The aim of this study is to comprehensively analyze the causal relationship between osteoporosis and cognitive impairment in China community using the combination of observational study and Mendelian randomization (MR).

Baseline data from the West China Health and Aging Cohort Study were used to explore phenotypic associations between L1-L4 bone mineral density (BMD), total hip BMD, femoral neck BMD, osteoporosis, osteopenia and cognitive function. A two-sample MR design was used to evaluate the causal association between BMD and Alzheimer’s disease (AD) using summary statistics from published genome-wide association studies, with single nucleotide polymorphisms (SNPs) significantly associated with BMD as instrumental variables and AD as the outcome variable.

The cross-sectional study showed that after adjusting for a series of confounding factors, osteoporosis was found to be negatively associated with Mini-Mental State Examination (MMSE) score compared with normal bone mass group (β=-0.84, 95% CI: -1.39~-0.29, P=0.003), indicating that the patients with osteoporosis had lower MMSE scores and worse cognitive function than those with normal bone mass, and the results were robust. The relationship between BMD at different sites and cognitive scores was different.Specifically, total hip BMD (β=1.58, 95% CI: 0.20-2.95, P=0.024) and L1-L4 BMD (β=1.17, 95% CI: 0.13-2.21, P=0.028) were positively correlated with MMSE score, while femoral neck BMD was not significantly correlated with MMSE score (β=1.34, 95% CI: -0.11-2.79, P=0.070). Two-sample MR analysis using 86 SNPs associated with heel BMD-T values in a Chinese population as instrumental variables showed no causal association between heel BMD-T and AD risk (IVW: OR=0.95, 95% CI: 0.84-1.07, P=0.417). The results of multiple sensitivity analyses were robust.

The evidence from this study suggests a positive association between osteoporosis and cognitive impairment in Chinese, but further studies are needed to confirm the causal relationship between the two traits. Based on the common risk factors and pathogenesis, it is beneficial in practice to strengthen the management of osteoporosis patients, especially those with low total hip BMD and L1-L4 BMD, to prevent the occurrence of cognitive impairment.

To investigate the relationship between dynamic changes in cholesterol, high-density lipoprotein, and glucose index (CHG) and new-onset cardiovascular disease (CVD) in the middle-aged and elderly Chinese population.

In this study, the China Health and Retirement Longitudinal Study (CHARLS) data were utilized. Both K-means clustering and cumulative measures were used to characterize the dynamic changes of CHG. Cox proportional hazards regression model was used to assess the association between CHG changes with CVD. The nonlinear relationship between cumulative CHG and CVD was further assessed using restricted cubic spline. Subgroup analyses were conducted to assess whether the association between CHG changes and CVD differed across participant subgroups.

A total of 4 710 participants were included, and a total of 785 (16.7%) developed CVD during the follow-up period. The patterns of changes in CHG over the two follow-up visits were categorized into three classes by K-means clustering: persistently low (class 1), persistently medium (class 2), and persistently high (class 3). The risk of CVD was significantly increased in class 2 (HR=1.38, 95% CI: 1.17-1.64) and class 3 (HR=1.44, 95% CI: 1.11-1.87), compared with class 1. With the first quartile as reference, the third and fourth quartile of cumulative CHG had an increased risk of CVD and stroke. RCS analysis revealed a significant positive linear relationship between cumulative CHG and the risk of CVD (P_nonlinearity=0.372) and stroke (P_nonlinearity=0.200). Subgroup analyses did not identify variables that significantly interacted with changes in CHG.

Dynamic changes in CHG are significantly associated with the risk of CVD. The simplicity and affordability of CHG make it particularly valuable for large-scale screening, providing a new reference index for the risk prediction of CVD in the future.

To investigate the longitudinal association between smoking cessation, secondhand smoke (SHS) exposure, and accelerated biological aging, and to further explore the heterogeneous associations of SHS exposure on biological aging among individuals who have quit smoking.

This study was based on data from the baseline and the first repeat assessment of the UK Biobank. Phenotypic Age (PA) was constructed using the validated PA algorithm, and PA acceleration was calculated. Multivariable linear regression models were used to perform change analysis to assess the associations between changes in smoking behavior and SHS exposure with changes in PA acceleration. Stratified analyses were conducted to identify potential effect heterogeneity.

A total of 11 189 eligible participants were included. Compared to never smokers, persistent smokers showed significantly greater PA acceleration (β=0.94, 95% CI: 0.22-1.65), whereas long-term quitters were associated with lower PA acceleration (β=0.30, 95% CI: 0.05-0.55). Compared with those consistently unexposed to SHS, individuals with increased SHS exposure exhibited greater PA acceleration(β=0.40, 95% CI: 0.01-0.79). Notably, among long-term quitters, frequent SHS exposure was associated with significantly greater biological aging (β=0.80, 95% CI: 0.02-1.57).

Smoking cessation can partially reverse the adverse effects of smoking on biological aging, although long-term damage may not be fully reversible. Moreover, SHS exposure significantly accelerates biological aging, with more pronounced effects observed among individuals who have quit smoking.

To investigate the chain mediating effect of family health and self-efficacy in the relationship between health literacy and self-management behaviors in older adults with chronic comorbidities.

Based on data from the 2021 Psychology and Behavior Investigation of Chinese Residents, 310 patients aged ≥60 years with chronic comorbidities were selected for the study. They were investigated using the Health Literacy Scale (HLS-SF12), Chronic Disease Self-Management Behavior Scale, Family Health Scale (FHS-SF), and New General Self-Efficacy Scale (NGSES). Partial correlation analysis was used to explore the correlation between health literacy, family health, self-efficacy, and self-management behaviors. The chain mediating effect was analyzed using Model 6 of the PROCESS 4.2 plugin in SPSS 27.0.

