To analyze the interaction between Body Mass Index (BMI) and sex on sleep quality of rural older adults in Chengdu, and to explore the differences in their sleep quality under different BMI and sex stratifications.

Based on the data of a cluster randomized controlled trial for rural older adults in Chengdu, 508 people aged 60 and above were involved. Questionnaires were administered using instruments such as the Pittsburgh Sleep Quality Index (PSQI) to collect information on sleep quality and demographics. Information of height and weight was obtained by physical measurements. Linear mixed models were used to analyze the interaction between BMI and sex on sleep quality, and stratified analyses were performed.

There was a significant interaction between BMI and sex on sleep quality (P<0.001). When stratified by sex, PSQI scores in the overweight and obese populations were significantly higher than the normal/underweight populationonly among the males. (difference=0.46, P=0.031; difference=1.53, P<0.001). When stratified by BMI, females had significantly higher PSQI scores than males in normal/underweight and overweight stratifications (difference=1.85, P<0.001; difference=2.17, P<0.001).

There is a significant interaction effect of BMI and sex on sleep quality among rural older adults. Comparing to males, females have poorer sleep quality in normal/underweight and overweight stratifications. Males have poorer sleep quality with higher BMI levels. Our study suggests that future sleep interventions and policy programs should be tailored according to different sex and BMI.

To assess the association between the cardiometabolic index (CMI) and the risk of kidney stone prevalence, and to analyze its role across different population subgroups.

This cross-sectional study included health examination data from 76 624 adults. The association between CMI and the risk of kidney stones was evaluated using multivariable logistic regression models. Stratified analyses were conducted to explore the effect of different population characteristics. A piecewise linear regression model was used to assess the nonlinear relationship between CMI and kidney stone risk.

CMI levels were positively associated with the prevalence of kidney stones, with the prevalence increasing from 4.33% in the lowest tertile to 9.94% in the highest tertile (P<0.001). Even after adjusting for potential confounders, CMI remained significantly associated with an increased risk of kidney stones (OR = 1.15, 95% CI = 1.10-1.20, P<0.001). Stratified analyses showed that the effect of CMI on kidney stone risk was more pronounced in individuals aged ≥60 years (OR = 1.19, 95% CI = 1.08-1.32, P<0.001) and in males (OR = 1.16, 95% CI = 1.10-1.21, P<0.001), while no significant association was found in females (OR = 1.11, 95% CI = 0.96-1.28, P = 0.157). A nonlinear relationship was observed between CMI and kidney stone risk. Risk significantly increased when CMI was <0.73 (OR = 1.15, 95% CI = 1.10-1.20, P<0.001), while the risk plateaued for CMI ≥0.73 (OR = 1.09, 95% CI = 1.03-1.15, P = 0.002).

Elevated CMI is significantly associated with a higher risk of kidney stones, demonstrating a nonlinear threshold effect. As a comprehensive marker reflecting metabolic burden, CMI may be useful for screening and targeting interventions in high-risk populations for kidney stones.

To analyze the trends and characteristics of the number of patients, prevalence, incidence, disability-adjusted life years (DALY), and years lived with disability (YLD) of depressive disorders among the Chinese population from 1990 to 2021, with the hope of providing a theoretical basis for early prevention, intervention, and clinical decision-making regarding depressive disorders.

Depressive disorders data from the GBD 2021 database (Global Burden of Disease Study 2021 Data Resources) were extracted to analyze the number of patients, incidence, prevalence, DALY and YLD in the Chinese population. The software STATA 14.0 and Joinpoint Regression Program 4.8.0.1 were utilized to analyze the incidence, prevalence, DALY, and YLD of depressive disorders across different genders and age groups. Furthermore, the average annual percent change (AAPC) in depressive disorders was calculated.

In 2021, there were 42.3602 million new cases of depressive disorders in China, an increase of 38.9% from 30.4910 million in 1990. The number of patients was 53.1147 million, an increase of 54.0% from 34.4794 million in 1990. Both the standardized incidence and prevalence showed a slow downward trend (the AAPC was -0.57% and -0.44%, respectively, P<0.001). The incidence of depressive disorders in people aged 10 to 24 showed a sudden increase in different years, and the incidence of depressive disorders in people over 65 also showed an accelerating upward trend. The DALY in 1990 and 2021 were 5.4267 million and 7.8659 million person-years, respectively, with a cumulative increase of 44.9%. The DALY rate increased from 461.27 /100 000 to 552.87 /100 000, with an increase of 19.8%. The standardized DALY and YLD rates decreased slowly with each year (the AAPC was -0.53% and -0.53%, respectively, P<0.001).

Depressive disorder is still one of the main causes of global disease burden and a major public health issue facing our country. There is an urgent need to actively explore and implement effective prevention and treatment strategies to reduce the disease burden of depressive disorders.

To explore the correlation between complex multimorbidity and their influencing factors and to reveal the interactions between diseases and factors using network inference methods to identify high-risk populations.

Based on longitudinal data from 2016 to 2022 in the Urumqi public health surveillance database and electronic medical record information database, this study collected information on the occurrence of complex multimorbidity and related variables. The structure of the Bayesian network was learned using the maximum-minimum hill-climbing algorithm combined with prior knowledge, and parameter learning was conducted using Bayesian estimation. Directed acyclic graphs were employed to identify confounding factors and guide the construction of regression models.

A total of 6 938 participants were included in the study, of which 12.96% (899/ 6 938) developed complex multimorbidity over the seven-year period. After screening influencing factors, six predictors were selected for model construction, resulting in a model with 7 nodes and 10 directed edges. The results indicated that age, gender, source, and BMI weredirectly related to the occurrence of complex multimorbidity, all serving as parent nodes in the model. The results of logistic regression based on DAG guidelines showed that the risk of complex multimorbidity would increase by 8.70% [OR=1.087 (95%CI:1.077-1.098)] for each year of age increase in patients with chronic diseases; the OR of complex multimorbidity for rural residents compared to urban residents=0.274 (95%CI: 0.237-0.317); the OR of complex multimorbidity for obese people compared with thenormal weight people=1.019 (95%CI: 1.008-1.504).

