Postmenopausal osteoporosis (PMOP) is highly prevalent among elderly women. Current research on the effects of physical activity types and region-specific dietary patterns is insufficient. Large-scale cross-sectional studies are needed to analyze these multidimensional factors.

To investigate the impact of physical activity and dietary patterns on PMOP and their interaction effects.

In May 2022, a baseline survey was conducted among postmenopausal women aged 60 and above in Hongguang Town, Pidu District, Chengdu. Physical activity levels were assessed using the International Physical Activity Questionnaire (IPAQ), and dietary information was collected via a food frequency questionnaire. Dietary patterns were identified using factor analysis, and bone density was measured by dual-energy X-ray absorptiometry (DXA). Multivariate logistic regression was used to analyze the independent and interaction effects.

A total of 1 136 postmenopausal women (mean age 67.2±5.1 years) were included, with a PMOP prevalence of 32.8%. After adjustment, recreational physical activity was negatively associated with PMOP (OR=0.64, 95% CI: 0.45-0.92). The Sichuan-style high-sodium red meat pattern and freshwater fish–poultry pattern showed no significant association after adjustment. Interaction analysis revealed that walking had a significant synergistic effect with dietary patterns (P_interaction=0.008), while other physical activities did not.

Physical activity and dietary patterns have independent and synergistic effects on PMOP. This study provides region-specific clues for exercise and dietary interventions for PMOP in Southwest China. Future research should validate these findings through multicenter studies.

To explore the mediating role of depression between cardiometabolic multimorbidity (CMM) and disability status among older adults, and to provide a theoretical basis for the prevention and management of disability among the elderly.

Based on cross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS) in 2020, 8 270 elderly individuals aged≥60 years were included. Correlation and mediation analyses were conducted to examine the associations among depression, CMM and disability. The PROCESS 4.1 macro was employed to test the mediating effect of depression, and the mediating variables were verified using the Bootstrap method.

The detection rate of disability was 19.1%. After controlling for confounders, both CMM and depression were positively correlated with disability(r=0.142, r=0.209, P<0.001). CMM significantly predicted disability status of the elderly (β=0.414, t=13.040, P<0.001), with depression accounting for 17.39% of the total effect (β=0.072, 95% CI:0.056-0.091).

Cardiometabolic multimorbidity can directly or indirectly influence the disability status through the mediating role of depression. Relevant authorities should enhance public awareness campaigns and implement integrated intervention strategies addressing both physiological and psychological aspects to mitigate disability risk in older adults.

To reveal the trajectory of depressive symptoms among bereaved older adults in China and to explore the factors influencing them.

Based on the longitudinal data provided by the China Health and Retirement Longitudinal Study (CHARLS), this study used the Latent growth mixture model (LGMM) to identify individuals’ depressive symptom trajectories over time, and multivariate logistic regression was used to analyse the influencing factors.

Four patterns of trajectories of depressive symptoms among bereaved older adults were found: low depression rapidly increasing group (10.2%), high depression rapidly decreasing group (11.5%), high depression slowly increasing group (23.9%), and low depression continuously stable group (54.4%). The results of the multivariate logistic regression analysis showed that, in the trajectory of depressive symptom onset among elderly parents who lost their children in China, living in urban areas, having fewer days with poor sleep per week, and reporting good self-rated health status are all protective factors, while low life satisfaction is a risk factor (all P<0.05).

This study reveals heterogeneity in changes in depressive symptoms among bereaved older adults in China. The government and medical institutions should meet individualized support measures based on the characteristics of different groups.

To analyze the prevalence of multimorbidity and disability among urban and rural elderly in China, exploretheir association, and inform policy optimization.

Using the 2020 CHARLS database, descriptive analysis, chi-square tests, and Kruskal-Wallis H tests were used to depict the urban-rural differences. Cluster analysis identified multimorbidity patterns. Binary logistic regression (for BADL disability) and generalized ordered logistic regression (for IADL disability levels) were used to analyze the impact of multimorbidity patterns on disability.

Chronic disease prevalence was 88.38%, and multimorbidity prevalence was 69.84%. Urban older adults had a higher multimorbidity rate (73.27%) than their rural counterparts (68.62%). Cluster analysis identified five comorbidity patterns, with Pattern 5 (complex multimorbidity pattern) being the most prevalent (urban:39.97%, rural:28.93%). Rural older adults exhibited significantly higher proportions of moderate and severe IADL disability (11.65%, 8.04%) compared to urban residents (7.83%, 6.94%). Regression analyses demonstrated a significant association between multimorbidity and higher disability prevalence, with Pattern 5 having the strongest impact on both BADL (OR=2.87, 95% CI:2.22-3.71) and IADL (moderate disability: OR=3.16, 95% CI:2.60-3.84; severe disability: OR=2.62, 95% CI:1.98-3.47).

Multimorbidity is highly prevalent and significantly associated with disability among older adults in both urban and rural China, with the complex multimorbidity pattern (Pattern 5) showing the strongest association. Urban older adults experience more complex multimorbidity patterns, while rural older adults face more severe disability. Policy development should address urban-rural disparities through targeted health management strategies and interventions.

To explore the correlation between body roundness index (BRI) and hypertension in middle-aged and elderly people.

The research data were from China Health and Retirement Longitudinal Study (CHARLS). The baseline data of participants in 2011 and the follow-up data from 2013 to 2020 were collected, and the body roundness index was calculated. Cox regression was used to analyze the relationship between BRI and hypertension. The linear trend test was used to explore the linear trend of the incidence of hypertension in the four quartiles of BRI. The dose-response relationship between BRI and hypertension was analyzed by restricted cubic spline model. The receiver operating characteristic curve and the area under the curve were used to evaluate BRI and common obesity assessment, so as to evaluate their ability to predict hypertension risk.

