This study aims to explore the association between the Life’s Essential 8(LE8) and the prevalence of Metabolic-associated fatty liver disease(MAFLD) and its different subtypes.

Based on the baseline data of Chinese Cohort of Working Adults(CCWA), study subjects were selected through systematic random sampling. Sociodemographic characteristics and lifestyle behaviors were obtained via questionnaires, and physical examination data were collected. MAFLD was diagnosed based on the physical examination information, and the LE8 score was used to assess LE8. A total of 21 614 participants with complete data were included. A multivariate logistic regression model was employed to analyze the relationship between LE8 scores and the risk of MAFLD.

In the study population, the prevalence of MAFLD was 25.50%. The total population’s LE8 score was 72.81±13.78. Individuals with MAFLD exhibited a significantly lower mean LE8 score (64.59±12.89)compared to those without MAFLD (75.63±12.92). Notably, the lowest LE8 score was observed among patients with diabetic MAFLD (54.60±12.00). Each one-point increment in LE8 was associated with a 7% reduction in the risk of MAFLD occurrence(OR=0.93, 95% CI: 0.92-0.93). Specifically, the risk decreased by 5% for overweight/obese MAFLD (OR=0.95, 95% CI: 0.94-0.95), 2% for metabolic dysfunction/lean MAFLD (OR=0.98, 95% CI: 0.97-0.99), and 10% for diabetic MAFLD (OR=0.90, 95% CI: 0.90-0.91). Furthermore, compared to individuals with a high LE8 score, those with a medium LE8 score had a 4.44-fold increased risk of developing MAFLD (OR=4.44, 95% CI: 4.03-4.89), while those with a low LE8 score had a 13.63-fold increased risk (OR=13.63, 95% CI: 11.67-15.94).

The LE8 score is associated with MAFLD and different subtypes of MAFLD.A lower LE8 score significantly increases the risk of MAFLD and different subtypes of MAFLD. Improving LE8 may serve as an effective strategy for MAFLD prevention.

To explore the developmental trajectories of sarcopenia and its influencing factors in patients with chronic respiratory diseases.

The data from three waves (2011, 2013, and 2015) of the China Health and Retirement Longitudinal Study (CHARLS) were used to screen patients with chronic respiratory diseases who had sarcopenia-related information. Group-based trajectory modeling was employed to fit the developmental trajectories of sarcopenia in these patients,and multinomial logistic regression was used to analyze the influencing factors.

A total of 1 138 chronic respiratory diseases patients with sarcopenia-related information were included in the study. Four developmental trajectories were identified:the low-risk stable group (38.66%, n=440), the high-risk declining group (15.29%, n=174), the U-shaped risk group (23.46%, n=267), and the high-risk stable group (22.58%, n=257). Multinomial logistic regression analysis indicated that age, gender,education level, body mass index (BMI), disease type, and hypertension were the influencing factors for the developmental trajectories of sarcopenia in patients with chronic respiratory diseases.

The progression of sarcopenia in patients with chronic respiratory diseases is characterized by dynamism and reversibility. Intervention should be preferentially carried out for the elderly, females, individuals with low education levels, low BMI, respiratory system comorbidities, and hypertension to improve muscle function and overall prognosis in patients with chronic respiratory diseases.

Based on biopsychosocial (BPS) perspective, this study explores the prevalence of dementia and related risk factors, providing a reference for the prevention and control of dementia.

Using the 2018 China Health and Retirement Longitudinal Study (CHARLS) data, a statistical analysis was conducted on individuals aged 60 and above. Lasso regression was employed to select variables, and binary logistic regression was used to analyze risk factors for dementia. The dataset was divided into a 7:3 ratio to construct a logistic nomogram prediction model for the risk of dementia, and the model was validated using receiver operating characteristic curve (ROC), decision curve analysis (DCA), and calibration curves.

A total of 3 464 study subjects were included, with 2 425 in the training set and 1 039 in the test set. The prevalence of dementia was 23.96%. Through lasso regression and logistic regression analysis, five risk factors were identified: gender (OR=3.918, P<0.001), age (OR=1.398, P<0.001), education level (OR=1.589, P<0.001), napping (OR=0.799, P=0.013), and life insurance (OR=0.613, P=0.016). The evaluation of the logistic nomogram prediction model for the risk of dementia showed that the area under the curve (AUC) for the training set was 0.729 (95% CI: 0.706-0.752) and the AUC for the test set was 0.713(95% CI: 0.677-0.749). The DCA threshold probability for the training set was 10%-84%, and the threshold probability for the test set was 15%-78%. The calibration curves for both the training and test sets showed good agreement with the prediction curve.

Gender, age, education level, napping, and life insurance are the main risk factors for dementia and society should focus on and effectively intervene in these factors. In addition, the constructed nomogram prediction model for the risk of dementia has good predictive performance and can be used for external prediction.

This study aims to identify latent subtypes of Chinese elderly patients with hypertension based on their health profiles, analyze underlying driving factors and provide scientific evidence for developing targeted health management strategies.

Using two waves (Wave 3 and Wave 4) of Harmonized CHARLS data, this study assessed the health status of Chinese elderly patients with hypertension across three dimensions, including physical condition, psychological condition and quality of life. Latent profile analysis identified health status subtypes, latent transition analysis explored inter-subtype transitions over time. Based on this, logistic regression and decision tree models were used to further investigate the key factors influencing the latent subtype transitions.

Four health status subtypes were identified: Comprehensive well-adapted,Multidimensional dysfunction, Low positive affect-driven, and High negative affect-sensitive. The Comprehensive well-adapted subtype had the highest stability (61.4%), while the Multidimensional dysfunction subtype had the lowest (4.10%). Gender,education, marital status, afternoon napping, physical exercise, social participation, sleep duration, and satisfaction with children and marriage were significantly associated with subtype transitions.

Elderly hypertensive patients exhibit high health status heterogeneity, necessitating targeted interventions. Priority should be given to solitary-living older women with lower education, and to promoting adequate sleep, physical exercise, and social engagement. Improved social support,community involvement and mental health services can enhance their quality of life.

To understand the disease burden, age, period, and cohort impact of diarrhea caused by unsafe water in China from 1990 to 2021.

