To investigate the associations between serum liver enzymes of alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT) and cardiovascular diseases in the Chinese community-dwelling older adults.

Based on the baseline data of the West China Health and Aging Cohort, a total of 7 422 participants aged 60 years and above without liver diseases were selected in this study. Logistic regression and restricted cubic spline models were used to analyze the dose-response relationship between serum liver enzymes and the risk of coronary artery disease (CAD) and stroke.

Logistic regression models showed that compared with the lowest serum ALT level group, the highest group had a higher risk of CAD (OR=1.35, 95% CI: 1.06-1.74). Restricted cubic spline models showed no nonlinear association between serum ALP, ALT, AST, and GGT and the risk of CAD (P_nonlinearity=0.796,0.122, 0.583, and 0.424, respectively). For stroke, the risk in the highest serum ALP level group was higher compared with the lowest group (OR=1.27, 95% CI: 1.02-1.58); additionally, each one-unit increase in log₁₀ALP was associated with a higher risk of stroke (OR=2.13, 95% CI: 1.01-4.47). Restricted cubic spline models showed no nonlinear association between serum ALP,ALT, AST, and GGT and stroke (P_nonlinearity=0.595, 0.669, 0.809, and 0.907, respectively).

Higher serum liver enzymes may be associated with an increased risk of cardiovascular diseases in the Chinese older adults.

To analyze the relationship between circadian syndrome (CircS), changes in CircS and the progression of frailty, providing a theoretical basis for the early prevention of frailty and the development of interventions.

Based on data from the 2011—2018 China Health and Retirement Longitudinal Study (CHARLS), the frailty index (FI) was constructed using 39 health deficits to examine frailty, and CircS was diagnosed by metabolic syndrome (MetS) components, sleep and depression. Changes in CircS were obtained by comparing the status of CircS in 2011 and 2015. The relationships between CircS, changes in CircS, and the risk of frailty, as well as FI trajectories, were analyzed by Cox proportional hazards regression and linear mixed-effects models.

In the fully adjusted Cox regression model, CircS was significantly associated with the risk of frailty (HR=1.604, P<0.001). Individuals with abnormal component scores of 6 (HR=2.110, P<0.001) or 7 (HR=3.136, P<0.001) showed a substantial increase in the risk of frailty compared with no CircS. Compared with persistent CircS-free individuals, those newly developing CircS (HR=2.534, P<0.001), and those with persistent CircS (HR=3.681, P<0.001) were at higher risk of frailty. In fully adjusted linear mixed-effects models, FI increased significantly faster in participants with CircS compared with individuals without CircS (β=3.932, P<0.001) and tended to increase significantly as the number of abnormal components increased (P_trend<0.001). Participants with CircS had the greatest increase in FI compared with individuals who were persistently CircS-free (β=5.588, P<0.001). Age (P=0.013) and alcohol consumption (P=0.023) interacted with CircS, but the direction of the effect of CircS on frailty remained consistent across subgroups.

CircS and its changes were positively associated with the progression of frailty among Chinese middle-aged and older adults, underscoring the importance of early identification of CircS and monitoring the changes in CircS to reduce the risk of frailty and mitigate the progression of frailty.

To explore the impact of psychological resilience and various types of social participation, as well as their interaction, on cognitive impairment in older adults.

This study utilized data from the 2018 China Longitudinal Healthy and Longevity Survey (CLHLS). Analyses were conducted using χ² tests, logistic regression, restricted cubic splines, and additive interaction models.

Cognitive impairment was observed in 1 421 elderly individuals (19.46%). Risk factors for cognitive impairment included lack of domestic participation (OR=1.73, 95% CI: 1.48-2.02), lack of socialization (OR=1.75,95% CI: 1.45-2.11), lack of leisure activities (OR=1.86, 95% CI: 1.52-2.28), and low psychological resilience (OR=1.58, 95%CI: 1.35-1.84). Among elderly individuals with low psychological resilience, non-linear dose-response relationships were observed between three types of social participation and cognitive impairment (P-overall<0.01, P-nonlinear<0.01). An additive interaction between low psychological resilience and lack of social participation in cognitive impairment was identified. Using elderly individuals with high psychological resilience and corresponding types of social participation as the control group, the risk of cognitive impairment for elderly individuals with low psychological resilience and no domestic, no socialization, or no leisure activities was 3.13 (OR=3.13, 95% CI: 2.51-3.91) times, 2.77 (OR=2.77, 95% CI: 2.06-3.72) times, and 3.75 (OR=3.75, 95% CI: 2.93-4.81) times higher, respectively, compared to the control group.

Lack of social participation, low psychological resilience, and their interactions increase the risk of cognitive impairment, suggesting that comprehensively enhancing both psychological resilience and social participation in older adults may improve cognitive function.

To explore the mediating roles of self-care ability and self-rated health between physical inactivity and depressive symptoms among elderly individuals.

Data from 8 279 participants (≥60 years) in the 2020 CHARLS database were analyzed using correlation and regression to explore the relationship between physical inactivity, self-care ability, self-rated health and depressive symptoms. The chain mediating effect model was used to analyze the multiple mediating effects.

Depressive symptoms prevalence was 40.89% among people aged 60 and above. Physical inactivity (β=0.402, P<0.01), self-care ability (β=-0.186, P<0.001) and self-rated health (β=-1.724, P<0.001) directly predicted depressive symptoms. The simple mediation effects were 0.142 for self-care ability and 0.072 for self-rated health between physical inactivity and depressive symptoms, with a chain mediation effect of 0.056.

Self-care ability and self-rated health have a direct mediating effect and a chain mediating effect between physical inactivity and depressive symptoms in the elderly. Enhancing physical activity may improve body functional capacity, self-care ability and health, thereby reducing depressive symptoms risk.

To fit and predict the incidence trend of pulmonary tuberculosis in Guiyang City, assess whether the End TB Strategy target for 2035 (incidence <10 per 100 000 population) can be achieved, and provide a reference for relevant departments to optimize prevention and control measures.

Based on the anonymized tuberculosis case data from Guiyang City between 2010 and 2024, after excluding records with missing onset times and duplicate entries, a transmission dynamics model was constructed by integrating demographic and epidemiological data. Taking into account the latent period of tuberculosis, infection progression, and case detection, the Bayesian method was employed to estimate transmission parameters and predict incidence trends from 2025 to 2050. The effectiveness of various control measures was evaluated through parameter optimization strategies.