Cox regression analysis showed that after adjusting the relevant covariates, BRI was correlated with the incidence of hypertension. The incidence of hypertension in the highest quartile of BRI was 1.29 times higher than that in the lowest quartile. Linear trend test showed that the incidence of hypertension increased with the increase of BRI quartile level (27.27%, 29.78%, 37.69%, 43.70%). RCS analysis showed that the higher the BRI, the greater the risk of hypertension. ROC curve analysis showed that the diagnostic performance of BRI was better than that of BMI, WHtR and WWI.

High BRI is associated with an increased risk of hypertension in middle-aged and elderly people in China.

To understand the core information awareness of chronic diseases and its influencing factors among adult residents in Quanzhou City, and to provide a direction for further improving the health literacy of Quanzhou residents.

Using data from the 2023 Quanzhou Chronic Disease Social Factors Survey, the core information awareness of chronic diseases among residents was descriptively analyzed. Multivariate unconditional logistic regression was employed for analyzing influencing factors.

The core information awareness of chronic diseases among adult residents in Quanzhou 2023 was 78.5%. The awareness rate was higher in males (79.6%) than in females (77.7%) and showed a declining trend with increasing age (χ²=290.339, P<0.01). The higher education, the higher the awareness rate (χ²=481.641, P<0.01). Urban residents had a higher awareness rate (80.7%) compared to rural residents (77.3%), and residents in demonstration areas for comprehensive prevention and control of chronic diseases had a higher awareness rate (80.8%) than those in non-demonstration areas (76.0%). Multivariate unconditional logistic regression analysis showed that influencing factors included age (age 45-<65: OR: 0.805, 95% CI: 0.700-0.927; age 65 or above: OR: 0.646, 95% CI: 0.550-0.759), education level (primary school OR: 1.252, 95% CI: 1.102-1.424; junior high school OR: 1.905, 95% CI: 1.663-2.181; high school or Technical secondary school OR: 2.715, 95% CI: 2.251-3.275; College degree or above OR: 4.309, 95% CI: 3.419-5.431) and demonstration areas for comprehensive prevention and control of chronic diseases (OR: 1.120, 95% CI: 1.016-1.235). Generally, an educational attainment of primary school or above and a demonstration areas for comprehensive prevention and control of chronic diseases were the factors that promoted the awareness of core information of chronic diseases. Adult residents aged 45 and above and those in non-demonstration areas for comprehensive prevention and control of chronic diseases are risk factors for lack of awareness of core information of chronic diseases.

The core information awareness of chronic diseases among Quanzhou residents still needs improvement. Focusing on influencing factors such as age, education, and demonstration areas for comprehensive prevention and control of chronic diseases can better enhance the health literacy of residents regarding chronic diseases, effectively preventing and controlling chronic diseases.

To assess the impact of environmental factors on the chronic respiratory disease (CRD) burden among the Chinese population during 1990—2021, providing scientific evidence for formulating targeted prevention strategies and clinical interventions.

Based on the data of the Global Burden of Disease Study 2021 (GBD 2021), this study adopted descriptive epidemiological methods to analyze the disease burden indicators of chronic respiratory diseases (CRD). Further, the Joinpoint regression model was used to analyze the temporal trend changes of disease burden, and the Age-Period-Cohort (APC) model was constructed to systematically evaluate the impact of environmental risk factors on the disease burden of CRD.

Both the CRD-standardised mortality rate and the standardised DALY rate showed a decreasing trend over the period (P<0.05). As of 2021, outdoor particulate matter has become the primary contributor to the burden of chronic respiratory disease in China. The impact of environmental factors on the disease burden of CRD in China increased with age, with those aged 80 years or older being the most severely affected. Cohort analyses showed that people born in 1912—1951 were more affected by environmental factors, especially indoor air pollution and ambient particulate matter.

The long-term impact of environmental factors on the disease burden of CRD among Chinese residents still cannot be ignored. It is necessary to further strengthen environmental monitoring, formulate and implement stricter environmental standards, especially in controlling outdoor air pollution.

To investigate the association between Tsampa consumption and biological age acceleration.

Utilizing baseline data from the China Multi-Ethnic Cohort study (CMEC), a composite biomarker-based biological age was constructed using the Klemera-Doubal Method (Biological age based on Klemera and Doubal’s method, KDM-BA). Biological aging was quantified as the difference between KDM-BA and chronological age. Tsampa consumption information was obtained via a Food Frequency Questionnaire (FFQ). Weekly intake was calculated based on consumption frequency and gram weight, and participants were categorized into four groups: non-consumption, low, moderate, and high, based on the 25th and 75th percentiles. Multiple linear regression was employed to analyze the association between Tsampa consumption and biological age acceleration. Stratified analyses were conducted using sex, age, smoking, alcohol consumption, and BMI as stratification factors.

A total of 4 335 participants were included. Compared to non-consumption, Tsampa consumption showed a negative association with biological age acceleration(β=-0.66,95% CI:-0.99- -0.327). A statistically significant association was found for moderate Tsampa consumption (700-1 400 grams)(β=-1.24,95% CI: -2.04- -0.44). Associations for low and high consumption levels were not statistically significant [Low:(β=0.11, 95% CI:-0.67-0.88); High:(β=-0.39,95% CI:-1.37-0.60)]. The protective effect of Tsampa consumption against biological age acceleration was stronger in males than in females [Males: (β=-0.83, 95% CI: -1.24- -0.43); Females:(β=-0.61,95% CI:-1.08- -0.13)].

Tsampa consumption is negatively associated with biological age acceleration, suggesting its potential beneficial role in promoting healthy aging in the Tibetan region.

To assess the exposure levels and potential health risks of benzoic acid, sorbic acid, saccharin sodium, and cyclamate in sweet and sour pickled vegetables for sale in Wuhan.

Utilizing the monitoring data of benzoic acid, sorbic acid, saccharin sodium, and cyclamate in sweet and sour pickled vegetables from the Wuhan Food Safety Risk Surveillance Program from 2021 to 2024, the point assessment method and the safety limit method were used to evaluatethe exposure risks of these additives.

