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Background: Primary healthcare workers in China were vital in controlling COVID-19, facing unprecedented challenges due to the pandemic's suddenness and transmissibility. This paper analyzed their work in Guangzhou, highlighting key difficulties in past epidemic control efforts., Methods: Semi-structured qualitative interviews were conducted with selected primary healthcare workers in Guangzhou City and audio-recorded until saturation of themes was reached. The data were analyzed independently for themes using NVivo V.12., Results: Thematic analysis of qualitative interview data revealed that challenges and difficulties encountered in grassroots epidemic prevention and control work during the COVID-19 pandemic were primarily categorized into seven dimensions: human resource allocation, material and vehicle support, epidemic prevention subsidies and compensation, humanistic care, upper-level management, horizontal collaboration, and resident cooperation., Conclusion: Based on the findings, the research team recommends that administrative departments and institutions related to primary healthcare should appropriately schedule personnel work and rest time, adjust work content flexibly, optimize the allocation of medical and logistical resources, and increase investment in primary healthcare work as well as staff protection., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Jin, Feng, Xiao, Tian, Yao, Zhang, Wu, Zhu, Zheng, Chen, Liu, Ma, Chen and Dong.)

Background: Primary health-care (PHC) resource plays a critical role in addressing challenges related to healthcare accessibility and costs, as well as implementing a graded diagnosis and treatment system. This study aims to analyze the extent and components of inequality in PHC resource allocation in Guangzhou., Methods: By utilizing data from the Annual Report on Healthcare Institutions for community and township health centers in Guangzhou from 2012 to 2020, this paper analyses the distribution of human, material and financial resources. It examines inequities in health resource allocation using the Gini coefficient. Additionally, it investigates the internal structure of overall inequality through the two-stage nested Theil decomposition method and explores the influencing mechanisms of inequality using the concentration index decomposition method., Results: The findings indicate that between 2012 and 2020, except for beds in 2018 and 2019, the Gini coefficients for resource allocation relative to population size remained below 0.3. Moreover, the Gini coefficient for geographical area ranged from 0.1228 to 0.3481. The two-stage nested Theil decomposition results reveal that within-district disparity contributes the most to the overall inequality, exceeding 46 %. The Concentration indexes show negative values, and the decomposition analysis highlights the significant contribution of the number of individuals served (over 72 %) to the inequality in health resource allocation., Conclusion: At the administrative district level, the allocation of PHC resources in Guangzhou demonstrates overall equity, with within-district inequality identified as the primary contributor to the overall inequality. The distribution of PHC resources in Guangzhou follows a pro-poor pattern. The key factors influencing equity enhancement in PHC resource allocation in Guangzhou include the number of individuals served, the presence of township health centers among institution types, the number of hospital admissions per capita, and the proportion of children aged 0-3., Competing Interests: The authors declare that they have no competing interests.The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: The purpose of this study was to explore the job burnout of primary healthcare workers in Guangzhou during the prevention and control of COVID-19 epidemic and its influencing factors from the perspective of institutional operation and management in 2021-2022., Methods: A cross-sectional study involved 866 primary healthcare workers from different districts of Guangzhou, China. The Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS) was utilized to assess job burnout. From the perspective of organizational operation and management, the possible causes of job burnout among primary healthcare workers during COVID-19 have been categorized into 7 major aspects. Univariate and multivariate logistic regression analyses were conducted to identify influencing factors for job burnout in primary healthcare workers., Results: The detection rate of job burnout among primary healthcare workers was 78.29%. Men (OR = 2.39) and whose institution was located in urban-rural fringe (OR = 1.56) were more likely to detect job burnout. Conversely, institution heads showed a lower risk of job burnout. From the perspective of institutional operation and management, workers who were not satisfied with personnel management (OR = 2.41), materials and vehicles (OR = 2.89), subsidies and compensation (OR = 2.18), humanistic care (OR = 2.11), superior management (OR = 8.32) were found to have a higher risk of job burnout., Conclusion: The detection rate of job burnout among primary healthcare workers in Guangzhou was relatively high during the period of COVID-19. When there is another sudden major epidemic, the managers of institutions can focus on and deal with the problems related to the operation and management of institutions such as personnel management, materials and vehicles, subsidies and compensation, humanistic care, and superior management, so as to provide logistical support for the workers and alleviate their job burnout., (© 2024. The Author(s).)

In the past decade, two-dimensional (2D) perovskite surface treatment has emerged as a promising strategy to improve the performance of three-dimensional (3D) perovskite solar cells (PSCs). However, systematic studies on the impact of organic spacers of 2D perovskites on charge transport in 2D/3D PSCs are still lacking. Here, using 2D perovskite film/C 60 heterostructures with different organic spacers [butylamine (BA), phenylethylamine (PEA), and 3-fluorophenethylamine (m-F-PEA)], we systematically investigated the carrier diffusion and interfacial transfer process. Using a 2D perovskite film with a thickness of ∼7 nm, we observed subtle differences in electron transfer time between 2D perovskites and C 60 layers, which can be attributed to limited thickness and similar electron coupling strength. However, with the thickness of 2D perovskite increasing, electron transfer efficiency in the (BA) 2 PbI 4 /C 60 heterostructure exhibits the most rapid decrease due to poor carrier diffusion of (BA) 2 PbI 4 caused by stronger exciton-phonon interactions compared to (PEA) 2 PbI 4 and (m-F-PEA) 2 PbI 4 in thickness-dependent charge transfer research. Meanwhile, the fill factor of 2D/3D PSC treated with BAI exhibits the most rapid decrease compared to PEAI- and m-F-PEAI-treated 2D/3D PSCs with the concentration increase of passivators. This study indicates that it is easier to enhance open-circuit voltages and minimize the decrease of fill factor by increasing the concentration of passivators in 2D/3D PSCs when using passivators with a rigid molecular structure.

