Objective: To understand the growth and development levels of four physical measurements in children aged 3-6 years in China, so as to provide a reference for child nutrition improvement and health promotion. Methods: A stratified random sampling method was used to collect physical measurement data from 120 kindergartens 25 842 children aged 3-6 years across 24 provinces and cities in seven natural geographical regions of North China, Northeast China, East China, Central China, South China, Southwest China and Northwest China from 2020 to 2023. The development levels of head circumference, chest circumference, waist circumference, and hip circumference were evaluated using a grading method. The analysis of gender and age differences was conducted using Mann-Whitney U- test and Kruskal-Wallis test, and the comparison of abnormal detection rates for different genders was conducted using Chi square test. Results: The distribution range of children aged 3-6 was 51.74(50.08, 53.33) cm in terms of head circumference, 55.73(52.09, 59.04) cm in terms of chest circumference, 53.04(48.92, 56.40) cm in terms of waist circumference, and 59.36(56.30, 62.32) cm in terms of hip circumference. The detection rate of abnormal head circumference in boys and girls aged 3-6 years old was relatively high (19.71%-42.02%), and the detection rate of abnormal physical circumference development levels in boys was higher than that in girls of all ages ( χ 2=5.63-83.35, P <0.05). The detection rate of abnormal hip circumference (4.89%-6.53%) and chest circumference (4.51%-6.38%) in boys and girls aged 3-6 was relatively low, and there was no statistically significant difference in the abnormal rate between different ages and genders ( χ 2=0.00-1.61, 0.00-3.71, P >0.05). The detection rate of abnormal waist circumference in boys and girls aged 3-6 was relatively high (13.70%-42.45%), and the detection rate of abnormal waist circumference in girls was higher than that in boys aged 4-6 groups ( χ 2=10.49-58.18, P < 0.05). Conclusions The overall physical development of children aged 3-6 years in China is improving, but the abnormal detection rates for head circumference and waist circumference are relatively high. Child healthcare should focus on preventing and treating abdominal obesity, with differentiated health intervention strategies based on different age groups and genders.

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.

Objective: This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Methods: Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. Results: A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, P<0.001) and young people(χ2=120.210, P<0.001) were more likely to develop these dysfunctions. Gender(OR=1.564, 95%CI: 1.487-1.645), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), oral health status (OR=0.881, 95%CI: 0.839-0.926), smoking history (OR=1.152, 95%CI=1.080-1.229), and drinking history (OR=0.854, 95%CI: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, P=0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.
Female ; Humans ; Adolescent ; SARS-CoV-2 ; Smell ; COVID-19/complications* ; Cross-Sectional Studies ; COVID-19 Vaccines ; Incidence ; Olfaction Disorders/etiology* ; Taste Disorders/etiology* ; Prognosis

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Objective: To understand the behavioral characteristics of vaccination of human papillomavirus (HPV) vaccine based on diffusion of innovation theory, and to put forward suggestions for improving the vaccination willingness. Methods: The women who had made an appointment or received at least one dose of HPV vaccine in two community health service centers with HPV vaccination qualification in Hangzhou were recruited by convenience sampling method. A questionnaire survey was conducted according to cervical cancer risk factors, HPV vaccine knowledge and the time of vaccination. The diffusion of HPV vaccination and the characteristics of vaccinees in different stages was analyzed. Results: A total of 448 women, aged from 18 to 45 years old, with a median of 30.5 years old, were investigated. The spread of HPV vaccine were divided into five stages: April 2017 and before was the initial stage, with 8 leaders, accounting for 1.79%; October 2017 to February 2018 was the slowly rising stage, with 59 early vaccinees, accounting for 13.17%; April 2018 to April 2019 was the rising stage, with 160 most early vaccinees, accounting for 35.71%; May to August 2019 was the rapidly rising stage, with 170 most late vaccinees, accounting for 37.95%; September 2019 to the end of the survey was the standstill stage, with 51 laggards, accounting for 11.38%. All of the leaders had participated in cervical cancer screening, voluntarily vaccinated, and knew the susceptible population of cervical cancer, the targeted HPV types and the suitable population of vaccine. The median age of the first pregnancy was 27 years old. Six of them had three pregnancies. The early vaccinees and the most early vaccinees were recommended by doctors or friends to get HPV vaccine. The median age of first pregnancy was 26 and 28 years old, respectively. Their other characteristics were similar to those of the leaders. The characteristics of most late vaccinees were similar to those of the laggards. They were were mainly students who were recommended by their friends to receive HPV vaccination, did not participate in cervical cancer screening, did not know the susceptible population of cervical cancer, the targeted HPV types and the suitable population of vaccine. Conclusions People with high risk of HPV exposure, awareness of cervical cancer and screening are more likely to receive HPV vaccination at the early stage. It is necessary to strengthen the health education of HPV vaccination, and make full use of the influence of doctors and early vaccinees, which is helpful to promote the early vaccination of HPV vaccine among the right age population.

