Introduction Research on the effects of campus street openness and greenery on college students' moderate to vigorous physical activity (MVPA) is relatively limited, as is research based on campus street view data. Methods This study utilized campus street view data to explore the relationship between objective campus environmental factors and college students' campus walkability and MVPA. The data were collected from surveys conducted at 34 universities in China involving 1173 college students. Results We found that both campus walkability and MVPA of college students will not be affected by campus greenery but they are significantly positively affected by campus sky view factor (SVF) which affects college students' MVPA through partial mediation effect of campus walkability. Conclusions SVF is the most different environmental factor in Chinese university campuses, but it is the most important factor that affects the evaluation of campus walkability and promotes MVPA of college students. Therefore, the issues of visual enclosure and spatial suppression on campus streets should be given attention. The results suggest that designers should focus on enhancing the openness of campus street spaces in campus planning, landscape design, and healthy campus construction.

AbstractSichuan cuisine was previously fitted into the Chinese Heart-Healthy Diet (CHH) trial to verify the antihypertensive effect. Whether the modified Sichuan diet lessens cardiovascular disease (CVD) is not fully explored. We aimed to estimate the effects of the Sichuan version of CHH diet (CHH diet-SC) on the 10-year risk of CVD and vascular age. A single-blinded randomised controlled feeding trial was conducted. General CVD prediction model was used in manners of intention-to-treat and per-protocol set. After a 7-d run-in period, fifty-three participants with pre- and grade I hypertension from local communities were randomised and provided with either CHH diet-SC (n 27) or a control diet (n 26) for 4 weeks. Mean absolute and relative estimated CVD risks were reduced by 4·5 % and 27·9 % in the CHH diet-SC group, and the between-group relative risk reduction was 19·5 % (P < 0·001) using linear mixed-effects models. The sensitivity analysis with datasets and models showed consistent results, and pre-specified factors were not associated with the intervention effects. The vascular age of CHH-SC group was theoretically 4·4 years younger than that of the control group after intervention. Compared with a typical diet, adopting the CHH diet-SC over 1 month significantly reduced 10-year CVD risks and vascular ages among local adults with mild hypertension.

AbstractAimThe aim of the study was to investigate the correlation between fear of COVID‐19 and mental health of nurses and the effects of psychological capital and burnout in this relation.DesignA cross‐sectional study.MethodsThe online surveys were conducted among mainland Chinese nurses. Participants (n = 445; average age 32.89 ± 6.76 years) completed an online‐questionnaire based on the Fear of COVID‐19 Scale, the Psychological Capital Scale, Maslach Burnout Inventory Human Services Survey for Medical Professionals Scale and the 12‐Item Short Form Health Survey. Data analysis was conducted by Pearson's correlation analysis, Harman single‐factor test and the bootstrap method for mediating effect testing.Results(1) The study demonstrated a significant direct effect of fear of COVID‐19 on nurses' mental health, as well as on mediating factors such as burnout and psychological capital. (2) Regression analyses confirmed that while psychological capital bolstered mental health, burnout undermined it, with fear of COVID‐19 further imposing a negative influence. (3) Fear of COVID‐19 exerted an effect on the mental health of nurses by the independent and chain intermediary functions of psychological capital and burnout, resulting in a total mediating effect of −0.233.

