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.

Objective. This study is aimed at exploring the trends in the prevalence, awareness, treatment, and control of hypertension in rural northeast China from 2008 to 2018. Methods. Two successive cross‐sectional surveys were conducted in Liaoning rural areas in 2008 and 2018, which included 131520 and 10926 representative participants aged ≥ 40 years, respectively. Results. Overall, the age‐standardized prevalence of hypertension increased from 44.7% to 53.6%, and male residents showed a faster pace of increase and a 2.1‐fold increase than female residents (25.5% vs. 10.6%) from 2008 to 2018. Moreover, the mean systolic and diastolic blood pressures increased by 9.0% and 4.1%, respectively, and the increase rates were greater in men than in women (9.2% vs. 8.9% and 5.3% vs. 3.5%, P < 0.05). Additionally, the prevalence of stage 2 and above hypertension was significantly higher in men than in women. However, the awareness, treatment, and control rates showed no improvement and remained unacceptably low. Control rates were 3.7% in 2008 and 3.6% in 2018. Even among individuals who received medical treatment, only 8.7% and 10.1% had controlled hypertension in 2008 and 2018, respectively. Conclusions. The prevalence of hypertension and mean blood pressure increased steadily in the past 10 years in rural northeast China, especially in men. However, the awareness, treatment, and control rates of hypertension remained extremely low. Therefore, long‐term comprehensive strategies are urgently needed to prevent further development of cardiovascular diseases in these areas.

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: The high heterosexual marriage rate could be a ‘double-edge’ sword for the emotional health of Chinese men who have sex with men (MSM). The aim of this study was to determine if current marriage and breakdown of marriage (divorce) have different effects on the mental health of Chinese MSM. Methods: Eight hundred seven MSM were recruited using respondent-driven sampling from four cities in northeastern China. Gay-related stressful events (GRSE) were measured using the Gay Related Stressful Life Events Scale; social support was measured by the Social Support Rating Scale (SSRS); and depressive and anxiety symptoms were assessed using the Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS), respectively. Results: Of the study participants, 13.4% were married to women and 4.5% were divorced. The rates of marriage or divorce were 35.3 and 75.8% for participants 30–39 and > 40 years of age, respectively. The current married MSM had the highest SDS (50.0 ± 10.9) and SSRS (35.8 ± 8.6) levels, but the lowest SAS (38.7 ± 12.1) levels. Divorced MSM had the highest SAS (44.4 ± 9.6) and lowest SSRS (30.8 ± 8.1) levels. Age, GESE number, and HIV infection were predictors for SDS and SAS, and current marriage was associated with significantly decreased level of SAS (β = − 0.136, P = 0.001) based on multiple linear analysis. Conclusions: Current marriage is associated with significantly decreased levels of anxiety symptoms among Chinese MSM. More studies are needed to understand the mechanisms underlying the effects of different marriage status on the emotional distress of Chinese MSM.

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.

Background: To measure the effects of using different combinations of multiple informants and the impact score on the estimated prevalence of mental health problems in Chinese schoolchildren. Methods: Complete information on the Strengths and Difficulties Questionnaire (SDQ) were obtained from students (S), parents (P), and teachers (T) for 4986 schoolchildren (11–17 years-old). We used 3 criteria to determine the prevalence of mental health problems: SDQ cut-off value (previously established in the United Kingdom), SDQ cut-off value plus an impact score of 1 or more, or plus an impact score of 2 or more. A student was defined as having a mental health problem if any informant (S, P, or T) classified the child as ‘abnormal’. We compared the prevalence of mental health problems determined from 1 informant, 2 informants, and 3 informants. Results: The prevalence of overall mental health problems increased with rising number of informants, but decreased with increasing impact score. When the impact score was not considered, the prevalence was 8.2% to 14.2% when rated by 1 informant, 18.8% to 24.7% when rated by 2 informants, and 28.3% when rated by all 3 informants. Failure to measure the impact score led to a two to threefold greater estimate of the prevalence of mental health problems. Conclusions: The types, number, and combinations of multiple informants and use of the impact score must be considered when comparing the results of different studies. It is preferable to use multiple informants and have the impact score taken the impact into account to reflect the real burden of mental health burden in children and adolescent.