The detection rates of benzoic acid, sorbic acid, saccharin sodium, and cyclamate in sweet and sour pickled vegetables (n=790)were 83.0%, 45.2%, 49.6%, and 77.5%, respectively. The over-standard rates of benzoic acid, saccharin sodium, and cyclamate were 3.4%, 4.2%, and 2.8%, respectively. The maximum concentrations of benzoic acid, sorbic acid, saccharin sodium, and cyclamate were 2.21 g/kg, 0.837 0 g/kg, 0.963 0 g/kg, and 3.13 g/kg, respectively. The average daily exposure to benzoic acid, sorbic acid, saccharin sodium, and cyclamate was well below their respective ADI values. Cumulative risk assessment showed that the Hazard Index (HI) of the four additives combined was less than 1.

The exposure risk from sweet and sour pickled vegetables in this study was within an acceptable rang.

To understand the main dietary heavy metal pollution situation of Huanggang residents, and to analyze the sources of pollution, and evaluate the health risks of heavy metal intake through dietary pathways.

From 2019 to 2023, a total of 1 402 samples from 11 major categories and 30 subcategories were collected and detected in ten counties and districts of Huanggang City. The Nemerow contamination index method, Spearman rank correlation test, cluster analysis, and principal component analysis were usedto comprehensively evaluate the food contamination situation and possible sources. Evaluate the non carcinogenic and carcinogenic health risks of the population using the total target hazard quotient (TTHQ) and total target carcinogenic risk (TTCR).

The average content of heavy metals(Pb、Cd、Hg、As、Cr) in food was 0.007-0.217 mg/kg, 0.001-0.632 mg/kg, 0.001-0.012 mg/kg, 0.003-0.103 mg/kg, and 0.005-0.376 mg/kg, respectively. The detection rate of heavy metals was 0.0%-100.0%, and the exceedance rate was 0.0%-31.7%. Except for Hg, there were statistically significant differences in the content, detection rate, and exceedance rate of heavy metals in different types of food (P<0.001). The detection rate and exceedance rate of heavy metals in edible fungi were relatively high. Region, season, stage, processing level, moisture content, and packaging level were all influencing factors of heavy metal content in food. The two possible sources of heavy metals in edible fungi were industrial emissions and traffic exhaust. Except for bamboo fungus and shiitake mushrooms, which were heavily and mildly contaminated respectively, all other foods were safe. The TTHQ of different populations was between 1 and 10, and the TTCR was greater than 1×10^-4. Children had higher TTHQ than adults, and females had higher TTCR than males. The main sources of heavy metals for TTHQ and TTCR in the population were total As and Cd.

The overall degree of heavy metal pollution in the main diets of Huanggang City is still within a controllable range. There may be certain cumulative health risks of heavy metals for residents through dietary intake, and special attention should be paid to the health risks of children.

To investigate the dose–response relationship between different levels of physical activity and sedentary time and mental health among primary and secondary school students, thereby providing a robust scientific basis for the effective prevention of mental health problems in children and adolescents.

A health survey was conducted among 3 982 students selected by convenience sampling from eight primary and secondary schools in Haizhu District, Guangzhou. Mental health status was compared between students with and without regular physical activity habits. Zero-inflated negative binomial (ZINB) models and generalized additive models (GAMs) were subsequently employed to analyze the dose–response relationship between physical activity, sedentary behavior, and mental health outcomes.

Among the 3 982 participants, only 5.73% met the World Health Organization’s recommended levels of physical activity. Sedentary time was generally excessive, with only 25.24% of students reporting sedentary time of 3 hours or less per day. After stratified propensity score matching, significant differences in the number of days feeling unhappy were observed across all six matched groups between students with and without regular physical activity habits. Compared with ≤10 minutes of daily moderate-to-vigorous physical activity (MVPA), longer durations of MVPA and outdoor activity were associated with improved mental health outcomes, with greater benefits observed as activity duration increased (MVPA: 11–29 minutes: +21.55%, 30–59 minutes: +24.19%, ≥60 minutes: +25.86%; outdoor activity: 11–30 minutes: +23.81%, 31–44 minutes: +19.19%, 45–60 minutes: +25.42%, ≥60 minutes: +28.28%). In contrast, compared with ≤3 hours of sedentary time, longer durations of sedentary behavior were associated with poorer mental health (3–4 hours: -9.40%, 4–5 hours: -15.43%, >5 hours: -44.27%). The GAM analysis further confirmed the findings of the ZINB modeL.

A dose–response relationship exists between physical activity, sedentary behavior, and mental health among primary and secondary school students. Longer durations of physical activity are associated with greater mental health benefits, while prolonged sedentary time is linked to poorer mental health outcomes. These findings provide empirical support for optimizing youth-targeted physical activity interventions and mental health promotion policies.

To explore the status quo of disease perception stress of primary infertility patients in childbearing age, and analyze the relationship between it and couples’ support and coping.

A total of 798 primary infertility patients of childbearing age admitted to the hospital from January 2023 to January 2025 were selected for the study. The General information Questionnaire, the Simplified version of the Disease Perception Questionnaire (BIPQ) scale, the Marital Support Coping (DCI) Scale, and the Stigma Scale for Female Infertility Patients (ISS) were used for the investigation.

The BIPQ score of primary infertility in childbearing age was (55.67±6.43), and the pressure of disease perception was high. Pearson correlation analysis showed that BIPQ score was negatively correlated with DCI score (r=-0.243) and positively correlated with ISS score (r=0.309) (P<0.05). The results of multiple linear regression analysis showed that the higher the age, the higher the stress of patients (B=2.996, 95% CI: 2.349-3.642), the higher the educational level, the lower the pressure (B=-2.149,95% CI: -2.831--1.468), the higher the pressure of patients who think that childbirth is the most important thing in life (B=4.969, 95% CI:4.277-5.661), and the worse the relationship between husband and wife, the higher the pressure (B=2.396, 95% CI: 1.692-3.100), the higher the DCI score, the lower the stress (B=-0.044, 95% CI:-0.065--0.022), and the higher the ISS score, the higher the stress(B=0.077, 95% CI:0.055-0.099) (P<0.05).