Objective: To estimate the optimal quarantine period for inbound travelers and identify key risk factors to provide scientific reference for emerging infectious diseases., Methods: A parametric survival analysis model was used to calculate the time interval between entry and first positive nucleic acid test of imported cases in Guangzhou, to identify the influencing factors. And the COVID-19 epidemic risk prediction model based on multiple risk factors among inbound travelers was constructed., Results: The approximate 95th percentile of the time interval was 14 days. Multivariate analysis found that the mean time interval for inbound travelers in entry/exit high-risk occupations was 29% shorter (OR 0.29, 95% CI 0.18-0.46, p  < 0.0001) than that of low-risk occupations, those from Africa were 37% shorter (OR 0.37, 95% CI 0.17-0.78, p  = 0.01) than those from Asia, those who were fully vaccinated were 1.88 times higher (OR 1.88, 95% CI 1.13-3.12, p  = 0.01) than that of those who were unvaccinated, and those in other VOC periods were lower than in the Delta period. Decision tree analysis showed that a combined entry/exit low-risk occupation group with Delta period could create a high indigenous epidemic risk by 0.24., Conclusion: Different strata of imported cases can result in varying degrees of risk of indigenous outbreaks. "low-risk groups" with entry/exit low-risk occupations, fully vaccinated, or from Asia deserve more attention than "high-risk groups.", Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Zheng, Tan, Zhao, Chen, Dong and Chen.)

Aging is a critical risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine efficacy. The immune responses to inactivated vaccine for older adults, and the underlying mechanisms of potential differences to young adults, are still unclear. Here we show that neutralizing antibody production by older adults took a longer time to reach similar levels in young adults after inactivated SARS-CoV-2 vaccination. We screened SARS-CoV-2 variant strains for epitopes that stimulate specific CD8 T cell response, and older adults exhibited weaker CD8 T-cell-mediated responses to these epitopes. Comparison of lymphocyte transcriptomes from pre-vaccinated and post-vaccinated donors suggested that the older adults had impaired antigen processing and presentation capability. Single-cell sequencing revealed that older adults had less T cell clone expansion specific to SARS-CoV-2, likely due to inadequate immune receptor repertoire size and diversity. Our study provides mechanistic insights for weaker response to inactivated vaccine by older adults and suggests the need for further vaccination optimization for the old population., (© 2023. The Author(s).)

A comprehensive analysis of the prognostic, diagnostic, and biological significance of miR-148a-3p and cathepsin A (CTSA) in hepatocellular carcinoma (HCC) was performed using bioinformatics algorithms with The Cancer Genome Atlas (TCGA) data. miR-148a-3p and CTSA gene expression in HCC tissues and nontumor specimens was analyzed using TCGA database with R software. CTSA staining analysis was validated using the Human Protein Atlas database. Prognostic, diagnostic, gene set enrichment, Gene Ontology, Kyoto Encyclopedia of Genes and Genomes, and immune infiltration analyses were implemented using the TCGA database with R software. Based on TCGA data and our cohort populations, CTSA expression was significantly elevated in HCC tissues compared with nontumor specimens. A significant negative correlation between miR-148a-3p and CTSA was observed in the TCGA data and our cohort population. Mechanistically, CTSA was a direct gene target of miR-148a-3p. Both CTSA and miR-148a-3p could serve as prognostic and diagnostic indicators in HCC. miR-148a-3p expression was significantly and negatively correlated with the StromalScore, ImmuneScore, and ESTIMATEScore in patients with liver cancer. miR-148a-3p mimic-mediated apoptosis and the inhibition of HCC cell growth and migration were counteracted by CTSA overexpression. The miR-148a-3p/CTSA axis was implicated in immune cell infiltration and carcinogenesis of HCC. miR-148a-3p and CTSA might be prospective molecular targets to enhance the potency of immunotherapy in HCC., (© 2022 Wiley Periodicals LLC.)

Objectives: This study sought to identify the epidemiological investigation challenges of the COVID-19 pandemic and offer insights into the underlying issues., Design: An exploratory qualitative study used thematic analysis of semistructured and in-depth individual interviews., Setting: This study was conducted in Centers for Disease Control and Prevention in Guangdong Province., Participants: Twenty-four participants consented to participate in an in-depth interview. Transcribed recordings were managed using NVivo software and analysed using inductive thematic analysis., Results: The qualitative analysis revealed five key themes: high-intensity epidemiological investigation task, emergency management requiring improvement in the early stage, respondent uncertainty, impact on work and social life and inadequate early-stage Joint Prevention and Control Mechanism., Conclusion: This survey focuses on the epidemiology workforce at the forefront of the COVID-19 pandemic and qualitatively describes their experiences, vocational issues and psychological stressors. We found that the problems of epidemiological investigation posed intense challenges to the epidemiology workforce. These findings highlight the epidemiological investigation challenges associated with this pandemic. We have provided some suggestions that may help improve the efficiency and quality of the epidemiology workforce in China., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Here, we evaluated the immune properties of the HLA-A2 restricted CD8 + T cell epitopes containing mutations from B.1.1.7, and furthermore performed a comprehensive analysis of the SARS-CoV-2 specific CD8 + T cell responses from COVID-19 convalescent patients and SARS-CoV-2 vaccinees recognizing the ancestral Wuhan strain compared to B.1.1.7. First, most of the predicted CD8 + T cell epitopes showed proper binding with HLA-A2, whereas epitopes from B.1.1.7 had lower binding capability than those from the ancestral strain. In addition, these peptides could effectively induce the activation and cytotoxicity of CD8 + T cells. Our results further showed that at least two site mutations in B.1.1.7 resulted in a decrease in CD8 + T cell activation and a possible immune evasion, namely A1708D mutation in ORF1ab 1707-1716 and I2230T mutation in ORF1ab 2230-2238 . Our current analysis provides information that contributes to the understanding of SARS-CoV-2-specific CD8 + T cell responses elicited by infection of mutated strains or vaccination., Competing Interests: The authors declare no competing interests., (© 2022 The Author(s).)

Leisure activities, particularly physically and cognitively stimulating leisure activities, mitigate cognitive decline. The present study aimed to examine the relationship between mahjong playing, leisure physical activity, and mild cognitive impairment (MCI). Older adults with and without MCI were recruited (n = 489, healthy group; and n = 187, MCI group). The regression results showed that years of mahjong playing (odds ratio = 0.595, 95% confidence interval [0.376, 0.961], p = .032) and physical activity (odds ratio = 0.572, 95% confidence interval [0.381, 0.849], p = .012) were associated with reduced odds of having MCI after adjusting for a series of covariates. Leisure physical activity and mahjong playing interacted with each other and produced combined effects on the odds of having MCI. Combined cognitive and physical interventions may produce larger benefits on cognition than either intervention alone.

