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Background: Health education in primary and middle schools in China has been implemented for more than two decades since 1990s. This study aims to assess the students' health literacy gained through school health education, and provide scientific base to the concerned government agencies for updating the relevant national policy for school-based health education. Methods: The study was conducted through cross-sectional multi-stage cluster-stratified sampling survey in 77 elementary and 76 middle schools in 24 project provinces and two municipal cities in China. A self-administered questionnaire was developed. The reliability of the questionnaire was assessed using Cronbach's alpha and Spearman-Brown coefficient. A descriptive analysis was used to summarize the outcome. Results: The survey covered 8,008 subjects (4,011 from elementary and 3,997 from middle schools). The correct answer given on the majority of health knowledge was higher than 60% among the surveyed subjects. However, it was found that there were differences on student knowledge and practices from regions and economic levels; and the healthy personal behaviours between elementary and middle school students varied. Positive correlations between knowledge and practices, knowledge and attitudes were observed among subjects. Conclusions: Health literacy of the primary and middle school children in China was found to be limited and unbalanced. Thus school-based health education should be enhanced and the national guidelines for school health education and curriculum framework should be updated. (Contains 1 figure and 2 tables.)

Elucidating the influence mechanisms of seed germination and seedling growth is important for revealing the natural regeneration of forest plantations. We collected the seeds from 58-year-old Quercus acutissima Carruth. forest, and the seeds were further divided into three classes: large, medium, and small, and sown under the forest gaps (I, 197.82 m2; II, 91.85 m2, III, understory) to observe seed germination and early seedling growth. Precipitation in the study area and soil moisture content in the forest gaps were also observed during the trial period. The results showed that the precipitation in 2019 was similar to that in 2020; both were significantly lower than the precipitation in 2021. The difference in soil water content between gaps I and II was not significant, and both were significantly lower than III. The order of seedling emergence rate in gaps was II > III > I, but the minimum was almost close to zero in I. Large and medium seeds showed significantly greater emergence rate than small seeds. The seedlings of II had higher seedling height, ground diameter, ground diameter relative growth rate, seedling biomass, root surface area, and root volume than those of III. Large seeds had the highest ground diameter, ground diameter relative growth rate, biomass, root mass ratio, root shoot ratio, and root surface area. Correlation analysis showed that seedling biomass was significantly and positively correlated with root surface area and root volume, and significantly and negatively correlated with specific root length and specific root surface area. The regulation of soil moisture in the gap and the adaptability related to seed size were two key factors influencing the seed germination and early seedling growth of Q. acutissima. [ABSTRACT FROM AUTHOR]

This study poses the following research questions: What is the prevalence of bullying in vocational schools in China? What are the differences between different genders and professions? How should individuals, families, and schools do to affect school bullying? What can we do to improve and to respond school bullying, to reduce its occurrence and consequences? This cross-sectional study was conducted in 2018 with 95,873 students from 85 vocational schools. The main outcome indicators were self-reported involvement in bullying (perpetrator, victim, perpetrator-victim, or uninvolved). Multinomial logistic regression analyses were conducted, with personal characteristics, relational characteristics, and school climate as predictors. A total of 30.4% of participants reported being bullied, 2.9% reported bullying others, and 21.7% reported being bullied and bullying others. Majors related to primary and secondary industries are more likely to involvement in bullying than majors related to tertiary industries. Boys were more involved in physical or verbal bullying, whereas girls were more involved in relational bullying and cyberbullying. Sex, history of fighting, and emotional/mental state were the strongest individual factors associated with bullying. Having friends was inversely associated with bullying involvement; moreover, a positive relationship with parents and a good parenting style (warmth, democracy, and mutual concern) protected students from bullying others as well as being bullied. School bullying programs, happiness at school, and insecurity at school were strong negative predictors of bullying. Bullying is prevalent among vocational school students in China. An appropriate response to school bullying requires strengthening student capacity to correctly understand and deal with bullying, identifying victims and vulnerable groups, developing school-based interventions, involving parents in prevention programs, and enhancing students' sense of responsibility in supervision, reporting, and creating a friendly environment. [ABSTRACT FROM AUTHOR]

Ulcerative colitis (UC) is considered an immune disease, which is related to the dysbiosis of intestinal microbiota and disorders of the host immune system and metabolism. Sophora flavescens Aiton has been used for the clinical treatment of UC in China and East Asia for thousands of years. It has many traditional prescriptions and modern preparations, and its curative effects are definite. We are the first to report that the flavonoids in Sophora flavescens (S. flavescens) Aiton EtOAc extract (SFE) could potentially attenuate the dextran sodium sulfate–induced UC in mice, which changed the current understanding of considering alkaloids as the only anti-UC pharmacological substances of S. flavescens Aiton. Based on the 16S rRNA gene sequencing and metabolomic analysis, it was found that the anti-UC effects of SFE were due to the regulation of gut microbiota, reversing the abnormal metabolisms, and regulation of the short-chain fatty acids synthesis. Notably, according to the interaction networks of specific bacteria and "bacteria and metabolites" co-expression network, the SFE could enrich the abundance of the commensal bacterium Lactobacillus , Roseburia , norank_f__Muribaculaceae , Anaerotruncus , Candidatus_Saccharimona , and Parasutterella , which are proposed as potentially beneficial bacteria, thereby playing vital roles in the treatment of UC. [ABSTRACT FROM AUTHOR]

