Introduction: It is accepted that nano- and micro-plastic (NMP) pollutants threaten ecosystems and human health by their bioaccumulation but, interestingly, their toxicity is shape-dependent. However, a clear definition of irregular NMPs, as the dominant shape in environmental and biological samples, is currently lacking when compared to spherical and fibrous NMPs. Objectives: This study quantifies morphometric descriptors in order to develop a standardized definition for irregular NMPs. Methods: Hyperspectral images of 34 spherical, 50 fibrous, and 45 irregular NMPs were collected from the literature. All shape-related features reported previously were analyzed using a machine learning model. Using five-fold cross-validation, a decision tree-based ensemble classifier with fixed parameters and Gini coefficient was established to screen key morphometric descriptors and their optimal interval ranges. The model was independently validated, enabling the accurate distinction of irregular NMPs from spherical and fibrous NMPs. Results: Three morphometric descriptors, including circularity, roundness, and perimeter-to-area ratio, were identified using five-fold cross-validation as optimal indicators for NMP shape classification. Optimal interval ranges for irregular NMPs were as follows: circularity (0.388 ± 0.004–0.768 ± 0.004), roundness (0.248 ± 0.01–0.752 ± 0.06) and perimeter-to-area ratio (>11.608 ± 1.39). This approach generated a 96.0% macro-averaged accuracy across these NMPs, with 100% precision and 89.0% recall. Conclusions: Irregular NMPs may be characterized using three morphometric descriptors, such as circularity, roundness, and perimeter-to-area ratio. The three-descriptor combination has highly accurate discrimination from spherical and fibrous NMPs.

Introduction: Currently, the disease burden of chronic cadmium poisoning remains unquantifiable due to the absence of disability weights (DWs). This study aimed to derive DWs for mild and severe chronic cadmium poisoning. Methods: Adopting the pairwise comparison (PC) method from the Global Burden of Disease (GBD) study, health state descriptions for mild and severe chronic cadmium poisoning were developed, and a severity spectrum of 13 health states was constructed based on GBD 2023. Questionnaires collecting demographic information and PC task questionnaires were distributed to the general population (n=552) and medical professionals (n=488). Results: Heatmaps confirmed response consistency. Probit regression and Loess modeling revealed that DWs for mild and severe chronic cadmium poisoning were 0.099 and 0.363, respectively, in the general population, and 0.102 and 0.397, respectively, among medical professionals. Spearman correlation coefficients comparing DWs values with reference studies (GBD 2023 study and a Chinese national study) ranged from 0.64 to 0.95. Conclusion: To our knowledge, this is the first study to successfully establish DW parameters for chronic cadmium poisoning. No significant differences were observed between DWs derived from the general population and those derived from medical professionals. This study provides a methodological reference for establishing DWs of environmental pollutants to assess their indirect disease burden.

Recent studies indicate that microplastics and nanoplastics (MNPs) act as key vectors for contaminants including cadmium (Cd). However, the bioavailability induced by their interaction remains controversial. Since both MNPs and Cd primarily accumulate in the liver after ingestion by organisms, hepatotoxicity induced by coexposure to MNPs (100 mg/kg body weight (BW)), 100 nm and 1 μm polystyrene (PS), and Cd (5 mg/kg BW) was examined in this study. Single or combined exposure models were established, and gavage was performed 5 times a week for 5 weeks. We observed that polystyrene (PS) accumulated in the mice liver. In comparison to the control group, all exposure groups exhibited significantly increased serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities, altered hepatic antioxidant enzyme activities, decreased P62 protein expression, and elevated Beclin-1 expression and LC3II/I ratios, indicating that PS alone or in combination with Cd disrupted liver structures and induced excessive autophagy and oxidative damage. Specifically, the 1 μm PS group induced significantly stronger hepatotoxic effects than the 100 nm PS group. In contrast, for 100 nm PS, although it was less toxic when administered alone, it significantly enhanced the Cd-induced liver injury. Notably, triple exposure to 100 nm PS, 1 μm PS, and Cd resulted in the most severe liver dysfunction, histopathological alterations, and activated cellular autophagy. Mechanistic investigations revealed that PS exposure alone or in combination with Cd triggered excessive autophagy and oxidative stress in hepatocytes by interfering with the PI3K/AKT/mTOR signaling pathway, thereby mediating liver injury. This study innovatively demonstrates that coexposure to different-sized PS particles and Cd can lead to complex liver injury patterns while particle size influences their combined hepatotoxicity with Cd.

