To analyze the epidemiological trends of lung cancer in China and the world from 1990 to 2021, and to predict future standardized morbidity and mortality. By assessing the key factors affecting the burden of lung cancer, such as age, time period and birth cohort, the aim is to reveal the risk patterns of morbidity and mortality in different groups, provide a scientific basis for lung cancer prevention and control strategies, and support disease prevention, early intervention and resource allocation optimization.

The data of this study were from the Global Burden of Disease 2021 (GBD 2021) database. Statistical analysis was performed using R 4.4.1 software. The annual percent change (APC) and average annual percent change (AAPC) were calculated by Joinpoint regression model to evaluate the trend of lung cancer incidence and mortality. At the same time, the age-period-cohort model combined with the endogenous factor algorithm (IE) was used to decompose and analyze the age, period and cohort effects, and to evaluate the independent effects of each factor on the risk of morbidity and mortality.

From 1990 to 2021, the average annual standardized incidence of lung cancer in China increased by 0.95%(95%CI: 0.76%-1.13%, P<0.001 ), and the average annual standardized mortality increased by 0.38%(95%CI: 0.13% -0.63%, P=0.003). The global standardized incidence of lung cancer decreased by 0.25%(95%CI: -0.36% -0.13%, P<0.001), and the global standardized mortality decreased by 0.54 %(95%CI: -0.7% -0.37%, P<0.001). It is estimated that the overall standardized incidence of lung cancer in China will decrease to 57.78/100 000 by 2044.It is estimated that the overall standardized incidence of lung cancer in China will decrease to 57.78/100 000 by 2044. The standardized incidence rate of male decreased to 73.59/100 000, and the standardized incidence rate of female increased to 44.80/100 000. The global standardized incidence of lung cancer decreased to 29.82/100 000. During the same period, the overall standardized mortality rate of lung cancer in China decreased to 48.23/100 000. The standardized mortality rate of males decreased to 62.88/100 000, while that of females increased to 36.18/100 000. From 1990 to 2021, the RR value of the period change of lung cancer incidence in China increased year by year, and the RR value of the period change of mortality increased first and then decreased. The cohort effect of lung cancer incidence and mortality also showed a trend of increasing first and then decreasing.

From 1990 to 2021, the incidence and mortality of lung cancer in China continued to rise, while the world showed a downward trend. The incidence and mortality of lung cancer increased with age, and men were significantly higher than women. The period effect increased year by year, and the cohort effect increased first and then decreased. The prediction shows that the incidence and mortality of lung cancer in China and the world will decline as a whole from 2022 to 2044, and the global data is positively correlated with SDI.

To analyze the correlation between the Geriatric Nutritional Risk Index (GNRI) and the risk of all-cause and cardiovascular disease (CVD) mortality in elderly populations, and to investigate whether the Cardiovascular-Kidney-Metabolic Syndrome (CKM) modulates this association.

This study was based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) cohort data from 2014 to 2018. The baseline was set in 2014, and participants were prospectively followed for 4 years until the follow-up ended in 2018. Participants were divided into two groups according to the Geriatric Nutritional Risk Index (GNRI): the nutritionally normal group (GNRI ≥ 98) and the malnutrition group (GNRI < 98). Kaplan-Meier analysis and log-rank tests were used to assess differences in survival rates between the groups. Restricted cubic spline (RCS) analysis was employed to explore the non-linear relationship between GNRI and survival risk. Cox proportional hazards models were used to evaluate the associations of GNRI and CKM stratifications with survival risk and to investigate the interaction effect of CKM staging.

A total of 1 725 elderly participants were included, and during the 4-year follow-up, 530 cases of all-cause mortality and 160 cases of CVD mortality were recorded. Significant differences in survival probabilities of all-cause and CVD mortality were observed among different GNRI groups (both P<0.001). GNRI showed a linear negative correlation with both all-cause and CVD mortality risks (P<0.001, P for non-linearity>0.05). After adjusting for confounding factors, compared to the nutritionally normal group, the elderly in the poor nutrition group had a 63% higher risk of all-cause mortality (HR=1.63, 95%CI: 1.34 - 1.97) and a 45% higher risk of CVD mortality (HR=1.45, 95%CI: 1.01 - 2.07). Additionally, CKM staging had a significant modulating effect on the association between GNRI and all-cause mortality risk (P for interaction < 0.05), but it did not have a significant modulating effect on the association between GNRI and CVD mortality risk (P for interaction > 0.05).

GNRI is an independent predictor of all-cause and CVD mortality risk in elderly populations, and its protective effect against all-cause mortality risk is more pronounced in patients with earlier CKM staging.

To analyze the association between Body Roundness Index (BRI) and to cardiometabolic comorbidities among individuals aged 35-75 years in Zhejiang Province.

Residents aged 35-75 years recruited in the 2022 China National Nutrition and Health Survey (Zhejiang region) were selected as the study population. Statistical analyses were performed using R 4.3.3 and SPSS 30.0. The χ² test and logistic regression were used to evaluate the impact of BRI on cardiometabolic diseases.

The overall prevalence rates of hypertension, diabetes, dyslipidemia, coronary heart disease, stroke, and cardiometabolic comorbidities in Zhejiang residents aged 35-75 years were 41.43%, 15.46%, 40.07%, 1.20%, 0.78%, and 27.99%, respectively. Logistic regression analysis showed that after adjusting for confounders, individuals in the fourth quartile (Q4) of BRI had a higher risk of hypertension (OR=4.10, 95%CI: 3.11-5.38）, diabetes (OR=3.18, 95%CI: 2.20-4.61), dyslipidemia (OR=3.84, 95%CI: 2.95-5.00), coronary heart disease (OR=3.40, 95%CI: 0.74-15.71), stroke (OR=1.10，95%CI: 0.34-3.56) and cardiometabolic comorbidities (OR=5.20, 95%CI: 3.76-7.13) compared with the first quartile (Q1). Female participants (OR=1.43, 95%CI: 1.28-1.60) had a lower risk compared to males (OR=1.70，95%CI: 1.48-1.96). Significant interaction effects of age and smoking on the risk of cardiometabolic comorbidities were observed, with the risk significantly higher in middle-aged adults (35-54 years). In a population with normal BMI, ROC curve analysis indicated that BRI was superior to BMI in predicting the risk of CMM, however, both AUC values were below 0.7, suggesting that the predictive ability remains weak.

