Objective To explore the differences of intestinal flora, metabolic pathways, and functional genes among people at ten-year risk of atherosclerotic cardiovascular disease (ASCVD) in Tibetan population. Methods Based on the follow-up survey data of the natural population cohort in Lhasa in southwest China, a total of 94 people were included in the “China Blood Lipid Management Guide 2023” for follow-up analysis. DNA was extracted from stool samples and analyzed by macro genomic sequencing. The composition of intestinal flora of people at different 10-year risks of ASCVD was compared by bioinformatics method. The metabolic pathway and functional genes were predicted by Kyoto Encyclopedia of Gene and Genome (KEGG) and MetaCye database. Linear discriminant analysis and generalized linear regression were used to screen differential bacteria and explore their relationship with related phenotypes. Results The α diversity of people at risk of ASCVD in the middle and high 10-year risk was significantly decreased (t=-8.213, P=0.032). Strains closely related to butyrate production such as Bacteroides uniforms, (LDA=4.035, P=0.001), Faecalibacterium prausnitzii (LDA=3.876, P=0.003), Bacteroides ovatus (LDA=3.648, P=0.006), Bacteroides fragilis (LDA=3.604, P=0.003), Ruminococcus bicirculans (LDA=3.188, P=0.009), and Roseburia hominis(LDA= 3.169, P=0.004) were enriched in the population with low 10-year risk of ASCVD. The pathways and functional genes related to lipopolysaccharide synthesis (LDA=2.619, P=0.004) and lipid metabolism (LDA=2.694, P=0.001) were significantly up-regulated in the middle and high 10-year ASCVD risk population. Conclusion The intestinal microflora and metabolic function of the people at 10-year risk of ASCVD are significantly changed, and the imbalance of intestinal flora may also be one of the important reasons for changing the 10-year risk of ASCVD.

Objective To explore the clustering of lifestyle among middle school students in Zhengzhou and its correlation with high blood pressure, in order to provide a scientific basis for the development of effective strategies for preventing and controlling high blood pressure in adolescents. Methods A multi-stage cluster random sampling method was used to select 8 middle schools in Zhengzhou in 2021, with a total of 2 791 students included. A self-made questionnaire was used to investigate their general information and dietary and exercise behaviors, as well as measuring their height, weight, and blood pressure. A latent class clustering analysis was conducted, as well as a binary logistic regression analysis for correlation. Results In total 23.5% of the middle school students were reported to have high blood pressure, with a higher prevalence among junior high school students (26.0%) than high school students (20.2%) (χ²=12.760, P<0.001). A latent class clustering analysis of dietary and exercise behaviors identified two categories: sub-healthy and healthy lifestyles. Logistic regression analysis found that after adjusting for gender, ethnicity, age, grade, and BMI, the risk of high blood pressure in sub-healthy students was 1.357 times that of healthy students (OR=1.357, 95%CI: 1.083-1.701). Conclusion Sub-healthy lifestyles increase the risk of high blood pressure in adolescents, providing new information for exploring the risk factors of cardiovascular and metabolic abnormalities in adolescents as well as the prevention and control of high blood pressure in adolescents.

Objective To analyze the epidemiological characteristics and treatment-related deaths within 12 months of HIV/AIDS patients aged 50 and above reported in a province, providing a basis for targeted prevention and control measures. Methods Data on HIV/AIDS cases aged 50 and above reported in a province from 2010 to 2019 were collected from the China CDC Information System for Comprehensive Prevention and Control of AIDS, and the epidemiological characteristics and treatment-related deaths within 12 months were analyzed. The comparison of rates was performed using the χ² test, trend changes were analyzed using the trend χ² test, and the comparison of CD4⁺ T lymphocyte detection results between groups was performed using non-parametric tests. Results From 2010 to 2019, a total of 2 875 cases of HIV/AIDS aged 50 and above were reported in the province, accounting for 19.4% of the total cases (14 819 cases). The proportion of new cases increased from 10.3% in 2010 to 24.6% in 2019, with a statistically significant difference (χ²_trend =126.741, P < 0.001), and the annual reported incidence showed an increasing trend (χ²_trend=936.208, P < 0.001). The male-to-female ratio was 5.3:1, with an average age of (58.40±7.50) years. The majority were farmers, accounting for 49.0% (1 408/2 875). The primary education level accounted for 42.0%(1 208/2 875). The majority were identified by medical institutions, accounting for 64.5% (1 854/2 875); sexual transmission was the primary route, accounting for 96.8% (2 784/2 875). Among male cases, same-sex transmission accounted for 49.5% (1 423/2 416). Among female cases, non-marital heterosexual transmission and spousal transmission accounted for 49.0% (212/433) and 51.0% (221/433), respectively. The median CD4⁺ T lymphocyte count at the initial test was 266 cells/mm³. There was a statistically significant difference in CD4⁺ T lymphocyte counts between males and females (Z=-5.395, P < 0.001). The treatment rate within 12 months of diagnosis was 56.7% (1 632/2 875), showing an increasing trend each year (χ²_trend=115.054, P < 0.001). The mortality rate within 12 months of diagnosis was 15.2% (433/2,875), showing a decreasing trend each year (χ²_trend=61.654, P < 0.001). Conclusion The number and proportion of HIV/AIDS cases aged 50 and above in the province have been increasing annually. It is necessary to strengthen targeted health education and interventions for this population as well as expand testing to achieve early detection and treatment.

Objective To investigate the high-risk factors for preeclampsia in Urumqi, establish a risk prediction model, and validate its effectiveness. Methods A total of 6 138 pregnant women undergoing antenatal examination from February 2021 to February 2023 were collected through the integrated platform of clinical research in Urumqi Maternal and Child Health Hospital. General data, pregnancy history, and pregnancy complications were recorded. The patients were randomly divided into a modeling group (n=4 308) and a validation group (n=1 830) in a 7:3 ratio. The logistic regression model analysis method was used to construct a Nomogram prediction model. The receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were employed to assess the discrimination, calibration, and clinical applicability of the prediction model. Results The advanced age (OR=1.887, 95%CI: 1.535-2.319), overweight (OR=3.221, 95%CI: 2.699-3.844), family history (OR=1.575, 95%CI: 1.254-1.979), hypertension history (OR=17.552, 95%CI: 7.021-43.882), hypertension complicating pregnancy (OR=1.827, 95%CI: 1.388-2.405), preeclampsia history (OR=6.216, 95%CI: 3.578-10.770), and primiparity (OR=2.384, 95%CI:1.777-3.200) were identified as independent risk factors of preeclampsia in Urumqi. The results of ROC curve test showed that the area under the curve and 95%CI of the model group were 0.762 (0.742-0.782), and for the validation group were 0.765 (0.734-0.796). The calibration curve and DCA curve demonstrated that the Nomogram had good accuracy and clinical applicability. Conclusion The established nomogram prediction model exhibited good predictive ability and provides an important reference for clinical practitioners to identify high-risk patients. Early intervention measures should be implemented to prevent further progression and improve maternal and infant outcomes.

