Objective To investigate the internal exposure levels of selenium, arsenic, chromium, and cadmium in blood and urine of general population in Jiangxi Province from 2017 to 2018. Methods A multi-stage complex sampling method was employed to detect the content of selenium, arsenic, chromium, and cadmium in the fasting venous whole blood and urine samples of 720 selected subjects using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The exposure situation of residents in different genders, ages, urban and rural areas, and monitoring sites was analyzed. Spearman correlation was used to evaluate the bivariate correlation between blood metal concentrations and urine metal levels. Results The median levels of blood selenium and urine selenium in the general population of Jiangxi Province from 2017 to 2018 were 90.89 μg/L and 13.67 μg/L, respectively. The median levels of blood arsenic and urine arsenic were 1.26 μg/L and 24.03 μg/L, respectively. The median levels of blood chromium and urine chromium were 0.51 μg/L and 1.84 μg/L, respectively. The median levels of blood cadmium and urine cadmium were 0.85 μg/L and 0.61 μg/L, respectively. There were statistically significant differences in blood selenium (Z=-5.09, P < 0.01) and urine selenium concentrations (Z=-3.94, P < 0.05) between different urban and rural areas, with concentrations higher in urban areas. Except for blood cadmium and urine cadmium, there were statistically significant differences in the concentration levels of other inorganic substances between different monitoring sites (P < 0.05). Differences in blood selenium (H=34.56, P < 0.05), blood cadmium (H=54.14, P < 0.05), and urine cadmium (H=63.447, P < 0.05) among different age groups were statistically significant, with concentrations gradually increasing with age. No statistically significant differences in concentrations of other inorganic substances between different genders were found (P > 0.05) except for urine selenium (Z=-3.77, P < 0.05). The strongest correlation coefficient among the four inorganic substances was 0.419 for blood cadmium and urine cadmium. Conclusion Residents in different regions of Jiangxi Province exhibit varying levels of internal exposure to selenium, arsenic, and chromium. Cadmium showed no regional differences in whole blood and urine load levels within the province, suggesting cadmium accumulation and a positive correlation with age.

Objective To review and analyze the literature related to public health events in China from 2003 to 2023, so as to provide reference for predicting, preventing, and responding to future public health events, and to enhance China’s capacity to deal with sudden public health emergencies. Methods A total of 2 717 articles related to public health field published between 2003 and 2023 and indexed in databases including SCI, CSSCI, CSCD, and PKU core in China National Knowledge Infrastructure (CNKI) were selected as data sources. The CiteSpace software was utilized to explore research hotspots and trends in the evolution of pathways in the field of public health events. Results The study revealed fluctuations in the number of publications on public health events. Author collaboration was relatively stable, while institutional collaboration intensity was low and interdisciplinary collaboration was limited. Research hotspots included emergency management, sudden events, epidemic prevention and control, infectious diseases, and online public opinion. Research content encompassed the epidemic characteristics, influencing factors, emergency response capabilities, and governance responses to public health events.Research topics went through three stages: exploration of public health theories, system construction, and social governance. Conclusion Future research directions will focus mainly on risk communication, public opinion management, and collaborative governance in public health events.

Objective To understand the clinical features and epidemiological characteristics of monkeypox cases in Shangcheng district, Hangzhou city, providing reference basis for monkeypox epidemic prevention and control work. Methods Data on 35 monkeypox cases detected by medical institutions in Shangcheng district, Hangzhou city from July to December 2023 were collected, including demographic information, clinical manifestations, epidemiological information, laboratory test results, and the clinical features and epidemiological characteristics of the cases were analyzed. Results All 35 monkeypox cases were male sexual contacts, with a median age of 28 years (range: 20 to 37 years). None had a history of smallpox vaccination, and all of them were identified through active medical consultation. Among them, 25 cases (71.43%) admitted to having had male homosexual contact within 21 days before onset, with an interval from last exposure to onset ranging from 1 to 14 days, median (Q1, Q3) of 6 (5, 9) days. Clinical symptoms mainly included fever, rash, inguinal lymph node pain, and muscle soreness; 24 cases (68.57%) presented with fever, all 35 cases had a rash, of which 9 cases (25.71%) had painful rashes, predominantly in the genital or anal region, accounting for 65.71% (23/35). Eleven cases (31.43%) of monkeypox cases were co-infected with Human Immunodeficiency Virus (HIV), with a 48.57% (17/35) prevalence of sexually transmitted diseases. Throat swabs and vesicle swabs were collected from all cases for nucleic acid testing, with a positive detection rate of 62.86% (22/35)in throat swabs, median CT value of 31, and 100% (35/35) in vesicle swabs, median CT value of 22. Conclusion The main clinical feature of monkeypox is rash, and the early recognition of skin rash by clinical doctors is key to early detection of cases.The high positive rate of monkeypox nucleic acid detection in vesicle specimens indicates the need for timely nucleic acid testing in high-risk individuals presenting with rash symptoms for early diagnosis and treatment.

