To investigate the causal relationship between 211 intestinal microorganisms and anxiety by Mendelian randomization analysis.

Based on the genome-wide association study data of MiBioGen Alliance and Finnish database, the qualified instrumental variables were extracted, and the inverse variance weighting method was used as the main Mendelian randomized analysis method, combined with MR-Egger and Weighted median methods. Finally, the results were verified by Cochran’s Q statistics, intercept terms of MR-Egger regression, MR-PRESSO, and leave-one-out methods.

Cyanobacteria (OR=1.103, 95%CI: 1.001-1.215, P=0.048), Shigella (OR=1.159, 95%CI: 1.027-1.309, P=0.017), and Slackia (OR=1.170, 95%CI: 1.047-1.307, P=0.017) were positively correlated with the risk of anxiety. Firmicutes (OR=0.857, 95%CI:0.754-0.974, P=0.018), Clostridium (OR=0.817, 95%CI: 0.701-0.951, P=0.009), Clostridium (OR=0.849, 95%CI: 0.736-0.980, P=0.025), Eubacterium_rectale_group (OR=0.861, 95%CI: 0.748-0.993, P=0.039), Ruminococcaceae_UCG004(OR=0.886, 95%CI: 0.789-0.994, P=0.039), and Ruminococcaceae_UCG011(OR=0.919, 95%CI: 0.854-0.989, P=0.025) were negatively correlated with anxiety risk. The results were verified and no heterogeneity and horizontal pleiotropy were found.

This study evaluates the potential causal relationship between intestinal microorganisms and anxiety, providing reference for the diagnosis, prevention and treatment of anxiety in the future.

To construct the trajectories of four kinds of scores in Rey Auditory Verbal Learning Test (RAVLT) and to explore the relationship between each trajectory and the progression of mild cognitive impairment (MCI) to Alzheimer’s disease (AD).

Data were collected from the Alzheimer’s Disease Neuroimaging Program (ADNI). The research subjects were MCI patients who had been followed up for more than 5 years and completed the RAVLT test. Four kinds of trajectories with different scores of RAVLT were constructed based on the group-based trajectory model (GBTM). Cox regression model was used to explore the relationship between four different score trajectories and the progression of MCI patients to AD.

In the analysis of the four types of RAVLT scores, it was found that three trajectories were identified in the verbal learning scores.Compared with the low-stable group, the risk of AD in the moderate-stable group was lower (adjusted HR=0.27, 95%CI: 0.11-0.71). The delayed recall score identified three trajectories. Compared with the low-stable group, the high-rising group had an increased risk of AD (adjusted HR=3.38, 95%CI: 1.41-8.11).

MCI patients with lower verbal learning scores or higher delayed recall scores have a higher risk of developing AD.

To analyze the changing trend of disease burden of senile dementia attributed to high BMI in China from 1990 to 2019, and to provide references for the formulation of prevention and control strategies for senile dementia in China.

The data of death number, mortality rate, disability adjusted life years (DALY) number and DALY rate of senile dementia attributed to high BMI in China from 1990 to 2019 were extracted from the global disease burden database, and the estimated annual percentage of change (EAPC) was used to analyze the change trend in terms of sex, age and exposure rate.

From 1990 to 2019, the disease burden of senile dementia attributed to high BMI in China showed an upward trend. The burden of women was higher than that of men, and the latter had the fatest increase. The mortality rate and DALY rate increased with the increase of age, with the fastest increase in males aged 60 to 70 years and females aged 60 to 75 years, respectively.Males had larger EAPC than females in the same age group. From 1990 to 2019, the DALY loss of senile dementia caused by high BMI had the fatest increase, and the standardized (summary exposure value) SEV rate of high BMI increased rapidly (EAPC=3.67%, P < 0.001).

From 1990 to 2019, the burden of senile dementia attributed to high BMI in China became heavier. With the increase of aging and obesity rate, the burden of senile dementia attributed to high BMI is expected to continue to increase rapidly without no sustained and effective intervention.

The 25(OH)D deficiency is a prevalent issue among patients with chronic kidney disease (CKD). The aim of our study is to investigate whether low levels of 25(OH)D are associated with increased all-cause and cardiovascular mortality in patients with CKD.

This retrospective cohort study utilized the National Health and Nutrition Examination Survey (NHANES) and the National Death Index (NDI) 2007—2018 database to investigate the association between 25(OH)D levels and all-cause mortality as well as cardiovascular mortality. A total of 2 668 eligible subjects were included in this study, with follow-up conducted until December 31, 2019. Cox proportional hazards regression, restricted cubic spline, Kaplan-Meier survival curves, and competing risk survival analysis were performed to evaluate the associations. Furthermore, subgroup and sensitivity analyses were performed.

During a median follow-up of 6 years in a weighted population of 11 715 452 eligible participants, there were 665 deaths from any cause, including 196 cardiovascular-related deaths. After adjusting for covariates, lower levels of 25(OH)D were significantly associated with increased risks for both all-cause (HR=0.85, 95%CI: 0.77-0.94) and cardiovascular mortality (SHR=0.80, 95%CI: 0.67-0.94). Consistent results were also observed when analyzing 25(OH)D as a categorical variable (quartile) (both P<0.05). Weighted restricted cubic splines revealed an inverse J-shaped association between levels of 25 (OH) D and all-cause mortality (P_nonliner> 0.05). Subgroup analysis (P_interaction>0.05) and sensitivity analysis (HR=0.85, 95%CI: 0.77-0.93) yielded similar findings.

Lower 25(OH)D levels, both as a continuous and categorical variable, are significantly associated with an increased risk of all-cause mortality and cardiovascular disease-related mortality.The 25(OH)D has a negative j-shaped association with all-cause and cardiovascular mortality.

To explore the causal relationship between lipoprotein (a) [Lp (a)] and cerebral small vascular disease (CSVD) by Mendelian randomization (MR) analysis.

