To investigate the associations between blood benzene levels and the prevalence of heart diseases, as well as myocardial injury biomarkers, using data from the National Health and Nutrition Examination Survey (NHANES).

A total of 3 546 participants with available blood benzene measurements and heart disease questionnaire data were included in the study. Weighted logistic regression and weighted generalized linear models were used to perform multivariable-adjusted analyses. Restricted cubic spline (RCS) models were constructed to explore potential nonlinear relationships.

After natural logarithmic transformation, each one-unit increase in blood benzene was significantly associated with a higher odds of congestive heart failure (OR=1.59, 95% CI: 1.03-2.44, P=0.037), coronary heart disease (OR=1.59, 95% CI: 1.08-2.34, P=0.020), and myocardial infarction (OR=1.39, 95% CI:1.07-1.81, P=0.013). Meanwhile, serum lactate dehydrogenase levels increased by an average of 4.78 U/L (95% CI: 2.61-6.96, P<0.001), and high-sensitivity cardiac troponin I levels increased by an average of 1.10 ng/L (95% CI: 0.00-2.20, P=0.050). Although RCS analyses did not reveal significant non-linear associations, they supported a positive dose-response and dose-effect relationship between blood benzene levels and these adverse cardiac outcomes.

Blood benzene levels are significantly positively associated with the odds of heart disease and cardiac injury biomarkers, providing important clues for further investigation into the potential impact of low-level benzene exposure on cardiovascular health.

To analyze the epidemiological characteristics of hand, foot, and mouth disease (HFMD) in Hebei Province from 2014 to August 2024, and to provide a scientific basis for the formulation of effective prevention and control measures.

The case report data of HFMD in Hebei Province from 2014 to August 2024 were extracted from the Chinese Disease Prevention and Control Information System. Descriptive epidemiological methods were used for analysis, and the incidence trend of HFMD was predicted by the ARIMA model.

A total of 371 393 cases of HFMD were reported with 26 deaths from 2014 to August 2024. The average annual incidence and mortality rates were 45.279 1 per 100 000 and 0.003 2 per 100 000, respectively. The incidence rate of HFMD decreased year by year, as did the number of severe cases and deaths. The disease showed a clear seasonal pattern, with a high incidence period from May to July every year. The incidence rates in Langfang, Baoding, and Chengde were high. Children aged 1-4 were the most susceptible group, with more male cases than female. Enterovirus 71, Coxsackievirus A16, and other enteroviruses accounted for 20.62%, 26.87%, and 52.51%, respectively. Using the SARIMAX model to predict the number of HFMD cases from September 2024 to August 2025, which would decrease first and then increase. And the seasonal peak of incidence in 2025 would be higher than that in 2024.

The incidence rate of HFMD in Hebei Province has shown a downward trend, but the peak in 2025 is predicted to be higher than that in 2024. It is necessary to strengthen the monitoring of the epidemic and etiology, scientifically formulate prevention and control plans, and prepare for the response.

To investigate the association between the cardiometabolic index (CMI) and diabetes risk among hypertensive patients.

Utilizing health examination data from the National Basic Public Health Service Project in Jianye District, Nanjing (2019—2023), CMI was calculated basing on triglycerides, high-density lipoprotein cholesterol, waist circumference, and height. Diabetes was diagnosed according to the National Basic Diabetes Prevention and Management Guidelines (2022). Multivariable logistic regression models were applied to evaluate the association between CMI and diabetes risk, with odds ratios(ORs) and 95% confidence intervals(CIs) calculated. Restricted cubic spline analysis was used to explore the dose-response relationship. Subgroup analyses were performed to assess effect modifications.

This study included 56 760 hypertensive patients, with a final effective sample of 28 665 after excluding those with missing CMI-related indicators, of whom 7 535 had diabetes. Compared to those with lower CMI, hypertensive patients with higher CMI had significantly increased diabetes risk (P<0.001). Logistic analysis showed the highest CMI group (Q4) had a 40% higher diabetes risk than the lowest group (Q1) (OR=1.40, 95% CI: 1.30-1.52). Dose-response analysis revealed a nonlinear relationship (nonlinear P<0.001), indicating extreme CMI values might signal higher metabolic risks. Stratified analysis found a stronger association between CMI and diabetes risk in female hypertensive patients (OR=1.21, 95% CI: 1.16-1.27).

In Nanjing Jianye District residents, there is a significant positive correlation between CMI and diabetes risk in hypertensive patients, more pronounced in women. It is recommended to include CMI in metabolic risk assessment for community hypertensive patients, with a focus on personalized intervention for abdominal obesity and dyslipidemia in women.

To classify the general self-efficacy of patients with chronic comorbidities by using latent class analysis, thereby to analyze the influencing factors which affect the general self-efficacy of middle-aged and elderly patients with chronic disease comorbidities based on the results of category analysis, and to provide references for improving the mental health in the multi-dimensional health of the elderly in China and realizing “healthy aging”.

Based on the Ningxia Natural Science Foundation project in 2023, a multi-level stratified random sampling method was adopted to screen out 967 comorbidity patients. Latent class analysis and logistic regression analysis were used to explore the current situation and influencing factors of the general self-efficacy of patients with chronic comorbidities in Ningxia.

Among the 967 study subjects, the diseases with the highest prevalence rates among patients with comorbidities were hypertension, musculoskeletal disorders, and diabetes. The latent class analysis revealed that 402 individuals had low general self-efficacy, 161 had high general self-efficacy, and 403 had moderate general self-efficacy.The C2 “High Self-Efficacy Group” consisted of individuals aged 45 to 59 years (with OR values and 95% CI intervals being 0.374, 0.188; 0.208-0.671; 0.085-0.418), had lower educational levels (with OR values and 95% CI intervals being 0.192, 0.157; 0.041-0.893; 0.011-0.297), and those who received some financial support from their children (with OR values and 95% CI intervals being 0.491, 0.340; 0.328-0.736; 0.209-0.553) generally had lower general self-efficacy (all OR values <1). Among the middle-aged and elderly with two chronic diseases in their comorbidity status, those from C2 “High Self-Efficacy Group” had higher general self-efficacy (with OR values being 6.709, 3.303, both >1, and 95% CI intervals being 4.397-10.138; 2.468-4.421). In addition to the above factors, middle-aged and elderly living in rural areas (with an OR value of 0.616 and a 95% CI range of 0.402-0.944) in C1 “Moderate Self-Efficacy Group” generally had lower general self-efficacy, while those who occasionally Participated in activities from C2 “High Self-Efficacy Group” generally had lower general self-efficacy (with an OR value of 0.377 and a 95% CI range of 0.191-0.744).