The mortality and disability-adjusted life year (DALY) rates of diarrhea caused by unsafe water in China from 1990 to 2021 were collected and organized through the 2021 Global Burden of Disease Study (GBD 2021).Joinpoint regression was used to analyze temporal trends and calculate the average annual percentage change (AAPC). Using Stata MP 17 (64-bit) software, a Bayesian age-period-cohort model was used to analyze the impact of age, period, and cohort on diarrhea caused by unsafe water in China from 1990 to 2021.

The mortality rate, standardized mortality rate, DALY rate, and standardized DALY rate of diarrhea caused by unsafe water in China showed a decreasing trend year by year from 1990 to 2021 (AAPC=-10.69%, -10.92%, -11.48%, -10.74%, P<0.001). Similar decreasing trends were observed in both males and females. The age effect in the APC model indicated that people under 5 years old and those over 65 years old had a higher risk of mortality from diarrhea caused by unsafe water (RR values were all>1). The period effect showed that the mortality and DALY risk of diarrhea caused by unsafe water decreased from 1990 to 2021. The cohort effect showed that the earlier the population was born, the higher the risk of death and DALY from diarrhea caused by unsafe water.

From 1990 to 2021, the mortality and DALY risk of diarrhea caused by unsafe water in China have decreased. However, children and the elderly still have a high risk of diarrhea caused by unsafe water. It is necessary to actively provide safe drinking water, reduce the spread and impact of diarrhea caused by unsafe water sources, and protect public health.

To translate McCusker Subjective Cognitive Impairment Inventory-Self Report (McSCI-S) into Chinese and to examine its reliability and validity.

The modified Brislin model was adopted to form the Chinese version of the McSCI-S scale through translation and back-translation processes. A convenience sampling method was used to investigate 460 residents from Huzhou. The reliability and validity of the scale were evaluated based on item response theory and classical test theory.

The Chinese version of the McSCI-S was a unidimensional instrument comprising 29 items. The S-CVI/Ave was 0.986. Confirmatory factor analysis showed that the model fit was good. The criterion-related validity coefficient was 0.506.The total Cronbach’s α coefficient of the scale was 0.970, and the test-retest reliability was 0.903.

The Chinese version of the McSCI-S has good reliability and validity and can be used as a self-report instrument for assessing subjective cognitive impairment among residents in China.

To analyze the spatial distribution characteristics and changing trends of newly reported echinococcosis cases in endemic areas of Sichuan Province from 2020 to 2024, so as to provide a reference for formulating precise prevention and control strategies.

Based on the China Disease Control and Prevention Information System, county-level data on new cases of echinococcosis reported from 2020 to 2024 in endemic areas of Sichuan Province were collected. GeoDa 1.2.0 software and ArcGIS 10.3 software were used to conduct global spatial autocorrelation analysis, local spatial autocorrelation analysis and hotspot analysis on the reported incidence rates.

From 2020 to 2024, 378 new cases of echinococcosis were reported in 35 endemic counties in Sichuan Province. The annual reported incidence rates were 2.11 per 100 000, 2.54 per 100 000, 2.80 per 100 000, 3.19 per 100 000, and 4.29 per 100 000, respectively. Among the endemic prefectures, Aba Prefecture recorded the highest average annual reported incidence rate (5.64 per 100 000), while Ganzi Prefecture ranked second (2.31 per 100 000). The global spatial autocorrelation analysis showed that the reported incidence rate of echinococcosis in Sichuan Province had a positive spatial correlation in 2020, 2022, and 2024 (Moran’s I=0.295, 0.257, and 0.109; Z>1.96; P<0.05 for all years), and was randomly distributed in 2021 and 2023 (Moran’s I=-0.065 and 0.042; Z<1.96; P>0.05 for both years). Local spatial autocorrelation analysis identified four clustering patterns: “High-High”, “High-Low”, “Low-High” and“Low-Low”. The “High-High” clusters were primarily concentrated in Aba County, Barkam City, and Rangtang County within Aba Prefecture. The hotspot analysis indicated that from 2020 to 2024, the hotspots of the reported incidence of echinococcosis in Sichuan Province shifted from Ruoergai, Hongyuan, and Heishui counties in the north-central region of Aba Prefecture toward the southwestern border areas between northern Aba Prefecture and Ganzi Prefecture, and the primary hotspot regions were concentrated in Rangtang County, Aba County, Barkam City, and Jinchuan County of Aba Prefecture, along with Seda County of Ganzi Prefecture.

From 2020 to 2024, the reported incidence rate of echinococcosis in endemic areas of Sichuan Province showed an increasing trend, with significant spatial clustering observed. It is recommended to strengthen the management of sources of infection and wildlife host control measures in hotspot areas, and to develop regional comprehensive prevention and control strategies.

To investigate the association between circadian syndrome (CircS) and metabolic dysfunction-associated steatotic liver disease (MASLD).

Utilizing data from the 2017—2020 US National Health and Nutrition Examination Survey (NHANES), 2 060 adults aged ≥20 years were included. MASLD was diagnosed based on vibration-controlled transient elastography (CAP ≥274 dB/m) and metabolic risk criteria. CircS was defined as meeting ≥4 components (abdominal obesity,dyslipidemia, hypertension, hyperglycemia, sleep duration ≤6 h/day, depressive symptoms). Multivariable logistic regression was used to analyze the association between CircS, the number of CircS components, and MASLD [odds ratio (OR) and 95%confidence interval(CI)], adjusting for demographic and lifestyle confounders. Subgroup analyses were performed, and a MASLD risk prediction nomogram was constructed using LASSO-selected variables.

Among the participants, 786 (38.2%) had MASLD and 839 (40.7%) had CircS. The fully adjusted model revealed a significant positive association between CircS and MASLD (OR=3.95, 95% CI: 3.19-4.90). The number of CircS components showed a dose-response relationship with the presence of MASLD (P for trend <0.05), with individuals having ≥6 components exhibiting the highest odds of MASLD (OR=8.35, 95% CI: 5.27-13.50). Subgroup analysis indicated a stronger association in younger adults aged <50 years (OR=5.69,95% CI: 4.12-7.87). The nomogram incorporating CircS demonstrated moderate predictive ability (training set AUC=0.715).

This study is the first to reveal an independent positive association between CircS and MASLD, particularly pronounced in younger adults, with a dose-response relationship. CircS may serve as a potential association marker for MASLD,suggesting that interventions targeting circadian rhythm disruption could represent a novel prevention and management strategy.

To understand the current situation of indoor particulate matter and microbial pollution in fitness centers in China, and their association with respiratory symptoms among practitioners.

