Design and implementation of clinical decision support systems in mental health helpline Services: A systematic review.

BACKGROUND: Clinical Decision Support Systems (CDSSs) are electronic systems used to conduct assessments based on patient characteristics and to offer treatment recommendations for clinicians to consider during their decision-making processes. CDSSs are needed by mental health helpline services to optimise service delivery for clients and counsellors, while also collecting the data needed for the administration of the service. The aim of this systematic review was to provide a comprehensive overview of the design and implementation of CDSSs in mental health helpline services, to identify current issues in their design and implementation, and to provide recommendations that may address any identified issues. MATERIALS AND METHODS: Keywords related to mental health, helplines and CDSS were searched in three databases in April 2022 and September 2023. In total, 21 articles published between 1987 and 2023 met the inclusion criteria. RESULTS: The objectives of the mental health helplines services included in this study included suicide risk reduction, diagnosis, treatment and monitoring of mental health disorders, and support of clinicians or counsellors in making better and more accurate decisions by incorporating real-time data analysis. All included studies demonstrated co-design activities, however, the level and degree of end-user involvement differed across the studies. The factors that impact CDSS implementation success depend on the design and implementation approach, user experience and context. CDSS evaluations in the included studies assessed reliability, utility, user friendlessness, cost-effectivenessand participant satisfaction. Few studies considered data privacy and integration issues. CONCLUSION: More interactive methods should be adopted during the design of CDSSs for mental health helpline services. Increased frequency and intensity of user participation in system design, that goes beyond providing feedback on research materials, enables user opinions to be fully understood and addressed. Comprehensive frameworks should be developed to guide requirements gathering, system design and system evaluation practices. These factors are interrelated and may impact implementation success. From the outset therefore, the design of a CDSS in the mental health helpline domain should consider the full system development cycle.

Microbial colony sequencing combined with metabolomics revealed the effects of chronic hexavalent chromium and nickel combined exposure on intestinal inflammation in mice.

The pollution and toxic effects of hexavalent chromium [Cr(VI)] and divalent nickel [Ni(II)] have become worldwide public health issues. However, the potential detailed effects of chronic combined Cr(VI) and Ni exposure on colonic inflammation in mice have not been reported. In this study, 16S rDNA sequencing, metabolomics data analysis, qPCR and other related experimental techniques were used to comprehensively explore the mechanism of toxic damage and the inflammatory response of the colon in mice under the co-toxicity of chronic hexavalent chromium and nickel. The results showed that long-term exposure to Cr(VI) and/or Ni resulted in an imbalance of trace elements in the colon of mice with significant inflammatory infiltration of tissues. Moreover, Cr(VI) and/or Ni poisoning upregulated the expression levels of IL-6, IL-18, IL-1ß, TNF-α, IFN-γ, JAK2 and STAT3 mRNA, and downregulated IL-10 mRNA, which was highly consistent with the trend in protein expression. Combined with multiomics analysis, Cr(VI) and/or Ni could change the α diversity and ß diversity of the gut microbiota and induce significant differential changes in metabolites such as Pyroglu-Glu-Lys, Val-Asp-Arg, stearidonic acid, and 20-hydroxyarachidonic acid. They are also associated with disorders of important metabolic pathways such as lipid metabolism and amino acid metabolism. Correlation analysis revealed that there was a significant correlation between gut microbes and metabolites (P < 0.05). In summary, based on the advantages of comprehensive analysis of high-throughput sequencing sets, these results suggest that chronic exposure to Cr(VI) and Ni in combination can cause microbial flora imbalances, induce metabolic disorders, and subsequently cause colonic damage in mice. These data provide new insights into the toxicology and molecular mechanisms of Cr(VI) and Ni.

Biomarkers prediction and immune landscape in ulcerative colitis: Findings based on bioinformatics and machine learning.