Bayesian networks effectively identify the relationships between complex multimorbidity and influencing factors, as well as the interactions among these factors, thus enabling inference about the risk of complex multimorbidity occurrence. Prevention and control of complex multimorbidity requires attention to aging, urban environments, and obesity management.

Toconstruct a Genetic Algorithm optimized Support Vector Machine (GA-SVM) model based on multi-source data predicting acute respiratory infectious diseases and toevaluate its predictive effectiveness, providing a reference for establishing an early warning system for respiratory infectious diseases.

Symptom surveillance cases, meteorological and atmospheric pollution, data and stringency index obtained from 2020 to 2022 were used as modeling and forecasting samples, respectively. By picking up the optimum lagging week number of the potential predictive variables and filter out the most important variables successively, the independent variables were obtained. Then the full time series data were divided into validation set and training set in a 1:4 ratio. The parameters were optimized by genetic algorithm. We used the weekly number of new cases of respiratory infectious diseases as the dependent variable to structure the GA-SVM model. The performance was evaluated based on the following metrics: root mean square error (RMSE), meansabsolute percentage error (MAPE), predictive correlation coefficient (PCC) and R-squared (R²).

The most important variables were stringency index with 2-weeks-lag, symptom surveillance cases with 1-week-lag, maximum temperature with 1-week-lag, school activities with 2-weeks-lag and O₃ index with 1-week-lag. The GA-SVM model performed best when C=18.04, γ=0.175 4 while average RMSE=6.362, average MAPE=24.59%, average PCC=0.896 and average R²=0.804.

The model showsgood predictive performance for the reported cases of acute respiratory infectious diseases in Xuhui District, which confirms the feasibility of applying GA-SVM to multi-source data based on symptom monitoring for predicting respiratory infectious diseases, providing methodological references for the application of multi-source data in the early warning of infectious diseases.

To study the protective effect of melatonin on PM2.5-induced inflammation and lymphangiogenesis in the lung of ApoE^-/- mice.

Twenty-eight male ApoE^-/- mice were randomized into: control group, PM2.5 group, melatonin group and PM2.5+melatonin group. All mice were fed with western diet for 24 weeks. From the 25th week, mice in the melatonin group and PM2.5+melatonin group were daily orally gavage with melatonin (20 mg/kg·bw) for 8 weeks; mice in the PM2.5 group and PM2.5+melatonin group were exposed to PM2.5 by tracheal instillation (5mg/kg); and mice in the control group and melatonin group were instilled with saline at the same time. After 24 h of PM2.5 exposure, mice were euthanized and weight gain and lung weight/body weight ratio in four groups were analyzed. The concentrations of inflammatory cytokines (TNF-α and IL-6) in the lung tissue of mice were measured. Immunofluorescence staining of lung tissue was visualized the lymphatic marker LYVE1 expression. Western Blot was used to assess the protein expression levels of lymphangiogenesis markers PROX1 and LYVE1, lymphangiogenesis regulatory proteins VEGF-C and VEGFR-3 in lung tissues.

The levels of TNF-α and IL-6 and the protein expressions of PROX1, LYVE1, VEGF-C and VEGFR-3in lung tissues of PM2.5 group were significantly higher than the control group (P<0.05). Moreover, the levels of TNF-α, IL-6 and the protein expressions of PROX1, LYVE1, VEGF-C and VEGFR-3 in lung tissues of the PM2.5+melatonin group were significantly lower than the PM2.5 group (P<0.05).

Ambient PM2.5 exposure obviously increases lung inflammation of ApoE^-/- mice, and may increase lymphangiogenesis in lung through regulating the VEGF-C/VEGFR-3 signaling pathway in the lung tissues; melatonin markedly improves PM2.5-induced lung inflammation and reduces lymphangiogenesis in lung.

To explore the relationship between occupational physical activity and dyslipidemia among coal mine employees, providing reference for improving the prevention and control of dyslipidemia among coal mine employees and formulating health strategies.

This study was conducted in 2023 at Xishan coal electricity corporation occupational disease prevention and control institute. It was a cross-sectional study, with a total of 9 864 coal mine employees included in the analysis. We collected physical activity data using the International Physical Activity Questionnaire, and diagnosed dyslipidemia using the "Chinese Guidelines for the Prevention and Treatment of Adult Blood Lipid Disorders". We analyzed the relationship between occupational physical activity and dyslipidemia among coal mine employees using a multiple factor logistic regression model.

The proportion of low, medium, and high intensity occupational physical activities among coal mine employees were 38.42%, 35.75%, and 25.83%, respectively. There were intergroup differences (P<0.05) in the incidence of high TG and dyslipidemia among occupational physical activities of different intensities, but this difference was not observed in the incidence of high TC, low HDL, and high LDL (P>0.05). After adjusting for factors such as gender, age, and leisure time physical activity, the incidence of dyslipidemia was lower among coal miners engaged in moderate to high-intensity occupational physical activity compared to those engaged in low-intensity physical activity (OR=0.84, 95%CI:0.76-0.94; OR=0.77, 95%CI:0.69-0.87); The incidence of low HDL was also lower (OR=0.85, 95%CI:0.77-0.95; OR=0.83, 95%CI:0.73-0.93).

There is a negative correlation between occupational physical activity and dyslipidemia among coal mine employees. For coal mine workers engaged in low-intensity occupational physical activities, it is recommended to intervene in other modifiable behavioral risk factors related to dyslipidemia to maintain healthy blood lipid levels.

To explore the relationship between oral hygiene behavior and depression level in elderly people.

This article used the 2018 data from the Chinese Elderly Health Longevity Factors Survey (CLHLS) to select 10 148 eligible research subjects. Pearson correlation analysis was used to explore the correlation between oral hygiene behavior, dietary diversity, life satisfaction, and depression levels in the elderly. The Process4.1 plugin model in SPSS was used to analyze the mediating role of dietary diversity and life satisfaction between oral hygiene behavior and depression levels in the elderly.