Using genome-wide association study (GWAS) public database, the single nucleotide polymorphisms independently associated with Lp (a) (P < 5 × 10^-8) were selected as instrumental variables (IVs). The main outcomes of this study were white matter hyperintensity (WMH), cerebral microhemorrhage, and lacunar infarction. Inverse variance weighted (IVW) mothod was used to evaluate the causal relationship between Lp (a) and CSVD. Sensitivity analysis was carried out by MR-Egger and MR-PRESSO to evaluate the pleiotropy of IVs. Furthermore, weighted median method, simple median method, and maximum likelihood ratio method were used to test the reliability of the results.

IVW results showed that there was a positive risk relationship between Lp (a) and WMH (OR=1.083, 95%CI: 1.035-1.134, P <0.001), but Lp (a) was not correlated with cerebral microhemorrhage (P=0.568) and lacunar infarction (P=0.651). MR-Egger analysis showed that the MR analysis of Lp (a) and WMH was not affected by horizontal pleiotropy (P=0.721).

MR analysis shows that Lp (a) is related to the increased risk of WMH.

To understand the risk factors of two common chronic diseases in order to provide evidence for the prevention of common chronic diseases and government investment in disease management.

Four waves follow-up data of China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018 were used. In total 2 992 and 1 952 patients with hypertension and rheumatism or arthritis, stomach diseases and rheumatism or arthritis were included. Cox proportional hazard model and shared vulnerability model were used to analyze the influencing factors of multimorbidity.

For people with hypertension and rheumatism or arthritis, living in rural areas (HR=1.367, 95%CI: 1.096-1.705), advanced age group (HR=1.342, 95%CI: 1.013-1.778), obesity (HR=2.424, 95%CI: 1.790-3.283), rheumatism or arthritis as first onset disease (HR=3.797, 95%CI: 3.059-4.713) and other chronic diseases more than 1 (HR=2.694, 95%CI: 2.042-3.555) were associated with a higher possibility of multimorbidity, while people with high education level (HR=0.766, 95%CI: 0.594-0.988) had a lower possibility of multimorbidity, and the shared vulnerability model outperformed Cox model. For people with stomach disease and rheumatism or hypertension: advanced age (HR=0.392, 95%CI: 0.240-0.640), highly educated (HR=0.667, 95%CI: 0.461-0.964),and overweight (HR=0.720, 95%CI: 0.540-0.96)) were associated with lower possibility to have multimorbidity, negative health self-assessment (HR=1.409, 95%CI: 1.038-1.912), being lean (HR=1.935, 95%CI: 1.198-3.126), and having more than 1 chronic diseases (HR=2.339, 95%CI: 1.644-3.328) were associated with higher possibility to have multimorbidity, and there was no significant difference between the two models in this population.

In the hierarchical survival data, the fitting effect of the shared fragile model is better than that of the traditional model. In the group of patients with hypertension and rheumatism or arthritis, there is an increased risk of rheumatism or arthritis in the older age group, obesity and the first onset of rheumatism or arthritis, and the incidence of stomach disease and rheumatism or arthritis is lower in the higher age group and overweight group. Therefore, the prevention measures of chronic multimorbidity should be taken based on different combinations of common diseases to identify high-risk groups respectively, carry out different intervention behaviors, accurately invest medical resources, and reduce the disease burden of the government.

To investigate the relationship between hearing loss and the risk of muscular dystrophy in the middle-aged and elderly, so as to provide scientific basis for the prevention and intervention of myogenic in this population.

In this study, people aged 45 and above in the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015 were selected as research subjects. Self-reported hearing loss was used to evaluate hearing loss. Based on the consensus of Asian muscular dystrophy working group in 2019, muscular dystrophy was determined. Cox proportional hazard model was used to investigate the relationship between hearing loss and the risk of myasthenia.

Among 11 528 middle-aged and elderly people, the incidence of baseline hearing loss was 12.8%. During the 4-year follow-up, there were 558 new cases of muscular dystrophy, with an incidence of 6.4%. The results of the Cox proportional hazard model showed that subjects with hearing loss had an increased risk of muscular dystrophy by 31.1% (HR=1.311, 95%CI: 1.059-1.625) compared with those without hearing loss. The results of stratified analysis showed that the relationship between hearing loss and muscular dystrophy was more obvious in women, the elderly, rural household registration, married people, those with education level of junior high school or above, and those with high annual family income.

Hearing loss is related to the increased risk of muscular dystrophy in middle-aged and elderly people in China. Early screening and intervention for hearing loss may help reduce the incidence of future muscular dystrophy.

To investigate the status and distribution characteristics of microbial pollution on the surface of indoor air and public facilities at a metro station of a city in the central south China.

The total number of bacteria and fungi in the air and those of bacteria, fungi, coliform, and Staphylococcus aureus on the surface of key public facilities were sampled and detected. Multiple linear regression and Logistic regression were used to analyze the influencing factors.

The median of the total number of bacteria and fungi in the indoor air of metro station was 194.35 and 346.29 CFU/m³, respectively, the median of the total number of bacteria and fungi on the surface was 15.00CFU/25cm² and 0.00CFU/50cm², and the positive rates of coliform group and Staphylococcus aureus were 2.22% and 11.11%, respectively. There were differences in the temporal and spatial distribution of microorganisms in the indoor air of the metro: the total number of bacteria in the station hall was the highest and the total number of fungi in the platform was the highest; the total number of bacteria was the highest in the early peak period and the highest in the evening peak period. The total number of bacteria and fungi on the surface of the ticket inspection machine was higher than that of other public facilities, the total number of fungi on the surface of public facilities at noon was lower than that in the evening peak period, and the positive rate of coliform group was lower than that in the morning peak period. The total number of bacteria in the indoor air of subway station was negatively correlated with temperature (β=-0.06,95%CI: -0.11 to -0.01) and wind speed (β=-0.28, 95%CI: -0.55 to -0.01). The total number of air fungi was positively correlated with relative humidity (β=0.01, 95%CI: 0.00 to 0.02) and negatively correlated with PM_2.5 (β=-0.01, 95%CI: -0.02 to-0.01). There was a negative correlation between the total number of bacteria on the surface and PM_2.5 (β=-0.04, 95%CI: -0.07 to -0.02).