Family health and self-efficacy played a chain mediating role in the relationship between health literacy and self-management behaviors. The direct effect of health literacy on self-management behaviors was significant (β=0.446, 95% CI: 0.239-0.653), accounting for 66.87% of the total effect. The separate mediating effect of family health was significant (β=0.071, 95% CI: 0.004-0.154), accounting for 10.64% of the total effect. The separate mediating effect of self-efficacy was significant (β=0.117, 95% CI: 0.043-0.206), accounting for 17.54% of the total effect. The chain mediating effect of family health and self-efficacy was also significant (β=0.034, 95% CI: 0.010-0.067), accounting for 5.10% of the total effect.

Health literacy not only directly influences self-management behaviors of elderly patients with chronic comorbidities, but also indirectly through family health and self-efficacy as separate or chain-mediated pathways. It is recommended to promote the self-management behaviors of elderly patients with chronic comorbidities in a multidimensional way by enhancing health literacy, improving the family health environment, and increasing self-efficacy.

To explore the impact of arthritis, depression and their interaction on the disability risk in Chinese elderly.

Using data from the China Health and Retirement Longitudinal Study (CHARLS), eligible participants were enrolled, and 2015 baseline data and incident disability during the 5-year follow-up were collected. Multivariable cox regression models were established to analyze the effects of arthritis and depression on disability risk among Chinese elderly and to assess, on the multiplicative and additive scales, the impact of their interaction on disability risk.

A total of 7 875 participants were included, and 586 new cases of disability occurred during the 5-year follow-up period, with an incidence rate of 7.4%.The multivariable cox regression analysis showed that arthritis (HR=1.92, 95% CI: 1.63-2.26) and depression (HR=2.65, 95% CI: 2.22-3.16) were both risk factors for disability. The interaction analysis showed that there was no multiplicative interaction between arthritis and depression on the disability risk (P>0.05), but there was an additive interaction effect (P<0.05), with the relative excess risk due to interaction (RERI) of 1.08 (95% CI: 0.32-1.85), the attributable proportion of interaction (AP) of 0.26 (95% CI: 0.09-0.42), and the synergy index (SI) of 1.51 (95% CI: 1.09-2.08).

Both arthritis and depression are risk factors for disability in Chinese elderly, and there is an additive interaction between them. We should pay more attention to elderly people with comorbid arthritis and depression and take active measures to reduce the disability risk in Chinese elderly.

The aim of this study was to investigate the association between relative fat mass (RFM) and the risk of arthritis in middle-aged and elderly Chinese adults.

A cross-sectional analysis was performed using 2011 CHARLS data and included a total of 12 921 participants, including 6 144 males (47.55%) and 6 777 females (52.45%), with a mean age of (59.49 ± 9.60) years. Multivariable logistic regression and restricted cubic splines (RCS) were used to analyze the cross-sectional association between RFM and arthritis. A total of 8 350 middle-aged and elderly people who were not diagnosed with arthritis in the 2011 cross-sectional study were included in the longitudinal study and followed up until 2018. Kaplan-Meier curves, multivariable Cox proportional hazards regression models, and RCS were used to analyze the longitudinal association between different baseline RFM levels and the risk of incident arthritis in 2011. Meanwhile, the consistency of this association in different population subgroups was assessed by subgroup analysis, and sensitivity analysis was used to verify the stability of the model results.

In the cross-sectional study, multivariable logistic regression analysis showed that higher RFM was associated with an increased risk of arthritis after adjusting for confounders (OR=1.02, 95% CI: 1.02-1.03). Middle-aged and older adults in the Q3 (OR=1.30, 95% CI: 1.15-1.48) and Q4 (OR=1.60, 95% CI: 1.40-1.82) groups had a higher risk of arthritis compared with the first quartile (Q1). In the longitudinal study, a total of 916 individuals were first diagnosed with arthritis during the follow-up period. Multivariable Cox regression analysis showed that higher RFM was associated with an increased risk of incident arthritis after adjusting for confounders (HR=1.02, 95% CI: 1.02-1.04). The risk of incident arthritis was significantly higher in the Q4 group(HR=1.56, 95% CI:1.23-1.98) compared with Q1. Subgroup analysis showed no significant interactions between RFM and each subgroup variable. The results of the sensitivity analysis were generally consistent with the conclusions of the primary analysis. ROC curves showed that RFM had a better diagnostic efficacy for arthritis than obesity indicators such as BMI.

Higher levels of RFM are associated with an increased risk of arthritis in the middle-aged and elderly Chinese population, paying attention to RFM levels may help in the early identification of populations at risk for arthritis, providing new insights for disease prevention and intervention.

The purpose is to analyze the impact of sedentary behavior and depression and their interaction on the risk of all-cause and cardiovascular mortality in the general population.

The study included adults recruited from the National Health and Nutrition Examination Survey (NHANES) conducted between 2007 and 2018, with follow-up until December 31, 2019. Cox proportional hazards regression models were used to assess the associations between sedentary behavior, depression, and their interactions with the risks of all-cause and cardiovascular mortality.