As emerging environmental contaminants, nano- and micro-plastics (NMPs) have drawn increasing research attention due to potential hazards to organisms. Particle shape is a key factor influencing the toxic effects of NMPs, and NMPs of different shapes cause varying degrees of tissue damage. We investigated the specific mechanisms of polystyrene NMPs (PS-NMPs) with different shapes underlying damage to the colonic intestinal barrier. We divided 120 five-week-old male C57BL/6J mice into seven groups that were orally exposed to different doses of PS-NMPs for 5 weeks. Hematoxylin and eosin staining showed that both shapes of PS-NMPs induced colon pathological injuries, with more pronounced damage in the PS-Fibers groups. DAO and D-LA levels were increased in the medium- and high-dose groups. In all PS-Fibers groups, DAO and D-LA levels were significantly elevated. Immunohistochemical analysis revealed discontinuous distribution and reduced expression of ZO-1 and occludin in the PS-NMPs groups. Alcian blue-periodic acid-Schiff staining results indicated that both types of PS-NMPs significantly reduced the number of goblet cells. The levels of ZO-1, occludin, MUC2, and E-cadherin were significantly decreased in the high-dose PS-Beads group and all PS-Fibers groups. The expression of pro-inflammatory cytokines was significantly increased in the high-dose PS-Beads group and all PS-Fibers groups. Mechanistically, PS-Fibers induced colonic intestinal barrier damage by activating both the TLR4/NF-κB/iNOS and FAK/NF-κB/iNOS pathways, whereas PS-Beads induced damage primarily via the TLR4/NF-κB/iNOS pathway. These findings highlight the effect of differently shaped PS-NMPs on affecting colonic barrier function, thereby providing new insights into the adverse health effects of NMPs.

China experienced a catastrophic haze episode in January 2013 (2013JHE), no study has compared the prevalence of acute respiratory symptoms between smokers and non-smokers in 2013JHE. A rapid cross-sectional assessment of perceived air pollution and the prevalence of coughing, phlegm, and wheezing was conducted among 4303 adults sampled from three cities in Liaoning. Odds ratios (ORs) were calculated for the prevalence of coughing, phlegm, and wheezing. A path analysis was performed to test the relationships between number of cigarettes smoked daily, perceived air pollution score (PAPS), protective behavior score (PBS), and irritating feeling score (IFS). Among the participants, 26.3% felt irritated; 26.9% had acute respiratory symptoms; 22.9% had coughing; 20.2% had throat pain. The ORs for coughing, phlegm, and wheezing were all significantly increased among individuals with a history of respiratory disease, PAPS, PBS, and IFS. However, the ORs for coughing and wheezing were borderline significantly decreased among smokers, and the number of cigarettes smoked daily was negatively associated with PAPS and PBS in the path model. The 2013JHE had a serious impact local residents and significantly increased the prevalence of acute respiratory symptoms. Non-smokers and residents with a history of respiratory disease appear to be more susceptible sub-populations.