The primary infertility patients in childbearing age have a high level of disease perception pressure, so we should focus on those who are older, have low educational level, have a traditional concept of fertility, have poor relationship between husband and wife and have a high sense of shame, and formulate corresponding intervention strategies to improve the mental health level of patients.

To assess the current utilization of health services and the influencing factors among women of childbearing age in rural and pastoral areas of Xizang, and to provide evidence-based recommendations for improving healthcare accessibility in Xizang.

Using data from the Seventh National Health Service Survey in Xizang and guided by the Andersen’s Health Service Utilization Behavior Model, we analyzed factors influencing healthcare utilization among 2 025 women aged 15-49 in rural and pastoral areas. In addition, focus group interviews were conducted to complement the quantitative findings.

The two-week outpatient visit rate among women of childbearing age was 5.93%, and the inpatient admission rate within the past year was 8.99%. Binary logistic regression analysis revealed that women with urban-rural medical insurance (OR=0.142, 95% CI: 0.035-0.571) and those with a self-rated health score ≥80 (OR=0.315, 95% CI: 0.179-0.554) were less likely to use outpatient services. In contrast, women who had signed up for family doctor services (OR=2.310, 95% CI: 1.036-5.152), were unaware of such services (OR=2.818, 95% CI: 1.125-7.056), or had chronic conditions (OR=3.081, 95% CI: 2.043-4.646) showed significantly higher outpatient utilization. In terms of inpatient services, lower utilization was observed among women aged 25-34 (OR=0.473, 95% CI: 0.277-0.809), 35-44 (OR=0.228, 95% CI: 0.127-0.407), and 45-49 (OR=0.191, 95% CI: 0.096-0.379), as well as those with a history of alcohol consumption (OR=0.366, 95% CI: 0.225-0.595). Conversely, higher inpatient utilization was associated with having a primary school education (OR=1.652, 95% CI: 1.128-2.421), being married (OR=2.925, 95% CI: 1.648-5.192), being employed (OR=2.587, 95% CI: 1.388-4.821), and having chronic illnesses (OR=2.351, 95% CI: 1.667-3.317). Qualitative analysis indicated that poor transportation, limited health awareness, financial constraints, and dissatisfaction with medical services were the primary barriers to healthcare utilization.

The utilization of health services among women of childbearing age in surveyed areas of Xizang remains suboptimal. Efforts to enhance service utilization should focus on strengthening health education, expanding healthcare infrastructure, and improving service quality in rural and pastoral regions.

To explore the impact of social support on sleep quality among elderly people, and investigate the mediating role of anxiety symptoms between social support and sleep quality. The goal is to provide scientific evidence for improving sleep quality in this population.

Social Support scale, Generalized Anxiety Disorder 7-item (GAD-7), and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate social support, anxiety symptoms and sleep quality of older adults. After excluding outliers and missing values, Pearson correlation analysis and multiple linear regression models were employed to examine the relationships among social support, anxiety symptoms, and sleep quality in older adults. The Bootstrap method was applied to test the mediating effect of anxiety symptoms.

A total of 1 194 participants were included, including 717 females (60.1%). Social support was negatively correlated with anxiety symptoms and sleep quality index (r= -0.180, P<0.001; r= -0.148, P<0.001), while anxiety symptoms were positively correlated with sleep quality index (r= 0.349, P<0.001). Mediation analysis revealed that anxiety partially mediated the relationship between social support and sleep quality, accounting for 37.5% of the total effect. Among men, anxiety symptoms accounted for 21.4% of the mediating effect, while among women, they accounted for 46.2%.

Better social support is associated with lower anxiety levels and improved sleep quality. Providing adequate social support for community-dwelling older adults is crucial for enhancing their sleep quality, physical health, and mental well-being.

To understand the demand for and preferences of mental health services among residents in Shanghai communities, providing a basis for service design and policy-making.

Using discrete choice experiments, we surveyed 647 permanent residents aged 16 and above in Shanghai regarding their preferences for seven attributes of mental health services under varying degrees of psychological distress: distance from the service provider to home, type of service provider, composition of service providers, service medium, service content, service stability, and the cost per service.

The cost of service (mild psychological distress β=0.398, severe psychological distress β=0.320), type of service provider (mild β=0.224, severe β=0.210), service stability (mild β=0.112, severe β=0.132), composition of service providers (mild β=0.101, severe β=0.120), and distance to the service provider (mild β=0.109, severe β=0.124) were identified as key attributes influencing residents’ choices of mental health services. Willingness-to-pay analysis showed that residents were more willing to pay for services within 15 km (mild WTP=328.837, severe WTP=464.453), services provided by public mental health institutions (mild WTP=676.65, severe WTP=788.226), services delivered by psychotherapists (mild WTP=303.584, severe WTP=449.14), face-to-face plus online services, basic supportive services (mild WTP=31.056, severe WTP=86.389), and stable services (mild WTP=339.593, severe WTP=494.968).

Accessibility and stability of services are key attributes influencing service choice. The selection of service providers is characterized by a preference for public institutions as the mainstay, supplemented by non-profit organizations. Residents have a higher willingness to pay for supportive “psychotherapy” compared to medical intervention and rehabilitation services. It is recommended to strengthen the construction of grassroots service networks, enhance accessibility and stability, optimize processes, and establish coordinated mechanisms to improve satisfaction and utilization of mental health services.

To investigate the impact of community-based elderly care service utilization on mental health outcomes and its underlying pathways among older adults with chronic diseases, providing evidence for targeted interventions in this population.

A descriptive statistical and correlation analysis was conducted on the use of community-based elderly care services, mental health, and social adaptability among 280 elderly individuals aged 60 and above with chronic diseases. The mediating effect of social adaptability was tested using the Bootstrap method.