A total of 25 836 adults were included, with a median follow-up of 77.0 (44.0-117.0) months. There were 2 312 all-cause deaths, including 688 cardiovascular deaths. After multivariate adjustment, sedentary behavior was associated with increased risks of all-cause mortality (HR=1.3, 95% CI: 1.1-1.4) and cardiovascular mortality (HR=1.4, 95% CI: 1.2-1.7). Depression was also associated with increased risks of all-cause mortality (HR=1.3, 95% CI: 1.1-1.4) and cardiovascular mortality (HR=1.2, 95% CI: 1.0-1.5). Individuals who were both sedentary and depressed had the highest risks of all-cause mortality (HR=1.6, 95% CI: 1.3-1.8) and cardiovascular mortality (HR=1.7, 95% CI: 1.3-2.3). An additive interaction between sedentary behavior and depression was observed for cardiovascular mortality.

Sedentary behavior and depression are independently associated with increased mortality risks, and there is an additive interaction between these factors.

To describe the spatio-temporal distribution of the incidence of colorectal cancer(CRC) in China and provide epidemiological evidence for prevention and treatment.

Based on the data of CRC incidence in the Chinese Cancer Registry Annual Report from 2008 to 2021, the temporal trend was analyzed by the Joinpoint regression model, the spatial autocorrelation analysis was conducted to examine spatial distribution patterns, and the influencing factors were analyzed by the age-period-cohort model.

From 2005 to 2018, the age standardized incidence rate (ASIR) of CRC in China was 23.77/100 000, showing a downward trend (AAPC=-1.1%). The ASIR of males and urban areas was higher than that of females and rural areas. The incidence of CRC exhibited a spatial clustering pattern in the eastern region. The eastern region was identified as a high-risk hotspot area. The age effect indicated that the risk of developing CRC increased with age. Time effect showed that the incidence of CRC in China was on the decline, but the incidence of CRC in rural areas was on the rise. In terms of the cohort effect, the population born between 1925 and 1929 had the highest risk of developing CRC.

From 2005 to 2018, the ASIR of CRC had decreased, but there were population and regional differences. The eastern region had been identified as a hotspot area.

To explore the application of the advanced LSTM-Informer model in predicting and early warning of pulmonary tuberculosis incidence, providing a reference for relevant authorities to formulate prevention and control measures, and offering new methodologies and insights for forecasting other infectious diseases.

Pulmonary tuberculosis incidence data for Jining City from January 1, 2010, to December 31, 2022, were obtained from the National Notifiable Disease Reporting System (NNDRS). Monthly incidence rates were calculated by integrating demographic data from the Jining Statistical Yearbook (2010—2022). The final 12, 18, and 24 months of data were used as test sets to evaluate model performance, with the remaining data constituting the training set. The LSTM-Informer model was constructed and its reliability assessed through comparison with standalone LSTM and Informer models.

The predictive performance of the three models across different forecast horizons was evaluated using error metrics: Mean Squared Error (MSE), Root Mean Squared Error (RMSE), Mean Absolute Error (MAE), Mean Absolute Percentage Error (MAPE), and the Coefficient of Determination(R²). Results demonstrated that the LSTM-Informer model consistently outperformed the single models. In the prediction of the 12-month length, the MSE of the model was 0.028, which was 59.4% lower than that of LSTM, the MAE value of 0.155 was 34.0% lower than that of LSTM, and the R² value was 0.850. When the forecast horizon extended to 18 months, the model maintained a stable MAPE of 0.104 and an R² of 0.808. Even at the 24-month horizon, the LSTM-Informer model retained significant advantages(R²=0.782).

Compared to single models, the LSTM-Informer model, leveraging both local and global feature extraction, significantly enhances prediction accuracy for medium-to-long-term forecasts. It shows considerable promise for providing novel theoretical support and reference for developing pulmonary tuberculosis incidence early-warning systems locally.

The clinical symptoms and ultrasound images of gallstone disease (GSD) and gallbladder polyps (GP) overlap, yet they have distinct prognoses and management strategies. Misdiagnosis can lead to excessive or delayed intervention. This study aims to develop and validate a differential diagnostic model based on multidimensional clinical indicators to enhance the differentiation between GSD and GP.

We included 371 518 individuals from health check-ups at a hospital in Kaizhou District, Chongqing, from 2015 to 2020, selecting 24 307 GSD or GP patients. These were split into a training set (19 445 cases) and an internal validation set (4 862 cases) at an 8:2 ratio. Variables were selected using Lasso regression and XGBoost algorithm, and a diagnostic model was built with Logistic regression. The model’s calibration, discrimination, and clinical applicability were evaluated using the calibration curve, the area under the ROC curve (AUC), and decision curve analysis, respectively.For external validation, 14 341 GSD and GP patients undergoing health checkups during the same period at a hospital in the Liangjiang New Area, Chongqing, were included to assess the model’s discriminative performance.

Women, older individuals, those with high BMI, central obesity, elevated GGT and ALT levels, high blood glucose levels, and fatty liver were more likely to be diagnosed with GSD. Individuals with high HDL-C and LDL-C levels were more likely to have GP. The model demonstrated good calibration and discrimination, with an ROC AUC of 69.4% (95% CI: 67.8%-70.9%). Decision curve analysis further indicated that the model had good clinical applicability, and external validation further confirmed its discriminatory performance. An online tool (https://yitingxu129.shinyapps.io/logisticmodel/) was created to aid in differentiating GSD and GP.

This study shows that gender, age, BMI, and blood biochemistry indicators are valuable in differentiating GSD and GP.The developed model has good predictive performance and clinical applicability and is expected to assist radiologists in making accurate differential diagnoses of GSD and GP, reduce misdiagnoses, and lower the disease burden.

To investigate the relationship between serum perfluorinated and polyfluoroalkyl substances (PFAS) exposure and metabolic abnormalities in overweight and obese children and adolescents.