The direct impact of oral hygiene behavior on depression levels in the elderly was significant (β=-0.206,P<0.01); Dietary diversity and life satisfaction significantly affected the level of depression in elderly people (β=-0.270, P<0.01); (β=-2.992,P<0.01); The mediating effects of dietary diversity and life satisfaction on the relationship between oral hygiene behavior and depression levels in elderly individuals were-0.069 (95%CI:-0.088 - -0.051) and -0.099 (95%CI:-0.145 - -0.055), respectively, with a chain mediation effect of -0.060 (95%CI:-0.071 - -0.049).

Dietary diversity and life satisfaction have a mediating effect between oral hygiene behavior and depression levels in the elderly, and there is a chain mediating effect between dietary diversity and life satisfaction and depression levels in the elderly.

To evaluate the associations between circulating monounsaturated fatty acids(cMUFAs) and cardiovascular-specific death using epidemiological methods.

This study included 36 254 patients with cardiovascular disease from the UK Biobank. Cox proportional hazards models were employed to examine the associations between cMUFAs and various fatalities, including cardiovascular death, ischaemic heart disease death, stroke death, cancer death, and all-cause death. Moreover, the study examined the dose-response relationship between cMUFAs and outcomes using quartiles, deciles, and restricted cubic splines. A subgroup analysis was conducted to validate the effects of cMUFAs on cardiovascular-specific deaths across different subgroups.

A positive correlation was observed between cMUFAs and all-cause death (HR=1.556, 95% CI: 1.419-1.705), as well as CVD (HR=1.504, 95% CI: 1.261-1.794), IHD (HR=1.572, 95% CI: 1.265-1.953), and cancer death (HR=1.291, 95% CI: 1.109-1.502). However, no significant association was found between cMUFAs and stroke death (P=0.582). The study revealed the existence of non-linear relationships between cMUFAs and cardiovascular-specific death. Subgroup analyses indicated that the association with all-cause death was more pronounced in females and current smokers. Furthermore, individuals aged over 50 years demonstrated a more pronounced correlation with IHD death.

In patients with cardiovascular disease, elevated levels of cMUFAs are associated with an increased risk of CVD death, IHD death, cancer death, and all-cause death. This association demonstrates a non-linear correlation trend.

To investigate the effect of tea intake on cognitive function in the elderly and the mediating role of relationship of impaired activities of daily living (ADLs) and depressive states.

The data for this study came from the 2018 China Longitudinal Health and Longevity Survey (CLHLS), which included a total of 8,818 valid samples. The logistic regression was used to analyze the effects of frequency and type of tea drinking on cognitive function in the elderly, and the possible mechanism of this effect was further explored using a chain multiple mediation model.

The elderly who regularly consumed tea were less likely to develop cognitive impairment (OR=0.80, 95% CI: 0.68-0.95), in which only green tea consumption was observed to be a protective factor for the development of cognitive impairment (OR=0.81, 95%CI: 0.65-1.00), and no significant evidence was found for other types of tea. Impaired activities of daily living and depressive state mediated the effect of regular tea consumption on cognitive functioning, with beta values and 95%CIs of -0.005 (-0.008--0.001) and -0.005(-0.007--0.003), while the continuous mediating effects of the two mediating variables, although significant, had β-values that were too small and effects that accounted for too little to be of practical significance.

Regular tea consumption is associated with a reduced risk of developing cognitive impairment in the elderly, especially among those who consume green tea. Impairment in activities of daily living and depression levels almost exclusively mediated the association between tea consumption and cognitive function.

To investigate the associations between leisure screen time and theinsomnia symptoms among adolescents.

A random cluster sampling method was used to assess leisure screen time among adolescents aged 12-18 attending schools in Pidu District, Chengdu. Participants reported their screen time on school days and weekends via self-administered questionnaires. Insomnia symptoms were collected using the Insomnia Severity Index (ISI). Adolescents were categorized into two groups based on their ISI scores: the non-insomnia group (ISI score <7) and the insomnia group (ISI score ≥7). Logistic regression models, adjusted for multiple confounders, were used to estimate the association between leisure screen time and the occurrence of insomnia symptoms.

A total of 13 240 adolescents participated, comprising 6 581 boys (49.7%) and 6 659 girls (50.3%), with a mean age of 15.4 years (±1.57). Of these, 51.8% reported an average daily leisure screen time exceeding 2 h, and the prevalence of insomnia symptoms was 35.3%. After adjusting for all confounding factors, logistic regression analysis indicated that leisure screen time >2 h was a significant risk factor for insomnia symptoms (OR=1.13, 95%CI=1.03-1.23). Further analysis by quartiles of leisure screen time revealed that adolescents in Q3 (OR=1.15, 95%CI=1.02-1.28) and Q4 (OR=1.22, 95%CI=1.08-1.39) had significantly increased risks of insomnia, whereas no significant association was observed in the Q2 group. A clear dose-response relationship was observed between leisure screen time and insomnia (P_trend<0.001). Subgroup analyses by sex, region, economic status, single child, and caretaker did not reveal significant interactions (P_interaction>0.05).

Prolonged leisure screen time significantly increases the risk of insomnia symptoms among adolescents. Parents and schools should encourage physical activity and reduce electronic device usage to promote their well-being.

To analyze the influencing factors on the occurrence of anxiety and depression among secondary school students in Shanxi Province in 2023 based on the random forest algorithm and to construct a prediction model to provide a scientific basis for preventing and controlling the occurrence of negative emotions such as anxiety and depression among secondary school students.

In September 2023, 104 826 secondary school students in 11 cities of Shanxi Province were selected by stratified random whole-cluster sampling method for questionnaire survey, and the Generalized Anxiety Scale (GAD-7) and the Center for Streamlined Depression Scale (CES-D) were used to investigate anxiety and depression. Epidata was used for database establishment, chi-square test was used for between-group comparisons, logistic regression was used for influencing factor analysis, and Python 3.7 was used to establish a random forest prediction model and rank the importance of each variable.

