To analyze the trends of maternal, infant and neonatal mortality rates in Jiangxi Province from 2003 to 2020 in the aggregate and in urban and rural areas, and to predict the maternal mortality rate (MMR), infant mortality rate (IMR), and neonatal mortality rate (NMR) in the aggregate and in urban and rural areas in 2030, in order to provide a basis for the development and planning of the maternal and child health care industry in Jiangxi Province during the period of Healthy China 2030.

Based on the combined and urban-rural MMR, IMR, and NMR data of Jiangxi Province from 2003 to 2020, the Gray GM (1, 1), support vector machine (SVM), neural network auto-regression (NNAR), quadratic exponential smoothing (ES) models were established, and the optimal model was selected to predict the combined and urban-rural MMR, IMR, and NMR for the years 2021-2030. The already predicted aggregate mortality rates were then used to adjust the urban and rural MMR, IMR, and NMR.

In Jiangxi Province, the combined MMR, IMR, and NMR in 2025 and 2030 were 3.09/100 000, 2.52‰, 1.38‰, 1.67/100 000, 1.51‰, and 0.79‰. The urban MMR, IMR, and NMR in 2025 and 2030 were 2.44/100 000, 2.28‰, 1.28‰, and 1.22/100 000, 1.44‰, 0.75‰.And rural MMR, IMR, and NMR in 2025 and 2030 were 3.79/100 000, 2.81‰, 1.52‰,1.90/100 000, 1.63‰, and 0.89‰.

It is expected that Jiangxi Province will reach the targets set out in the “Healthy China 2030” Plan and other policies ahead of schedule in 2025 and 2030 in terms of MMR, IMR and NMR. Although the gap between urban and rural areas in terms of maternal, infant and neonatal mortality rates continues to narrow, the relevant indicators in rural areas are still higher than those in urban areas, an objective gap that indicates that the continued promotion of maternal and child health-care services in rural areas and the optimization of resource allocation at the grass-roots level are still the key directions of public health work.

To explore the mediating effect of self-compassion on social support and diabetes distress (DD) among community-dwelling elderly individuals with type 2 diabetes mellitus (T2DM).

From June to July 2024, a cross-sectional survey was conducted among elderly T2DM patients in communities in Nanjing. The survey used the general information questionnaire, DDS, SSRS, and SCS. A multiple linear regression model was employed to examine the factors influencing DD, and the mediating effect of self-compassion was analyzed by the Bootstrap method for validation.

The prevalence of DD among the respondents was 35.1%, and the scores for social support and self-compassion were (39.48±8.13) and (91.18±9.10), respectively. Social support and self-compassion were significantly positively correlated (r=0.344, P<0.001). Social support (β=-0.132, P<0.001) and self-compassion (β=-0.216, P<0.001) were the influencing factors of DD, and self-compassion exhibited a partial mediating effect in the relationship between social support and DD, accounting for 37.02% of the total effect.

Community healthcare workers should pay attention to the screening of DD among elderly T2DM patients, and actively explore comprehensive intervention strategies that integrate social support with self-compassion to enhance their psychological well-being.

To analyze the spatiotemporal trends of occupational noise-induced hearing loss (ONIHL) in the Chinese working population, predict its medium- and long-term disease burden, and provide scientific evidence for occupational disease prevention and control strategies.

Based on the Global Burden of Disease (GBD) 2021 database, data on Years Lived with Disability (YLDs) due to ONIHL in the Chinese working population between 1990 and 2021 were obtained. Joinpoint regression analysis was employed to assess temporal trends in disease burden, while an age-period-cohort (APC) model was developed to examine shifts in epidemiological patterns. Additionally, an Autoregressive Integrated Moving Average (ARIMA) model was applied to project the future burden of disease through 2040.

From 1990 to 2021, the average annual percentage change (AAPC) in the age-standardized rate of YLDs for ONIHL among the Chinese working population was 0.22%(95% CI: 0.19%-0.24%), with sex-specific rates of 0.15%(95% CI:0.13%-0.17%) in males and 0.33%(95% CI: 0.29%-0.37%) in females. In 2021, the age-standardized rate of YLDs was higher in males than in females, reaching a peak of 510.61 per 100 000 in individuals aged 60-64 years. According to the APC model, the YLDs rate increased with age and calendar period, and exhibited an initial increase followed by a decline across successive birth cohorts. Projections using the ARIMA model suggest that the overall age-standardized rate of YLDs is projected to increase to 166.66 per 100 000 by 2040.

From 1990 to 2021, the age-standardized rate of YLDs for ONIHL among the Chinese working population demonstrated a consistent upward trend, with males bearing a higher burden than females. The disease burden also escalated with increasing age. Over the next 19 years, the disease burden is expected to persist in rising, underscoring the urgent need to strengthen workplace noise control measures to mitigate the adverse health effects of occupational noise on the labor force.

To assess the public awareness of tuberculosis (TB) prevention and control knowledge in high-altitude Xizang during the 13th Five-Year Plan period (2016-2020) and provide evidence for optimizing regional TB health education strategies.

A multistage stratified cluster random sampling method was employed to select study participants aged 15 years and older who had resided in the Xizang region for over six months. Data ware managed using EpiData 3.1 and analyzed with IBM SPSS Statistics 24.0.

Among 1 191 participants, awareness rates of the five core TB prevention indicators were 32.58% (388/1 191), 78.51% (935/1 191), 77.25% (920/1 191), 62.05% (739/1 191), and 47.69% (568/1 191), respectively. The overall awareness rate was 59.61% (3550/5 955), while the full-awareness rate (all five messages) reached 11.50% (137/1 191).