We identified SARS-CoV-2 specific antigen epitopes by HLA-A2 binding affinity analysis and characterized their ability to activate T cells. As the pandemic continues, variations in SARS-CoV-2 virus strains have been found in many countries. In this study, we directly assess the immune response to SARS-CoV-2 epitope variants. We first predicted potential HLA-A*02:01-restricted CD8 + T-cell epitopes of SARS-CoV-2. Using the T2 cell model, HLA-A*02:01-restricted T-cell epitopes were screened for their binding affinity and ability to activate T cells. Subsequently, we examined the identified epitope variations and analyzed their impact on immune response. Here, we identified specific HLA-A2-restricted T-cell epitopes in the spike protein of SARS-CoV-2. Seven epitope peptides were confirmed to bind with HLA-A*02:01 and potentially be presented by antigen-presenting cells to induce host immune responses. Tetramers containing these peptides could interact with specific CD8 + T cells from convalescent COVID-19 patients, and one dominant epitope (n-Sp1) was defined. These epitopes could activate and generate epitope-specific T cells in vitro , and those activated T cells showed cytolytic activity toward target cells. Meanwhile, n-Sp1 epitope variant 5L>F significantly decreased the proportion of specific T-cell activation; n-Sp1 epitope 8L>V variant showed significantly reduced binding to HLA-A*02:01 and decreased proportion of n-Sp1-specific CD8 + T cell, which potentially contributes to the immune escape of SARS-CoV-2. Our data indicate that the variation of a dominant epitope will cause the deficiency of HLA-A*02:01 binding and T-cell activation, which subsequently requires the formation of a new CD8 + T-cell immune response in COVID-19 patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Qiu, Xiao, Wang, Zhu, Mao, Chen, Gao, Deng, Su, Su, Fang, Zhang, Zhang, Xie, Yuan, Luo, Huang, Wang and Chen.)

Vaccine hesitancy is a major obstacle to the achievement of universal child vaccination, which has been studied extensively in Western countries but much less so in Asian countries, especially China. This cross-sectional survey is aimed to assess the prevalence of vaccine hesitancy and to explore the reasons for vaccine hesitancy among parents in Guangzhou. In January 2020, a questionnaire adapted to the Chinese setting from a widely-used hesitancy scale was administered to a sample of parents who brought their children aged <13 years to Community Health Service Centers for vaccination in Guangzhou. The incidence of vaccine hesitancy among those parents was 6.6% (50/755). Regression analysis showed that differences in socio-economic characteristics were not associated with the occurrence of vaccine hesitancy among parents in Guangzhou. However, strong distrust of domestic vaccine quality (OR = 10.9, 95% CI = 1.5-81.4), being required to have their children vaccinated for nursery and school entry (OR = 3.6, 95% CI = 1.7-7.7), and not being aware of which vaccines are officially required and which are optional (OR = 2.1, 95% CI = 1.1-4.3) were the risk factors significantly associated with vaccine hesitancy. In order to increase parents' trust in domestic vaccine quality and reduce the prevalence of vaccine hesitancy, it is essential to strengthen quality control in domestic vaccine manufacturing and to proactively disseminate clear and accurate information about vaccines to parents. Furthermore, advocating the value of vaccination among all citizens of Guangzhou is crucial.

Rapid detection of antibiotic residues in duck meat is of great significance for strengthening food safety and quality supervision of duck meat and fighting against inferior products in the duck meat market. The objective of the current paper was to evaluate the potential of synchronous fluorescence spectroscopy (SFS) coupled with chemometric methods for the rapid detection of sulfamethazine (SM2) and ofloxacin (OFL) residues in duck meat.The SFS spectral data from duck meat containing different concentrations of SM2 and OFL were preprocessed by baseline offset. The detection conditions, including the adding amounts of β-mercaptoethanol solution and o-phthalaldehyde solution, as well as the reaction time, were optimized by a single factor experiment for obtaining a better detection effect, and their optimal values were 400 μL , 25 μL , and 40 min, respectively. By comparing 2 chemometric models based on peak-height algorithm and peak-area algorithm, the prediction model based on peak-height algorithm was a better quantitative model with correlation coefficient for the prediction set (Rp) of 0.9031 and 0.9981, the root mean error for the prediction set (RMSEP) of 7.9509 and 0.5267 mg/kg, recovery of 81.7 to 155.1% and 96.4 to 111.2%, and relative standard deviation (RSD) of 4.1 to 6.7% and 2.9 to 6.8% to predict SM2 and OFL residues in duck meat, respectively. Overall, the results of this investigation showed that SFS technique was an effective and rapid tool for the detection of SM2 and OFL residues in duck meat., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: To mobilize family's positive involvement in improving and sustaining self-management activities of older adults with diabetes, we developed a couple-based collaborative management model (CCMM) for community-dwelling older Chinese. Methods: The model was developed stepwise through applying theoretical models, interviewing older couples and community healthcare workers, as well as incorporating expert reviews. A 3-month pilot study was conducted to test the model's feasibility and its treatment effects by linear regression on 18 pairs of older couples aged 60 years+, who were equally divided into a couple-based intervention arm and a patient-only control arm. Results: The developed CCMM covered four theory-driven intervention modules: dyadic assessment, dyadic education, dyadic behavior-change training, and dyadic monitoring. Each module was delivered by community healthcare workers and targeted at older couples as the management units. Based on interviews with older couples and healthcare workers, 4 weekly education and training group sessions and 2-month weekly behavior change booster calls were designed to address older adults' main management barriers. These modules and session contents were evaluated as essential and relevant by the expert panel. Furthermore, the CCMM showed good feasibility and acceptability in the pilot, with non-significant yet more positive changes in physiological outcomes of diabetic participants and couples' well-being and exercise levels of these in the intervention arm than their controlled counterparts. Conclusion: We systematically developed a couple-based collaborative management model of diabetes, which was well-received by healthcare practitioners and highly feasible among older Chinese couples living in the community. The model's treatment effects need to be verified in fully powered randomized controlled trials. Clinical Trial Registration: http://www.chictr.org.cn/showproj.aspx?proj=42964, identifier: ChiCTR1900027137., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Liu, Xiao, Peng, Zhao, Wu, Yu, Ou, Chen, Wu, Xu and Liao.)