Higher BRI levels were positively associated with cardiometabolic comorbidities. To identify high-risk populations for cardiometabolic comorbidities early, targeted management and intervention strategies should be implemented to reduce the burden of cardiometabolic diseases. However, caution is warranted when promoting the use of BRI in public health and clinical practice, as further research is needed to validate its effectiveness.

To investigate the independent effects and interaction of smoking and shift work on anxiety, depression, and Comorbid Anxiety and Depressive symptoms (CAD) among steelworkers.

Steelworkers undergoing occupational health check-ups from March to September 2017 were studied. Anxiety, depressive symptoms and CAD were assessed using the SAS self-assessment questionnaire and the SDS self-assessment questionnaire. Basic information of workers, demographic characteristics, smoking, and shift data were collected using the Health Assessment Questionnaire. The shift-weighted index (WSI) and smoking index were analyzed for the dose-response relationship between them and the CAD; the WSI were grouped according to the Akaike information crite-rion. Logistic regression analyzed the relationship between smoking, shift work (WSI), and anxiety, depression, and CAD. And to explore the interactive effect of both on CAD.

A total of 3 657 workers were included in this study. The detection rates for anxiety, depression, and CAD were 28.63%, 27.15%, and 22.52%, respectively. WSI > 159 and a smoking index ≥ 200 were independent risk factors for these conditions. Smoking and shift work showed multiplicative and synergistic effects on CAD, with SI, RERI, and AP of 11.86 (8.54-16.47), 28.94 (8.42-49.47), and 0.89 (0.84-0.93), respectively.

Both smoking and shift work increase the risk of anxiety, depression, and their comorbidity. Their combined presence significantly elevates CAD risk in steelworkers. Proper health management measures are recommended to improve mental health.

To analyze the influencing factors of hearing loss among workers in different workshop noise operations in a certain automobile manufacturing enterprise, and propose corresponding protective suggestions.

A stratified cluster sampling method was employed, and on-site questionnaire surveys were conducted to collect basic information, personal history, occupational history, and exposure status of the study subjects. Physical examinations were performed to obtain their hearing results. The study subjects were divided into four groups based on different workshops: the stamping workshop, the assembly workshop, the painting workshop, and the welding workshop. They were also categorized into two groups based on hearing: the normal hearing group and the hearing loss group. The relationship between various exposure characteristics and hearing loss was analyzed for 1 411 noise-exposed workers who met the inclusion and exclusion criteria, categorized by different workshops and hearing groups.

The detection rate of hearing loss in the research subjects was 20.13% (284/1 411), with the highest detection rate in the assembly workshop (25.00%). There was a statistically significant difference in the detection rate of hearing loss among different workshops (P<0.05). The differences in noise exposure levels and noise exposure duration among the four workshops were statistically significant (P<0.05); The detection rate of hearing loss in noise combined with organic solvent exposure was the highest (34.55%), significantly higher than that in noise combined with dust (21.69%), noise combined with other factors (20.00%), and noise alone (15.47%), with statistically significant differences between the groups (P<0.01). The detection rate of hearing loss in the noise combined with organic solvent exposure group was the highest in the final assembly and welding workshops, and the differences between different exposure groups in the two workshops were statistically significant (P<0.05). Logistic regression showed that workers exposed to noise combined with organic solvents and noise combined with dust had 2.67 times (P<0.01) and 1.43 times (P<0.05) higher risk of hearing loss, respectively, compared to those exposed to noise alone.

The exposure of noise combined with organic solvents and noise combined with dust in automobile manufacturing enterprises is the main influencing factor of hearing loss among workers. The detection rate of hearing loss in the final assembly workshop is the highest. Therefore, it is necessary to strengthen noise control and health protection in the workplace, and implement occupational health monitoring.

To investigate the association between dietary lycopene intake and cognitive function in adults aged 60 years and older.

Participants were selected from adults aged 60 years and older in the 2011-2014 NHANES database. A logistic regression model was constructed and adjusted for confounding factors such as age and gender to explore the relationship between dietary lycopene intake and cognitive function in older adults.

A total of 2 524 participants were included in this study, with a median dietary lycopene intake of 1 905.25 mcg. After adjusting for age, gender, and other confounding factors, the logistic regression model showed a significant negative correlation between cognitive impairment and dietary lycopene intake in immediate recall test (OR=0.75; 95%CI: 0.58-0.98), delayed recall test (OR=0.78; 95%CI: 0.60-0.99), and digit-symbol substitution test (OR=0.67; 95%CI: 0.49-0.91). Additionally, a significant negative correlation was observed between cognitive impairment and dietary lycopene intake based on composite cognitive scores (OR=0.67; 95% CI: 0.50-0.90). Trend analysis indicated that the risk of cognitive impairment decreased progressively with increasing dietary lycopene intake.

Dietary lycopene intake is negatively correlated with cognitive impairment in older adults. Increased lycopene intake may reduce the risk of cognitive impairment in the elderly.

To investigate the protective effect of folic acid on the epithelial-mesenchymal transition (EMT) induced by N-methyl-N ’-nitro-n-nitroguanidine (MNNG) and its signaling mechanism.

SD rats were randomly divided into blank group, model group, low-dose, medium-dose and high-dose folate groups (1.25, 2.5, 5 mg/kg), control group was given 10 mL/kg normal saline, and other groups were given 25 mg/kg MNNG.All were administered with free drinking water once a day for 12 weeks. After 12 weeks, the expression of E-cadherin and N-cadherin protein was observed by immunohistochemistry. The expressions of E-cadherin, ZO-1, N-cadherin and Vimentin were detected by Western blot. In vitro (0.1, 0.2, 0.4 μg/mL), the concentration of folic acid was treated with 20 μmol/L MNNG for 24 h, and the mRNA transcription levels of E-cadherin, ZO-1, N-cadherin, Vimentin, TGF-β, Wnt/β-catenin, JAK/STAT 3 signaling pathways were detected by RT-qPCR. The expressions of E-cadherin, ZO-1, N-cadherin and Vimentin were detected by Western blot.