Objective To analyze the epidemiological characteristics, changing trends, and spatial-temporal aggregation of hand-foot-mouth disease (HFMD) in Wenzhou from 2013 to 2022, so as to scientifically guide the decision-making of prevention and control. Methods The infectious disease report data for HFMD in Wenzhou city were collected from the China Disease Prevention and Control Information System for the period 2013—2022. Spatial-temporal scanning analysis was conducted using StatsCan software, and spatial autocorrelation analysis was performed using ArcMap 10.2 software to identify spatial-temporal aggregation patterns. Results A total of 260 401 cases of HFMD were reported in Wenzhou from 2013 to 2022, with an average annual incidence of 276.93 per 100 000 and a severe disease rate of 13.82 per 100 000. The incidence exhibited a decreasing trend (χ²_trend=26 402.606, P < 0.05). The incidence rate among individuals over 6 years old increased (χ²_trend=1 814.455, P < 0.05), as did the rates among nursery children, students, and teachers (χ²_trend=5 493.085, P < 0.05; χ²_trend=1 752.584, P < 0.05; χ²_trend=9.424, P < 0.05). Spatial analysis revealed aggregation of HFMD cases in 2017, with a Moran I value of 0.433 514 (Z=2.42 775 and P=0.015 193), indicating positive spatial correlation and hot spots concentrated in Wencheng county and Pingyang county. Spatial-temporal scanning identified a primary aggregation covering Rui’an city, Cangnan county,Pingyang county, and Wencheng county, from January 1, 2014, to December 31, 2018, with a radiation radius of 44.67km (LLR=12 534.45, RR=1.98, P < 0.01). The proportion of enterovirus type 71 (EV-A71) in group A showed a downward trend (χ²_trend=171.245, P < 0.05), while the proportion of other enteroviruses, including coxsackievirus group A 16 (CV-A16), increased(χ²_trend=93.481, P < 0.05). Conclusion The incidence of HFMD in Wenzhou remains high, although both the incidence and severity rates have decreased. Other enteroviruses, including coxsackievirus group A 6 (CV-A6), have become the dominant pathogens, and there has been an increase in incidence among teachers and individuals over 6 years old. The main aggregation areas were identified as Rui’an city, Cangnan county, Pingyang county, and Wencheng county.

Objective To understand the epidemic characteristics of diabetic nephropathy in China and to provide scientific basis for the prevention and treatment of diabetic nephropathy. Methods Data from the Global Burden of Disease (GBD) database in 2019 was selected to collect data on the incidence of diabetic nephropathy in China from 1990 to 2019. The characteristics and trends of standardized incidence rates and age-specific incidence rates in each year were described, and the Joinpoint regression model was used to analyze the temporal trend of the incidence rate of diabetic nephropathy in China. Results There was no turning point in the trend of age-standardized prevalence of type 1 diabetic nephropathy in the whole population and women in China, and the annual percent change (APC) equaled the average annual percent change (AAPC), showing an upward trend. The average annual growth rate of the whole population was 1.02% (95%CI: 0.87%-1.17%), and that of women as a whole was 1.21% (95%CI: 1.08%-1.35%). The turning point of male trend was in 1994, 2011, and 2017, with an overall average annual growth of 0.56% (95%CI: 0.20%-0.92%). The incidence rates for age groups under 20 years old showed a decreasing trend (AAPC=-0.71% to -0.12%), while those aged 20 and above showed an increasing trend (AAPC=1.06% to 3.99%), all with statistical significance (P<0.05). The standardized incidence rates of type 2 diabetic nephropathy for the whole population, males, and females in China had turning points in 1995, 2000, 2005, 2010, and 2015, with an overall annual decrease of 0.15%(95%CI: -0.17% to -0.12%) for the whole population, 0.12% for males (95%CI: -0.16% to -0.09%), and 0.18% for females(95%CI: -0.22% to -0.15%). Conclusion The epidemic trend of diabetic nephropathy in China from 1990 to 2019 is still grim, and more attention should be paid to diabetes and its complications. In particular, the prevalence rate of women has been higher than that of men, and the prevalence rate of type 2 diabetic nephropathy in the age group of 15-39 years old, 55-59 years old, and ≥ 75 years old, as well as the age group of ≥ 20 years old with the increasing prevalence of type 1 diabetic nephropathy.Strategies and measures should be promptly implemented to address these issues.

Objective To explore the pollution level and spatiotemporal characteristics of indoor dust di (2-ethylhexyl) phthalate(DEHP) in daily life and the influencing factors of potential family environment and personal living habits, providing scientific basis for the prevention and control of DEHP pollution in indoor dust. Methods Considering the factors of climate, economy and pollution level, household dust samples were collected and investigated in 9 typical cities of Lanzhou, Luoyang, Panjin,Mianyang, Qingdao, Shenzhen, Shijiazhuang, Wuxi, and Xi’an. DEHP content in the treated dust samples was measured using gas chromatography-mass spectrometry (GC-MS). The Wilcoxon rank sum test was employed to examine differences in DEHP levels across various seasons, dominant wind directions, types of home decoration, and living habits. Multiple linear regression was used to identify factors influencing DEHP content in indoor dust. Results DEHP levels in indoor dust varied significantly with season and dominant wind direction in some cities (P<0.05). Specifically, Luoyang and Mianyang exhibited higher DEHP levels during the heating season compared to other periods, while Shenzhen and Shijiazhuang showed lower levels during the heating season (P<0.05). In Mianyang, the upwind areas had significantly higher DEHP levels than the downwind areas (P<0.05). Factors influencing household dust DEHP levels included PM_2.5 (β=0.003, 95%CI: 0.001-0.005), PM₁₀ (β=-0.003,95%CI: -0.005 to -0. 001), formaldehyde (β=3.626, 95%CI: 0.195-7.057), and per capita GDP (β=-0.072, 95%CI: 0.050-0.095). Conclusion DEHP is commonly found in indoor dust in daily life. Seasonal variations and wind direction affect its levels in different cities, though no consistent pattern of pollution characteristics is observed across the cities. Additionally,DEHP content in indoor dust may be influenced by temperature, PM₁₀, xylene, computer use, carpet use, and indoor plant cultivation..