Pancreatic cancer (PC), highly malignant, is one of the most lethal cancers. Interferon-induced transmembrane protein 1 (IFITM1) has recently been regarded as a new molecular marker in human cancers. However, the role of IFITM1 in PC remains unclear. In this study, a short hairpin RNA (shRNA) was constructed to assess the effect of IFITM1 on PANC-1 and ASPC-1 cells. The level of IFITM1 was downregulated in cells transfected with shRNA targeting IFITM1 (sh-IFITM1). Silencing of IFITM1 significantly decreased cell viability, downregulated the level of Ki-67, arrested cell at G1/S phase, reduced the number of cells in S phase, and decreased cyclinD1, cyclinE, CDK2, and CDK4 levels. Moreover, Hoechst staining and Western blotting analysis showed that cell apoptosis was induced by IFITM1. IFITM1 knockdown suppressed the MAPK signaling pathway by downregulation of p-ERK, p-P38, and p-JNK levels. These findings suggested that IFITM1 could be considered a potential therapeutic target for PC.

Objective: The aim of this study was to investigate the expression of FXYD domain-containing ion transport regulator 6 (FXYD6) mRNA and protein in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) tissues with cirrhosis, the corresponding paracancerous tissues and the normal liver tissues, and to explore the clinical significance of FXYD6 expression in HBV-related HCC with cirrhosis., Methods: The FXYD6 mRNA and protein were examined by semi-quantitative reverse transcription polymerase chain reaction and immunohistochemistry, respectively., Results: The FXYD6 mRNA in HBV-related HCC tissues was significantly higher than that in the cirrhosis tissues or that in the normal liver tissues. The positive expression rate of FXYD6 protein was statistically higher in HBV-related HCC tissues than that in HBV-related cirrhosis or that in normal liver tissues. There was no significant correlation between the expression of FXYD6 protein and gender, age, histological differentiation, tumor diameter, tumor number, integrity of tumor capsule or not and alpha fetoprotein (AFP) concentration in serum, but the protein expression was associated with microvascular invasion, pathological stage, and early recurrence after operation within 1 year., Conclusion: FXYD6 might be involved in hepatocyte carcinogenesis and tumor progression in HBV-related HCC with cirrhosis and indicated a poor prognosis., Competing Interests: Conflict of interest: The authors state no conflict of interest., (© 2020 Xiongfei Chen et al., published by De Gruyter.)

Background: China's limited health care resources cannot meet the needs of chronic disease treatment and management of its rapid growing ageing population. The improvement and maintenance of patient's self-management is essential to disease management. Given disease management mainly occurs in the context of family, this study proposes to validate a Couple-based Collaborative Management Model of chronic diseases that integrates health professionals and family supporters; such as to empower the couples with disease management knowledge and skills, and to improve the couples' health and quality of life., Methods: The proposed study will validate a couple-based collaborative management model of Type 2 Diabetes Mellitus (T2DM) in a community-based multicenter, two-arm, randomized controlled trial of block design in Guangzhou, China. Specifically, 194 T2DM patients aged ≥55 and their partners recruited from community health care centers will be randomized at the patient level for each center at a 1:1 ratio into the couple-based intervention arm and the individual-based control arm. For the intervention arm, both the patients and their spouses will receive four-weekly structured group education & training sessions and 2 months of weekly tailored behavior change boosters; while these interventions will be only provided to the patients in the control group. Behavior change incentives will be targeted at the couples or only at the patient respectively. Treatment effects on patients' hemoglobin, spouses' quality of life, alongside couples' behavior outcomes will be compared between arms. Study implementation will be evaluated considering its Reach, Effectiveness, Adoption, Implementation and Maintenance following the RE-AIM framework., Discussion: This study will generate a model of effective collaboration between community health professionals and patients' family, which will shield light on chronic disease management strategy for the increasing ageing population., Trial Registration: Chinese Clinical Trial Registry, ChiCTR1900027137, Registered 1st Nov. 2019.

Background: Cognitive impairment represents a risk factor for falls in older adults. However, cognition is a complex construct comprising several functional domains. The relationship between specific cognitive domain and falls in cognitively healthy older adults is unclear., Objectives: This study aims to investigate the relationship between falls, attention, and executive function in older adults while considering the three components of attention (alerting, orienting, and executive control) and three components of executive function (updating, inhibition, and shifting)., Methods: Cognitively healthy older adults were recruited (n = 60 for fallers and n = 100 for non-fallers). The participants were assessed on the Attention Network Test (alerting, orienting, and executive control), running memory test (updating), Stroop test (inhibition), and digit switching test (shifting). Confounder-adjusted logistic models were used to examine the associations between falls and specific cognitive functions in cognitively healthy older adults., Results: The results showed that falls were associated with alerting, executive control, and updating. These associations were not attenuated when adjusting for a series of covariates such as age, gender, education, balance, general health, and emotional status., Conclusions: The results suggest that among cognitively healthy older adults, falls are related to three specific cognitive functions: alerting, executive control, and updating. Disentangling the mechanism and contribution of cognitive deficits in fall risk may provide insights for the development of prevention and rehabilitation strategies for falls in older adults., (© 2020 S. Karger AG, Basel.)