In Ningxia, there are more middle-aged and elderly with moderate to low general self-efficacy. Age, educational level, residence,Participation in activities, financial support from children, and comorbidity status all affect the general self-efficacy of middle-aged and elderly in Ningxia. It is recommended to improve the elderly health service system in rural areas, establish elderly activity centers, encourage older people to Participate in more activities, form good exercise habits, and focus on rural Patients with lower educational levels. A series of health activities should be carried out in combination with the characteristics of comorbidities such as hypertension, arthritis, diabetes, etc., to helppatients manage with a positive attitude.

To systematically assess the trend of high BMI-related gout disease burden in China, Japan and Korea and globally from 1990 to 2021, and to provide a scientific basis for gout prevention and control.

Based on data from the Global Burden of Disease Study (GBD), the disease burden characteristics of high BMI-induced gout were resolved by gender and age group,and trends in the rate of standardized disability-adjusted life years (DALYs) were analyzed by using the Joinpoint regression model,and trends in the burden of disease were predicted for the period of 2022-2035 by the ARIMA model.

From 1990 to 2021,the rates of standardized DALYs among adults in China,Japan,Korea,and the world showed a simultaneous upward trend,with an increase of 114.82% in China,which was significantly higher than that of Japan(38.41%),Korea(62.40%), and the global average(62.01%). Gender analysis showed that the rate of standardized DALYs was higher in males than in females in all regions. The age distribution showed a single-peak pattern of increasing and then decreasing, with peak ages of 55-59 years for males and 65-69 years for females in China and globally, whereas peak ages were reached most recently in Japan for males(70-74 years) and females(75-79 years), and peak ages for males in South Korea(60-64 years) were in the middle of the range between China and Japan, and peak ages for females were in line with the global trend(65-69 years).The results of the Joinpoint regression showed that the peak ages of 1990-2021 DALYs rates of gouty diseases attributable to high BMI in China,Japan,and Korea and globally were on the rise in 2021 (AAPC was 2.50%,1.04%,1.58%,and 1.58%,respectively,all P<0.05).

The burden of gout associated with high BMI continues to increase in China,Japan,Korea,and globally,and it is necessary to strengthen the comprehensive management of BMI in the population and to implement focused interventions for high-risk age and gender groups.

To analyse the association between high blood pressure and dietary behaviors among children and adolescents aged 9 to 17 years in Inner Mongolia, and to develop targeted preventive measures for high blood pressure among children and adolescents in Inner Mongolia.

The data were obtained from the National Monitoring and Intervention Work Program for Common Diseases and Health Influencing Factors in Students, and a total of 129 821 primary and secondary school students were included in the stratified random cluster sampling method in September each year. The χ² test was used for the analysis of single factors, and binary logistic regression was used for multifactorial analyses, and risk prediction of high blood pressure was performed by column-line plots.

In Inner Mongolia, the overall high blood pressure of children and adolescents aged 9-17 years was 16.23%, with simple systolic blood pressure increase as the main cause. By gender, the overall high blood pressure rates of boys and girls were 15.42% and 17.05%, respectively, and the difference was statistically significant (χ²=63.38, P<0.001); the overall high blood pressure rates of primary schools, junior high school, and high school were 14.95%, 16.89%, and 17.77%, respectively, according to the school segments. The difference was statistically significant (χ²=124.95, P<0.001). Logistic regression model analysis showed that the risk of high blood pressure was higher in female students than in male students (OR=1.13, 95% CI:1.10-1.17), and the risk of high blood pressure was higher in junior high school and high school students than in primary school students [OR=1.14(95% CI:1.10-1.18), 1.18(95% CI:1.13-1.23), respectively], the risk of high blood pressure was lower for students in flag counties than for students in urban areas (OR=0.89,95% CI:0.86-0.92), and the rate of high blood pressure was lower for Mongolian and other students than for Han Chinese students [OR=0.96(95% CI:0.92-0.99), and 0.93(95% CI:0.87-0.99)], the risk of high BP was lower for those who ate fried food ≤1 time per week than for those who ate it ≥2 times per week (OR=0.86,95% CI:0.77-0.97), the risk of high BP was lower for those who ate chocolate ≤1 time per week than for those who ate it ≥2 times per week (OR=0.94,95% CI:0.91-0.97), and the risk of high BP was lower for those who ate butter ≤1 time per week had a lower risk of high blood pressure than students who ate it ≥2 times per week (OR=0.95,95% CI:0.92-0.98), ate pastry ≤1 time per week had a lower risk of high blood pressure than students who ate it ≥2 times per week (OR=0.93,95% CI:0.90-0.96), and drank soya milk ≤1 time per week had a higher risk of high blood pressure than students who drank it ≥2 times per week (OR=1.13,95% CI:1.03-1.24), and students who ate breakfast every day had a higher risk of high blood pressure than those who ate it sometimes or never [OR=1.15(95% CI:1.11-1.19),1.23(95% CI:1.15-1.31), respectively].

Dietary behaviour is closely associated with high blood pressure in children and adolescents, and this aspect should be actively addressed in future preventive measures.

To analyze the changing trends of urolithiasis burden among Chinese young and middle-aged adults from 1990 to 2021 and predict disease burden from 2022 to 2030, providing evidence for public health strategies and healthcare resource allocation.

Utilizing the Global Burden of Disease 2021 database, we calculated incidence and disability-adjusted life years (DALYs) for urolithiasis in Chinese adults aged 20-54. Joinpoint regression identified temporal trends and turning points. Age-period-cohort modeling decomposed age, period, and cohort effects on incidence. Autoregressive integrated moving average (ARIMA) models projected future disease burden.