Compared with the model group, folic acid could improve the precancerous lesions caused by MNNG, up-regulate the expression of E-cadherin (F=90.3，P<0.001) and ZO-1 protein (F=188.9，P<0.001), and down-regulate the expression of N-cadherin (F=68.9，P<0.001) and Vimentin protein (F=82.6，P<0.001). The results of cell Western blot showed that compared with the control group, the expression levels of E-cadherin and ZO-1 were decreased, decreasing to 63.7% (95%CI: 0.589-0.675, P<0.001) and 57.1% (95%CI: 0.494-0.706, P<0.001) of the control group. Cell RT-qPCR results showed that compared with the model group, E-cadherin mRNA levels were increased (F=8.5, P=0.007), the expression of ZO-1 mRNA increased (F=31.5, P<0001), N-cadherin mRNA levels were decreased (F=34.1, P<0.001), and the expression of Vimentin mRNA decreased (F=17.8, P<0.001).Cell RT-qPCR confirmed that MNNG can promote the transcription of key mRNA in TGF-β signaling pathway, Wnt/β-Catenin signaling pathway, and JAK/STAT 3 signaling pathway. The downstream transcription factors snail and ZEB1 mRNA transcription were activated, while folic acid could antagonize the process.

Folic acid has certain protective ability against MNNG induced esophageal epithelial-mesenchymal transformation, which may be related to inhibiting the activation of JAK/ STAT3 signaling pathway.

To investigate the effects of blackcurrant on lipid metabolism and intestinal flora in High-Fat Diet mice.

A total of 150 C57BL/6J mice aged 7-8 weeks were selected, with half male and half female. Twelve mice were randomly selected and fed a normal diet as a blank control group. The other mice were fed a high-fat diet for 8 weeks, and the mice with successful obesity modeling were selected and randomly grouped according to gender. The 60 mice were divided into four groups, including high-fat（normal saline）, low-dose（1 250 mg/（kg·d））, medium-dose（2 500 mg/（kg·d））, and high-dose（5 000 mg/（kg·d））, with six mice in each group. The subjects were given continuous gavage for 10 weeks. To evaluate the effect of the intervention and explore the possible mechanism of the intervention. The results were described by (). Differences between groups were tested by ANOVA (α=0.05).

There were significant differences in liver weight, liver coefficient and kidney weight between ND female group and HFD female group and each subject group (P<0.05). The subcutaneous fat mass, perirenal fat mass, perirenal fat mass, and mesenteric fat mass in the ND male group were significantly different from those in the HFD male group and the LOW male group (P<0.05). The subcutaneous fat mass, perirenal fat mass and uterine fat mass of ND female mice were significantly different from those of HFD female group and LOW female group (P<0.05). There were significant differences in TC, TG, HDL-C and LDL-C between the ND male group and the HFD male group and the HIGH male group (P<0.05), and there were significant differences in TG and LDL-C between the ND female group and the HFD female group, the LOW female group and the HIGH female group (P<0.05). There was a significant difference in ALT among the groups (P<0.05). The cells of the liver tissue and adipose tissue in the ND group were intact, and the cells in the HFD group had large fat vacuoles, and the cells in each test group tended to return to normal levels. There was a significant difference in β-diversity among the four groups (P<0.01). The changes in the abundance of Firmicutes, Bacteroidota, and Verrucomicrobiota were also observed (P<0.05).

Blackcurrant can reduce body fat and visceral fat, regulating blood lipid metabolism, protect liver function and regulate intestinal flora.

To investigate the association between dietary oxidative balance score (DOBS) and the risk of sarcopenia in patients with hypertension.

Patients with hypertension aged 20 years and above who participated in four survey cycles of the National Health and Nutrition Examination Survey (NHANES), 2011-2018. Weighted logistic regression and restricted cubic spline were used to analyze the association between DOBS and the risk of sarcopenia in patients with hypertension, and subgroups analysis was performed according to gender and age.

A total of 2 775 patients with hypertension were included, with 349 (12.6%) diagnosed with sarcopenia. After adjusting for multiple covariates, higher DOBS were significantly associated with decreased risk of sarcopenia in patients with hypertension. For each one-point increase in DOBS, the risk of sarcopenia in patients with hypertension was reduced by 11.4% (OR=0.886, 95%CI: 0.842-0.933). As a categorical variable, the OR of DOBS Q3 group was 0.331 (95%CI: 0.116-0.941) and the OR of Q4 group was 0.124 (95%CI: 0.051-0.301) compared with Q1. A restricted cubic spline model indicated a linear negative dose-response association between DOBS and sarcopenia in patients with hypertension (P _non-linear=0.148). Subgroup analysis indicated no significant interaction of gender and age on the association of DOBS and sarcopenia in patients with hypertension (P _interaction > 0.05).

Higher DOBS is significantly associated with a lower risk of sarcopenia in patients with hypertension.

To understand the current status of varicella vaccination among age-eligible children in Chuxiong Prefecture and its influencing factors, in order to provide a reference basis for improving the varicella vaccination rate among age-eligible children throughout the prefecture.

Using multi-stage stratified random sampling, a questionnaire survey was conducted from May to August 2023 among guardians of children aged 1-14 years in three counties and cities of Chuxiong Prefecture, which included basic information, varicella vaccination information, varicella, and knowledge of varicella vaccine. To analyze the influencing factors of varicella vaccination in age-eligible children.

