Across countries, the predominant diets are clearly different and highly related with human health. Therefore, it is necessary to evaluate dietary nutrients between them. This study aimed to evaluate dietary nutrients in China and compare those between Chinese and Mediterranean (Italian), Japanese and American diets. Dietary intakes of 2659 subjects in south-east China, Zhejiang province, from 2010 to 2012, were estimated by three consecutive 24-h dietary recalls. The contribution of carbohydrate to total energy in Chinese subjects was lower than that in Japanese and American subjects, but higher than that in Italian subjects. However, the energy contribution from fat in Chinese subjects was higher than that in Japanese and American subjects, and similar to that in Italian subjects. Moreover, the Chinese diet had lower daily intakes of fiber, calcium, phosphorus, potassium, selenium, vitamin A, vitamin B₁, vitamin B₂ and vitamin C, compared with the Japanese, American and Italian diets. Nevertheless, intakes of sodium, iron, copper and vitamin E were higher among Chinese people relative to the people of other three countries. The present study demonstrated that the structure of the Chinese diet has been shifting away from the traditional diet toward high-fat, low-carbohydrate and low-fiber diets, and nutrients intakes in Chinese people have been changing even worse than those in American people.

Objectives: Along with the development of the times and progress of the society, the total fertility rate (TFR) markedly changed in each country. Therefore, it is critical to describe the trend of TFR and explore its influencing factors. However, previous studies did not consider the time lag and cumulative effect in the associations between the influencing factors and TFR. Thus, our study aimed to analyze the associations from a new dimension. Methods: The study was employed using national-level data from the World Bank and United Nations Development Programme. Distributed lag non-linear models with 5-year lag were used to examine the independent associations between the relevant factors and TFR. Results: The cumulative exposure-TFR curves were inverted U-shaped for log gross domestic product (GDP) per capita and life expectancy at birth, while the cumulative exposure-response curves were approximately linear for female expected years of schooling and human development index (HDI). However, it is worth noting that in the developed regions, TFR increased slightly with the high level of GDP per capita, female expected years of schooling and HDI. Conclusions: Nowadays, with the growth of GDP per capita, life expectancy at birth, female expected years of schooling and HDI, TFR are on a drastic downward trend in most regions. Besides, with the development of society, when levels of the factors continued to increase, TFR also showed a slight rebound. Therefore, governments, especially those in developing countries, should take measures to stimulate fertility and deal with a series of problems caused by declining TFR.

Background Hypertensive disorders of pregnant women are one of the important causes of maternal and perinatal morbidity and mortality. Evidence showed mental stress might be a risk factor of gestational hypertensive disorders. Objective The objective of this study was to evaluate the relationships between mental stress and gestational hypertension/preeclampsia in pregnant women. Methods Relevant studies were identified by PubMed, Cochrane, Chinese medical datasets (Wanfang, CNKI, and VIP Database). Only case-control or cohort studies evaluating an association of preeclampsia or gestational hypertension with mental stress were included in the present meta-analysis. Essential information was extracted from the qualified studies. Odds ratio (OR) was used as a pooled effect size. Potential heterogeneity and publication bias were detected as well. Results Thirteen studies were included in the final analyses, which totally recruited 668,005 pregnant women. The results indicated that mental stress was associated with an increased risk of gestational hypertension (OR, 1.26; 95% confidence interval [CI], 1.00–1.59; P = 0.047) and preeclampsia (OR, 1.49; 95% CI, 1.27–1.74; P < 0.001). Meanwhile, work stress (OR, 1.50; 95% CI, 1.15–1.97; P = 0.003) and anxiety or depression (OR, 1.88; 95% CI, 1.08–3.25; P = 0.02) were positively associated with risk of preeclampsia. Conclusions Mental stress during life or pregnancy may be a risk factor for gestational hypertension and preeclampsia among pregnant women. Target Audience: Obstetricians and gynecologists, family physicians Learning Objectives: After completing this CME activity, physicians should be better able to evaluate the mental stresses that put patients at risk for preeclampsia and gestational hypertension, identify risk factors for preeclampsia and gestational hypertension, and determine possible measures to prevent preeclampsia and related conditions.

Nowadays, the vaccination with COVID-19 vaccines is being promoted worldwide, professionals and common people are very concerned about the efficacy and safety of COVID-19 vaccines. No published systematic review and meta-analysis has assessed the efficacy and safety of the COVID-19 vaccines based on data from phase III clinical trials. Therefore, this study has estimated the efficacy and safety of COVID-19 vaccines and the differences between vaccine types. PubMed, Embase, the Cochrane Library, CNKI, Wanfang, medRxiv databases and two websites were used to retrieve the studies. Random-effects models were used to estimate the pooled efficacy and safety with risk ratio (RR). A total of eight studies, seven COVID-19 vaccines and 158,204 subjects were included in the meta-analysis. All the vaccines had a good preventive effect on COVID-19 (RR = 0.17, 95% CI: 0.09–0.32), and the mRNA vaccine (RR = 0.05, 95% CI: 0.03–0.09) was the most effective against COVID-19, while the inactivated vaccine (RR = 0.32, 95% CI: 0.19–0.54) was the least. In terms of safety, the risk of overall adverse events showed an increase in the vaccine group after the first (RR = 1.46, 95% CI: 1.03–2.05) or second (RR = 1.52, 95% CI: 1.04–2.20) injection. However, compared with the first injection, the risk of local (RR = 2.64, 95% CI: 1.02–6.83 vs. RR = 2.25, 95% CI: 0.52–9.75) and systemic (RR = 1.33, 95% CI: 1.21–1.46 vs. RR = 1.59, 95% CI: 0.84–3.01) adverse events decreased after the second injection. As for the mRNA vaccine, the risk of overall adverse events increased significantly, compared with the placebo, no matter whether it was the first (RR = 1.83, 95% CI = 1.80–1.86) or the second (RR = 2.16, 95% CI = 2.11–2.20) injection. All the COVID-19 vaccines that have published the data of phase III clinical trials have excellent efficacy, and the risk of adverse events is acceptable. The mRNA vaccines were the most effective against COVID-19, meanwhile the risk and grade of adverse events was minimal, compared to that of severe symptoms induced by COVID-19.