The model achieved a mean absolute percentage error (MAPE) of 5.02%, and an R² of 0.86 in fitting the 2010—2019 data. Projections indicated that under current strategies, Guiyang City would fail to meet the 2035 TB control target. However, with optimized interventions, the target could be achieved two years ahead of schedule.

Enhancing active case detection and preventive treatment for latent TB infections could enable Guiyang City to reach the End TB Strategy’s 2035 goal.

To analyze the current status and changing trends of ischemic stroke burden attributable to high LDL-C in China from 1990 to 2021. By integrating the prediction results for the next decade, this research offers actionable insights for designing evidence-based interventions targeting ischemic stroke prevention and management in China.

Data were obtained from the Global Burden of Disease Study (GBD) 2021 database and screened for Chinese regions, causes of ischemic stroke deaths, and high LDL-C risk factors. The disease burden was measured using indicators such as mortality and disability-adjusted life year (DALY) rates, and systematically analyzed the trends using the Joinpoint regression model. The autoregressive moving average (ARIMA) model was employed to predict the standardized mortality and standardized DALY rates of ischemic stroke attributable to high LDL-C in China from 2022 to 2031.

The overall trend of ischemic stroke rates attributable to high LDL-C in the Chinese population was declining between 1990 and 2021, with mean annual percentage changes (AAPC) of-0.42% (95% CI: -0.66%~-0.18%, P<0.05) and -0.46% (95% CI: -0.63%~-0.29%, P<0.05), with significant age and sex disparities observed. According to the ARIMA model, China’s standardized mortality and DALY rates linked to elevated LDL-C would decline to 15.01 per 100 000 population and 319.00 per 100 000 population, respectively, by 2031.

The disease burden of ischemic stroke attributable to high LDL-C remains substantial in China, and the interventions on LDL-C levels in the priority populations of men and elderly ischemic stroke patients should be reinforced, and prevention and control strategies as well as institutional support should be improved for the purpose of alleviating the disease burden of ischemic stroke more effectively.

To analyze the spatial-temporal clustering of mumps during periods with different immunization strategies in Tai’an.

The immunization strategy for MuCV from 2009 to 2024 was divided into 1-dose period (2009-2013), 2-dose early period (2014-May 2020), and 2-dose later period (June 2020-2024). Mumps incidence data from 2009 to 2024 were obtained from the China Disease Control and Prevention Information System for descriptive epidemiological, trend analysis and spatial-temporal clustering analysis during different immunization strategy periods.

The annual average incidence rate of mumps in Tai’an from 2009 to 2024 showed a general downward trend during the three immunization periods (χ²_trend=4 273.971, P<0.001), and there were statistically significant differences (χ²=4 977.100, P<0.001). The trend surface analysis showed that it increased first and then decreased from west to east during three immunization periods. From north to south, the rate decreased and then increased during the 1-dose period, whereas a generally downward trend was observed during the 2-dose period. The global spatial autocorrelation analysis showed that mumps exhibited significant spatial clustering (P<0.001) during three immunization periods. The local autocorrelation analysis showed that the "High-High" clusters were predominantly concentrated in the townships/subdistricts covered by Taishan District, Daiyue District, Mount Tai Scenic Area, and Ningyang County, while the "Low-Low" clusters were mainly distributed in those under Feicheng City and Xintai City during the three immunization periods. The spatiotemporal scanning analysis showed that the main clusters were predominantly located in townships/subdistricts covered by Ningyang County, Taishan District, Daiyue District, and the Mount Tai Scenic Area during the three immunization periods, and this was basically consistent with the "high-high" clusters identified by the local spatial autocorrelation analysis.

The incidence of mumps during different immunization strategy periods exhibited spatial-temporal clustering in Tai’an City. It is necessary to strengthen the surveillance and early warning for mumps in high-priority regions.

To analyze the epidemiological characteristics of non-melanoma skin cancer (NMSC) in China from 2005 to 2018 and to predict future incidence trends, thereby providing a scientific basis for the prevention and control of NMSC.

Incidence data for NMSC from 2005 to 2018 were obtained from the Chinese Cancer Registry Annual Reports. Joinpoint regression was used to estimate the average annual percentage change (AAPC) and annual percentage change (APC) to reflect time trends. An age-period-cohort model based on the intrinsic estimator algorithm was employed to assess the effects of age, period, and birth cohort. A Bayesian age-period-cohort (BAPC) model using integrated nested Laplace approximation was applied to predict future trends.

From 2005 to 2018, the age-standardized incidence rate (ASIR) of NMSC in China was 1.33 per 100 000, showing an upward trend, with an AAPC of 3.7% (95% CI: 2.5%-4.9%). The ASIR was higher in males (1.46/100 000) than in females (1.21/100 000), although the increase was faster in females (AAPC = 8.8%). The incidence rate in urban areas (1.44/100 000) was higher than in rural areas (1.15/100 000). The risk of NMSC incidence increased with age. The cohort effect showed a downward trend in ASIR. Predictions suggested that the ASIR of NMSC in China will continue to rise, reaching 2.52/100 000 by 2030 (95%CI: 0.22/100 000-4.83/100 000), though future trends remain uncertain.

From 2005 to 2018, the ASIR of NMSC in China showed a rising trend, with significant differences across age, sex, and regions. It is recommended to strengthen targeted prevention and health education efforts in different areas to enhance public awareness of NMSC.

To analyze the epidemiological characteristics of malignancy deaths and the changing patterns of potential life loss in Hengshui City from 2015 to 2024, providing data support for the formulation of malignancy prevention and control strategies.

We collected data on malignancy deaths among registered residents in Hengshui City, calculated the standardized mortality rates for total, gender, age, and malignancy categories, and analyzed the potential life loss and trends for the top four leading causes of malignancy deaths.