AIMS:Multimorbidity, especially physical-mental multimorbidity, is an emerging global health challenge. However, the characteristics and patterns of physical-mental multimorbidity based on the diagnosis of mental disorders in Chinese adults remain unclear. METHODS:A cross-sectional study was conducted from November 2004 to April 2005 among 13,358 adults (ages 18-65years) residing in Liaoning Province, China, to evaluate the occurrence of physical-mental multimorbidity. Mental disorders were assessed using the Composite International Diagnostic Interview (version 1.0) with reference to the Diagnostic and Statistical Manual of Mental Disorders (3rd Edition Revised), while physical diseases were self-reported. Physical-mental multimorbidity was assessed based on a list of 16 physical and mental morbidities with prevalence ≥1% and was defined as the presence of one mental disorder and one physical disease. The chi-square test was used to calculate differences in the prevalence and comorbidity of different diseases between the sexes. A matrix heat map was generated of the absolute number of comorbidities for each disease. To identify complex associations and potential disease clustering patterns, a network analysis was performed, constructing a network to explore the relationships within and between various mental disorders and physical diseases. RESULTS:Physical-mental multimorbidity was confirmed in 3.7% (498) of the participants, with a higher prevalence among women (4.2%, 282) than men (3.3%, 216). The top three diseases with the highest comorbidity rate and average number of comorbidities were dysphoric mood (86.3%; 2.86), social anxiety disorder (77.8%; 2.78) and major depressive disorder (77.1%; 2.53). A physical-mental multimorbidity network was visually divided into mental and physical domains. Additionally, four distinct multimorbidity patterns were identified: 'Affective-addiction', 'Anxiety', 'Cardiometabolic' and 'Gastro-musculoskeletal-respiratory', with the digestive-respiratory-musculoskeletal pattern being the most common among the total sample. The affective-addiction pattern was more prevalent in men and rural populations. The cardiometabolic pattern was more common in urban populations. CONCLUSIONS:The physical-mental multimorbidity network structure and the four patterns identified in this study align with previous research, though we observed notable differences in the proportion of these patterns. These variations highlight the importance of tailored interventions that address specific multimorbidity patterns while maintaining broader applicability to diverse populations.

Objective:Tissue uptake and distribution of nano-/microplastics was studied at a single high dose by gavage in vivo. Methods:Fluorescent microspheres (100 nm, 3 μm, and 10 μm) were given once at a dose of 200 mg/(kg∙body weight). The fluorescence intensity (FI) in observed organs was measured using the IVIS Spectrum at 0.5, 1, 2, and 4 h after administration. Histopathology was performed to corroborate these findings. Results:In the 100 nm group, the FI of the stomach and small intestine were highest at 0.5 h, and the FI of the large intestine, excrement, lung, kidney, liver, and skeletal muscles were highest at 4 h compared with the control group ( P < 0.05). In the 3 μm group, the FI only increased in the lung at 2 h ( P < 0.05). In the 10 μm group, the FI increased in the large intestine and excrement at 2 h, and in the kidney at 4 h ( P < 0.05). The presence of nano-/microplastics in tissues was further verified by histopathology. The peak time of nanoplastic absorption in blood was confirmed. Conclusion:Nanoplastics translocated rapidly to observed organs/tissues through blood circulation; however, only small amounts of MPs could penetrate the organs.

Objectives Burnout is common among medical personnel in China and may be related to excessive and persistent work-related stressors by different specialties. The aims of this study were to assess the prevalence of burnout, work overload and work-life imbalance according to different specialties and to explore the effect of specialty, work overload and work-life imbalance on burnout among medical personnel.Design A cross-sectional study.Setting This study was conducted in 1 tertiary general public hospital, 2 secondary general hospitals and 10 community health service stations in Liaoning, China.Participants A total of 3299 medical personnel participated in the study.Methods We used the 15-item Chinese version of the Maslach Burnout Inventory General Survey (MBI-GS) to measure burnout. Multivariable logistic regression models were used to explore the association between medical specialty, work overload, work-life imbalance and burnout.Results 3299 medical personnel were included in this study. The prevalence of burnout, severe burnout, work overload and work-life imbalance were 88.7%, 13.6%, 23.4% and 23.2%, respectively. Compared with medical personnel in internal medicine, working in obstetrics and gynaecology (OR=0.61, 95% CI 0.38, 0.99) and management (OR=0.45, 95% CI 0.28, 0.72) was significantly associated with burnout, and working in ICU （Intensive Care Unit）(OR=2.48, 95% CI 1.07, 5.73), surgery (OR=1.66, 95% CI 1.18, 2.35) and paediatrics (OR=0.24, 95% CI 0.07, 0.81) was significantly associated with severe burnout. Work overload and work-life imbalance were associated with higher ORs for burnout (OR=1.64, 95% CI 1.16, 2.32; OR=2.79, 95% CI 1.84, 4.24) and severe burnout (OR=4.33, 95% CI 3.43, 5.46; OR=3.35, 95% CI 2.64, 4.24).Conclusions Burnout, work overload and work-life imbalance were prevalent among Chinese medical personnel but varied considerably by clinical specialty. Burnout may be reduced by decreasing work overload and promoting work-life balance across different specialties.