Abstract Objective: To determine whether the Chinese heart-healthy diet (Sichuan cuisine version) (CHH diet-SC) was more expensive than the conventional Sichuan diet and explore the food groups and nutrients that mainly affected the cost of CHH diet-SC. Design: Cost analysis of 4-week intervention diets in the Sichuan center representing southwestern China in the CHH diet study. Setting: A multicentre, parallel-group, single-blind, randomised feeding trial evaluating the efficacy of lowering blood pressure with the cuisine-based CHH diet. Participants: Totally, fifty-three participants with hypertension aged 25–75 years in the Sichuan center were randomised into the control group (n 26) or the CHH diet-SC group (n 27). Results: The CHH diet-SC was more expensive than the control diet (¥27·87 ± 2·41 v. ¥25·18 ± 2·79 equals $3·90 ± 0·34 v. $3·52 ± 0·39, P < 0·001), and the incremental cost-effectiveness ratio for a 1-mm Hg systolic blood pressure reduction was ¥9·12 ($1·28). Intakes and the cost of seafood, dairy products, fruits, soybeans and nuts, whole grains and mixed beans were higher for the CHH diet-SC than for the control diet (P < 0·001). Intakes of vitamin B1, vitamin B6, vitamin C, Mg and phosphorus were positively correlated with the cost (P < 0·05). Conclusions: The CHH diet-SC costs more than the conventional Sichuan diet, partly due to the high cost of specific food groups. Positive correlations between the intakes of vitamin B1, vitamin B6, vitamin C, Mg, phosphorus and the dietary cost could be a direction to adjust the composition within the food groups to reduce the cost of the CHH diet-SC.

BACKGROUND AND OBJECTIVES:Sichuan cuisine is characterized by high salt and oil content. We aimed to evaluate the effects of the Sichuan cuisine version of Chinese heart-healthy diet (CHH diet-SC) on blood pressure reduction among hypertensive adults.METHODS AND STUDY DESIGN:The Chinese heart-healthy diet (CHH) trial was a multicenter randomized controlled feeding trial among Chinese hypertensive people. We conducted a secondary analysis of the CHH trial using data from the Sichuan center in Southwest China. Fifty-three people aged 25 to 75 years with a mean systolic blood pressure (SBP) between 130 and 159 mmHg were enrolled. Eligible participants underwent a 1-week run-in period with the typical local diet and were randomized 1:1 to consume the CHH diet-SC (n=27) or typical local diet (n=26) for the next 4-week. The primary outcome was the net change in SBP, the secondary outcomes included diastolic blood pressure (DBP), mean arterial pressure (MAP), and the rate of BP control.RESULTS:Compared with the control group, the CHH diet-SC decreased cooking salt, oil, and red meat content and increased inclusion of whole grains, fruits, seafood, low-fat dairy, soybean, and nuts; the SBP experienced reductions of 7.54, 8.60, 9.14, and 10.1 mmHg at the end of weeks 1 through 4; the DBP was reduced 4.01 mmHg at week 4; the MAP was significantly reduced 6.02 mmHg finally; and rate of BP control significantly increased (p<0.05).CONCLUSIONS:Adoption of the CHH diet-SC for 4 weeks can significantly reduce BP and increase the rate of BP control in hypertensive adults.

Abstract Background: Evidence suggests that maternal HDL-c levels are associated with preterm birth (PTB) and small for gestational age (SGA). However, existing evidence remains controversial. We aimed to explore the associations of maternal HDL-c levels with PTB and SGA in China.Method: A prospective study that included 1068 pregnant women was conducted in 2017. The concentrations of high-density lipoprotein cholesterol (HDL-c) were analyzed in early, middle, and late pregnancy as continuous variables and categorical variables (by percentile groups). Data on gestational age, as well as the weight and length of the neonates were recorded after delivery. Multivariable logistic regression models were used to estimate the associations between maternal HDL-c levels and PTB and SGA. Result:PTB and SGA occurred in 3.0% and 8.1% of births. Mean maternal HDL-c levels in early pregnancy was equal to that in middle pregnancy (1.67 vs. 1.66 mmol/L, p = 0.309), but decreased slightly from middle pregnancy to late pregnancy (1.66 vs. 1.52mmol/L, p < 0.001). In middle pregnancy, every unit elevation of HDL-c was positively associated with SGA (OR = 2.57, 95 % CI: 1.23-5.35). In late pregnancy, every unit elevation of HDL-c reduced the risk of PTB (OR = 0.12, 95 % CI: 0.03-0.58), but increased the risk of SGA (OR = 2.59, 95 % CI: 1.22-5.47). In early pregnancy, low (<25th percentile) HDL-c was positively associated with PTB (OR = 2.56, 95 % CI: 1.11-5.09), and high (>75th percentile) HDL-c was positively associated with SGA (OR = 2.92, 95 % CI: 1.69-5.04), compared with referent (25th-75th percentile) HDL-c.Conclusion:Maternal high levels of HDL-c could reduce the risk of PTB but increase the risk of SGA. There may exist appropriate reference range for maternal HDL-c in early pregnancy. Maternal HDL-c levels should be monitored regularly during pregnancy to decrease adverse perinatal outcomes.