BACKGROUND: Ulcerative colitis (UC) presents diagnostic and therapeutic difficulties. The primary objective of this study is to identify efficacious biomarkers for diagnosis and treatment, as well as acquire a deeper understanding of the immuneological characteristics associated with the disease. METHODS: Datasets relating to UC were obtained from GEO database. Among these, three datasets were merged to create a metadata for bioinformatics analysis and machine learning. Additionally, one dataset specifically utilized for external validation. Least absolute shrinkage and selection operator (LASSO) and random forest (RF) were employed to screen signature genes. The artificial neural network (ANN) model and receiver operating characteristic (ROC) curve were used to assess the diagnostic performance of signature genes. The single sample gene set enrichment analysis (ssGSEA) was applied to reveal the immune landscape. Finally, the relationship between the signature genes, immune infiltration, and clinical characteristics was investigated through correlation analysis. RESULT: By intersecting the result of LASSO, RF and WGCNA, 8 signature genes were identified, including S100A8, IL-1B, CXCL1, TCN1, MMP10, GREM1, DUOX2 and SLC6A14. The biological progress of this gene mostly encompasses acute inflammatory response, aggregation and chemotaxis of leukocyte, and response to lipopolysaccharide by mediating IL-17 signaling pathway, NF-kappa B signaling pathway, TNF signaling pathway, NOD-like receptor signaling pathway. Immune infiltration analysis shows 25 immune cells are significantly elevated in UC samples. Moreover, these signature genes exhibit a strong correlation with various immune cells and a mild to moderate correlation with the Mayo score. CONCLUSION: S100A8, IL-1B, CXCL1, TCN1, MMP10, GREM1, DUOX2 and SLC6A14 have been identified as credible potential biomarkers for the diagnosis and therapy of UC. The immune response mediated by these signature biomarkers plays a crucial role in the occurrence and advancement of UC by means of the reciprocal interaction between the signature biomarkers and immune-infiltrated cells.

The effectiveness of high-intensity laser therapy in individuals with neck pain: a systematic review and meta-analysis.

OBJECTIVES: The primary objective of this meta-analysis was to determine whether high-intensity laser therapy (HILT) was effective in improving pain intensity, cervical range of motion (ROM), functional activity, and quality of life (QOL) in individuals with neck pain. DATA SOURCES: PubMed, PEDro, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov were searched from inception to March 26, 2022. STUDY SELECTION: Randomized controlled trials (RCTs) involving HILT for neck pain were selected. DATA EXTRACTION AND DATA SYNTHESIS: Two raters were independent in data extraction. The methodological quality was evaluated using the PEDro scale, and the level of evidence was assessed using the GRADE system. RevMan5.4 was used for meta-analysis. RESULTS: Eight RCTs were included and their PEDro scores were moderate to high. Compared with placebo, HILT was effective in improving pain intensity (SMD 2.12, 95%CI 1.24 to 3.00; moderate quality evidence), cervical flexion (SMD 1.31, 95%CI 0.27 to 2.35; moderate quality evidence), extension (SMD 1.43, 95%CI 0.24 to 2.63; moderate quality evidence), right lateral flexion (SMD 1.36, 95%CI 0.15 to 2.56; low-quality evidence). There was a trend of better outcome in functional activity after HILT (SMD 1.73, 95%CI -0.05 to 3.54; low quality evidence). LIMITATIONS: There was limited information available on QOL. CONCLUSION: HILT may be considered as an adjunctive treatment modality for neck pain. There was moderate quality evidence that HILT may improve pain intensity and cervical ROM in individuals with neck pain, but there was low quality evidence that HILT was not effective in improving functional activity. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021254078 CONTRIBUTION OF THE PAPER.

Preparation of the RIPK3 Polyclonal Antibody and Its Application in Immunoassays of Nephropathogenic Infectious Bronchitis Virus-Infected Chickens.

Receptor interacting protein kinase 3 (RIPK3) is a vital serine/threonine kinase in regulating the programmed destruction of infected cells to defend against RNA viruses. Although the role of RIPK3 in viruses in mice is well characterized, it remains unclear where in nephropathogenic infectious bronchitis virus (NIBV) in chickens. Here, we use a self-prepared polyclonal antibody to clarify the abundance of RIPK3 in tissues and define the contributions of RIPK3 in tissue damage caused by NIBV infection in chickens. Western blot analyses showed that RIPK3 polyclonal antibody can specifically recognize RIPK3 in the vital tissues of Hy-Line brown chicks and RIPK3 protein is abundantly expressed in the liver and kidney. Moreover, NIBV significantly upregulated the expression levels of RIPK3 in the trachea and kidney of chicks in a time-dependent manner. In addition, the activation of necroptosis in response to NIBV infection was demonstrated by the coimmunoprecipitation (CoIP) experiments through RIPK3 in the necrosome, which phosphorylates its downstream mixed-spectrum kinase structural domain-like protein (MLKL). Our findings offered preliminary insights into the key role of RIPK3 protein in studying the underlying mechanism of organ failure caused by NIBV infection.