From 1990 to 2021, urolithiasis cases increased from 9.566 million to 10.197 million (EAPC=0.20%), while age-standardized incidence declined (EAPC= -0.39%). DALYs decreased from 58 700 to 42 200 person-years (EAPC= -1.06%), with DALY rate declining (EAPC= -1.67%). Males consistently exhibited higher standardized incidence and DALY rates. Age-period-cohort analysis showed a linear rise in incidence risk with age, with relative risks (RR) from 0.279 to 2.331. The period effect had a “rising-declining” fluctuation (RR 0.937-1.080). The cohort effect decreased steadily as birth year advanced, with RR values from 0.835 to 1.607. Projections suggest cases will reach 10.396 4 million by 2030, yet standardized incidence and DALY metrics will maintain downward trajectories.

Despite decreasing standardized disease burden and persistent gender disparities since 1990, urolithiasis demonstrates age-progressive risks, period-specific fluctuations, and cohort-driven mitigation. Predicted high absolute burden underscores the urgency for targeted prevention strategies to address this persistent public health challenge.

To analyze and compare the characteristics of comorbidity patterns in skeletal fluorosis patients across different endemic regions, laying the foundation for further research on influencing factors, while providing references for healthcare systems to develop more targeted, effective, and cost-efficient chronic disease management plans for this special population.

This study adopted a cross-sectional design, selecting patients over 40 years old with skeletal fluorosis from Nayong County, Guizhou Province (a coal-burning fluorosis endemic area), Jishan County, Shanxi Province (a water-drinking fluorosis endemic area), and Ruoergai County, Sichuan Province (a tea-drinking fluorosis endemic area) as research subjects. The Apriori algorithm was used to analyze the dataset, and indicators such as the minimum conditional support were set to derive disease association rules. Additionally, Yule’s Q method was applied for systematic cluster analysis, and a dendrogram was drawn to explore the comorbidity patterns of chronic diseases in the elderly.

In the coal-burning type disease area, patients aged over 70 accounted for the highest proportion (43.55%), and the prevalence rates of chronic kidney disease (12.61%), hypertension (33.24%), and cholelithiasis/cholecystosis (11.89%) were higher than those in the drinking-water type and tea-drinking type disease areas. The tea-drinking type disease area was dominated by individuals aged 50-60 years (38.57%), with the highest prevalence of other bone diseases (68.93%). The drinking-water type disease area had the largest proportion of patients aged 60-70 years (43.04%).Comorbidity analysis showed that the coal-burning type disease area had the highest comorbidity rate (43.98%). In terms of comorbidity patterns, the most typical combination of two concurrent diseases was diabetes-coronary heart disease, while the combination of three concurrent diseases was mainly diabetes-coronary heart disease-hypertension. The tea-drinking type disease area had a comorbidity rate of 34.29%, with the main two-disease comorbidity pattern being coronary heart disease-cholelithiasis/cholecystosis, and the three-disease comorbidity pattern adding other bone diseases to the above combination. The drinking-water type disease area had the lowest comorbidity rate (21.43%), with the main two-disease comorbidity being cholelithiasis/cholecystosis-stroke, and the three-disease comorbidity pattern being stroke combined with diabetes and hypertension.Cluster analysis independently showed that the coal-burning type disease area could be clustered into 6 categories (dominated by metabolic cardiovascular diseases), the tea-drinking type disease area into 4 categories (highlighting metabolic skeletal diseases), and the drinking-water type disease area into 5 categories (characterized by multi-system metabolic inflammatory diseases).

There are significant differences in the comorbidity patterns of skeletal fluorosis patients among coal-burning, tea-drinking, and water-drinking fluorosis endemic areas. The coal-burning endemic area is dominated by metabolic and cardiovascular diseases such as diabetes, coronary heart disease, and hypertension. In the tea-drinking endemic area, there is a significant association between coronary heart disease and gallstones/gallbladder cysts, as well as a comorbidity pattern of diabetes and pulmonary tuberculosis. The water-drinking endemic area is characterized by the association between gallstones/gallbladder cysts and stroke; meanwhile, the combination of kidney disease and metabolic diseases highlights multisystem damage.

To analyze the exposure levels and health risks of nine pollutants in urban and rural drinking water of Liaoning Province, and to provide a reference for ensuring drinking water safety.

Water samples from 28 large-scale water supply units were monitored in 2024. The indicators included bisphenol A (BPA), nitrosodimethylamine (NDMA), di(2-ethylhexyl) adipate (DEHA), diethyl phthalate (DEP), dibutyl phthalate (DBP), perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), vanadium (V), and chlorinated paraffins (CPs). The results were evaluated according to the standards for drinking water quality (GB 5749-2022), except for CPs. The comparison of concentration differences between the two groups was performed using the Mann-Whitney U test, while the Kruskal-Wallis rank-sum test was employed for comparisons among multiple groups. The χ² test was used for the comparison of rates. Using the health risk assessment methods of the U.S. Environmental Protection Agency and the technical guide for environmental health risk assessment of chemical exposure (WS/T 777-2021), the health risks to people through oral of drinking water were assessed.

A total of 112 water samples were collected and tested. The detection rates of the indicators, in descending order, were PFOA (36.61%)> NDMA (25.89%)> PFOS (16.07%)> DBP (15.18%)> BPA (4.46%)>CPs (2.67%). DEHA, DEP, and V were not detected. Except for CPs, the compliance rate for DBP was 99.96%, while all other indicators reached 100%. BPA and NDMA concentrations in wet season were higher than that in dry season, and the detection rate of NDMA was also higher in the wet season compared to the dry season; the NDMA concentration in the finished water was higher than that in the tap water, and all these differences were statistically significant (P<0.05). In surface water sources for drinking water, the concentrations of NDMA and DBP were higher than those in groundwater (P<0.05); the detection rates of DBP and PFOA in surface water were higher than those in groundwater (P<0.05). The hazard quotient (HQ) for PFOA is greater than 1, indicating a high non-carcinogenic risk; the carcinogenic risk values (CR) of NDMA, PFOA of male and female, and PFOS are all between 1.0×10^-6 to 1.0×10^-4, indicating a certain risk.

In Liaoning Province, there is exposure to BPA, NDMA, DBP, PFOA, PFOS and CPs in drinking water samples. NDMA, PFOA and PFOS carry a certain level of potential carcinogenic risks, but all are within the acceptable range. PFOA presents a certain non-carcinogenic risk and requires attention.

To analyze the current situation of job burnout among family doctors in primary medical and health institutions in Sichuan Province and its influencing factors.

