Objective To examine the concentration of trihalomethanes （THMs） in drinking water in Longgang District,Shenzhen,and to evaluate the potential risk of THMs to human health. Methods The concentration of THMs in the municipal water supply of Longgang District,Shenzhen was monitored from 2019 to 2023. An evaluation of the health risk associated with THMs exposure through drinking water and bathing in Longgang District,Shenzhen was conducted using a health risk assessment model. Results The detection rates of trichloromethane （TCM） were all 100.00%. The detection rates of bromo-dichloromethane （DCBM） were over 97.00%,and the detection rates of dibromo-chloromethane （DBCM） ranged from 76.34% to 95.83%. The lowest detection rate was found for tribromomethane （TBM）. The carcinogenic risk of THMs through drinking water exceeded that through skin exposure,while the carcinogenic risk of THMs through skin exposure was below 1.0×10^-6. Additionally,the carcinogenic risk of THMs exposed to peripheral water through drinking water was greater than 1.0×10^-6 but less than 1.0×10^-4. Furthermore,the non-carcinogenic risks of THMs in different exposure paths,various water sample types,and diverse water collection periods were found to be <1. Conclusions The carcinogenic risk values of TCM,DCBM,and DBCM in drinking water exceed the recommended levels set by USEPA,indicating a certain level of health risk within an acceptable range. The carcinogenic risk of exposure through drinking water is higher than that through bathing skin.

Objective To explore the relationship between Chinese visceral adiposity index （CVAI） and new-onset stroke in a large sample cohort of middle-aged and elderly individuals. Methods A Cox regression model was established using data from the China Health and Retirement Longitudinal Study （CHARLS） conducted between 2011 and 2018,to investigate the relationship between CVAI and new-onset stroke. Restricted cubic spline model was used to examine potential non-linear relationships,while subgroup analyses explored the moderating effects of social,demographic,and economic factors. Results A total of 6 902 participants were included in this study,among whom 398 （5.76%） experienced new-onset stroke. The median CVAI at baseline was 93.26 （63.21,123.96）,and the CVAI in new-onset stroke patients was higher than that in non- new-onset stroke patients （P<0.01）. Cox regression model results showed that after adjusting covariates,the risk of new-onset stroke increased by 67.2% for every one quartile increase of CVAI （60.75） （P<0.01）. Compared with CVAI Q₁ group （< 63.21）,CVAI Q₂,Q₃,and Q₄ groups （63.21 - <93.26,93.26- <123.96,and ≥123.96） had an increased risk of new-onset stroke by 78.5%,96.7%,and 184.2%,respectively （all P < 0.01）. The risk of new-onset stroke increased with increasing CVAI （P_trend < 0.001）. Restricted cubic spline regression analysis showed that there was a dose-response relationship between CVAI and new-onset stroke （P<0.01）,and the relationship was linear （P_nonliner =0.53）. Subgroup analysis showed that age may have a moderating effect on the relationship between the two groups （P_interaction <0.05）,and the lower age group was more affected. Conclusions The CVAI is closely associated with new-onset stroke,showing a dose-response relationship. Younger individuals with high CVAI should be particularly vigilant about their risk for developing strokes.

Objective To analyze the incidence trend of hepatitis A in China from 2005 to 2021,and provide the scientific reference for the prevention and treatment of hepatitis A. Methods Disease data and population data were obtained from the Public Health Science Data Center of the Chinese Center for Disease Control and Prevention and the work dynamics of the Bureau of Disease Control and Prevention of the National Health Commission,as well as the population data of the National Bureau of Statistics. Joinpoint regression model was used to analyze the reported incidence trend of hepatitis A in China. Results A total of 582 531 cases of hepatitis A were reported in China from 2005 to 2021,with an average annual reported incidence of 2.5343/100 000 and an average annual percent change （AAPC） of -10.00% （P<0.001）,showing a downward trend. From 2005 to 2018,the reported incidence of hepatitis A showed a decreasing trend in 26 provincial administrative regions （P<0.05 or P<0.01）,and a stable trend in 5 provincial administrative regions （all P>0.05）. There was no statistical significance in the 1-year-old group and the ≥85 year-old group （both P>0.05）,and the other age groups showed a downward trend （all P<0.01）. Conclusion The overall reported incidence of hepatitis A in China from 2005 to 2021 is in a downward trend,but it is still necessary to implement health education and strengthen the disease prevention awareness and self-protection ability of the population.