Background No studies in China have assessed the guideline-concordance level of the first-course of non-small cell lung cancer (NSCLC) diagnosis and treatment and its relationship with survival. This study comprehensively assesses the current status of guideline-concordant diagnosis (GCD) and guideline-concordant treatment (GCT) of NSCLC in China and explores its impact on survival.Methods First course diagnosis and treatment data for NSCLC patients in Liaoning, China in 2017 and 2018 (n=1828) were used and classified by whether they underwent GCD and GCT according to Chinese Society of Clinical Oncology (CSCO) guidelines. Pearson's chi-squared test was used to determine unadjusted associations between categorical variables of interest. Logistic models were constructed to identify variables associated with GCD and GCT. Kaplan-Meier analysis and log-rank tests were used to estimate and compare 3-year survival rates. Multivariate Cox proportional risk models were constructed to assess the risk of cancer mortality associated with guideline-concordant diagnosis and treatment.Results Of the 1828 patients we studied, 48.1% underwent GCD, and 70.1% underwent GCT. The proportions of patients who underwent both GCD and GCT, GCD alone, GCT alone and neither GCD nor GCT were 36.7%, 11.4%, 33.5% and 18.4%, respectively. Patients in advanced stage and non-oncology hospitals were significantly less likely to undergo GCD and GCT. Compared with those who underwent neither GCD nor GCT, patients who underwent both GCD and GCT, GCD alone and GCT alone had 35.2%, 26.7% and 35.7% higher 3-year survival rates; the adjusted lung cancer mortality risk significantly decreased by 29% (adjusted hazard ratio[aHR], 0.71; 95% CI, 0.53-0.95), 29% (aHR, 0.71; 95% CI, 0.50-1.00) and 32% (aHR, 0.68; 95% CI, 0.51-0.90).Conclusion The 3-year risk of death is expected to be reduced by 29% if patients with NSCLC undergo both GCD and GCT. There is a need to establish an oncology diagnosis and treatment data management platform in China to monitor, evaluate, and promote the use of clinical practice guidelines in healthcare settings.

Environmental accumulation of nano- and microplastics pose serious risks to human health. Polystyrene (PS) is a polymer commonly used in the production of plastics. However, PS can adsorb cadmium (Cd), thereby influencing bioavailability and toxicity in vivo. Moreover, PS and Cd can accumulate in the mammalian kidney. Therefore, the aim of the present study was to assess the effects of combined exposure to PS and Cd in the kidney. Kidney damage was evaluated in male mice gavaged with PS (diameter, 100 nm and/or 1 μm) and Cd for 25 days.The results showed that PS at 100 nm caused more severe oxidative damage and cell apoptosis than PS at 1 μm. Combined exposure to PS at both 100 nm and 1 μm caused more severe kidney damage than the single administration groups. The extent of kidney toxicity caused by Cd differed with the combination of PS particles at 100 nm vs. 1 μm. The degree of damage to kidney function, pathological changes, and cell apoptosis induced by Cd+100 nm PS+1μm PS was the most severe. An increase in the Bax/Bcl2 ratio and overexpression of p53 and caspase-3 revealed that renal cell apoptosis might be induced via the mitochondrial pathway. Collectively, these findings demonstrate that the size of PS particles dictates the combined effects of PS and Cd in kidney tissues. Kidney damage caused by the combination of different sizes of PS particle and Cd is more complicated under actual environmental conditions.