Xizang’s overall TB core knowledge awareness rate (59.61%) falls below the 85% target set by the National TB Control Plan (2016-2020). Tailored interventions are recommended, including Tibetan-Chinese bilingual health campaigns targeting agricultural/pastoral workers, individuals with limited education, and employees of government agencies/enterprises. Concurrent efforts should enhance livelihood support and bilingual training for grassroots workers in high-altitude regions.

To identify potential drug targets related to preeclampsia and explore their public health value in precision prevention based on gene expression–associated genetic variants and Mendelian randomization.

By integrating genome-wide association studies (GWAS) and expression quantitative trait loci (eQTL) data, potential druggable genes for preeclampsia were identified using Summary data-based Mendelian Randomization (SMR), Transcriptome-Wide Association Study (TWAS), and colocalization analysis. Drug annotation and potential side effect assessments were conducted using public drug databases, and Phenome-wide Mendelian Randomisation (MR-PheWAS) was applied to evaluate potential causal associations between the identified genes and 783 disease traits.

Seven potential drug targets were identified: ALDH2, BCAR1, IL27, MUTYH, PABPC1, SULT1A1 and SULT1A2. Among them, IL27 and SULT1A1 showed consistent and significant associations across multiple analyses. ALDH2 and MUTYH were identified as strong candidates with known involvement in oxidative stress and DNA repair pathways. Several genes were linked to existing drugs, suggesting potential for drug repurposing in preeclampsia.

Drug-target Mendelian randomization provides novel insights into the molecular mechanisms of preeclampsia and facilitates the identification of therapeutic targets. The findings offer a promising foundation for early screening, genetic risk stratification, and individualized prevention, contributing to the development of precision public health strategies for pregnancy-related disorders.

To understand the prevalence of dyslipidemia among Nu residents with different characteristics in Yunnan Province, and analyze the associated risk factors of dyslipidemia.

In 2021, we used a multi-stage stratified cluster random sampling method to select permanent Nu residents aged 18 and above in Nujiang Prefecture, Yunnan Province as survey subjects. We obtained survey subject information through three parts: questionnaire survey, body measurement, and laboratory examination. To analyze the prevalence intensity and distribution characteristics of dyslipidemia among Nu residents in Yunnan Province, and to explore the related influencing factors of dyslipidemia among Nu residents.

This study included a total of 963 valid participants. The prevalence of dyslipidemia among Nu ethnicity residents aged 18 and above was 35.5%. The prevalence rates of hypercholesterolemia (TC), hypertriglyceridemia (TG), high LDL-cholesterol (LDL-C), and low HDL-cholesterol (HDL-C) were 15.5%, 12.4%, 10.6%, and 15.9%, respectively. Significant risk factors for dyslipidemia included age ≥60 years (OR=1.527, 95% CI=1.007-2.315), overweight (OR=3.194, 95% CI=1.417-7.197), obesity (OR=3.112, 95% CI=1.267-7.645), hypertension (OR=1.395, 95% CI=1.027-1.895), and diabetes mellitus (OR=2.022, 95% CI=1.341-3.049).

The prevalence rate of dyslipidemia among adults of the Nu ethnic group is close to the national average. The next step will be to focus on high-risk groups such as those aged≥60 years, overweight, and obese, while strengthening the management of patients with chronic diseases such as hypertension and diabetes to effectively reduce the prevalence of dyslipidemia.

To assess the current status and influencing factors of occupational health literacy (OHL) among key populations in Yunnan Province.

In accordance with the requirements of the National Key Population Occupational Health Literacy Monitoring and Intervention Technical Plan, a stratified cluster random sampling method was used to select workers from three key industries in the secondary sector and five key industries in the tertiary sector in Yunnan Province. A questionnaire survey was conducted to assess their OHL levels. The pearson χ² test and multivariate logistic regression analysis were used to analyze the influencing factors of OHL.

In 2023, the sample of Yunnan Province included 9 718 people. The overall OHL level was 48.4%, with the OHL level of the secondary sector was 55.0% and that of tertiary industry was 45.5%. Female workers had significantly higher OHL levels than males (χ²=11.529, P<0.05); higher income (χ²=166.574, P_{for trend}<0.001) and higher education levels (χ²=99.473, P_{for trend}<0.001) were positively associated with OHL levels. The multivariate logistic regression analysis showed that using “junior high school and below” and “monthly income<3 000 yuan” as reference groups, having a college degree or above (OR=1.180, 95% CI:1.042-1.335) and a monthly income of ≥9 000 yuan (OR=2.615, 95% CI:1.967-3.477) were protective factors for higher OHL levels (P<0.05). Using state-owned enterprises as the reference, working in private enterprises (OR=0.854, 95% CI:0.763-0.956) and public institutions (OR=0.865, 95% CI:0.756-0.991) were risk factors for OHL levels (P<0.05).

The OHL level in Yunnan Province needs to be further improved. Low-income groups, individuals with lower educational backgrounds, and workers in emerging industries should be key targets for future attention and intervention. To enhance OHL levels and safeguard workers’ health, targeted education and awareness campaigns should be designed based on the specific characteristics of each group.

To investigate the prevalence of night eating syndrome (NES) among university students and explore its associations with depression, stress, and body mass index (BMI), thereby providing evidence for identifying high-risk populations and developing targeted interventions.

A cross-sectional study was conducted in Nanjing, recruiting 500 university students for a questionnaire survey. The Night Eating Questionnaire (NEQ), Self-Rating Depression Scale (SDS), and Perceived Stress Scale (PSS) were used to assess NES symptoms, depressive mood, and stress levels. Statistical analyses included the Mann-Whitney U test, chi-square test, correlation analysis, and logistic regression models.