The standardized mortality rates for malignancy among registered residents in Hengshui City from 2015 to 2024 were 81.05/100 000, 72.89/100 000, 92.47/100 000, 97.23/100 000, 105.47/100 000, 97.66/100 000, 115.93/100 000, 116.78/100 000, 125.23/100 000, and 125.87/100 000, showing an upward trend (AAPC=6.20%, P<0.05). The standardized mortality rates for males were higher than those for females (all P<0.05). The top four leading causes of malignancy deaths among registered residents in Hengshui City were lung cancer, stomach cancer, liver cancer, and colorectal cancer, accounting for 26.51%, 11.34%, 11.57%, and 4.64% of deaths, respectively. The standardized mortality rates for all four malignancies showed an upward trend, with AAPC values of 11.01%, 15.17%, 3.35%, and 9.43%, respectively (all P<0.05). The proportions of malignancies, lung cancer, liver cancer, and stomach cancer in the 70-79 age group showed a significant upward trend for both males and females, and the proportion was the highest. The average age at death from malignancies, lung cancer, liver cancer, and stomach cancer showed a slight upward trend (AAPC: 0.46%, 0.47%, 0.54%, 0.46%, respectively; P<0.05), while the trend in the average age at death from colorectal cancer was not significant. Among the top four leading causes of malignancy deaths, lung cancer had the highest mean potential life loss (PYLL: 12 123.00 person-years), liver cancer had the highest average potential life loss (AYLL: 15.97 years), and lung cancer had the highest potential life loss rate (PYLLR: 2.80‰). Based on the average potential life loss, the order of life loss was liver cancer, colorectal cancer, lung cancer, and stomach cancer.

The standardized mortality rates for different types of malignancies showed an upward trend, with significantly higher rates for males than females. The proportion of deaths occurring in the 70-79 age group rose significantly, whereas that in the 40-49 age group declined. AYLL from malignant tumors showed an overall downward trend, while the PYLLR for lung, liver, and colorectal cancer increased, suggesting a growing impact on the life expectancy of residents with Hengshui household registration. These trends should be utilized to adjust malignancy prevention and control measures accordingly.

To analyze the death status and life loss of patients with severe mental disorders in Wuhan during the period from 2018 to 2022, in order to provide references for formulating bailout management policy for patients with severe mental disorders.

The death data on gender, age, diagnosis, cause of death, and other related information were obtained from the National Information System for Severe Mental Disorders during 2018—2022. Excel 2022 and SPSS 21.0 software were applied to analyze the death characteristics, death cause distribution and mortality. Years of life lost (YLL) and related indicators were used to analyze the life expectancy reduction due to severe mental disorders.

From 2018 to 2022, a total of 3 557 patients with severe mental disorders died in Wuhan, most of them had schizophrenia (2 541 cases, 71.44%). There were more male patients (2 019 cases, 56.76%) than female patients (1 538 cases, 43.24%). The average age of death was 58.06±15.21 years, mainly concentrated in the elderly population over 60 years old (1 719 cases, 48.33%). Significant differences in mortality rates were observed between 2018 and 2022(χ²=58.678, P<0.001), with statistically significant differences found only among patients with schizophrenia (χ²=45.600, P<0.001) and those with mental retardation accompanied by mental disorders (χ²=16.120, P=0.003). Physical diseases were the leading cause of death (2 193 cases, 61.65%). For patients aged 1-69 years, all causes of death resulted in 83 380.75 person-years of potential years of life lost (PYLL), an average years of life lost (AYLL) of 30.71 years, and a potential years of life lost rate (PYLLR) of 173.89%. The greatest total loss of life was caused by schizophrenia, while the highest AYLL was observed for epilepsy with mental disorders (34.08 years).

Severe mental disorders are important diseases that cause life loss, and combined physical diseases are the main cause of death for patients in Wuhan from 2018 to 2022. It is suggested that we should pay more attention to chronic disease management of patients with severe mental disorders, strengthen bailout, and take multiple measures to reduce the risk of death of patients.

To assess the internal exposure level of pentachlorophenol (PCP) among residents of traditional agricultural production areas in Guangzhou and analyze its possible influencing factors.

From June to August 2023, a two-stage random sampling method was used to select village/neighborhood committees and households in a town in a traditional agricultural production area of Guangzhou. All eligible permanent residents older than 6 years from the selected households were selected as the research subjects. Questionnaire survey, physical examination and urine sample collection were carried out on a household basis. The concentration of PCP in urine was detected by headspace solid-phase microextraction and gas chromatography mass spectrometry, and the health risk of residents exposed to PCP was evaluated. Multiple linear regression model was used to analyze the possible influencing factors of urinary PCP exposure.

The actual effective sample size of this study was 284, aged 7-85 years. The detection rate of PCP in urine was 92.3% (262/284), and the detection value ranged from <LOD to 18.010 μg/L. The median urinary concentrations of pentachlorophenol for non-creatinine-adjusted and creatinine-adjusted were 0.625 μg/L and 0.611 μg/g creatinine, respectively. The median exposure of residents to PCP based on creatinine-corrected urinary PCP concentrations was 0.013 μg/(kg·BW·d) and the maximum exposure was 0.735 μg/(kg·BW·d), lower than the reference dose of 5 μg/(kg·BW·d) established by the U.S. Environmental Protection Agency. Multiple regression analysis found higher urinary PCP exposure in residents with low education (GM ratio=0.549, 95% CI: 0.339-0.890), long outdoor activities (GM ratio=1.393, 95% CI: 1.005-1.931) and pets at home (GMratio=0.674, 95% CI: 0.457-0.995), and lower urinary PCP levels were in residents with low BMI (GM ratio=0.758, 95% CI: 0.602-0.953).

The 284 residents in traditional agricultural production areas of Guangzhou were generally exposed to PCP, but the level of internal exposure posed an acceptable risk to their health.Educational level, BMI, outdoor activity time, and keeping pets at home were factors that affected the level of urinary PCP exposure.

To clarify the spatial and temporal distribution pattern of the incidence of non-occupational carbon monoxide poisoning in Shandong Province, to reveal the meteorological driving factors behind it, and to provide reference for its scientific prevention and control.

Non-occupational carbon monoxide poisoning incident reports were collected through the China Disease Control and Prevention Information System Public Health Emergency Reporting Management Information System. Descriptive analysis was used to study the prevalence characteristics of non-occupational carbon monoxide poisoning. Spatial autocorrelation analysis and spatio-temporal scanning analysis were performed to explore spatio-temporal aggregation using ArcGIS 10.7 and SaTScan 10.1.2 software, respectively. The influence of meteorological factors on the incidence of non-occupational carbon monoxide poisoning was assessed using an optimal parameter geographical detector.