Objective To investigate the pathogen pollution in the poultry and environment in Changsha live poultry wholesale market. Methods In total 817 live poultry and environment samples from Changsha county wholesale poultry market were collected from 2022 to 2023. AIV, NDV, C. psittaci, Brucella, and S. suis nucleic acids were detected by real-time fluorescence PCR, and the results were statistically analyzed. Results The overall positive rates of AIV, NDV, C. psittaci, Brucella, and S.suis in market poultry and environment were 64.01%, 32.19%, 6.36%, 0.24%, and 17.75%, respectively. The positive rates of NDV and S. suis in 2023 were higher than those in 2022, and the positive rates of five pathogens were the highest in October or December. There were significant differences in the positive rates of NDV (χ²=6.23, P=0.01) and S. suis (χ²=45.40, P<0.01) in different years and in AIV (χ²=50.50, P<0.01), NDV (χ²=41.28, P<0.01), C. psittaci (χ²=32.83, P<0.01), and S. suis (χ²=59.43,P<0.01) in different months. The sampling sites with the highest positive rates of AIV, NDV, C. psittaci, Brucella, and S. suis were poultry stores (67.53%), market public areas (44.00%), market public areas (8.00%), sheep/dog stores (3.57%), and poultry stores (19.02%). The samples with the highest positive rates of AIV, NDV, C. psittaci, Brucella, and S. suis were poultry drinking water (90.91%), air (61.11%), poultry cages (9.59%), sheep/dogs and other cages (3.77%), and air (31.25%). The positive rates of AIV (χ²=69.06, P<0.01), NDV (χ²=20.98, P<0.01), Brucella (χ²=27.25, P<0.01), S. suis (χ²=8.37, P=0.02) in different sampling sites and AIV (χ²=155.80 , P<0.0l), NDV (χ²=132.59, P<0.01), Brucella (χ²=10.10, P<0.0l) and S. suis (χ²=49.92,P<0.01) in different samples were significantly different. Conclusion The AIV, NDV, C. psittaci, Brucella, and S. suis nucleic acid pollution are common in poultry and environment in Changsha live poultry wholesale market, which indicates that the live poultry wholesale market needs to strengthen the prevention and control measures of zoonosis, such as place disinfection, health education and epidemic surveillance.

Objective To investigate whether the amino acid variation in the nonstructural protein of Severe Acute Respiratory Syndrome Coronavirus2 (SARS-CoV-2) is related to the severity of Corona Virus Disease 2019 (COVID-19). Methods The data obtained from the Global Shared Influenza Data Initiative (GISAID) database were analyzed, and the nonstructural protein amino acid mutations with high mutation rate in SARS-CoV-2 sequences were screened. The outcomes were divided into mild and severe diseases, and the chi-square test was used to compare the basic characteristics between the groups. The relationship between the mutations selected and the prognosis of the patients was analyzed. Results A total of 23 498 cases were included, including 11 444 males (48.70%) and 12 054 females (51.30%). The median age ［M（P₂₅，P₇₅）］ was 38 (26-53) years old. The severe infection rate of novel coronavirus in male was higher than that in female (χ²=226.564, P < 0.001). The severe infection rate of novel coronavirus increased with the increase of age (χ²=6 088.032, P < 0.001). The year of onset (χ²=1 604.070, P <0.001) and continent (χ²=4 520.240, P < 0.001) were significantly correlated with the severity of novel corona virus infection.Several amino acid variations in the SARS-CoV-2 gene group associated with the severity of novel corona virus’s sensitive dyeing were determined. NSP4_T492I (aOR=0.574, 95%CI: 0.487-0.676), NSP12_G671S (aOR=0.657, 95%CI: 0.458-0.941),NSP6_T77A (aOR=0.422, 95%CI: 0.235-0.759), and NSP3_P1228L (aOR=0.124, 95%CI: 0.080-0.190) were negatively correlated with novel coronavirus’s severe infection. NSP12_P323L (aOR=2.126, 95%CI: 1.531-2.953), NSP13_P77L (aOR=1.923, 95%CI: 1.115-2.369), and NSP14_A394V (aOR=20.486, 95%CI: 9.649-43.495) were positively correlated with novel coronavirus’s severe infection. Conclusion The amino acid variation of SARS-CoV-2 nonstructural protein may be related to the severity of COVID-19 virus infection, and it is necessary to screen several nonstructural protein amino acid variants which can be related to the severity of novel coronavirus infection.