In accordance with the National Health Risk Factor Surveillance Program for Public Places, this study investigated 280 fitness centers across 31 provinces(autonomous regions, municipalities) and the Xinjiang Production and Construction Corps from March to September 2022 (the warm season) and from October 2022 to February 2023 (the cold season). Air samples were collected to measure PM₁₀, PM_2.5,total plate count (TPC), and total fungal count (TFC), while a questionnaire survey was administered to practitioners. χ² tests were employed to compare the exceedance rates of these air quality parameters across different geographical regions and seasons. Additionally, logistic regression analysis was conducted to examine the association between indoor air pollutant exposure levels and the prevalence of respiratory symptoms among practitioners.

Among the measured air quality parameters, airborne TFC exhibited the highest exceedance rate (21.74%), particularly in southern regions during the warm season. The exceedance rates for PM₁₀, PM_2.5, and TPC were 8.21%, 14.25%, and 0.23%, respectively. Respiratory symptoms were reported by 23.15% of practitioners, with significant differences (P<0.05) observed across age, smoking history, alcohol consumption, and length of service. Logistic regression analysis identified elevated concentrations of PM₁₀≥225 μg/m³, PM_2.5≥135 μg/m³, TPC≥500 CFU/m³, and TFC≥250 CFU/m³ as significant risk factors for respiratory symptoms among gym practitioners (P<0.05). The corresponding adjusted OR (95% CI) were 3.64 (1.77-7.48), 2.19 (1.15-4.16), 3.84 (1.66-8.90),and 1.63 (1.09-2.44), respectively.

Exposure to PM₁₀, PM_2.5, TPC, and TFC in fitness centers in China may increase the risk of respiratory symptoms among practitioners.

To explore the independent and interactive effects of meteorological factors and air pollutants on the outpatient visits of respiratory diseases in Xining City, and to provide a scientific basis for urban public health protection in plateau areas.

A time-stratified case-crossover design was used. Outpatient visit data for respiratory diseases from three hospitals in Xining during 2016—2021 were included, and pollutant data were obtained from the China Air Quality Online Monitoring Platform. A generalized nonlinear model was applied to assess the lagged effects of CO, O₃, SO₂, NO₂, PM₁₀,PM_2.5 and temperature. Interactions were quantified using a bivariate response surface model, relative excess risk due to interaction (RERI), and attributable proportion (AP).

The single pollutant model analysis showed that the risk of outpatient visits increased with higher concentrations of CO and NO₂. SO₂, PM₁₀ and PM_2.5 showed a ‘first increase and then decrease’ curve, and the peak RRs were 1.69, 1.55 and 1.80, respectively. O₃ showed a ‘U’ shaped curve, and the trough RR was 0.76. The lag effect analysis indicated that same-day effects were strongest for SO₂, NO₂ and PM₁₀. The peak RR of SO₂ reached (RR=1.54, 95% CI: 1.26-1.88) at lag 7 days, and the cumulative lag effect of NO₂ reached (RR=1.20, 95% CI: 1.11-1.31) at lag 3 days. The interaction analysis showed that SO₂, NO₂, PM₁₀ and PM_2.5 had a significant synergistic effect at low temperatures, but had an antagonistic effect with O₃. Under high temperature conditions, it only had a synergistic effect with O₃.

The risk of respiratory diseases in Xining is affected by the concentration of pollutants, temperature and their interaction. Low temperature aggravates the health hazards of gaseous pollutants and particulate matter, and high temperature enhances the hazard effect of O₃.

To assess the contamination levels and health risks of lead (Pb), cadmium (Cd), arsenic (As), mercury(Hg), and copper (Cu) in Astragalus, Eucommia ulmoides leaves, and Cornus officinalis from Shaanxi Province, providing a scientific basis for safety evaluation and standard establishment.

Samples of Astragalus, Eucommia ulmoides leaves,and Cornus officinalis were collected from major producing areas in Shaanxi. The concentrations of the five heavy metals were determined using microwave digestion-inductively coupled plasma mass spectrometry (ICP-MS). The contamination levels were evaluated using the single-factor pollution index and the Nemerow composite pollution index, while health risks were assessed by comparing health guidance values or benchmark doses with estimated human exposure levels.

Both the single-factor pollution index and the Nemerow composite pollution index values for Astragalus and Cornus officinalis were below 0.7, indicating low heavy metal contamination and a safe consumption level. In contrast, Eucommia ulmoides leaves exhibited a Nemerow composite pollution index of 0.79, reaching the alert threshold, with Pb and Hg identified as the primary contaminants, necessitating stricter control during cultivation and processing. For all three food and medicinal substances, the exposure levels via dietary intake were higher than those via medicinal use. For Astragalus, Eucommia ulmoides leaves, and Cornus officinalis, the Pb exposure levels via dietary intake were 0.107 μg/kgBW, 0.698 μg/kgBW, and 0.266 μg/kgBW,respectively. The As exposure levels were 0.108 μg/kgBW, 0.138 μg/kgBW, and 0.039 μg/kgBW, respectively. The Cd exposure levels were 0.007 μg/kgBW, 0.060 μg/kgBW, and 0.011 μg/kgBW, respectively. The Hg exposure levels were 0.002 μg/kgBW, 0.031 μg/kgBW, and 0.007 μg/kgBW, respectively. The Cu exposure levels were 2.611 μg/kgBW, 1.979 μg/kgBW,and 0.987 μg/kgBW, respectively.

Astragalus and Cornus officinalis from Shaanxi pose minimal heavy metal contamination risks, whereas Eucommia ulmoides leaves require targeted monitoring for Pb and Hg. When dietary exposure was considered, the heavy metal exposure risks for all three food and medicinal substances were within acceptable limits.

To investigate the association between the Geriatric Nutritional Risk Index(GNRI) and metabolic syndrome(MS) among elderly people of ethnic minorities in Guizhou Province, providing scientific evidence for the health management of the elderly in this region.

Based on the “Southwest Regional Cohort Study of Natural Populations of Ethnic Minorities”, this study included 4 521 elderly individuals aged 60 and above from the Miao, Dong, and Bouyei ethnic groups in Guizhou Province. Data on demographic characteristics, lifestyle, physical examination, and biochemical indicators were collected. Logistic regression, subgroup analyses, and restricted cubic splines (RCS) were used to evaluate the association between GNRI and MS. Within each ethnic group, the optimal cut-offs from ROC curves (107.9 for the overall population, 108.0 for the Miao, 110.1 for the Dong, and 106.0 for the Bouyei) were applied to categorize GNRI into high and low levels for subsequent sensitivity analyses.