The level of microorganisms in indoor environment of three metro stations in a city in the central south China is low, and the surface of public facilities is contaminated by pathogenic bacteria. The distribution of bacterial and fungal concentrations in metro stations vary among regions and time periods, which is related to temperature, humidity, wind speed, and PM_2.5.

To investigate the effect of built environment on cardiovascular disease in middle-aged and elderly people.

In this study, 17 256 subjects were selected from China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, and the built environment and meteorological data of their cities were collected. Multivariate logistics regression model and weighted quantile regression model were used to analyze the relationship between built environment and cardiovascular disease in the middle-aged and elderly.

Multivariate logistics regression analysis showed that for every increase of interquartile range (IQR) in land use mixture, residential land, and industrial land, the OR values were 1.13(95%CI: 1.07-1.19), 1.16 (95%CI: 1.10-1.23), and 1.11 (95%CI: 1.06-1.16), respectively. When the proportion of commercial land and green space area increased by 1 IQR, the OR values (95%CI) were 0.88 (95%CI: 0.85-0.92) and 0.94 (95%CI: 0.90-0.98), respectively. The mixed degree of land use, the proportion of residential land, and the proportion of industrial land all increased the risk of cardiovascular disease in men and women (P < 0.05), while the proportion of commercial land decreased the risk of cardiovascular disease in men and women. The green space area only decreased the risk of cardiovascular disease in women (P < 0.05). In the mixed exposure of 8 kinds of built environmental factors, the proportion of industrial land and residential land were 34.13% and 29.20%, respectively.

The built environment has a significant impact on the risk of cardiovascular disease in the middle-aged and elderly, and the area of green space has a more significant effect on the cardiovascular disease in the middle-aged and elderly women.

To investigate the potential relationship between dietary flavanone intake and asthma so as to provide reference for the prevention and control of asthma.

Adults over 20 years old in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2008 were selected as research subjects. Multivariate logistic regression model was used to analyze the relationship between flavanone intake and asthma. Finally, subgroup analysis was used to explore the relationship between flavanone intake and asthma in different sex and age groups.

A total of 5 415 subjects were included, of whom 710 (13.11%) had asthma. The median intake of flavanone was 0.27 mg/d. The intake of flavanone in patients with asthma was significantly lower than that in normal people, and the difference was statistically significant (Z=10.207, P < 0.001). After adjusting for age, sex, body mass index, race, education, drinking, smoking, monthly family poverty, hypertension, and diabetes, the incidence of asthma in the highest quantile was significantly lower than that in the lowest quantile (OR=0.781, 95%CI:0.615-0.991), and the risk of asthma decreased with the increase of flavanone intake (P _trend = 0.015).

There is a negative correlation between flavanone intake and asthma. Flavanone may be a protective factor for asthma, and the correlation may be more obvious in women and young and middle-aged people under 50 years old.

To investigate the causal relationship between tea intake and sex hormone levels by two-sample Mendelian randomization analysis.

Single nucleotide polymorphisms related to tea intake were screened from the genome-wide association study as genetic instrumental variables. Five Mendelian randomized methods including simple model, weighted model, inverse variance weighted (IVW) analysis, weighted median method, and MR-Egger method were used to study the causal association between tea intake and sex hormone levels, which was evaluated by the β value.

A total of 41 SNPs were included in this study. The results of inverse variance weighting method showed that tea intake could increase the level of bioavailable testosterone (β=0.073, P < 0.05) and decrease the level of estradiol (β=-0.023, P < 0.05). The estimated results of MR-Egger effect showed that tea intake could increase the level of bioavailable testosterone (β=0.179, P<0.05) and decrease the level of estradiol (β=-0.049, P<0.05), and the weighted median method also found that tea could increase the level of bioavailable testosterone (β=0.120，P<0.05) and decrease the level of extradiol (β=-0.047, P<0.05), consistent with the results of IVW method. MR-Egger regression method showed that there was no horizontal pleiotropy, leaving one method and Cochran’s Q statistics test showed no heterogeneity, and the direction of single SNP was correct.

Tea intake can up-regulate testosterone level and down-regulate estradiol level. Reasonable tea intake will contribute to the effective intervention of sex hormone-related diseases and provide important reference for the prevention and treatment of clinical diseases.

To systematically analyze the incidence of nutritional risk in patients with Alzheimer’s disease.

Chinese database (WIP, National Knowledge Infrastructure, Wan fang database, Sino Med) and English database (Cochrane library, PubMed, Embase, Web of Science) were searched, and the related studies on the influencing factors of malnutrition in patients with Alzheimer’s disease were collected. After screening and evaluating the literatures according to the criteria, Stata16.0 and Revman5.4 were used to analyze the prevalence of nutritional risk of Alzheimer’s disease and its influencing factors by meta-analysis.

A total of 25 articles were included, the number of patients with Alzheimer’s disease was 3 372, and the number of patients with nutritional risk was 2 038, involving 12 influencing factors. Meta-analysis showed that the prevalence rate of nutritional risk of AD was 62.5% (95%CI: 56.1%-68.9%). Marital status (OR=0.5, 95%CI: 0.34-0.73), course of disease (MD=0.36, 95%CI: 0.05-0.66) and swallowing function (OR=4.86, 95%CI: 1.74-13.61) were the influencing factors of nutritional risk of AD. Albumin (MD=-7.50, 95%CI: -9.25 to -5.75), cholesterol (MD=-0.87, 95%CI: -1.31 to -0.43), and hemoglobin (MD=-2.71, 95%CI: -3.96 to -1.46) were negatively correlated with nutritional risk in Chinese patients with Alzheimer’s disease.

