To investigate the longitudinal association between glycemic profile and the incidence of chronic kidney disease (CKD), as well as the impact of genetic susceptibility on this association.

Utilizing baseline survey and genetic data from the UK Biobank, Cox proportional hazards models were employed to assess the correlation between baseline hemoglobin A1c (HbA1c) levels and glycemic status with the onset of CKD, along with the role of genetic susceptibility in this relationship.

A total of 81 059 participants were included in this study, with 15.2% classified as prediabetic and 6.9%as diabetic. During a median follow-up period of 13.5 years, 3 637 new cases of CKD were observed. Multivariable-adjusted models indicated that both type 2 diabetes (T2D) and prediabetes significantly increased the risk of developing CKD compared to participants with normal blood glucose levels, with hazard ratios (HRs) and 95% confidence intervals (CIs) of 2.04 (95%CI:1.85-2.25) and 1.09 (95%CI: 1.00-1.18), respectively. A clear risk gradient was observed when HbA1c was below the diabetes threshold; participants with HbA1c ≥6.6% had approximately double the risk of CKD compared to those with HbA1c <5.0%. A significant multiplicative interaction between glycemic status and genetic risk was found (P _interaction <0.001). In all genetic risk groups, hyperglycemia significantly increased the risk of CKD. Among participants with high genetic risk, those with both T2D and high genetic risk exhibited the highest CKD risk (HR=6.67, 95%CI: 5.75-7.74) compared to those with low genetic risk and normal blood glucose.

Glycemic status is associated with the risk of CKD across all genetic risk groups.

To explore the association between blood pressure levels and the risk of stroke-related death in type 2 diabetic population.

A survey was carried out on 9 708 type 2 diabetic patients who participated in the chronic disease patient health management of basic public health services in Huai’an District and Qing jiang pu District (former Qing he District) of Huai’an city. Multivariate proportional-hazards Cox regression analysis was used to analyze the association between blood pressure levels and the risk of stroke-related death in type 2 diabetic patients, and further stratified analysis was carried out according to smoking, body mass index (BMI), central obesity, and dyslipidemia respectively. The follow-up duration was calculated from December 31, 2013 to December 31, 2020, and death from stroke (I60-I69) was defined as the end-point event.

The follow-up duration was 63 833.8 person-years, and the stroke death density was 5.4 per 1 000 person-years. After adjusting for relevant confounding factors, taking the normal blood pressure group as the reference, the HR value of the stroke-related death risk in the grade III hypertension group was 4.45 (95%CI: 2.09-9.48). The stratified analysis results showed that compared with the normal blood pressure group, among smokers, those with BMI ≥ 24.0 kg/m², those with central obesity, and those with dyslipidemia, the stroke-related death risks in the grade III hypertension group increased by 3.12 (HR=4.12, 95%CI:1.16-14.67), 1.97 (HR=2.97, 95%CI: 1.26-7.00), 3.19 (HR=4.19, 95%CI: 1.27-13.86), and 5.49 (HR=6.49, 95%CI: 1.97-21.43) times, respectively. Sensitivity analysis was carried out by excluding the baseline stroke patients, participants who died in the first year of follow-up, and those over 80 years old, and a significant positive relationship between blood pressure levels and the risk of stroke-related death was found.

Elevated blood pressure levels will increase the risk of stroke-related death in type 2 diabetic patients, and there is a positive relationship between blood pressure levels and the risk of death. Among type 2 diabetic patients, those with low BMI have a higher risk of stroke-related death than those with high BMI.

To construct a mitochondrial-related risk assessment model to explore the impact of mitochondria on the survival of patients with non-small cell lung cancer (NSCLC), predict immune status, and evaluate its potential value.

Mitochondrial and NSCLC-related data were downloaded from the MitoCarta3.0 database and The Cancer Genome Atlas (TCGA) database, respectively. Differentially expressed mitochondrial-related genes were screened, and a risk scoring model was constructed using Cox regression analysis. Based on the median risk score, NSCLC patients in the TCGA database were divided into high-risk and low-risk groups. The validity of the prognostic model was verified using Kaplan-Meier analysis, receiver operating characteristic (ROC) curves, clinical case feature analysis, and immune status assessment.