Vulnerable road users (pedestrians, bicyclists, and motorcyclists) account for an increasing proportion of traffic injuries. We used a case-crossover study design to examine the association between cell-phone usage and traffic injuries among pedestrians, bicyclists, and electric bicycle riders during the course of their travel. We studied 643 pedestrians, bike riders, and electric bike riders aged 10–35 years who were involved in a road injury, visited the emergency department in one of the 3 hospitals in Shanghai, China, in 2019, and owned a cell phone. Half of the participants (n  = 323; 50.2%) had used a cell phone within 1 minute before the injury happened. A pedestrian's or rider's use of a mobile phone up to 1 minute before a road injury was associated with a 3-fold increase in the likelihood of injury (odds ratio = 3.00, 95% confidence interval: 2.04, 4.42; P  < 0.001). The finding was consistent across subgroups by sex, occupation, reason for travel, mode of transportation, and location of injury. Use of a cell phone when walking or riding was associated with an increased risk of road injury. Measures should be taken to make people aware of this detrimental impact on the risk of road injury. [ABSTRACT FROM AUTHOR]

With the ever increasing importance of testing drug quality, rapid analytical methods are needed for supervision of Chinese herbal medicines. Near-infrared spectroscopy is one of the most powerful tools in quality assessment of Chinese herbal medicines. In this work, near-infrared spectroscopy was applied to develop a rapid method for quantitative determination of typhaneoside and isorhamnetin-3-O-glucoside in different processed products of Pollen Typhae. A total of 71 batches of samples were collected from different regions in China. After acquisition of near-infrared spectra, different pre-processing methods were compared, and a competitive adaptive reweighted sampling algorithm was used to perform the variable selection. Then a partial least squares regression algorithm was applied to build the quantitative models. The root mean square error of calibration, root mean square error of cross validation, and root mean square error of prediction were 0.0190, 0.0364, and 0.0158%, respectively, for a quantitative model of typhaneoside. The root mean square error of calibration, root mean square error of cross validation, and root mean square error of prediction were 0.0190, 0.0377, and 0.0170%, respectively, for a quantitative model of isorhamnetin-3-O-glucoside. Moreover, the relative prediction deviation values of both quantitative models were larger than 3, indicating good performance of the partial least squares (PLS) models. The results demonstrated that high accuracy prediction of typhaneoside and isorhamnetin-3-O-glucoside could be obtained by near-infrared spectroscopy, to allow an alternative method for quality assessment of different processed products of Pollen Typhae. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to test a model which involved clans and health providers to increase antenatal care attendance in rural minority areas of China with high HIV prevalence.Methods: Formative research was conducted to determine barriers and facilitators to antenatal care use. A strategy involving clans in addressing the barriers identified was developed. Implementation of the new strategy was done through three plan-do-study-act (PDSA) cycles, lasting four months each.Results: Awareness and uptake of antenatal care increased significantly after the intervention. The proportion of post-partum women who used any antenatal care increased from 21.3% to 64.5% (p < 0.001), and the proportion who knew that antenatal care is necessary increased from 77.8% to 89.8% (p < 0.001). The proportion of pregnant women who attended antenatal care (p < 0.001) and the proportion of pregnant women who went for a first antenatal care visit in early pregnancy (p < 0.001) all showed increasing trends during the study period.Conclusion: Involving clans in antenatal care programmes in rural minority areas of China had an impact on antenatal care use. A quality improvement approach incorporating PDSA cycles can help local health authorities make context-specific, evidence-informed decisions to improve uptake of health services. [ABSTRACT FROM AUTHOR]

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Abstract: The aim of this study was to investigate the pesticide residues in market vegetables in Shaanxi Province of China. The concentrations of 33 pesticides were determined by gas chromatography (GC) in 285 samples. Ten organophosphorus pesticides (OPs) were found in concentrations ranging from 0.004 to 0.257mg/kg. The mean levels of omethoate, phorate, chlorpyrifos, methidathion, ethoprophos in vegetables exceeded the maximum residue limits (MRLs) allowed by the Ministry of Health, of China. Other detectable OP pesticide residues levels were below their MRLs. Dicofol were detectable in green pepper and chives samples. Five pyrethroid pesticides (PYRs) were detectable in vegetable samples respectively. The results provide useful information on the current contamination status of a key agricultural area in China, and point to the need for urgent action to control the excessive use of some chemicals. [Copyright &y& Elsevier]