The prevalence rate of nutritional risk in Chinese patients with Alzheimer’s disease is high and is related to marital status, course of disease, albumin, cholesterol, hemoglobin and swallowing function. Clinical attention should be paid to related factors and early identification and intervention to reduce the occurrence of nutritional risk and the impact of nutritional risk on the progression of Alzheimer’s disease.

To analyze the time trend and potential influencing factors of hospitalization of children with mental disorders in Beijing.

The information on hospital admissions of children with mental disorders living in Beijing from 2014 to 2018 was collected. Joinpoint regression model and grey correlation analysis were used to explore the changing trend of hospital admissions and the correlation intensity of the influencing factors.

From 2014 to 2018, the number of hospitalized children with mental disorders showed an upward trend with an average annual change rate of 19.33%. In the subgroup, the number of hospitalized children with mood disorders increased most rapidly (average annual percentage rate change (AAPC) =34.39%), followed by female children (AAPC=31.97%). The results of grey correlation analysis showed that per capita disposable income (correlation degree 0.841) and per capita GDP (correlation degree 0.837) had the strongest correlation with the number of hospitalized children with mental disorders.

The number of hospitalized children with mental disorders increased significantly from 2014 to 2018, and the trend of hospitalization of children with mental disorders with different characteristics and the correlation order of influencing factors were different. We should focus on the strongly related factors of different children with mental disorders and strengthen the mental health education and prevention and control of children in Beijing so as to provide reference for the formulation of relevant policies.

To investigate the relationship between folic acid supplementation behavior and the risk of gestational diabetes mellitus (GDM) in peri-pregnant women, so as to provide evidence for health care of perinatal women.

Based on the monitoring data of pregnancy health care system in Tongzhou district of Beijing from January 2016 to December 2021, multivariate stepwise Logistic regression model and interaction model were used to investigate the effect of folic acid supplementation behavior on the risk of GDM in perinatal women.

A total of 92 708 subjects were included in this study, including 9 926 patients with GDM, with a prevalence rate of 10.71%. The results of Logistic regression analysis showed that folic acid supplementation during perinatal period (OR=0.627, 95%CI: 0.421-0.933), regular folic acid supplementation (OR=0.927,95%CI: 0.887-0.968), simple folic acid supplementation (OR=0.815, 95%CI: 0.778-0.853), and folic acid supplementation before pregnancy (OR=0.921, 95%CI: 0.882-0.963) were associated with the reduced risk of GDM (P<0.05). The results of interaction analysis showed that there was significant interaction between folic acid supplementation type (OR=0.761, 95%CI:0.726-0.798) and folic acid supplementation time (OR=0.721, 95%CI: 0.658-0.791) and whether folic acid supplementation was regular or not (P<0.05).

Folic acid supplementation before pregnancy and folic acid alone can effectively reduce the incidence of GDM. Nutrition and health education before pregnancy should be strengthened and the importance of regular folic acid supplementation before pregnancy should be emphasized in order to reduce the risk of GDM and protect maternal and infant health.

To understand the current situation of nosocomial infection management in primary medical institutions in Guizhou Province, and to provide reference for standardizing the professional development of nosocomial infection management in primary medical institutions.

By using the method of electronic questionnaire survey, the management of nosocomial infection in primary medical institutions in Guizhou Province from April 1 to 30, 2022 was investigated, and 611 valid questionnaires were retrieved.

Among the 611 primary health care institutions, 401 medical institutions set up nosocomial infection committees, 149 medical institutions set up independent nosocomial infection management departments, 321 medical institutions were equipped with full-time staff for nosocomial infection management, and 573 medical institutions were equipped with part-time staff for nosocomial infection management. In total, 321 primary health care institutions were equipped with 334 full-time staff for nosocomial infection management. The average age was (35.19±8.57) years old, the gender was mainly female, the major was nursing, and the degree was bachelor degree or below. The management of nosocomial infection in different types of primary health care institutions was compared and analyzed, and there were differences in age, professional background, educational background, and working years of nosocomial infection department (P < 0.05). The focus of the full-time staff of nosocomial infection management was the issue of salary.

The construction of the organizational structure of nosocomial infection management in private grass-roots medical institutions in Guizhou Province needs to be strengthened, and some full-time staff are engaged in nosocomial infection management for a short time, so they need to strengthen their ability and training.

To understand the current situation of death anxiety of the elderly in rural areas of Sichuan and its influencing factors.

A questionnaire survey was conducted among 702 rural elderly from 6 prefecture-level cities in Sichuan Province. On the basis of describing the current situation of death anxiety, the χ² test and logistic regression analysis were used to explore the influencing factors of death anxiety.

The scores of emotional dimensions of death anxiety, stress and pain, time consciousness, and cognitive dimension of the elderly in rural areas of Sichuan were (1.10 ±1.33), (2.29 ±1.80),(0.76±0.79), and (1.18±0.79), respectively. The total score was (5.33±3.68), and 245 (34.90%) had high death anxiety. Multivariate analysis showed that the number of children (OR=0.742, 95%CI: 0.630-0.875)), subjective well-being (OR=0.453,95%CI: 0.335-0.612)) and physical fitness (OR=0.581, 95%CI: 0.452-0.746) were the protective factors of death anxiety in the elderly, while chronic diseases (OR=1.575, 95%CI: 1.032-2.404)) were the risk factors of death anxiety.

The death anxiety of the elderly in the rural areas of Sichuan is at a medium-low level, and the rural elderly with a small number of children, chronic diseases, poor physical fitness, and low subjective well-being have a higher level of death anxiety, which should be paid more attention to.

To understand the effect of establishing health records on the acceptance of health management services in young and middle-aged floating population with hypertension and type 2 diabetes, and to provide references for improving the utilization rate of health management services and realizing the equalization of basic public health services.