A total of 531 valid questionnaires were collected. The prevalence of NES was 6.0%(n=32), while the rates of depressive symptoms and perceived stress were 42.7%(n=227) and 49.0%(n=260), respectively. Students in the NES group had significantly higher levels of depression (P<0.001) and stress (P=0.002) compared to the non-NES group, whereas no significant difference was found in BMI (P=0.130). Spearman correlation analysis showed that NEQ scores were positively correlated with SDS and PSS scores (both P<0.001), but not with BMI (P>0.05). Logistic regression analysis revealed that depression (OR=22.995, 95% CI: 5.434-97.304, P<0.001) and stress (OR=2.825, 95% CI: 1.282-6.227, P=0.010) were positively associated with NES risk, and the risk increased with the severity of depression.

Depression and stress are critical risk factors for NES among university students. Enhancing mental health may serve as an effective approach to NES prevention and intervention.

To develop a knowledge, attitude, and behavior questionnaire on screen use among caregivers of children and to test its reliability and validity.

Based on the theory of “Knowledge-Attitude-Practice”, the initial questionnaire was formed through literature analysis, research group discussion, two rounds of Delphi expert consultation and pre-investigation. Through convenient sampling, 270 main caregivers of children aged 2 to 12 in Heilongjiang Province were selected for questionnaire investigation. Item analysis of the data was conducted, and internal consistency coefficient was used to analyze the reliability of the questionnaire. Exploratory factor analysis and content validity were used to evaluate the validity of the questionnaire.

The formal questionnaire consisted of 5 items on general information, 10 items on knowledge dimension, 7 items on attitude dimension, and 9 items on behavior dimension. The Item - Level Content Validity Index (I-CVI) ranged from 0.850 to 1.000. The Scale-Level Content Validity Index (S-CVI) was 0.808, and the Scale-Level Content Validity Index/Average (S-CVI/Ave) was 0.982. The factor loadings for all items were greater than 0.4, and the contribution rate of cumulative variance was 63.346%, indicating good validity. The Cronbach’s α coefficient of the questionnaire overall was 0.892, and the Cronbach’s α coefficient of the three dimensions ranged between 0.738 and 0.886, with good reliability.

The questionnaire has good reliability and validity, and can be used as an evaluation tool for the level of knowledge, attitude, and behavior of caregivers of children.

To investigate the causal association of twelve lifestyle behaviors in six categories (including smoking, drinking, physical activity, sexual behaviors, sleep habits and nutrients) on uterine fibroids using mendelian randomization (MR) method, and to investigate the mediating role of obesity related indicators.

Using genome-wide association study data, bidirectional MR analysis was first performed to identify exposures with causal associations with the outcome, which were then incorporated into multivariable MR to evaluate the independent causal effect of each variable, and finally two-step MR was used to evaluate the mediating role of obesity in the above causal pathways. Univariable MR analysis primarily employed the inverse-variance weighted (IVW) method, with the MR-Egger regression and the weighted median method used as the robustness verification methods; Multivariable MR was performed using the multivariable IVW method.

IVW results showed that genetically predicted regular smoking (OR=1.150, 95% CI: 1.006-1.316, P=0.041), higher alcohol intake (OR=1.306, 95% CI: 1.092-1.563, P=0.004) and higher carbohydrate intake (OR=1.681, 95% CI: 1.151-2.456, P=0.007) were risk factors for uterine fibroids, and were consistent with the results of the MR-Egger regression and the weighted median method. No reverse causal relationship was found in reverse MR analysis (all P values<0.05). Multivariable MR analysis showed that regular smoking (OR=1.302, 95% CI: 1.124-1.507, P<0.001) and carbohydrate intake (OR=1.410, 95% CI: 1.053-1.887, P=0.022) had independent causal effects on uterine fibroids. The two-step MR analysis showed that the waist hip ratio adjusted by body mass index mediated the effect of regular smoking on uterine fibroids, with a mediation proportion of 16.2%.

Regular smoking and higher carbohydrate intake are associated with an increased risk of uterine fibroids, with obesity partially mediating the relationship between regular smoking and uterine fibroids, emphasizing the importance of healthy lifestyle and weight management in the prevention of uterine fibroids.

To investigate the prevalence and associated factors of chronic pain among community-dwelling older adults in Shanghai, China.

A multi-stage stratified cluster sampling method was employed to recruit residents aged ≥60 years from August to November 2023. A structured questionnaire was used to collect data on demographic characteristics, pain status, and indicators of pain severity. Multivariate logistic regression was applied to identify factors associated with moderate to severe chronic pain.

A total of 3 606 valid responses were obtained. The overall prevalence of chronic pain was 73.9%, with mild pain being the most common (60.4%). The mean age of participants was 73.2±9.4 years. The most frequently reported pain sites were the lumbosacral region, shoulders, and neck. Major pain relief approaches included traditional therapies (55.7%), topical medications (41.5%), and oral analgesics (40.1%). Pain intensity was significantly correlated with psychological distress (r=0.793) and impaired daily functioning (r=0.795). Female sex (OR=1.291), higher educational attainment (OR=1.620-1.679), poor spousal health (OR=1.777-3.112), and impaired ability of daily living (OR=0.481) were independently associated with increased risk of moderate to severe pain.

Chronic pain is highly prevalent among older adults in Shanghai communities, predominantly manifesting as mild pain. Female gender, higher education level, poor spousal health, and limited self-care ability are significant risk factors for moderate to severe pain. Early identification of high-risk individuals and multidimensional interventions are essential to improve pain management and reduce the burden of chronic pain in this population.