Objective To evaluate the health risk of heavy metal concentration, source analysis and inhalation pathway of PM_2.5 in ambient air of Huai’an city. Methods The ambient air PM_2.5 samples were collected regularly at a monitoring site in Huai’an city from 2020 to 2022. The contents of 10 heavy metals in PM_2.5 were determined by ICP-MS, and the traceability analysis of heavy metals was carried out by enrichment factor method and principal component analysis. According to the national“Technical Standard for Assessing Population Health Risk”, the health risk of heavy metals to the population was evaluated. Results The annual average values of Al, Mn, Pb, Cr, Ni, As, Se, Sb, Cd and Tl in PM_2.5 of Huai’an city from 2020 to 2022 were 131.11, 28.52, 20.61, 8.09, 5.95, 4.11, 2.62, 1.84, 0.76, and 0.18 ng/m³, respectively. The concentration levels of these metals in winter and spring were higher than those in summer and spring (Z=2.390-7.182, P < 0.05). The results of enrichment factor analysis showed that the elements EF of Se, Cd, Sb, As, Pb, and Tl 6 were more than 100. The principal component analysis showed that the heavy metals in PM_2.5 in Huai’an city mainly came from mixed pollution of traffic, industrial production, coal combustion, and natural emission. For non-carcinogenic effects, Sb, Al, As, Cd, Cr, Mn, Ni, and Se 8 were lower than the screening concentration, and the risk of non-carcinogenic effects (HQ) was less than 1. For carcinogenic effects, the excess carcinogenic risks of As, Cd, and Cr were 1.77 × 10^-5,1.37 × 10^-6, and 9.70 × 10^-5, respectively. Conclusion The sources of heavy metals in PM_2.5 in Huai’an city are multiple compound pollution. The non-carcinogenic effects of Sb, Al, As, Cd, Cr, Mn,Ni, and Se 8 are acceptable, but As, Cd and Cr have potential carcinogenic risk.

Objective To analyze the effects of air pollutants on male semen quality and different stages of sperm development in Taiyuan. Methods Totally 7 614 men who were admitted to the Reproductive Department of the First Hospital of Shanxi Medical University from January 1 to December 31, 2019 were enrolled. Their age, semen collection season, and semen parameters were recorded. At the same time, the monitoring data of six air pollutants (SO₂, NO₂, CO, O₃, PM_2.5, and PM₁₀) were collected, and the exposure of air pollutants in the whole developmental period (0 to 90 days before semen collection) and three critical developmental periods (0-9 days, 10-14 days, and 70-90 days) were calculated. Nonparametric Mann-Whitney U test was used to compare the data difference between qualified and unqualified semen parameters. The generalized estimation equation was used to explore the effects of six kinds of air pollutants on the quality parameters of each sperm at different stages of sperm development. Results During the whole period of sperm development, the exposure concentrations of SO₂, NO₂, O₃, and PM_2.5 were different between the qualified and unqualified groups of normal sperm morphology. The exposure to PM₁₀ at 10 and 14 days before semen collection was positively correlated with semen volume (OR=1.245, 95%CI: 1.057-1.467), sperm concentration (OR=1.247, 95%CI: 1.027-1.514), total sperm count (OR=1.385, 95%CI: 1.167-1.643), total motility (OR=1.236,95%CI: 1.085-1.409), and forward movement (OR=1.207, 95%CI: 1.059-1.376). The O₃ exposure was positively correlated with sperm concentration (OR=1.250, 95%CI: 1.002-1.558; OR=1.173, 95%CI: 1.025-1.343), total sperm count (OR=1.255,95%CI: 1.026-1.537; OR=1.218, 95%CI: 1.074-1.380), and normal sperm morphology (OR=1.295, 95%CI: 1.047-1.602; OR=1.229, 95%CI: 1.076-1.404). Conclusion Exposure to air pollutants increases the risk of unqualified semen parameters at all stages of sperm development, and the critical window period focuses on 10-14 days before semen collection, which is the developmental stage of sperm motility. PM₁₀ and O₃ are the main reproductive toxins affecting the decline of male sperm quality in Taiyuan, which need to be paid attention to.

Objective To understand the correlation between food cooking methods, dietary preferences of residents in southwest China, and their body mass index (BMI), providing references for local residents’ nutritional health education and scientific dietary choices. Methods A convenient sampling method was used to survey 7 948 residents in Southwest China, and an unordered multinomial logistic regression model was employed to analyze the influencing factors of BMI. Results The majority of residents in Southwest China preferred slightly spicy and light flavors, each accounting for 41.1%. The fried, sautéed, and stir-fried foods (59.2%) and steamed, boiled, blanched, stewed foods (51.8%) were most frequently consumed by residents. In Southwest China, lower frequency of consuming fried, sautéed, and stir-fried foods was associated with a decreased risk of overweight and obesity (OR=0.658, 95%CI: 0.559-0.775), similar results were found in Sichuan, Chongqing, and Guizhou. In Guizhou, lower frequency of consuming steamed, boiled, blanched, stewed foods was associated with an increased risk of overweight and obesity (OR=1.411, 95%CI: 1.025-1.943). In Guizhou and Yunnan, preference for sour flavors was associated with a reduced risk of overweight and obesity (Guizhou: OR=0.512, 95%CI: 0.271-0.965; Yunnan: OR=0.475, 95%CI: 0.246-0.915). Conclusion Dietary preferences and food cooking methods vary among residents in Southwest China and are correlated with BMI. Sour flavors and high frequency of consuming steamed, boiled, blanched, stewed foods are protective factors against overweight and obesity, while frequent consumption of fried, sautéed, and stir-fried foods is a risk factor. It is recommended to strengthen nutritional education and promote residents to make informed choices in dietary preferences and cooking methods to improve public nutrition and health.

Objective To analyze the results of genetic metabolic disease screening and gene mutation characteristics in newborns in Haikou, Hainan. Methods A retrospective analysis was conducted on 185 660 newborns born at the Haikou Maternal and Child Health Hospital from March 2017 to March 2021 who underwent genetic metabolic disease screening. All newborns underwent tandem mass spectrometry screening for genetic metabolic diseases within 7 days after birth. The positivity rate of genetic metabolic disease screening in newborns was statistically analyzed, and the specific gene mutation characteristics of the metabolic diseases were investigated. Results Among 185 660 newborns in Haikou, 88 were diagnosed with genetic metabolic diseases, with a total prevalence rate of 1 in 2 110 (47.40 per 100 000). Among the 88 cases, the prevalence rates of organic acidemia, amino acid metabolism disorders, and fatty acid oxidation disorders were 1/3 640, 1/10 921, and 1/9 283, respectively, with methylmalonic acidemia, medium-chain acyl-CoA dehydrogenase deficiency, and citrin deficiency ranking the top three.Genetic testing revealed that in 42 cases of methylmalonic acidemia, MUT and MMACHC mutation genes were detected, with the c.609G>A mutation in the MMACHC gene being the most common（37.97%）. The ACADM mutation genes in 15 cases of medium-chain acyl-CoA dehydrogenase deficiency were mainly detected at c.387+1delG (25.00%), c.449_452delCTGA(16.67%), and c.1076C>T (16.67%). The SLC25A13 mutations in 8 cases of citrin deficiency were mainly detected at c.154C>T(37.50%) and c.1638_1660dup (25.00%). Other detected mutation genes in genetic metabolic diseases mostly had 2 or 1 mutation sites. During treatment and follow-up, 49 children were normal (55.68%), 36 children experienced developmental delays(40.90%), and 3 children died (3.41%). Conclusion Haikou, Hainan has a certain incidence of genetic metabolic diseases in newborns, with medium-chain acyl-CoA dehydrogenase deficiency, methylmalonic acidemia, and citrin deficiency having the highest prevalence. These diseases exhibit specific characteristics in mutation sites.

