To assess the energy and nutrient content in school lunches served in kindergartens/schools in Henan province and to provide evidence for improving the nutritional quality of student meals.

From 2021 to 2023, a total of 240 school lunch food samples were randomly selected from 16 kindergartens, 16 primary schools and 16 secondary schools in three cities in Henan Province on consecutive 5 days. The nutrient content of the food samples was determined by chemical analysis methods according to relevant national standards. The nutritional evaluation was conducted with reference to the "Nutritional Guidelines for Student Meals" and the "Dietary Nutrient Reference Intakes for Chinese Residents.

The energy supply (kJ) of the samples for kindergarten, elementary school, and junior high school students was 1979.4, 2 665.2, and 3 056.0, respectively, with 67.5%, 50.0%, and 45.0% exceeding the recommended amount by 80%. Protein content (g) was 19.7, 25.6, and 28.2, respectively, with 92.5%, 85.0%, and 85.0% exceeding the recommended amount by 80%. Sodium content (mg) was 1 133.0, 1 488.4, and 1 825.2, respectively, all exceeding the recommended amount. Vitamin A content (μ g) was 50.0, 65.0, and 75.0, with 97.5%, 97.5%, and 100% of the samples being 60% below the recommended amount. Calcium content (mg) was 120.5, 140.9, and 130.5, with 67.5%, 65.0%, and 67.5% of the samples being 60% below the recommended amount; zinc content (mg) was 1. 3, 1.7, and 1.8, with 40.0%, 65.0%, and 67.5% of the samples being 60%below the recommended amount. The ratio of iron supply to the recommended amount was 117.5%, 103.6%, and 63.9%; while the selenium supply was 93.3%, 46.4%, and 28.3% of the recommended amount, respectively. There were significant differences in the compositional ratios of energy, protein, and selenium to the recommended amount among samples from kindergarten, elementary school, and junior high school (all P<0.05). The proportions of energy intake from protein were 18.4%, 15.3%, and 16.0% for the kindergarten, elementary school, and junior high school samples, respectively, which were slightly high. The proportions of energy intake from fat and carbohydrate were adequate.

The nutritional content of school lunches served in some kindergartens and schools in Henan province was unbalanced, and the content of some nutrients differed significantly from the recommended amount, suggesting that guidance on the nutritional balance of school lunches should be strengthened.

To study the effects of gestational diabetes mellitus (GDM) on the gut microbiota of male and female infants.

From June 2016 to December 2019, 913 singleton pregnant women (aged 18–45 years) attending prenatal examinations at a county hospital in Hebei province were enrolled in the study. Information on prenatal examinations and laboratory test results were collected, and their offspring were followed up to 12 weeks of age. Fresh fecal samples were collected from the infants as samples. Based on the results of two maternal fasting blood glucose tests (at 12 and 24 weeks of gestation), a total of 48 healthy full-term infants with no history of antibiotic use were divided into two groups: the GDM group, in which the mothers had fasting blood glucose levels ≥ 5.1 mmol/L on both tests, and the control group, in which the mothers had normal fasting blood glucose levels on both tests. 16S rDNA sequencing was performed using high-throughput sequencing technology.

Of the 16 infants in the GDM group, 10 were male and 6 were female, while of the 32 infants in the control group, 17 were male and 15 were female. In the female infants, the Chao1 index of gut microbiota was lower in the GDM group than in the control group (t= –3.34, P< 0.01). LEfSe analysis showed that the highly expressed gut microbiota in the male infants of the GDM group were Lactobacillaceae and Lactobacillus, while in the female infants, it was Carnobacteriaceae. In male infants, the relative abundance of Lactobacillus was higher in the GDM group than in the control group (Z=4.66, P =0.03), and the relative abundance of Erysipelatoclostridium was lower in the GDM group than in the control group (Z= –4.45, P= 0.04). In female infants, the relative abundances of Lactobacillus and Rothia were lower in the GDM group than in the control group (Z= –10.19, P <0.01; Z= –4.42, P=0.04). There were no statistically significant gender differences in the gut microbiota at the phylum and genus level (all P > 0.05).

Compared with the offspring of mothers with healthy pregnancies, the gut microbiota richness of female infants of mothers with GDM was reduced, which may also affect the relative abundance of Lactobacillus and Rothia in female infants. In addition, the gut microbiota richness of female infants was lower than that of male infants, but gender had no significant effect on the composition of the infant gut microbiota.