Background: Hypertension is a growing problem worldwide and can often result in a variety of negative health outcomes. The aim of this study was to assess the effects of age at diagnosis, calendar period, and birth cohort on the change in the prevalence rate of hypertension in Guangzhou from 2004 to 2013., Methods: We used data from the Guangzhou Community Health Survey, a population-based study designed by the National Health and Family Planning Commission of the PRC every 5 years. A total of 27,299, 23,467, and 18,362 participants aged 15-79 years completed the survey in 2004, 2009, and 2013, respectively., Results: Age effects increased slowly before the age of 42 years but increased rapidly after the age of 42 years, peaking at 79 years. Cohort effects grew slowly before the end of the 1960s but grew quickly after the end of the 1960s. The risk of suffering from hypertension among people born in 1962, 1972, 1982, and 1992 was 1.39, 2.68, 5.55, and 11.53 times, respectively, than that of people born in 1952. The period effects increased 25% from 2004 to 2009 and later declined 27% from 2009 to 2013 in the entire population. There was no gender difference in age effects and period effects, but strong cohort effects on hypertension were observed among males compared with females., Conclusions: For Chinese individuals, the later one is born, the higher the risk is of suffering from hypertension. Strong cohort effects for hypertension were observed among males compared with females, indicating that males are more easily affected by hypertension based on the change in birth cohort., (© American Journal of Hypertension, Ltd 2019. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: Health literacy and health-information seeking behaviour (HISB) play vital roles in health outcome improvements. This study examines the extent of income-related inequality in health literacy and health-information seeking as well as the contributions of the main socioeconomic determinants in China., Methods: We analysed representative data of participants aged over 18 years as well as older adults from the Guangzhou Community Health Survey. A concentration index (CI) was used to quantify the degree of income-related inequity in health literacy and health-information seeking. Probit regression models were employed to decompose the CI into the contributions to each factor., Results: Results showed a significant pro-rich distribution of adequate health literacy (CI: 0.0602, P < 0.001; horizontal index [HI]: 0.0562, P < 0.001) and HISB from healthcare professionals (CI: 0.105, P < 0.001; HI: 0.0965, P < 0.001). The pro-rich distribution of health literacy was mainly attributable to education background (contribution: 54.76%), whereas income inequalities contributed most to the pro-rich distribution of health-information seeking among an urban population (contribution: 62.53%)., Conclusion: Public interventions in China to reduce inequality in health literacy and HISBs among the urban population, coupled with easily accessible information sources on health, warrant further attention from policymakers.

Objectives: Cyberbullying research in China is in early stage. This study describes the cyberbullying experiences of junior and senior high school students in Guangzhou, China, and to examine the risk factors associated with cyberbullying perpetrators, victims and perpetrator-victims among students. We also investigated the frequency of cyberbullying and coping strategies of student victims., Methods: Participants were 2590 students in grades 7, 8, 9 and 10 from six junior and senior high schools in October 2015 in Guangzhou, in south China, who completed a questionnaire. Data on participants' experiences with cyberbullying perpetration and victimisation during the previous 6 months were collected. Multinomial logistic regression was used to analyse factors associated with being perpetrators, victims and perpetrator-victims., Results: In this sample, 28.0% (725) of participants reported being a perpetrator and 44.5% (1150) reported being a victim in the previous 6 months. Specifically, 2.9% (74) reported being perpetrators only, 19.3% (499) reported being victims only and 25.2% (651) reported being perpetrator-victims (both perpetrator and victim). In addition, flaming was the most common form of cyberbullying in both perpetration and victimisation. Logistic regression analyses indicated that online game addiction in participants was associated with increased odds of being a perpetrator only; no democratic parenting style in the mother and physical discipline by parents were associated with increased odds of being a victim only; male students, students with low academic achievement, those spending over 2 hours a day online, experiencing physical discipline from parents and online game addiction were associated with increased odds of both perpetration and victimisation., Conclusions: Cyberbullying is a common experience among Chinese junior and senior high school students. These findings add to the empirical data on cyberbullying and reinforce the urgent need for cyberbullying prevention in China. Furthermore, from the perspective of practice, it is important to raise our awareness of cyerbullying and reduce the risk factors., Competing Interests: Competing interests: None declared., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

Estrogen residues, including diethylstilbestrol in chicken, are one of the main food safety concerns all over the world owing to a series of negative effects on the human body. Surface-enhanced Raman spectroscopy (SERS) coupled with multivariate analysis was applied to detect rapidly diethylstilbestrol residues in chicken. The detection conditions, including the sizes of colloidal gold nanoparticles (Au NPs) and the additional amounts of Au NPs, chicken extract containing diethylstilbestrol, and magnesium sulfate solution, as well as the adsorption time, were optimized by a single factor experiment to obtain a better detection effect of diethylstilbestrol residues in chicken. Partial least squares regression (PLSR) was the best quantitative model for the detection of diethylstilbestrol residues in chicken by comparing four chemometric models. Diethylstilbestrol residues in chicken could be predicted by PLSR with the low root mean square error (RMSE = 0.4128 mg/L), and the high determination coefficient (R 2  = 0.9811) and ratio of prediction to deviation (RPD = 7.2566) for the test set. A novel approach, which has the potential for the analysis of other estrogen residues in meat, was developed to detect rapidly the diethylstilbestrol residues in chicken by using SERS coupled with multivariate analysis.

Background: HIV-related discrimination amongst healthcare providers is one of the strongest obstacles to effectively responding to HIV. This study was conducted to explore the occurrence of and other factors related to discrimination against people living with HIV/AIDS amongst healthcare providers in Guangzhou, China., Methods: This was a cross-sectional study, conducted between July and October 2016, that enrolled healthcare providers from 9 healthcare institutions in Guangzhou, China. HIV-related discrimination was assessed using anonymous self-designed questionnaires. Chi-square tests were used to study the differences in the socio-demographic characteristics, occupational characteristics, HIV-related knowledge and personal attitudes between participants who had and had not discriminated against People living with HIV/AIDS (PLWHA). A multivariate logistic regression analysis was used to study the factors associated with HIV-related discrimination., Results: A total of 972 healthcare providers were investigated, and 386 (39.7%) had previously served HIV-positive individuals in their work. Administering HIV antibody tests for patients without his or her consent was the most frequent act of discrimination (65.3%), and other forms of discrimination, including "differential treatment" (51.0%), "disclosed information" (46.4%) and "refused to treat" (38.6%), were also prevalent. The logistic regression analysis indicated that people who had worked for 3-7 years, worked in secondary hospitals or lower, worked in surgical departments, had lower scores on HIV transmission knowledge, were dissatisfied with the occupational exposure protection system offered by the government, were worried about HIV-related exposure and feared HIV-related exposure were more likely to commit an act of medical discrimination against PLWHA., Conclusion: HIV-related discrimination was not unusual in the healthcare providers of Guangzhou, which may be related to their negative cognitions and attitudes as well as the hospital management system and government policy. Therefore, comprehensive HIV-related knowledge education should be implemented to change the attitude of healthcare providers. In addition, the current laws and regulations should be refined by the government to protect the rights of healthcare providers. The contradiction between designated hospitals and non-designated hospitals should be resolved to ensure that PLWHA receive timely and effective help and treatment.