A total of 12 088 cases of non-occupational carbon monoxide poisoning were reported in Shandong Province from 2019 to 2023, with peak incidence from November to March of the next year each year, and middle-aged and older populations people as the main high-risk groups. Global spatial autocorrelation analysis showed spatial clustering of non-occupational carbon monoxide poisoning incidence rates in both 2020—2022(P<0.05). The southern part of Shandong Province was gradually developing into a new hot spot. Spatio-temporal scanning analysis detected five aggregation zones, of which the primary aggregation zone was mainly concentrated in the northern part of Shandong Province (Nov 2019—Mar 2021, LLR=2 003.71, P<0.001). The results of the optimal parameter geographical detector showed that relative humidity and barometric pressure were important meteorological factors affecting morbidity, with the largest interaction between relative humidity and wind speed.

Non-occupational carbon monoxide poisoning in Shandong Province showed seasonal spatiotemporal clustering. It is recommended to strengthen the winter and spring health education work for middle-aged and older populations and other high-risk groups. At the same time, disease prevention and control organizations at all levels should establish good information communication with meteorological and propaganda departments. Early warning of non-occupational carbon monoxide poisoning accidents in key endemic areas such as northern Shandong Province and southern Shandong Province should be strengthened through these initiatives.

To investigate the relationships between different dimensions of biological rhythm disorders, depression and anxiety symptoms among adolescents, and to identify the key dimensions that have a greater impact on mental health, providing a basis for developing targeted interventions.

Conducted from September to November 2023 in Tianjin, this study recruited middle school students from urban and suburban areas using convenience and stratified cluster sampling methods, yielding 3 787 valid questionnaires. The Self-rating Questionnaire of Biological Rhythm Disorders for Adolescents (SQBRDA), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) were employed to assess biological rhythm disorders, depression, and anxiety symptoms, respectively. Network analysis was utilized to examine the association strengths between dimensions and to calculate centrality indices to pinpoint key nodes.

Activity rhythms showed higher centrality in the network (0.436), the edge weight between decreased interest and low mood was the largest in the depression symptom subnetwork (0.319), and the edge weight between persistent worry and excessive worry was the largest in the anxiety symptom subnetwork (0.446). In the biological rhythm subnetwork, the edge weight between activity rhythms and electronic product use rhythms was the largest (0.566). Females had stronger associations in the depression symptom network and the biological rhythm disorder network (0.194).

The study demonstrates a complex correlation network between adolescent biological rhythm disorders, depression and anxiety symptoms, especially activity rhythm and electronic product use rhythm.

To understand the longitudinal association of adverse childhood experiences and self-control with mobile phone dependence among junior high school students, and to provide reference for the development of prevention and control measures.

Convenience sampling was used to select 863 junior high school students from 18 classes in 2 middle schools as the research subjects. The Childhood Adversity Questionnaire, Self-Control Scale, and Mobile Phone Dependence Index Scale were used as the survey tools. Two follow-up surveys were conducted in November 2023 (T1) and May 2024 (T2). SPSS 23.0 was used for independent sample t-tests, one-way ANOVA, paired sample t-tests, partial correlation analysis, and factor analysis. Mplus 8.3 software was used for cross-lagged analysis and mediation effect testing.

The partial correlation analysis revealed that both the adverse childhood experiences and self-control were statistically significantly correlated with the mobile phone dependence of junior high school students (r=-0.646-0.762, P<0.05). The cross-lagged model analysis indicated that the adverse childhood experiences at T1 could positively predict the mobile phone dependence at T2 (β=0.107, 95% CI: 0.050-0.164, P<0.05); the mediation model analysis showed that the mediating effect of the adverse childhood experiences on the influence of self-control on the mobile phone dependence of junior high school students was (β=0.019, 95% CI: 0.006-0.033, P<0.05).

Adverse childhood experiences could positively and indirectly affect mobile phone dependence through self-control among junior middle school students.

To explore the association between self-reported myopia prevalence and parental reproductive age in middle school students.

A questionnaire survey was conducted among 1 485 students from 11 junior/senior high schools in Tong’an District, Xiamen through multistage cluster sampling, which was used to collect information on the characteristics of the students and their parents, as well as self-reported vision. Logistic regression models were used to analyze the relationship between parental reproductive age, parental vision and self-reported myopia prevalence in middle school students.

The self-reported myopia prevalence of middle school students was 80.4%. Among the students whose parental reproductive age was ≥40 years, the self-reported myopia prevalence was higher, which accounted for 84.2% and 83.2%, respectively (P<0.05). After adjusting for covariates, compared with students whose parental reproductive age was <20 years, the middle school students in groups of fathers aged 30-39 years (OR=2.04, 95% CI: 1.02-4.10) and ≥40 years (OR=2.18, 95% CI: 1.04-4.60), and mothers aged 30-39 years (OR=3.41, 95% CI: 1.83-6.36) and ≥40 years (OR=3.44, 95% CI: 1.66-7.12) had a higher risk of self-reported myopia. Among the students whose maternal reproductive age was 30-39 years, the risk of self-reported myopia increased with an increase in paternal reproductive age (P<0.05). When neither parent was myopic, the risk of self-reported myopia among students increased in the groups of fathers aged 30-39 years (OR=3.34, 95% CI: 1.35-8.49), ≥40 years (OR=3.93, 95% CI: 1.48-10.44), and mothers aged 20-29 years (OR=2.70, 95% CI: 1.33-5.49), 30-39 years (OR=3.04, 95% CI: 1.43-6.47), and ≥40 years (OR=3.93,95% CI: 1.63-9.49). When either parent was myopic, the differences in self-reported myopia risk were not statistically significant across different parental reproductive ages.

Advanced parental reproductive age is associated with an increased risk of self-reported myopia among middle school students, particularly in those with both parents being non-myopic. It is necessary to pay more attention to the prevention and control of myopia of middle school students with older parental reproductive age.

To examine the impact of social participation on life satisfaction in perimenopausal women and the mediating role of depression over time.

Using China Health and Retirement Longitudinal Study (2011—2018) data, a latent growth model analyzed trajectories of social participation, depression, and life satisfaction in 1 133 perimenopausal women and tested the longitudinal mediation of depressionin in the relationship between social participation and life satisfaction.