From July to September 2024, through the stratified random cluster sampling method, 588 family doctors from 15 primary medical and health institutions in 5 counties (cities and districts) in Sichuan Province were selected as the survey subjects. The basic information and job burnout of family doctors were investigated by using maslach burnout inventory human service survey.The χ² test or Fisher’s exact probability method was used to analyze the detection rates of job burnout amongfamily doctors with different characteristics, and the influencing factors of job burnout among family doctors were analyzed by using binary logistic regression.

The M-values of the scores of the three dimensions of emotional exhaustion, emotional alienation and personal achievement among family doctors in primary medical and health institutions in Sichuan Province were 25 points, 8 points and 41 points respectively. Job burnout was detected in 430 family doctors, with a detection rate of 73.13%.The detection rates of mild, moderate and severe were 34.69% (204 doctors), 35.88% (211 doctors) and 2.55% (15 doctors), respectively. Binary logistic regression analysis showed that compared with those aged 20-29, family doctors aged 40-49(OR=0.312,95% CI:0.178-0.548) and 50-59(OR=0.473,95% CI:0.242-0.926) had a lower risk of job burnout. Compared with those with contracted service numbers ≤2 000, family doctors with contracted service numbers ≥5 001 had a higher risk of job burnout(OR=2.345, 95% CI: 1.276-4.308). Frequent overtime work was a risk factor for job burnout in family doctors(OR=1.587, 95% CI: 1.042-2.418).Family doctors with an average annual total income of more than 50 001 yuan had a lower probability of being detected job burnout than those with an average annual total income of no more than 50 000 yuan (OR=0.558,95% CI:0.370-0.842).

The current situation of job burnout among family doctors in primary medical and health institutions in Sichuan Province is not optimistic. Effective measures should be taken from multiple dimensions to alleviate the job burnout of family doctors, and continuous dynamic monitoring should be carried out at the same time.

To analyze the contamination status of Listeria monocytogenes in the production and distribution stages of enoki mushrooms in Chengdu.

A total of 180 samples were collected from two major enoki mushroom manufacturers in Chengdu, including enoki mushrooms (30 samples), culture media (14 samples), environmental samples (25 samples), tools and equipment (64 samples), operators (30 samples), and other samples (17 samples). L.monocytogenes was isolated and identified according to the 2024 National Manual for Monitoring Food Contaminants and Harmful Factors. Whole-genome sequencing (WGS) was conducted on the isolates to predict serotypes and analyze lineages, sequence types (ST), clonal complexes (CC), antimicrobial resistance genes, and virulence genes. Homology among strains was determined based on core genome multilocus sequence typing (cgMLST) genetic characteristics.

A total of 69 L.monocytogenes strains were detected from 180 samples, with an overall detection rate of 38.33%. The strains belonged to two lineages (I and II), with lineage II being predominant (97.10%, 67/69). Three serotypes were identified, among which serotype 1/2a,3a was dominant (94.20%, 65/69). Seven CC types were detected, with CC8 (52.17%, 36/69) and CC155 (30.43%, 21/69) being dominant. Eight ST types were identified, among which ST8 (52.17%, 36/69) and ST155 (30.43%, 21/69) were the predominant types. All strains carried only the antimicrobial resistance gene fosX. All 69 strains carried virulence island 1 (LIPI-1), and six virulence genes (prfA, plcA, hly, mpl, actA, and plcB) were all positive. All 69 strains also carried virulence island 2 (LIPI-2); among the nine virulence genes, inlA, inlB, inlC, and inlJ were positive in all strains; inlE, inlG, and inlH were all negative; and the carriage rates of inlF and inlK were both 97.10% (67/69). CgMLST clustering analysis revealed the presence of homologous strains.

L.monocytogenes contamination is present in both the production and distribution stages of enoki mushrooms in Chengdu, with a potential for cross-contamination. Although current antimicrobial resistance is not severe, the strains harbor numerous virulence genes, suggesting potential for acquiring resistance genes and posing a threat to human health.

To investigate and to analyze the residue status of fishery anesthetics in commonly marketed fresh and live freshwater fish and shrimp in Shandong Province.

From 2021 to 2023, a total of 480 freshwater fish and shrimp were collected from 16 prefecture-level cities in Shandong Province, and the four anesthetics of eugenol, MS-222, diazepam, and oxazepam were detected by ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS).

Among the four anesthetics, eugenol had the highest detection rate of 31.9% (153/480), followed by diazepam and oxazepam with detection rates of 6.7% (32/480) and 3.1% (15/480), and MS-222 was not detected. Eugenol had the highest detection rate and level of detection in grass carp, diazepam was detected only in fish and oxazepam was detected only in shrimp.

The primary fishery anesthetic detected in commonly marketed fresh and live freshwater fish and shrimp in Shandong Province is eugenol, with overall low residue levels.

To analyze the influence of school bullying on the development track of adolescents’ early non-suicidal NSSI, and to provide evidence for the prevention of adolescents’ early NSSI.

A total of 941 first grade students were investigated in March 2023, September 2023 and March 2024 by using the School Bullying Questionnaire and the Adolescents’ Non-Suicidal Self-Injury Behavior Assessment Questionnaire (ANSAQ). The heterogeneity of the developmental trajectory of early non-suicidal NSSI was analyzed by the latent variable growth mixed model (LGMM), and the influence of school bullying on the heterogeneity of NSSI was explored by multiple logistic regression analysis.

The LGMM results showed that class 1 (Class1) was the “low-risk mitigation group” (87.35%) and class 2 (Class2) was the “medium-risk stable group” (7.23%); Category 3 (Class3) was the “high-risk deteriorating group” (5.42%); Male students were the protective factors in the “medium-risk stable group” (OR=0.369, 95% CI=0.216-0.631) and the “high-risk deteriorating group” (OR=0.325, 95% CI=0.121-0.872), and bullying was the protective factor in the “medium-risk stable group” (OR=1.375, 95% CI=1.269-1.490) and “high-risk worsening group” (OR=1.526, 95% CI=1.343-1.734).

The developmental trajectory of non-suicidal NSSI in early adolescents is heterogeneous, and school bullying is a risk factor for NSSI in early adolescents.

To explore the association ofbody mass index (BMI), body roundness index (BRI), waist circumference (WC), and waist hip ratio (WHR) with the risk of all-cause mortality in a community-based cohort.