Objective To study the impact of exposure to green space during pregnancy on low birth weight (LBW) and preterm birth (PTB) in pregnant women, and to explore the susceptible window period of green space exposure, providing data support for related research fields. Methods This study recruited pregnant women and their infants in the Sichuan multi-level infant and early life (SMILE) cohort study as the research subjects, and information on sociodemographic characteristics, lifestyle habits, and birth outcomes were collected. A 250m buffer zone was delineated based on the pregnant women’s residential addresses, and the average normalized difference vegetation index (NDVI) during pregnancy was calculated. Cox proportional hazards regression models were used to analyze the impact of green space exposure during pregnancy on LBW and PTB and to identify the key window period of green space exposure affecting LBW and PTB. Results In total 6 612 pregnant women were included in this study, and the prevalence rates of LBW and PTB were 3.36% and 3.43%, respectively. It was found that the fourth quartile of NDVI was negatively correlated with LBW and PTB (LBW:HR=0.38, 95%CI: 0.24-0.59, P=0.012; PTB: Q4:HR=0.33, 95%CI: 0.21-0.51, P < 0.001). In the third trimester of pregnancy, NDVI had a protective effect on LBW (Q2: HR=0.28, 95%CI: 0.19-0.42, P=0.003; Q3: HR=0.17, 95%CI: 0.11-0.27, P<0.001; Q4: HR=0.07, 95%CI: 0.04-0.12, P<0.001)and PTB (Q2: HR=0.19, 95%CI: 0.13-0.28, P < 0.001; Q3: HR=0.10, 95%CI: 0.07-0.16, P<0.001; Q4: HR=0.03, 95%CI:0.02-0.06, P<0.001), and as the level of NDVI increased, the protective effect became stronger. Conclusion Green space during pregnancy is negatively correlated with LBW and PTB. Late pregnancy may be a key window period of exposure, and higher levels of green space are more beneficial for maternal and child health.

Objective To investigate the current status and influencing factors of the utilization of medical assistance policy resources by difficult groups with chronic diseases and economic difficulties in urban villages, analyze the existing problems, and propose corresponding strategies to promote precision management of diseases for vulnerable groups and facilitate health poverty alleviation in the new era. Methods Firstly, using a questionnaire survey, two out of four urban village streets in a certain district of Chengdu were randomly selected to investigate the existing problems in the utilization of medical assistance by difficult groups. Secondly, telephone interviews were conducted to analyze the reasons for not utilizing medical assistance even though meeting the conditions, and countermeasures were proposed. Results Difficult groups utilized the policy of subsidizing and participating in insurance the best, while the utilization of outpatient, inpatient, and supplementary medical assistance policies was the worst. The results of multivariate Logistic regression analysis showed that having more than three comorbidities (OR=0.134) was a risk factor for assistance utilization. Having disabilities (OR=2.625), higher educational level (OR=3.500), and higher average monthly medical expenses (OR=4.148) were protective factors for utilization of assistance. The follow-up results indicated that factors such as patients’ lack of policy awareness, misunderstandings about policies, not seeking treatment at designated hospitals, some Chinese medicine not being reimbursed, and complex application procedures were the main causes leading to their non-utilization of policies. Conclusion Difficult groups with diseases utilize well the government assistance policies obtained through direct help, but the utilization of policies requiring proactive application is poor. The characteristics of patients’ own diseases, inadequate explanation of policies, high reimbursement thresholds, and limited reimbursement scope are the main reasons for difficult groups not applying for medical assistance.

Objective To explore the construction of technical evaluation index system of primary children’s health management services, and to provide reference basis for improving the technical aspects of health management services for children at the grassroots level. Methods By means of literature analysis, policy induction and expert discussion, a preliminary framework and content pool for the evaluation index system of technical assessment for primary children’s health management services were established. The Delphi expert consultation method was then used to determine the content of each index. Results After two rounds of expert consultations, a two-level index system with 2 primary indicators and 5 secondary indicators, two of which had 2 tertiary indicators under each, was constructed. Specific content was assigned to this index system, and corresponding scores were allocated on a percentage basis. The positive coefficient of the experts in the two rounds of consultations were 92% and 100% respectively, and their authority coefficients were both 0.88. The coordination coefficients for the rationality assessment of the index in the two rounds of expert consultation were all between 0 and 1 (P < 0.05). Conclusion The constructed evaluation index system for technical assessment of primary children’s health management services using the improved Delphi method is reasonably effective, and this evaluation index system can provide a reference for the technical assessment of health management services for children at the grassroots level..

Objective To analyze the the current status and deficiencies of the county medical community construction policy and proposes policy recommendations to optimize the construction of the county medical community. Methods Based on the perspective of policy tools, a three-dimensional analysis framework was constructed combining policy evolution and stakeholder dimensions, and content analysis was used to quantitatively analyze the policy text in three dimensions. Results A total of 29 policy documents were included after screening. The overall utilization of policy tools showed an imbalance, with the utilization of capacity-type policy tools as high as 35.38%, but sub-tools such as financial investment (3.07%) and technical support(2.83%) were less used. Incentive-type policy tools were the least used, accounting for only 8.96%, with sub-tools such as price adjustment and promotion further education accounting for only 0.71% and 0.47%, respectively. The distribution of stakeholders was uneven, with primary medical and health institutions and county hospitals being the main targets, accounting for 27.77% and 25.52%, respectively. With the evolution of policies, the number and variety of policy tools used showed a rapid increase, but capacity-type policy tools still dominated, and there was an imbalance in the internal structure of policy tools. Additionally, the involvement of two key stakeholders including medical personnel and the public, was relatively low. Conclusion There is significant differentiation in the utilization of policy tools, with insufficient use of symbolic, incentive-type policy tools.It is suggested to improve the internal structure of policy elements, enhance the balance of policy tool utilization, continuously optimize policy tools, increase the use of incentive-type and symbolic policy tools, and strengthen the participation of two key stakeholders: medical personnel and the public.