The overall prevalence of MS was 23.9%, with prevalence rates of 24.6%, 25.4%, and 21.3% among the Miao, Dong, and Bouyei ethnic groups, respectively. In Model 3, which adjusted for all covariates, GNRI as a continuous variable was positively correlated with MS risk in the total population, Miao, and Dong groups, with OR (95% CI) of 1.07 (1.05-1.09), 1.07 (1.04-1.10), and 1.07 (1.04-1.11), respectively. However, this association was not significant in the Bouyei group (P=0.172). When GNRI was categorized, in the total population and Miao and Dong groups, higher GNRI quartiles(Q2-Q4) were associated with a gradient increase in MS risk compared with the Q1 reference group. However, this association was not statistically significant in the Q2 group or in any quartile group of the Bouyei ethnic group. Sensitivity analysis showed that the high-GNRI group had a significantly increased risk of MS (overall population: OR=1.98; Miao: OR=2.43; Dong: OR=1.76; all P<0.001), whereas the association remained non-significant in the Bouyei population (OR=1.03, P=0.845). Subgroup analysis showed that GNRI interacted with ethnicity and educational level, with stronger associations in the Dong group and among individuals with lower educational levels. RCS analysis indicated a linear positive association between GNRI and MS in the total population, while a non-linear positive association was observed in the Dong, Miao, and Bouyei groups.

Among the elderly Miao and Dong populations in Guizhou, an elevated GNRI was an independent risk factor for MS. No such association was observed in the Bouyei ethnic group. The relationship between GNRI and MS varied by ethnicity, indicating that ethnicity-specific nutritional intervention cut-offs and MS prevention strategies should be developed.

To explore the association between serum 25-hydroxyvitamin D [25(OH)D] concentration and the risk of respiratory tract infections(RTIs) in obese populations, analyze the influence of obesity stratification on the relationship between the two, and provide a scientific basis for the infection prevention and control strategies of RTIs in obese populations.

Based on the data of the National Health and Nutrition Examination Survey（NHANES） of the United States from 2009 to 2018,participants over 20 years old were included as the research subjects. The relationship between serum 25(OH)D and the risk of RTIs in obese people was analyzed using multivariable logistic regression, subgroup analysis, restricted cubic spline analysis,and logistic inflection point model.

A total of 21 532 research subjects were finally included (12 989 cases in the non-obese group, 4 629 cases in the grade I obese group, 2 196 cases in the grade II obese group, and 1 718 cases in the grade III obese group), and there were significant differences in baseline characteristics among the groups (P<0.001). The overall prevalence rate of RTIs was 17.5%. Compared with the non-obese group, the serum 25(OH)D levels of obese people at all levels were significantly decreased, and the proportion of serum 25(OH)D deficiency increased with the aggravation of obesity (up to 16.9% in the grade III obese group). Serum 25(OH)D level was a protective factor for reducing the risk of RTIs. However, its protective effect showed a gradient decreasing trend with the increase of obesity degree. Among participants with adequate serum 25(OH)D, the protective effect persisted: grade I obesity group (OR=0.75, 95% CI: 0.62-0.88), grade II obesity group (OR=0.78, 95% CI: 0.70-0.86),and grade III obesity group (OR=0.82, 95% CI: 0.74-0.90). There was a clear threshold effect in the non-obese group (inflection point=29.96 nmol/L), the threshold in the grade I obese group shifted down to 25.97 nmol/L, while the grade II and grade III obese groups showed a linear relationship.

Obese individuals have a deficiency in serum 25(OH)D, which is closely associated with an increased risk of respiratory tract infections. Moreover, the higher the degree of obesity, the more limited the protective effect of serum 25(OH)D. Therefore, stratified joint intervention strategies need to be developed for obese individuals.

To explore the relationship between weight-specific handgrip strength (Wt-HGS) and metabolic syndrome(MetS) and its components, providing new evidence for metabolic risk assessment in children and adolescents.

Data were derived from the 2021 Evaluation and Monitoring of School-based Nutrition and Growth in Shenzhen (EMSNGS) study. Based on handgrip strength percentile reference standards, handgrip strength was categorized into quartiles (Q1-Q4) using both age-specific(Age-HGS) and weight-specific (Wt-HGS) percentiles, with Q1 defined as the low handgrip strength group. The prevalence of MetS and its components was compared between the low handgrip strength groups based on the two standards.

A total of 3 272 children and adolescents aged 10-18 years were included in the study, with a median age of 13.8 (11.9, 15.6) years and a MetS prevalence of 3.9% (n=129). The prevalence of MetS was significantly higher in the low handgrip strength group defined by Wt-HGS than in that defined by Age-HGS (boys: 9.4% vs 2.6%; girls: 5.9% vs 1.4%). Logistic regression analysis revealed that, compared to the highest quartile of Wt-HGS (Q4), the odds ratio (OR) for MetS risk in boys in the Q1 group was 5.26 (95% CI: 2.55-10.85), and for girls, the risk was even higher (OR=11.91, 95% CI: 2.78-51.04). After adjusting for age, puberty stage, and other potential confounders, the association remained statistically significant.

Lower Wt-HGS may be a risk factor for MetS in children and adolescents, highlighting the potential value of muscle strength assessment and targeted interventions in the early prevention and control of MetS.

Exploring the mediating role of psychological resilience in the relationship between childhood trauma and the severity of depression among individuals with depressive disorder, and to identify subtypes of depressive disorder by latent profile analysis and analyze the related factors among subtypes.

General information questionnaire, Hamilton Depression Rating Scale (HAMD), Childhood Trauma Questionnaire (CTQ-SF) and Connor-Davidson Resilience Scale (CD-RISC) were used to investigate 360 patients with depressive disorder in outpatient department and ward of Traditional Chinese Medicine Department of Shanghai Mental Health Center.