Microplastics (MPs) can enter the human body through respiration and pose a hazard to human health. Wearing masks has become a routine behavior during the COVID-19 pandemic. The level of respirational exposure and the influence of wearing masks are currently unknown. We recruited 113 college students and divided them into natural exposure (NE), surgical mask (SM), and cotton mask (CM) groups. Nasal lavage fluid (NLF) was collected and MPs characteristics were analyzed using polarized light microscopy and laser direct infrared system. We found a relatively high abundance of MPs in NLF in the SM group (41.24 ± 1.73 particles/g). The particle size distribution and fibrous MP percentage significantly differed among the three groups. The main components in the NE, SM, and CM groups were polypropylene (58.70 %)，polycarbonate (PC, 49.49 %)，and PC (54.29 %). Components such as polyamide, polyethylene and polyethylene terephthalate were also detected. Wearing surgical masks increased the MP abundance in NLF (β = 0.36, P < 0.01). As the wear time increased, the abundance of MPs also rose (β = 0.28, P < 0.05). However, those who used bedding containing synthetic fibers had lower MP abundance in their NLF. This study highlights the use of NLF to evaluate MP exposure, which is associated with potential health risks.

Background Few studies have assessed the burden of mental disorders among children and adolescents considering the impact of co-morbidities and suicide on disability adjusted life years (DALYs).Methods This was a multicenter cross-sectional study. Our survey data in Liaoning Province (LN) were used to estimate the burden of six mental disorders, supplemented with data from other investigative studies conducted in China to assess four other disorders. DALYs were derived from the sum of years lived with a disability (YLDs) adjusted for co-morbidities, and the years of life lost (YLLs) adjusted for suicide. The changes in DALYs, YLDs, and YLLs were compared with and without adjustment for co-morbidities and suicide.Results The DALYs rate of mental disorders among children and adolescents in LN decreased from 1579.6/105 to 1391.4/105, after adjusting for both co-morbidities and suicide (-11.9%). The DALYs rate for major depression, anxiety disorder, and conduct disorder (-80.8/105, -75.0/105 and -30.2/105, respectively) were the top three contributors to the DALYs reduction (-188.2/105). The YLDs decreased from 72724.8 to 62478.5 after co-morbidity adjustment (-17.8%), mainly due to the reduction by major depression (-35.3%) and attention deficit/hyperactivity disorder [ADHD] (-34.2%). The YLLs increased from 130 to 1697.8 after adjusting for suicides (+ 56.9% of all suicide YLLs), mainly due to the contribution of major depression (+ 32.4%) and anxiety disorder (+ 10.4%). Compared to GBD 2010, the estimated DALY rate for mental disorders in LN was to be about 80%, with the proportion of DALYs and DALY rates explained by major depressive disorder accounted for only approximately one-third (14.6% vs. 41.9% and 202.6 vs. 759.9, respectively). But the proportion and absolute level of DALY rates explained by anxiety disorders were approximately 2-fold higher (39.7% vs. 19.6% and 552.2 vs. 323.3, respectively).Conclusions The DALYs of mental disorders among Chinese children and adolescents were approximately 80% of the global level, with anxiety disorders imposing about 2 times the global level. Co-morbidity and suicide must be adjusted when calculating DALYs.

Microplastics (MPs) are ubiquitous in the environment. However, it is unclear whether MPs are present in mammalian lungs through inhalation, and if so, could be possibly found in fetal tissues. In this study, we aim to determine the presence and characteristics of particles in domestic and fetal pig lung tissue in the natural environment. Specimens from the lungs of domestic pigs (n = 10) and fetal pigs that already died in matrix during vaginal birth from the non-contaminated area (n = 10) were obtained from farmers' nearby sludge treatment plant. These specimens were compressed between two glass microscope slides, which were examined under polarized light microscopy. In addition, Agilent 8700 LDIR Chemical imaging system (LDIR) was used to determine the quantitative and qualitative characteristics of MPs. According to the polarized light microscope survey of domestic pig lungs, we observed an average of 12 particles/g, which was more than the 6 particles/g observed in fetal pig lungs, which ranged in size from 115.14 μm to 1370.43 μm. All the observed MP particles were fiber in shape. LDIR indicated an average of 180 particles/g of domestic pig lungs, ranging in size from 20.34 μm to 916.36 μm, which was twice as many MPs observed in fetal pig lungs. Furthermore, the compositions of MPs were different between them. LDIR indicated that polyamide (PA) was the most common polymer identified in domestic pig lungs (46.11%), while polycarbonate (PC) was the most common polymer in fetal pig lungs (32.99%). These findings confirmed the presence of MPs in the lung tissue of both domestic and fetal pigs in the natural environment, but the main characteristics differed. This fact indicated the increasing risk of MPs to human respiratory tract is increasing. Further research should be conducted to entirely estimate the specific exposure level on humans and offspring.

