small(all P＞0.05).Conclusion High-fat diet has little effects on the pharmacokinetic parameters of metronidazole,which does not significantly change the degree of drug absorption,but can significantly delay the time to peak.

Objective To evaluate the bioequivalence of test product and reference product in a single dose of amoxicillin clavulanate potassium tablet under fasting and fed conditions in healthy volunteers.Methods An open label,randomized,single dose,four-period,crossover bioequivalence study was designed.Fasting and postprandial tests were randomly divided into 2 administration sequence groups according to 1:1 ratio,amoxicillin clavulanate potassium tablet test product or reference product 375 mg,oral administration separately,liquid chromatography tanden mass spectrometry was applied to determine the concentration of amoxicillin and clavulanate potassium in plasma of healthy subjects after fasting or fed administration,while Phoenix WinNonlin 8.2 software were used for pharmacokinetics(PK)parameters calculation and bioequivalence analysis.Results Healthy subjects took the test product and the reference product under fasting condition,the main PK parameters of amoxicillin are as follows:Cmax were(5 075.57±1 483.37)and(5 119.86±1 466.73)ng·mL-1,AUC0_twere(1.32 × 104±2 163.76)and(1.30 × 104±1 925.11)ng·mL-1,AUC0-∞were(1.32 × 104±2 175.40)and(1.31 ×104±1 935.86)ng·mL-1;the main PK parameters of clavulanic acid are as follows:Cmax were(3 298.27±1 315.23)and(3 264.06±1 492.82)ng·mL-1,AUC0-twere(7 690.06±3 053.40)and(7 538.39±3 155.89)ng·mL-1,AUC0-∞were(7 834.81±3 082.61)and(7 671.67±3 189.31)ng·mL-1;the 90％confidence intervals of Cmax,AUC0-tand AUC0-∞ after logarithmic conversion of amoxicillin and clavulanate potassium of the two products were all within 80.00％-125.00％.Healthy subjects took the test and reference product under fed condition,the main PK parameters of amoxicillin are as follows:Cmax were(4 514.08±1 324.18)and(4 602.82±1 366.48)ng·mL-1,AUC0-twere(1.15 × 104±1 637.95)and(1.15 × 104±1 665.69)ng·mL-1,AUC0-∞ were(1.16 × 104±1 646.26)and(1.15 × 104±1 607.20)ng·mL-1;the main PK parameters of clavulanic acid are as follows:Cmax were(2 654.75±1 358.29)and(2 850.51±1 526.31)ng·mL-1,AUC0-twere(5 882.82±2 930.06)and(6 161.28±3 263.20)ng·mL-1,AUC0-∞ were(6 022.70±2 965.05)and(6 298.31±3 287.63)ng·mL-1;the 90％confidence intervals of Cmax,AUC0-t and AUC0-∞ after logarithmic conversion of amoxicillin and clavulanate potassium of the two products were all within 80.00％-125.00％.Conclusion The two formulations were bioequivalent to healthy adult volunteers under fasting and fed conditions.

Objective:To describe the current distribution of daily physical activity time among ele-mentary and junior high school students in Beijing,and to analyze the influencing factors and pathways at the individual,family,school and community levels.Methods:Data were drawn upon from a cross-sectional investigation in Beijing in 2023,and a total of 3 157 elementary and junior high school students were included in the final analysis.Questionnaire was used to collect data on basic characteristics,over-all and in-school physical activity time per day,the number of sports mastered,perceived physical activi-ty benefits and barriers scales,perceived family,school,and community physical activity supportive en-vironment scales.Log-binomial regression model was used to analyze the associations between physical activity time and influencing factors,and structural equation modeling was used for the path analysis of the influencing factors.Results:The reported rates of ≥ 2 hours of overall physical activity per day and≥1 hour of physical activity in school per day among elementary and junior high school students in Beijing in 2023 were 33.1％and 64.8％,respectively.The associations between the number of sports mastered by students and the reported rate of ≥2 hours of overall physical activity per day showed a typical dose-response relationship(P-trend＜0.001).The perceived physical activity benefits-to-barriers ratio(PR=1.24,95％CI:1.20-1.28),scores of perceived family,school,and community physical acti-vity supportive environment scales were all positively associated with the reported rate of≥2 hours of overall physical activity per day(PR=1.51,95％CI:1.38-1.66;PR=1.50,95％CI:1.37-1.64;PR=1.21,95％CI:1.16-1.27).The structural equation modeling showed that the number of sports mastered by the students(β=0.11,P＜0.001),perceived physical activity benefits-to-barriers ratios(β=0.15,P＜0.001),and scores of supportive environment scales consisting of family,school,and community(β=0.13,P＜0.001)were associated with the reported rates of ≥2 hours of overall physi-cal activity per day directly.In addition,the scores of supportive environment scales could indirectly in-fluence the reported rates of ≥2 hours of overall physical activity per day by influencing the number of sports mastered by the students(β=0.21,P＜0.001)and the perceived physical activity benefits-to-barriers ratio(β=0.56,P＜0.001),while the number of sports mastered by the students could indi-rectly influence the reported rates of ≥2 hours of overall physical activity per day by influencing the per-ceived physical activity benefits-to-barriers ratios(β=0.05,P=0.003).The influencing factors and pathways of the reported rates of ≥ 1 hour of physical activity in school per day were similar with those of the reported rates of ≥2 hours of overall physical activity per day described above.Conclusion:The dai-ly physical activity time among elementary and junior high school students in Beijing in 2023 fell short of meeting the national requirement.There was a need to build a supportive environment consisting of fami-ly,school,and community for physical activity,to promote the students'sports skills,to establish the idea of independent physical activity,and to ensure that primary and secondary school students were given one hour of physical activity time every day,both inside and outside the school.