To construct a set of MCI identification toolkit suitable for the elderly and their families, and to provide reference for guiding the elderly to self-identify MCI.

Using the corpus research method, through reviewing the literature, guidelines, books and other materials, a list of tools was formed, and the first draft of the identification toolkit wasconstructed. After expert consultation and demonstration, the final draft of the identification toolkit was formed by incorporating identification tools with an expert recognition rate of more than 70%. Descriptive statistical analysis was used to analyze the application results of the identification tool.

After expert consultation and demonstration, the effective recovery rate of the questionnaire was 83.33 %, and the expert authority coefficient was 0.875. A family identification toolkit including the mini-mental state examination (MMSE) and the elderly cognitive decline informer questionnaire (IQCODE) was formed. Among the 781 respondents, 256 elderly people had mild cognitive impairment, with an overall prevalence of 32.78 %.

The constructed family identification toolkit for MCI in the elderly is suitable for the elderly, family members and caregivers, and can provide a reference for guiding families to self-identify MCI in the elderly.

To analyze the current situation and influencing factors of two-week illness among children aged 0-6 years in Sichuan Province, and to explore the influence of family parenting styles on children’s two-week illness, so as to provide reference for improving the quality of children’s health services.

Based on data from the seventh health service survey of Sichuan Province, the relationship between family parenting style and children’s two-week illness was explored using logistic modeling.

Rural (OR=0.554, 95% CI: 0.311-0.985), left-behind families (where parents do not live permanently or are primarily cared for by someone other than the parents) (OR=1.775, 95% CI: 1.028-3.067) are more sensitive to children’s two-week illness. Indicators such as whether a parent is a permanent resident, the child’s primary caregiver, whether they have commercial insurance, whether they are placed in a childcare facility, and the number of toys they own vary among children’s two-week illness rates (P<0.05).

Different family parenting styles have a great impact on children’s two-week illness. It is recommended to further improve the mechanism of primary children’s health care services, emphasize the role of family in children’s health, and create a child-friendly environment for children to grow up.

To investigate the heterogeneous effects of Diagnosis-Intervention Packet (DIP) payment reform on the quantity distribution and cost patterns of high/low-complexity cases (measured by Case Mix Index, CMI), and to reveal hospital hierarchical response mechanisms under cost-control pressures, thereby providing policy recommendations.

Using three-year pre-and post-DIP pilot data (2018-2023), we constructed a difference-in-differences (DID) fixed-effects model with medical insurance patients as the treatment group and non-insured patients as the control group. The model incorporated diagnosis-related group (DRG) fixed effects and a policy×high-CMI interaction term to quantify heterogeneous impacts across complexity levels.

The DIP policy significantly reduced per-case medical costs (β₃=-803.570, P<0.001), per-case medical service costs (β₃=-128.434, P=0.019), and per-case material costs (β₃=-290.519, P<0.001) in the treatment group, alongside a reduction in the absolute deviation from the mean by 228.644 CNY (P=0.016) and a shortened average length of stay by 1.080 days (P<0.001). Stratified by CMI, high-CMI cases exhibited additional reductions in per-case costs (β₃=-309.400), material costs (β₃=-549.843), and hospitalization days (β₃=-0.715) compared to low-CMI cases, yet showed an increase in per-case medical service costs (β₃=273.834).

Hospitals adopted distinct response mechanisms under DIP-driven cost constraints. For high-CMI cases, cost control was achieved through technology-for-materials substitution (prioritizing technical service income while reducing material expenditures), whereas low-CMI cases relied on comprehensive cost suppression.These findings highlight the need for complexity-tiered payment adjustments to balance cost containment and care quality.

To explore the operational efficiency of primary care organizations in the pilot counties of close-knit county medical communities in Sichuan Province, and to provide a reference for continuing to promote the high-quality development of close-knit county medical communities across the country and help build a more synergistic and efficient county medical service network.

Primary care organizations in 37 pilot counties in Sichuan Province were used for the study, and data envelopment analysis and Malmquist index model were used for static and dynamic measurement of operational efficiency, respectively.

The mean values of comprehensive efficiency, pure technical efficiency, and scale efficiency of primary care organizations in pilot counties in Sichuan Province in 2022 were 0.806, 0.936, and 0.863, respectively. Among them, the operational efficiencies of Wenchuan (0.314), Jiuzhaigou (0.226), Seda (0.116), and Ganzi (0.061) were located below 0.400. Compared with 2018, their comprehensive efficiency and pure technical efficiency have improved, while scale efficiency was flat. The mean value of the total factor productivity index of primary care organizations in the pilot counties from 2018 to 2022 was 0.975. Further decomposing the total factor productivity index, the mean values of the technical efficiency index, the technical progress index, the pure technical efficiency index, and the scale efficiency index were 1.014, 0.962, 1.022, and 0.992, respectively.

After the implementation of the policy, the operational efficiency of primary care organizations in the pilot counties of Sichuan Province showed significant improvement, but there is still much room for improvement, and the differences between counties are more obvious. In the future, we should focus on the technical progress and scale efficiency, strengthen the continuing medical education of primary medical personnel, innovate and carry out the new technology of primary characteristics, and reasonably balance and effectively allocate the medical resources in the counties.

To analyze the characteristics and issues of Jiangsu’s healthcare system policies and provide optimization insights.

Using Rothwell and Zegveld’s policy tool classification, a three-dimensional framework (policy tools, development process, policy goals) was constructed to quantify 70 policy texts from the 13th and 14th Five-Year Plan periods.