A total of 1 924 questionnaires were collected and 1 921 questionnaires were valid, with a validity rate of 99.84%. 1 918 study participants were finally included in the analysis, with a varicella vaccination rate of 35.82% among children and an overall knowledge rate of varicella and varicella vaccine among guardians of 58.33%. The results of multifactorial analysis showed that living in the city (OR=2.00, 95%CI: 1.62-2.48), per capita monthly family income >10 000 (vs. per capita monthly family income <2 000, OR=2.47, 95%CI: 1.33-4.59), and parental occupation of medical personnel or retired (vs. occupation of housework and inactive work, OR=1.63, and 95%CI: 1.03-2.58), and future willingness to be vaccinated against varicella (OR=5.06, 95%CI: 3.39-7.56) had higher varicella vaccination rates among age-eligible children.

The varicella vaccination rate is low among age-eligible children in Chuxiong Prefecture, and publicity and education on vaccination should be strengthened to increase the willingness of parents of age-eligible children to receive the vaccine, thereby increasing the varicella vaccination rate.

To determine the optimal cut-off point of the General Self-Efficacy Scale (GSES) among middle school students and to establish a precise criterion for evaluating their self-efficacy.

A convenience sampling method was conducted a total of 2 494 junior high school students from grades 7-9 in two junior high schools in Guangzhou were selected for a questionnaire survey. The questionnaire includes demographic characteristics such as students’ gender, grade, and age, general self-efficacy, sleep, family functioning, and smartphone dependence. The latent profile analysis (LPA) was used to classify students’ self-efficacy, and the optimal cut-off point was determined based on the Receiver Operator Characteristic curve (ROC) and the Volume Under the ROC Surface (VUS).

A total of 2 494 middle school students were surveyed in this study. There were 1 285(51.52%) boys and 1 209(48.48%) girls. The self-efficacy of boys was 27(22-31) and that of girls was 24 (20-29), which is statistically significant different (Z=-7.86, P<0.01). LPA identified three categories of self-efficacy: low (862, 34.56%), medium (1 166, 46.75%), and high (466, 18.69%) self-efficacy types. The VUS method determined the optimal cut-off points for the GSES scale to be 22 and 32 points, respectively.The results of the ordinal logistic regression analysis showed that females (OR=1.58, 95%CI: 1.34-1.86), mild family dysfunction (OR=2.86, 95%CI: 2.38-3.44), severe family dysfunction (OR=4.46, 95%CI: 3.51-5.68), mobile phone addiction (OR=1.58, 95%CI :1.1-1.64), and lack of regular exercise (OR=1.75, 95%CI: 1.43-2.15) were positively associated with low self-efficacy, while sleeping time ≥9 hours (OR=0.78, 95%CI: 0.66-0.93) and outdoor activity time ≥1 hour (OR=0.8, 95%CI: 0.65-0.97) were negatively correlated with low self-efficacy among middle school students.

This study provides a clear and scientific assessment criterion for evaluating the self-efficacy level of middle school students through the combination of LPA and VUS methods, offering a powerful tool for more accurate assessment of middle school students’ self-efficacy.

To investigate the association between newly developed non-alcoholic fatty liver disease (NAFLD) in the third trimester of pregnancy and adverse pregnancy outcomes, and to evaluate the necessity of prevention, monitoring, and health education for NAFLD during pregnancy.

This retrospective study included 3 505 singleton primiparous pregnant women without NAFLD in early pregnancy, registered at Beijing Friendship Hospital, Capital Medical University, from March 2020 to December 2022. Logistic regression analysis was used to investigate the association between newly developed NAFLD in the third trimester and adverse pregnancy outcomes, including cesarean section, preterm birth, small-for-gestational-age infants, large-for-gestational-age infants, and postpartum hemorrhage.

After adjusting for factors such as maternal age, gravidity, pre-pregnancy body mass index (BMI) level, gestational weight gain level, relevant medical histories, and educational level, the risk of postpartum hemorrhage was found to be increased in women with newly developed NAFLD in the third trimester (OR=2.136, 95%CI: 1.009-4.080, P=0.031). No statistically significant associations were found with cesarean section, preterm birth, small-for-gestational-age infants, or large-for-gestational-age infants.

A positive association between newly developed NAFLD in the third trimester of pregnancy and postpartum hemorrhage was revealed, highlighting the importance of strengthening surveillance and prevention for NAFLD during pregnancy to reduce the risk of postpartum hemorrhage.

To evaluate the quality of life of the urban older adults with comorbidity from a multi-dimensional perspective, and to verify the influencing factors of the quality of life of the urban older adults with comorbidity by combining the theory of social embeddedness mechanisms.

The questionnaire data of 465 urban older adults with comorbidity were selected as the study sample. One-way ANOVA and independent samples t-test analysis were used to test the differences of different demographic characteristics in the quality of life of the urban older adults with comorbidity, and AMOS 28.0 was used to construct a social embedding structure model of the quality of life of the urban older adults with comorbidity.

The perceived quality of life among urban older adults with comorbidity was rated at a moderate level. In addition, there were significant differences in the quality of life of urban older adults with comorbidity with different genders, ages, marital status, education level, work status, and retirement status. Social support (β=0.10, P<0.001) and social resources (β=0.20, P<0.001) demonstrated positive effects on the quality of life of urban older adults with comorbidity.

Self-reported quality of life are generally higher among urban older adults with comorbidity. Social scenario has a positive effect on social support, and the quality of life of the urban older adults with comorbidity is indirectly improved by strengthening social support. At the same time, social resources not only directly contribute to the quality of life, but also indirectly have a positive impact through social support paths.

To understand the current status of medication adherence in patients with HIV/AIDS who have failed antiretroviral therapy and to analyze the mediating effect of anxiety in the influence of family care on medication adherence.

A total of 600 patients with HIV/AIDS who failed antiretroviral therapy were included as study subjects, and data on patients’ demographic characteristics, behavioral characteristics, anxiety, family caring and medication adherence were collected through telephone interviews, and mediation analyses were used to analyze the mediating effect of anxiety on the relationship between family caring and medication adherence.