Preparation of polyclonal antibody against phosphatidylethanolamine binding protein 1 recombinant protein and its functional verification in pulmonary hypertension syndrome in broilers.

Pulmonary hypertension syndrome (PHS) is a disease that is difficult to overcome for fast-growing broilers. It causes pulmonary vascular remodeling and ascites in broilers. As a classical inhibitor of cancer metastasis, phosphatidylethanolamine binding protein 1 (PEBP1) regulates angiogenesis in the process of tumor metastasis through multiple signal pathways. However, whether PEBP1 can regulate pulmonary artery remodeling in broilers with PHS has not been reported. This study constructed the prokaryotic expression vector of [PEBP1]-pET32a by genetic engineering technology, the recombinant PEBP1 protein was expressed in large quantities, and the PEBP1 polyclonal antibody was prepared by immunizing rabbits with the recombinant PEBP1 protein. Western blot and immunofluorescence results showed that PEBP1 was expressed in many kinds of animal tissues. However, due to the species specificity of polyclonal antibodies, the expression level of PEBP1 protein in broilers and ducks with high homology was significantly higher than that in other species of animals. More interestingly, we found that the expression of PEBP1 protein decreased significantly in broilers with PHS. These studies laid a foundation for further exploration of the mechanism of pulmonary artery remodeling. In addition, the PEBP1 polyclonal antibody provided convenience for further study of the role of PEBP1 in PHS.

HerbKG: Constructing a Herbal-Molecular Medicine Knowledge Graph Using a Two-Stage Framework Based on Deep Transfer Learning.

Recent advances have witnessed a growth of herbalism studies adopting a modern scientific approach in molecular medicine, offering valuable domain knowledge that can potentially boost the development of herbalism with evidence-supported efficacy and safety. However, these domain-specific scientific findings have not been systematically organized, affecting the efficiency of knowledge discovery and usage. Existing knowledge graphs in herbalism mainly focus on diagnosis and treatment with an absence of knowledge connection with molecular medicine. To fill this gap, we present HerbKG, a knowledge graph that bridges herbal and molecular medicine. The core bio-entities of HerbKG include herbs, chemicals extracted from the herbs, genes that are affected by the chemicals, and diseases treated by herbs due to the functions of genes. We have developed a learning framework to automate the process of HerbKG construction. The resulting HerbKG, after analyzing over 500K PubMed abstracts, is populated with 53K relations, providing extensive herbal-molecular domain knowledge in support of downstream applications. The code and an interactive tool are available at https://github.com/FeiYee/HerbKG.

SentiMedQAer: A Transfer Learning-Based Sentiment-Aware Model for Biomedical Question Answering.

Recent advances have witnessed a trending application of transfer learning in a broad spectrum of natural language processing (NLP) tasks, including question answering (QA). Transfer learning allows a model to inherit domain knowledge obtained from an existing model that has been sufficiently pre-trained. In the biomedical field, most QA datasets are limited by insufficient training examples and the presence of factoid questions. This study proposes a transfer learning-based sentiment-aware model, named SentiMedQAer, for biomedical QA. The proposed method consists of a learning pipeline that utilizes BioBERT to encode text tokens with contextual and domain-specific embeddings, fine-tunes Text-to-Text Transfer Transformer (T5), and RoBERTa models to integrate sentiment information into the model, and trains an XGBoost classifier to output a confidence score to determine the final answer to the question. We validate SentiMedQAer on PubMedQA, a biomedical QA dataset with reasoning-required yes/no questions. Results show that our method outperforms the SOTA by 15.83% and a single human annotator by 5.91%.

Preparation of a JAZF1 protein polyclonal antibody and its potential role in broiler ascites syndrome.