Background:It has been reported that the prevalence of chronic diseases is high among old people and they have poor chronic diseases knowledge. This study was therefore designed to evaluate the awareness rate of chronic diseases knowledge among people aged over 60 years, to explore its related factors and to provide evidence for future health education. Methods:A cross-sectional study was conducted from April to August in 2011. People aged 60 years and above from 3 communities in Jinan were selected by cluster sampling. Nine hundred and twenty five participants were interviewed face-to-face using a structured questionnaire. Results:The awareness rates of chronic diseases knowledge varied from 29.5% to 90.2%. Four healthy lifestyles including quitting smoking and less drinking, keeping broad-minded, maintaining balanced diet and moderate physical activity were best known (from 86.3% to 90.2%). The least known knowledge were 2 complications of hypertension: nephropathy (29.5%) and retinopathy (37.2%). Participants with the following characteristics or behaviors were more likely to have higher chronic diseases knowledge: younger age, female, Han Chinese, higher level of education, having health insurance, participating in societies, having family history of chronic diseases, frequently gathering with friends/relatives, usually going to provincial hospitals/hospitals affiliated with medical universities, usually going to municipal hospitals and usually going to community health center/station. Conclusions:Old people in Jinan had incomplete chronic diseases knowledge and the overall awareness rate was not high. The older people’s chronic diseases knowledge should be improved and health education programs should target males, older people with lower educational level, having no health insurance, having no family history of chronic diseases, participating in no societies, and less frequently gathering with friends/relatives. Also, lower level medical facilities should improve their skills of health education. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Principal component analysis and orthogonal partial least-squares discriminant analysis are used in this paper. • We found 7 pharmacodynamics biomarkers in plasma and 6 pharmacodynamics biomarkers in urine. • Amino acid metabolism pathway and tricarboxylic acid cycle metabolism pathway. • Biological network, canonical pathways and functions related to the Pharmacodynamic biomarkers. Abstract Moutan Cortex charcoal (MCC), the processed root bark of Paeonia suff ;ruticosa Andrews (Paeoniaceae), is a kind of traditional Chinese medicine (TCM) and has been used for treating blood-heat and hemorrhage(BHH)syndrome in China for thousands of years. In order to explore potential metabolic mechanism, 1H NMR-based metabonomics technique was applied to evaluate the effect of MCC on metabolic changes in plasma and urine of BHH rat models. Serum and urine samples were obtained from male SD rats with normal group, model group and MCC group for study. Based on 1H NMR spectra obtained from plasma and urine samples, principal component analysis (PCA) and orthogonal partial least-squares discriminant analysis (OPLS-DA) models were capable of distinguishing the three group. And the 13 pharmacodynamic biomarkers of MCC were identified in the plasma and urine. The results showed that BHH induced great metabolic disorders in plasma and urine metabolisms. However, MCC could reverse the imbalanced metabolites by alanine, aspartate and glutamate metabolism and citrate cycle (TCA cycle) pathway, and its effect was also confirmed by the general signs and pharmacodynamics assessments. The results indicated that NMR-based metabolomic profiling method is sensitive and specific enough to evaluate the MCC efficacy and mechanism of action on BHH syndromes. [ABSTRACT FROM AUTHOR]

Objective This study aimed to explore whether the depression of offspring caregivers can be affected by the intergenerational disagreements on preferred living arrangements for the elderly, and the extent of this influence. Methods A total of 875 participants from five urban neighborhoods were investigated in a cross-sectional survey in Jinan, China. Depressive symptoms were assessed by the Self-rating Depression Scale (SDS). Multiple stratification was performed based on participants’ characteristics, then generalized linear models (GLM) were used to adjust confounding factor and analyze the effect of the intergenerational disagreements on depressive symptoms among participants with different characteristics. Results The intergenerational disagreements on preferred living arrangements for the elderly greatly impact on offspring caregivers’ depressive symptoms. Especially in the following two situations: (1) in the case of older adults were relatively independent and offspring caregivers had to co-reside with older adults against their own will, the max mean difference on the depression measures was up to 10.603 ( p < 0.001), in comparison with both parties were willing to co-reside. (2) In the case of older adults were fully dependent and offspring caregivers had not to hire a maid to care older adults against their own will, the max mean difference on the depression measures was up to 8.937 ( p < 0.001), in comparison with both parties were willing not to hire a maid. Conclusion Intergenerational disagreements on preferred living arrangement for the elderly have negative effect on offspring caregivers’ depressive symptoms. [ABSTRACT FROM AUTHOR]

