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At pressent, there are many controversies in China about the recommendations in Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome (hereinafter referred to as the “Guidelines”) revised in 2021, and it's believed that some clauses lack theoretical support. Some researches in China have showed that sodium restriction and negative sodium balance are the only reason for hyponatremia. Sodium retention is the stress protective reaction mechanism for hyponatremia, not the basis for sodium restriction treatment. This article dialectically evaluates the relationship between peripheral circulation dysfunction, hepatorenal syndrome pathogenesis and diagnosis and treatment, and believes that the AASLD Guidelines have weakened the clinical guiding significance, and looks forward to the development of ascites and hepatorenal syndrome diagnosis and treatment guidelines with Chinese intellectual property rights and in line with Chinese clinical practice.

In order to improve the anti-rollover performance of heavy-duty vehicles in large curvature curves or under emergency obstacle avoidance conditions, an integrated active anti-rollover controller combining active steering and direct yaw moment was proposed. Firstly, the rollover factor model based on load transfer ratio (LTR) was established. Then, utilizing yaw rate, sideslip angle and roll angle as the states, an adaptive model predictive control strategy for vehicle chassis based on the real-time rollover factor was designed. Finally, the CarSim/Simulink simulation platform and the hardware-in-loop (HIL) hardware in the loop test bench were set up. The experimental results show that compared with the traditional vehicle stability control method, the proposed control system controller can control the roll angle and sideslip angle within 4°and 0. 5°by allocating the extra yaw moment and the steering angle of the front wheel reasonably under the condition of double lane change (DLC) and variable curvature road. The rollover factor is suppressed in a reasonable range, which means that the rollover anti-performance and yaw tracking performance of the vehicle are effectively improved, and the stability and safety of the heavy vehicle in the variable curvature curve are therefore realized. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of the Oxford Health Alliance-Community Interventions for Health on chronic diseases prevention and control capacity in community medical staff in Hangzhou., Methods: A two year comprehensive intervention on chronic disease prevention and control capacity was conducted in the medical staff in Xiacheng district and Gongshu district, Xihu district was used as control according to the study design principal of parallel comparison and non-random grouping. The intervention effect was evaluated with Cochran-Mantel-Haenszel test. A total of 985 questionnaires were completed in the baseline survey and 870 questionnaires were completed in the follow-up survey., Results: After 2 year intervention, the detection rates of blood cholesterol, blood pressure and fasting blood glucose by community medical staff significantly increased compared with the rates before the intervention (χ² =7.97, P =0.05 ; χ² =27.21, P =0.00 ; χ² =21.32, P=0.00). While, in the control district, the fasting blood glucose detection rate increased from 25.37% to 31.19%, the differences showed statistical significance (χ² =15.29, P=0.00). The communication between community medical staff and patients about healthy diet pattern was improved after the intervention, the difference was statistical significant (χ² =8.64, P=0.03). However, no significant differences in communication about increasing physical activity and smoking cessation between community medical staff and patients was found before and after intervention both in intervention districts and in control district. Furthermore, multivariate logistic regression analysis indicated that the interventions on screening of common chronic diseases and management of chronic diseases patients were related with the detections of blood cholesterol, blood pressure and fasting blood glucose. Moreover, the intervention on counsel and suggestion for chronic disease prevention and control had some influence on the communication about chronic disease risk factors between community medical staff and patients., Conclusion: The intervention on chronic disease prevention and control capacity in community medical staff was effective to improve the detection of chronic diseases in community and the communication between the medical staff and patients.

Objective: To understand the perceptions of physical activity-related built environment among urban adults in Hangzhou., Methods: A face-to-face interview was conducted among the urban residents aged 25-59 years selected through multistage stratified random sampling in Hangzhou in 2012. The Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A) was used to assess the perception of built environment among residents, including residential building density, the diversities of stores, facilities and others, the accessibility to public service, the street connectivity, walking/cycling facilities, aesthetics, traffic safety, and public security. The multilevel logistic regression model was used to assess the demographic characteristics, BMI and other factors' influence on people's perceptions., Results: Among 1 362 local residents surveyed, no sex, martial status and occupation specific significant differences in the perception of built environment were found. After adjusting other factors, the age group 45-59 years was positively related to the score of street connectivity (OR=2.02, 95% CI: 1.30-3.15). The educational level of college or higher was positively associated with the score of residential building density (OR=1.97, 95% CI: 1.29-3.00) but negatively associated with the score of facility variety (OR=0.65, 95% CI: 0.43-0.97). Overweight or obesity was negatively related to the scores of walking/cycling ways (OR=0.67, 95%CI: 0.48-0.95) and public security (OR=0.75, 95% CI: 0.57-0.99). Compared with the class I residential area, the people in class III residential area had lower perception scores on facility diversity (OR=0.11, 95% CI: 0.04-0.30), accessibility to public service (OR=0.33, 95% CI: 0.11-0.95), street connectivity (OR=0.30, 95% CI: 0.11-0.86) and traffic safety (OR=0.39, 95% CI: 0.17-0.91)., Conclusion: The perceptions of physical activity-related built environment was associated with age, educational level, BMI and residential area. The personal characteristics should be considered while performing environment intervention on physical activity.