HAMD was positively correlated with CTQ-SF and the scores of all dimensions (P<0.01), and negatively correlated with CD-RISC and the scores of all dimensions (P<0.01). There was a significant negative correlation between CTQ-SF and CD-RISC (P<0.01). The mediation effect test indicated that childhood trauma had a significant direct predictive effect on the severity of depressive disorder (β=0.079, t=12.984, P<0.001). After adding psychological resilience as a mediating variable, the direct predictive effect of childhood trauma on the severity of depressive disorder remained significant (β=0.050, t=2.636, P<0.01). Latent profile analysis showed that patients with depressive disorder could be classified into low-trauma-high-resilience depressive disorder (72.8%) and high-trauma-low-resilience depressive disorder (27.2%). Gender, age, marital status and educational background were the predictors of latent profile classification(P<0.05).

The severity of depression is correlated with childhood trauma and psychological resilience, and childhood trauma can effectively predict the severity of depression. Individuals with higher levels of childhood trauma and lower levels of psychological resilience are more prone to developing depressive disorder. It is recommended to enhance individual psychological resilience to reduce the occurrence of depressive disorder.

To understand the changing trend of drowning disease burden among Chinese children and adolescents from 1990 to 2021, and to provide a reference for formulating prevention and control strategies.

The standardized disability adjusted life years(DALYs) rate, standardized mortality and standardized incidence rate of drowning children and adolescents under 20 years of age in China from 1990 to 2021 were collected through the Global Burden of Disease (GBD) database in 2021. Average annual percentage change (AAPC)and the annual percentage change (APC) were used to analyze the trend of changes in drowning disease burden among children and adolescents of different ages and genders.

From 1990 to 2021, the standardized DALYs rate (AAPC=-6.30%) and the standardized mortality rate (AAPC= -6.15%) of children and adolescents drowning in China declined more than the standardized incidence rate (AAPC=-3.70%) (all P<0.001). The crude DALYs rates, crude mortality rates, and crude incidence rate in the <5, 5-<10, 10-<15, and 15-<20 age groups decreased (AAPC range was -8.53% to -2.38%, all P<0.001), and the <5 age group decreased the most rapidly (all P<0.001). The standardized DALYs rate, standardized mortality rate and standardized incidence rate of male and female drowning showed a downward trend(all P<0.001), and the decline rate of male drowning was higher than that of female drowning.

The overall disease burden of drowning among children and adolescents in China has shown a downward trend from 1990 to 2021. In the future, a multidimensional and immersive drowning prevention and emergency rescue education system should be constructed based on age and gender differences to enhance the safety literacy and self-rescue and mutual-rescue abilities of children and adolescents.

To investigate the associations between motoric cognitive risk syndrome(MCR) and its parameters with sarcopenia among elderly individuals in rural areas, and the moderating effect of lifestyle behaviors (physical activity, alcohol consumption, smoking) on the relationship between MCR and sarcopenia, to provide a scientific basis for developing targeted intervention strategies and preventive measures.

A convenience sampling method was employed, and 652 elderly participants were recruited from rural regions of Anhui Province for this study. MCR was assessed by a combination of subjective cognitive decline and slow gait, and sarcopenia was assessed by Sarcopenia Five(SARC-F). The regression method was used to analyze the correlation between MCR and its parameters and sarcopenia, and the moderating role of lifestyle behaviors in the above correlation was analyzed.

Older adults with MCR had higher SARC-F scores (β=0.819, P<0.05), and had a higher risk of developing sarcopenia (OR=1.794, P<0.05). Stratified analysis revealed that lifestyle behaviors significantly moderated the association between MCR and sarcopenia, with the effect of MCR on sarcopenia risk being more pronounced among individuals who did not exercise, did not consume alcohol, and did not smoke.

MCR is associated with a higher risk of sarcopenia, and exercise, alcohol consumption, and smoking have a moderating effect on the above associations.

To analyze the colorectal cancer(CRC) screening results and colonoscopy compliance among rural residents in Sichuan Province, providing evidence for optimizing CRC screening strategies.

From January to December 2023, through cluster sampling, residents aged 40 to 74 from rural areas of 8 districts/counties in Sichuan Province were selected to participate in CRC screening. The high-risk rate, colonoscopy compliance rate, and lesion detection rate were calculated. The χ² test and multivariable logistic regression model were used to analyze factors influencing colonoscopy compliance.

A total of 26 134 residents participated in the initial screening, with 5 483 identified as high-risk individuals, yielding a high-risk rate of 20.98%. Among them, 3 901 individuals underwent colonoscopy, resulting in a compliance rate of 71.15%. Multivariable logistic regression analysis showed that the compliance was significantly lower in the 70-74 age group(OR=0.55, 95% CI: 0.41-0.74) compared to the 40-44 age group. Higher education levels were associated with increased compliance. Self-employed individuals (OR=2.28, 95% CI: 1.59-3.26), those with a history of intestinal polyps (OR=3.40, 95% CI: 2.55-4.53), and those who were double-positive in both the high-risk factor questionnaire (HRFQ) and the fecal occult blood test (FOBT) (OR=3.03, 95% CI: 2.52-3.65) had higher compliance rates. Colonoscopy detected 230 cases of lesions, with a detection rate of 5.90%. Males had a higher lesion detection rate than females across all age groups.

The CRC screening program in rural areas of Sichuan Province has achieved positive results, but the compliance with colonoscopy still needs improvement, particularly among males, the elderly, and those with lower education levels. Efforts should be intensified to deliver targeted health education to these key populations, with the aim of further improving the overall compliance with colonoscopy and early detection rates.

To analyze the specific paths of the resource allocation efficiency of community home care in China and provide strong support for the balanced development of the resource allocation of such services.

Based on the relevant data from China Civil Affairs Statistical Yearbook, China Statistical Yearbook, China Health Statistics Yearbook, and China Social Statistics Yearbook (2020—2023), this study used the Data Envelopment Analysis (DEA) method to measure the allocation efficiency of community-based home care resources in China. On this basis, the Fuzzy-set qualitative comparative analysis (fsQCA) was employed to explore the configurational paths for the efficient allocation of community-based home care resources.

The average values of the comprehensive efficiency, pure technical efficiency, and scale efficiency of community home care services in China were 0.533, 0.640, and 0.810, respectively. There were significant differences among different regions and provinces. There were three paths to improve the efficiency of community home care services, with an overall consistency of 0.925, indicating a strong explanatory power of the model.

The overall efficiency level of community home care services needs to be enhanced. It is recommended to optimize management processes and technological innovation, strengthen the radiation and driving force of advantageous regions, precisely expand the scale of the elderly care industry, effectively improve the resource allocation efficiency, adhere to the principle of development based on local conditions, and explore new differentiated elderly care paths.