[Display omitted] • The inhibition of Curcumae Rhizoma on thrombin was demonstrated for the first time. • Handheld NIR spectrometers can be used to evaluate pharmacodynamics of Curcumae Rhizoma. • The analytical performance of handheld-NIR is compared with that of benchtop NIR. • The key factor limiting the performance of handheld NIR is scanning range. • An accurate global PLSR model was developed for the analysis of two products of Curcumae Rhizoma. It's far from enough to describe the blood circulation promoting effect of Curcumae Rhizoma (CR), which is widely grown as a functional vegetable or spice in south and southeast Asian countries, and processed Curcumae Rhizoma (PCR), only by disclosing the content of a couple of relative compounds. In this study, the thrombin inhibitory effect as well as 2,2′-azino-bis (3-ethylbenz-thiazoline-6-sulfonic acid) (ABTS) and 2,2-diphenyl-picrylhydrazyl (DPPH) free radical scavenging ability of CR/PCR extracts was investigated, and TANGO Fourier transform near-infrared (FT-NIR, Bruker, Germany)—a benchtop instrument allowing the full range NIR wavelength scanning—and handheld-NIR spectrometer (Micro-NIR, NIR-S-G1, InnoSpectra corporation, China) that can be connected to smart phones were used to realize the rapid detection of pharmacodynamic indicators. model was evaluated based on the determination coefficient (R2), root mean square error (RMSE), standard error of test set (SEP) and ratio of performance to deviation (RPD). The results of pharmacodynamics experiment confirmed for the first time that CR has significant inhibitory effect on thrombin, and the modeling results revealed that Micro-NIR had a good prediction on the antioxidant capacity (ABTS and DPPH free radical clearance) with RPD greater than 3, but showed a general predictive performance on thrombin inhibition ability (RPD = 2.434). In contrast, FT-NIR provided a good prediction for all the three indicators, with R2 greater than 0.9 and RPD greater than 4.5. Further insights into the capability of the two devices were obtained by analyzing the wavebands selection work. In the full wavelength range, wavebands related to thrombin inhibition were mainly distributed in the combination area which is out of the reach of handheld Micro-NIR, thus resulting in a decrease in the prediction ability. Therefore, compared to the benchtop-NIR, the detection range of the handheld-NIR is the main factor limiting its capability Based on an overall assessment, handheld NIR spectrometer, by greatly expanding the application scenario of NIR technology, is considered as a useful device with a satisfying predictive ability through model construction. [ABSTRACT FROM AUTHOR]

• Qualitative and quantitative models were established for quality evaluation and control of Curcumae Rhizoma based on NIR and VCPA-GA. • Quality markers of Curcumae Rhizoma products were well reflected by NIR. • VCPA-GA method was innovatively used to solve the problem that NIR quantification could not be achieved in previous studies. • Pearson correlation work proved the superiority of the overall wavenumber selection in quantification. • NIRS is a rapid and economical method for TCM monitoring. Curcumae Rhizoma (CR) and vinegar processed Curcumae Rhizoma (PCR) are common medicinal materials widely used in clinical practice in China. There are sliced CR (SCR) and two kinds of PCR products which are processed by different methods: WPCR—prepared with the whole CR root boiled in vinegar and then sliced, and SPCR—prepared with the whole CR root steamed and sliced before boiled with vinegar. In this study, the feasibility of Fourier transform near infrared spectrum (FT-NIR) used to determine the main discrepant components of SCR, WPCR and SPCR were investigated. High performance liquid chromatography (HPLC) was used to identified five discrepant compounds in the three kinds of CR products—curzerene, curcumenol, curdione, furanodienone and demethoxycurin. Pretreatment of NIR qualitative data by different methods revealed that the second derivative in combination with 9 points of Savitzky-Golay smooth (2D9S) could accurately distinguish SCR, SPCR and WPCR from each other, and the discrimination ability was improved significantly by wavebands selection. Then a model with great accuracy was established by combining with wavebands selection and partial least squares regression (PLSR). Compared with the competitive adaptive reweighted sampling (CARS) selection method, 2D9S- variable combination population analysis (VCPA)-Genetic algorithm (GA)-PLSR model was evidently more accurate in prediction of the content of curzerene, curcumenol, curdione and furanodienone, with an R2p of 0.9558, 0.9129, 0.9098 and 0.9350, as well as a ratio of performance to deviation (RPD) of 4.8454, 3.4640, 3.3020 and 4.0082, respectively. Whereas, the content of demethoxycurin failed to be well predicted. The correlation analysis revealed that the results of wavebands selection were consistent with the trend of changes in the content of these target compounds and the findings of NIR absorption analysis, and the characteristic chemical bonds of these compounds corresponded to the areas with significant correlation in the heat map. It can be concluded that the NIR system, combined with appropriate variable selection and linear regression method, can precisely distinguish SCR, SPCR and WPCR from each other, and can accurately and rapidly determine the four discrepant compounds in the three CR products, suggesting a potential of being routinely used for a more diversified analysis in medicinal herbs study. [ABSTRACT FROM AUTHOR]