Based on the population characteristics, family characteristics, health and public service characteristics of 6 391 young and middle-aged patients with chronic diseases aged 30 to 59 years old in 2017, Probit model and tendency score matching method were used to analyze the effect of health files on the acceptance of health management services in young and middle-aged floating population with hypertension and type 2 diabetes.

The results of Probit model showed that the coefficients of establishing health records for hypertension patients, type 2 diabetes patients, and patients with both diseases were 0.940, 0.905, and 1.333, respectively, and they were all significant at 1% level, indicating that the establishment of health records had a positive effect on the health management services of young and middle-aged floating population with chronic diseases. After correcting the endogenous problems of the model, the result remained robust. Heterogeneity analysis found that there were differences in age, self-rated health, and health education in the establishment of health records.

The establishment of health records has a positive impact on the acceptance of health management services for patients with chronic diseases in young and middle-aged floating population. In the future, we should pay attention to the basic public health service needs of patients with hypertension and type 2 diabetes in young and middle-aged floating population, carry out health education and publicity work for patients with different characteristics, and improve the awareness and utilization rate of basic public health services.

To evaluate the service effect of health education institutions in China, identify the existing problems, and put forward feasible solutions.

The Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) and Rank-sum ratio (RSR) were used to evaluate the service effect of health education institutions in 31 provinces (autonomous regions and municipalities directly under the central government).

In total 14 indicators for evaluating the service effectiveness of health education institutions were selected in the study. Among them, the top two index with the largest weight were the number of people covered by short messages and the number of audio and video products, while the last two were the number of host websites and the number of programs by co-operating with TV stations. The evaluation of entropy weight TOPSIS method showed that the Ci value of each region was between 0.022 and 0.665. The evaluation results of RSR method showed that the number of areas where the service effect of health education institutions was poor, average, good, and excellent were 2,13, 13, and 3, respectively. The general trend of the two results was basically consistent with that of the fuzzy joint model.

The fuzzy combination of entropy weight TOPSIS method and RSR method can better evaluate the service effect of health education institutions in China. There is an imbalance between the content and the region in the service of health education institutions. We should increase the total investment in health education publicity and human resources, and put forward measures according to the differences of different regions, so as to improve the service effect of health education institutions and enhance residents’ well-being and satisfaction.

To analyze the coupling and coordination relationship of high-quality development of tertiary public general hospitals in Guangxi, and to explore the path of high-quality development of tertiary public general hospitals, so as to provide a basis for related policy formulation.

The evaluation index system of high-quality development of tertiary public general hospitals in Guangxi was constructed from the four dimensions of medical quality, operational efficiency, sustainable development, and satisfaction evaluation. The coefficient of variation method and rank sum ratio method were used to comprehensively evaluate and classify the high-quality development level of the tertiary public general hospitals in 14 prefectures and cities in Guangxi in 2019, and the coupling coordination degree model was used to calculate the coupling and coordinated development level.

Most of the sample hospitals were in the primary coordination stage, and the proportion of other coupling coordination types from high to low were intermediate coordination (22.73%), reluctant coordination (18.18%), on the verge of disorder (13.64%), and good coordination (4.55%). According to the principle of optimal classification, the tertiary public hospitals in Guangxi were divided into high, medium, and low grades. Most of the hospitals were in the middle level and there was much room for development and progress.

The coupling coordination degree of the tertiary public general hospitals in Guangxi is not high, and there are still some problems, such as uneven distribution of medical resources, large differences in medical quality, and lack of motivation for personnel training. It is necessary to improve the medical service system and improve the core competitiveness.

To understand the attitude of public health physicians towards prescription rights, and to provide support and reference for further exploring the policy formulation and promotion of public health physicians’ prescription rights.

By using the key person method and snowball method, an online cross-sectional questionnaire survey was conducted among public health doctors in all levels of disease prevention and control centers, hospitals, maternal and child health hospitals, grass-roots medical institutions, professional public health and other institutions in Sichuan Province. A total of 246 questionnaires about the current situation, cognition, influence, attitude, and suggestions of public health doctors on prescription rights were qualitatively and quantitatively analyzed.

About 95% of the participants supported to give public health doctors the right of prescription, which was a sign of the identity of public health “doctors”, which could promote the integration of prevention and treatment, improve the efficiency and quality of the public health system, and improve the medical professional ability of public health doctors, so as to improve the quality and effect of public health. The lack of prescription power would reduce the medical professional recognition of public health physicians and the effectiveness of public health doctors in undertaking public health work. Most participants expressed their willingness to accept different forms of prescription rights.

The community of public health doctors has a high demand for prescription rights, and it is considered that the implementation of prescription rights of public health doctors is an important measure to improve the current situation of the separation of medical treatment and prevention of public health doctors and promote the high-quality development of public health doctors.

To investigate the predictive value of infection-related blood indexes combined with palliative performance scale (PPS) score in 14-day survival of patients with pulmonary infection after palliative treatment.

A total of 111 inpatients with pulmonary infection treated in the Department of Palliative Medicine, West China Fourth Hospital of Sichuan University from January 2022 to December 2022 were divided into survival group (n = 53) and death group (n = 58) according to the survival condition of 14 days after treatment. Age, sex, prevalence, infection-related blood index level, and PPS score of the two groups were compared by univariate analysis. Multivariate COX regression analysis was used to analyze the factors affecting the 14-day survival prognosis of patients with pulmonary infection after palliative treatment. The nomogram was constructed and the receiver operating characteristic (ROC) curve was used to verify the predictive performance of the model. The reliability of the model was determined by calibration curve and the clinical practicability of the model was evaluated by decision curve analysis (DCA).