Background A multitude of literature has shown that during the 2019 COVID-19 outbreak, people's reliance on social media has been closely related with serious psychological problems. The “information epidemic” has sparked each country's attention. These countries including China have tried to find the solution and taken a series of measures. In January 2021, the COVID-19 broke out again in Shijiazhuang, China. Has the impact of social media on mental health changed? Methods Our data are based on an online survey of Chinese in January 2021, with 904 valid samples from 18 different provinces in China. We applied the methods of structural equation model analysis and the tendency value matching to conduct systematic analysis. Results Our research found that 38.9% of the population suffered from depression and 12.61% of the population suffered from anxiety. Chinese urban residents are more dependent on social media, with up to 80.1% of participants using social media frequently. Our research found that the relationship between social media use and residents' mental health has dramatically changed. More use of social media has been significantly associated with less depression and anxiety, especially among young people and women. Our findings are the first to reveal the relation's change between social media and mental health. Conclusions These findings implied that changes in the social media environment probably lead to changes in relationship between social media use and mental health since the outbreak began in 2019. Truthful and comprehensive social media information and a healthy positive social media environment can contribute to residents' mental health improvement and the fight against “information epidemic.”

Background Acknowledging the role of inflammation in colorectal carcinogenesis, this study aimed to evaluate the associations between diet-associated inflammation, as measured by the energy-adjusted dietary inflammatory index (E-DIITM), and distinct stages of colorectal carcinogenesis. Methods The Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial enrolled participants without a colorectal cancer history, who were asked to complete baseline questionnaires and food frequency questionnaires. To estimate the associations between the E-DII and risks of newly incident colorectal adenoma, recurrent adenoma, and colorectal cancer, multivariable-adjusted Cox proportional hazards regression models were employed. Results Among 101,680 participants, with an average age of 65 years, a total of 1177 incident colorectal adenoma cases, 895 recurrent adenoma cases and 1100 colorectal cancer cases were identified. Higher E-DII scores from food and supplement (HRQ5 vs Q1: 0.86 [0.69-1.06], P-trend: 0.27) or from food only (HRQ5 vs Q1: 0.82 [0.64-1.05], P-trend: 0.06) were not associated with higher risks of incident adenoma. However, the elevated risk of recurrent adenoma was found in the highest category of E-DII from food plus supplement (HRQ5 vs Q1: 1.63 [1.28-2.03], P-trend: < 0.001) when compared with the lowest category. A significant association between colorectal cancer risk and E-DII from food plus supplement (HRQ5 vs Q1: 1.34 [1.09-1.65], P-trend: 0.009) was found, where this association was only pronounced in distal colorectal cancer. Conclusion Higher E-DII scores from diet plus supplement but not from diet only were associated with a higher risk of recurrent adenoma and distal colorectal cancer. The role of nutrient supplements on cancer risk, especially when combined with diet, needs to be elucidated in future studies.