Policy tools: environmental-type dominated (58.83%), followed by supply-type (34.78%), demand-type (6.38%) was minimal. Policy process: implementation (52.27%) and planning (40.24%) prevailed, while supervision (6.48%) and evaluation (1.02%) were underdeveloped. Policy goals: advancing public hospital quality (44.11%) was prioritized, whereas strengthening medical insurance (9.03%) lagged.

Structural imbalance in policy tools, fragmented policy processes, and divergent goals were observed. Recommendations: optimize tool allocation by increasing demand-type tools, integrate policy processes, and align goals systematically.

To evaluate the health economy of the whole-process management strategy of personalized lung cancer screening according to the size of lung nodules compared with the annual screening strategy and the natural development strategy.

Based on the publicly available dataset from the US NLST, a decision tree-Markov model was constructed. Incremental cost-utility analysis was used to evaluate the economic efficiency of the three strategies, and one-way sensitivity analysis and probabilistic sensitivity analysis were conducted to test the stability of the model results.

Compared with the natural development strategy, the incremental cost-utility ratios (ICER) of the whole-process management strategy and the annual screening strategy were 82 798.96 yuan/quality-adjusted life year (QALY) and 71 168.05 yuan/QALY, respectively.Compared with the annual screening strategy, the ICER of the whole management strategy was 129 227.28 yuan/QALY. Univariate sensitivity analysis showed that the proportion of lung cancer patients with stage III and IV lung cancer had a significant impact on ICER. Probability sensitivity analysis showed that when the Willingness to pay (WTP) was 89 358 yuan/QALY, the economic probability of the whole management strategy was 0.279. When WTP was 268 074 yuan/QALY, the economic probability of the whole process management strategy was 0.826.

When WTP is 1 time the Gross Domestic Product (GDP), the annual screening strategy is the best choice. When WTP is 3 times the GDP per capita, the whole-process management strategy is the best choice.

To analyze the internal structure and influencing factors of hospitalization expenses for rare disease patients at different medical levels in Jiangxi Province’s “Health Expenditure Accounting System 2011” (SHA2011) sentinel hospitals, providing references for rare disease treatment in Jiangxi Province and its healthcare institutions.

Data on rare disease patients from 2018 to 2022 were collected from the sample hospitals in Jiangxi Province. Structural variation analysis and grey correlation analysis were employed to examine changes in the internal composition of hospitalization expenses and their interrelationships, while a random forest model was used to identify factors influencing the average total cost per hospitalization case.

From 2018 to 2022, the average hospitalization costs per case were 19 082.70 yuan (provincial), 8 175.29 yuan (municipal), and 6 586.23 yuan (county/district). The random forest model revealed that medication fees and diagnostic examination fees were key factors affecting rare disease hospitalization costs, with structural variation values of -3.15, -1.79, and 5.30 for medication fees, and -3.86, 5.48, and 2.16 for diagnostic examination fees at provincial, municipal, and county/district levels, respectively. Grey correlation analysis showed that surgical fees and nursing fees had low correlation degrees with hospitalization costs across all levels, ranking between 7th and 8th.

From 2018 to 2022, hospitalization expenses at all levels exhibit fluctuating trends but remained generally high. Medication fees and diagnostic examination fees are critical influencing factors, though their structural variation trends and contribution rates differed significantly across hospital tiers. Additionally, surgical and nursing fees demonstrate consistently low correlation with hospitalization costs at all levels.

To analyze the impact of pain intensity on depression levels among rural elderly individuals, and to explore the mediating role of Activities of Daily Living (ADL) and the moderating effect of internet use.

This study was based on the 2020 China Health and Retirement Longitudinal Study (CHARLS). Partial correlation analysis was used to explore the relationships between pain intensity, ADL, depression levels, and internet use among rural elderly individuals. The Bootstrap method (Model 4,58) was used to analyze the mechanisms through which ADL and internet use affect the relationship between pain intensity and depression levels.

Pain intensity had a significant direct effect on depression levels among rural elderly individuals (β=1.537, 95% CI: 1.347-1.728). ADL played a significant mediating role between pain intensity and depression levels (β=0.319, 95% CI: 0.262-0.380). Internet use weakened the negative effect of pain intensity on ADL (β=0.508, P<0.01) and strengthened the negative effect of ADL on depression levels (β=-0.224, P<0.01).

Pain intensity positively influences depression levels among rural elderly individuals. ADL partially mediates the relationship between pain intensity and depression levels. Internet use moderates the effects between pain intensity and ADL, as well as between ADL and depression levels. Therefore, it is recommended to guide rural elderly individuals at the personal, family, and community levels to utilize internet technologies to disrupt the "pain-ADL decline-depression" chain reaction.

To explore the relationship between smartphones usage, internet usage and subjective, objective cognitive functions.

Multi-stage cluster random sampling method was used to select 45-70 year old permanent residents from 7 sample villages in Pingyin County, Shandong Province who meet the standards. The subjective cognitive decline-questionnaire 9 (SCD-Q9) and the montreal cognitive assessment basic scale (MoCA-B) were used to evaluate the subjective and objective cognitive functions, respectively. The logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) of the relationship between smartphones usage, internet usage and subjective, objective cognitive function. Furthermore, the non-linear relationship between smartphones usage, internet usage and cognitive function scores was explored.

This study included 1 654 participants. Compared with those who did not use mobile phones, those who used mobile phones had a 42% lower risk of experiencing abnormal objective cognitive scores (OR=0.58, 95% CI: 0.46-0.73), and the risk of abnormal objective cognitive scores was relatively low when using a mobile phone for less than or equal to 2 hours per day or more than 2 hours per day (0.65, 0.51-0.82; 0.69, 0.55-0.88). Compared to those who did not use the internet, internet users had a 41% lower risk of experiencing abnormal objective cognitive scores (0.59, 0.47-0.74), and people who spent less than 1 hour online or more than 2 hours online had a lower risk of experiencing abnormal objective cognitive scores compared to those who spent less than or equal to 1 hour online (0.65, 0.52-0.83; 0.66, 0.52-0.83). Nonlinear correlation showed that as the duration of mobile phone use and internet usage gradually increased, the objective cognitive score showed a trend of first increasing and then decreasing.