Social participation, depression, and life satisfaction showed increasing trends. After controlling for education, the intercept of social participation negatively predicted the intercept of depression (β=-1.198, P<0.001), and the intercept of depression negatively predicted the intercept of life satisfaction (β=-0.058, P<0.001). The slope of social participation negatively predicted the slope of depression (β=-0.909, P<0.05), while the slope of depression negatively predicted the slope of life satisfaction (β=-0.101, P<0.001). The intercept and slope of depression showed longitudinal mediation between social participation and life satisfaction, with indirect effects of 0.069(95% CI: 0.037-0.112) and 0.092(95% CI: 0.024-0.215),respectively.

Social participation indirectly affects life satisfaction by influencing the level of depression. Providing flexible participation opportunities and emotional support may enhance psychological well-being and life satisfaction in perimenopausal women.

To analyze the prevalence of diabetes and self-management behaviors among elderly Dai, Hani, and Bai in rural areas of Yunnan.

A multi-stage stratified random sampling approach was used to conduct a questionnaire survey and blood glucose measurement on 4 229 rural residents aged ≥60 years from the Dai, Hani, and Bai ethnic groups in Yunnan.

The age-standardized prevalence rate of diabetes among elderly individuals in the surveyed areas was 7.6%for the Dai ethnic group, 5.0% for the Hani ethnic group, and 16.0% for the Bai ethnic group. The differences in diabetes prevalence among the three ethnic groups were statistically significant (χ²=105.856, P<0.001), with the Bai group having the highest prevalence, followed by the Dai and then the Hani. The differences in prevalence among the three ethnic groups within each age group were all statistically significant (all P<0.01). Among diabetic patients, the rates of adhering to taking prescribed medications, self-monitoring blood glucose, and taking at least one measure to control blood glucose in the past two weeks were 94.7%, 42.1%, and 100.0% for the Dai ethnic group, 79.4%, 26.5%, and 94.1% for the Hani ethnic group, and 98.2%, 57.6%,and 98.8% for the Bai ethnic group, respectively. Across all three ethnic groups, dietary control was the most commonly adopted measure for managing blood glucose in the two weeks prior to the survey. The overall blood glucose control rate among the three ethnic groups was 47.7%. The blood glucose control rates among elderly diabetic patients were 50.9% for the Dai, 58.8% for the Hani, and 44.2% for the Bai ethnic groups, with no statistically significant differences observed among the groups (P>0.05).

Significant ethnic differences in diabetes prevalence and self-management behaviors are observed among elderly individuals from the Dai, Hani, and Bai ethnic groups in rural Yunnan. Targeted health interventions and management strategies should be developed to address ethnic backgrounds and health needs of these populations.

To explore the relationship between subjective cognitive decline and frailty in community-dwelling older adults with comorbidities, and analyze the mediating effects of self-perceptions of aging and cognitive reserve.

From June to October 2023, 505 community-dwelling older adults aged 65 and above in Xinxiang City with comorbidities were selected to conduct a questionnaire survey. Descriptive statistics, ANOVA and correlation analysis were performed on the data, and AMOS 27.0 was used to construct a chain mediation model.

Subjective cognitive decline had a positive impact on frailty (β=0.100, 95% CI: 0.006-0.191, P=0.040). Self-perceptions of aging and cognitive reserve played a mediating role between subjective cognitive decline and frailty (β=0.079, 95% CI: 0.042-0.123, P<0.001; β=0.029, 95% CI: 0.011-0.056, P<0.001), accounting for 36.12% and 13.37% of the total effect value, respectively. Moreover, self-perceptions of aging and cognitive reserve jointly played a chain-mediating role between subjective cognitive decline and frailty (β=0.010, 95% CI: 0.004-0.021, P<0.001), accounting for 4.77% of the total effect value.

The findings that self-perceptions of aging and cognitive reserve play independent mediating roles and a chain-mediating role between subjective cognitive decline and frailty suggest that attention should be paid to the subjective feelings of community-dwelling older adults with comorbidities. It is essential to cultivate a positive view of aging among the elderly and enhance their cognitive reserve levels. By doing so, the onset of frailty can be delayed, thus promoting healthy aging.

To explore the compliance of telemedicine services on third-party platforms since the release of the“Telemedicine Supervision Rules (Trial)” in 2022.

An anonymous standardized patient method was employed to assess the compliance of diagnostic behaviors on eight well-known, large-scale third-party internet healthcare platforms in China.Diagnostic scenarios were designed around five representative clinical cases. Based on the Telemedicine Supervision Rules (Trial),20 regulatory indicators were extracted across five key dimensions—clinical practice supervision, pharmaceutical services, prescription and medical record standards, identity verification, and quality and safety oversight.

The platforms generally deviated from policy requirements in areas such as online first diagnosis, medication prescribed before diagnosis and prescription authenticity, with average compliance rates of 29%, 25%, and 10%, respectively. Some platforms were suspected of using artificial intelligence to replace doctors in consultations. Compliance was better in areas such as physician qualification certification and real-name authentication, patient real-name authentication, termination of online medical services, and prohibiting patients from being directed to other medical providers, with only a few cases of violations. The causes of compliance issues included the policy’s failure to adapt to industry development, low government regulatory willingness, weak regulatory effectiveness, and the profit-driven behavior of platforms and healthcare providers.

Third-party platforms still face varying degrees of compliance issues in medical practices, pharmaceutical services, prescription regulation, and personnel identity management. It is recommended to strengthen government regulatory functions, enforce platform accountability, improve the dynamic adjustment mechanism of policies, and enhance social supervision and industry self-regulation.

To analyze the disease burden of patients with cervical cancer (CC) and precancerous lesions in Suzhou in 2022,evaluate the cost-effectiveness of different human papillomavirus (HPV) vaccines, and explore the optimal vaccination mode in Suzhou.

A retrospective survey was conducted to investigate the medical expenses and hospitalization costs of patients with CC and precancerous lesion in Suzhou City in 2022. Using the PRME model, we evaluated the cost-effectiveness of different immunization strategies and combined sensitivity analysis to determine the optimal solution.