Background: Invasive fungal infection (IFI) has become an increasing problem in NICU neonates, and end-organ damage (EOD) from IFI is one of the leading causes of morbidity and mortality in neonates. This study was conducted to summarize clinical data on epidemiology, risk factors, causative pathogens, and clinical outcomes of IFI-associated EOD among neonates in a center in China for the sake of providing references for prevention and treatment of fungal infections in neonates in future., Methods: The clinical data of IFI neonates who received treatment in a tertiary NICU of China from January 2009 to December 2022 were retrospectively analyzed, including causative pathogens and the incidence of EOD. The neonates were divided into EOD group and non-EOD (NEOD) group. The general characteristics, risk factors and clinical outcomes of the two groups were compared., Results: Included in this study were 223 IFI neonates (137 male and 86 female) with a median gestational age (GA) of 30.71 (29,35) weeks and a median birth weight (BW) of 1470 (1120,2150) g. Of them, 79.4% were preterm infants and 50.2% were born at a GA of ≥ 28, <32 weeks, and 37.7% with BW of 1000-1499 g. Candida albicans (C. albicans) was the most common Candida spp. in these neonates, accounting for 41.3% of all cases, followed by C. parapsilosis (30.5%) and C. glabrata (7.2%). EOD occurred in 40 (17.9%) of the 223 cases. Fungal meningitis was the most common EOD, accounting for 13.5% of the 40 EOD cases. There was no significant difference in the premature birth rate, delivery mode, GA and BW between EOD and NEOD groups, but the proportion of male infants with EOD was higher than that without. There was no significant difference in antenatal corticosteroid use, endotracheal intubation, invasive procedures, use of antibiotics, total parenteral nutrition, blood transfusion, postnatal corticosteroid use, fungal prophylaxis and the incidence of necrotizing enterocolitis between the two groups, but the proportion of C. albicans infection cases in EOD group was higher than that in NEOD group (57.5% vs. 37.7%). Compared with NEOD group, the proportion of cured or improved infants in EOD group was significantly lower (P < 0.05), and the number of infants who died or withdrew from treatment was larger (P < 0.05)., Conclusions: Our retrospective study showed that preterm infants were prone to fungal infection, especially very preterm infants. C. albicans was the most common Candida spp. for IFI, and was a high-risk factor for EOD. EOD can occur in both full-term and premature infants, so the possibility of EOD should be considered in all infants with IFI., (© 2024. The Author(s).)

Background: Dengue fever is a mosquito-borne febrile illness. Southeast Asia experienced severe dengue outbreaks in 2019, and over 1000 cases had been reported in Jiangxi, a previously known low-epidemic region in China. However, the emergence of a dengue virus epidemic in a non-epidemic region remains unclear., Methods: We enrolled 154 dengue fever patients from four hospitals in Jiangxi, from April 2019 to September 2019. Real-time PCR, NS1 antigen rapid test, and IgM, IgG tests were performed, and 14 samples were outsourced to be sequenced metagenomically., Results: Among the 154 cases, 42 were identified as imported and most of them returned from Cambodia. A total of 113 blood samples were obtained and 106 were identified as DENV-1, two as DENV-2, and five were negative through RT-PCR. All DENV-1 strains sequenced in this study were all classified to one cluster and owned a high similarity with a Cambodia strain isolated in 2019. The evolutionary relationships of amino acid were consistent with that of nucleotide genome result. The sequence-based findings of Jiangxi strains were consistent with epidemiological investigation., Conclusion: Epidemiological analysis demonstrated that the emergence of dengue cases led to autochthonous transmission in several cities in Jiangxi, a low-epidemic region before. This study emphasized future prevention and control of dengue fever in both epidemic and non-epidemic regions., 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 Zhang, Chen, Wang, Wang, Wu, Zhou, Wang, Luo, Tu, Chen, Huang, Ju, Peng, Rao, Wang, Jiang, Ai and Zhang.)

Aim: To examine the reliability and validity of the Geriatric Depression Scale-15 (GDS-15) and the Patient Health Questionnaire-9 (PHQ-9) for evaluating depression in older adults., Methods: A total of 1546 participants aged ≥60 years were investigated face-to-face with the PHQ-9 and GDS-15 anonymously. Internal consistency reliability was evaluated with Cronbach's α, and structural equation modeling was used to study the construct validity of the scale. Logistic regression was used to discusses the impact of demographic characteristics on the scale., Results: The consistency rate between the GDS-15 and PHQ-9 was 96.10%. The Cronbach's α and split-half reliability in the scales were >0.7. The model fit indices χ 2 /df., comparative fit index and root mean square error of approximation in the GDS-15 were 2.769, 0.815 and 0.077, respectively. The minimum fit function χ 2 in the PHQ-9 model was 93.742, with 27 df., the comparative fit index was acceptably low (comparative fit index 0.837) and the root mean square error of approximation was acceptably high (root mean square error of approximation 0.118). Item standardized path regression coefficients of the GDS-15 model varied between 0.07 and 0.76, among which the coefficients of item 2 and item 9 were 0.12 and 0.07, respectively. Whereas in the PHQ-9, the item standardized path regression coefficients were high (r > 0.45), except for item 3 (r = 0.34). The GDS-15 was affected by urban-rural distribution (OR = 2.104, P = 0.027), whereas the PHQ-9 was affected by sex (OR = 4.266, P = 0.007)., Conclusions: The similar psychometric performance of the PHQ-9, along with its ease of use and relative brevity, makes it attractive compared with the longer GDS-15 for use in Chinese older adults, whereas the influence of sex distribution on the PHQ-9 should be paid attention to. Geriatr Gerontol Int 2020; 20: 138-143., (© 2019 Japan Geriatrics Society.)