The aim of this study was to determine the presence of microplastics (MPs) in the upper respiratory tract of indoor and outdoor workers, to assess the type and the extent of contamination. Sputum and nasal lavage fluid were collected, and plastic particles were quantitatively analyzed by polarizing microscopy and a laser direct infrared chemical imaging system. The polarized light microscopy results showed that suspicious MPs were found in the nasal lavage and sputum of both couriers and office staff, and the abundance of MPs in the nasal lavage of office staff was significantly higher than in couriers (P < 0.0001). The chemical imaging results showed that polycarbonate (24.2%) and polyvinylchloride (PVC) (23.0%) were the predominant plastic materials in the sputum of couriers, while polyamide (PA) (25.3%) and polyethylene (22.9%) were dominant in the nasal lavage fluid. The sputum and nasal lavage fluid of office staff were both dominated by PVC (39.1% and 41.1%, respectively) and PA (24.8% and 31.6%, respectively). Therefore, this study revealed that microplastic pollution was found in the respiratory tract of both indoor and outdoor workers, but the distribution of MP particles differed between the two populations.

Nano- and micro-plastic (NMP) pollution has emerged as a global issue; however, uptake in the blood is controversial. Also, there is no evidence that NMPs are excreted via urine. This study was designed to clarify the time course of NMPs absorption in blood and the excretion in urine. Male mice received a single administration of fluorescent polystyrene (PS) beads (100-nm and 3-μm) via tail vein injection, gavage, or pulmonary perfusion. Blood and urine samples were measured 0.5, 1, 2, and 4 h after exposure by confocal laser scanning microscope (CLSM). Transmission electron microscopy (TEM) was performed to corroborate the findings. Fluorescence particles were detected in both blood and urine from the 100-nm and 3-μm PS-treated groups after exposure. In the 3-μm PS treated group, particles with corresponding diameters were detected after intravenous injection and pulmonary perfusion, and particles with a diameter <3 μm were detected in blood samples after gavage. The fluorescent signal in urine was particularly weak and the size was <3 μm. Significant time course changes in fluorescence intensity were demonstrated in blood and urine (P < 0.05) after intravenous injection and pulmonary perfusion in the 100-nm PS-treated group. By contrast, significant changes were detected in the urine (P < 0.05), but not the blood, after gavage. TEM confirmed the presence of particles with corresponding diameters in blood samples; however, the excretion in urine was difficult to confirm for nano-plastics (NPs) and micro-plastics (MPs) because all particles with diameters of approximately 100 nm and 3 μm had irregular shapes and no clear boundaries. Our findings revealed that both NPs and MPs enter the blood circulation through digestive and respiratory pathways. Both 100-nm and 3-μm NMPs may be excreted through urine, but further evidence is needed. The physical and chemical properties of MPs may be impacted by digestive processes in vivo.

微塑料作为一种新型污染物,已引起学者广泛关注.儿童正处于生长发育的关键阶段,易受到微塑料的影响.研究概述了微塑料的来源和相关法律法规,详细介绍了微塑料进入人体的途径、近期研究中发现微塑料的一些毒性作用及其对儿童健康的潜在危害,以期为儿少卫生工作者提供研究思路.

Objective This study was designed to provide the evidences on the toxicokinetics of microplastics（MPs） and nanoplastics（NPs） in the bodies of mammals.Methods 100 nm, 3 μm, and 10 μm fluorescent polystyrene（PS） beads were administered to mice once by gavage at a dose of 200 mg/kg body weight. The levels and change of fluorescence intensity in samples of blood, subcutaneous fat, perirenal fat, peritesticular fat, cerebrum, cerebellum, testis, and epididymis were measured at 0.5, 1, 2, and 4 h after administration using an IVIS Spectrum small-animal imaging system. Histological examination, confocal laser scanning, and transmission electron microscope were performed to corroborate the findings.Results After confirming fluorescent dye leaching and impact of pH value, increased levels of fluorescence intensity in blood, all adipose tissues examined, cerebrum, cerebellum, and testis were measured in the 100 nm group, but not in the 3 and 10 μm groups except in the cerebellum and testis at 4 h for the 3 μm PS beads. The presence of PS beads was further corroborated.Conclusion After a single oral exposure, NPs are absorbed rapidly in the blood, accumulate in adipose tissues, and penetrate the blood-brain/testis barriers. As expected, the toxicokinetics of MPs is significantly size-dependent in mammals.