People who use mobile phones and the internet have a lower risk of experiencing objective cognitive score abnormalities. As the duration of mobile phone use and internet usage increases, the objective cognitive score shows a non-linear trend of first increasing and then decreasing. Overuse of mobile phones and the internet (such as>5.5 h/d) may have adverse effects on cognitive function.

To explore the relationship between intergenerational emotional support and depression of migrant elderly following children and its mechanism of action.

A total of 210 migrant elderly following children participated in this study. And they completed the Intergenerational Emotional Support Questionnaire, Flow Centre Depression Scale, Short boredom proneness scale and Seff-Rating Scale of Sleep.

(1) Intergenerational emotional support significantly and negatively predicted depression in migrant elderly following children (β=-0.354, P<0.001); (2) Boredom proneness played a mediating role between Intergenerational emotional support and depression of migrant elderly following children. The mediation effect value was -0.129 (95% Bootstrap CI=［-0.215，-0.068］), the mediating effect accounted for 36.44% of the total. (3) Sleep problem moderated the relationship between boredom proneness and depression of migrant elderly following children (β=0.137, P=0.009). Specifically, moderated mediation analysis showed that the impact of boredom proneness on depression strengthened with sleep problem getting worse among the migrant elderly following children (simple slope=0.384, 95% CI: 0.235-0.533, P<0.001). When there was mild sleep problem, the influence of boredom proneness function on depression was weaker (simple slope=0.110, 95% CI: -0.044-0.263, P=0.160).

This study highlights the mediating and moderating mechanisms linking intergenerational emotional support to depression of migrant elderly following children. More importantly, it has prominent implications for the prevention and intervention of depression among migrant elderly following children.

To investigate the dose-response effect of green elements and duration of green exercise on executive function among college students.

Using a mixed experimental design, 90 physically active college students were assigned to greener and less green environment exercise groups and 10-, 20-, and 30-minute exercise durations according to their physical activity level. All subjects completed a moderate-intensity two-legged jump-rope workout, during which heart rate was monitored using a Polar RS800. Inhibitory control, working memory and cognitive flexibility were tested before and after the exercise.

(1) The inhibitory control as well as working memory in the greener group was significantly better than that of less-green environment at the end of the exercise; (2) inhibitory control, working memory, and cognitive flexibility were significantly better in 20 versus 30 minutes condition than in 10 minutes, but 20 versus 30 minutes was not significant.

Green environments and long duration exercise are more conducive to improving executive function, but there is no significant synergistic effect of green environments and exercise duration.

To sinicize the Climate Change Health Protection Behavior Scale (CCHPB) for adolescents, and to explore the reliability and validity of the scale among Chinese adolescents.

The Chinese translation model of the scale was carried out with the help of Brislin’s translation model, and the structural validity of the scale was comprehensively evaluated by exploratory factor analysis and confirmatory factor analysis.

The results showed that the internal consistency of the Chinese version of the CCHPB scale was excellent (α=0.923), and the Cronbach’s α coefficient of all dimensions of the scale was higher than 0.878, indicating that the Chinese version of the CCHPB scale had excellent reliability indicators. The results of exploratory factor analysis and confirmatory factor analysis strongly confirmed the four-factor structure of the scale. In addition, all indicators in the adaptability of the confirmatory factor analysis model met the adaptation criteria, which clearly indicated that the scale had good structural validity.

The CCHPB scale can be used to evaluate the health protection behaviors of adolescents under possible climate change situations.

To evaluate the effect of exercise intervention on executive function in adult patients with depression.

Seven databases, Web of Science, PubMed, Embase, Cochrane Central, China Knowledge (CNKI), Wanfang Database, and Wipro Journal Network (VIP), were searched to include randomized controlled trials from the time of database construction to July 2024. Stata 18.0 and Review Manager 5.4.1 software were used for statistical analysis.

A total of 7 papers with 497 subjects were included. Meta-analysis showed that exercise intervention significantly enhanced executive function (SMD=0.29, 95% CI［0.13, 0.44］), with inhibitory control (SMD=0.31, 95% CI［0.02, 0.60］), working memory (SMD=0.25, 95% CI［0.09, 0.40］) and cognitive flexibility (SMD=-0.33, 95% CI［-0.49, -0.17］) significantly improved (P<0.05). Subgroup analyses showed that the exercise intervention of low to moderate intensity, 30-60 minutes per session, lasting 12-16 weeks had the best effect on improvement of inhibitory control; the exercise intervention of high intensity, 30-60 minutes per session, lasting 3-8 weeks had the best effect on improvement of working memory and cognitive flexibility.

Exercise intervention can effectively enhance the executive function and its subdomains in patients with depression, and it is recommended to choose the appropriate exercise modality and dosage according to the actual situation of the patients in order to optimize the effect of the intervention.

To investigate the variations in the species composition and functional attributes of intestinal microbiota in individuals suffering from metabolic fatty liver disease in Tibetan regions, and to provide a research basis for the prevention and treatment of metabolic fatty liver disease in Tibetan population.