To analyze the levels and potential health risks of dietary cadmium exposure among residents of Chongqing city from 2012 to 2022, and to provide a basis for regional decision-making on food safety.

The detection data from 2012 to 2022 on cadmium concentrations of 9 219 samples from 11 food categories, including rice and rice products, wheat and wheat products, other grains and grain products, leafy vegetables, root and tuber vegetables, legumes, other fresh vegetables, poultry, livestock, fruits, and eggs and egg products, were collected from the Chongqing Food Safety Risk Monitoring System. The cadmium content in food samples was detected by graphite furnace atomic absorption spectroscopy according to the national standard (GB 5009.15–2014) and inductively coupled plasma mass spectrometry according to (GB 5009.268–2016). The limit of detection (LOD) for different food types ranged from 0.000 1 to 0.01 mg/kg, and the left-censored results were replaced by the middle bound (MB) and upper bound (UB) detections. Dietary survey data from 3 354 residents in 6 districts/counties of Chongqing city were also extracted from the three waves of the China Health and Nutrition Survey conducted in 2011, 2015, and 2018. A Monte Carlo simulation was used to estimate dietary cadmium exposure levels for Chongqing residents during three time periods: 2012–2014, 2015–2018, and 2019–2022. The health risks associated with these exposure levels were then assessed.

Cadmium was detected in 5 143 (55.79%) of all samples at levels ranging from 0.015 6 to 0.024 7 mg/kg. For Chongqing residents during 2012–2014, 2015–2018, and 2019–2022, the estimated mean dietary cadmium intake (µg/kg bw/month) was 12.69, 13.47, and 11.19 with MB substitutions for the left-censored food sample measurements used in the estimates) and 12.87, 13.62, and 12.42 (with UB substitutions for the left-censored food sample measurements used in the estimates), respectively. All these values were below the provisional tolerable monthly intake (PTMI) of 25 µg/kg bw/month established by the Joint FAO/WHO Expert Committee on Food Additives (JECFA). The estimated mean dietary cadmium intake (µg/kg bw/month) for the highly exposed population (95 th percentile) during 2012–2014, 2015–2018, and 2019–2022 was 40.53, 39.42, and 34.53 (with MB) and 40.47, 38.43, and 36.63 (with UB), respectively, which was 1.62, 1.58, and 1.38 times the PTMI. Rice and rice products were the main source of dietary cadmium exposure risk in all periods, contributing 52.45% (with MB) and 51.87% (with UB) of total dietary cadmium exposure in 2012–2014, 65.42% (with MB) and 62.13% (with UB) in 2015–2018, and 47.54% (with MB) and 42.88% (with UB) in 2019–2022. Leafy vegetables were the second largest contributor, accounting for 23.86% (with MB) and 23.39% (with UB) of total dietary cadmium exposure in 2012–2014, 15.12% (with MB) and 14.21% (with UB) in 2015–2018, and 29.98% (with MB) and 37.12% (with UB) in 2019–2022.

Dietary cadmium exposure among Chongqing residents from 2012 to 2022 was relatively low, posing a minimal health risk to the general population. However, the high-exposure population may face some health risks from dietary cadmium exposure. Rice and rice products, and leafy vegetables were identified as the main sources of risk from dietary cadmium exposure.

To investigate the molecular epidemiological characteristics and drug resistance of HIV-1 among newly diagnosed antiretroviral therapy (ART)-naive infected individuals aged < 50 years in Pudong New Area, Shanghai, 2019–2021, and to provide evidence to refine local HIV prevention and control strategies.

Blood samples (n=374) were collected from individuals newly diagnosed with HIV infection between 2019 and 2021. Inclusion criteria were as follows: (1) confirmed first-time HIV-positive diagnosis by Western blot and without prior ART, (2) age less than 50 years, (3) voluntary participation, and (4) current residence or employment in Pudong New Area. Exclusion criteria were: (1) unsuccessful RNA extraction or sequencing, (2) mixed bases in the HIV-pol region sequence ≥5%, and (3) sequences shorter than 1 000 base pairs. The HIV-1 pol gene was amplified by reverse transcription-polymerase chain reaction (RT-PCR) for both pretreatment drug resistance genotyping and HIV-1 subtype determination, with subsequent analysis using the Stanford University HIV Drug Resistance Database for 302 successfully sequenced samples. Demographic and epidemiologic data were collected through structured in-person interviews.