The detection rates of anxiety and depression among secondary school students in Shanxi Province in 2023 were 33.26% and 23.72%, respectively, and were higher for girls than for boys, and higher for students in general and vocational high schools than for junior high school students. The results of multifactorial regression analysis showed that female students(OR: 1.846、1.655，95% CI: 1.794-1.901、1.602-1.710), high school(OR: 2.019、1.670，95% CI: 1.956-2.083、1.612-1.731), vocational high school(OR: 1.167、1.356，95% CI: 1.085-1.254、1.254-1.466), non-conventional family(OR: 1.105、1.248，95% CI: 1.072-1.140、1.206-1.292), living in school(OR: 1.102、1.117，95% CI: 1.070-1.136、1.080-1.155), eating fried food ≥1 time/day(OR: 1.296、1.375，95% CI: 1.227-1.369、1.297-1.457), being seriously injured(OR: 1.636、1.688，95% CI: 1.524-1.755、1.569-1.816), being bullied in school(OR: 2.315、3.411，95% CI: 2.150-2.492、3.165-3.677), being scolded by parents(OR: 2.881、3.191，95% CI: 2.766-3.001、3.059-3.328), smoking(OR: 1.344、1.435，95% CI: 1.266-1.427、1.349-1.527), drinking alcohol(OR: 2.062、2.113，95% CI: 1.978-2.151、2.022-2.208), and Internet addiction(OR: 3.635、3.976，95% CI: 3.289-4.016、3.611-4.377) were the risk factors for the detection of anxiety and depressive mood in secondary school students, and eating fresh fruits≥1 time/day(OR: 0.824、0.758，95% CI: 0.800-0.849、0.73-0.783), eating breakfast frequently(sometimes: OR: 0.843、0.715，95% CI: 0.781-0.910、0.661-0.773; daily: OR: 0.538、0.384，95% CI: 0.500-0.579、0.356-0.414), doing moderate to high-intensity exercise frequently(1-3 days/week: OR: 0.888、0.821，95% CI: 0.854-0.923、0.787-0.857; ≥4 days/week: OR: 0.931、0.848，95% CI: 0.893-0.971、0.810-0.887), and having a large number of physical education hours(2-3 sessions/week: OR: 0.826、0.859，95% CI: 0.801-0.853、0.829-0.890; ≥4 sessions/week: OR: 0.741、0.758，95% CI: 0.695-0.789、0.705-0.815) were the protective factors for the detection of anxiety and depressive protective factors for mood detection. Drinking sugary drinks≥1 time/day(OR: 1.198，95% CI: 1.122-1.279) and eating vegetables≥1 time/day(OR: 0.861，95% CI: 0.828-0.895) were independent risk factors and independent protective factors for the detection of depressed mood, respectively. The AUC of the Random Forest model predicting the risk of anxiety and depressed mood was 0.999 8 and 0.999 7, with a sensitivity of 99.53% and 99.67%, and a specificity of 99.47% and 98.98%, respectively. Being scolded by parents, Internet addiction and alcohol consumption were the common factors that had a greater degree of influence on anxiety and depression among secondary school students.

The detection rate of anxiety and depression among secondary school students in Shanxi Province is high, being scolded by parents, alcohol consumption and Internet addiction are the factors that have a greater influence on the occurrence of anxiety and depression, and the random forest model has a high predictive value.

The Perth Alexithymia Questionnaire (PAQ) was translated into a Chinese version of the questionnaire and tested for reliability and validity in adolescents.

The Chinese version of the PAQ scale was formed according to the procedures of forward translation, back translation, cultural adaptation and pre-survey. During February and April 2024, 7 975 adolescents from Shandong Province, Anhui Province, and Hunan Province were selected to test the reliability of the Chinese version of the PAQ. The item analysis was performed using the coefficient of determination and correlation coefficient methods, and the reliability and validity were assessed using confirmatory factor analysis, criterion-related validity, internal consistency reliability, and test-retest reliability. The Toronto Alexithymia Scale, the Patient Health Questionnaire and the Generalized Anxiety Disorder Scale were used as validity scales, and 1 083 adolescents were retested 4 weeks later to determine the reliability of the retest.

The results of the confirmatory factor analysis showed that the Chinese version of the PAQ scale was a 5-factor model (GFI=0.921, NFI=0.938, CFI=0.940, TLI=0.931, RMSEA=0.060). The Cronbach α coefficient for the Chinese version of the PAQ total scale was 0.953. The Cronbach α coefficients for the five subscales of Negative-Difficulty Identifying Feelings, Positive-Difficulty Identifying Feelings, Negative-Difficulty Describing Feelings, Positive-Difficulty Describing Feelings, and General-Externally Orientated Thinking were 0.821, 0.852, 0.807, 0.834 and 0.859, respectively. The retest reliability of the Chinese version of the PAQ scale was 0.762. The retest reliabilities for the five subscales of Negative-Difficulty Identifying Feelings, Positive-Difficulty Identifying Feelings, Negative-Difficulty Describing Feelings, Positive-Difficulty Describing Feelings, and General-Externally Orientated Thinking were 0.717, 0.676, 0.716, 0.709 and 0.692, respectively. The total score of the Chinese version of the PAQ scale was positively correlated with the total score of the Toronto Alexithymia Scale, depressive symptoms, and anxiety symptoms (r=0.782, 0.378, 0.369, P<0.01).

The Chinese version of the PAQ scale showed excellent psychometric properties on all measures in the adolescent population and can be used as an important tool for assessing adolescents’ alexithymia.

To explore the current status of coupled coordination of medical resource supply and service utilization in township health hospitals in Sichuan Province, and to provide reference for optimizing medical resource allocation.

The data concerning the allocation of health resources and the utilization of services in township health centers of various cities (prefectures) in Sichuan Province from 2017 to 2021 were selected. The comprehensive evaluation index was utilized to comprehensively assess the allocation of health resources and service utilization, and the coupling coordination degree model was employed to analyze the relationship between the two systems.