Assuming that 13-year-old girls in Suzhou received domestic bivalent HPV vaccine (2vHPV) or 9-valent HPV vaccine (9vHPV) in 2022, and the vaccination rate reached 90.00%, the model predicted that it could avoid 77-103 cases of CC and 17-23 deaths in the future, saving 42.54-56.64 disability-adjusted life years (DALYs). Compared with not receiving the vaccine, the incremental cost-effectiveness ratio (ICER) of 2vHPV and 9vHPV was 10 423.54 yuan/DALYs and 131 348.23 yuan/DALYs, respectively, and both were cost-effective.

Both 2vHPV and 9vHPV are cost-effective. Compared to 9vHPV, vaccinating 13-year-old girls with 2vHPV is a more cost-effective vaccination strategy. The cost of vaccines plays a crucial role in determining the ICER. When the price of 9vHPV drops below 90.50 yuan per dose, its ICER becomes lower than that of 2vHPV at 63.00 yuan per dose. Therefore, reducing HPV vaccine prices through government negotiation, centralized procurement, and promoting domestic vaccines is recommended.

In order to further optimize the allocation of primary health resources, this study analyzed the status quo and equity of primary health resources allocation in Inner Mongolia from 2019 to 2023.

Using Lorenz curve, Gini coefficient and Theil index, the equity of primary health resource allocation in Inner Mongolia was measured and analyzed.

In the medical and health resources of all the cities in Inner Mongolia Autonomous Region, Hohhot ranked first. According to the fairness of population allocation, the Gini coefficient ranged from 0.025 9 to 0.155 3，the total Theil index ranged from 0.004 0 to 0.077 3，and the intra-regional variance rates ranged from 61.65% to 93.50%. According to the fairness of geographical area allocation, the Gini coefficient ranged from 0.453 8 to 0.516 5, the total Theil index ranged from 0.256 7 to 0.352 8, and the inter-regional difference rate ranged from 13.12% to 24.93%. According to the fairness of GDP allocation, the Gini coefficient ranged from 0.100 7 to 0.379 2, the total Theil index ranged from 0.096 9 to 0.240 2, and the inter-regional difference rate ranged from 24.56% to 38.06%.

The total amount of primary health resources in Inner Mongolia has achieved continuous growth, but there is a structural imbalance in the allocation of medical human capital. The fairness of allocation according to population and GDP is significantly better than that according to geographical area. The distribution of primary health resources in different cities is uneven, forming a gradient pattern of "central uplift-edge collapse", with noticeable underutilization of primary health resources.

To explore the factors affecting the acceptance of pre-pregnancy eugenic health examination for women of childbearing age and provide evidence for improving pre-pregnancy health care services.

A multi-stage stratified random sampling method was adopted to investigate the pre-pregnancy eugenic health examination of 1 995 women of childbearing age in Mianyang City, Sichuan Province through questionnaires. Based on the Andersen theoretical model, four logistic regression analysis models were established to explore the factors influencing the acceptance of pre-pregnancy eugenic health examination by women of childbearing age.

The rate of pre-pregnancy eugenic health examination was 61.1%, of which 53.1% were free and 46.9% were self-paid. The predisposing characteristics, enabling resource-financing, enabling resource-organization and perceived needs were incorporated into the regression model layer by layer. It was found that enabling resource-organization had the greatest impact. Model 4 had the strongest overall explanatory power. Logistic regression analysis results showed that women of childbearing age without insurance or only with commercial insurance (OR=0.526, 95% CI: 0.278-0.996) and those who purchased the urban-rural resident basic medical insurance (OR=0.757, 95% CI:0.597-0.959) had a lower rate of pre-pregnancy eugenic health examination compared to those who purchased urban employee basic medical insurance (P<0.05). From the organizational perspective, women of childbearing age who knew about the free pre-pregnancy eugenic health examination policy (OR=2.907, 95% CI: 2.267-3.728). From the perceived demand perspective, women who planned to get pregnant (OR=1.811,95% CI: 1.459-2.249) were more inclined to accept the pre-pregnancy eugenic health examination (P<0.05).

It is necessary to further promote the implementation of free pre-pregnancy health care service policy, strengthen health education based on primary medical and health institutions, and promote more women of childbearing age to take the initiative to accept pre-pregnancy eugenic health examination services.

To investigate the impact of social jetlag on body mass index (BMI) among shift nurses and its underlying mechanisms.

A convenience sample of 429 shift nurses from five tertiary hospitals in Sichuan Province was selected.Data were collected using the Munich Chronotype Questionnaire for Shift Workers (MCTQshift), the Pittsburgh Sleep Quality Index (PSQI), the Morningness-Eveningness Questionnaire (MEQ-5), and BMI measurements. Statistical analyses included univariate analysis, partial correlation analysis, and moderated mediation model testing.

Social jetlag significantly predicted BMI levels (β=0.348, 95% CI: 0.259-0.437, P<0.001). Sleep quality partially mediated the relationship between social jetlag and BMI,with an effect size of 0.101(95% CI: 0.030-0.172, P<0.001), accounting for 29% of the total effect. The predictive effect of social jetlag on BMI (β=0.194, 95% CI: 0.108-0.281, P<0.001) and the effect of sleep quality on BMI (β=-0.121, 95% CI: -0.215~-0.027,P=0.012) were both moderated by chronotype.

This study revealed the potential mechanisms through which social jetlag affects BMI levels among shift nurses. It highlights the importance of reducing social jetlag and improving sleep quality, as well as the role of chronotype in moderating the adverse effects of social jetlag on BMI abnormalities. These findings provide a theoretical basis for nursing managers to develop more scientific and effective interventions for BMI management among shift nurses, ultimately reducing BMI abnormalities and promoting their physical and mental health.

This study aimed to explore the associations between different physical activity (PA) patterns and depressive and anxiety symptoms, and to provide scientific evidence for health departments to formulate preventive strategies for depression and anxiety and refine PA guidelines.

Data from adults aged 18 years and above from the National Health and Nutrition Examination Survey (NHANES) database from 2007 to 2012 were used. PA data were obtained through the Global Physical Activity Questionnaire (GPAQ). Participants were divided into three groups based on the total time and frequency of Moderate-to-vigorous physical activity (MVPA): inactive (MVPA time≤150 min/week), weekend warrior (WW; MVPA time≥150 min/week, and MVPA frequency≤2 days/week) and regularly active (RA; MVPA time≥150 min/week, and MVPA frequency≥3 days/week). Depressive and anxiety symptoms were assessed by the Patient Health Questionnaire-9 and the Anxiety Self-Report Questionnaire, respectively. Multiple weighted logistic regression was used to explore the relationship between PA patterns and depressive and anxiety symptoms.