The service utilization rate reached 60% among participants, with a mean GHQ-12 score of 18.41±4.75. Significant positive correlations emerged between service utilization and social adaptation(r=0.288, P<0.001). Both service utilization and social adaptation demonstrated negative associations with psychological distress (r=-0.365,P<0.001;r=-0.464,P<0.001). The utilization of community-based elderly care services by older adults with chronic diseases negatively influences GHQ-12 scores by enhancing their social adaptability, with the mediating effect of social adaptability accounting for 30.81% of the total effect.

Community-based elderly care services exert beneficial effects on mental health in older adults with chronic diseases, partially mediated through enhanced social adaptability.

To understand the cognitive situation of health emergency response capabilities among emergency response personnel in urban and district-level disease control institutions in Tianjin, identify the training needs of the personnel, and provide countermeasures and suggestions for enhancing the emergency response capabilities of urban and district-level disease control institutions in Tianjin.

Using a cross-sectional survey, an online questionnaire survey was conducted in 2024 to assess the emergency response capabilities and training needs of district-level emergency responders across the city. A total of 946 valid questionnaires were included, and multiple linear regression analysis was used to analyze the influencing factors of the self-assessment scores for health emergency response capabilities.

The score of health emergency response capabilities among urban and district-level disease control institutions in Tianjin was (59.55±6.641) out of the total possible score，with an average score of (2.38±0.27) per item. The results of multiple linear regression analysis showed that the number of participations in health emergency response events (β=0.982) and professional technical titles (β=0.817) were the main influencing factors of the emergency response capability score. There was a significant demand for training in public health response to infectious diseases (47.99%), basic knowledge and skills related to infectious diseases (46.19%), and on-site handling procedures for public health emergencies (40.80%).

The reasonable and balanced composition of education and professional titles is an important link to improve the emergency response capability of district-level CDC in Tianjin. Participating in on-site disposal is an important way to enhance emergency capabilities. It is necessary to improve the normalized emergency drill mechanism, and carry out systematic, cutting-edge and targeted training based on needs, so as to continuously improve the emergency response capability of district-level CDCs.

To analyze the spatial distribution of women of childbearing age and the allocation of resources for maternal and neonatal care, and to assess the spatial accessibility of critical maternal care resources, providing a scientific basis for optimizing resource allocation.

Taking the critical maternal care centers in Jiangsu Province in 2024 as the supply side and the population of women of childbearing age in Jiangsu Province as the demand side, the comprehensive service capacity index was constructed using the entropy weight method. The spatial accessibility of resources was evaluated using the shortest distance method and the Gaussian two-step floating catchment area method.

The distribution of women of childbearing age was mainly concentrated in the urban areas of Nanjing, Suzhou, and Wuxi. 92.91% of the critical maternal care centers were located in the top 20% of areas with the highest population density of women of childbearing age. The proportions of provincial, municipal, and county-level critical maternal care centers were 19.69%, 21.26%, and 59.06%, respectively. They were allocated 35.08%, 21.41%, and 43.51% of the bed resources and 37.03%, 21.60%, and 41.36% of the physician resources, respectively. The average annual delivery volume was 4 874.32 cases, 2 472.48 cases, and 1 628.47 cases, respectively. In terms of time cost, the average time for women of childbearing age in the province to reach the nearest critical maternal care center was 18.74 minutes. 69.81% of women of childbearing age could obtain care services within 15 minutes, 27.40% of the population needed 15-30 minutes, and 2.79% of the population needed more than 30 minutes. From the perspective of supply and demand, when the time thresholds were 15 minutes, 30 minutes, and 45 minutes, the proportions of the population with good or better accessibility were 16.69%, 24.42%, and 29.03%, respectively.

The spatial accessibility of critical maternal care resources in Jiangsu Province is generally good, but the distribution of obstetrician resources does not fully match the population distribution. The accessibility level of resource allocation in some areas such as Dongtai City and Xiangshui County in Yancheng City still needs to be improved. The "abundance and high quality" in resource-intensive areas has not been fully transformed into fairness and accessibility. It is recommended to enhance the fairness and efficiency of resource allocation through measures such as balancing supply and demand and improving management and service capabilities.

To analyze the evolution characteristics and influencing factors of total health expenditure structure in Qinghai Province from 2009 to 2021, and to provide reference for regional health policy optimization.

The data of total health expenditure and influencing factors of total health expenditure in Qinghai Province from 2009 to 2021 were selected. Based on the financing source method, the structural change degree analysis method was used to explore the dynamic changes of health financing structure, and the principal component regression model was used to identify the key influencing factors.

From 2009 to 2021, the average annual growth rate of total health expenditure in Qinghai Province was 13.86%, the proportion of government health expenditure increased from 39.81% to 49.21%, the proportion of personal expenditure decreased from 30.04% to 22.09%, the overall structural change degree was 18.79%, and the financing balance was significantly improved. Principal component regression showed that population size (β=0.114), economic development (β=0.114), medical resource supply (β=0.113) and urbanization rate (β=0.112) were the main positive driving factors, while the proportion of personal expenditure (β=-0.091) was significantly inhibited.

The scale of health financing in Qinghai Province continues to expand, and the burden of residents is gradually reduced. However, it is necessary to optimize the structure of government investment, improve the efficiency of resource utilization, and optimize the structure of medical insurance payment.

To analyze the differences in inpatient cost structure and variation between patients discharged against medical advice (DAMA) and those discharged per medical advice (DC) under the DRG payment model, aiming to support resource optimization and risk communication strategies.

Front-page medical records of all DAMA and DC inpatients from a tertiary general hospital between 2020 and 2024 were collected. Descriptive statistics and univariate analysis were used to compare cost differences. Cluster analysis and structural variation degree analysis were conducted to examine cost composition and annual variation trends.