Exercise induces the expression of peroxisome proliferator-activated receptor gamma co-activator 1-α (PGC-1α) in skeletal muscle, which promotes the cleavage of fibronectin type III domain-containing protein 5 (FNDC5) to irisin. To explore the relationship between irisin and its regulators, we analyzed the plasma irisin levels and the muscle levels of FNDC5 and PGC-1α after exercise. Male C57BL/6J mice underwent a treadmill exercise (60% of VO 2max ) for 30 min or one hour (h), and blood and gastrocnemius samples were collected before exercise (pre-exercise), immediately after exercise, and during 24-h recovery after 1-h exercise. We found that plasma irisin levels were significantly increased during exercise (P < 0.05), while FNDC5 protein levels were not significantly increased. Moreover, PGC-1α mRNA and protein levels were significantly increased during 30-min exercise, but were decreased during 1-h exercise. After 1-h exercise, the irisin levels peaked at 6 h (20.71 ± 0.25 ng/ml) and decreased to pre-exercise levels by 24 h (15.45 ± 0.27 ng/ml). Likewise, PGC-1α mRNA and protein levels were increased at 1 h and maintained at elevated levels for 6 h; thereafter, the expression levels of PGC1-α protein were decreased to pre-exercise levels at 12 h. Thus, the restoration of PGC-1α expression to the pre-exercise levels was followed by the decrease in plasma irisin levels. By contrast, during 24-h recovery, the expression levels of FNDC5 mRNA and protein were maintained at elevated levels. These results suggest that the coordinated expression of FNDC5 and PGC-1α may contribute to the increased levels of plasma irisin after exercise.

Background: We aimed to describe the trends and associated factors of hypertension among residents aged ≥15 yr in Guangzhou, China., Methods: Three standardized cross-sectional health surveys were conducted in 2004, 2009 and 2013 using a multi-stage cluster sampling method, and a total of 69128 qualified participants were included in the study. The data were obtained through physical health examination and questionnaire survey., Results: The age-standardised prevalence of hypertension increased from 12.5% to 16.0% between 2004 and 2009 and declined from 16.0% to 14.0% between 2009 and 2013, and crude prevalence respectively was 14.6%, 19.1% and 18.8% in 2004, 2009 and 2013. The proportion of optimal blood pressure dropped from 51.1% to 33.2%, high-normal blood pressure increased from 20.1% to 28.9%, grade 1 hypertension and grade 2 or 3 hypertension increased from 11.5% to 13.6% and 3.9% to 5.8% between 2004 and 2013. The average age was significantly increased ( P <0.001) from 42.8 to 47.5 yr, and the average body mass index slightly increased ( P <0.001) from 22.4 to 23.0. Logistic regression analysis shows that higher age, male, higher body mass index, smoking and drinking alcohol were potential risk factors for hypertension., Conclusion: Both crude and age-standardized prevalence of hypertension were initially increased, but subsequently decreased in Guangzhou during 2004-2013. The optimal blood pressure population decreased significantly while the high-normal blood pressure population increased substantially during the survey period., Competing Interests: Conflict of Interests The authors declare that there is no conflict of interests.

Histone deacetylase inhibitor (HDACi) has been a major target of anticancer agents. Quisinostat (JNJ‑26481585), a novel second‑generation HDACi, has previously demonstrated antiproliferative activity against non‑small cell lung cancer; however, the function of quisinostat in hepatocellular carcinoma (HCC) remains to be elucidated. In the present study, it was revealed that quisinostat suppressed the cell viability of HepG2 cells in vitro and in vivo. Increased cell apoptosis was observed in quisinostat‑treated HepG2 cells. The underlying mechanism revealed that quisinostat treatment activates the cleavage of caspase proteins. Furthermore, quisinostat upregulated p53 acetylation at K381/K382 sites by impairing the interaction between histone deacetylase 6 and p53, which resulted in the activation of p53, and triggered cell cycle arrest at the G1 phase. Collectively, the results of the present study demonstrated the antiproliferative effect of quisinostat on HepG2 cells; these results suggest that histone deacetylase may be a promising therapeutic target of HCC.

People living with HIV or AIDS (PLWHA) experienced severe medical discrimination which is seriously affecting their lives. However, few studies examined the epidemic characteristics of self-perceived medical discrimination from the discrimination objects such as PLWHA. Therefore, we aimed to investigate the epidemiological status and analyze the influential factors of the self-perceived medical discrimination on PLWHA in South China. The self-designed questionnaire was used to investigate the medical discrimination status of the 443 infected persons, who were randomly recruited from the representative AIDS designated hospitals in Guangdong Province in South China. The results showed that 49.0% of PLWHA experienced medical discrimination, and 55.3% received discriminatory treatment, 48.4% experienced refusal of treatment, 36.4% had private information leaked and 12.9% received mandatory test. However, 52.2% patients chose to endure discrimination in silence. Compared with the Asymptomatic HIV-infected patients, AIDS patients perceived more medical discrimination. The Logistic regression analysis indicated that PLWHA self-perceived medical discrimination status was influenced by 4 factors: the voluntary of first medical detection, the route of transmission, the stage of the disease and the familiarity with the HIV/AIDS-related law. Additionally, the two dimensions of the life quality scale were influenced by medical discrimination, namely, overall function and disclosure worry. Ultimately, our study provides a better understanding of the relationship between infection status, quality of life and the medical discrimination they experienced or perceived. It will help health professionals and policy makers to develop tailored behavioral and policy-oriented intervention strategies for PLWHA to tackle different types of medical discrimination in high-risk settings.

Natural polynucleotides including Micrococcus lysodeikticus and calf thymus DNA exhibit enantioselective recognition to S-ofloxacin regulated by Cu(2+). This is the first report that ofloxacin and Cu(2+) have cooperative effects on the local distortions of polynucleotides. At the [Cu(2+)]/[base] ratio of 0.1, S-ofloxacin is more liable to induce the locally distorted structures of polynucleotides, of which the association constant of S-ofloxacin toward DNA-Cu(II) is three times higher than that of the R-enantiomer. The apparent increase of adsorption capability and cooperativity, as well as the change of adsorption mechanism were detected in the adsorption of ofloxacin enantiomers on polynucleotides upon Cu(II)-coordination. This study not only discloses the effect of the chiral drug on the structural transition of long double-stranded DNA, but provides fundamental data to develop a novel enantioseparation method based on natural polynucleotides., (© 2015 Wiley Periodicals, Inc.)