A total of 15 851 participants were included in this study, including 10 694 (67.5%) in the inactive, 1 006 (6.3%) in the WW, and 4 151 (26.2%) in the RA. Compared with the inactive, the WW and RA had a lower risk of depressive symptoms by 67.9% (OR=0.321, 95% CI: 0.205-0.502) and 49.1% (OR=0.509, 95% CI: 0.383-0.676), respectively.In terms of anxiety symptoms, compared with the group, RA was associated with a 17.2% lower risk of anxiety symptoms (OR=0.828, 95% CI: 0.719-0.954), while WW had no statistically significant lower risk of anxiety symptoms (OR=0.800, 95% CI:0.628-1.018). There was no statistical difference in the risk of depressive and anxiety symptoms between WW and RA (P>0.05).

This study demonstrates that both WW and RA, as long as they meet the PA guidelines (MVPA time≥150 min/week), can effectively reduce the risk of depressive symptoms in adults. For reducing the risk of anxiety symptoms, in addition to meeting the PA guidelines, it is also necessary to ensure PA for at least three days per week.

To evaluate the applicability of the Job Content Questionnaire (JCQ-22) based on classical test theory (CTT) and item response theory, and to optimize and adjust it.

A survey of 917 occupational groups who had a physical examination at a hospital from September 1 to September 30, 2021 was conducted using JCQ-22, and the entries were comprehensively analyzed using the Rasch model, two-parameter logistic model (2PL), and grade-response model (GRM) in the IRT, combined with Cronbach’s α coefficient within CTT, and the factor analysis method.

In the IRT analysis, the difficulty coefficients of the entries ranged from -2.49 to 0.36, and the difficulty coefficients of “JOB4”, “JOB7”, “JOB10”,“JOB11” had a differentiation degree lower than 1.34, and the corresponding average information content was significantly lower than the other entries. In the CTT analysis, a total of 18 entries met the statistical criteria, therefore, combining the IRT and CTT, the JCQ-22 was optimized and adjusted, and the results showed that the adjusted scale JCQ-18 had 18 entries, which was more concise and had a more stable structure.

Most of the entries of JCQ-22 performed well, while some of the entries did not meet the acceptable standards and need further optimization.

To combine reverse transcription recombinase-aided amplification (RT-RAA) technology with the CRISPR/Cas13a detection system to establish a rapid, sensitive, and specific detection method for arthropod-borne viruses (RT-RAA-CRISPR/Cas13a).

We designed and synthesized RT-RAA isothermal amplification primers and specific crRNAs for four arthropod-borne viruses, namely, Zika (ZIKV), dengue (DENV), Japanese encephalitis (JEV), and chikungunya (CHIKV), and screened for the optimal combinations of amplification primers and crRNAs to establish the detection system.Viral nucleic acids were detected by fluorescence and lateral flow assay to determine the sensitivity and specificity. A TCEP/EDTA-based heat lysis protocol was optimized to enable virus detection without nucleic acid extraction.

Highly efficient amplification primers and crRNAs for ZIKV, DENV, JEV and CHIKV were screened, and an RT-RAA-CRISPR/Cas13a fluorescence and lateral flow assay was established for detection of arthropod-borne viruses. The method can complete the detection in 40 min, and the lowest detection limit was 10² copies/μl (ZIKV, DENV and CHIKV) to 10¹ copies/μl (JEV), and the sensitivity was comparable to that of RT-qPCR. There was no cross-reactivity among the four pathogens, and the specificity was high. Meanwhile, this method combined with nucleic acid extraction-free method can directly detect virus particles in liquid samples, which has the potential for field site application.

The CRISPR/Cas13a-assisted RT-RAA method established in this study demonstrates notable advantages, including simple operation, rapid reaction, high specificity, superior sensitivity, and low cost, and does not rely on specialized nucleic acid detection equipment, but only requires a thermostatic heating instrument to complete the detection. The method is suitable for the immediate detection of arthropod-borne viruses, offering a novel technical platform for arbovirus identification.

To investigate the incidence of adverse reactions of recombinant zoster vaccine (RZV) in people≥50 years, and to provide reference for RZV vaccination.

The data of 523 patients who received RZV in the outpatient department of Guizhou Center for Disease Control and Prevention from September 2021 to September 2023 were analyzed.

A total of 523 patients were inoculated with the RZV and the overall incidence of adverse reactions was 50.10%. The incidence of adverse reactions was 63.22% in the 50-59 age group, 40.72% in the 60-69 group, and 26.47% in those aged ≥70 years. Among females and males, the incidence was 44.88% and 61.73%, respectively. The incidence was 61.27% in underweight individuals, 46.59% in those with normal weight, and 30.00% in those who were overweight or obese. Patients with a history of endocrine disease, cardiovascular disease, and shingles showed incidences of 70.83%, 63.72%, and 53.85%, respectively.

The incidence of adverse reactions following RZV vaccination in individuals ≥50 years in Guiyang is relatively low, and most adverse reactions are mild. The incidence rate is influenced by factors such as age, gender, weight, and the presence of underlying diseases. Post-vaccination monitoring and treatment following RZV administration should be tailored to each individual.

To explore the association between serum uric acid (SUA), the uric acid to high-density lipoprotein cholesterol ratio (UHR), and liver function among Zhuang minority male residents aged 35-74 years in Guangxi, and to provide scientific evidence for developing strategies to regulate SUA levels and preserve hepatic health.

A cross-sectional study was conducted based on the Guangxi Ethnic Minorities Cohort, using structured questionnaires, physical examinations, and blood and urine sample collection. Logistic regression analysis was used to identify factors associated with liver dysfunction, while restricted cubic spline was performed to evaluate dose-response relationships of SUA and UHR with liver dysfunction.