The comprehensive evaluation index of medical resource supply and service utilization in township health centers in Sichuan Province improved from 0.27 and 0.45 in 2017 to 0.30 and 0.52 in 2021, respectively, and more than 90% of the areas were subject to lagging medical resource supply; the type of coupling coordination ranged from reluctant coupling coordination to primary coupling coordination; reluctant coordination was the main type; and the LISA chart showed Aba as the "high - high" aggregation point, Luzhouwas low - low aggregation point.

The level of resource supply and service utilization and coupled coordinated development of township health centers in Sichuan Province has been increasing, and the level of health resource supply and service utilization has not been synergistically developed, and most of them are subject to the lagging supply of health resources, and there is a localized aggregation effect of the degree of coupled coordination in space.

To investigate the relationship between social alienation and health promotion behaviors in community chronic co-morbid older adults, and explore the mediating role of self-perceived aging.

Using the convenience sampling method, A questionnaire survey was conducted using the General Information Questionnaire, the General Alienation Scale, the Simplified Self-perceived Aging Scale, and the Health Promoting Lifestyle Scale on 611 community-based older adults with chronic co-morbidities in Hangzhou, and structural equation modeling was constructed using AMOS.

The total score of chronic co-morbid social alienation in the community was (36.38±10.41) points, the total score of self-perceived aging was (50.10±14.68) points, and the score of health promotion behavior was (93.79±15.56) points. The results of the mediation effect test showed that the effect value between social alienation and health promotion behavior was -0.205 (95%CI: -0.285 to -0.121), accounting for 45.86% of the total effect; the effect value of self-perceived aging in the mediation effect between social isolation and health promotion behavior was -0.242 (95%CI: -0.299 to -0.191); the total effect value was -0.447 (95%CI: -0.508 to -0.383), and the mediation effect accounted for 54.14% of the total effect.

Social alienation and self-perceived aging of chronic co-morbid older adults directly affect health promotion behaviors, while social alienation can indirectly affect health promotion behaviors through self-perceived aging.

To explore the potential categories of health literacy of the elderly with chronic disease comorbid disability and their relationship with family nursing quality.

713 comorbid disabled elderly in Urumqi, Xinjiang were investigated by general data, function of daily living index, health literacy scale for chronic disease patients and Family Care Quality Scale for disabled elderly (FCCI). Mplus 8.3 was used to make potential profile analysis of their health literacy, and SPSS 26.0 software was applied. To compare the quality of family care for the elderly with comorbidity and disability in different categories of health literacy.

The health literacy of the elderly with concomitant disabilities can be divided into three categories:high health literacy - high willingness (35.5%), medium health literacy - good acceptance (47.7%), and low health literacy - low access to information (16.8%). There were significant differences in the total score of family care quality and the scores of each dimension among the 3 different health literacy groups (P<0.001). The total score of family care quality in the group with high health literacy and high willingness was the highest (47.47±0.128), and the total score of family care quality in the group with low health literacy and low information access was the lowest (40.28±0.315). The scores of family care quality in the group with high health literacy and high willingness were higher than those in the other two groups, including scores of disabled elderly (28.03±0.053), caregiver (11.02±0.054) and family members (8.42±0.062). The scores of family care quality in the group with low health literacy and low access to information were lower than those in the other two groups, including scores of disabled elderly (24.78±0.176), caregiver (8.97±0.116) and family members (6.53±0.101).

There are three potential categories of health literacy for the elderly with comorbid disabilities, and the quality of family care for the elderly with comorbid disabilities is different in different potential categories. It is suggested that targeted personalized intervention programs should be developed based on the groups with the same health literacy of the elderly with comorbid disabilities, so as to improve the quality of their family care.

To explore the potential categories of primary caregiver burden in families of cancer patients and their potential related factors, and to provide scientific basis for more targeted policy interventions.

From February to April 2023, we conducted a questionnaire survey among the primary family caregivers of cancer patients at the Third Affiliated Hospital of Harbin Medical University using convenience sampling. Latent profile analysis was employed to identify potential categories of caregiver burden. The modified BCH method was used to assess the differences in family resilience, individual resilience, and caregiving ability across different burden categories.

A total of 367 participants were included in the study, and their caregiving burden was divided into two categories, named "mild caregiver burden group" and "moderate and severe caregiver burden group". The respondents of "moderate to heavy caregiver burden" were mostly female who were highly educated and had spouse and children. Different potential categories of family caregiver burden profiles showed statistically significant differences in family resilience (χ²=5.333，P=0.021), individual resilience (χ²=31.687，P<0.001), and caregiving ability (χ²=13.391，P<0.001).

There are heterogeneous subgroups of primary caregiver burden in families of cancer patients, and policy makers should implement targeted interventions to reduce the burden of primary caregivers for families with cancer patients, and to improve their personal and family resilience and caring abilities.

To understand the utilization and demand status of cancer screening services among residents in Sichuan Province, and provide scientific basis for further promoting cancer screening strategies.

Using multi-stage stratified clustering and probability proportional to size (PPS) sampling, a face-to-face questionnaire survey was conducted among 15-74-year-old permanent residents from 10 cities (prefectures) in Sichuan Province. Using chi-square test for univariate analysis of cancer screening service utilization and demand, and using logistic regression model for multivariate analysis.

A total of 7 442 valid questionnaires were collected, with an effective rate of 91.30%. 1 099 residents (14.77%) had undergone cancer screening, aged between 40 and 60 years old (OR=1.62, 95%CI:1.31-2.00), female (OR=1.92, 95%CI:1.65-2.25), married, with a college/undergraduate education or above, civil servants and public institution staff (OR=1.59, 95%CI:1.20-2.09), with a family history of cancer, urban household registration (OR=1.46,95%CI:1.23-1.74), poor self-rated health status, and higher utilization rate of cancer screening services for urban employees with basic medical insurance.5034 residents (67.64%) had a demand for cancer screening services. Married individuals with higher education levels, total household income ≥ 60000 yuan/year (OR=1.20,95%CI:1.07-1.35), family history of cancer, and poor self-rated health status had a higher demand for cancer screening services.

There is a high demand for cancer screening services among residents in Sichuan Province, but the actual utilization is insufficient. It is recommended to improve and promote cancer screening work by strengthening health education and establishing a multi-channel funding mechanism for cancer screening.