This study was based on a prospective cohort study conducted in Pudong New Area. Obesity-related indicators were obtained at the baseline survey, mortality data was collectedduring the follow-up period.The associations between BMI, BRI, WC, WHR and the risk of all-cause mortality were assessed using cox proportional hazard model, restricted cubic spline (RCS) regression model, and receiver operator characteristic (ROC) curve.

A total of 9 448 participants was included in the analysis. The median follow-up time was 10.77 years, during which 987 deaths occurred,the all-cause mortality was 10.08/1 000 person-years.After multi-variable adjustment,the HR(95% CI) of elevated BRI, WC, and WHR were 1.07(1.01-1.14), 1.12(1.05-1.20), and 1.14(1.07-1.21), respectively.There were U-shaped dose-response relationship betweenBMI, BRI, WC and all-cause mortality; and alinear dose-response relationshipbetween WHR and all-cause mortality. BRI had the highest accuracy in predicting all-cause mortality, with the AUC of 0.62(95% CI=0.60-0.64).

Obesity is a significant risk factor for all-cause mortality, proper control of obesity and fat distribution can help reduce the risk of all-cause mortality.

To analyze the impact of the outpatient mutual assistance reform of employee medical insurance on outpatient costs in medical and pharmaceutical institutions, offering valuable insights for deepening outpatient medical system reforms and optimizing chronic disease management.

Outpatient cost indicators for hypertensive patients in City L from January 2022 to December 2023 were collected. Univariate analysis and a two-group interrupted time-series model were employed to compare changes in cost indicators before and after the reform.

A total of 688 510 valid cases were included, with 158 474 (23.02%) from pharmacies, and 530 036 (76.98%) from hospitals. The overall outpatient costs in medical and pharmaceutical institutions showed statistically significant differences before and after the reform (Z/t= -3.486/6.972, P<0.05), with post-reform data showing reduced total expenditures. However, the reform also led to a decline in the average reimbursement rate per visit, with a more pronounced effect observed in retail pharmacies than in medical institutions. Furthermore, the reform was associated with increased utilization of Chinese herbal medicines, accompanied by a significant rise in related expenditures (Z/t= -4.229/-4.285, P<0.05).

The outpatient mutual assistance reform of employee medical insurance has alleviated the financial burden of hypertension patients in medical and pharmaceutical institutions, though the payment capacity of health insurance slightly declined in the early stages of reform. It is essential to coordinate the outpatient mutual assistance reform with other policies, establish a comprehensive tripartite linkage system involving medical management, insurance payment, and drug supply, and optimize outpatient management strategies for chronic diseases.

To explore the mediating role of emotional exhaustion in the relationship between workload and turnover intention among grassroots disease control and prevention staff, and the regulatory effect of policy perception.

A total of 1 108 District CDC staffs in Wuhan were selected by general survey in January 2024, and descriptive statistical analyses, regression analyses, and moderated mediated effects analyses were conducted.

(1) Workload could not directly affect the turnover intention in grassroots CDC staff (β= -0.031, P>0.05). (2) Emotional exhaustion played complete mediating roles between workload and turnover intention (95% CI: 0.269-0.371), with mediating effect size of 0.318. (3) Policy perception played a moderating role in the former half of the pathway of the aforementioned mediation model (β= -0.085, 95% CI: -0.170--0.002).

There is a moderated mediating effect between workload and turnover intention in grassroots CDC staffs, and emotional exhaustion is the mediating variable between them. Policy perception buffered the influence of workload on emotional exhaustion. Therefore, reasonably controlling working hours and task volumes, guiding grassroots disease control personnel to alleviate negative emotions, and enhancing their positive perception of the reform known as “public welfare first-class security, public welfare second-class management” can help reduce the level of intention to leave.

To evaluate the spatial accessibility of various types of healthcare institutions in an urban district of a prefecture-level city in the Yangtze River Delta, in order to provide a basis for optimizing healthcare service allocation.

This study obtained 2024 healthcare facility data and population data for each subdistrict (town) through secondary data collection, and gathered population spatial distribution data and road traffic data from public service platforms. The Two-Step Floating Catchment Area (2SFCA) method based on a Gaussian decay function was used to assess the accessibility levels of different healthcare institutions within the district.

Within a 15-minute drive, 42.5% of demand points cannot access primary healthcare institutions and are classified as inaccessible areas. Comprehensive specialty healthcare institutions exhibit a clustered distribution in the southeastern region, indicating significant regional disparities in development. Dental service institutions demonstrate overall good accessibility; however, resource levels remain notably insufficient in the northwestern region. Accessibility to rehabilitation service institutions is relatively balanced overall, though areas requiring improvement still exist in the northwest.

The distribution pattern of medical institutions in city districts is “dense in urban areas and sparse in suburbs”, and the results of the accessibility of various types of medical institutions are different, so the results of this study can provide a reference for other cities to evaluate the spatial allocation of medical resources.

To explore the equity of health supervisor allocation in health supervision agencies in Yunnan Province from 2019 to 2023, and to provide a basis for further optimizing the reform of health supervision in Yunnan Province.

Using the National Health Supervision Information Reporting System and Yunnan Statistical Yearbook data, the configuration of health supervisors in agencies in Yunnan Province was described, and the equity was analyzed by using the agglomeration degree and the Theil Index.

The number of health supervisors in Yunnan Province from 2019 to 2023 was 1 795, 1 762, 1 824, 1 796 and 1763, respectively;The numbers of health supervisors per 10 000 population was 0.37, 0.36, 0.39, 0.38, and 0.38, respectively.The health supervisor’s agglomeration degree in the four regions of Yunnan Province from 2019 to 2023 was different, with that in Central and Northeast regions were always greater than 1, and Northwest region was always the lowest and less than 1 (0.61-0.67). The difference between the health supervisor agglomeration degree and population agglomeration degreeranged from -0.68 to 0.74, with the difference fluctuating around 0 for Northwest and Central regions, also the difference for Northeast Yunnan was always less than 0. There was no significant change in the Theil Index of health supervisors in Yunnan Province from 2019 to 2023, and the Theil Index by geographical distribution (0.073-0.078) was always higher than that calculated by population distribution (0.030-0.032), and the contribution rate between regions was greater than that with regions.

The provision of health supervisors in Yunnan Province has improved, but it is still lower than the national standard.The geographic equity of the allocation is not as fair as the demographic equity. The distribution of resources for health supervisors should be conducted with comprehensive consideration of the population density and the radius of the medical services.