To evaluate the policy effects of medical resource allocation and service utilization in the Beijing-Tianjin-Hebei region, identify regional disparities, analyze policy outcomes, and propose recommendations.

Based on panel data from 30 provinces (autonomous regions and municipalities) across China from 2010 to 2022, the synthetic control method was employed to assess the policy effects of coordinated medical and health development in the Beijing-Tianjin-Hebei region.

Under the influence of the policy, the growth of medical resources and service utilization in Beijing has continued to decline, with non-capital core functions effectively relocated. In Hebei, the growth of medical resources and service utilization has increased significantly, showing remarkable results in medical resource expansion. For Tianjin, the policy effects on some indicators were unstable, but it remained affected by the policy.

It is recommended to innovate service models,promote the balanced distribution of medical resources, improve the efficiency of service utilization, and enhance the level of homogenized services.

To construct the AIDS prevention behavior education program for elderly women based on the theory of planned behavior, and to provide reference for the development of AIDS prevention behavior education for elderly women.

Based on the theory of planned behavior, semi-structured interviews were conducted with 16 experts and 15 elderly women around the four dimensions of behavioral attitude, subjective norms, perceived behavioral control, and behavioral intention, and a preliminary plan was constructed. Using the Delphi method, two rounds of consultation were conducted with 20 specialists. Selection criteria for program components required all items to meet the following thresholds: mean scores more than 3.5 for both importance and feasibility, coefficient of variation less than 0.25, and full score percentage more than 20%. This process resulted in the final formulation of an AIDS prevention behavior education program targeting elderly women.

The response rates of experts in the two rounds were 100% and 90%, respectively. The authority coefficients of experts were 0.888 and 0.884, respectively. The Kendall’s coefficients of concordance were 0.193 and 0.218, respectively (both P<0.001).Finally, an AIDS prevention behavior education program for elderly women was established, including 4 first-level items, 10 second-level items, 19 third-level items, and 6 participatory teaching methods.

The AIDS prevention behavior education program for elderly women based on the theory of planned behavior is scientific and reliable, which provides new ideas and methods for AIDS prevention behavior education for elderly women.

To explore the effects of community-based self-management intervention on depression, anxiety, and quality of life in high-risk populations with chronic obstructive pulmonary disease(COPD), providing scientific evidence for the formulation of community-based COPD prevention and intervention policies.

Data on sociodemographic characteristics, lifestyle, health status, and lung function were collected from 464 participants through 8 community-based self-management sessions for COPD conducted in Suzhou. Anxiety and depression were assessed using the Generalized Anxiety Disorder-7(GAD-7) scale and the Patient Health Questionnaire-9 (PHQ-9). Quality of life was assessed using the EQ-5D-3L scale (including the EQ-VAS).

The results from the PHQ-9 and GAD-7 scales indicated that, after the intervention,the proportion of participants in the mild depression (anxiety) group and moderate or severe depression (anxiety) group significantly decreased, while the proportion of participants in the normal group increased significantly (P<0.05). A significant change was also observed in the PHQ-9 scale for the group with FEV1/FVC≥70% (P=0.018). In terms of quality of life,significant differences were found in the distribution of self-care, pain/discomfort, and anxiety/depression dimensions between pre- and post-intervention in both the overall population and the FEV1/FVC≥70% group (P<0.05). Except for the FEV1/FVC<70% group in EQ-VAS analysis, significant improvements were observed in the EQ-5D-3L utility index and EQ-VAS scores in all groups (P<0.001).

Community self-management interventions can improve the psychological health and quality of life of high-risk COPD populations, with more pronounced effects in the FEV1/FVC≥70% group. This study provides support for community-based COPD intervention strategies in Suzhou.

To explore the mediating effect of empowerment on the relationship between social support and health literacy in patients with type 2 diabetes mellitus.

A cross-sectional survey was conducted with 243 patients with type 2 diabetes mellitus recruited by convenience sampling from a Grade III Class A hospital in Guiyang. Data were collected using a general information questionnaire, the Diabetes Health Literacy Scale (DHLS), the Diabetes Empowerment Scale-Short Form(DES-SF), and the MOS Social Support Survey (MOS-SSS). Statistical analyses in SPSS 26.0 included the Wilcoxon rank-sum test, Kruskal-Wallis H test, Spearman correlation analysis, and multiple linear regression analysis. A structural equation model was constructed using AMOS 24.0, and the mediating effect was tested through the bootstrap method.

The health literacy score was 53.00 (40.00, 61.00), the empowerment score was 31.00 (27.00, 36.00), and the social support score was 72.00 (61.00, 81.00) among the 243 patients with type 2 diabetes mellitus. Social support was positively correlated with health literacy (r=0.539, P<0.01), social support was positively correlated with empowerment (r=0.613, P<0.01), and empowerment was positively correlated with health literacy (r=0.597, P<0.01). Social support could directly and positively predict health literacy, and also indirectly predict health literacy through empowerment. The mediating effect value of empowerment was 1.036, accounting for 32.1% of the total effect.

Empowerment plays a partial mediating role between social support and health literacy in patients with type 2 diabetes mellitus. Therefore, by improving social support and strengthening empowerment, health literacy can be enhanced in patients with type 2 diabetes mellitus.

To explore the association between the number of living children and dementia among older adults, as well as the influence of social support and lifestyle on this association.

This study included 6 232 participants aged ≥65 years from the Hubei Memory and Aging Cohort, categorized by number of living children (0, 1-2, ≥3). Multivariable logistic regression was used to analyze the associations with dementia, stratified by residence, sex, education level, and personal monthly income, while also examining the modifying effects of social support and lifestyle habits.