Objective To investigate the prevalence and influencing factors of mild cognitive impairment (MCI) in the elderly in China, so as to provide scientific basis for slowing down the decline of cognitive function and improving their quality of life. Methods Based on the theory of health ecology, people aged 65 and above were selected from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). The research subjects with dementia and missing key variables were excluded, and finally 11 157 elderly people were included. Multivariate unconditional Logistic regression was used to analyze the influencing factors of MCI in Chinese elderly. Results In this study, 1 526 people ≥ 65 years old had MCI, and the prevalence rate of MCI was 13.7%. The results of multivariate unconditional Logistic regression showed that female (OR=1.242, 95%CI: 1.061-1.455) and advanced age (80 to 94 years old: OR=1.744, 95%CI: 1.359-2.239; ≥ 95 years old: OR=3.014, 95%CI: 2.272-3.998), self-rated worse health status (OR=2.308, 95%CI: 1.202-4.433), hearing impairment (OR=4.760, 95%CI: 4.129-5.487), no exercise(OR=1.204, 95%CI: 1.006-1.441), low score of healthy diet (1-2) (OR=1.562, 95%CI: 1.288-1.894), no social participation activities (housework, social activities, recreational activities, social activities), long sleep time (> 8 hours) (OR=1.347, 95%CI:1.156-1.569), disability (OR=2.987, 95%CI: 2.246-3.974), instrumental activity of daily living (IADL) impairment (OR=3.347,95%CI: 2.510-4.462), living in elderly care institutions (OR=1.569, 95%CI: 1.136-2.166), and poor economic accessibility of medical services (OR=1.155, 95%CI: 1.005-1.328) were risk factors for MCI among the elderly in China. Conclusion The prevalence of MCI in the elderly in China is grim. Gender, age, self-rated health status, hearing function, exercise, healthy diet score, social participation, sleep duration, ADL, IADL, living style, and accessibility of medical services are the main influencing factors of the disease in Chinese elderly. Multi-dimensional and systematic intervention measures are needed to slow down the cognitive decline of the elderly in China.

Objective To analyze the direct disease economic burden of inpatients with endocrine diseases during pregnancy, to provide a strong basis for optimizing the allocation of health resources and disease cost control in public hospitals, and to strengthen the theory of prevention and treatment of endocrine-related diseases during pregnancy. Methods CRITIC-VIKOR model was used to evaluate the direct disease economic burden of inpatients with endocrine diseases during pregnancy. Results The four endocrine diseases during pregnancy were toxic diffuse goiter, polycystic ovary syndrome, postpartum hypopituitarism, and gestational diabetes. Among them, the economic burden of toxic diffuse goiter was heavy, wih the benefit ratio of 0, and the disease burden of polycystic ovary syndrome was relatively light, with the benefit ratio of 1. The benefit ratios of the remaining two diseases were 0.761 and 0.756, respectively. Conclusion CRITIC-VIKOR model can be used to evaluate the direct economic burden of inpatients with endocrine diseases during pregnancy. We should strengthen the hierarchical management and classification of endocrine diseases during pregnancy, improve early screening and intervention, and further optimize the cost structure of endocrine diseases during pregnancy to reduce economic burden.

Objective To systematically understand the cognitive status of immunization professionals in Jinan on the relevant vaccination guidance in the “National Immunization Program Vaccine Child Immunization Program and Instructions (2021 Edition)”, in order to provide more targeted technical guidance and better improve the immunization program and guidance principles for children. Methods In September 2022, a questionnaire survey was conducted on 15 immunization technical backbones in the district and county CDCs of Jinan, as well as 423 vaccination units (including maternity vaccination rooms)engaged in pre-check and vaccination. The survey data was descriptively analyzed, and χ² tests and multivariate logistic regression analysis were conducted using Excel 2010 and SPSS 18.0 software. The awareness rate of the corresponding knowledge of the survey subjects was calculated based on the accuracy of the answers given by the 15 CDC personnel to the overall knowledge of the immunization program, the knowledge of immunization of children with special health conditions, and the knowledge of simultaneous vaccination. Results The awareness rates of the survey subjects for the overall knowledge of the immunization program, the knowledge of immunization of children with special health conditions, and the knowledge of simultaneous vaccination were 29.91%, 23.29%, and 48.63%, respectively. The results of the multiple-factor logistic regression analysis showed that educational level (OR=1.88, 95%CI: 1.13-3.12), years of preventive vaccination work (OR=1.49, 95%CI:1.01-2.22), and professional qualification category (OR=0.25, 95%CI: 0.068-0.88) were influencing factors of the awareness rate of the immunization program for the survey subjects. Educational level (OR=3.01, 95%CI: 1.63-5.57) and profession (OR=0.24, 95%CI: 0.075-0.78) were influencing factors of the awareness rate of immunization for children with special health conditions. Only gender (OR=0.37, 95%CI: 0.16-0.86) was an influencing factor of the awareness rate of simultaneous vaccination for the survey subjects. Conclusion The cognitive level of immunization clinic staff in Jinan regarding the immunization program, including the vaccination of children with special health conditions and simultaneous vaccination, still needs to be further improved. It is recommended to reasonably increase professional technical training focused on relevant knowledge of immunization. It is also recommended to further improve and refine the guidelines or instructive documents related to the immunization of children with special health conditions and simultaneous vaccination.

Objective To evaluate the pilot hospitals of modern hospital management system in Sichuan Province, so as to provide reference for strengthening the construction of modern hospital management system. Methods The index weight, comprehensive evaluation, ranking and grading of the pilot hospitals were carried out by criteria importance through inter-criteria correlation (CRITIC), technique for order preference by similarity to ideal solution (TOPSIS), and rank-sum ratio (RSR). Results The range of RSR (Ci) of pilot hospitals in 2021 was 0.409 to 0.611, and 3, 14, 14, and 2 hospitals were graded as good, relatively good, average, and poor. The grading results were statistically significant, and the proportion of medical service income was the main influencing factor of the evaluation results. Conclusion The pilot project of modern hospital management system in Sichuan Province has achieved initial results, and the level of rational drug use in each pilot hospital has been improved, but there is still a gap in operation quality and safety, medical service price adjustment, and outpatient service management.

Objective To explore the research hotspots and development trends of health management (physical examination)centers, providing reference and ideas for further research in health management (physical examination) centers in China. Methods A total of 7 516 articles published by health management (physical examination) centers and included in the China National Knowledge Infrastructure (CNKI) and PubMed databases were analyzed using CiteSpace software to analyze and visualize the knowledge map of keywords and publishing institutions. Results Since 1995, the number of research articles from health management (physical examination) centers had been increasing, with the highest numbers of published Chinese and English articles in the journals “Chinese Journal of Health Management” (164 articles) and “Medicine” (112 articles), respectively. The most frequen keywords in Chinese and English articles were influencing factors (242 times) and risk factors (113 times), and the research hotspots of health management (physical examination) centers also focused on cardiovascular metabolic diseases and common malignant tumors. “Elderly people,” “health management,” and “intestinal flora” were emerging persistent keywords until 2023. The density of the network map of collaboration among Chinese research institutions was relatively low, with few connections between institutions. Conclusion The number of research articles from health management (physical examination) centers in China has been increasing year by year, and research on health management, intestinal flora, and related topics is at the forefront of research in health management (physical examination) centers, with elderly people as the main research subjects.These studies will provide epidemiological theory and practical experience for the prevention and control of chronic diseases, but further multi-center and interdisciplinary cooperation and comprehensive implementation of medical service charges for health management are needed to promote the long-term development of health management.