Based on the follow-up survey data of the Southwest region natural population in Lhasa, a total of 103 subjects were included for follow-up analysis according to the guidelines for the prevention and treatment of metabolic-associated (non-alcoholic) fatty liver disease (2024 edition). The demographic information, anthropometric indicators, blood biochemical indicators, and fecal samples were collected, and DNA was extracted for metagenomic sequencing analysis. The composition of intestinal flora in patients with metabolic fatty liver disease and healthy people was compared by bioinformatics methods. The metabolic pathways and their coding genes were analyzed by genome encyclopedia (KEGG) . Linear discriminant analysis was used to screen the differential flora, and Spearman rank correlation and linear regression were used to explore its relationship with related phenotypes.

The alpha diversity of patients with metabolic fatty liver was significantly reduced (W=858, P<0.001). The abundance of Bacteroidetes in the intestinal tract of patients with metabolic fatty liver was significantly lower than that of normal people (H=8.990, P=0.003). These include Bacteroides uniformis, Bacteroides fragilis, Bacteroides ovatus, and the butyrate-producing Porphyromonas Phocaeicola salanitronis (LDA>3, P<0.050). Fusobacterium varium (LDA=2.16, P=0.024) was significantly enriched in MAFLD population and positively correlated with multiple disease phenotypes. Glucose and lipid metabolism-related pathways and KO genes were also significantly enriched in patients with metabolic fatty liver.

The intestinal microbiota and metabolic function of Tibetan patients with metabolic fatty liver disease are significantly changed, and the disruption of intestinal flora balance may also have a close association with the onset and progression of metabolic fatty liver disease among Tibetan patients.

To analyze the status and influencing factors of latent tuberculosis infection (LTBI) screened by the recombinant mycobacterium tuberculosis fusion protein (EC) test in Henan Province, and to understand the willingness of LTBI individuals to accept preventive treatment, with the aim of providing data support for improving tuberculosis (TB) control strategies in Henan Province.

In 2023, the EC test was used to screen for LTBI and conduct preventive treatment among high-risk groups for TB (including school teachers and students, healthcare workers, close contacts, and HIV/AIDS patients) in counties participating in the Henan Province TB Care Action public welfare project. Excel 2019 and SPSS 21.0 software were used to analyze the data. Binary logistic regression model was used to analyze the influencing factors of latent tuberculosis infection.

A total of 4 818 subjects were included in the study, excluding those who had not been screened for latent infection due to other reasons such as screening contraindications. The positive rate of EC test was 4.42% (213/4 818). Four patients with active pulmonary tuberculosis were found, and the detection rate was 83.02/100 000 (4/4 818). 204 people met the criteria for preventive treatment, 86 people received preventive treatment, the acceptance rate was 42.16% (86/204), the completion rate was 89.53%(77/86), among which the main reason for refusal was that they thought they would not get sick (77.97% (92/118)). Binary logistic regression model analysis results showed that with students as the control group, medical staff (OR=9.762，95% CI：3.441-27.697), close contact staff (OR=6.853, 95% CI：3.074-15.277), HIV/AIDS (OR=4.387, 95% CI：1.582-12.165) were risk factors for TB infection.

Healthcare workers, close contacts, and HIV/AIDS patients are the focus of LTBI screening. Additionally, enhancing the awareness of preventive treatment among individuals with latent infections is crucial to improving the acceptance rate of preventive treatment and advancing TB control efforts in Henan Province.

To investigate the effect of depressive symptoms on the risk of developing type 2 diabetes mellitus in middle-aged and elderly people in China.

Based on the data from the China Health and Retirement Longitudinal Study (CHARLS) 2011 and 2018, 9 697 middle-aged and elderly people aged 45 years or older were included as study subjects. Chained equations were used to perform g-formula analysis after multiple interpolation of missing values of covariates, and stratified analyses were performed to explore the association between depressive symptoms and the risk of developing type 2 diabetes mellitus with respect to age and gender.

The results of the analysis after multiple interpolation of covariates and adjustment for confounding showedthat the mean risk of developing type 2 diabetes mellitus in study participants with depressive symptoms which was 1.3 times higher than that of those without depressive symptoms ［RR(95% CI):1.37(1.15-1.62)］, with a mean hazard difference of 0.02. Those with mild depressive symptoms had a mean risk of type 2 diabetes mellitus of 1.27 times higher than that of those without depressive symptoms ［RR(95% CI):1.27(1.07-1.52)］, with a mean difference of 0.01; those with severe depressive symptoms had a mean risk of developing type 2 diabetes mellitus that was 2.22 times higher than that of those who were not depressed ［RR(95% CI):2.22(1.64-3.00)］; the mean difference was 0.06.

Depressive symptoms and the risk of type 2 diabetes mellitus were significantly associated with the risk of developing type 2 diabetes mellitus among middle-aged and elderly people in China. Associated with the risk of developing type 2 diabetes, the risk of developing the disease increased with the severity of depressive symptoms.

To understand the aging trend and some characteristics of people living with HIV who first received antiretroviral therapy (ART) in Guizhou province from 2005 to 2022, and to provide reference for the development of follow-up management measures for the elderly population.

The baseline characteristics of HIV/AIDS patients receiving ART in Guizhou province from 2005 to 2022 were collected from the National HIV/AIDS Antiretroviral Treatment Information System. Joinpoint regression was used to analyze the trends of baseline gender, age, transmission route, time from diagnosis to treatment initiation, and CD4+T lymphocyte (CD4+) level.