Compared to older adults with 1-2 living children, those with no living children (OR=1.705, 95% CI: 1.205-2.412) and ≥3 living children (OR=1.344, 95% CI:1.030-1.753) had an increased risk of dementia. Stratified analysis revealed that compared with elderly people with 1-2 living children, those without living children in rural areas (OR=2.392, 95% CI: 1.544-3.707), males (OR=2.013, 95% CI: 1.190-3.404), females (OR=1.854, 95% CI: 1.094-3.144), those with low education levels (OR=1.859, 95% CI: 1.278-2.702), and those with low personal monthly income (OR=1.802, 95% CI: 1.211-2.682) had significantly higher risks of dementia. Among older adults with ≥3 living children, urban residents (OR=2.677, 95% CI: 1.557-4.603), males (OR=2.058, 95% CI: 1.259-3.363), those with higher education levels (OR=2.550, 95% CI: 1.298-5.009), and those with higher personal monthly income(OR=2.424, 95% CI: 1.096-5.361) all showed significantly elevated risks of dementia. Compared to older adults with poor social support and unhealthy lifestyles, the overall population with good social support (OR=0.569, 95% CI: 0.453-0.716) and healthy lifestyles (OR=0.485, 95% CI: 0.381-0.618) showed significantly lower dementia risk. Among childless older adults, those maintaining healthy lifestyles demonstrated even greater risk reduction (OR=0.515, 95% CI: 0.276-0.960). Among those with ≥3 living children, both good social support (OR=0.410, 95% CI: 0.306-0.549) and healthy lifestyles (OR=0.419, 95% CI: 0.307-0.573) were associated with the most substantial protective effects against dementia.

Older adults with no living children or ≥3 living children had significantly higher dementia risk compared to those with 1-2 living children. Compared with the elderly with 1-2 living children, the elderly in rural areas, males, females, with low education levels and low monthly personal income without living children, and urban elderly with ≥3 living children, males, and those with higher education levels and high monthly personal income had a higher risk of developing dementia. Good social support and healthy living habits were associated with a lower risk of dementia in the ungrouped population and elderly people with multiple children. Moreover,healthy living habits were also associated with a lower risk of dementia in the elderly without living children. No significant association was observed among those with 1-2 living children.

To explore the mediating roles of sleep duration and depressive symptoms in the relationship between instrumental activities of daily living (IADL) and self-rated health (SRH) among older adults.

A total of 8 363 older adults (≥60 years) from the 2020 China Health and Retirement Longitudinal Study (CHARLS) were included. Spearman’s rank correlation analysis was employed to assess correlations among IADL, sleep duration, depressive symptoms, and SRH. Bootstrap analysis was used to examine the mediating effects of sleep duration and depressive symptoms on the association between IADL and SRH.

IADL exerted a significant direct effect on SRH (β=-0.074, 95% CI: -0.081~-0.066). Significant mediating effects were observed for sleep duration alone (β=-0.002, 95% CI: -0.003~-0.001), depressive symptoms alone (β=-0.029, 95% CI: -0.032~-0.001), and the chained pathway through sleep duration and depressive symptoms (β=-0.002, 95% CI: -0.003~-0.001).

IADL limitations may directly and negatively impact SRH in older adults, and may also indirectly affect SRH through the independent or sequential mediating effects of sleep duration and depressive symptoms.Interventions aimed at enhancing IADL capacity, optimizing sleep duration, and alleviating depressive symptoms could improve SRH and promote physical and mental well-being among older adults.

To explore the mechanism of soy isoflavones (SIF) in improving memory in aging ovariectomized rats.

Forty 8-week-old SD female rats were randomly assigned to the sham control (CON), aging combined with ovariectomy(OVX/D-Gal), 160 mg/kg SIF (SIF) and 0.8 mg/kg estradiol replacement therapy (ERT). Except for the CON group, rats in other groups underwent bilateral ovariectomy combined with intraperitoneal injection of D-galactose (100 mg/kg·d) for 12 weeks.After the intervention, memory was assessed using the shuttle box test. Transmission electron microscopy was used to observe the synaptic ultrastructure of hippocampal neurons. The protein P53, PSD-95, GluA1, P38 and the phosph-P38 (p-P38)expressions were measured by Western blot. The levels of TNF-α and estradiol were detected by ELISA. One-way ANOVA method was used to analyze the overall differences. LSD method was used to analyze the pairwise comparison between groups with homogeneous variance, and Dunnett’s test was used to analyze those with uneven variance, with α=0.05.

Significant differences were observed among the groups in avoidance latency time (ALT), active avoidance response rate (AAR),synaptic interface curvature (SIC), synaptic cleft width (SCW), postsynaptic density (PSD) thickness, serum E2 levels, protein expressions of P53, PSD-95, GluA1 and P38 in the hippocampus, and p-P38/P38 (F-value=10.905, P-value<0.010; F-value=9.825, P-value<0.010; F-value=8.027, P-value<0.010; F-value=124.228, P-value<0.001; F-value=24.9810, P-value<0.001; F-value=16.410, P-value<0.001; F-value=5.667, P-value<0.050; F-value=6.091, P-value<0.050; F-value=8.766, P-value<0.050; F-value=25.218, P-value<0.001; F-value=19.014, P-value<0.001). Compared with CON group, rats in the OVX/D-Gal group exhibited significantly reduced serum E2 and increased hippocampal P53, accompanied by prolonged ALT and decreased AAR. The SIC and PSD thickness declined, and the SCW widened. The level of TNF-α and the ratio of p-P38/P38 in the hippocampus increased, while the protein expressions of P38, PSD-95 and GluA1 were decreased (all P-value<0.050).In the SIF group, there was no significant change in serum E2 level compared to the OVX/D-Gal group, while P53 expression was decreased. The ALT shortened and the AAR increased. Besides, higher SIC, increased PSD thickness, and narrower SCW were observed in the SIF group. The level of TNF-α and the ratio of p-P38/P38 in the hippocampus declined, while the protein expressions of PSD-95, GluA1 and P38 increased (all P-value<0.050).

SIF can improve the memory ability of aging rats with ovariectomy, which may be related to the enhancement of synaptic plasticity through inhibiting TNF-α and its downstream P38MAPK, thereby increasing GluA1 expression.

To compare and analyze the reported incidence of adverse events following immunization (AEFI) before and after the adjustment of the poliomyelitis immunization schedule in Tianjin.

We obtained AEFI case data and the vaccine doses for poliomyelitis vaccine from the Immunization Program Information System from May 2016 to December 2019(pre-adjustment) and from January 2020 to September 2024 (post-adjustment). Reported incidence rates were calculated and compared between the periods.