Objective To investigate and analyze the knowledge,attitude,and practice of occupational exposure among emergency medical staff,to provide a basis for improving their occupational protection level. Methods In April 2023,8 public hospitals in Yuncheng City were randomly selected. A total of 40 emergency medical staff from each hospital participated in a questionnaire survey on knowledge,attitude,and practice of occupational exposure. Descriptive analysis was used to analyze the knowledge,attitude,and practice of occupational exposure among emergency medical staff in this region. Univariate and multivariate analysis methods were employed to analyze the factors affecting these aspects. Results The scores for knowledge,attitude,and practice of occupational exposure among 302 emergency medical staff in Yuncheng City were （6.80±2.23）,（7.21±1.96）,and （6.47±2.11） points respectively. The items with lower average scores for knowledge included standard prevention concepts,occupational exposure medication plans,and standard preventive measures. For attitude scoring items with lower average scores included strengthening immune acceptance to reduce the risk of post-exposure infection,requiring serological monitoring after exposure,and experiencing negative emotions after occupational exposure. Practice scoring items with lower average scores included tracking and monitoring after occupational exposure,correctly handling the scene after occupational exposure,and reporting immediately after an occurrence. Multiple linear regression analysis revealed that educational level （β'=0.353,0.132,0.058）,years of experience in emergency positions （β'=0.247,0.328,0.142）,history of emergency exposure （β'=0.203,0.248,0.215）,perceived level of emergency exposure risk （β'=0.196,0.177,0.314）,and participation in emergency self-protection training courses （β'=0.362,0.638,0.455） were all significant factors associated with the knowledge,attitude,and practice scores of occupational exposure among emergency medical staff. Conclusions The knowledge,attitude,and practice of occupational exposure among emergency medical staff are at a moderate level. Understanding the high and low score items of knowledge,attitude,and practice of occupational exposure,as well as the differences in knowledge,attitude,and practice levels of occupational exposure among emergency medical staff in different situations,can lead to targeted and more effective intervention measures to effectively improve the occupational protection level of emergency medical staff.

Objective To explore the status of enteral nutrition （EN） tolerance and its influencing factors in patients undergoing radical gastrectomy. Methods From January 2021 to December 2023，1 347 inpatients who underwent radical gastrectomy and received EN at Nantong Tumor Hospital were selected for this study. They were divided into the EN tolerance group （499 cases） and the EN intolerance group （848 cases） based on whether gastrointestinal discomfort occurred during EN. The current status of EN tolerance in patients after radical gastrectomy was investigated，and relevant patient data were collected to analyze the main factors affecting their EN tolerance. Results The incidence of EN intolerance among patients who underwent radical gastrectomy was 62.95% （848/1 347），while the EN tolerance rate was 37.05% （499/1 347）. Among the patients with EN intolerance，the incidence of diarrhea was 41.98% （356/848），abdominal distension was 36.79% （312/848），gastric retention was 18.04% （153/848），and vomiting/reflux was 3.18% （27/848）. Multivariate Logistic regression analysis demonstrated that age （OR=2.519），EN catheterization method （nasal jejunal tube OR=0.643，fistula OR=2.996），the time of first postoperative mobilization （>4 h OR=0.567），the type of nutritional preparation （OR=3.705），the use of sedative/analgesic drugs （OR=2.474），and the initial EN infusion method （OR=3.434） were independent influencing factors on EN tolerance in patients after radical gastrectomy. Conclusions The incidence of EN intolerance after radical gastrectomy is relatively high，with factors such as age，EN catheterization method，and the time of first postoperative mobilization exerting an influence. Clinically，appropriate EN feeding strategies should be adopted based on the patient's actual condition to minimize the occurrence of feeding intolerance.

Objective To investigate the nutritional anemia in infants and young children aged 6-36 months in Xi 'an and analyze the related factors of anemia,so as to provide the basis for guiding the screening and prevention of anemia in local infants and young children. Methods From January to December 2022,infants and young children aged 6-36 months who underwent physical examination in three hospitals in Xi 'an were selected for this study. The parents of infants and young children were surveyed with questionnaires and physical examination of infants and young children. The finger peripheral blood of infants and young children was collected for hemoglobin detection and micro nutritive test. The Logistic regression analysis model was used to analyze anemia related factors. Results A total of 1 890 infants and young children aged 6-36 months were enrolled,and the prevalence of nutritional anemia was 24.50% （463 cases）. Multivariate logistic regression analysis showed that age （OR=0.511）,birth weight < 2 500 g （OR=2.179）,premature infant （OR=1.788）,maternal anemia in late pregnancy （OR=1.840）,maternal education level （OR=0.739）,primary caregiver was mother （OR=0.593）,complementary food supplementation later than 6 months of age （OR=1.456）,trace element/vitamin supplementation （OR=0.116）,insufficient intake of meat and milk （OR=2.349）,and picky/partial eating （OR=2.492） were independent factors for anemia in infants and young children aged 6-36 months. Conclusions The prevalence of nutritional anemia in infants and young children aged 6-36 months in Xi 'an is high,and there are many influencing factors. It is necessary to strengthen the guidance of infant feeding,help high-risk children to establish good eating habits,improve nutritional status,comprehensively reduce the risk of nutritional anemia in infants and young children,and improve children's health.