Objective To investigate the impact of social and family elderly care on the social participation (labor participation, social recreational activities) of the elderly. Methods A multi-stage stratified random sampling method was employed to conduct a questionnaire survey on the elderly in five urban districts of Xuzhou city. Totally 1 000 elderly individuals aged 60 and above were selected as the study subjects. Descriptive analysis and χ² test were performed using Stata 18.0. A binary logistic regression model was utilized to explore the influence of social and family elderly care on the social participation of the elderly. A significance level of α=0.05 was set for the tests. Results Among the 1 000 elderly individuals, 217 were engaged in labor, and 623 participated in recreational activities, with participation rates of 21.7% and 62.3%, respectively, indicating relatively low participation rates. A higher level of elderly care was associated with a lower probability of labor participation among the elderly. Elderly individuals with higher economic support from their children had a higher probability of labor participation. Moreover, compared to elderly individuals without material support from their children, those receiving such support had a higher probability of participating in recreational activities. Conclusion Family and social elderly care are important influencing factors for the social participation of the elderly. It is essential to further improve the elderly care system, enhance the level of social participation among the elderly, to achieve the goal of active aging.

Objective To explore the influencing factors of falls in the elderly and to provide evidence for the prevention of falls. Methods The study was based on a large sample of 179 141 individuals in Shanghai, with a final inclusion of 40 244 participants. Firstly, independent variables including basic demographics, living environment, health status, and lifestyle habits were selected, with falls as the dependent variable, and univariate and multivariate logistic regression analyses were conducted. Secondly, negative emotions were considered as independent variables, and multivariate logistic regression analysis was performed. Results The fall incidence rate in the elderly within 90 days was 19.55%. Living alone (fall within 30 days: OR=1.161, 95%CI:1.051-1.282; fall between 31-90 days: OR=1.173, 95%CI: 1.070-1.287), unclean living environment (OR=1.775, 95%CI:1.331-2.367; OR=1.117, 95%CI: 1.037-1.203), having ≥3 chronic diseases (OR=2.024, 95%CI: 1.763-2.322; OR=2.089,95%CI: 1.835-2.379), using urine or stool pads (OR=1.581, 95%CI: 1.351-1.850; OR=1.445, 95%CI: 1.239-1.685), and low frequency of outdoor activities (occasional outdoor activitie: OR=1.458, 95%CI: 1.171-1.816; OR=1.359, 95%CI: 1.114-1.658;rarely going out: OR=2.084, 95%CI: 1.673-2.596; OR=2.053, 95%CI: 1.682-2.506) were identified as risk factors for falls within 30 days and 31 to 90 days. Advanced age (70-79 years: OR=1.179, 95%CI: 1.063-1.308; 80 years and above: OR=1.159, 95%CI: 1.040-1.292), abnormal vision (OR=1.235, 95%CI: 1.079-1.414), and needing assistance with household chores (partially completed by others: OR=1.572, 95%CI: 1.139-2.169; fully completed by others: OR=1.649, 95%CI: 1.269-2.143)were risk factors for falls within 30 days. There was no collinearity between the independent variables. Compared with those who did not feel negative emotions, the elderly who frequently felt fatigued had a lower risk of falling (fall within 30 days: OR=0.886, 95%CI: 0.811-0.968; fall between 31-90 days: OR=0.900, 95%CI: 0.828-0.977), while the elderly who frequently felt angry had a higher risk of falling (fall within 30 days: OR=1.491, 95%CI: 1.248-1.782; fall between 31-90 days: OR=1.270,95%CI: 1.067-1.513). Conclusion Elderly individuals living with others, maintaining a clean and tidy indoor environment, having a flat and clutter-free floor, and maintaining a good emotional state have a reduced risk of falling. For elderly individuals with relatively good activities of daily living (ADL) and cognitive function, it is advisable to encourage appropriate outdoor activities and engage in moderate-intensity and frequency physical activities to prevent falls.

Objective To investigate whether there is a mediating effect of cognitive function between social participation and frailty. Methods Using the China Health and Retirement Longitudinal Survey (CHARLS) database, three rounds of survey data in 2011, 2013, and 2015 were selected for the study. The data in 2011 were the baseline data, and the ID number was used to match the participants in the follow-up in 2013 and 2015. A total of 3 139 people were enrolled in this cohort study. Cox regression model and simple mediating effect model were used to analyze the relationship among social participation, cognitive function, and frailty. Results A total of 259 patients had frailty during the follow-up period. The results of multivariate Cox regression model adjusting social demography and lifestyle showed that social participation (HR=0.641, 95%CI: 0.496-0.829)and cognitive function (HR=0.952, 95%CI: 0.928-0.977) were associated with frailty. The results of the intermediary model with relevant covariates showed that cognitive function has a significant mediating effect between social participation and frailty. Conclusion Social participation and cognitive function are associated with frailty, and cognitive function has some mediating effect between social participation and frailty.

Objective To explore the correlation between sleep and depression in middle-aged and elderly people in Chinese community, so as to provide references for improving sleep quality, mental health and quality of life of middle-aged and elderly people. Methods The data of this study were collected from the China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2018. After screening the data, 6 312 participants were included in the study, and they were divided into groups according to their nocturnal sleep duration. The multivariate linear regression model and multivariate logistic regression model were constructed, and the covariates were adjusted to analyze the relationship between nocturnal sleep duration and depression. Results There were 76.81% of the patients having too short or too long sleep at night (7 to < 8 hours was the normal sleep time).The scores and detection rates of depression in 2018 were significantly different among different night sleep length groups (F=30.127, χ²=67.928, P<0.001). There was a negative correlation between night sleep time and depression score (β=-0.278, P<0.001). After further consideration of covariates, short sleep duration (≤ 5 h) was a risk factor for depression (OR=1.621, 95%CI:1.371-1.918), and the risk of depression was higher in women than in men (OR=1.673, 95%CI: 1.363-2.054 in women; OR=1.501, 95%CI: 1.120-2.012 in men). Conclusion The nocturnal sleep of the middle-aged and elderly is related to depression and is affected by demographic, socio-economic factors, health behavior factors and other covariables, and middle-aged and elderly women have a higher risk than men and older age. Attention should be paid to sleep health and mental health of the middle-aged and elderly, so as to improve their quality of life.

Objective To investigate the toxic effect of nano-copper oxide on copper death in mouse alveolar macrophages. Methods MTT assay was used to detect the survival rate of mouse alveolar macrophages (MH-S) treated with nano-copper oxide, transmission electron microscope to observe the morphology of MH-S cells, Western Blot to detect the expression of copper death protein FDX1 and DLAT, transcriptional group sequencing to explore the changes of cell gene expression and key signal pathways in the process of copper death induced by nano-copper oxide, and one-way ANOVA to analyze the difference. Results Copper oxide nanoparticles with 40nm size could enter MH-S cells, decrease the dose-response survival rate of MH-S cells (P < 0.001), increase the concentration of Cu²⁺ in MH-S cells, and induce the expression of FDX1 (P=0.004) and DLAT protein (P < 0.001). However, the administration of copper death inhibitor tetra thiomolybdate (TTM) reduced the cytotoxicity, decreased the level of intracellular Cu²⁺ (P=0.0038), and decreased the expression of FDX1 (P=0.012) and DLAT (P < 0.05).The sequencing results showed that nano-copper oxide could activate IL-17 inflammatory pathway, while TTM could inhibit IL-17 signal pathway. Conclusion Nano-copper oxide can induce the death of copper in mouse MH-S cells, which provides a new clue for the study of the toxic mechanism of nano-copper oxide.