From 2005 to 2022, a total of 29 366 elderly patients (aged≥50 years) in Guizhou Province received ART treatment for the first time. The proportion of elderly men receiving ART showed a decreasing trend from 2007 to 2022 (APC=-1.30%, P<0.001). The proportion of elderly patients with married status and having a spouse decreased (APC=-2.44%, P<0.001). The proportion of elderly patients with infection through heterosexual transmission reached a turning point in 2007, and it showed a rapid upward trend from 2005 to 2007 (APC=264.70%, P<0.001). The proportion of elderly patients with a one-to-two-year time interval from diagnosis to starting treatment decreased from 2005 to 2007 (APC=-10.22%, P<0.001), and then showed an upward trend from 2007 to 2022 (APC=1.29%, P<0.001). The proportion of elderly patients with baseline CD4+ level≤200 showed a turning point in 2013 ［95% CI: 2008-2018］, and it decreased from 2005 to 2013 (APC=-8.11%, P<0.001).

From 2005 to 2022, the elderly patients who first received ART in Guizhou province were mainly male, married, heterosexual transmission, 1-2 years from diagnosis to treatment, and baseline CD4+ level ≤200, and the proportion of elderly patients was on the rise. Follow-up management strategies of ART should be developed for the elderly population to improve the quality of ART.

To analyze the disease characteristics, comorbidity patterns, and healthcare burden of hospitalized patients with hypertension and comorbidities, providing evidence for optimizing hypertension comorbidity management.

A retrospective analysis was conducted on 810 747 hospitalized patients with hypertension and comorbidities from all general hospitals in Zhanjiang, Guangdong, between 2016 and 2022. Systematic cluster analysis was used to generate a dendrogram and identify comorbidity patterns. Inter-group comparisons were performed to analyze hospitalization costs across different patterns.

From 2016 to 2022, the number of hospitalized hypertensive patients with comorbidities showed an overall increasing trend, with a higher and rising proportion of males. The age distribution shifted toward older populations, with patients aged ≥85 years increasing annually. The top five most common comorbidities were atherosclerotic heart disease, cerebral infarction, type 2 diabetes, lipoprotein metabolism disorders, and chronic gastritis. Cluster analysis identified eight comorbidity patterns: cardiovascular disease, cerebrovascular-metabolic disease,hepatic-renal disease, spinal-digestive disease, cerebral ischemia, senile cataract, dizziness-vertigo, and stroke. The senile cataract group incurred the highest total hospitalization costs(4 705.6,P<0.001). Among multi-comorbidity patterns, the hepatorenal disease group exhibited the highest total hospitalization costs(4 527.8), and the cardiovascular disease group had significantly higher Western medication and material expenses (P<0.001).

Hospitalized hypertensive patients with comorbidities are increasing in number and age. Prevention efforts should prioritize cardiovascular, metabolic, and digestive comorbidities. Eight distinct comorbidity patterns were identified, with senile cataract and hepatic-renal disease patients representing key populations for cost containment.

To explore the impact of the triglyceride-glucose index (TyG) and obesity indicators on the risk of non-alcoholic fatty liver disease (NAFLD) among participants aged ≥60 years, so as to provide evidence for the early prevention of NAFLD.

A stratified random cluster sampling method was used to select 95 932 elderly individuals in 2022 in Nanjing. These individuals underwent questionnaires, physical examinations, and laboratory tests. A logistic regression model was used to analyze the effects of the TyG and multiple obesity indicators on the risk of NAFLD, followed by the interaction analysis between TyG and each obesity indicator. The diagnostic value of the TyG and its combination with obesity indicators was assessed using receiver operating characteristic curves.

In the study, the prevalence of NAFLD was 39.66%. After adjusting for confounding factors, logistic regression analysis showed that as the increase of TyG and obesity indicators, including BMI, Chinese visceral adiposity index, and lipid accumulation product, the risk of NAFLD in the elderly increased, with odds ratios of 1.86 (1.80-1.93), 3.69 (3.57-3.80), 3.66 (3.54-3.79), and 3.28 (3.17-3.39), respectively (P<0.001). Interaction analysis revealed that compared to low levels of both the TyG and obesity indicator, one variable at a high level or both at high levels increased the risk of NAFLD, indicating a synergistic effect. The diagnostic ability of the TyG combined with obesity indicators for NAFLD risk was higher than that of the TyG alone.

The risk of NAFLD in individuals aged ≥60 years increases with higher levels of the TyG and obesity indicators, and they have a combined effect on NAFLD risk. TyG combined with BMI may be a simple and efficient tool for the early screening of NAFLD in elderly people.

To analyze the burden of spinal injuries and its changing trends in China from 1990 to 2021, providing a theoretical basis for the prevention of spinal injuries.

Using the GBD 2021 database, indicators such as incidence, prevalence, and Years Lived with Disability (YLD) were extracted to describe the changes in the burden of spinal injuries in China. Data visualization was performed using the R language, the Joinpoint model was used to analyze the temporal trends of disease burden, the APC model was used to estimate age, period, and cohort effects, and the BAPC model was used to predict the standardized incidence rate of spinal injuries from 2022 to 2040.

Compared to 1990, the YLD rate and standardized YLD rate of spinal injuries in China showed a decline in 2021, while other indicators increased; the disease burden increased with age, with males having a higher burden than females; falls were the main cause of the disease burden; the average annual percentage change in standardized incidence rate, standardized prevalence rate, and standardized YLD rate from 1990 to 2021 was 0.007%, 0.156%, and -0.344%, respectively; the age-period-cohort model showed that the incidence rate increased with age, fluctuated upwards with time, and fluctuated downwards with the birth cohort; the prediction model indicated that the standardized incidence rate of spinal injuries will show a declining trend from 2022 to 2040.

The burden of spinal injuries in China from 1990 to 2021 showed an upward trend, with gender and age differences, falls being the main cause, and the elderly and males being the key burden groups; effective measures should be taken for intervention.