This study was a cross-sectional design. The study subjects were overweight and obese children and adolescents aged 5-17 years who visited the Department of Child Health Care at the Children’s Hospital Affiliated to Nanjing Medical University from July to October 2022. Logistic regression analysis was used to investigate the association between PFAS exposure and high blood glucose, high triglyceride, high cholesterol, low high-density lipoprotein, hypertension, high uric acid, insulin resistance and ≥2 cardiometabolic abnormalities in overweight and obese children and adolescents. Bayesian kernel machine regression and quantile g-computation were used to analyze the relationship between mixed exposure to PFAS and the risk of metabolic abnormalities in overweight and obese children.

Among the 220 overweight and obese children, 166 were male(75.5%), with an age of 10.7 (8.8, 12.3) years. A total of 131 children (59.1%) had ≥2 cardiometabolic abnormalities. The levels of PFHxA and PFNA were positively correlated with the risk of hypertriglyceridemia in overweight and obese children (OR_PFHxA=1.670, 95% CI: 1.005-2.776; OR_PFNA=1.415, 95% CI: 1.062-1.883). The concentration of PFHpA was positively correlated with the risk of hypertension (OR=1.980, 95% CI: 1.269-3.087). Four serum PFAS concentrations were positively correlated with the risk of insulin resistance. Serum PFHpA and PFNA concentrations were positively correlated with the risk of ≥2 cardiometabolic abnormalities (OR_PFHpA=1.716, 95% CI: 1.155-2.551; OR_PFNA=1.324, 95% CI: 1.003-1.749). In overweight and obese children, the mixed exposure to PFAS was positively correlated with the risk of hyperglycemia, insulin resistance, hypertension, hypertriglyceridemia, and ≥2 cardiometabolic abnormalities, with PFHpA having the largest weight.

Exposure to serum PFAS could increase the risk of abnormal glucose and lipid metabolism, hypertension and ≥2 obesity-related metabolic abnormalities in overweight and obese children and adolescents.

To evaluate the dietary quality of Miao pregnant women in Guizhou in the year before pregnancy and early pregnancy, and to explore the correlation between different dietary intake levels and neonatal adverse birth outcomes.

A prospective cohort study was conducted in Qiandongnan Miao and Dong Autonomous Prefecture of Guizhou Province from June 2022 to March 2023. A total of 511 subjects were included in the study. A food frequency questionnaire was used to collect dietary data of 1 year before pregnancy and early pregnancy, and diet balance index 2022(DBI-22) and diet balance index for pregnancy(DBI-P) were used to evaluate dietary quality. χ² test was used to analyze the difference in the incidence of neonatal adverse birth outcomes between different food intake levels, and binary logistic regression was used to analyze the relationship between different food intake levels and neonatal adverse birth outcomes.

More than 90.0% of pregnant women had dietary imbalance one year before pregnancy and early pregnancy, and the dietary quality in early pregnancy was slightly higher than that in one year before pregnancy. The two stages were mainly characterized by excessive intake of cereals and livestock and poultry meat, and insufficient intake of milk, soybeans and nuts, aquatic products, eggs and food types.Compared with insufficient or excessive intake, women with appropriate intake of fruits in the year before pregnancy and of cereals, vegetables, and soybeans and nuts in early pregnancy had a lower incidence of neonatal adverse birth outcomes(P<0.05). Risk factors for neonatal adverse birth outcomes included excessive intake of cereals (OR=2.261, 95% CI: 1.035-4.938) and insufficient intake of fruits (OR=2.036, 95% CI: 1.354-3.061) in the year before pregnancy. In early pregnancy, excessive intake of cereals (OR=2.814, 95% CI: 1.429-5.544) and fruits (OR=1.988, 95% CI: 1.112-3.555), as well as insufficient intake of vegetables (OR=2.059, 95% CI: 1.305-3.249), and soybeans and nuts (OR=2.367, 95% CI: 1.412-3.969), were risk factors for neonatal adverse birth outcomes.

Pregnant women of Miao nationality in Guizhou generally have unbalanced dietary structure from pre-pregnancy to early pregnancy. Dietary intake level is closely related to the risk of neonatal adverse birth outcomes. Strengthening pregnancy preparation and nutritional intervention during pregnancy can help reduce the incidence of neonatal adverse birth outcomes.

To analyze the epidemiological characteristics of Salmonella foodborne diseases in Hunan Province from 2014 to 2023, and to provide references for disease prevention and control, thereby promoting the rational allocation and targeted intervention of public health resources.

Active surveillance data were collected through the "Foodborne Disease Monitoring and Reporting System", and descriptive analysis was conducted on the epidemiological characteristics of Salmonella foodborne diseases in Hunan from 2014 to 2023. Global and local spatial autocorrelation analyses were performed using ArcGIS 10.8 software.

From 2014 to 2023, sentinel hospitals in Hunan Province reported a total of 2 459 Salmonella-positive cases through active surveillance, with a positivity rate of 7.79%. The lowest number of cases was recorded in 2014 (142 cases), while the lowest positivity rate (5.26%) occurred in 2016. In contrast, 2023 showed the highest figures, with 455 cases and a positivity rate of 10.24%. The incidence exhibited clear seasonality, with higher case numbers in July (426 cases), August (385 cases), and September (354 cases). The positivity rates were also elevated in June (11.92%), July (11.71%), and August (11.17%), indicating that the period from June to September was the peak season for Salmonella infections. The majority of cases (1 572 cases, 66.93%) were concentrated in children aged 5 years and younger. Among the suspected food exposures linked to Salmonella infections, dairy and dairy products accounted for the highest proportion (22.15%). Global spatial autocorrelation analysis revealed a positive spatial correlation in Salmonella positivity rates across Hunan Province from 2015 to 2016. Local spatial autocorrelation analysis further identified "high-high" clustering areas, primarily in Liuyang City, Yuhua District, Tianyuan District, Shifeng District, and Yuetang District.