Objective To explore the mechanism of Canopy homolog 2 (CNPY2) and aerobic exercise through nuclear factor kappa-B (NF-κB) signal pathway in non-alcoholic fatty liver disease (NAFLD) induced by high fat diet. Methods Male CNPY2 knockout (CNPY2 KO) mice and wild (WT) mice aged (12±1) weeks were randomly divided into control group (CON),hyperlipidemic model group (MOD), and hyperlipidemic model exercise group (MOD+EX) after one week of adaptive feeding.CON group was fed with normal diet, and MOD group and MOD+EX group were fed with high fat diet until the end of 18 weeks.From the 10^th week, the mice in the MOD+EX group received adaptive treadmill training for a week, followed by continuous exercise intervention until the end of the 18-week experiment. The serum levels of TC, TG, LDL-C, HDL-C, ALT, and AST were detected by automatic biochemical analyzer, the pathological morphology of liver was analyzed by HE staining and oil red O staining, the protein expressions of CNPY2, IκB α, p-IκBα, NF-κB, and NF-κB in liver were detected by Western Blot, thelevels of TNF-α and IL6 in liver were detected by ELISA, and the expressions of NF- κB mRNA, TNF- α mRNA, and IL-6 mRNA in liver were detected by q RT-PCR. The data were analyzed by single factor analysis of variance and independent sample t-test. Results The expression of CNPY2 in MOD group was higher than that in CON group (t=-5.730, P=0.001) while the expression of CNPY2 in MOD+EX group was lower than that in MOD group (t=3.714, P=0.010).Compared with CON group, the serum levels of TC, TG, LDL-c, ALT, and AST in MOD group of WT mice and CNPY2 KO mice were higher (WT: t=-13.325, P < 0.001; t=-4.889, P < 0.001; t=-10.442, P < 0.001; t=-3.500, P=0.003; t=-15.122, P <0.001; CNPY2 KO: t=-6.910, P < 0.001; t=-4.962, P < 0.001; t=-7.457, P < 0.001; t=-4.584, P < 0.001; t=-7.336, P <0.001).The levels of TNF-α, IL-6, p-IκBα/IκBα, p-NF-κB/NF-κB, NF-κB mRNA, TNF-α mRNA, and IL-6 mRNA in liver were increased significantly (WT: t=-25.179, P < 0.001; t=-21.043, P < 0.001; t=-9.177, P < 0.001; t=-12.207, P < 0.001; t=-5.205, P=0.002; t=-6.910, P < 0.001; t=-4.802, P=0.003; CNPY2 KO: t=-18.878, P < 0.001; t=-21.840, P < 0.001; t=-14.033, P < 0.001; t=-12.511, P < 0.001; t=-6.870, P < 0.001; t=-9.546, P < 0.001; t=-8.303, P < 0.001), HDL-C level decreased (WT: t=11.695, P < 0.001; CNPY2 KO: t=6.598, P < 0.001), and hepatocyte steatosis with large amount of lipid droplets was observed. Compared with MOD group, the above-mentioned indexes were effectively improved in WT mice and CNPY2 KO mice in MOD+EX group. Compared with WT mice, the above-mentioned indexes of CNPY2 KO mice were improved effectively. Conclusion CNPY2 regulates NF-κB signal pathway and participates in the formation and development of NAFLD. Both CNPY2 gene deletion and aerobic exercise can improve NAFLD, which may be related to the decrease of liver CNPY2 expression, inhibition of NF-κB signal pathway, down-regulation of liver inflammatory cytokines and reduction of liver inflammation.

In the context of Healthy China, it is of great significance to improve the quality of medical student training. Selecting good classroom teaching models is fundamental in the training of medical students. Presentation, Assimilation, and Discussion(PAD) classroom and Bridge, Objective, Pre-Assessment, Participation, Practice, and Post-Assessment (BOPPPS) teaching models are popular among university teachers and have been widely used in theoretical and practical teaching of various courses. However, both teaching models still have certain limitations. In order to fully leverage the advantages of both teaching models, the joint application of the two teaching models in recent years has attracted widespread attention from scholars. Therefore, this article analyzes the fusion points of the joint application of the two teaching models in the training of medical students, providing reference for the joint application of the two models.