As a novel functional protein, juxtaposed with another zinc finger protein 1 (JAZF1) can regulate the growth and apoptosis through various pathways, and maintain the body's normal physiological metabolism. To explore the important role of JAZF1 in broiler ascites syndrome (BAS), we analysed the expression and distribution of the protein in poultry and mammal tissues based on the prepared polyclonal antibody. In this study, the recombinant plasmid PET32a-JAZF1 was constructed by TA cloning, subcloning and other technical methods, and the fusion protein His-JAZF1 was successfully expressed. After purification, His-JAZF1 was used as the antigen to prepare high-quality chicken-derived antibodies. Subsequently, the results showed that JAZF1 protein in broiler tissues could be specifically recognized by this antibody. Immunofluorescence showed that JAZF1 protein mainly exists in the cytoplasm of pulmonary artery, liver, kidney, heart and lung tissue cells of various animals. The expression of this protein was more obvious in broiler and duck tissues than in mammalian tissues. In addition, western blotting combined with immunofluorescence showed that BAS caused a significant decrease in JAZF1 protein in tissue cells. This effect further indicated that JAZF1 protein was closely related to the occurrence of BAS and provided a new entry point for the functional study of JAZF1 protein.

Traditional Chinese Mind and Body Exercises for Neck Pain: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Neck pain is common and can have a significant impact on patients' physical functionality, mobility, and quality of life (QOL). In clinical practice, traditional Chinese mind and body exercise (TCMBE) is a combination of different types of exercise based on traditional Chinese medicine, including qigong, tai chi, the 12-words-for-life-nurturing exercise, and so on, and many studies have found that it is safe and effective at helping patients with neck pain. OBJECTIVE: The aim of this study was to investigate the effectiveness of TCMBE on pain intensity, functional mobility, and QOL in individuals with neck pain. METHODS: The PubMed, MEDLINE, PEDro, and Embase databases were systematically searched for relevant studies. Randomized controlled trials reporting the effects of TCMBE on pain intensity, functional mobility, and QOL in individuals with neck pain were included. Screening, data extraction, and literature quality assessments were performed independently by two reviewers. RevMan5.4 software was used for data analysis. RESULTS: Six studies with 716 participants met the inclusion criteria. Compared with the control groups, TCMBE had no therapeutic advantage in improving pain intensity (visual analogue scale: mean difference (MD) = 1.8, 95% confidence interval (CI): -7.70 to 11.46, and P = 0.70); functional mobility (neck disability index: MD = 0.15, 95% CI: -6.37 to 6.66, and P = 0.96; neck pain and disability scale: MD = 1.31, 95% CI: -4.10 to 6.71, and P = 0.64); or 36-item short-form health survey (SF-36) scores for physical function (MD = 5.58, 95% CI: -8.03 to 19.18, and P = 0.42), general health (MD = 1.87, 95% CI: -4.99 to 8.72, and P = 0.59), body pain (MD = 2.26, 95% CI: -3.80 to 8.32, and P = 0.46), vitality (MD = 6.24, 95% CI: -1.49 to 13.98, and P = 0.11), social function (MD = 8.06, 95% CI: -4.85 to 20.98, and P = 0.22), role physical (MD = -1.46, 95% CI: -8.54 to 5.62, and P = 0.69), or role emotional (MD = 6.5, 95% CI: -3.45 to 16.45, and P = 0.2). However, TCMBE was less effective at improving mental health results based on the SF-36 survey (MD = 3.37, 95% CI: 0.5 to 6.24, and P = 0.02). CONCLUSIONS: Based on the meta-analysis, there is insufficient evidence to support the clinical use of TCMBE in improving pain intensity and enhancing functional mobility and QOL in individuals with neck pain.

Preparation of ribosomal protein S14 polyclonal antibody in broiler pulmonary artery: Its application in broiler ascites syndrome.

RPS14 (ribosomal protein S14) gene maintains the normal physiological activities of the body by regulating the biosynthesis of ribosomes and the translation of important proteins. This study aims to explore the potential role of RPS14 in broiler ascites syndrome (BAS). We successfully prepared polyclonal antibody against RPS14 and studied the localization and expression of RPS14 protein in a variety of animal key tissues. In this experiment, the recombinant expression plasmid PET28a-RPS14 was constructed using the prokaryotic expression technology of foreign genes. Under the conditions of IPTG induction, a His-RPS14 protein with a molecular weight of about 22 kDa was expressed, and the purified recombinant protein was used as an antigen to prepare rabbit anti-chicken serum. Western blot results showed that the serum could specifically identify RPS14 protein in important tissues of broilers. Immunofluorescence combined with homology analysis showed that the antiserum had significant species specificity. Compared with other species, the expression of this protein in key tissues of broilers and ducks was more significant. More importantly, western blotting and immunofluorescence showed that BAS significantly reduced the expression level of RPS14. This further indicated that RPS14 protein can be used as one of the important entry points for BAS research.