From 2014 to 2023, Salmonella foodborne diseases in Hunan showed an increasing trend with significant spatial clustering. Prevention and control efforts should be strengthened during high-incidence periods, among high-risk populations, and in key regions.

To investigate the prevalence of human papillomavirus(HPV) infection among females in Nanhai District,Foshan City, and elucidate the distribution patterns of HPV genotypes across different cervical lesions.

HPV genotyping results from 28 592 female patients who underwent physical examinations or medical consultations at the Seventh Affiliated Hospital of Southern Medical University between 2020 and 2024 were collected. Statistical analyses were conducted on HPV subtype infection status, age distribution, and clinical diagnosis.

From 2020 to 2024, HPV infection among females in Nanhai District, Foshan City, exhibited a distinct U-shaped age distribution (higher infection rates in the ≤20 and ≥61 age groups), with high-risk types predominating. High-risk HPV types 52, 16, and 58 were identified as the primary pathogenic variants in this region, with HPV16 infection rates showing a significant increase correlating with lesion severity.The 9-valent vaccine could cover 78.26% of cervical cancer-associated HPV genotypes in this region, but its overall HPV infection coverage rate was 42.80%.

The HPV infection pattern among females in Nanhai District, Foshan City from 2020 to 2024 demonstrated significant age-related disparities, with a U-shaped infection rate trend over the five-year period. It is recommended to enhance screening and education for age-eligible populations, strengthen surveillance and vaccine promotion, and continuously monitor the epidemiological trends of non-vaccine-covered high-risk types (e.g., HPV 51, 68, 39).

To investigate the dynamic development trajectories of internet addiction in children and adolescents after COVID-19, and the influence of factors such as gender, ethnicity, parental education and non-suicidal self-injury, and provide a reference for the formulation of precision psychological intervention programs.

In the Chengdu Positive Child Development Cohort, we conducted follow-up surveys at four time points from December 2019 to June 2022, using the Internet Addiction Scale (IAT) and the Deliberate Self-Injury Scale (DSHI). The study involved 3 865 students from grades 1 to 6. The latent growth mixture model (LGMM) was used to analyze the development trajectory of internet addiction in children and adolescents. Factors associated with changes in each latent category of internet addiction were analyzed using multiple logistic regression.

There was a clear upward trend in internet addiction among children and adolescents over time. The developmental trajectories among children and adolescents with internet addiction could be categorized into four distinct groups, labeled as C1 "low-level-slow-rise group" (77.7%), C2 "low-level-deteriorating group" (9.3%), C3 "high-level-remitting group(8.2%) and C4 "high-level-stable group" (4.8%). Males, non-Han ethnicity, maternal education below junior high school, and non-suicidal self-injury were identified as risk factors associated with adverse trajectory changes in internet addiction among children and adolescents.

Children and adolescents with internet addiction exhibited significant group heterogeneity and individual differences in their development trajectories, so precise psychological intervention programs should be given according to different categories to use limited psychological resources to improve the intervention effect rationally.

To compare the characteristics and trends of disease burden of pressure ulcers in children in China and globally from 1990 to 2021.

Data from the Global Burden of Disease 2021 (GBD 2021) were retrieved, and the incidence, prevalence, and disability-adjusted life years (DALYs) of pressure ulcers in children aged 0-14 years in China and globally from 1990 to 2021 were analysed. Age-standardized rate (ASR) and estimated annual percentage change (EAPC) were calculated to assess temporal trends, and the joinpoint regression model was employed to identify any turning points.

From 1990 to 2021, in China, the age-standardized incidence and prevalence rates of pressure ulcers among children aged 0-14 years both declined, with estimated EAPCs of -1.92% and -1.97%, respectively, ranking second worldwide in speed of decline. The age-standardized DALY rate remained relatively stable. The age-standardized incidence, prevalence, and DALYs rates of pressure ulcers in children globally all showed a downward trend, with estimated annual percentage changes of -0.44%,-0.46%, and -2.41%, respectively. In China, the incidence, prevalence and DALYs rate of pressure ulcers in children aged 0-14 years increased with age. Globally, the incidence and prevalence rates of pressure ulcers in children aged 0-14 years increased with age, and the rate of DALYs was higher in children aged 5-9 years. The age-standardized incidence and prevalence rates were higher in high SDI regions. The age-standardized DALYs rate was higher in low and low-middle SDI regions.

From 1990 to 2021, the burden of pressure ulcers in children aged 0-14 years globally and in China was gradually decreasing. Targeted prevention and intervention strategies are needed for children of different ages and in areas of different economic levels. Children with chronic or critical illnesses that require long-term bed rest should be paid paticular attention.

To explore the relationship between four dimensions of father’s parenting involvement (emotional, rule-setting, academic, and daily life), peer relationships, and the depression status of rural children.

A total of 657 rural children were assessed using the Father Involvement Questionnaire, the Peer Relationships Scale, and the Child Depression Inventory. SPSS 27.0 software and the Process 4.1 plugin were used to analyze the relationship between paternal parenting involvement and the depression status of rural children, as well as the mediating effect of peer relationships.