To investigate the mediating effects of daily activity ability and depression on pain status and subjective life expectancy in elderly patients with chronic diseases, and to provide suggestions and references for active aging.

Based on The China Health and Retirement Longitudinal Study (CHARLS) 2020 data, 5 768 patients with chronic diseases aged ≥60 years were selected as the study subjects, and Spearman correlation analysis was used to explore the correlation between pain, ability to perform activities of daily living, depression, and subjective life expectancy, and PROCESS 4.1 program Model 6 was used to construct the chain-mediated model.

Pain was positively correlated with impaired daily activity ability and depression (r=0.399, P<0.001; r=0.370, P<0.001), was negatively correlated with subjective life expectancy (r=-0.221, P<0.001); The mediating effects of daily activity ability and depression on pain and subjective life expectancy were significant, with simple mediating effects of -0.023 (95%CI: -0.031 to -0.016) and -0.042 (95%CI: -0.049 to -0.034), respectively. The chain mediation effect was -0.013(95%CI: -0.016 to -0.010). The total mediating effect of daily activity ability and depression on pain and subjective life expectancy was -0.078, accounting for 57.78%.

There is a chain mediated effect between daily activity ability and depression on pain status and subjective life expectancy in elderly patients with chronic diseases. With the popularization of primary medical and health services, the family doctor service team needs to improve the comprehensive management of elderly patients with chronic diseases, improve the subjective well-being of elderly patients with chronic diseases from pain management, daily activity intervention, depression regulation and other aspects, and prolong the subjective life expectancy.

To explore the impact of social participation on cognitive decline in middle-aged and elderly people, and to provide a reference for improving or maintaining the cognitive health of middle-aged and elderly people.

A total of 6 645 middle-aged and elderly people over 50 years old in the 2018 China Longitudinal Survey on Influencing Factors of Elderly Health (CLHLS) were selected as the research subjects, and cognitive frailty was evaluated by the Mini-Mental State Evaluation Scale (MMSE) and Frailty Index (FI). A multivariate logistic regression model was used to analyze the effects of social participation type and intensity on cognitive weakness.

The higher the participation of middle-aged and elderly people in family activities, individual activities, and group activities, the lower the incidence of cognitive weakness. High participation in family activities had the highest effect on mild (OR=0.271, 95%CI:0.228-0.321), moderate (OR=0.463, 95%CI:0.361-0.592) and severe (OR=0.079, 95%CI:0.043-0.146) cognitive frailty. The incidence of cognitive frailty was negatively moderated by high participation in family activities (OR=2.263, 95%CI:1.579-3.244), and the incidence of cognitive frailty was negatively moderated by urban middle-aged and elderly people in group activities (OR=0.459, 95%CI:0.289-0.727) and high participation (OR=0.490, 95%CI:0.331-0.725).

It is of great significance to increase the enthusiasm of middle-aged and elderly people for social participation, especially family activities, to delay the decline of cognitive frailty.

To investigate the intrinsic relationships among family functioning, life events and insomnia in adolescents with depression.

A survey was conducted on 165 adolescents diagnosed with depression who were receiving treatment at a tertiary hospital in Guangzhou. The study utilized a general information questionnaire, Family APGAR Index, Insomnia Severity Index, and Adolescent Life Events Scale. Descriptive and correlation analyses were performed using SPSS, and mediation effects were tested using the Process plugin.

The insomnia rate among adolescent depression patients was 77.58%. There was a significant positive correlation between insomnia and the total score of life events and its dimension factors (P<0.01), while insomnia showed a significant negative correlation with the total score of family functioning and its dimension factors (P<0.01). The results of the Bootstrap test indicate that family care, growth factors and cooperation play a partial mediating role between life events and insomnia in adolescent depression patients (β=0.019, 95% CI: 0.003-0.036; β= 0.013, 95% CI: 0.01-0.026; β= 0.011, 95% CI: 0.000-0.024), accounting for 15.45%, 10.57% and 8.94% of the total effect, respectively.

Adolescents with depression experience moderate to high levels of insomnia. Life events in adolescents with depression can directly affect insomnia, or indirectly influence it through family care.

To establish a method for the determination of 18 phthalates (PAEs) metabolites in urine by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) based on solid-phase support liquid-liquid extraction (SLE) technology.

Urine sample spiked with internal standards was first hydrolyzed by enzyme, then purified on a SLE column. The separation was performed on a BEH C18 column. The detection was performed in multi-reaction monitoring scan under negative mode. Internal standard method was applied for quantitative analysis.

The 18 PAEs metabolites showed good linear relationships in the range of 0.10-80 ng/ml (r>0.999). The average recoveries of 18 PAEs metabolites ranged from 84.0%-113.0% with relative standard deviations between 1.1% and 9.5%. The limits of detection and quantitation of the method were 0.001-0.07ng/ml and 0.002-0.2 ng/ml, respectively. The intra-day and the inter-day precisions were 1.3%-7.0% and 1.0%-8.1%, respectively. 160 urine samples were analyzed with this method. Except for 3 PAEs metabolites that were not detected, the detection rates of the remaining 15 PAEs metabolites ranged from 1.9% to 100%, and the detection rates of 8 PAEs metabolites were 100%. Among them, mono-n-butyl phthalate had the highest concentrations with a median concentration of 126 ng/ml.

This method is simple, sensitive, and accurate, and it is suitable for the determination of 18 PAEs metabolites in large batchs of urine samples.

To explore the effects and mechanisms between chronic pain and depression in middle-aged and older adults in China, and to provide reference for promoting pain management and improving interventions.

13,253 middle-aged and older adults from the fifth issue of the China Health and Retirement Longitudinal Study (CHARLS) were included. Propensity score matching method, logit model, OLS regression and Bootstrap mediation test were used to explain the mediating effects of subjective life expectancy (SLE), sleep duration and Internet use between chronic pain and depression and the moderating role of social participation.