The effectiveness of eye tracking in the diagnosis of cognitive disorders: A systematic review and meta-analysis.

BACKGROUND: Eye tracking (ET) is a viable marker for the recognition of cognitive disorders. We assessed the accuracy and clinical value of ET for the diagnosis of cognitive disorders in patients. METHODS: We searched the Medline, Embase, Web of Science, Cochrane Library, and Pubmed databases from inception to March 2, 2021, as well as the reference lists of identified primary studies. We included articles written in English that investigated ET for cognitive disorder patients-Mild cognitive impairment (MCI), Alzheimer's disease (AD), Amyotrophic lateral sclerosis (ALS), and dementia. Two independent researchers extracted the data and the characteristics of each study; We calculated pooled sensitivities and specificities. A hierarchical summary of receiver performance characteristics (HSROC) model was used to test the diagnostic accuracy of ET for cognitive impairment (CI). FINDINGS: 11 studies met the inclusion criteria and were included in qualitative comprehensive analysis. Meta-analysis was performed on 9 trials using Neuropsychological Cognitive Testing (NCT) as the reference standard. The comprehensive sensitivity and specificity of ET for detecting cognitive disorders were 0.75 (95% CI 0.72-0.79) and 0.73 (95% CI 0.70 to 0.76), respectively. The combined positive likelihood ratio (LR+) was 2.74 (95%CI 2.32-3.24) and the negative likelihood ratio (LR-) was 0.27 (95%CI 0.18-0.42). CONCLUSIONS: This review showed that ET technology could be used to detect the decline in CI, clinical use of ET techniques in combination with other tools to assess CI can be encouraged.

Dichlorvos poisoning caused chicken cerebrum tissue damage and related apoptosis-related gene changes.

Dichlorvos (DDVP) is an organophosphorus compound with insecticidal effects. Organophosphorus pesticides can easily enter humans or animals through various channels, causing cerebrum nerve cell damage. The purpose of this research was to investigate whether acute dichlorvos poisoning can cause cerebrum neurotoxic injury and change the expression of apoptosis-related genes in broilers, further clarify the neurotoxic mechanism after acute dichlorvos exposure, and provide a research basis for prevention, treatment and gene drug screening in the later stage. In this experiment, healthy yellow-feathered broilers were randomly assigned to the control group, the low-dose group (1.13 mg/kg) and the high-dose group (10.2 mg/kg) for modelling observation, and detection was conducted based on H&E (haematoxylin and eosin) staining, transmission electron microscopy analysis of tissue sections, immunofluorescence techniques and real-time quantitative polymerase chain reaction (qRT-PCR). The results showed that organophosphorus poisoning was accompanied by obvious neurological symptoms such as limb twitching and massive salivation. In addition, we observed that compared with the control group, the number of lysed nuclear neurons, deformed vascular sheaths, and glial cells and the expression of glial fibrillary acidic protein (GFAP) in the poisoned group of broilers increased significantly, and the increase was more obvious in the low-dose group. However, cell apoptosis and mitochondrial structure dissolution were most pronounced in the high-dose group. Moreover, the qRT-PCR results also revealed significant changes in the expression of apoptosis-related genes. The expression levels of ACC, LKB1 and GPAT increased significantly, while the expression of HMGR, PPARα, CPT1 and AMPKα1 decreased significantly. In summary, these results indicated that dichlorvos may cause the lysis of cerebrum nerve cell nuclei, completely destroy the structure of mitochondria, change the expression of related apoptotic genes, enhance cell apoptosis, and cause neurogenic damage to the cerebrum. These research results offer a theoretical foundation for the prevention and treatment of acute organophosphate toxicosis.

Differentially expressed genes accompanying neurobehavioral deficits in a modified rat model of vascular dementia.