PURPOSE:Successful aging is an effective approach to coping with population aging; however, the definition and associated factors vary due to culture and demographic distribution differences. This study was designed to assess successful aging of the older adults in China and explore the associated factors.METHODS:A community-based cross-sectional study was performed in Liaoning, China. After double-cognitive function screening, 3558 older adults (1656 males and 1902 females) ≥65 years of age served as our subjects. Successful aging was assessed based on the following: physical disability; cognitive function; activities of daily living; and self-rated psychological/mood status.RESULTS:The rate of successful aging was 31.7% in males and 29.4% in females. After adjustment for age, multivariate logistic regression showed that successful aging was significantly associated with, in odds ratio sequence, visual ability, self-rated chronic disease, marital status, and filial piety in males, and with visual ability, self-rated chronic disease, watching television, and ethnicity in females.CONCLUSION:The level of successful aging in China is lower than in other countries. Demographic characteristics, health status, individual behavior, and social-psychological factors are all associated with successful aging. Overall, visual ability had the most crucial role in successful aging for the older adults, whether males or females.

Purpose: Few studies have assessed the individual and joint effects of the mother's, father's and teacher's mental health symptoms on schoolchildren's behavior and emotional wellbeing simultaneously in the same study.Patients and Methods: A cross-sectional survey was conducted among 8488 Chinese schoolchildren aged 6-17 years in northeast China.The Strengths and Difficulties Questionnaire (SDQ) and General Health Questionnaire (GHQ) were used to measure the mental health of the students, their parents and the teacher in charge of the class, respectively.A total of 6173 students (72.73%) with full mental health information from all three caretakers were included in the final analysis.Results: We found a significantly elevated risk of mental health symptoms in children when their mothers (odds ratios (OR)=2.30,95% CI=1.93-2.73),fathers (OR=2.08,95% CI=1.73-2.50)and teachers (OR=1.18,95% CI=1.01-1.39) reported poorer mental health, and the risk increased significantly with the number of the caretakers with mental symptoms.A father with poor mental health has both direct and indirect effects on a child's emotional health, by worsening the influence of a mother's poor mental health.Conclusion: All three caretakers have a significant negative influence on schoolchildren's emotional well-being, in the order of mother > father > teacher.It is desirable to assess and manage students' mental health in the both the family and school contexts.

1Institute of Preventive Medicine, China Medical University, Shenyang, Liaoning, 110122, People’s Republic of China; 2Institute of Chronic Diseases, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, 111200, People’s Republic of China; 3Research Center for Universal Health, School of Public Health, China Medical University, Shenyang, Liaoning, 110122, People’s Republic of China Purpose: Successful aging is an effective approach to coping with population aging; however, the definition and associated factors vary due to culture and demographic distribution differences. This study was designed to assess successful aging of the older adults in China and explore the associated factors. Methods: A community-based cross-sectional study was performed in Liaoning, China. After double-cognitive function screening, 3558 older adults (1656 males and 1902 females) ≥65 years of age served as our subjects. Successful aging was assessed based on the following: physical disability; cognitive function; activities of daily living; and self-rated psychological/mood status. Results: The rate of successful aging was 31.7% in males and 29.4% in females. After adjustment for age, multivariate logistic regression showed that successful aging was significantly associated with, in odds ratio sequence, visual ability, self-rated chronic disease, marital status, and filial piety in males, and with visual ability, self-rated chronic disease, watching television, and ethnicity in females. Conclusion: The level of successful aging in China is lower than in other countries. Demographic characteristics, health status, individual behavior, and social-psychological factors are all associated with successful aging. Overall, visual ability had the most crucial role in successful aging for the older adults, whether males or females.