A total of 13 HIV-1 subtypes and unique recombinant forms (URFs) were identified among the 302 sequenced samples, of which 72.52% were from homosexual and 27.48% from heterosexual infections. The predominant strains were CRF07_BC (40.40%), CRF01_AE (36.09%) and CRF55_01B (8.28%). A significant variance in the distribution of viral subtypes was observed among individuals infected by different sexual transmission routes (χ²=22.161, P=0.003). However, the distribution of the prevalent strains CRF01_AE, CRF07_BC and CRF55_01B did not differ significantly between homosexual and heterosexual transmission (χ²=4.854, P=0.088), nor among the three age groups 15–24, 25–34 and 35–49 years (χ²=1.383, P=0.847). Resistance analysis showed a resistance rate of 5.96% in this population, with resistance levels ranging from low to intermediate to high. Non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs) and protein inhibitors (PIs) accounted for 4.97%, 0.66% and 0.33% of resistance, respectively. The difference in resistance rates between subtypes was statistically significant (χ²=10.511, P=0.037). All cases (n=25) of the recombinant subtype CRF55_01BC had mutations at the resistance locus, resulting in an 88.00% incidence of mutations at potential resistance loci and a 12.00% incidence of resistance associated with moderate to high levels of resistance.

From 2019 to 2021, among the newly diagnosed HIV-1 infected individuals of young and middle-aged population in Pudong New Area, Shanghai, the genetic subtypes were predominantly CRF07_BC, CRF01_AE and CRF55_01B. However, new recombinant strains have emerged, indicating a trend toward diversification. In addition, varying degrees of pre-treatment drug resistance were observed in several subtypes.

To assess the awareness and willingness to use post-exposure prophylaxis (PEP) and influencing factors among men who have sex with men (MSM) in Heilongjiang province for further promotion and implementation of PEP programs among MSM.

Using snowball sampling, we recruited 404 MSM residing in Harbin city who were ≥18 years old, HIV negative, or unaware of their HIV status. Face-to-face interviews were conducted among the MSM from September to November 2021 to collect relevant information by taking a self-developed PEP questionnaire based on that used in the national sentinel surveillance program. Chi-squared tests, univariate and multivariate unconditional logistic regression analyses were used to analyze factors influencing MSM's willingness to accept PEP.

Of the MSM surveyed with a median age of 36 years, 68.812% reported the willingness to use PEP. Univariate analysis revealed that marital status, education, personal monthly income, sexual orientation, primary venue for finding male partners, HIV knowledge, sexual role during anal intercourse, number of male sex partners in the least 6 months, frequency of condom use during anal sex with men in the least 6 months, number of HIV tests, PEP awareness, and the maximum acceptable price of PEP were significant factors associating with willingness to accept PEP (all P<0.050). Multivariate unconditional logistic regression analysis showed that education level (odds ratio [OR]=5.500, 95% confidence interval [95%CI]: 2.174–13.911), number of male sex partners (OR=21.708, 95%CI: 6.258–75.305), frequency of condom use during anal sex with men in the least 6 months (OR=9.301, 95%CI: 2.711–31.904), and number of HIV tests (OR=3.218, 95%CI: 1.500–6.904) were the main factors influencing willingness to use PEP.

The willingness to accept PEP is relatively high among MSM in Heilongjiang province, suggesting that PEP should be promoted among local MSM to reduce HIV infection.

To investigate the positive rate of hepatitis E virus (HEV) immunoglobulin G (IgG) antibodies in pregnant women in China and to provide a reference for the prevention and control of hepatitis E in the women.

PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched, supplemented by a retrospective literature search, to collect relevant literature published domestically and internationally from January 1, 1989, to December 31, 2023, on the seroprevalence of HEV in pregnant women in China. R 3.5.2 software was used for meta-analysis of the included literature.