In this survey 29.33% of the population had family care disorder, 15.8% were in anxiety and 56.0% had good medication adherence. The mean score of medication adherence was moderate at 7.15±1.38. Anxiety in HIV/AIDS antiretroviral treatment failure patients fully mediated the effect of family care on medication adherence. The mediating effect (0.033) (95%CI: 0.017-0.053) accounted for 47.8% of the total effect (0.069) (95%CI: 0.033-0.105).

The percentage of local HIV/AIDS patients with good adherence to medication in patients who have failed antiretroviral therapy is relatively low. By increasing the level of family care and helping patients to alleviate anxiety, medication adherence can be effectively improved and treatment outcomes can be improved.

To measure the workload of primary public health services in rural township health centers, providing empirical evidence for the healthy development of the rural medical and health system.

A multi-stage stratified random sampling method was employed to select 50 township health centers in Guangxi. Data related to primary public health services and primary medical services were collected, and the workload of primary public health services was analyzed using the equivalent method.

The Pearson correlation coefficient between the total equivalent value of primary public health services and the number of permanent residents served was r=0.782, P<0.05; the coefficient of variation for the total equivalent value of different types of primary public health services was F=51.061, P<0.05; the coefficient of variation for the unit equivalent value of resident health records established in different regions was F=2.836, P<0.05, and for the unit equivalent value of health and family planning supervision and coordination services in different regions was F=6.346, P<0.05.

The total value of primary public health services is strongly positively correlated with the number of permanent residents served. There is a significant difference in the total workload of different types of primary public health services. There are differences in the work efficiency of units providing resident health record establishment and health and family planning supervision and coordination services in different regions.

To investigate the impact of community environment on the trajectory of cognitive function among older adults in China, providing a reference for promoting the construction of age-friendly communities and actively addressing aging.

Based on the data from the China Longitudinal Aging Social Survey from 2014 to 2020, 4 269 elderly individuals were selected. A group-based trajectory model was applied to construct trajectories of cognitive function changes, and a multinomial unordered logistic regression model was used to analyze the relationship between community environment and trajectories of cognitive function.

Three groups of cognitive function trajectories were identified: “Low Decline Group” (21.06%), “Moderate Stable Group” (66.19%), and “High Stable Group” (12.75%). Taking the “low decline group” as the reference group, after controlling for individual basic characteristics and health characteristics, it was found that the higher the community environment score of the elderly, the more their trajectory tended to be in the “High Stable Group” (OR=1.10, 95%CI: 0.93-1.30; OR=1.41, 95%CI: 1.21-1.66), indicating that the community environment has a protective effect on the cognitive decline of the elderly. Stratified analysis showed that compared to females and the elderly living alone, the improvement of the community environment is more beneficial for males and the non-living alone elderly to slow down their cognitive decline.

There is heterogeneity in the cognitive function trajectories of the elderly, and the community environment affects the attribution of cognitive function trajectories. Optimizing the community environment for males and non-lonely elderly can significantly protect their cognitive function.

To explore the impact of standardized clinical pathway management on the cost changes of anterior cruciate ligament injury of the knee and its value in medical practice, with the intention of providing experience for the reform of clinical pathways for disease types and medical insurance payment systems in the context of the DRG payment system.

The study selected a tertiary general hospital in City L as the research object and utilized the interrupted time series analysis method to compare the data before and after the implementation of clinical pathway management.

After the implementation, the average cost per case of this disease type significantly decreased, and the cost structure was optimized. The main cost items such as drug fees, examination fees, and treatment fees all showed a downward trend. The optimization of hospitalization frequency was limited, and the control of consumable costs still needed to be strengthened.

Although clinical pathway management has achieved certain results, it also faces challenges. During the implementation, it is necessary to be vigilant against the decomposition of hospitalizations, strengthen medical insurance supervision and technical monitoring, and optimize hospital management processes. Emphasis should be placed on the value of medical labor and the adjustment of salary systems. Continuous control of consumables is needed to control costs and optimize resource utilization. In the future, the system should be continuously improved to enhance service quality and efficiency, promote the high-quality development of public hospitals, and advance the reform of medical insurance payment systems.

To develop an evaluation index system for public health emergency response capacity of county-level centers for Disease control and Prevention (CDC) to promote the construction of public health emergency response system and improve the emergency response capacity of county-level CDC in China.

The index system framework was developed based on a literature review and group discussions. The Delphi method was applied to select the evaluation indicators through two rounds of expert consultation involving 26 experts, and the weights of the indicators were determined using the Analytic Hierarchy Process (AHP).

The system included 6 primary indicators, 21 secondary indicators, and 69 tertiary indicators. The weights of each indicator were calculated using the Analytic Hierarchy Process (AHP). The weight of first-level indicators from high to low were emergency response capacity (0.212), emergency system construction (0.199), emergency support capacity (0.175), monitoring and early warning capacity (0.170), emergency team (0.161), information communication and departmental collaboration (0.083). Among the second-level indicators, the weights of training exercise (0.490), early warning and prediction (0.490), and emergency fund guarantee (0.490) were in the top three. The consistency ratio (CR) values for the first-level, second-level, and third-level indicators were all below 0.1, which met the standard requirements of consistency test, and the weight division of indicators was reasonable.

This study provides indicator guidance for improving the emergency response capacity of county CDC, and promote the construction of public health emergency response system in China and the improvement of emergency response capacity of county CDC.

To understand the current situation of self-rated health among older adults, to analyze the influence of good childhood traits on older adults' self-rated health, and to make suggestions for factors with high influence to promote the improvement of health in the whole society.

Using data from the Chinese Family Panel Studies (CFPS), select data for individuals aged≥60, with self-rated health as the dependent variable. Independent variables include age, gender, smoking, drinking, household registration, marital status, education levels, working status, medical insurance, health status before the age of 14, leadership spirit before the age of 14, and adventurous spirit before the age of 14. Employ the χ² test and binary logistic regression to analyze the influencing factors of self-rated health in the elderly. Additionally, use a random forest model to rank the importance of these influencing factors.