Objective To investigate the internal exposure levels of selenium, arsenic, chromium, and cadmium in blood and urine of general population in Jiangxi Province from 2017 to 2018. Methods A multi-stage complex sampling method was employed to detect the content of selenium, arsenic, chromium, and cadmium in the fasting venous whole blood and urine samples of 720 selected subjects using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The exposure situation of residents in different genders, ages, urban and rural areas, and monitoring sites was analyzed. Spearman correlation was used to evaluate the bivariate correlation between blood metal concentrations and urine metal levels. Results The median levels of blood selenium and urine selenium in the general population of Jiangxi Province from 2017 to 2018 were 90.89 μg/L and 13.67 μg/L, respectively. The median levels of blood arsenic and urine arsenic were 1.26 μg/L and 24.03 μg/L, respectively. The median levels of blood chromium and urine chromium were 0.51 μg/L and 1.84 μg/L, respectively. The median levels of blood cadmium and urine cadmium were 0.85 μg/L and 0.61 μg/L, respectively. There were statistically significant differences in blood selenium (Z=-5.09, P < 0.01) and urine selenium concentrations (Z=-3.94, P < 0.05) between different urban and rural areas, with concentrations higher in urban areas. Except for blood cadmium and urine cadmium, there were statistically significant differences in the concentration levels of other inorganic substances between different monitoring sites (P < 0.05). Differences in blood selenium (H=34.56, P < 0.05), blood cadmium (H=54.14, P < 0.05), and urine cadmium (H=63.447, P < 0.05) among different age groups were statistically significant, with concentrations gradually increasing with age. No statistically significant differences in concentrations of other inorganic substances between different genders were found (P > 0.05) except for urine selenium (Z=-3.77, P < 0.05). The strongest correlation coefficient among the four inorganic substances was 0.419 for blood cadmium and urine cadmium. Conclusion Residents in different regions of Jiangxi Province exhibit varying levels of internal exposure to selenium, arsenic, and chromium. Cadmium showed no regional differences in whole blood and urine load levels within the province, suggesting cadmium accumulation and a positive correlation with age.

Objective To review and analyze the literature related to public health events in China from 2003 to 2023, so as to provide reference for predicting, preventing, and responding to future public health events, and to enhance China’s capacity to deal with sudden public health emergencies. Methods A total of 2 717 articles related to public health field published between 2003 and 2023 and indexed in databases including SCI, CSSCI, CSCD, and PKU core in China National Knowledge Infrastructure (CNKI) were selected as data sources. The CiteSpace software was utilized to explore research hotspots and trends in the evolution of pathways in the field of public health events. Results The study revealed fluctuations in the number of publications on public health events. Author collaboration was relatively stable, while institutional collaboration intensity was low and interdisciplinary collaboration was limited. Research hotspots included emergency management, sudden events, epidemic prevention and control, infectious diseases, and online public opinion. Research content encompassed the epidemic characteristics, influencing factors, emergency response capabilities, and governance responses to public health events.Research topics went through three stages: exploration of public health theories, system construction, and social governance. Conclusion Future research directions will focus mainly on risk communication, public opinion management, and collaborative governance in public health events.

Objective To understand the clinical features and epidemiological characteristics of monkeypox cases in Shangcheng district, Hangzhou city, providing reference basis for monkeypox epidemic prevention and control work. Methods Data on 35 monkeypox cases detected by medical institutions in Shangcheng district, Hangzhou city from July to December 2023 were collected, including demographic information, clinical manifestations, epidemiological information, laboratory test results, and the clinical features and epidemiological characteristics of the cases were analyzed. Results All 35 monkeypox cases were male sexual contacts, with a median age of 28 years (range: 20 to 37 years). None had a history of smallpox vaccination, and all of them were identified through active medical consultation. Among them, 25 cases (71.43%) admitted to having had male homosexual contact within 21 days before onset, with an interval from last exposure to onset ranging from 1 to 14 days, median (Q1, Q3) of 6 (5, 9) days. Clinical symptoms mainly included fever, rash, inguinal lymph node pain, and muscle soreness; 24 cases (68.57%) presented with fever, all 35 cases had a rash, of which 9 cases (25.71%) had painful rashes, predominantly in the genital or anal region, accounting for 65.71% (23/35). Eleven cases (31.43%) of monkeypox cases were co-infected with Human Immunodeficiency Virus (HIV), with a 48.57% (17/35) prevalence of sexually transmitted diseases. Throat swabs and vesicle swabs were collected from all cases for nucleic acid testing, with a positive detection rate of 62.86% (22/35)in throat swabs, median CT value of 31, and 100% (35/35) in vesicle swabs, median CT value of 22. Conclusion The main clinical feature of monkeypox is rash, and the early recognition of skin rash by clinical doctors is key to early detection of cases.The high positive rate of monkeypox nucleic acid detection in vesicle specimens indicates the need for timely nucleic acid testing in high-risk individuals presenting with rash symptoms for early diagnosis and treatment.

Objective To investigate the pathogen pollution in the poultry and environment in Changsha live poultry wholesale market. Methods In total 817 live poultry and environment samples from Changsha county wholesale poultry market were collected from 2022 to 2023. AIV, NDV, C. psittaci, Brucella, and S. suis nucleic acids were detected by real-time fluorescence PCR, and the results were statistically analyzed. Results The overall positive rates of AIV, NDV, C. psittaci, Brucella, and S.suis in market poultry and environment were 64.01%, 32.19%, 6.36%, 0.24%, and 17.75%, respectively. The positive rates of NDV and S. suis in 2023 were higher than those in 2022, and the positive rates of five pathogens were the highest in October or December. There were significant differences in the positive rates of NDV (χ²=6.23, P=0.01) and S. suis (χ²=45.40, P<0.01) in different years and in AIV (χ²=50.50, P<0.01), NDV (χ²=41.28, P<0.01), C. psittaci (χ²=32.83, P<0.01), and S. suis (χ²=59.43,P<0.01) in different months. The sampling sites with the highest positive rates of AIV, NDV, C. psittaci, Brucella, and S. suis were poultry stores (67.53%), market public areas (44.00%), market public areas (8.00%), sheep/dog stores (3.57%), and poultry stores (19.02%). The samples with the highest positive rates of AIV, NDV, C. psittaci, Brucella, and S. suis were poultry drinking water (90.91%), air (61.11%), poultry cages (9.59%), sheep/dogs and other cages (3.77%), and air (31.25%). The positive rates of AIV (χ²=69.06, P<0.01), NDV (χ²=20.98, P<0.01), Brucella (χ²=27.25, P<0.01), S. suis (χ²=8.37, P=0.02) in different sampling sites and AIV (χ²=155.80 , P<0.0l), NDV (χ²=132.59, P<0.01), Brucella (χ²=10.10, P<0.0l) and S. suis (χ²=49.92,P<0.01) in different samples were significantly different. Conclusion The AIV, NDV, C. psittaci, Brucella, and S. suis nucleic acid pollution are common in poultry and environment in Changsha live poultry wholesale market, which indicates that the live poultry wholesale market needs to strengthen the prevention and control measures of zoonosis, such as place disinfection, health education and epidemic surveillance.