To investigate the policy effects and underlying mechanisms of the Beijing Sub-Center construction on the allocation of medical resources.

Panel data from 16 districts in Beijing spanning 2005 to 2022 was analyzed. The entropy weight method was utilized to assess healthcare resource allocation, while the regression control method was applied to estimate policy effects.

The Beijing Sub-Center construction significantly enhanced hospital capacity and staffing in Tongzhou District, yielding average annual treatment effects of 732.168 additional hospital beds and 1 998.943 healthcare personnel. These impacts were statistically significant (P<0.1) across multiple years. However, the policy showed no notable effect on the number of hospital beds per 1 000 people or the total number of healthcare institutions.

The construction of the Beijing Sub-Center has effectively bolstered hospital capacity and increased healthcare personnel in Tongzhou District. Nevertheless, a gap persists between resource availability and the rising demand fueled by population growth. It is recommended to moderately expand medical service facilities, optimize the spatial distribution of resources, and enhance the efficiency and equity of healthcare resource allocation across Beijing.

To estimate the utilization of cancer screening and physical examinations in Beijing and analyses its main influencing factors, and to provide evidence for improving cancer prevention and control strategy.

From November to December 2024, a questionnaire survey was conducted among residents aged 35 to 74 from 10 districts in Beijing using probability proportionate to size (PPS) sampling and random sampling. Multivariable-adjusted logistic regression was employed to explore the potential factors influencing residents’ cancer screening behavior.

A total of 4 452 residents were included in the analysis, with 39.4% having undergone cancer screenings or physical examinations within the past 5 years. Female residents (OR=1.33, 95% CI: 1.16-1.52), those with basic medical insurance (OR=1.63, 95% CI: 1.41-1.89), residents with a family history of cancer (OR=2.11, 95% CI: 1.78-2.50), and those willing to uptake cancer screening and physical examinations (OR =1.71, 95% CI: 1.46-2.01) were more likely to have cancer screening(P<0.05).

The utilization rate of cancer screening and physical examinations among residents in Beijing remains low. To address this issue, measures such as innovating “individual-family” and “extended-family” cancer screening models, promoting the translation of cancer prevention knowledge into actionable behaviors, supporting the adoption of appropriate screening technologies, and establishing and intelligent management system should be implemented. These measures will comprehensively improve the coverage of cancer screening and physical examination services among residents, thereby achieving cancer early diagnosis and treatment, and contributing to the Healthy China initiative.

To investigate the mediating role of life satisfaction in the relationship between different types of leisure activities and cognitive function among rural older adults in Guizhou Province.

In July-August 2022, a face-to-face questionnaire survey was conducted in 12 villages across 2 counties in Guizhou Province, targeting at adults aged 60 and above. Using a self-administered questionnaire, Mini-mental State Examination(MMSE), and Satisfaction With Life Scale(SWLS), data was analyzed via descriptive statistics, partial correlation, and multiple regression. Mediation was assessed using the “mediation” package in R 4.3.1 and validated via the Bootstrap method.

A total of 1 298 adults aged 60 years and above were included in this study. The average score for cognitive function was 20.29±5.96, and the average score for life satisfaction was 26.41±4.61. Leisure activities were categorized into family-oriented and non-family-oriented types, with average scores of 8.64±3.04 and 8.86±2.55, respectively. Both types of leisure activities were positively correlated with life satisfaction and cognitive function (P<0.05). Life satisfaction partially mediates the relationship between family-oriented leisure activities and cognitive function, with an indirect effect of 0.059 (95% CI: 0.032-0.090), accounting for 13.4% of the total effect. This indirect effect is significant in elderly women (0.116, 95% CI: 0.064-0.170), representing 26.3% of the total effect, but not in elderly men.

In Guizhou Province, life satisfaction mediated the link between family-oriented leisure activities and cognitive function among rural older women. Strengthening support for rural older adults’ leisure activities can enhance their life satisfaction and cognitive function.

To investigate the impact of social capital on the patient activation of rural empty-nest elderly patients with chronic diseases and the mediating role of self-efficacy.

A questionnaire survey was conducted among 425 rural empty-nest older adults with chronic diseases using multistage stratified random sampling combined with convenience sampling. Pearson correlation analysis was employed to examine the relationships between variables. Independent t-tests and ANOVA were used for group comparisons. Multiple linear regression analysis was conducted to examine the effects of social capital and self-efficacy on patient activation. The mediating role of self-efficacy between social capital and patient activation was analyzed using the PROCESS macro.

Correlation analysis showed that social capital, self-efficacy, and patient activation were positively correlated with each other (r=0.300, 0.224, and 0.312, P<0.001). The mediation effect analysis indicated that social capital (β=0.224, 95% CI:0.116-0.283), social participation (β=0.141, 95% CI:0.035-0.166), social support (β=0.189, 95% CI: 0.075-0.215), and social connections (β=0.180, 95% CI:0.049-0.152) had significant direct predictive effects on patient activation. Additionally, self-efficacy played a partial mediating role, accounting for 12.50% of the total effect.

Primary healthcare teams and government authorities should focus on and strengthen the dual-pathway intervention of social capital development and self-efficacy enhancement for rural empty-nest elderly patients with chronic diseases. This approach can more effectively activate their engagement in autonomous health management.

To establish a method for the determination of three datura alkaloids including atropine, hyoscine and racanisodamine in poisoned samples by ultra performance liquid chromatography-hybrid triple quadrupole linear ion trap-mass spectrometry(UPLC-QqLIT-MS), and provide scientific basis for the quick handling of food poisoning event and the clinical treatment of patients.

Blood, urine and residual food samples from patients were added with borax-NaOH buffer solution, and the analytes were extracted using ethyl acetate, dried with nitrogen, and dissolved in the initial mobile phase. Separation was achieved on a DikmaLeapsil C18 chromatographic column (2.1 mm×150 mm, 2.7 μm) with gradient elution using a mobile phase consisting of water and acetonitrile (containing 0.1% formic acid and 2 mmol/L ammonium formate). The quantitative determination was carried out by using the multi reaction monitoring mode, and the qualitative analysis of the suspected positive results was carried out by using the enhanced product ion (EPI) scanning mode.