Smoking, drinking, higher education levels, being employed, good health status before the age of 14, good leadership spirit before the age of 14, and good adventurous spirit before the age of 14 all have OR values greater than 1 and P<0.05, suggesting they may be protective factors for elderly self-rated health. In contrast, being female and living in rural areas have OR values less than 1 and P<0.05, suggesting they may be risk factors for elderly self-rated health. The top three influencing factors are health status before the age of 14, leadership spirit, and adventurous spirit.

Childhood characteristics have a certain impact on health in old age. To promote the physical health of the elderly, we can improve the physical and mental health of children and cultivate their leadership and adventurous spirit.

To explore the relationship between sleep quality and health-related quality of life (HRQoL) among middle-aged and elderly adults with multiple chronic conditions and their family caregivers based on the actor-partner interdependence model, and to further explore the mediating role of depressive symptoms.

A general information questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Geriatric Depression Scale (GDS-15), and the Short Form Health Scale (SF-36) were used to survey middle-aged and elderly adults with multimorbidity and their family caregivers, and data were analyzed using actor-partner interdependence model.

Participants’ sleep quality negatively predicted their HRQoL, and depressive symptoms partially mediated the relationship between sleep quality and HRQoL (the actor effect). In addition, sleep quality in middle-aged and elderly adults with multimorbidity positively predicted caregivers’ depressive symptoms, which in turn negatively predicted their HRQoL (β=-0.25, P<0.05)(the partner effect).

Sleep quality in middle-aged and elderly adults with multimorbidity and caregivers can affect their own HRQoL through depressive symptoms. The patient’s sleep can influence the caregivers’ depressive symptoms and the caregivers’ depressive symptoms can influence the patient’s HRQoL.

To explore the mediating pathway mechanisms of depression and life satisfaction in the effects of social activities on quality of life in older adults and to inform the enhancement of quality of life in older adults and the achievement of healthy aging.

A stratified whole group sampling method was used to select 893 older adults aged 60 years and above in Kunming and Xuanwei, Yunnan Province. A face-to-face questionnaire survey was conducted, which included general demographic characteristics, frequency of social activities, life satisfaction, Patient Health Questionnaire (PHQ-9), and EuroQoL Five Dimension Questionnaire (EQ-5D-5L). Univariate and Spearman correlation analyses were performed using SPSS, and Tobit regression (stata) and Structural Equation Model (AMOS) were used to analyze the effects of social activities, depression, and life satisfaction on quality of life as well as to test for the chain mediation effect.

The health utility values of quality of life in the elderly ranged from -0.208 to 1.000, and Spearman correlation analysis showed that the quality of life in the elderly was positively correlated with social activities and life satisfaction (r_s=0.07, 0.32, P<0.05); the quality of life was negatively correlated with the condition of depression (r_s=-0.53, P<0.05); the chain mediation effect analysis showed that depression produced independent mediation effect between social activities and the quality of life of the elderly, with an effect coefficient of 0.029 (95%CI: 0.013-0.050); and depression and life satisfaction had a chain mediation effect between social activities and quality of life with an effect coefficient of 0.003 (95%CI: 0.001-0.006).

Active participation in social activities in older adults can reduce their depressive symptoms, thereby increasing their life satisfaction and consequently improving their quality of life.

To analyze the current status of family resilience in stroke patients and the influencing factors, with further exploration of the pathways between the influencing factors.

A convenience sampling method was used to survey 285 stroke inpatients using the General Information Questionnaire, the Family APGAR Questionnaire (APGAR), the Chinese-version Perceived Stress Scale (CPSS-14), and the Family Resilience Assessment Scale for Stroke Patients. Analyzing the mechanism of influencing factors on family resilience through structural equation modeling.

The family resilience score of stroke patients was (103.98±20.19). The results of the structural equation modeling analysis showed that social demography factors of place of residence had a negative indirect effect on family resilience through family functioning (β=-0.259, P<0.001), and per capita monthly family income had a positive indirect effect on family resilience through perceived stress and family functioning (β=0.373, P<0.001). Disease-related factors such as whether it was a first stroke or not, and the degree of dysfunction had a negative indirect effect on family resilience through perceived stress and family functioning (β=-0.140, P<0.001; β=-0.453, P<0.001). Perceived stress had a negative indirect effect on family resilience through family functioning (β=-0.849, P<0.001) and family functioning had a direct positive effect on family resilience (β=0.966, P<0.001).

The family resilience of stroke patients is at a medium level. Emphasis should be placed on stroke patients who live in rural areas, have a lower economic level, have a first stroke, and have a higher degree of dysfunction. Family resilience can be effectively improved by enhancing family functioning and reducing perceived stress.

To investigate the impact of omorbidities on sleep duration in middle-aged and elderly individuals in China.

This study was a cross-sectional analysis using data from the 2020 China health and retirement longitudinal study database to examine the relationship between comorbidities and sleep duration. Directed acyclic graphs were used to identify potential confounding factors. Overlap weighting and linear regression with double confounding adjustment were applied to minimize group differences and make inter-group comparisons more akin to a randomized trial. The impact of comorbidities on sleep duration was explored through linear regression, and sensitivity analyses were conducted to verify the robustness of the results, with subgroup analyses performed.

A total of 17 010 participants aged 45 years and older were included in the analysis. The results indicated that comorbidities affected individual sleep duration. Individuals with multimorbidity had a sleep duration that was approximately 0.12 hours shorter compared with those without multimorbidity (B=-0.121 4, P<0.05). Sensitivity analysis showed an E-value of 1.48. Furthermore, this impact was more pronounced in females (B=-0.159 4, P<0.05) and in the middle-aged group (45-60 years) (B=-0.225 8, P<0.05).

There is a difference in sleep duration between middle-aged and elderly individuals with chronic disease comorbidity, with a more pronounced effect observed in females and the middle-aged group. The study utilizes overlap weighting, demonstrating the significant impact of comorbidities on sleep duration, providing empirical evidence for improving sleep conditions in this population.