Objective:To investigate the effect of Stemona tuberosa alkaloids on the apoptosis of human hepatoma SMMC-7721 cells and the expression of apoptosis-related proteins including B lymphocytoma-2 （Bcl-2）， Bcl-2-associated X protein （Bax）， and cleaved cysteinyl aspartate-specific protease-3 （cleaved Caspase-3）. Method:SMMC-7721 cells were routinely cultured， passaged， and treated with various concentrations （50， 75， 112， 167， and 250 mg·L^-1） of S. tuberosa alkaloids， while those in the blank control group were only treated with 10% fetal bovine serum. The cell proliferation was determined by tetrazolium bromide （MTT） colorimetry and colony assay and the cell apoptosis by Hoechst 33258 staining. The protein expression levels of Bcl-2， Bax， and cleaved Caspase-3 were detected by Western blot. Result:S. tuberosa alkaloids inhibited the proliferation of SMMC-7721 cells， and the inhibition rate was significantly increased in comparison with that in the blank control group （P<0.01）， with the half maximal inhibitory concentrations （IC₅₀） at 24 h， 48 h， and 72 h being （173.36±8.75）， （112.14±16.50）， and （96.41±2.60）mg·L^-1， respectively. The cell colony-inhibitory activity was significantly increased in a dose-dependent manner （P<0.01）. Compared with the blank control group， S. tuberosa alkaloids promoted the apoptosis of SMMC-7721 cells， manifested as increased number of apoptotic cells and elevated apoptotic rate （P<0.01）. The typical morphological changes such as brightly blue-fluorescent condensed nuclei， cytoplasmic shrinking， and karyopyknosis were found under the upright fluorescence microscope. As revealed by comparison with the blank control group， the expression of Bcl-2 was significantly down-regulated （P<0.01）， while the protein expression levels of pro-apoptotic protein Bax and cleaved Caspase-3 in the 75， 112， 167， and 250 mg·L^-1 S. tuberosa alkaloids groups were significantly up-regulated （P<0.01）. Conclusion:S. tuberosa alkaloids inhibit the proliferation of SMMC-7721 cells and promote their apoptosis possibly by inhibiting Bcl-2 protein expression and promoting Bax and cleaved Caspase-3 protein expression.

Objective:To understand the current situation of hospice care attitude among nursing students in Tibet university, to analyze the factors affecting nursing students' attitude towards hospice care; put forward the intervention measures to promote the development of hospice care ability.Methods:From June to August, 2019, 194 nursing undergraduates from Medical College of Tibet University were surveyed by questionnaire, including the Chinese version of the Frommelt Hospice care attitude scale (Fatcod-B), the Caring Ability evaluation scale (CAI), and the general nursing students questionnaire. SPSS 24.0 was used to transcribe and statistically analyze the data.Results:The total score of the hospice care attitude of nursing students was (93.56±7.42), the average score of items was (3.22 ± 0.25), and the highest score of caring attitude was (3.68 ± 0.56), the attitude dimension score of communication with terminal patients was the lowest (2.66 ± 0.42). The ability of nursing students to care for others, the degree of death topic discussion and the experience of other people's death can influence their palliative care attitude.Conclusions:The attitude of the undergraduate nursing students in Tibet is above the middle. Palliative care, and the nursing students' caring ability and communication ability should be improved by strengthening the practical experience and education and training, so as to promote the development of the students' palliative care ability.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Objective: To explore the management effects of health knowledge-attitude-practice education on phosphorous control in peritoneal dialysis patients with hyperphosphatemia. Methods: A total of 64 peritoneal dialysis patients with hyperphosphatemia with long-term stable follow-up in the People’s Hospital of Quzhou from 2016 to 2018 were selected, and randomly divided into control and intervention groups. The groups received regular health education and health knowledge-attitude-practice education for 3 months, respectively. T-test and paired t-test were used to analyze the difference in the two groups, before and after intervention, in the score of knowledge-attitude-practice, serum phosphorus level, daily dietary phosphorous, and dosage of phosphate binder. Results: Before the health education intervention,there was no significant difference between the two groups’ questionnaire score of knowledge-attitude-practice of hyperphosphatemia, serum phosphorus, intact parathyroid hormone (iPTH), daily dietary phosphorous, dosage of phosphorus binder, and weekly urea clearance index in gender, age, and other general information. After 3 months of health education, the total score, knowledge, and behavior scores were higher in both groups than before intervention, and the scores of the intervention group were significantly higher than the control group. The scores increased by 16.64, 6.15, and 9.52 points respectively in the control group, and by 26.26, 11.67, and 13.56 points respectively in the intervention group. There was no significant difference in attitudes and beliefs between the groups before and after the intervention. After the intervention, the serum phosphorus level decreased, dosage of phosphate binder increased in both groups, the daily dietary phosphorous and iPTH decreased in the intervention group. These differences were statistically significant. The serum phosphorus level of the intervention group (1.86±0.42) mmol/L was lower than the control group (1.97±0.33) mmol/L, and the daily dietary phosphorous of the intervention group (831.22±187.85) mg/d was lower than the control group (928.23±192.81) mg/d. The difference in dosage of phosphate binder and iPTH of the groups was not statistically significant. Conclusions Health knowledge-attitude-practice education in peritoneal dialysis patients with hyperphosphatemia can improve their level of knowledge-attitude-practice, and promote the reduction of serum phosphorus.