All dimensions of father’s parenting involvement had a significant positive impact on peer relationships(β_emotional=0.394, β_rule-setting=0.227, β_academic=0.219, β_{daily life}=0.202). The emotional, rule-setting, and academic dimensions of paternal parenting involvement significantly negatively predicted children’s depression levels (β_emotional=-0.032, β_rule-setting=-0.025, β_academic=-0.028), while the daily life dimension showed no significant effect. Peer relationships significantly negatively influenced depression levels (β_emotional=-0.159, β_rule-setting=-0.162, β_academic=-0.162, β_{daily life}=-0.168).

Peer relationships play a bridging role between father’s parenting involvement and depression in rural children. Father’s involvement in emotional, rule-setting, and academic aspects can directly predict children’s depressive symptoms, or indirectly predict them through peer relationships. Parenting involvement in the daily life dimension indirectly influences children’s depression through peer relationships.

The aims of this study were to develop the Adolescents Self-injury Tendency Scale (ASITS) under peer influence, and test the reliability and validity of this scale.

A primary questionnaire was developed using a literature review, semi-structured interviews, and expert evaluation. Afterward, 1 938 middle and high school students were surveyed with the initial questionnaire, and ASITS was formulated through item analysis and exploratory factor analysis. Furthermore, we conducted confirmatory factor analysis in the second sample (n=3 160) and tested the scale’s reliability and validity.

ASITS comprised 4 factors and 15 items. The model showed good fit (RMSEA=0.04, SRMR=0.01, CFI=0.98, TLI=0.97). Cronbach’s α for the total scale and each factor ranged from 0.72 to 0.84. The criterion validity showed that ASITS was positively correlated with self-injurious behavior, depression-anxiety-stress symptoms, loneliness and peer pressure (r=0.38,0.31, 0.34, 0.22, P<0.001), and negatively correlated with core self-evaluation (r=-0.34, P<0.001).

ASITS has good reliability and validity, thus providing a reliable tool for evaluating adolescents’ tendency to inflict self-injury under peer influence.

To explore the influence of family sports behavior environment on adolescent internet addiction behavior, and to explore the role of parent-child and peer relationships at the interpersonal relationship level.

Convenience sampling was used to survey 909 junior high school students using the Family Sports Behavior Environment Scale, 10 item Internet Addiction Scale, Parent-Child Intimacy Scale, and Children and Adolescents Peer Relationship Scale.

The chain mediation effect analysis showed that parent-child relationship and peer relationship played a mediating role between family sports behavior environment and internet addiction, respectively. The mediating effects of the three paths in the father-child relationship accounted for 24.9%, 11.4%, and 9% of the total effect, respectively. The mediating effects of the three paths in the mother-child relationship accounted for 25%, 8.3%, and 8.3% of the total effect, respectively.

Family sports behavior environment can directly predict the degree of internet addiction among junior high school students, and at the same time, family sports behavior environment can indirectly influence the internet addiction behavior of junior high school students through the chain mediation effect of parent-child and peer relationships.

To explore the relationship between tooth loss and cognitive level in the elderly, and to verify the mediating roles of dietary diversity and social participation.

This paper used the data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2018, and screened out 5 774 eligible research subjects. Spearman correlation analysis was used to explore the correlations among tooth loss, dietary diversity, social participation and cognitive level in the elderly.The chain mediating effects of dietary diversity and social participation between tooth loss and cognitive level in the elderly were analyzed using Model 6 of the Process 4.1 add-in in SPSS.

The direct effect of tooth loss on cognitive level in the elderly was significant (β=-0.298, P<0.01). Dietary diversity and social participation significantly influenced the cognitive level of the elderly (β=0.059, P<0.05; β=0.063, P<0.01). The mediating effects of dietary diversity and social participation between tooth loss and cognitive level in the elderly were -0.016 (95% CI: -0.005~-0.030) and -0.04 (95% CI: -0.016~-0.065), respectively, and the chain mediating effect was -0.011 (95% CI: -0.006~-0.017).

Tooth loss in older adults can directly affect their cognitive level, and can also influence cognitive function through the independent or chain mediating effects of dietary diversity and social participation. In the future, attention should be paid to the tooth loss situation of older adults, and their nutritional intake and social participation should be ensured to reduce the risk of cognitive impairment and achieve healthy aging.

To assess the economic burden of multimorbidity and complex multimorbidity, focusing on cost variations across medical insurance system, synergistic cost effects of multimorbidity clusters, and expenditure patterns among older versus non-older adults, thereby providing evidence to optimize disease management, health resource allocation, and targeted interventions for high-risk populations.

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines, CNKI, WanFang Data, SinoMed, PubMed, Embase, Web of Science,Scopus, and Cochrane Library were systematically searched for studies on the economic burden of multimorbidity until July 2024. Two reviewers independently screened studies and extracted data. Meta-analysis was performed using Review Manager 5.4 and Stata 18.0.

A total of 27 studies with 13 266 248 participants were included. Patients with multimorbidity had significantly higher annual per capita costs across all categories compared to those with a single condition. Healthcare costs (Total: SMD=0.34, 95% CI: 0.08-0.60; Out-of-pocket: SMD=0.36, 95% CI: 0.11-0.60), hospitalization costs (Total: SMD=0.36, 95% CI: 0.20-0.51; Out-of-pocket SMD=0.20, 95% CI: 0.02-0.39), and outpatient costs (Total: SMD=0.34, 95% CI:-0.02-0.70; Out-of-pocket: SMD=0.20, 95% CI: 0.04-0.36). Costs were also higher for ≥4 conditions than for ≥2.Geographically, total costs were higher in the US and the Eurozone than in mainland China and Singapore. The cost increase effect was highest in the US (SMD=0.38, 95% CI: 0.36-0.40), followed by Eurozone (SMD=0.26, 95% CI: 0.21-0.30) and China (SMD=0.26, 95% CI: 0.12-0.40), with significant subgroup differences (P<0.001). Costs varied by multimorbidity patterns (e.g., higher for diabetes/hypertension), severity (positively correlated with cumulative illness scores and CCI), and age (higher in adults ≥65 years).