To investigate the effects of the combination of all-trans retinoic acidand tofacitinib on human fibroblast-like synoviocytes from rheumatoid arthritis and explorethe mechanisms of autophagy and apoptosis in the NF-κB signalingpathway.

Cells were adaptively cultured and stimulated with TNF-α and IL-1β.Subsequently, HFLS-RA cells were intervened with ATRA, tofacitinib, and their combination.Cell proliferation rate, migration ability, inflammatory cytokine concentrations, and apoptosis levels were detected. Different concentrations of ATRA, autophagy inhibitor (3-MA), andtheir combination were also used to intervene, and relevant protein expressions were detected by Western Blotting.

The combined use of ATRA and tofacitinib inhibited the proliferation and migration of HFLS-RA cells, upregulated IL-6 and IL-10 levels, downregulated IL-17 and VEGF levels, and promoted early apoptosis. Different concentrations ofATRA downregulated Bcl-2, upregulated IκBα, and affected the expression of XIAP, P65, and IKKα/β. The combination of autophagy inhibitor 3-MA and ATRA further upregulated IκBα, downregulated Bcl-2, IKKα/β, and P65.

ATRA may inhibit the activationof the NF-κB pathway by suppressing cell proliferation and migration, downregulating IL-6levels, and inducing apoptosis.

To investigate the potential role of ferroptosis in the neurotoxicity induced by deltamethrin (DM) exposure.

Mice hippocampal neuronal cells HT22 cells were treated with DM at different doses (1, 2, 5, 10, 20, 50, 100, 200, and 400 μmol/L) for 24 h, cell survival rate was detected by MTT method to determine the optimal dose (2, 10, and 50 μmol/L). The cell morphology was observed by microscope. The level of lipid peroxidation was detected by flow cytometry. The level of glutathione (GSH) and the content of ferrous ion (Fe²⁺) were detected by the kit. The levels of ferritin heavy chain (FTH), light chain (FTL) protein and glutathione peroxidase 4 (GPX4) were detected by Western Blotting.

With the increase of DM dose, the number of HT22 cells gradually decreased, the morphology changed and the tentacles antennae broke. Compared with the control group, the survival rate of DM infected groups were significantly decreased (F=349.8, P<0.01), and the level of intracellular lipid peroxidation was significantly increased (F=14.86, P<0.01). With the increase of dose, GSH level in HT22 cells in 2, 10 and 50 μmol/L DM groups was significantly lower than that in control group (F=11.56, P<0.01), and Fe²⁺ level in 10 and 50 μmol/L DM groups was significantly higher than that in control group (F=17.67, P<0.01). Compared with the control group, GPX4 and FTL protein expressions in the 50 μmol/L DM group were significantly decreased with the increase of dose (F_GPX4=3.313, P<0.05; F_FTL=2.003, P<0.05), and FTH protein expressions in the 2, 10, 50 μmol/L DM groups were significantly increased with the increase of dose (F=16.95, P<0.01). Pretreatment with Fer-1, an ferroptosis inhibitor, for 2 h significantly reversed GSH, lipid peroxidation and Fe²⁺ levels in 50 μmol/L DM group (F_GSH=215.5, P<0.01; F_{lipid p eroxide}=17.97, P<0.01; F_Fe²⁺=23.26, P<0.01).

DM exposure induces ferroptosis in HT22 cells of mice hippocampal neurons leading to neurotoxicity, the mechanism of which may be related to intracellular lipid peroxidation and iron metabolism disorder.

To analyze the alarm information of monitoring platform for vaccine cold chain in Shandong Province and to provide scientific basis for improving the cold chain guarantee level of vaccines.

We have collected data on overtemperature and blackout alarms from January 1 to December 31, 2024 in Shandong Province through the cold chain monitoring platform, and descriptive analysis was conducted by season, region, and unit type.

The cold chain monitoring platform in Shandong Province is equipped with 5 463 data recording devices and 25 159 data collection devices, which monitor in real-time the temperature of vaccine storage and transportation in 16 cities’ Centers for Disease Control and Prevention and vaccination units throughout the province. The summer month of July has the highest number of alarm information, with an average of 4.2 for overtemperature and 2.0 for blackout alarm. The winter month of December has the lowest number of alarm information, with an average of 1.1 for both overtemperature and blackout alarms. The average number of overtemperature alarms in Tai’an City, Rizhao City, and Heze City exceeds 40, while the average number of overtemperature alarms in Jining City is at least 17.6. The average number of blackout alarms in Binzhou City, Liaocheng City, Heze City, and Dezhou City exceeds 20, while Jinan City has the lowest number of blackout alarms, with an average of 10.1. The CDC has the highest number of overtemperature alarms, with an average of 59.7 alarms. The routine vaccination clinic has the highest number of blackout alarms, with an average of 19.8 alarms. The average number of overtemperature alarms and blackout alarms in the rabies exposure prevention and treatment outpatient department are relatively high, with 48.2 and 18.8 alarms, respectively.

There are seasonal, regional, and unit type differences in vaccine cold chain alarms, and targeted measures should be taken to strengthen vaccine cold chain management and ensure vaccine safety.

To investigate the current status of tuberculosis(TB) infection prevention and control in primary health care institute in Chongqing.

According to evaluation criterion of the Guideline on tuberculosis infection prevention and control in primary health care institute,the survey was conducted on 146 community health service centers and 506 township health centers in Chongqing. The data of tuberculosis infection prevention and control was collected and analyzed, including organizational management, outpatient settings and workflow, ventilation and disinfection, and personal respiratory protection. SPSS 25.0 soft for descriptive statistical analysis.