The three alkaloids exhibited good linearity (r ≥ 0.997 1) within the concentration range of 0.5-100 μg/L across different matrices. The detection limits ranged from 0.05 to 0.12μg/L.The average recoveries were 91.9%-110.0%, with relative standard deviations of 1.16%-9.03%. The EPI scanning function can effectively eliminated false positive results by confirming suspicious positives.

This method is simple, rapid, and accurate for qualitative and quantitative determination of atropine, hyoscine, and racanisodamine in poisoned samples. It effectively reduces false positives and is suitable for screening and confirmation of datura alkaloid poisoning.

To conduct molecular surveillance and evolutionary analysis of avian influenza virus (AIV) in air samples collected from the live poultry wholesale market in Changsha, providing laboratory data for the prevention and control of human AIV infections.

Air samples were collected from poultry stalls in live poultry wholesale market in Changsha. AIV nucleic acid detection and nucleotide sequencing were performed. The sequencing results were analyzed using BLAST, key amino acid (aa) residue alignment, and nucleotide evolutionary analysis.

All 27 air samples from the live poultry wholesale market tested positive for AIV nucleic acid (100% positivity rate). Two AIV nucleotide sequences (CS17 and CS11) were obtained. For CS17, the HA and NA genes exhibited the highest nucleotide similarities to A/duck/Bangladesh/38285/2019(H11N3)(98.47%) and A/mallard/South Korea/JB21-58/2019 (H5N3) (98.94%), respectively. For CS11, the HA and NA genes showed the highest nucleotide similarities to A/environment/Fujian/EV01/2020(H11N3)(95.34%) and A/duck/Wenzhou/771/2013 (H7N3) (95.30%), respectively. Internal gene analysis revealed that CS17 originated from H3N8, H4N6, H3N2, and H6N1 viruses, while CS11 was derived from H7N9, H3N2, and related viruses. Both CS17 and CS11 were identified as H11N3 subtype AIV (abbreviated as H11N3-CS17 and H11N3-CS11, respectively).The H11N3-CS17, H11N3-CS11, and 101 H11N3 strains (retrieved from GISAID) exhibited conserved molecular features in their HA proteins. All strains retained a single basic amino acid (aa) at the HA cleavage site and preserved Q/G residues at the receptor-binding sites. No critical mutations were observed at R293K (NA protein), S31N (M2 protein), E627K, or D701N (PB2 protein), nor deletions in the 69-73 (NA protein) or 218-230 (NS1 protein) regions. Notably, specific mutations were identified: L89V (PB2 protein), and N30D and T215A (M1 protein). Phylogenetic analysis indicated that the HA and NA genes of both strains belonged to the Eurasian lineage. H11N3-CS17 clustered into a subclade with H11N3 viruses from ducks in Bangladesh and Japan, while H11N3-CS11 formed a subclade with H11N3 viruses from domestic ducks and live poultry market environments in China.

Two H11N3 subtype AIV strains were identified in air samples from the live poultry wholesale market in Changsha. These strains exhibited molecular features of low pathogenicity and avian receptor specificity but displayed distinct genetic reassortment and evolutionary subclades, warranting further surveillance.

To understand the health care providers’ willingness to recommend nasal spray influenza vaccine and the influencing factors, and to provide suggestions for formulating an immunization service strategy for the nasal spray influenza vaccine.

From March to May 2023, a convenience sampling method was used to conduct an online questionnaire survey among 171 health care providers in vaccination clinics in Shanghai, Weifang and Wuhan. We analyzed their willingness to recommend nasal spray influenza, as well as the reasons and influencing factors.

The willingness of Chinese health care providers to recommend the nasal spray influenza vaccine was 83.04%. The more the vaccine and the more they accepted the vaccine, the higher the willingness was (OR=2.71,95% CI:1.50-4.63,P<0.001). The reasons why they were willing to recommend the vaccine were that they believed in its safety, fewer side effects, effectiveness and convenience of vaccination. The main reasons for being unwilling to recommend it were that they lacked the knowledge about the supplier and pricing method of the vaccine, and trust in its safety and effectiveness.

Chinese health care providers have a high willingness to recommend nasal spray influenza vaccine, which is mainly affected by their perception of and acceptance about the vaccine. During the formulation of the vaccine’s immunization service strategy, providing health education and specific training to health care providers may help them understand the market information, safety and effectiveness of the vaccine.

To systematically evaluate the willingness to receive HPV vaccination and influencing factors among college students in China.

Relevant studies were retrieved from PubMed, Embase, Web of Science, The Cochrane Library, CINAHL, PsycINFO, China Biomedical Literature Database, CNKI, Wanfang Database, and VIP Database from the establishment of the databases to March 12, 2025. Meta-analysis was conducted using Stata 17.0 and RevMan 5.4 to assess the willingness to receive HPV vaccination and influencing factors among college students.

A total of 35 studies involving 62 958 samples were included. The meta-analysis results showed that the willingness rate of college students in China to receive HPV vaccination was 67.0%. Female (OR=3.47, 95% CI: 2.49-4.85), having a history of sexual behavior (OR=1.91, 95% CI: 1.09-3.35), accepting premarital sex (OR=1.36, 95% CI: 1.04-1.78), having a family history of tumors (OR=1.69, 95% CI: 1.28-2.23), monthly consumption level≥2 000 yuan (OR=1.50, 95% CI: 1.22-1.84), knowing about HPV vaccine (OR=1.75, 95% CI: 1.11-2.77), knowing that HPV vaccine is on the market (OR=1.71, 95% CI: 1.44-2.03), knowing that HPV infection is related to cervical cancer (OR=1.44, 95% CI: 1.15-1.81), having someone around who has received HPV vaccine (OR=2.23, 95% CI: 1.66-3.01), and having a high score in the cognition of HPV and its vaccine (OR=1.86, 95% CI: 1.32-2.62) were identified as promoting factors.

The willingness rate of Chinese college students to receive the HPV vaccine is relatively high, relevant epidemic prevention departments and health institutions should strengthen the professional popularization of HPV vaccine-related knowledge among college students, and try to improve the HPV vaccine vaccination service system and cervical cancer prevention and control service system.

To analyze the information of aquatic products that were not allowed to enter the country from 2019 to 2024, and put forward suggestions for ensuring the quality and safety of imported aquatic products.

The data of aquatic products that were not allowed to enter the country during the period from 2019 to 2024, as published by the General Administration of Customs, were sorted out and analyzed.