Multimorbidity imposes a significant economic burden with regional and group variations. Optimized disease management, improved health insurance coverage, and targeted health policies to reduce the burden are urgently needed. Future studies should focus on economic impacts of specific multimorbidity patterns to develop precise interventions.

To investigate the contracting status and satisfaction levels of community residents with family doctor contract services in Zhejiang Province, and to analyze the associated influencing factors.

A multi-stage stratified sampling method was used to randomly select seven community health service centers in Hangzhou, Wenzhou, and Zhoushan,Zhejiang Province. A cross-sectional questionnaire survey was conducted among individuals visiting these centers from January to March 2024. Analysis of factors influencing satisfaction levels with family doctor contract services was performed using an ordered logistic regression model.

A total of 713 questionnaires were distributed, with 643 valid responses, yielding a response rate of 90.18%. Among the respondents, 373 had contracted family doctor contract services, resulting in a contracting rate of 58.01%. The main reasons for not contracting were having never heard of the family doctor contract service (40.00%) and considering it unnecessary (26.67%). The overall satisfaction score with family doctor services among the contracted population was 4.11 ± 1.16. Satisfaction was assessed across five dimensions showing statistically significant differences (H=20.182, P<0.001). Ordered logistic regression analysis revealed that individuals living with a spouse and/or children (OR=2.316, 95% CI:1.040-5.160) reported higher satisfaction levels with family doctor contract services. Conversely, lower satisfaction levels were observed among individuals with an annual household income of 200 000-<500 000 yuan (OR=0.242, 95% CI: 0.102-0.573), those with an annual household income of ≥500 000 yuan (OR=0.212, 95% CI: 0.074-0.605), those reporting moderate awareness of family doctor contract services (OR=0.282, 95% CI: 0.163-0.486), and those reporting good awareness (OR=0.011, 95% CI: 0.004-0.028).

Currently, the family doctor contracting rate and satisfaction among community residents in Zhejiang Province are relatively high, but there is still room for improvement. Further efforts are needed to enhance publicity, improve service quality, and increase both the contracting rate and satisfaction of residents.

To explore the chain mediating role of activities of daily living and physical pain between chronic diseases and depressive symptoms in the elderly, and to provide new perspectives and intervention strategies for the prevention and alleviation of depressive symptoms in the elderly.

Based on the data of the 2020 China Health and Retirement Longitudinal Survey (CHARLS), the chain mediation model was constructed with the help of the PROCESS 4.1 program, and 5 000 repeated samplings were conducted using the Bootstrap method to verify the mediation variables.

A total of 7 505 elderly people aged 60 and above were included. Chronic diseases in the elderly were positively correlated with depressive symptoms (r=0.284, P<0.01), activities of daily living (r=0.265, P<0.01), and physical pain (r=0.379, P<0.01). The mediation test showed that chronic diseases in the elderly had a direct effect on depressive symptoms (β=0.451, 95% CI: 0.384-0.520), and activities of daily living (β=0.302, 95% CI: 0.280-0.324) and pain (β=0.522, 95% CI: 0.486-0.558) had significant individual mediating effects between the two. The chain mediating effect of activities of daily living and physical pain between the number of chronic diseases and depressive symptoms was significant (β=0.036, 95% CI: 0.029-0.044), and the total mediating effect and chain mediating effect accounted for 48.46% and 4.10% of the total effect, respectively.

Chronic diseases are significantly associated with depressive symptoms in the elderly. Activities of daily living and physical pain have a chain mediating effect between chronic diseases and depressive symptoms in the elderly. Emphasis should be placed on the synergistic effect of pain management and functional rehabilitation in the elderly. Early prevention should be carried out to reduce depressive symptoms in patients with chronic diseases and improve the quality of life of the elderly.

To investigate the impact of sleep deprivation on the physical and mental health of adolescents, and to provide theoretical references for improving the health level of adolescents.

Using data from the 2022 China Family Panel Studies (CFPS), participants aged 9-18 years were included. Observations aged >18 years, beyond the senior-high schooling stage, or with missing values on key variables were excluded. Multiple linear regression and propensity score matching were employed to estimate the effects of sleep deprivation on self-rated health and depressive symptoms among adolescents.

The final analytical sample comprised 2 600 valid observations, 61.96% of whom were classified as sleep-deprived. Insufficient sleep had significant negative impacts on adolescents’ self-rated health (β=-0.118, P=0.004) and depression (β=0.607, P<0.001). The results of propensity score matching through nearest neighbor matching, radius matching, and kernel matching showed that the average treatment effect of sleep status on adolescents’ self-rated health was -0.160 to-0.110, and on depression was 0.742 to 0.763.

Insufficient sleep leads to a decline in adolescents’ self-rated health and an increase in depressive symptoms. It is essential to ensure that adolescents get adequate sleep to promote healthy physical and brain development, alleviate anxiety and depression, and support their overall physical and mental well-being.

To analyze the current status of the provision of intergenerational support and depression among people aged 45-60 in China, and evaluate its impact on depression, providing a theoretical basis for further improving their health status.

Based on the 2018 China Health and Retirement Longitudinal Study Database (CHARLS), 7 861 middle-aged individuals aged 45-60 were included as the research subjects for analysis. The demographic characteristics, intergenerational support status, and depression status were described. The stepwise regression method was used to explore the influence of intergenerational support on depression status.