Significant differences were found between the two groups in total and itemized inpatient costs. DAMA patients exhibited a “majority low-cost, minority high-expenditure” pattern, dominated by drug expenses and relatively low treatment costs. In contrast, DC patients showed more balanced cost distribution with stable proportions of diagnostic, treatment, and drug costs. Structural variation analysis indicated greater variation among DC patients, driven by changes in treatment and general medical service fees, while DAMA patients were mainly affected by diagnostic cost fluctuations.

Medical institutions should prioritize optimizing the cost structure of DAMA patients to enhance resource allocation and cost control, promoting standardized clinical practice and effective use of medical insurance funds under DRG reform.

This study is based on the log-binomial model, aiming to explore the impact of adverse early childhood experiences on frailty in old age among middle-aged and elderly people in rural areas of Ningxia, and to provide scientific methods and evidence-based references for promoting the health of middle-aged and older adults in China.

Utilizing the health follow-up data collected by the research group during the Extended Consolidation Phase of Health Poverty Alleviation (July-August 2024), middle-aged and elderly people aged 45 and above were selected as the research subjects, and a total of 5 644 valid samples were included. The χ² test was used to analyze the differences in frailty among different characteristic subjects in middle-aged and elderly people, and the log-binomial regression model was used to explore the effect of adverse childhood experiences on frailty in later years in middle-aged and elderly people.

A total of 900 middle-aged and elderly people suffered from frailty in this study, accounting for 15.95% of the total number. The results of the log-binomial regression model showed that two adverse childhood experiences, namely, going hungry during childhood and adolescence (PR=1.587, 95% CI:1.244-2.025), poor physical health during childhood and adolescence (PR=1.492, 95% CI:1.115-1.996), and very poor (PR=1.856, 95% CI:1.351-2.549), were risk factors for frailty in the later years of middle-aged and elderly people in rural Ningxia. The presence of both parents (PR=0.628, 95% CI:0.547-0.720) and the average health of the father (PR=0.644, 95% CI:0.422-0.983) during childhood and adolescence were protective factors for the occurrence of frailty in the later years of middle-aged and elderly people in rural Ningxia.

The incidence of frailty in old age among middle-aged and elderly people in rural Ningxia is relatively high. Among them, the problem of frailty in old age is more severe among middle-aged and elderly people exposed to two kinds of adverse childhood experiences, namely, going hungry during childhood and adolescence, poor physical health during childhood and adolescence, and very poor health. The sensitivity and attention to the public health threat of adverse childhood experiences should be enhanced. The occurrence and development of risk events should be detected and intervened as early as possible to reduce the risk of frailty in the later years of middle-aged and elderly people and improve their physical fitness and health level.

To investigate the influence of childhood adverse experiences on mobile phone dependence of middle school students, and to explore the mediating role of self-efficacy and self-control.

A total of 1 724 college students from three undergraduate colleges in Hunan, Hubei and Guizhou were investigated from April to June 2024 by using the health Hazard Behavior questionnaire, Adverse Childhood Experience Scale (ACEQ), self-efficacy scale (GSES) and Self-control Scale (SCS).

The standardized path coefficient (β=0.518), self-efficacy and self-control had partial mediating effect and chain mediating effect between adverse childhood experiences and the aggregation of harmful behaviors of college students. The effect sizes of the three mediators were 0.029 (95% CI: 0.016-0.044), 0.132 (95% CI: 0.110-0.156) and 0.034 (95% CI: 0.025-0.045), accounting for 4.07%, 18.51% and 4.77% of the total effect, respectively.

Adverse childhood experiences directly affect the aggregation of harmful behaviors of college students, and self-efficacy and self-control play a chain mediating role in the influence of adverse childhood experiences on the aggregation of harmful behaviors of college students.

To analyze the relationship between dietary patterns and central obesity to provide a theoretical basis for preventing and improving central obesity.

A multi-stage stratified cluster random sampling method was used to select adult residents aged 18 and above in Handan City for the 2022 monitoring of Chinese residents’ nutrition and health status as the survey subjects. Collect basic and dietary information of survey subjects and conduct physical examinations. Calculate the central obesity rate among residents. Exploratory factor analysis was used to extract dietary patterns, and the quartiles of factor scores for each dietary pattern were ranked from low to high as Q1, Q2, Q3, Q4. Apply binary logistic regression to analyze the relationship between dietary patterns and central obesity.

The standardized central obesity rate of adult residents in Handan was 53.3%. Six dietary patterns were extracted, namely the meat-fish-fruit-fungi pattern, snack-beverage-milk pattern, vegetable-staple-low-legume pattern, nut pattern, egg pattern, and alcohol pattern. Binary logistic regression analysis showed that the meat-fish-fruit-fungi pattern was associated with central obesity (Q4: OR=0.422, 95% CI: 0.216-0.822). The vegetable-staple-low-legume pattern was associated with central obesity (Q4: OR=2.138, 95% CI: 1.052-4.343). The alcohol patterns were associated with central obesity (Q4: OR=2.013, 95% CI: 1.085-3.734).

The central obesity rate of adult residents in Handan is relatively high. The meat-fish-fruit-fungi pattern is a protective factor for central obesity, while the vegetable-staple-low-legume pattern and alcohol pattern are risk factors for central obesity. It is recommended to moderately increase the intake of high-quality proteins such as meat, fish, and legume, as well as fruits and fungi, and reduce the intake of staple food, and avoid excessive alcohol consumption.

To analyze the impact of screen exposure and behaviors such as smoking, alcohol consumption, and sugary drink intake on the risk of developing central obesity, and to provide evidence for obesity prevention and control.

This study utilized the Guizhou Adult Chronic Disease Natural Population Cohort. A baseline survey was conducted from 2010 to 2012 among adult residents from 48 townships across 12 counties (districts/cities) in Guizhou Province using multi-stage stratified cluster random sampling. Follow-up was conducted from 2016 to 2020. A total of 2 310 participants with complete baseline and follow-up data were included in the analysis. Participants were divided into four groups based on screen exposure duration: <2 h, 2~<3 h, 3~<4 h, and ≥4 h; and into four groups based on non-screen sedentary duration: <1 h, 1~<2 h, 2~<3 h, and ≥3 h. Cox proportional hazards regression models were used to analyze the impact of screen exposure and non-screen sedentary behavior on central obesity under different behavioral patterns.