Compared with the 14-day survival group, the palliative treatment group had lower PPS score, higher C-reactive protein, procalcitonin, white blood cell, and neutrophil count, and the difference was statistically significant (P<0.05). The results of multivariate COX regression analysis showed that high procalcitonin level (HR=2.201, 95%CI:1.394-3.143) and low PPS score were independent risk factors for poor prognosis of patients with pulmonary infection after palliative treatment for 14 days (with reference to < 20%, 20%-30%: HR=0.333, 95%CI: 0.183-0.606; 40%-50%: HR=0.125,95%CI: 0.043-0.362; > 50%: HR=0.107, 95%CI: 0.014-0.814). The nomogram was constructed based on procalcitonin combined with PPS score. The area under the ROC curve (AUC value: 0.864, 95%CI: 0.809-0.919), calibration curve, and DCA curve results showed that the model had good predictive efficiency and clinical practicability compared with single index prediction.

Procalcitonin level combined with PPS score is a good predictor of poor prognosis in patients with pulmonary infection after palliative treatment for 14 days.

To explore the mechanism of online social participation affecting the health of the elderly through online social support and online risk exposure, and to explain the regulatory role of intergenerational cohabitation.

The data of online social participation and health status of people over 60 years old in Henan Province in 2023 were selected, and the moderated mediating effect, moderating effect, and regulated mediating effect were tested with the moderated intermediary effect model in PROCESS4.0 macro program.

Online social participation positively affected online social support (β=1.734, P < 0.001) and online risk exposure (β=1.453, P < 0.001). Online social support positively affected physical health (β=0.183, P < 0.001) and mental health (β=0.398, P < 0.001). Online risk exposure negatively affected physical health (β=-0.490,P < 0.001) and mental health (β=-0.598, P < 0.001). The interaction between online social participation and intergenerational cohabitation negatively affected online risk exposure (β=-0.784, P < 0.001), and the mediating effect differences between intergenerational cohabitation group and non-intergenerational cohabitation group were 0.384 (95%CI: 0.146-0.678) and 0.469(95%CI: 0.205-0.778) respectively on the physical/mental health path of online social participation.

Online social participation has a positive impact on the physical and mental health of the elderly through online social support, and a negative impact on physical and mental health through online risk exposure. Intergenerational cohabitation weakens the positive impact of online social participation on online risk exposure and the intermediary effect of online risk exposure.

To explore the chain-mediated relationship between worker occupation fit (WOF) and occupational stress between occupational fatigue and depressive symptoms.

The method of stratified cluster sampling was used to study the medical staff in Sichuan Province. Pearson correlation analysis, stepwise regression model, and bootstrap method were used to analyze the relationship and chain mediating effect among WOF, occupational stress, occupational fatigue, and depression.

In total 1 988 subjects were enrolled in this study, of which 43.5% (864/1 988) had depressive symptoms, and 6.5%(130/1 988) had severe depressive symptoms; 31.1% (618/1 988) had occupational fatigue symptoms, and the WOF level was 31.6±7.1. Stepwise regression analysis showed that with WOF, WOF type and occupational stress added to the model, the explanation of depressive symptoms in the model increased by 37.3% and 41.4%, respectively. Intermediary effect analysis showed that WOF and occupational stress had chain mediating effect between occupational fatigue and depressive symptoms, and the proportion of chain mediating effect was 1.80% (β = 0.020, bias corrected and accelerated 95%CI: 0.016-0.039).

The occurrence of depressive symptoms in medical staff is not only affected by occupational fatigue but also mediated by WOF and occupational stress.

According to the theory of life course, family environmental factors in early life have influence on individual health. The objective is to understand the influence and importance of family environmental factors in early life and other factors in adulthood on self-rated health of the middle-aged and elderly, so as to provide reference for active aging and healthy aging.

The demographic data, social support, and early family environmental factors of people over 45 years old from Chinese General Social Survey (CGSS) data in 2021 were collected. Chi-square test, binary Logistic regression, and random forest model were used to analyze the influencing factors and importance of self-rated health of the middle-aged and elderly.

Among the 4 311 subjects, 2 427 were unhealthy and 1 884 were healthy. The regression results showed that the middle-aged and elderly people aged 79 and over, working in agriculture, not working, never engaging in social and recreational activities, middle-and lower-middle-level socioeconomic status, and fathers with college education or above had a higher rate of self-rated unhealth (P < 0.05). The self-rated unhealthy rate of the middle-aged and elderly with normal and overweight, non-depression, average family economic level and higher than the average level of BMI was lower (P < 0.05). The order of influencing factors was depression (73.717), family economic level (55.361), nature of work (47.074), personal socio-economic status (42.177), BMI (38.952), age (28.842), frequency of social and recreational activities (28.270), and father’s education level (22.319).

There are many factors affecting the self-rated health of the middle-aged and elderly in China. Depression, family economic level, and the nature of work are important factors affecting the self-rated health of the middle-aged and elderly in China. Attention should be paid to special groups such as depression, low income, perennial farming, and out of work.

To establish a screening model for patients with chronic obstructive pulmonary disease (COPD).

By using the method of multi-stage stratified random sampling, 4 587 permanent residents ≥ 40 years old in Guizhou Province were investigated by questionnaire, physical examination, and pulmonary function examination. Variables to be included into the model were screened by univariate analysis and then further screened by multivariate Logistic regression. Logistic regression (LR), random forest (RF) and support vector machine (SVM) were used to construct the screening model of COPD patients, and the area under the curve (AUC) was used to evaluate the effect of the model. Delong method was used to test the difference of AUC between models.

According to the results of multivariate Logistic regression analysis, age, frequent cough before 14 years old, asthma, daily smoking, cooking fuel and exhaust, and harmful gas exposure were included in LR, RF and SVM models. The AUC of the three model training sets were 73.64%, 87.14%, and 73.30%, respectively, and the AUC of the test set were 76.10%, 70.96%, and 76.08%, respectively, all of which had good screening results. The results of Delong method showed that the screening effects of the three models were different between the training set and the test set.

This study established an economical, rapid, and effective screening model for COPD patients through six simple variables such as age and asthma.

To investigate the relationship between muscle strength and the risk of depression in the middle-aged and elderly, and to provide reference for the prevention and treatment of depression in the middle-aged and elderly in China.