Before the adjustment, the reported incidence rates of AEFI in Tianjin were 37.00 per 100 000 doses for bOPV and 50.52 per 100 000 doses for IPV, the incidence rates of common adverse reactions were 30.06 per 100 000 doses (bOPV) and 43.87 per 100 000 doses (IPV), while those of abnormal reactions were 5.26 per 100 000 doses(bOPV) and 5.32 per 100 000 doses (IPV). After the adjustment, the reported incidence rates of AEFI declined to 26.70 per 100 000 doses for bOPV and 33.13 for IPV per 100 000 doses, the incidence rates of common adverse reactions were 21.10 per 100 000 doses (bOPV) and 28.24 per 100 000 doses (IPV), and abnormal reactions were 4.62 per 100 000 doses (bOPV) and 3.57 per 100 000 doses (IPV). There were statistically significant differences in the reported incidence of AEFI before and after the adjustment (χ²=7.45, P<0.01; χ²=24.20, P<0.01).

After the adjustment to the immunization strategy of polio vaccine in Tianjin, AEFI reporting rates decreased, with rare serious adverse reactions and favorable overall safety.

To analyze the drug resistance and molecular network characteristics of HIV/AIDS treatment failure patients in Urumqi City, and provide a theoretical basis for AIDS prevention and control.

A total of 1 281 patients who received antiviral treatment in AIDS antiviral designated medical institutions in Urumqi City from 2018 to 2023 and had a viral load (VL) ≥1 000 copies/mL were classified as treatment failure patients and included. The pol region gene of HIV-1 was amplified by nested PCR, and a phylogenetic tree was constructed using the neighbor-joining method. χ² text and logistic regression were used to analyze the factors related to drug resistance, and a molecular network was constructed using 1.5%optimal gene distance. The drug resistance mutation sites were analyzed through the online tool HIV drug resistance database of Stanford University in the United States.

Five gene subtypes were identified in 1 281 sequences, with the dominant subtype being CRF07_BC (92.58%). The HIV-1 resistance rate was 55.27%, while the resistance rates to Nucleoside reverse transcriptase inhibitors (NRTIs), Non-nucleoside reverse transcriptase inhibitors (NNRTIs), and Protease inhibitors (PIs) were 25.53%, 48.40%, and 7.57%. The main resistance sites were K103 (29.98%), M184 (22.79%), and Q58 (5.31%). Multivariable logistic regression indicated lower risk of drug resistance among females (OR=0.686, 95% CI=0.538-0.873), those aged 25-49 years (OR=0.444, 95% CI=0.245-0.804), patients on AZT+3TC+NVP/EFV (OR=0.506, 95% CI=0.375-0.683), and those with baseline CD4+ T-cell counts of 200-349 (cells/μL) (OR=0.547, 95% CI=0.400-0.750). By constructing a molecular network, a total of 62 transmission clusters were identified, with 402 patients entering the network, resulting in a network entry rate of 31.38%. A total of 173 patients developed drug resistance, with a resistance rate of 43.03%. Male patients had a higher network entry rate than female patients,and genetic subtypes CRF07_BC, CRF01_AE, and CRF55_01B all appeared in clusters.

The drug resistance rate of HIV/AIDS treatment failure patients in Urumqi is relatively high, and drug-resistant strains appear in clusters in the molecular network. It is necessary to strengthen drug resistance monitoring and reduce the clustered transmission of drug-resistant strains.

To investigate the association between the serum uric acid to albumin ratio (UAR) and hypertension.

This study included data from 23 552 U.S. adults from the NHANES database(2007—2016). Multivariable logistic regression models and smooth curve fitting were used to examine the linear and nonlinear relationships between UAR and hypertension. Threshold effect analysis was applied to identify inflection points, and subgroup analyses were conducted to assess the association across different populations. Finally, the diagnostic performance of UAR for hypertension was evaluated using receiver operating characteristic(ROC) curves.

After adjusting for all confounding factors, multivariable logistic regression analysis showed that higher UAR was significantly associated with an increased prevalence of hypertension (OR=1.11, 95% CI: 1.09-1.13). Compared with the low UAR group, the middle (OR=1.14, 95% CI: 1.05-1.24) and high (OR=1.46, 95% CI: 1.33-1.60) UAR groups had significantly increased risks of hypertension(P<0.05). Smooth curve fitting revealed a J-shaped nonlinear relationship between UAR and hypertension. Threshold effect analysis indicated that below the threshold of 4.66, UAR was negatively correlated with hypertension (OR=0.75, 95% CI: 0.61-0.92), whereas above 4.66, a positive correlation was observed (OR=1.12, 95% CI: 1.10-1.14). Consistent results were obtained in subgroup analyses, and interaction effects were observed across subgroups stratified by sex, age, alcohol consumption, BMI, and diabetes (P<0.05). The ROC curve demonstrated that UAR had moderate predictive ability for hypertension, with an area under the curve (AUC) of 0.639.

UAR is closely associated with hypertension and may serve as a promising biomarker for assessing early hypertension risk.

To investigate the longitudinal association between sarcopenic obesity and cardiovascular disease (CVD) in the elderly in China.

Data from the China Health and Retirement Longitudinal Study (CHARLS) from 2015 to 2020 were used. A total of 4 349 elderly people aged 60 years and above were enrolled and divided into four groups based on body roundness index (BRI) and sarcopenia status,namely (1) normal BRI without sarcopenia group; (2) normal BRI with sarcopenia group; (3) high BRI without sarcopenia group; and (4) high BRI with sarcopenia group. Kaplan-Meier curves were used to estimate the cumulative incidence of CVD, stroke, and heart disease at different times. Multivariable-adjusted Cox proportional hazards regression models were then used to control for confounding factors to analyze the associations between sarcopenic obesity status and CVD, stroke, and heart disease. Finally, subgroup analyses were performed to test the consistency of the association effects of the four groups on CVD, stroke, and cardiac events.

Based on different sarcopenic obesity status, Kaplan-Meier survival curves showed differences in cumulative incidence between different groups (P<0.001). After full adjustment of covariates, high BRI sarcopenia significantly increased the risk of CVD (HR=1.41, 95% CI: 1.14-1.75), stroke(HR=1.77, 95% CI: 1.26-2.49) and heart disease (HR=1.32, 95% CI: 1.03-1.69) compared with normal BRI without sarcopenia. This further proved that sarcopenic obesity was an important risk factor for CVD, stroke and heart disease. In the subgroup analysis, it was consistently found that high BRI with sarcopenia was associated and CVD, stroke and heart disease.

In the elderly population in China, high BRI with sarcopenia is significantly associated with the risk of CVD,stroke, and heart disease. It is recommended that preventing and improving sarcopenia, controlling weight and exercising moderately can help delay the progression of CVD and promote healthy aging in the elderly.