To apply the Health Belief Model (HBM) to fall prevention of the elderly and estimate fall health beliefs and their relationships with fall-related behaviors, a citywide cross-sectional study was conducted among people aged 60 years or over in 13 out of 16 districts in Shanghai, China, in September 2018. A total of 5833 participants were investigated. Of this, 43.4% were male; 48.8% were aged 60-69; 18.1% were uneducated; and 50.3% were living in urban areas. People who were older, less educated, living in rural areas generally had lower scores in the 7 HBM dimensions and also had lower proportions of fall risk-reduction behaviors, except that the less educated elderly were more likely to participate in exercise and training and the rural elderly were more likely to check house environment and participate in exercise and training ( p < 0.001). The HBM dimensions were generally positively correlated with the risk-reduction behaviors except that "perceived severity" was negatively correlated with four risk-reduction behaviors and behavior number, "cues to action" was negatively correlated with purchasing shoes, and "perceived benefits" was negatively correlated with participating in exercise activities and fall prevention training ( p < 0.05). When HBM is applied in the field of fall prevention, the interpretation of the results of each dimension has its characteristics in the fields of injury research. Fall prevention strategies should focus on improving the health beliefs and behaviors in those who were older, less educated and living in rural areas, implementing different levels of fall prevention activities to meet different needs, improving the accessibility and applicability of related resources, and raising the organizational level of related fall prevention activities.

BACKGROUND Lung cancer is the most common cause of cancer-associated deaths worldwide. This study aimed to investigate the efficacy and safety of Traditional Chinese Medicine combining EGFR-TKIs in treatment of NSCLC patients harboring EGFR mutations. MATERIAL AND METHODS This study involved 153 advanced-stage NSCLC patients harboring EGFR mutations. Patients were divided into a Control group (administered EGFR-TKI, n=61) and an Experimental group (administered Traditional Chinese Medicine combining EGFR and TKI, n=92). Progression-free survival (PFS) was evaluated for exon 19 deletion and/or 21 deletion patients. Disease control rate (DCR) was assessed to observe therapeutic effects. Adverse effects, including rashes, diarrhea, ALT/AST increase, dental ulcers, and onychia lateralis, were also evaluated. RESULTS TCM combining EGFR-TKI (90.11%) demonstrated no DCR improvement compared to single EGFR-TKI (83.33%) (p>0.05). Median PFS (mPFS) of TCM combining EGFR-TKI (13 months) was significantly longer compared to that in the single EGFR-TKI group (8.8 months) (p=0.001). For 19DEL mutant NSCLC, the mPFS (11 months) in TCM combining EGFR-TKI was significantly longer compared to single EGFR-TKI (8.5 months) (p=0.007). The mPFS of L858 mutant NSCLC patients in EGFR-TKI combining CTM (14 months) was significantly longer compared to single EGFR-TKI (9.5 months) (p=0.015). TCM combining EGFR-TKI was more inclined to prolong mPFS of NSCLC with exon 21 deletion. TCM combining EGFR-TKI illustrated no additional adverse effects in NSCLC patients (p=0.956). CONCLUSIONS Application of Traditional Chinese Medicine prolonged progression-free survival and enhanced therapeutic effect in NSCLC patients harboring EGFR mutations receiving EGFR-TKI treatment. Meanwhile, adjunctive Chinese medicine combining EGFR-TKI in NSCLC with EGFR mutations caused no adverse effects.