The average screen exposure time among the subjects was 3.39±2.33 hours. Among the 2 310 participants, 999 developed new-onset central obesity, with an incidence rate of 43.2%. After adjusting for other factors, multivariate Cox regression analysis showed that as screen exposure duration increased, the risk of central obesity gradually rose. The risks of central obesity in the 2~<3 h, 3~<4 h, and ≥4 h screen exposure groups were 1.391 times (HR=1.391, 95% CI=1.076-1.796, P=0.012), 1.424 times (HR=1.424, 95% CI=1.167-1.737, P=0.001), and 1.795 times (HR=1.795, 95% CI=1.268-2.541, P<0.001) higher than that of the <2 h group, respectively. In contrast, non-screen sedentary behavior showed no statistically significant association with the risk of central obesity. The risks for the 1~<2 h, 2~<3 h, and ≥3 h non-screen sedentary groups were 0.874 (HR=0.874, 95% CI=0.709-1.078, P=0.303), 0.878 (HR=0.878, 95% CI=0.695-1.125, P=0.208), and 0.910 (HR=0.910, 95% CI=0.485-1.510, P=0.717) times that of the <1 h group, respectively. Interaction effects between screen exposure and smoking, alcohol consumption, and sugary drink intake further increased the risk of central obesity.

Screen exposure significantly contributes to central obesity. It is essential to control screen time and reduce unhealthy behaviors during screen exposure to lower the risk of central obesity.

To understand the detection rate and molecular typing characteristics of human rhinovirus in influenza-like cases among children in Guizhou Province from 2023 to 2024.

Throat swab samples of 4 771 children influenza-like cases in Guizhou Province from 2023 to 2024 were collected. A total of 11 common respiratory pathogens, including rhinovirus (HRV), enterovirus (EV), adenovirus (ADV), Boka virus (HBoV), influenza virus (IFV), parainfluenza virus (HPIV), common coronavirus (HCoV), novel coronavirus (SARS CoV-2), metapneumovirus (HMPV), respiratory syncytial virus (RSV) and mycoplasma pneumoniae (MP), were detected by multiple fluorescent quantitative PCR. Epidemiological data were analyzed by Excel 2021 and SPSS 22 statistical software for HRV; Select qualified HRV positive samples for VP4/VP2 gene sequencing, use MEGA11 for gene typing, and construct a phylogenetic tree using adjacency method.

A total of 371 HRV-positive samples were detected, with a detection rate of 7.78%. No statistically significant difference in HRV detection rates was observed between different gender groups (P=0.669) or age groups (P=0.328). However, a statistically significant difference was found across seasons (P<0.001). The detection rate of HRV co-infection was 3% (143/4 771), with HRV and EV co infection detected the most, accounting for 27.97% (40/143), followed by HRV and HPIV co infection, accounting for 14.69% (21/143), and RSV co-infection, accounting for 12.59% (18/143). A total of 20 HRV VP4/VP2 gene sequences were obtained, including 16 HRV-A strains, 1 HRV-B strain, and 3 HRV-C.

HRV is an important pathogen causing influenza-like cases in children in Guizhou Province from 2023 to 2024. HRV-A is the main popular plant type. There is co-infection with HRV in the case, with co infection of two pathogens being the most common. The main co-infection viruses are EV, HPIV, and RSV.

To analyze the regional differences in the vaccination coverage of China’s National Immunization Program (NIP) between the eastern and western regions (Changxing Town in Shanghai and Gengma Town in Gengma County, Yunnan Province), to identify weak links in implementation, and to provide a basis for optimizing cross-regional public health collaboration.

Based on the National Immunization Program Vaccination Coverage Monitoring Plan (2023 edition), a retrospective cohort study was conducted to systematically analyze the vaccination data of children born between 2017 and 2023 in the two regions (Changxing Town, n=3 749; Gengma Town, n=5 456). Chi-square tests were used to compare differences in vaccination rates, full-course rates, compliance rates, and timeliness rates.

Both regions achieved vaccination and compliance rates exceeding 90%. The full-course vaccination rate in Gengma Town (96.9%) was significantly higher than that in Changxing Town (94.2%, χ²=40.64, P<0.001). The impact of household registration type on full-course vaccination rates showed regional heterogeneity (Gengma Town OR=3.65; Changxing Town OR=1.89). The overall timeliness rate in Changxing Town was higher (92.5%-99.2%), but the timeliness rates for the first doses of measles and Japanese encephalitis vaccines among children born in 2018 and 2021 were significantly lower (P<0.001). In Gengma Town, delays in the primary immunization (DTaP1-3) and booster immunization (DTaP4) for diphtheria, tetanus, and pertussis were prominent among children aged 5-7. The timeliness rates for DTaP1-3 and DTaP4 among children born in 2018 were only 41.1% and 50.2%, respectively.

Significant spatial heterogeneity exists in the implementation of the NIP between the eastern and western regions.

To analyze the disease burden and changing trends of iron deficiency anemia (IDA) among children and adolescents in China from 1990 to 2021, and to provide evidence for policymakers to formulate prevention and control strategies.

Data from the Global Burden of Disease (GBD) 2021 study were used to extract indicators of iron deficiency anemia (IDA) among Chinese children and adolescents aged 0-19 years, including prevalent case number, prevalence, disability-adjusted life years (DALYs), and DALYs rate. Joinpoint regression models were established using Joinpoint Regression Program 4.9.0.0 to quantify trends in these indicators.