The overall effect size of chronic pain on depression was 0.876 (95%CI=0.781-0.972), with a direct effect of 0.745 (95%CI=0.668-0.822), accounting for 85.05%, and an indirect effect of 0.131 (95%CI=0.094-0.169), accounting for 14.95%. The mediating effects of SLE, sleep duration, and Internet use were 0.087 (95%CI=0.071-0.103), 0.093 (95%CI=0.066-0.121), and -0.049 (95%CI=-0.085--0.013), representing 9.93%, 10.62%, and -5.60% of the total effect respectively. Social participation negatively moderated the relationship between chronic pain and depression（β=-0.095，95%CI=-0.186--0.004）.

Chronic pain not only directly exacerbates depression in middle-aged and older adults but also indirectly worsens depression through SLE and sleep duration. However, Internet use and social participation can have compensatory and alleviating effects. It is recommended that physical and psychological therapies be emphasized and applied simultaneously, with special attention given to key populations such as women, rural dwellers, and chronic patients. Additionally, “Internet plus healthcare” and grassroots communities should be utilized to enhance pain management and intervention for middle-aged and older adults.

To investigate the association between biological aging and cognitive function in middle-aged and elderly Chinese.

The subjects were health check-up personnel over 45 years old from a top three hospital. The general demographic characteristics, covariates and cognitive function status were collected by questionnaire and Montreal cognitive assessment (MoCA). Multivariate linear regression and logistic regression were used to analyze biological aging index (BAI) and biological aging type (BAT) association with MoCA score and risk of mild cognitive impairment (MCI). Subgroup analysis was conducted by the middle-aged group (45-64 years old) and the elderly group (65 years old and above) to explore whether the correlation between biological aging and cognitive function was different in different age groups.

A total of 407 participants were included in this study. The average MoCA score was 23.30±4.30, and the detection rate of MCI was 41.5%. BAI was negatively correlated with MoCA score, and the regression coefficient after adjusting for covariates was -0.135 (95%CI: -0.229--0.042). Compared with those with delayed aging, subjects with premature aging had lower cognitive function scores (β=-0.882，95%CI：-1.566--0.198) and a higher risk of MCI (OR=1.736，95%CI：1.072-2.833). Subgroup analysis found that the association was still present in the middle-aged group, but not in the elderly group.

There is a negative correlation between biological aging and cognitive function in middle-aged and elderly people, and the cognitive function of subjects with premature aging is worse. This effect is more significant in middle-aged group, suggesting that individuals with premature aging should be identified in middle age or even earlier and that intervention measures should be taken to prevent or delay the occurrence of dementia.

To understand the various metal elements content and distribution in crayfish sold in Deyang, and to initial determine the harm of hazardous metallic elements to residents in Deyang.

A total of 102 samples were collected in Deyang using a stratified random sampling approach, the samples was digested by microwave digestion,17 mineral elements and 7 harmful metal elements were detected using inductively coupled plasma optical emission spectroscopy (ICP-OES) and inductively coupled plasma mass spectrometry(ICP-MS).

Mineral elements in all parts of the crayfish were detected and the content varies, in terms of total minerals, crayfish brain> crayfish intestine> crayfish gills> crayfish meat> crayfish hepatopancreas. For harmful metals, there was no exceedance in crayfish meat, As, Cu, Cd in crayfish hepatopancreas exceeded the standard rate of 97.0%, 2.97%, 27.7%, Hg, Pb, Cr did not exceed the standard, As, Cu, Pb, Cr and Al were all exceeded the standard in the non-edible parts by 2.17% to 100%. The enrichment pattern of all metal elements in crayfish in Deyang and Hubei was consistent, but the contents varied. In different sampling sessions, none of the harmful metal elements in crayfish meat exceeded the standard; As, Cu, Cd in crayfish hepatopancreas exceeded the standard rate of 2.8%-97%, and the rest of the elements did not exceed the standard. In different growth stages, except for As, there was no significant difference in the accumulation of hazardous metal elements between green and red crayfish.

Crayfish have a high mineral content and abundant nutrients, and local residents in Deyang City have a lower risk of heavy metal hazards in their daily intake of crayfish.

To explore the causal relationship between obstructive sleep apnea and atherosclerosis which is not clear through Mendelian randomization.

Genome-wide associations of different subtypes of obstructive sleep apnea and atherosclerosis were selected from the data published on the IEU Open GWAS (https://gwas.mrcieu.ac.uk/) website. Inverse variance weighting method (IVW), MR-Egger regression, simple model, weighted model and weighted median method were used to determine the causal correlation between them. A variety of sensitivity analysis and calculating F values were used to verify the accuracy of the results.

Five single nucleotide polymorphisms (Single nucleotide polymorphism, SNP) strongly associated with obstructive sleep apnea were included in the study, and the F values were all greater than 10. The results of IVW method showed that coronary atherosclerosis (OR:1.321,95%CI:1.150-1.518,P=8.3×10^-5) had significant statistical significance, while cerebral atherosclerosis(OR:0.331,95%CI:0.071-1.536,P=0.158) and peripheral atherosclerosis (OR:1.204,95%CI:0.962-1.508,P=0.106) had no statistical significance. The results of heterogeneity test, horizontal multiplicity analysis, sensitivity analysis and MR-PRESSO analysis made the causal relationship of Mendelian randomized analysis more reliable.

There is a causal correlation between obstructive sleep apnea and coronary atherosclerosis, and there is a positive correlation between obstructive sleep apnea and coronary atherosclerosis; there is no causal relationship between obstructive sleep apnea and cerebral atherosclerosis and peripheral atherosclerosis; reverse MR analysis found no causal correlation between selected atherosclerosis and obstructive sleep apnea.

To study the risk factors for health-related quality of life (HRQoL) changes in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) under different multimorbidity patterns.

AECOPD patients in five hospitals in Shanxi Province were selected from September 2021 to September 2023, and 214 patients were finally included. The minimal clinically important differences(MCID) of St George’s Respiratory Questionnaire (SGRQ) was combined to assess the HRQoL of the patients. This study started from multimorbidity (refer to ICD-10), multimorbidity patterns stratification was performed based on latent class analysis (LCA), and then ordered logistic regression analysis was used to analyze the risk factors affecting the change of SGRQ score at 3 months after discharge of patients with different multimorbidity patterns.