Background: Mother-to-child transmission (MTCT) is one of the main transmission routes of HIV, and the probability of MTCT can be dramatically reduced with comprehensive interventions. In southwest and western regions in China, the level of development in rural areas is relatively backwards and retains some original features, which also increases the difficulty of controlling infectious diseases. The Liangshan Prefecture started the prevention of MTCT programme in 2009. However, the implementation of the programme is not ideal, and the coverage of HIV testing is still low. Many Yi (local major ethnicity) women did not take antenatal care (ANC) and just gave birth to their babies at home for a variety of reasons., Methods: Women with pregnancy history in the last 5 years were recruited from two townships based on cluster sampling. Face-to-face interviews were conducted to collect data. Descriptive analysis was performed to describe demographic characteristics, history of pregnancy and ANC uptake, knowledge of and attitudes towards ANC. Multivariable analysis was used to identify factors associated with uptake of ANC., Results: Among 538 women who completed the questionnaires, 77.9% knew that ANC was necessary during and after pregnancy. However, only 24.2% actually accessed ANC. Almost all women (94.6%) expressed their willingness to receive ANC for pregnancy but barriers towards actual uptake of ANC existed including shyness, lack of independence and unavoidable cost. Multivariate analysis showed that no experience of living outside of Zhaojue for more than 6 months, higher number of births, not knowing the necessity of ANC during pregnancy and not knowing the government's promotion policies for ANC were associated with lack of ANC uptake., Conclusion: Although ethnic minority women in rural Liangshan expressed strong intention to use ANC, actual uptake of ANC was low. Knowledge of ANC and HIV prevention for MTCT should be improved among this population, and efforts should be made to help them overcome barriers to accessing ANC., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Obesity has become a global epidemic, with substantial impacts on children's health. Numerous intervention studies for the prevention of obesity in children have been conducted during the most recent decade, but very few have evaluated the long-term and sustainable effectiveness of such prevention efforts., Methods: We conducted a follow-up study during September 2015 and September 2017, based upon a previous 3-year cluster randomized-controlled study (RCT) for a comprehensive childhood-obesity intervention in 14 primary schools in Shanghai, China. A total of 929 students were enrolled in the study. Generalized estimating equation approaches were applied to analyse student's body mass index (BMI), BMI z-score at baseline and three annual long-term follow-ups., Results: Three years after the end of the RCT study, the odds of developing obesity and the odds of developing obesity or overweight in the intervention group were both lower than in the control group among girls [OR(obesity) = 0.299, p = 0.010 and OR (overweight/obesity) = 0.493, p = 0.013]; the odds of developing obesity or overweight in the intervention group was lower than in the control group among boys (OR = 0.369, p = 0.017). Compared with the baseline, the BMI z-scores in the intervention group were lower than those in the control group for both normal-weight students (-0.027) and overweight or obese students (-0.074)., Conclusions: The 3-year RCT showed significant and reliable long-term effects on preventing childhood obesity, particularly among girls., (© The Author(s) 2018; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.)

A sensitive, simple, and validated high-performance liquid chromatography with diode array detection and mass spectrometry detection method was developed for three ginger-based traditional Chinese herbal drugs, Zingiberis Rhizoma, Zingiberis Rhizome Preparatum, and Zingiberis Rhizome Carbonisata. Chemometrics methods, such as principal component analysis, hierarchical cluster analysis, and analysis of variance, were also employed in the data analysis. The results clearly revealed significant differences among Zingiberis Rhizoma, Zingiberis Rhizome Preparatum, and Zingiberis Rhizome Carbonisata, indicating variations in their chemical compositions during the processing, which may elucidate the relationship of the thermal treatment with the change of the constituents and interpret their different clinical uses. Furthermore, the sample consistency of Zingiberis Rhizoma, Zingiberis Rhizome Preparatum, and Zingiberis Rhizome Carbonisata can also be visualized by high-performance liquid chromatography with diode array detection and mass spectrometry analysis followed by principal component analysis/hierarchical cluster analysis. The comprehensive strategy of liquid chromatography with mass spectrometry analysis coupled with chemometrics should be useful in quality assurance for ginger-based herbal drugs and other herbal medicines., (© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Background: The relationship between obesity and hypertension varies with geographical area, race and definitions of obesity. Our study aimed to investigate the prevalence of obesity using standard Chinese criteria based on the body mass index (BMI) and the waist circumference (WC) and to examine the association between obesity and hypertension among middle-aged and elderly people in Jinan city., Methods: This cross-sectional study examined 1,870 subjects from the blocks randomly selected from among the 6 communities of Jinan, China in 2011-2012. The Student's t-test was used to compare numerical data, and the χ2 test was used to compare categorical data. Multivariate logistic regression analyses were performed to assess the effects of general and central obesity on hypertension after adjusting for age or for education level, smoking, alcohol consumption, and continuous age., Results: The prevalence of general obesity among people age 50 years and older was 21.1% (17.0% for males and 23.1% for females), and the prevalence of central obesity was 77.8% for men and 78.7% for women. For men, compared with a normal BMI, the ORs and 95% CIs for overweight and general obesity were 1.853 (1.252, 2.744) and 3.422 (1.894, 6.182), respectively, after adjusting for age, smoking, alcohol consumption and educational level. Compared with a normal WC, the ORs and 95% CIs for central obesity were 2.334 (1.573, 3.465) and 2.318 (1.544, 3.479), respectively, for men. For women, compared with a normal BMI, the ORs and 95% CIs were 1.942 (1.473, 2.599) and 4.011 (2.817, 5.712), respectively, after adjusting for age, smoking, alcohol consumption and educational level. Compared with a normal WC, the ORs and 95% CIs for central obesity were 2.488 (1.865, 3.319) and 2.379 (1.773, 3.192), respectively, for women., Conclusions: The relationship between hypertension and general obesity was stronger than the relationship between hypertension and either overweight or central obesity in both genders.