In organizational management measures, the proportion of infection control work included in the situation, training and assessment, plan formulation, and system establishment were all above 90%. There were statistically significant difference in the proportion of implementing regular evaluation mechanisms, establishing regular physical examination systems, and equipping tuberculosis infection control related facilities and items in different regions(P<0.05). In the setting and workflow of outpatient clinics, the proportion of online direct reporting (95.71%) and pre-examination triage system (90.18%) was relatively high, the proportion of institutions with separate tuberculosis waiting areas, consultation rooms, and supervision drug rooms/health management rooms (40.34%), as well as prominent signs, notices, directional signs (46.47%), was relatively low. There were statistically significant differences in the proportion of institutions with separate TB waiting areas, consulting rooms and supervision drug rooms/health management rooms in different regions, establishing a pre-screening triage system, and arranging priority for patients with suspected symptoms of TB or suspected TB patients or tuberculosis patients(P<0.05). 82.36% of institutions had good ventilation, and 61.04% of institutions mainly used mobile UV disinfection vehicles for UV disinfection. There was no statistically significant difference in ventilation, disinfection, and personal respiratory protection measures(P>0.05).

The prevention and control of tuberculosis infection in primary health care institute in Chongqing is generally good, but there are still weak links. It is necessary to further strengthen the outpatient setting of primary health care institute, the allocation of health resources in Wuling Mountain Area in southeast Chongqing, establish a regular physical examination system for tuberculosis, improve environmental facilities, enhance the personal protection awareness of medical personnel, and reduce the risk of tuberculosis infection.

To analyze the molecular transmission network characteristics and drug resistance of newly reported human immunodeficiency virus type 1 (HIV-1) infected individuals in Guiyang City, to provide a basis for epidemic trends and preventive and control measures.

Blood samples and demographic information of newly reported HIV-1 infected individuals who did not receive antiviral therapy in Guiyang City from 2021 to 2023 were collected. The obtained pol region gene sequences were uploaded to the Stanford University HIV drug resistance database for genotype and drug resistance analysis, and molecular transmission network was constructed based on the optimal gene distance (d=1.5%) and analyzed for factors influencing entry into the network.

A total of 171 samples were collected, and 123 (71.93%) were successfully amplified to obtain valid sequences. Six genotypes were found, mainly CRF07_BC (54.5%, 67/123) and CRF01_AE (24.4%, 30/123). A total of 38 sequences were integrated into the network, with an integration rate of 30.89%. 13 molecular clusters were formed, and the number of cases in the clusters ranged from 2 to 9. Multivariate Logistic regression results showed that heterosexual transmission, CRF07_BC and CRF01_AE were more likely to enter the network(P<0.05). CRF07_BC in Chongqing, Guangxi, Yunnan and Guiyang had cross-regional transmission. The drug resistance rate of 123 samples before treatment was 17.07% (21/123), the drug resistance rates were 7.32% for non-nucleoside reverse transcriptase inhibitors (NNRTIs), 3.25% for nucleoside reverse transcriptase inhibitors (NRTIs), 3.25% for protease inhibitors (PIs), and four samples showed dual drug resistance.

The genotypes of newly reported HIV-1 infected individuals in Guiyang were mainly CRF07_BC and CRF01_AE. CRF07_BC is closely related to Chongqing and Guangxi. The drug resistance rate of HIV-1 before treatment was high. In the future, we should continue to build molecular transmission networks for long-term monitoring of the area, cooperate with neighboring provinces and cities to take effective AIDS prevention and control measures to further curb the transmission and spread of the virus.

To investigate the association between lipoproteins determined by nuclear magnetic resonance (NMR) and osteoarthritis (OA) using Mendelian randomization (MR).

Using the genome-wide association study (GWAS) of 116 NMR-based lipoproteins and total OA, knee OA, and hip OA, univariate MR analyses were conducted to assess the association between lipoproteins and osteoarthritis.

Univariate MR results showed that 73 lipoproteins were significantly associated with total OA, LDL diameter (OR=1.07, 95% CI: 1.03-1.11) and small HDL phospholipids (OR=1.05, 95% CI: 1.01-1.08) presented risk effects on total OA,while the remaining lipoproteins were protective and were distributed in apolipoprotein B, cholesterols, intermediate density lipoprotein, and very-low-density lipoprotein subclasses. 57 lipoproteins were significantly associated with knee OA, all of which were found in total OA, with LDL diameter (OR=1.11, 95% CI: 1.05-1.18) presenting a risk effect on knee OA, while the remaining lipoproteins were protective. 90 lipoproteins were significantly associated with hip OA, with 7 of which presenting risk effects, distributed among HDL cholesterol (OR=1.07, 95% CI: 1.01-1.18)and most of its medium- and large-sized subclasses, while the remaining lipoproteins were protective.

NMR-based lipoproteins were causally associated with OA, as their different sizes and lipid compositions play different roles for OA at different sites.

To investigate the association between UHR and abdominal aortic calcification (AAC) in people aged≥40.

We used data from the 2013—2014 National Health and Nutrition Examination Survey (NHANES), including a total of 3 008 participants. Multiple logistic regression, subgroup analysis and restricted cubic spline (RCS) analysis were used to explore the correlation between UHR and AAC prevalence.

UHR was positively associated with AAC risk in all participants. Compared with the lowest UHR quartile, the highest quartile had a 134.6% increased risk of AAC (OR=2.346, 95%CI: 1.594-3.453). Interaction analysis showed that there was no significant interaction between UHR grouping and gender or age. Gender stratification showed a 213.6% increase in AAC in the Q4 group of females compared with the Q1 group (OR=3.136, 95%CI: 1.884-5.221), while no statistical significance was achieved in males (P=0.113). Age stratification revealed that for those over 60 years old, the risk of AAC in the Q2, Q3, and Q4 groups increased by 118.6% (OR=2.186, 95%CI: 1.140-4.191), 147.4% (OR=2.474, 95%CI: 1.464-4.181), and 347.8% (OR=4.478, 95%CI: 2.580-7.773) compared with the Q1 group, respectively, while in the 40-60 years old group, it did not reach statistical significance (P=0.338). RCS analysis showed that there was a nonlinear relationship between UHR and AAC.

s UHR is an independent risk factor for AAC, and the higher level of UHR, the higher risk of AAC. The association between UHR and AAC is more significant in females and people over 60 years old.