Form 2019 - 2024, there were a total of 3 798 batches of aquatic products were not allowed to enter the country; and they involved 62 importing countries and regions, with products from Ecuador accounting for as high as 21.94% of the total.The number of involved production enterprises reached 1 190, among which the enterprises from Vietnam, India, Indonesia, Ecuador and Pakistan accounted for more than 48% of the total.The main types of aquatic products that were not allowed to enter the country were crustaceans (HS0303) and frozen fish (HS0306), accounting for 64.98% of the total.There are 11 reasons for nonconformity, with the top three being inspection and quarantine (35.27%), certificates (27.80%) and food additives (17.52%). There are 7 nonconformity indicators related to food safety, with the top three being food additives (17.60%), quality (4.12%) and heavy metals (2.68%).

From 2019-2024, the number of batches of aquatic products that were not allowed to enter the country showed an overall increasing trend. The source countries, production enterprises, food categories, reasons for non-compliance, and non-compliance items related to food safety of the aquatic products that were not allowed to enter the country showed relatively concentrated distribution characteristics.

To investigate the association between the metabolic syndrome-insulin resistance index (METS-IR) and the risk of kidney stones, as well as its potential threshold effect.

Data were obtained from individuals undergoing health screening at the Affiliated Hospital of Yangzhou University in 2022. This cross-sectional study included 80 046 eligible participants. Participants were divided into three tertile groups based on METS-IR levels. Multivariate logistic regression was used to analyze the association between METS-IR and kidney stone risk. Piecewise linear regression was applied to evaluate the threshold effect, with sex-stratified and multiple subgroup analyses conducted.

The prevalence of kidney stones increased with higher METS-IR tertiles (low: 3.83%, medium: 6.47%, high: 9.91%). After multivariate adjustment, each standard deviation increase in METS-IR was associated with a 20% higher risk of kidney stones in women (OR=1.20, 95% CI: 1.08-1.33) and a 24% higher risk in men (OR=1.24, 95% CI: 1.18-1.31). Compared with the low METS-IR group, the high METS-IR group had a 41% higher risk in women (OR=1.41, 95% CI: 1.13-1.74) and a 56% higher risk in men (OR=1.56, 95% CI: 1.37-1.78), both showing significant dose-response relationships. A clear threshold effect was observed in men (inflection point=43.72, P<0.001), where each 1-unit increase in METS-IR below the inflection point was associated with a 5% higher risk (OR=1.05, 95% CI: 1.04-1.06), while the association weakened above the inflection point (OR=1.01, 95% CI: 1.00-1.02).

METS-IR is significantly associated with kidney stone risk, with a threshold effect observed in men. METS-IR may serve as a potential marker for assessing kidney stone risk, providing a new perspective for early screening and intervention, particularly in high-risk populations at the early stage of metabolic abnormalities.

To describe the clinical characteristics and ATP7B gene mutation spectrum of neurologic Wilson’s disease (WD) patients in southwest China and to explore genotype-phenotype correlations.

A total of 74 patients with neurologic WD admitted to West China Fourth Hospital of Sichuan University between August 2023 and July 2024 were enrolled. Patient demographics, clinical manifestations, and ATP7B gene mutation features were collected. Patients were stratified by mutation type to analyze associations between p.R778L, p.P992L, and loss-of-function (LOF) mutations and common initial symptoms or age at onset. Group comparisons were performed using Mann-Whitney U test, Kruskal-Wallis H test, Chi-square tests, or Fisher’s exact test as appropriate.

The median age at onset among 74 neurologic WD patients was 17.0 years (15.0, 25.8). The most common initial symptoms were tremor (67.6%) and dysarthria (36.5%). At enrollment, the predominant clinical manifestations were dystonia (77.0%), dysarthria (75.7%) and tremor (74.3%), with 44 patients having progressed to cirrhosis. Significant age or gender-related differences were observed in both initial and current symptoms. Genetic analysis revealed that the most frequent pathogenic mutations were p.R778L (28.08%) and p.P992L (18.49%). A total of 44 distinct pathogenic mutation combinations were detected, with the most common being p.R778L/p.R778L (11.3%) and p.R778L/p.P992L (9.9%). Genotype-phenotype analysis showed that LOF mutations were associated with earlier age at onset and dysarthria. No statistically significant correlations were found between p.R778L, p.P992L mutations and clinical phenotypes.

Neurologic WD patients exhibit significant clinical heterogeneity. p.R778L and p.P992L are the most common pathogenic mutations, while LOF mutations correlate with earlier age at onset and dysarthria. Clinicians should remain vigilant toward diverse initial symptoms and multi-system involvement in neurologic WD patients, emphasize individualized treatment strategies, and prioritize ATP7B gene testing to optimize precision diagnosis.

To investigate the relationship between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) and new-onset stroke in different glucose metabolism states, and to provide new perspectives on stroke prevention and treatment.

Based on data from the China Health and Retirement Longitudinal Study (CHARLS), a total of 8 567 participants were selected to participate in five surveys in 2011, 2013, 2015, 2018, and 2020. First, the cumulative risk of stroke onset was estimated using the Kaplan-Meier method based on NHHR quartile groupings, and the Log-rank test was used to compare differences between groups. Second, the association between NHHR and new-onset stroke in the total population and in individuals with different glucose metabolic status was analyzed using Cox proportional risk regression models, and interaction analyses were performed.

A total of 745 (8.4%) participants had a new stroke during the 9-year follow-up period. The incidence of stroke in the NHHR quartiles from Q1 to Q4 groups was 6.1%, 8.2%, 9.4%, and 11.1%, respectively. Kaplan-Meier analysis showed a significant difference in cumulative incidence risk of stroke among the different NHHR groups (P<0.05). Cox regression modeling showed that the risk of stroke was increased by 34%, 56%, and 75% in Q2, Q3, and Q4 groups, respectively, compared with Q1 group, with HR and 95% CI of 1.34 (1.07-1.68), 1.56 (1.25-1.95), and 1.75 (1.41-2.18). In prediabetic and diabetic patients, elevated NHHR increased the risk of stroke onset, whereas the association was not observed in the normoglycemic group, and there was a significant interaction between NHHR and glucose metabolic status (P=0.020).

NHHR is positively associated with the risk of new stroke and shows different characteristics in different glycaemic states.