A total of 15 articles (8 in Chinese and 7 in English) were included, with a cumulative study population of 36 188. The meta-analysis showed that the positive rate of HEV IgG antibodies among pregnant women in China was 13% (95% confidence interval [95%CI]: 11%–16%). Subgroup analysis showed that the positive rates of HEV IgG antibodies in pregnant women younger than 30 years old and 30 years old and older were 18% (95%CI: 12%–24%) and 15% (95%CI: 10%–19%), respectively; the positive rates of HEV IgG antibodies in pregnant women living in urban and rural areas were 29% (95%CI: 3%–55%) and 25% (95%CI: 5%–45%), respectively; and the positive rates of HEV IgG antibodies in pregnant women in the first, second, and third trimesters were 16% (95%CI: 3%–28%), 13% (95%CI: 7%–18%), and 15% (95%CI: 10%–21%), respectively. There were no statistically significant differences in the positive rates of HEV IgG antibodies among pregnant women of different ages, residences, and gestational ages (all P>0.05). Sensitivity analysis and publication bias tests showed that there was no publication bias in the literature included in this meta-analysis, and the results were relatively stable.

The positive rate of HEV IgG antibodies among pregnant women in China is relatively high. Attention should be paid to this high-risk group, and prevention and control measures for HEV infection should be strengthened.

To conduct a systematic review of willingness-to-pay (WTP)-based estimates of the value of statistical life (VSL) reported by studies in China, and to compare VSLs associated with different hazards and estimation methods in order to provide more accurate estimates of VSL for future policy decisions.

Empirical studies in China on WTP-based VSL estimates published through April 1, 2024 were collected by searching the China National Knowledge Infrastructure (CNKI), VIP Chinese Database, PubMed, Embase, Web of Science, and MEDLINEand supplemented by a literature review method.The VSL estimates reported in the studies were systematically evaluated in terms of research scope and methods.

Of the 28 studies reviewed, 11 were on VSLs related to air pollution, 9 to traffic safety, 5 to occupational safety, 2 to health conditions, and 1 to a combined circumstance, with 26 studies using stated preference surveys and 2 using revealed preference surveys. The median VSL estimate (in million of Chinese yuan) for all reviewed studies was 1.962 2, with VSL estimates of 1.689 0 for air pollution, 0.985 7 for traffic safety, 4.996 0 for occupational safety, and 4.033 0 for health conditions and combined circumstances; the median VSL estimates for studies using stated and revealed preference surveys were 1.825 6 and 1.553 0, respectively. The main factors influencing WTP were income, education, age, household size, and perceived health status for studies related to air pollution; income, education, age, and perceived risk for studies related to traffic safety; income, education, age, perceived risk, gender, and marital status for studies related to occupational safety; and income, education, age, and risk variation for studies related to health conditions.

VSL estimates from studies in China show some variation due to differences in research scope and methodology. The common factors influencing VSL estimates across studies are primarily income, education, age, and perceived risk.

To evaluate the reliability and validity of a national questionnaire on the intelligent maturity of infectious disease surveillance and early warning.

A questionnaire was developed based on the intelligent maturity index system for infectious disease surveillance and early warning. Expert consultation was used to assess the content, items, and content validity of the questionnaire. A random sampling method was taken to select 700 county (district) CDCs in the Chinese mainland for a one-month questionnaire survey in mid-October 2023. Item analysis was performed with the critical ratio method. Reliability was evaluated using Cronbach′s α coefficient and Spearman-Brown coefficient. Validity was analyzed using confirmatory factor analysis and content validity index.

In the item analysis, six items did not meet the standard: IT infrastructure construction, coverage of security measures such as cloud desktop and cloud terminal, adoption of national information standards for the informatization construction of infectious disease surveillance and early warning, ability to call national application programming interfaces (APIs) and use software development kits (SDKs) to achieve application integration, missed reporting rate of infectious diseases, and proportion of confirmed cases in the syndromic surveillance of infectious diseases. After comprehensive consideration, these items were retained. The reliability analysis showed that the total Cronbach′s α coefficient was 0.872. The Cronbach′s α coefficients for the three dimensions were 0.755 for intelligent strategy and foundation, 0.857 for intelligent business process and management, and 0.607 for intelligent effectiveness. The Spearman-Brown coefficient was 0.756. The validity analysis showed that the overall content validity index of the questionnaire was 0.985, and the content validity index of each item ranged from 0.820 to 1.000. The structural equation model constructed by confirmatory factor analysis fitted well after modification.

The national questionnaire on the intelligent maturity of infectious disease surveillance and early warning has good reliability and validity, and is suitable for evaluating the intelligent maturity of infectious disease surveillance and early warning on integrated regional platforms across provinces nationwide.