This study included 4 977 Zhuang minority male adults, with a mean age of 54.8 years. Among them,38.4% of participants had middle school education, 53.9% were farmers, and 47.1% with household income over 30 000 Yuan in the past year, 30.9% with SUA levels >420 μmol/L, and 10.4% had liver dysfunction. After adjusting for confounders, compared to the normal SUA group, the adjusted OR(95% CI) for liver dysfunction in the 421-479 μmol/L and ≥480 μmol/L groups were 1.30 (1.01-1.67) and 1.69 (1.32-2.15), respectively. Compared with the lowest UHR quartile (≤22.25%), the adjusted OR (95% CI) for the 22.26-28.96%, 28.97-38.26%, and ≥38.27% quartiles were 1.23 (0.89-1.71), 1.76(1.24-2.50), and 2.08 (1.39-3.11), respectively. The risk of liver dysfunction increased non-linearly with the increase of SUA and UHR levels (P_nonlinearity <0.001).

SUA and UHR demonstrated significant associations with the risk of liver dysfunction among Zhuang minority male residents aged 35-74 years in Guangxi. Targeted health education efforts should be strengthened to control SUA levels and reduce UHR, thereby helping to preserve liver function in middle-aged and older individuals of the Zhuang minority.

To analyze the risk factors for renal failure in patients with chronic kidney disease (CKD) complicated by hypertension.

A total of 230 CKD patients with hypertension admitted to Chaohu Hospital Affiliated to Anhui Medical University from April 2023 to April 2024 were enrolled. According to the occurrence of renal failure, the patients were divided into the renal failure group (n=47) and the non-renal failure group (n=183). Baseline characteristics were compared between the two groups. Lasso regression and multivariate logistic regression were used to screen for risk factors of renal failure.

Among the 230 patients, 47 (20.43%) developed renal failure. Logistic regression analysis revealed that hyperuricemia (OR=3.104, 95% CI: 1.661-5.800), anemia (OR=3.413, 95% CI: 1.706-6.828), hyponatremia (OR=2.852, 95% CI: 1.383-5.882),proteinuria (OR=2.858, 95% CI: 1.318-6.198), advanced age (OR=2.579, 95% CI: 1.396-4.765), and uncontrolled blood pressure (OR=2.211, 95% CI: 1.193-4.096) were independent risk factors for renal failure in CKD patients with hypertension.

CKD patients with hypertension have a high risk of renal failure. Advanced age, uncontrolled blood pressure, hyperuricemia, anemia, hyponatremia, and proteinuria are significant risk factors for renal failure in this population.

To investigate the correlation and dose-response relationship of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with type 2 diabetes mellitus (T2DM) in the elderly aged over 65 years.

The participants were from the medical examination of the elderly aged 65 years and over in Wujin district, Changzhou city in 2022. The survey contents included questionnaire survey, physical examination and laboratory examination. Logistic regression and restricted cubic spline were used to analyze the correlation and dose-response relationship of NLR and PLR with T2DM.

A total of 112 073 individuals were included in this study, with an average age of 72.66±5.62 years. Among them, 53 557 (47.79%) were male, and 16 935 (15.11%) were T2DM patients. After adjusting for relevant confounding factors, compared with the Q1 group of PLR, the ORs (95% CI) for T2DM in the Q2, Q3, and Q4 groups were 0.93 (0.88-0.97), 0.83 (0.79-0.87), and 0.73 (0.70-0.77).respectively (P _fortrend <0.001). Compared with the Q1 group of NLR, the ORs (95% CI) for T2DM in the Q2, Q3, and Q4 groups were 1.12 (1.06-1.18), 1.19 (1.13-1.25), and 1.35 (1.28-1.42), respectively (P _fortrend <0.001). Subgroup analysis results showed that the established in this study demonstrates notable advantages, including simple operation, rapid reaction, high specificity, superior sensitivity, and low cost, and does not rely on specialized nucleic acid detection equipment, but only requires a thermostatic heating instrument to complete the detection. The method is suitable for the immediate detection of arthropod-borne viruses, offering a novel technical platform for arbovirus identification.correlation between PLR and NLR and T2DM remained statistically significant across subgroups stratified by sex, age, hypertension, BMI, and abdominal obesity (all P-values < 0.05). Hypertension status and gender had significant interactions with the association between PLR, NLR and T2DM (P _{forinteraction} < 0.05). The results of the restricted cubic spline showed that PLR had a negative nonlinear relationship with the prevalence of T2DM (P=0.008), and NLR had a positive nonlinear relationship with the prevalence of T2DM (P<0.001). The threshold effect inflection points of PLR and NLR on T2DM were 158.0 and 2.47 respectively (log-likelihood ratio test P<0.05).

The risk of T2DM increased with the increase of NLR and decreased with the increase of PLR. This study also found nonlinear dose-response relationships between NLR, PLR and T2DM.

To investigate the prevalence of seasonal human coronaviruses (sHCoV) in acute respiratory infection cases in selected medical institutions in Shanghai before and after the COVID-19 pandemic.

A retrospective analysis was conducted on respiratory samples from 11 794 acute respiratory infection cases collected between January 2016 and December 2023 at nine medical institutions. Multiplex PCR was used to detect sHCoV, and the χ² tests were performed to compare detection rates across three periods (pre-pandemic, during the pandemic, and post-pandemic) and to assess changes in epidemic characteristics.

Among the 11 794 respiratory samples, the overall detection rate of eight common respiratory viruses declined significantly during and after the pandemic. The overall detection rate of sHCoV was 3.47% (409/11 794), decreasing to 1.58% (55/2 259) during the pandemic and further to 1.42% (32/3 482) post-pandemic (P<0.001). Before the pandemic, sHCoV circulated year-round, with peak activity from March to September. During the pandemic, the peak shifted to July-December, whereas post-pandemic, detections were observed throughout the year without a clear seasonal peak. Before the pandemic, the four sHCoV subtypes circulated alternately, with HCoV-NL63 being the most prevalent and remaining stable during the pandemic. However, post-pandemic, HCoV-229E became dominant, and subtype-specific trends shifted. Notably, HCoV-229E transitioned from a biphasic to a monophasic pattern, and re-emerging with a biphasic trend post-pandemic. The peak circulation periods of HCoV-HKU1 and HCoV-OC43 were delayed by 5-8 months, whereas HCoV-NL63 was not detected in the post-pandemic period.

The COVID-19 pandemic may have influenced the transmission patterns of sHCoV. After the pandemic, there was a decrease in the detection rate of sHCoV, a delayed seasonal peak, and changes in the viral subtype composition. Continued monitoring of these trends is essential to provide scientific support for respiratory infection prevention and control strategies.