Patients were divided into “cardiovascular disease group” and “cor pulmonale low burden group” through potential category analysis. Ordered logistic regression results showed that at 3 months after discharge, the probability of clinically significant increased in SGRQ in patients with high BMI (OR=2.96, 95%CI: 1.09-8.34, P=0.035) and patients with high direct bilirubin (OR=2.96, 95%CI: 1.07-8.35, P=0.037) in the cardiovascular disease group were 2.96 times higher than that of normal patients; the probability of clinically significant increased in SGRQ in patients with high direct bilirubin (OR=3.25, 95% CI:1.35-7.97, P=0.009) and patients with low oxygen saturation (OR=2.35, 95%CI:1.05-5.55, P=0.043) in the cor pulmonale low burden group were 3.25 and 2.35 times higher than those of normal patients (P<0.05).

The prognostic risk factors of AECOPD patients with different multimorbidity patterns are different, and regardless of the multimorbidity patterns, high direct bilirubin is an independent risk factor for HRQoL changes in patients with AECOPD. Moreover clinicians should closely detect in the the abnormal changes in BMI in AECOPD patients with cardiovascular disease.

To explore the incidence, time of occurrence and influencing factors of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in stable chronic obstructive pulmonary disease (COPD) patients within one year.

Retrospectively collected information on COPD case home page visits in Yunnan Province from 2016 to 2022, establishing a longitudinal observation cohort based on patients’ names and ID numbers. The incidence rate, time of occurrence and average number of AECOPD within one year of COPD were calculated, and the relationship between patients’ exposure factors and the number of AECOPD within one year was analyzed by using multivariate linear regression, and the exposure factors affecting AECOPD within one year of COPD patients were analyzed by using Cox regression.

The mean age of 405 428 COPD patients was（70.75±10.95）years, the mean number of comorbidities was 1.14±1.15, the incidence of AECOPD within one year was 17.55%, the mean duration of occurrence was（4.58±3.64）months, and the mean number of AECOPD per patient was 0.27. The regression results showed that gender (HR=1.473, 95%CI: 1.446-1.500), age (HR=1.011, 95%CI: 1.010-1.012), number of comorbidities (HR=1.083, 95%CI: 1.076-1.090), medical insurance type (HR=1.481, 95%CI: 1.394-1.574), and admission season (HR=1.115, 95%CI: 1.090-1.140) were the influencing factors for acute exacerbation in patients with COPD within one year.

The incidence of AECOPD in COPD patients in Yunnan Province within one year is 17.55%. We should start from various risk factors and focus on male, elderly, patients with multiple comorbidities, those admitted in spring and winter seasons, and non-resident medical insurance patients. Take corresponding preventive measures and strengthen the management of AECOPD.

To comprehensively understand the incidence of metabolic syndrome (MS) and its potential risk elements in middle-aged and elderly people in Tibet, and to provide a scientific and reliable reference for the development and implementation of precise prevention and control strategies for MS in Tibet.

Between June 2021 and December 2022, 6 286 middle-aged and elderly people were strictly screened in Tibet by multi-stage stratified cluster random sampling. The data were organized and analyzed by using SPSS27.0 software, and the differences in MS prevalence among different groups were compared by using the chi-square test and the trend chi-square test, and further analyses of the factors affecting the prevalence of MS were conducted using logistics regression.

Among 6 286 middle-aged and elderly participants, a total of 1 409 patients were screened, with an overall prevalence of metabolic syndrome of 22.41%, the older the age, the higher the prevalence of MS (χ² = 49.694, P < 0.001); the prevalence of MS in men was 27.8%, higher than that in women, which was 18.21%, with a statistically significant difference (P < 0.001). Multifactorial unconditional logistic regression analysis revealed that the main risk factors for the prevalence of MS were advanced age (OR=2.053, 95% CI: 1.545-2.728) for those aged 70 years and above, a family history of hypertension (OR=2.691, 95% CI: 2.293-3.158), a family history of diabetes (OR=4.480, 95% CI: 2.066-9.716) and a body mass index (BMI)≥24.0 kg/m² (OR=14.148, 95%CI: 11.778-16.995), however, female (OR=0.508, 95%CI: 0.443-0.584) and alcohol consumption (OR=0.628, 95%CI: 0.487-0.812) were protective factors for the development of MS. In addition, among the various combinations of abnormal components of MS, the aggregation pattern of “abnormal glucose + abnormal blood pressure +central obesity” was the most prevalent, involving a total of 340 cases, with a prevalence rate of 5.41%.

The prevalence of MS in middle-aged and elderly people in Tibet is at a high level, in which males, elderly people, people with a family history of hypertension or diabetes, and overweight or obese people should be regarded as the priority targets for MS prevention and control. This study provides a basic reference for the prevention and control of MS in Tibet, so that precise prevention and control measures can be taken according to the high-risk groups.

To explore the construction of the training system for preventive medical professionals and train high-level public health talents.

West China School of Public Health, Sichuan University, has deeply promoted the reform of talent education and teaching for undergraduate students in preventive medicine, exploring from aspects such as training objectives, curriculum and teaching material systems, practical ability training, and the cultivation of medical prevention integration capabilities. We have reconstructed the talent cultivation program, innovated the talent cultivation mode, and explored the new paradigm of cultivating top-notch and innovative talents for the preventive medicine specialty.

We have revised and completed the general training plan for public health and preventive medicine, constructed a modernized curriculum system of preventive medicine, strengthened the development and application of digital education, actively explored the in-depth cooperation with practice teaching bases, and taken the lead in the country in launching the innovative class of hospital infection management, the dual bachelor’s degree of preventive medicine and software engineering, and the micro-specialty of health insurance.

Under the strategic background of Healthy China, professional education of preventive medicine is the key path for the cultivation of public health talents in China. Colleges and universities should actively explore the innovation and development of the cultivation of preventive medicine professional talents, so as to contribute to the construction of Healthy China in the new era.