Based on the data of China Health and Retirement Longitudinal Study (CHARLS), the middle-aged and elderly people who participated in the survey in 2015 and 2018 were selected. Firstly, restricted cubic splines (RCS) were used to analyze whether there was a dose-response relationship between upper limb strength (standardized grip strength) and lower limb strength (time to stand up from a chair) and the risk of depression in the middle-aged and elderly. Secondly, the upper and lower limb strength were divided into three groups, and Logistic regression model was used to evaluate the correlation between upper and lower limb strength, overall muscle strength and depression risk in the middle-aged and elderly.

A total of 6 245 subjects were enrolled in this study. During the 3-year follow-up period, a total of 2 095 (33.5%) subjects had depressive symptoms.There was a dose-response relationship between upper and lower limb strength and the risk of depression in the middle-aged and elderly. Logistic regression model showed that after adjusting the confounding factors such as sex, age and marital status, stronger upper and lower limb strength could reduce the risk of depression by 24% and 28%, respectively. Compared with the weakest overall muscle strength group, the strongest muscle strength group had a 48% lower risk of depression (OR=0.52,95%CI: 0.41-0.67).

Strong muscle strength can reduce the risk of depression in the middle-aged and elderly.

To investigate the drug resistance and molecular epidemiological characteristics of clinically isolated Staphylococcus aureus in Huai’an city, so as to provide references for the diagnosis, treatment, prevention and control of infection.

Staphylococcus aureus isolated from clinical samples were collected and methicillin-resistant Staphylococcus aureus（MRSA）was detected by cefoxitin or oxacillin resistance phenotype or mecA gene. The drug sensitivity test was carried out by microbroth dilution method. Based on the whole genome sequencing, the strains were analyzed by single nucleotide polymorphism and multi-locus sequence typing. The virulence and drug resistance genes of the strains were identified by online database.

A total of 83 strains of Staphylococcus aureus were isolated from 7 types of clinical specimens, and MRSA accounted for 59.04%. The isolated strains had the highest resistance to penicillin (97.59%) and were sensitive to Nez Olamide, tigecyclines, vancomycin, teicoplanin, and nitrofurantoin, and multiple drug-resistant strains accounted for 57.83%. There were 20 ST types in 83 strains of Staphylococcus aureus, and ST398 (21.69%) was the main type. There were 187 292 SNP loci in 83 genomes. These strains carried 38 kinds of drug resistance genes, among which tet (38), blaZ, arlR, arlS, mgrA, norA, mepA, ErmC,LmrS, and mepR had higher carrying rates. These strains carried 8 enterotoxin genes including sea, seb, sec, sed, seh, selk, sell,and selq, among which selk and selq (both 32.53%) had the highest carrying rate, and ST1 strain carried the largest number of kinds of enterotoxin genes. The carrying rates of lukF-PV and lukS-PV genes encoded by PVL were 49.40% and 6.02%, respectively. The carrying rate of tsst-1 gene encoded by toxic shock syndrome toxin TSST-1 was 3.61%.

The drug resistance of Staphylococcus aureus isolated from Huai’an area is strong and the detection rate of MRSA is high. The ST types of strains are rich, and there is a certain correlation between ST types and pathogenicity.

To investigate the role of RIPK1/MLKL/PGAM5 pathway in traffic-related PM_2.5-induced heart injury in asthmatic mice.

In total 50 male BALB/c mice were randomly divided into control group (NS group), asthma group (OVA group), OVA+ low concentration PM_2.5 group (LPM_2.5, 1.8 mg/ kg ·bw), OVA+ medium concentration PM_2.5 group (MPM_2.5,3.6 mg/ kg ·bw), and OVA+ high concentration PM_2.5 group (HPM_2.5, 7.2 mg/ kg ·bw). OVA asthma model mice were instilled with different concentrations of PM_2.5 suspension through nasal cavity for 10 times. The pathological changes of heart tissue were observed by HE staining, the apoptosis of heart tissue was detected by Tunnel staining, and the protein and mRNA expression levels of RIPK1, RIPK3, MLKL, PGAM5, DRP1, and mRNA in mouse heart tissue were detected by qRT-PCR and Western blot methods.

Compared with NS group, the arrangement of central muscle fibers in PM_2.5 group was obviously disordered, the myocardial fibers in HPM_2.5 group were obviously broken, and the number of apoptotic cells was significantly increased. The protein expression of RIPK1, RIPK3, MLKL, PGAM5, DRP1, and p-DRP1 in HPM_2.5 group was higher than that in NS group (q₁=20.940, P < 0.05; q₂=7.311, P < 0.05; q₃=4.805, P < 0.05; q₄=5.976, P < 0.05; q₅=5.096, P < 0.05; q₆=10.390,P < 0.05). The expression of RIPK1, RIPK3, and DRP1 genes in HPM_2.5 group was significantly higher than that in NS group (q₁=7.952, P < 0.05; q₂=5.172, P < 0.05; q₃=5.430, P < 0.05).

Traffic-related PM2.5 can induce cardiac necrotic apoptosis in asthmatic mice through RIPK1/MLKL/PGAM5 pathway.

To evaluate the effect of EV71 inactivated vaccine on the epidemiological characteristics and reported incidence of hand, foot, and mouth disease (HFMD) in Quzhou city.

The surveillance data of HFMD cases in Quzhou city from 2009 to 2022 were collected by China Infectious Disease Reporting Information Management system, and the epidemiological characteristics were descriptively analyzed. The change trend of reported incidence of HFMD in Quzhou before and after the application of EV71 inactivated vaccine was analyzed by interruption time series design.

The average reported incidence of HFMD in Quzhou from 2009 to 2022 was 200.02/100 000. After the application of EV71 inactivated vaccine in Quzhou, the instantaneous change of HFMD reported incidence was -30.296/100 000 (t=0.30, P=0.773), the slope changes was-75.694/100 000 (t=5.43, P < 0.001), and the slope was -33.923 (β₁+β₃=33.923). The proportion of reported cases aged 0 to 4 years in all age groups decreased from 97.72% in 2009—2015 to 90.93% in 2016—2022.