Abstract Limited studies have examined the associations between diet quality and gestational weight gain (GWG) among Chinese pregnant women, adopting Chinese GWG guidelines. We prospectively investigate the associations of diet quality, using the Chinese Healthy Diet Index for Pregnancy (CHDI‐P), which assessed diet quality from ‘Diversity’, ‘Adequacy’ and ‘Limitation’ dimensions with overall 100 points, with GWG among participants enroled in Southwest China. Food consumption was collected by 24 h dietary recalls for three consecutive days and CHDI‐P scores were divided into tertiles. GWG was calculated according to the weight measured before delivery and classified into adequate weight gain (AWG), insufficient weight gain (IWG) and excessive weight gain(EWG) following Chinese GWG guidelines. Multinomial regression analyses and stratified analyses by pre‐pregnancy body mass index were performed to estimate the association between CHDI‐P and GWG. A total of 1416 participants were recruited in early pregnancy, and 971 and 997 participants were respectively followed up in middle and late pregnancy. The mean CHDI‐P score was 56.44 ± 6.74, 57.07 ± 7.44 and 57.38 ± 7.94 points in early, middle and late pregnancy, respectively. Women in the lowest CHDI‐P scores group had an increased risk of EWG in middle (OR = 1.53, 95% confidence interval [CI] = 1.08–2.17) and late pregnancy (OR = 1.71, 95% CI = 1.21–2.41) than women in the highest group, while overweight/obese women had a greater risk of EWG in late pregnancy (OR = 4.25, 95% CI = 1.30–13.90). No association was found between the CHDI‐P scores and IWG. Poor diet quality in middle and late pregnancy was associated with a higher risk of EWG.

Objectives Coronavirus disease 2019 (COVID-19) first broke-out in Wuhan China in December 2019, and spread throughout the entire country within a short time. This cross-sectional study investigated the prevalence of depression and anxiety and associated risk factors were analysed in patients with COVID-19. Methods This single-center cross-sectional study focussed on measuring depression and anxiety using self-report scales. Linear regression was used to determine independent predictors for depression and anxiety. Results A total of 78 patients who were confirmed to have COVID-19 were enrolled in the study. Prevalence of depression and anxiety symptoms were diagnosed in 35.9% and 38.5% of the patients, respectively. Multivariate linear regression analysis found female gender was an independent predictor for higher depression severity index. Having family members who were diagnosed with COVID-19 and family members who died from COVID-19 were independently associated with higher depression severity index and anxiety score. Conclusions Patients with COVID-19 especially those who had family members diagnosed with COVID-19 or died from COVID-19 were more susceptible to depression and anxiety than were other patients. Effective strategies should be pursued to improve the mental health of this patient population.

Objective To explore the health-related quality-of-life of pediatric liver transplant donors and examine the principal influencing factors of quality-of-life.Methods A total of 86consecutive pediatric liver transplant donors undergoing hepatectomy were recruited from West China Hospital of Sichuan University and Children's Hospital,Chongqing Medical University between January 2005 and December 2014.Health-related quality-of-life was measured with the Chinese version of Medical Outcomes Study Short Form-36 (SF-36).All participants fulfilled the criteria of left hepatic resection without middle hepatic vein involvement or left lateral lobectomy,no severe medical complications and communicating influent Chinese.The survey results were compared with those of general population.And the influencing factors of quality-of-life were also explored.Results A total of 80 questionnaires were distributed in accordance with the selection criteria and 71 (88.7％)returned.There were 24 males and 47 females with an average age of 29.4-± 8.0 years.The recipients had biliary atresia (BA,n =35),metabolic liver disease (n =15),primary hepatocirrhosis (n =11) and hepatic tumors (n =10).Most donors were recipients' parents.In general,all dimensions of healthrelated quality-of-life in donors were favorable as compared with general population (P ＞0.05).Mental health scores in donors donated to BA were better than those to non-BA (P =0.029).General health scores were lower in donors without recipients' medical insurance than those with recipients'medical insurance (P =0.033).Regarding physical functioning (P =0.038) and bodily pain (P =0.040),donors ＞2 years after surgery scored higher than those ＜2 years.Based upon principal component analysis,8 dimensions of SF-36 were integrated into one single dimension.The Results indicated that time since surgery was a principal influencing factor of donors' quality-of-life (P =0.037).Conclusions The outcomes of health-related quality-of-life are favorable for pediatric liver transplant donors.Time since surgery,recipients primary disease and medical insurance may impact the donors' postoperative quality-of-life significantly.