Objective: To evaluate the effect of child obesity intervention comprehensive program on the improvement of overweight, obese control and knowledge-attitude-practice., Methods: The study design was under cluster-randomized controlled trial, with 965 children in the intervention and 895 children in the control groups. Repeated measurement data on child obesity was analyzed through Generalized Estimating Equation models., Results: The risk of becoming overweight or obesity in the intervention group was 0.824 times more than children in the control group, showing a reduction of 17.6% the risk of being overweight or obese (P = 0.031). In addition, the possibility of increasing one unit of correct rate on obesity related knowledge, children in the intervention group children was 1.044 times (P = 0.001)than in the control group. On the mean obesity related correct attitude rate, it was 1.023 times (P = 0.001) in the intervention group of the control group. Regarding the possibility of increasing one unit om the mean obesity related behavior score, children in the intervention group was 1.522 times (P = 0.001)than those in the control group (P = 0.046)., Conclusion: The comprehensive child obesity intervention program could effectively reduce the risk of developing overweight or obesity and improving the obesity related knowledge, attitude and behavior in children.

Phycobilisomes were prepared from a marine red macroalga Polysiphonia urceolata (P. urceolata) by sucrose step-gradient ultracentrifugation. From the prepared phycobilisomes, an R-phycocyanin was isolated by gel filtration on Sephadex G-150 and then purified by ion exchange chromatography on DEAE-Sepharose Fast Flow and native polyacrylamide gel electrophoresis (PAGE) performed in neutral buffer systems. The purified R-phycocyanins showed not only a homogeneous trimer of 136 kDa in gel filtration and a single band in native PAGE, but also exhibited one band at about pH 5.7 in native isoelectric focusing (IEF). By a gradient SDS-PAGE the purified R-phycocyanin was determined to contain one α subunit of 17.5 kDa (α (17.5)) and two β subunits of 21.3 kDa and 22.6 kDa (β (21.3) and β (22.6)). The analysis from denaturing isoelectric focusing and two-dimension PAGE demonstrated that α (17.5), β (21.3) and β (22.6) had their pIs of 6.4, 5.3 and 5.4, respectively. Furthermore, mass spectroscopy analysis of β (21.3) and β (22.6) by MALDI-TOF mass spectrometry demonstrated the two β subunits had differences in peptide mass fingerprinting. These results revealed that the prepared R-phycocyanins were composed of one α and two β subunits. and , which have a structural foundation to show their pIs too close for them to be definitely resolved by native IEF, are postulated to be the most possible trimeric forms of the R-phycocyanins prepared from the phycobilisomes of P. urceolata.

Background and Objectives: Recent years have seen a rapid increase in the number of rabies cases in China and an expansion in the geographic distribution of the virus. In spite of the seriousness of the outbreak and increasing number of fatalities, little is known about the phylogeography of the disease in China. In this study, we report an analysis of a set of Nucleocapsid sequences consisting of samples collected through the trial Chinese National Surveillance System as well as publicly available sequences. This sequence set represents the most comprehensive dataset from China to date, comprising 210 sequences (including 57 new samples) from 15 provinces and covering all epidemic regions. Using this dataset we investigated genetic diversity, patterns of distribution, and evolutionary history., Results: Our analysis indicates that the rabies virus in China is primarily defined by two clades that exhibit distinct population subdivision and translocation patterns and that contributed to the epidemic in different ways. The younger clade originated around 1992 and has properties that closely match the observed spread of the recent epidemic. The older clade originated around 1960 and has a dispersion pattern that suggests it represents a strain associated with a previous outbreak that remained at low levels throughout the country and reemerged in the current epidemic., Conclusions: Our findings provide new insight into factors associated with the recent epidemic and are relevant to determining an effective policy for controlling the virus.

Subtle genetic variants in ion-channel genes might be at the origin of less rare forms of hypertension in the general population. To test this hypothesis, we observed the role of several important polymorphisms (T1155547C at exon7, G1155942T at exon8, G1156666A at intron10, and C1163527T at intron14) of WNK4 (with-no-kinase) gene on the prevalence of essential hypertension in a Chinese minority ethnic group-the Uyghur population. We did not find a significantly different distribution of genotype and allele frequency of T1155547C, G1155942T, and G1156666A between hypertensives and controls, but we observed a significantly higher frequency of T allele in hypertensive subjects than controls (8.4% vs. 5.7%) (P = 0.02) of C1163527T polymorphism at intron14. Compared with the individuals with two C allele, individuals with at least one T allele show 55% of excess risk in developing hypertension (OR = 1.56, 95% CI:1.06-2.28). In a further analysis, we did not observe a significantly higher or lower odds ratio of haplotype frequency in the hypertensives than in the controls across haplotype encompassing G1155942T, G1156666A, and C1163527T. Thus, a positive association of C1163527T at intron 14 reveals that the WNK4 gene might be involved in the prevalence of essential hypertension in the Uyghur population. Further study should be conducted to observe the role of this gene on hypertension in other populations.