In 2021, the prevalent case number, prevalence, DALYs, and DALYs rate of IDA among Chinese children and adolescents aged 0-19 years were 1 171.77×10⁴,3 505.11/10⁵,28.94×10⁴, and 86.57/10⁵, respectively. Compared with 1990, these values decreased by 71.94%, 62.65%, 75.88%, and 67.88% (all P<0.001). Gender differences revealed that females had significantly higher values than males in all four indicators except DALYs rate (P<0.001), with smaller declines than males. Age distribution of IDA exhibited a “U-shaped” pattern: the group under 5 years had the highest burden (486.69×10⁴ cases, prevalence 6 034.48/10⁵), while the 15-19 years group showed a rebound, particularly in females (184.61×10⁴ cases, prevalence 5 337.18/10⁵), approaching the levels of the group under 5 years.

The disease burden of IDA among Chinese children and adolescents has significantly decreased. However, notable age- and gender-based disparities persist, necessitating focused efforts to sustain gains in IDA prevention and control among children under 5 years of age, while addressing the resurgence of IDA among adolescent females. Further exploration of tailored nutrition strategies and comprehensive measures is essential.

To understand the quality of notifiable infectious diseases reporting in Sichuan Province from 2023 to 2024 and its influencing factors, and to provide reference basis for improving the reporting quality.

A total of 263 medical institutions were randomly selected by stratified sampling. Through on-site data review, case screening and spot checks, and verification of the reporting system, an investigation was conducted on the implementation of the management of notifiable infectious disease reporting in medical institutions, as well as the reporting rate of notifiable infectious diseases, the timely reporting rate, the completeness rate of filling, the accuracy rate of filling, and the consistency rate of online reporting information. Statistical analysis was conducted using R software 4.4.1. Logistic regression was used to analyze the influencing factors of report quality, and the TOPSIS method was adopted to evaluate the comprehensive filling quality of infectious disease reporting cards.

From 2023 to 2024, a total of 263 medical institutions were investigated, and the reporting rate of notifiable infectious diseases was 98.69%. The reporting rate in public medical institutions was higher than that in private ones (χ²=4.49, P< 0.05). The reporting rates of public medical institutions at or above the prefectural-level, county-level, and township-level showed a decreasing trend (Z=-5.68, P<0.01). The reporting rate of admission and discharge registration was the highest, followed by the outpatient department, and the reporting rate of radiological imaging registration was the lowest. The central region had the highest reporting rate (99.73%), while the three-state region had the lowest (94.00%). The timely reporting rate of the infectious disease report card was 95.40%, the complete filling rate was 97.15%, the filling accuracy rate was 86.78%, and the consistency rate of online report information was 94.49%. The comprehensive filling quality of infectious disease report cards in public township-level medical institutions is the best, followed by public county-level, public prefectural-level and public provincial-level medical institutions in sequence. The comprehensive filling quality of private medical institutions is the worst. Setting and filling norms for outpatient logs and admission and discharge logs, as well as conducting self-inspection notifications and rewards and punishments in a standardized manner, could improve the quality of infectious disease reporting.

The quality of notifiable infectious diseases reporting in medical institutions in Sichuan Provincewas generally good, but there are still weak areas and links in the reporting management work. Attention should be paid to the underreporting of public low-level medical institutions and the quality problems of the reporting cards of private and public high-level medical institutions. The quality of filling in basic information such as outpatient and admission and discharge registration, self-examination and feedback of abnormal information in radiological imaging registration should be strengthened.

To explore the intervention effect of group cup stacking games on elderly individuals with advanced age and mild cognitive impairment (MCI).

Using a self-controlled before-and-after design and convenience sampling, 30 elderly individuals with advanced-age MCI from a nursing home in Guangzhou were selected as the research subjects. They received a 6-week intervention of group cup stacking games. The Mini Mental State Examination (MMSE), the Connections Test Executive Time, Digit Breadth, and General Self-Efficacy Scale were used to assess the overall cognitive functioning, executive functioning, attention, and self-efficacy of the participants, respectively. Differences between pre- and post-intervention were compared by paired t-test and Wilcoxon signed rank test.

A total of 29 subjects were finally included in the study. Compared with pre-intervention, the overall cognitive function score of the subjects increased post-intervention (0.447, 95% CI: 0.062-0.826, P=0.023), and the score in the orientation cognitive domain also increased (0.380, 95% CI: -0.01-0.754, P=0.034). There were no statistically significant differences in the execution time of the Trail Making Test (0.123, 95% CI: -0.244-0.487, P=0.964), the Digit Span Test score (0.022, 95% CI: -0.343-0.385, P=0.707), and the self-efficacy score (0.297, 95% CI: -0.077-0.667, P=0.121).

The group cup stacking game intervention helps improve the overall cognitive function and orientation of elderly MCI patients with advanced age, and promotes their physical and mental health.

To establish a risk evaluation index system for delayed thrombolysis in patients with acute ischemic stroke (AIS) based on the three-dimensional framework of demand-supply-interaction, and to provide scientific evidence for clinical risk warning and intervention decision-making.

Literature analysis and focus group interviews were used to preliminarily establish an index system. The Delphi method and analytic hierarchy process were employed to determine indicator weights, followed by preliminary validation.

A total of 21 experts were consulted with an average working experience of (22.67±9.46) years, 12 of whom held deputy senior titles or above. The effective questionnaire recovery rate for both rounds was 100%, with an expert authority coefficient of 0.901 and coordination coefficients of 0.238 and 0.290, respectively. The final index system comprised 2 first-level indicators, 10 second-level indicators, and 95 third-level indicators. Classified by the three-dimensional demand-supply-interaction framework, the primary indicators were out-of-hospital delay factors (0.833 3) and in-hospital delay factors (0.166 7). Preliminary validation showed significant positive correlation between the total index score and door-to-needle time (r=0.72, P<0.001).

This study preliminarily constructs an operational risk evaluation index system for delayed thrombolysis in AIS patients, providing a theoretical framework for early risk identification, clinical decision support, and prognosis improvement. However, large-scale prospective studies are needed to further validate its clinical effectiveness.