FXYD6, FXYD domain containing ion transport regulator 6, has been reported to affect the activity of Na(+)/K(+)-ATPase and be associated with mental diseases. Here, we demonstrate that FXYD6 is up-regulated in hepatocellular carcinoma (HCC) and enhances the migration and proliferation of HCC cells. Up-regulation of FXYD6 not only positively correlates with the increase of Na(+)/K(+)-ATPase but also coordinates with the activation of its downstream Src-ERK signaling pathway. More importantly, blocking FXYD6 by its functional antibody significantly inhibits the growth potential of the xenografted HCC tumors in mice, indicating that FXYD6 represents a potential therapeutic target toward HCC. Altogether, our results establish a critical role of FXYD6 in HCC progression and suggest that the therapy targeting FXYD6 can benefit the clinical treatment toward HCC patients.

The specific interactions of Cu(2+) with self-complementary DNA sequences involving d[G4C4(GC)2G4C4], d[(GC)10], and d[(AT)10], as well as the chiral recognition mechanism of ofloxacin enantiomers via the Cu(II)-modulated DNAs, were investigated using characterizations of circular dichroism, gel electrophoresis, FT-IR spectroscopy, UV melting measurement, electron paramagnetic resonance, and HPLC. The Cu(II)-coordinated GC-rich DNAs exhibit amplified enantioselectivity toward the S-enantiomer of ofloxacin. Especially in the case of d[G4C4(GC)2G4C4], ofloxacin enantiomers intercalate into the two adjacent guanine bases through the minor groove mediated by Cu(2+), which leads to a more favorable binding between S-ofloxacin and DNA. The highest ee value of ofloxacin enantiomers in the permeate after being adsorbed by the Cu(II)-DNA complex is obtained as 49.2% in the R-enantiomer at the [Cu(2+)]/[base] molar ratio of 0.25, while at the [Cu(2+)]/[base] molar ratio of 0.05 the highest ee value of ofloxacin enantiomers in the retentate reaches 26.3% in the S-enantiomer. This work illustrates a novel promising route to construct DNA-based chiral selectors toward certain drug enantiomers through the programmable enantioselective recognition on the basis of DNA chirality and the specific binding of transition metal ions.

DNA-based chiral selectors are constructed to discriminate ofloxacin enantiomers through metal-ion anchoring on a special DNA double helix that contains successive GC pairs. The effects of metal ions involving Mg(2+), Ni(2+), Cu(2+), Ag(+), and Pt(2+) were studied on the regulation of DNA chiral discrimination towards ofloxacin enantiomers. It is shown that DNA-Cu(II) complexes exhibit the highest enantioselectivities at the [Cu(2+)]/base ratio of 0.1. The enantiomeric excess can reach 59% in R-enantiomer after being adsorbed by the RET-Cu(II) complex. Stereoselective recognition of ofloxacin enantiomers on the double helix is tunable via external stimulus, providing a programmable desorption process to regenerate DNA. This DNA-based chiral selector exhibits excellent reusability without apparent loss of enantioselectivity after three cycles of adsorption and desorption., (© 2014 Wiley Periodicals, Inc.)

Introduction: This article reports on the prevalence of noncommunicable diseases (NCDs) and their risk factors in the city of Guangzhou, China, and shows a trend toward epidemic proportions when municipal data are compared with provincial data., Methods: We conducted the Guangzhou Community Health Survey in the 12 administrative districts of Guangzhou to learn about NCDs and their risk factors. A community-based, face-to-face survey with a stratified multistage cluster sampling was used. Information was gathered on 27,743 respondents, aged 0 to 108 years, with a male to female ratio of 1 to 1. All participants completed a questionnaire, and those aged 15 years or older had a physical examination. Survey results were compared with the provincial results of the 2002 Guangdong Nutrition and Health Survey (GNHS)., Results: The data were weighted to the respondent's probability of selection and to the age- and sex-specific population. Prevalence estimate of self-reported NCDs was 16.0%. Hypertension and diabetes were reported as the most important NCDs. Of those who responded, 6.8% reported having more than 2 chronic conditions. The adjusted prevalence of hypertension decreased by 13.3% since 2002. Awareness, treatment, and control of hypertension and diabetes were improved. The estimated prevalence of current smoking decreased, and the prevalence of former smoking increased from 2002. However, the prevalence of overweight and obesity, especially central obesity, increased., Conclusion: Results were encouraging with regard to hypertension and diabetes. However, the unfavorable trends, especially for overweight, central obesity, and passive smoking, call for additional action.

Members of the FXYD domain-containing ion transport regulator protein family, including FXYD3 and FXYD5, play an important role in the pathogenesis of numerous tumors. However, the correlation between the expression of FXYD6 and tumors remains poorly understood. In the current study, the expression of FXYD6 was examined immunohistochemically in 72 cholangiocarcinoma tissues and 30 distal normal bile duct tissues matched with the tumors. The results show that the positive expression rate of FXYD6 was significantly higher in cholangiocarcinoma than that in normal bile duct tissue (69 vs. 33.3%; P=0.002). Furthermore, the positive expression rate of FXYD6 in well- and moderately-differentiated cholangiocarcinoma was clearly higher than that in poorly-differentiated and mucinous cholangiocarcinoma (85.7 vs. 40%; P=0.000). However, there was no significant correlation between the expression of FXYD6 and gender (P=0.393), age (P=0.174), histological type (P=0.123), T stage (P=0.164), lymph node metastasis (P=0.343), perineural invasion (P=0.088) and tumor location (P=0.238). The results of this study indicate that FXYD6 may be a new biomarker for cholangiocarcinoma and may be associated with a favorable prognosis in this malignant disease.

Background: Objective data on hypertension prevalence and management in local areas are scarce. We assessed the prevalence of hypertension and its management in Guangzhou adult population., Methods: A stratified multistage cluster sampling with probability proportional to size method was used in this survey. Information on a total of 23 939 respondents, aged 15 years old or above, having a gender ratio of 0.997 (male versus female) with completed questionnaire and blood pressure measurement, was obtained. Hypertension was defined as having a mean SBP of at least 140 mm Hg, a DBP of at least 90 mm Hg, and/or the prescription of antihypertensive drugs. Information related to the history of hypertension and treatment of hypertension was collected through a questionnaire., Results: The prevalence of hypertension was 11.8%. Among patients with hypertension, 54.4% were aware of their elevated BP, 49.3% had treatment, and 23.3% achieved targeted BP control. Among those who were aware of their hypertension, 90.4% underwent treatment, and among those who were treated, 43.6% were well controlled. Although the prevalence, awareness and treatment of hypertension varied significantly among adults with several social economics status, the control of hypertension did not show significant differences. Among treated patients, the control of hypertension showed significant differences among adults with education, occupation, insurance and income., Conclusions: It is the first time for Guangzhou to describe epidemic and management of hypertension. A baseline was established, which could provide useful information not only to policymakers but also to developing countries with a close urbanization and aging rate similar to Guangzhou.