In the past year, among respondents providing emotional, economic, and life care support, 2 046 (63.8%) frequently met their parents, 2 646 (59.4%) cases met their children frequently, and 3 634(88.0%) cases often contacted their children. The number of respondents of providing financial support to the parents and to their children were 1 439 (18.3%) and 2 781 (35.4%), respectively. There were 1 679 (52.4%) cases who took care of their parents, 1 851 (94.6%) cases who took care their children, and 1 965 (64.1%) cases who took care of their grandchildren. The detection rate of depressive symptoms was 35.1%. In binary logistic regression adjusting for other factors, the results showed that the risk of depression detection was 0.571 (0.385-0.848) lower in those with frequent contact with their children than in those with infrequent contact.

Regular contact with children significantly reduced the risk of depression, whereas financial support or caregiving alone did not have a significant effect on depression.

To explore the potential targets and mechanisms of β-carotene in the treatment of hyperuricemia (HUA) by integrating network pharmacology analysis with in vivo mouse experiments.

Targets related to β-carotene were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), CTDbase, and Swiss Target Prediction databases. Therapeutic targets for HUA were obtained from the GeneCards, DigSee, and DisGeNET databases. Venn diagram analysis was used to identify overlapping targets between β-carotene-related targets and HUA disease targets, and a protein-protein interaction (PPI) network was constructed. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on the identified overlapping targets. C57BL/6 mice were divided into 5 groups: normal group, HUA (model group), positive control allopurinol (62.5 mg/kg) group, 20 mg/kg β-carotene group, and 40 mg/kg β-carotene group. Except for the control group, all other groups were induced to establish the HUA mouse model using potassium oxonate and hypoxanthine. Serum levels of uric acid (UA), urea nitrogen (BUN), and creatinine (CRE) were measured using biochemical assay kits. Renal tissue injury was observed using hematoxylin-eosin (H&E) staining.Levels of interleukin-1β (IL-1β) and IL-18 were detected using enzyme-linked immunosorbent assay (ELISA) kits. Western blot was used to detect protein expression levels of NOD-like receptor protein 3 (NLRP3), apoptosis-associated speck-like protein (ASC), and cleaved Caspase-1. Immunohistochemical staining was used to observe NLRP3 expression levels in renal tissue.

Matching 254 β-carotene-related targets with 170 HUA-related targets yielded 15 overlapping β-carotene-HUA target genes. KEGG enrichment indicated that β-carotene primarily treated HUA by involving inflammation and apoptosis pathways, with NLRP3 inflammasome enrichment being the most significant. Compared to the model group, both 20 mg/kg β-carotene and 40 mg/kg β-carotene significantly reduced serum UA (F=119.3, P<0.01), BUN (F=112.7, P<0.01), and CRE (F=80.76, P<0.01) levels in HUA mice, alleviated renal injury, decreased renal tissue levels of IL-1β (F=97.8, P<0.01) and IL-18(F=137.0, P<0.01), and downregulated the expression levels of NLRP3 (F=178.4, P<0.01), ASC (F=392.5, P<0.01), and cleaved-Caspase-1 (F=171.6, P<0.01).

β-Carotene can alleviate renal injury and reduce inflammatory responses in HUA mice. Its mechanism may be associated with inhibiting the activation of the NLRP3 inflammasome.

To systematically analyze the problems existing in China’s public health emergency response plan system, comprehensively review relevant literature, and construct a complete problem framework.

A total of 3 171 relevant literature articles were retrieved from Chinese and English databases from 2003 to 2024, and 225 articles that met the criteria were ultimately included in the analysis. Problem descriptions were extracted, categorized, and organized into a problem list, and a problem system was constructed based on the emergency plan framework.

The system identified 29 types of problems within China’s emergency response plans, encompassing the plan system, preparedness framework, risk assessment, operational foundation, and operational environment.

The developed problem system systematically presents existing issues and provides theoretical and practical references for improving emergency response plans and enhancing public health emergency response capacity.

To explore the comorbidity patterns of chronic heart failure(CHF) patients with different cardiac function grades, and to provide a scientific basis for optimizing treatment plans and improving patient prognosis.

A cross-sectional study was conducted to collect the clinical information of 495 patients with CHF from 9 hospitals inside and outside Beijing from May 2018 to November 2022. Association rule analysis was applied to investigate comorbidity patterns among patients with varying degrees of cardiac function, and a comorbidity network for CHF patients was constructed and visually analyzed.

The comorbidity prevalence among the 495 CHF patients was 96.57%. The comorbidity ratios for patients with cardiac function grades II, III, and IV were 94.37%, 96.81%, and 97.25%, respectively. Hypertension (67.27%), hyperlipidemia (48.69%), and diabetes (46.46%) were the most common comorbidities among CHF patients, with the highest proportion of patients having two comorbidities (28.90%). As cardiac function declined, the frequency of comorbidities such as renal insufficiency and atrial fibrillation showed an increasing trend. In patients with cardiac function grades II, III, and IV, 34, 11, and 23 strong association rules were identified, respectively, further revealing the associations among hypertension, diabetes, and hyperlipidemia in CHF patients. The comorbidity network diagram demonstrated a close association between heart failure patients and conditions such as hypertension, hyperlipidemia, and diabetes, indicating a complex comorbid relationship. There was a difference in comorbidity network density among patients with varying cardiac function levels, with patients experiencing deterioration in cardiac function exhibiting more complex comorbid connections.

Strengthening the monitoring and management of comorbidities in clinical CHF patients could help integrate medical resources, optimize personalized intervention strategies, and enhance the overall effectiveness of chronic disease prevention and control.