Objective: To explore the association between walking time and the perception of built environment among local adults in Hangzhou., Methods: Through multistage stratified random sampling, a total of 1 440 urban residents aged 25-59 years were surveyed in Hangzhou by face-to face interview in 2012. The international physical activity questionnaire-long version (IPAQ-L) was used to assess the physical activity levels, including walking time in the past week. Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A) was used to obtain information about their perception of built environment. Multiple logistic regression was applied to estimate the relationship between waking and the perception of built environment., Results: Among the local adults in Hangzhou, the median of total physical activity was 2 766 met·min⁻¹·week⁻¹, the average walking time per week was 90 min for leisure and 100 min for transportation respectively. After controlling the age, marital status, BMI, educational level, employment, community type and the total PA scores, the leisure-time walking was negatively related to the accessibility to stores, facilities and other things for both man (OR=0.764, 95% CI: 0.588-0.992) and woman (OR=0.633, 95% CI: 0.481-0.833). In sex specific analysis, the leisure-time walking was negatively related with the residential density (OR=0.997, 95% CI: 0.996-0.999) while transportation related walking was positively related with walking/cycling way scores (OR=1.537, 95% CI: 1.138-2.075) in females. In contrast, there were no significant associations between perception of built environment and transportation related walking in males., Conclusion: Improving the built environment, such as the walking/cycling way, might be useful to increase the transportation related walking time for adults. The sex specific differences need to be considered in the environment intervention for walking promotion.

Objective: To evaluate the short-term impact of comprehensive community-based intervention programs on smoking cessation counseling services provided by community medical staff and related influencing factors in three districts of Hangzhou city., Methods: Within the framework of Community Interventions for Health (CIH) Program, a community trial was conducted in two districts (Xiacheng and Gongshu) and a district (Xihu) as control, by a parallel comparison and random grouping based quasi-experimental design. Two independent questionnaire-based surveys of cross-sectional samples in the intervention and comparison areas were used to assess the impact of intervention., Results: There were 299 and 141 medical staff in the areas of intervention and 'control', respectively. For the intervention area, the quantity of available resources increased from 2 to 3 and the quantity of used resources increased from 1 to 3 (both P < 0.001), while the area of control had a downward trend for both quantities. For the ratios of well-readiness for smoking counseling, in the intervention area were 35.5% , 52.0% before and after intervention (P < 0.001), while the 'controlled' area they were 28.1%, 39.3%, respectively (P = 0.162). A slight increase was seen in the intervention area for the proportion of the medical staff who had been provided smoking cessation counseling, as ≥ 90% patients (including asking smoking status, announcing risks related to the risks of smoking and advising smoking cessation programs etc.), while the proportion decreased in the area of 'control'. The improvement of preparedness would promote medical staff to ask their patients about smoking status (OR = 1.43, P = 0.007), while all factors as a whole would not influence the medical staff to inform patients about the danger of smoking and advice patients to quit smoking., Conclusion: Comprehensive community-based interventions could increase the opportunities for medical staff to acquire and utilize smoking cessation resources to some extent, as well as promote those staff's preparedness. However, intervention itself might fail to improve the behavior of providing such services. Support that came from the policy or from the institutions also need to be strengthened.

Objective: To explore the level of physical activities (PA) and related influencing factors among junior high school personnel in Hangzhou., Methods: In a cross sectional study, a self administered questionnaire was used to assess the levels of PA. Kruskal-Wallis H test and ordinal regression were applied to analyze the related factors., Results: Among the 1 497 school personnel included in this study, prevalence rates on the low, moderate and high levels of PA were 40.8%, 40.6% and 18.6%, respectively. Data from the multinomial logistic regression analysis indicated that:when comparing with the low level, people aged ≥ 45 (OR = 1.576, 95% CI:1.128-2.201) or those having minor perceived stress (OR = 1.490, 95% CI:1.141-1.946) more likely to fall into the moderate level. However, factors as higher awareness scores on the benefit of PA (OR = 1.070, 95%CI:1.002-1.143), being male (OR = 3.088, 95%CI:2.162-4.409), always or very often taking PA together with colleagues (OR = 2.903, 95%CI:1.587-5.312), taking PA once in a while together with colleagues (OR = 1.900, 95%CI:1.160-3.110) or having space to walk around home (OR = 1.657, 95% CI:1.022-2.688) would increase the likelihood of having high PA level. However, factors as marital status, socioeconomic status, years of working at school, BMI, level of having received education and positive impact from colleagues etc. did not seem to have significantly related to the PA level., Conclusion: Gender, age, stress from work and supportive environment should be taken into account while planning on promoting the PA level among junior high school personnel in Hangzhou.

Objective: to discuss the impact of different traffic crossroad exhaust pollution on the immune function of school-age children., Methods: A school in the heavy traffic polluted area and B school in the less traffic polluted area were selected. Total 142 students from five to six grades in both areas were sampled. The level of peripheral blood cells (WBC, lymphocytes, neutral cells, red blood cells, platelets) and the T lymphocyte subpopulations (the percentages of CD3+, CD4+, CD8+ and the ratio of CD4+/CD8+), saliva lysozyme contents and immunoglobulin content were determined., Results: Except for neutral cells, the peripheral blood cells level (WBC, lymphocytes, red blood cells, platelets) of children in the A school were higher than those in the B school. The contents of saliva lysozyme, immunoglobulin (IgG), T lymphocyte subpopulations (the percentages of CD3+, CD4+ and the ratio of CD4+/CD8+) in the A school were lower than those in the B school (P < 0.05)., Conclusion: Exhaust pollution of different traffic crossroads could inhibit nonspecific immunity and cell immunity, and impact the level of blood cells and humoral immunity.