Vascular dementia refers to the progressive loss of memory and other cognitive functions. The heterogeneity of cerebrovascular disease renders it challenging to elucidate the neuropathological substrates and mechanisms underlying vascular dementia. In this study, we performed neurobehavioral tests, RNA sequencing (RNA-seq), and quantitative real-time polymerase chain reaction (qRT-PCR) tests to evaluate a rat model of modified two-vessel occlusion (2-VO) and identify the differentially expressed genes in the hippocampus of 2-VO versus sham rats by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) annotations. Compared with the sham group, the 2-VO group revealed significantly reduced spontaneous motor behaviors, a lack of exploration for new objects, and varying degrees of spatial memory impairment. Although the genetic background of vascular dementia is well established for monogenic disorders, the relationship between key regulatory genes and signaling pathways remains obscure. Using RNA-seq and bioinformatic analyses, we identified 58 upregulated genes and 137 downregulated genes in the hippocampus of 2-VO rats compared to sham rats. Results were confirmed by qRT-PCR. ErbB3, a gene mainly involved in cranial nervous system development, negative regulation of neuronal apoptosis, and signal transduction, was downregulated in the hippocampus of 2-VO rats compared to sham rats. Moreover, ERBB3 plays an important role in neuron-protecting ERBB and PI3K-AKT signaling pathways, both of which were found to be enriched by GO and KEGG functional pathway analyses. Understanding the molecular mechanisms of vascular dementia may help establish potential treatment targets for cognitive deficits.

PINK1 overexpression protects against cerebral ischemia through Parkin regulation.

Mitochondrial dynamics and function are important for cell survival regulation under stress. In this study, we report that cerebral ischemia/reperfusion (I/R) injury significantly reduced mitochondrial function through reduced PTEN-induced kinase 1 (PINK1) expression, ATP (Adenosine triphosphate) levels, and increased oxidative stress compared to sham rats. PINK1 overexpression mice significantly improved mitochondrial function by increased mitochondrial complex I, II, and III activities and ATP levels with concomitant decline in reactive oxygen species levels. PINK1 overexpression mice after I/R injury significantly reduced apoptosis through downregulation of cytochrome c, p53 expressions compared to cerebral I/R injury rats. Furthermore, we showed from parkin siRNA studies that PINK1 regulated phosphorylation parkin is critical to the protection against cerebral I/R injury. Altogether, we show that PINK1 mediated parkin regulation is key to the protection against cerebral I/R injury through regulation of mitochondrial function and apoptosis.

Indoor air quality in classrooms of primary and secondary schools during autumn and winter in Hangzhou / 中国学校卫生

Objective@#To understand indoor air quality in middle and primary schools of Hangzhou in autumn and winter seasons, and to provide references of promoting indoor air quality of schools.@*Methods@#Totally 33 classrooms of 11 schools in urban area were selected into study during Sept.2018 to Jan.2019. Daily measurements of PM2.5 and CO2 were performed in selected classes during school working time by air quality monitors. Totally, monitoring data of 35 964 hours were analyzed using univariate and multiplicity analysis for PM2.5 and CO2 level, variability and possible influence factors.@*Results@#In autumn and winter, hourly average values of classroom PM2.5 and CO2 concentration level in Hangzhou were between 35.30 to 74.65 μg/m3 and between 949.17 to 2 029.98 mg/m3, respectively. The concentration levels of PM2.5 and CO2 were higher with the temperature(F=1 412.84, 775.66, P<0.01). No statistical significance was be found for the difference of PM2.5 concentration among monitoring times. Wave changes in CO2 were observed with time variation PM2.5 and CO2 concentration level of 68.42% monitoring times was complied with standards. School type and temperature correlated with PM2.5 concentration level. The PM2.5 concentration level in senior high school was higher than that in junior high school, while the value in primary school was the minimum(β=0.44, P<0.01). And the PM2.5 concentration increased with the temperature decreased(β=8.31, P<0.01). School type, temperature and monitoring time correlated with CO2 concentration level. CO2 concentration increased with the increase of grade, decrease in temperature and later time during the day(β=213.64, 162.38, P<0.01). The CO2 concentration level in later monitoring time was lower than that in earlier monitoring time(β=-16.28, P<0.01).@*Conclusion@#Classroom CO2 concentration level in Hangzhou was closed to that in European schools, while PM2.5 concentration level was much higher. Comparing with other cities in China, classroom PM2.5 and CO2 concentration level in Hangzhou is better. The results highlighted that school location, design and routine management should be advanced consideration for good air quality in classroom.