Objective To investigate whether the amino acid variation in the nonstructural protein of Severe Acute Respiratory Syndrome Coronavirus2 (SARS-CoV-2) is related to the severity of Corona Virus Disease 2019 (COVID-19). Methods The data obtained from the Global Shared Influenza Data Initiative (GISAID) database were analyzed, and the nonstructural protein amino acid mutations with high mutation rate in SARS-CoV-2 sequences were screened. The outcomes were divided into mild and severe diseases, and the chi-square test was used to compare the basic characteristics between the groups. The relationship between the mutations selected and the prognosis of the patients was analyzed. Results A total of 23 498 cases were included, including 11 444 males (48.70%) and 12 054 females (51.30%). The median age ［M（P₂₅，P₇₅）］ was 38 (26-53) years old. The severe infection rate of novel coronavirus in male was higher than that in female (χ²=226.564, P < 0.001). The severe infection rate of novel coronavirus increased with the increase of age (χ²=6 088.032, P < 0.001). The year of onset (χ²=1 604.070, P <0.001) and continent (χ²=4 520.240, P < 0.001) were significantly correlated with the severity of novel corona virus infection.Several amino acid variations in the SARS-CoV-2 gene group associated with the severity of novel corona virus’s sensitive dyeing were determined. NSP4_T492I (aOR=0.574, 95%CI: 0.487-0.676), NSP12_G671S (aOR=0.657, 95%CI: 0.458-0.941),NSP6_T77A (aOR=0.422, 95%CI: 0.235-0.759), and NSP3_P1228L (aOR=0.124, 95%CI: 0.080-0.190) were negatively correlated with novel coronavirus’s severe infection. NSP12_P323L (aOR=2.126, 95%CI: 1.531-2.953), NSP13_P77L (aOR=1.923, 95%CI: 1.115-2.369), and NSP14_A394V (aOR=20.486, 95%CI: 9.649-43.495) were positively correlated with novel coronavirus’s severe infection. Conclusion The amino acid variation of SARS-CoV-2 nonstructural protein may be related to the severity of COVID-19 virus infection, and it is necessary to screen several nonstructural protein amino acid variants which can be related to the severity of novel coronavirus infection.

Objective To explore the mechanism of Canopy homolog 2 (CNPY2) and aerobic exercise through nuclear factor kappa-B (NF-κB) signal pathway in non-alcoholic fatty liver disease (NAFLD) induced by high fat diet. Methods Male CNPY2 knockout (CNPY2 KO) mice and wild (WT) mice aged (12±1) weeks were randomly divided into control group (CON),hyperlipidemic model group (MOD), and hyperlipidemic model exercise group (MOD+EX) after one week of adaptive feeding.CON group was fed with normal diet, and MOD group and MOD+EX group were fed with high fat diet until the end of 18 weeks.From the 10^th week, the mice in the MOD+EX group received adaptive treadmill training for a week, followed by continuous exercise intervention until the end of the 18-week experiment. The serum levels of TC, TG, LDL-C, HDL-C, ALT, and AST were detected by automatic biochemical analyzer, the pathological morphology of liver was analyzed by HE staining and oil red O staining, the protein expressions of CNPY2, IκB α, p-IκBα, NF-κB, and NF-κB in liver were detected by Western Blot, thelevels of TNF-α and IL6 in liver were detected by ELISA, and the expressions of NF- κB mRNA, TNF- α mRNA, and IL-6 mRNA in liver were detected by q RT-PCR. The data were analyzed by single factor analysis of variance and independent sample t-test. Results The expression of CNPY2 in MOD group was higher than that in CON group (t=-5.730, P=0.001) while the expression of CNPY2 in MOD+EX group was lower than that in MOD group (t=3.714, P=0.010).Compared with CON group, the serum levels of TC, TG, LDL-c, ALT, and AST in MOD group of WT mice and CNPY2 KO mice were higher (WT: t=-13.325, P < 0.001; t=-4.889, P < 0.001; t=-10.442, P < 0.001; t=-3.500, P=0.003; t=-15.122, P <0.001; CNPY2 KO: t=-6.910, P < 0.001; t=-4.962, P < 0.001; t=-7.457, P < 0.001; t=-4.584, P < 0.001; t=-7.336, P <0.001).The levels of TNF-α, IL-6, p-IκBα/IκBα, p-NF-κB/NF-κB, NF-κB mRNA, TNF-α mRNA, and IL-6 mRNA in liver were increased significantly (WT: t=-25.179, P < 0.001; t=-21.043, P < 0.001; t=-9.177, P < 0.001; t=-12.207, P < 0.001; t=-5.205, P=0.002; t=-6.910, P < 0.001; t=-4.802, P=0.003; CNPY2 KO: t=-18.878, P < 0.001; t=-21.840, P < 0.001; t=-14.033, P < 0.001; t=-12.511, P < 0.001; t=-6.870, P < 0.001; t=-9.546, P < 0.001; t=-8.303, P < 0.001), HDL-C level decreased (WT: t=11.695, P < 0.001; CNPY2 KO: t=6.598, P < 0.001), and hepatocyte steatosis with large amount of lipid droplets was observed. Compared with MOD group, the above-mentioned indexes were effectively improved in WT mice and CNPY2 KO mice in MOD+EX group. Compared with WT mice, the above-mentioned indexes of CNPY2 KO mice were improved effectively. Conclusion CNPY2 regulates NF-κB signal pathway and participates in the formation and development of NAFLD. Both CNPY2 gene deletion and aerobic exercise can improve NAFLD, which may be related to the decrease of liver CNPY2 expression, inhibition of NF-κB signal pathway, down-regulation of liver inflammatory cytokines and reduction of liver inflammation.

In the context of Healthy China, it is of great significance to improve the quality of medical student training. Selecting good classroom teaching models is fundamental in the training of medical students. Presentation, Assimilation, and Discussion(PAD) classroom and Bridge, Objective, Pre-Assessment, Participation, Practice, and Post-Assessment (BOPPPS) teaching models are popular among university teachers and have been widely used in theoretical and practical teaching of various courses. However, both teaching models still have certain limitations. In order to fully leverage the advantages of both teaching models, the joint application of the two teaching models in recent years has attracted widespread attention from scholars. Therefore, this article analyzes the fusion points of the joint application of the two teaching models in the training of medical students, providing reference for the joint application of the two models.