The EV71 vaccine has achieved good prevention and control effect in a short time after coming into the market in Quzhou city, but the incidence rate is still high. It is necessary to strengthen the vaccination of children of school age, especially those less than 12 months old.

To analyze the effect of serum uric acid (UA) on cognitive function in patients with Alzheimer’s disease (AD).

The cognitive function of 259 patients with AD who were followed up more than 3 times in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) follow-up cohort were measured by Mini-Mental State Examination (MMSE). The trajectory analysis model was used to classify the subjects according to the changing trend of MMSE scores during the follow-up period. Taking different trajectory groups as dependent variables and serum UA as independent variables, multi-classification Logistic regression analysis was used to explore the effect of serum UA on cognitive function in patients with different types of AD after adjusting various confounding factors.

According to the trajectory model, the subjects were divided into three subgroups: cognitive sudden decline group, cognitive slow decline group, and cognitive stationary group. There was significant difference in serum UA among different trajectory subgroups (F=4.910, P=0.008). After adjusting for the influence of bio-behavioral-disease potential confounding factors, multi-classification Logistic regression found that serum UA was an independent risk factor for the outcome of cognitive slow decline group (cognitive slow decline group: OR=1.35, 95%CI: 1.03-1.77).With each increase of 10 mg/L in UA level, the risk of cognitive decline in AD patients in cognitive slow decline group was 35%higher than that in cognitive stable group. In the cognitive sudden decline group, there was no risk association between UA and cognitive function.

Compared with those with stable cognitive development, high level of serum UA is a risk factor for slow cognitive decline in patients with AD.

To investigate the related factors of death in patients with drug-resistant tuberculosis in Henan Province.

The data of tuberculosis patients diagnosed in all 18 prefecture-level cities and 2 directly administered counties in Henan Province from 2011 to 2021 were selected. The patients with complete course of treatment and treatment outcome were selected. The cumulative survival rate was calculated by Kaplan-Meier method, and Cox proportional hazard regression was used to identify the factors affecting the survival time of patients.

Among the 1 078 patients with drug-resistant tuberculosis, a total of 66 patients (6.1%) died, and the cumulative survival rate within 30 months was 90.1%. In total 50% of the patients died within 10 months. After controlling other factors, age (HR=1.053, 95%CI: 1.029-1.087), XDR-TB patients (HR=3.032, 95%CI: 1.584-5.767), smoking (HR=1.879, 95%CI: 1.006-3.509) and BMI (HR=0.294, 95%CI: 0.088-0.978) were the main risk factors for death of tuberculosis patients during treatment.

Among drug-resistant tuberculosis patients in Henan Province, elderly patients, XDR-TB patients, smoking patients and patients with BMI less than 18.5 have a relatively higher risk of death. Additional support should be provided for the treatment of these patients to reduce mortality.

To describe the distribution characteristics of the duration of respiratory events in patients with obstructive sleep apnea (OSA) and analyze the predictive factors of nocturnal minimum blood oxygen saturation.

A total of 265 OSA patients who underwent polysomnography (PSG) in the Sleep Medicine Center of the West China Fourth Hospital of Sichuan University from January to December 2022 were divided into mild, moderate, and severe groups according to their Apnea Hyponea Index (AHI) values. The differences of basic information and sleep parameters dominated by respiratory events were described. The correlation factors of nocturnal lowest oxygen saturation were selected, and the factors with r > 0.3 were included in the multiple linear regression model.

With the aggravation of OSA, the proportion of male, smoking and drinking increased, neck circumference, apnea index, longest apnea time, snoring index, and maximum systolic blood pressure increased (P < 0.05). The lowest oxygen saturation at night was correlated with sex, age, BMI, apnea index, longest apnea time, and average apnea time. Multiple linear regression results showed that the longest apnea time, apnea index, BMI, and the highest systolic blood pressure were negatively correlated with the lowest nocturnal oxygen saturation (P < 0.05). The longest apnea time was the strongest predictor of the lowest nocturnal oxygen saturation (standardized β=-0.516, P < 0.05, 95%CI: -0.579 to-0.453).

The longest apnea time plays an important role in evaluating the severity of OSA and predicting the lowest blood oxygen saturation at night.

To analyze the relationship between obstructive sleep apnea (OSA) and nocturnal blood pressure, and to evaluate the possible effect of obesity in this association, so as to provide reference for further exploring the mechanism of OSA-related hypertension.

A total of 753 adult patients diagnosed with OSA were randomly selected from August 2021 to December 2022 in the Sleep Medicine Center of the Fourth West China Hospital of Sichuan University because of snoring, apnea, and other reasons. After polysomnography (PSG) was completed, 753 adult patients diagnosed with OSA were selected as research subjects. The general data of patients, PSG related data, nocturnal blood pressure and related indicators were collected. Correlation analysis and structural equation model were used to analyze the effects of OSA and obesity on nocturnal blood pressure.

In patients with OSA, Apnea Hyponea Index (AHI) was positively correlated with systolic blood pressure (SBP), diastolic blood pressure (DBP) (r=0.297 and 0.222, P < 0.001), and BMI (r=0.443, P < 0.001), and BMI was positively correlated with SBP and DBP (r=0.313 and 0.260, P < 0.001). The results of structural equation model suggested that obesity played an intermediary role in the effect of OSA on nocturnal SBP and DBP. The standardized intermediary effect values were 0.063 (95%CI: 0.035-0.090) and 0.059 (95%CI: 0.032-0.087), respectively, and the proportion of intermediary effect was 21.72% and 26.22%, respectively.

OSA can directly affect the blood pressure of patients. At the same time, obesity plays an intermediary role in the effect of OSA on SBP and DBP.