This paper is to establish a three-dimensional finite element model (3D-FEM) of pelvic floor levator ani muscles in an old healthy women. We acquired the image data of the pelvic bones and pelvic floor muscles from CT and MRI scanning in a non-pregnant old healthy female volunteers. The 3-D reconstruction and mesh optimization of the whole pelvic bones and muscles with application of image processing software Mimics12.0 and Geomagic9.0 were obtained. Then we built the 3D-FEM of the musculoskeletal system of the pelvic bones and levator ani muscles with Ansys11.0 software. We obtained an accurate 3D-FEM of pelvic bones and levator ani muscles in the older healthy woman. The results showed that it was reliable to build 3D-FEM with CT and MRI scanning data and this model could vividly reflect the huge space anatomy of the real pelvic floor levator ani muscles. It avoids the defects to gain the model from the body of anatomical specimens in the past. The image data of model are closer to vivisection, and the model is more conducive to the latter finite element analysis.

Background: A large number of 2009 pandemic influenza A (H1N1) infections were localized in school populations., Objectives: To describe the epidemiology, clinical features and risk factors associated with an outbreak that occurred at a vocational boarding school in Guangzhou, P.R. China., Study Design: Data were collected prospectively and retrospectively through the use of on-site doctors and a post-outbreak survey and blood collection. The survey was used to confirm symptoms, and to investigate a series of flu-related factors such as dormitory conditions, health habits, vaccine history and population contact history. Blood samples were taken for serological analysis. Pandemic H1N1 infection was initially confirmed by a real-time RT-PCR assay. Following the identification of the outbreak by the Guangzhou CDC on September 4, cases were diagnosed symptomatically and retrospectively by serological analysis using the hemagglutination inhibition assay and a neutralization assay., Results: The infection rate was 32% (505/1570) and the attack rate was 22.2% (349/1570). The asymptomatic infection rate was 9.9% (156/1570). Sharing a classroom (OR=2.17, 95% CI: 1.62-2.91) and dormitory space (OR=2.32, 95% CI: 1.84-2.93) was associated with higher rates of infection. Opening windows for ventilation was the only control measure that significantly protected against infection., Conclusion: Social isolation and quarantine should be used to prevent the spread of infection. Ventilation and a control of air flow between classrooms and dorms should be implemented as possible. School closures may be effective if implemented early., (Copyright © 2010. Published by Elsevier B.V.)

Background: To evaluate the risk of the recurrence and the efficiency of the vaccination, we followed-up antibody responses in patients with the 2009 pandemic H1N1 influenza and persons who received the pandemic H1N1 vaccine in Guangzhou China., Methods: We collected serum samples from 129 patients and 86 vaccinated persons at day 0, 15, 30, 180 after the disease onset or the vaccination, respectively. Antibody titers in these serum samples were determined by haemagglutination inhibition (HI) assay using a local isolated virus strain A/Guangdong Liwan/SWL1538/2009(H1N1)., Results: HI antibody positive rate of the patients increased significantly from 0% to 60% at day 15 (χ(2) = 78, P<0.001) and 100% at day 30 (χ(2) = 23, P<0.001), but decreased significantly to 52% at day 180 (χ(2) = 38, P<0.001), while that of vaccinated subjects increased from 0% to 78% at day 15 (χ(2) = 110, P<0.001) and 81% at day 30 (χ(2) = 0.32, P = 0.57), but decreased significantly to 34% at day 180 (χ(2) = 39, P<0.001). Geometric mean titers (GMT) of HI antibodies in positive samples from the patients did not change significantly between day 15 and day 30 (T = 0.92, P = 0.36), but it decreased significantly from 80 at day 30 to 52 at day 180 (T = 4.5, P<0.001). GMT of vaccinated persons increased significantly from 100 at day 15 to 193 at day 30 (T = 4.5, P<0.001), but deceased significantly to 74 at day 180 (T = 5.1, P<0.001). Compared to the patients, the vaccinated subjects showed lower seroconversion rate (χ(2) = 11, P<0.001; χ(2) = 5.9, P = 0.015), but higher GMT (T = 6.0, P<0.001; T = 3.6, P = 0.001) at day 30 and day 180, respectively., Conclusion: Vaccination of 2009 influenza A (H1N1) was effective. However, about half or more recovered patients and vaccinated persons might have lost sufficient immunity against the recurrence of the viral infection after half a year. Vaccination or re-vaccination may be necessary for prevention of the recurrence.

Background: This study describes road traffic injuries among school-aged children in Guangzhou, China, and examines the effect of road safety knowledge and risk behaviours on road traffic injuries., Methods: A stratified cluster sample of 3747 children from six primary schools and six middle schools in Guangzhou, China, was surveyed. Data were collected on sociodemographic factors and road traffic injuries during the past year. Knowledge about road safety rules was assessed using a 14-item road safety knowledge index, and risky road safety behaviours were measured using a 25-item road safety behaviour index., Results: A total of 403 (10.8%) students reported having at least one road traffic injury during the past 12 months. A high proportion of injuries was found among children who were boys, in primary school and from the suburbs. Bicycle-related injuries were the most common (46.0% of all injuries). Motor vehicle-related injuries had higher hospitalisation rates and worse psychological impact than bicycle or pedestrian injuries. Children with low and medium road safety knowledge had 1.5 to 3 times the odds of injury compared with students with high road safety knowledge. Students with high scores on the risky road behaviour index had twice the odds of injury (OR 2.04, 95% CI 1.47 to 2.84) compared with students with low scores., Conclusion: Better road safety knowledge and the avoidance of walking or cycling-related risk behaviours are protective factors for road traffic injuries among Chinese school children. More injury prevention programmes are needed to improve road safety knowledge and reduce risk behaviours.