A total of 320 mitochondrial-related genes were obtained from NSCLC samples. Four key model genes (TIMM10, CYP24A1, BCL2L10, ACSM5) were selected through COX analysis, leading to the construction of a nomogram prediction model for NSCLC. Immune cell infiltration assessment revealed a negative correlation between risk scores and the enrichment of T cells, B cells, and macrophages; conversely, the enrichment of resting mast cells, cancer-associated fibroblasts, and myeloid progenitor cells was positively correlated with risk scores. Patients in the high-risk group had shorter overall survival and exhibited higher levels of immune suppressive cell infiltration. Validation of the IMvigor210 immunotherapy model showed significant differences in survival probabilities between high-risk and low-risk groups in bladder cancer.

This study established a mitochondrial gene risk scoring model for predicting the prognosis of NSCLC. TIMM10,CYP24A1, BCL2L10, and ACSM5 are promising potential targets for further research on NSCLC.

To describe the changes in the burden of depression among Chinese residents from 1990 to 2021 and to forecast future trends, providing reference for the prevention and control of depression.

Based on the 2021 Global Burden of Disease data, indicators such as the number of cases, incidence rate, prevalence rate, and disability-adjusted life years (DALYs) along with DALYs rates were selected to calculate the rate of change. The Join point regression model was employed to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to analyze the trend of disease burden. Future trends were predicted using R software combined with the GM (1,1) model.

In 2021, the total number of depression cases in China was approximately 42.36 million, with an incidence rate of 2 977.354 per 100 000 and a standardized incidence rate of 2 345.079 per 100 000. The total DALYs attributed to depression were 7.8659 million years, with a total DALYs rate of 552.87 per 100 000 and a standardized DALYs rate of 430.61 per 100 000. Compared to 1990, the standardized prevalence rates for the total population, males, and females decreased by 6.39%, 2.4%, and 9.17%, respectively; the standardized incidence rates decreased by 10.79%, 3.96%, and 14.93%; and the standardized DALYs rates decreased by 9.02%, 3.85%, and 12.43%. Join point regression analysis indicated that from 1990 to 1995 and from 2010 to 2015, the standardized incidence rate of depression among the total population in China showed an increasing trend (APC of 1.56% and 1.37%, respectively), while from 1995 to 2000 and 2005 to 2010, it exhibited a decreasing trend (APC of -2.74% and -1.45%,respectively). The standardized prevalence rates from 1990 to 1992, 1992 to 1995, and 2019 to 2021 all showed an upward trend (APC of 1.67%, 0.48%, and 0.96%, respectively), whereas from 1995 to 2000, 2000 to 2005, 2005 to 2010, and 2010 to 2019, they demonstrated a downward trend (APC of -1.06%, -0.22%, -1.02%, and -0.15%, respectively). The standardized DALYs rate increased from 1990 to 1994 (APC of 1.75%) and showed a decreasing trend from 1994 to 2000 and from 2000 to 2006 (APC of-1.55% and -0.46%, respectively).

The burden of depression among Chinese residents is increasing, with a higher burden observed in females. The risk of depression among the elderly should not be overlooked. Continued efforts are needed to enhance public awareness of depression-related health knowledge and implement preventive interventions.

To analyze the correlation between changes in uric acid trajectories in a male population undergoing health check-ups and the occurrence of hypertension, diabetes, and dyslipidemia.

This study selected 5 316 male subjects who met the inclusion and exclusion criteria from the Health Management Center of The Second Affiliated Hospital of Dalian Medical University over a ten-year period from 2012 to 2022. A group-based trajectory model (GBTM) was constructed based on uric acid levels, and the Cox proportional hazards regression model was utilized to analyze the risks of developing hypertension, diabetes, and dyslipidemia across different uric acid trajectory groups.

The study participants were categorized into low stable, low increasing, moderate increasing, and high increasing groups. The incidence of hypertension in the high increasing group was significantly higher than that in the low stable group. After adjusting for confounding factors, the Cox proportional hazards regression analysis indicated that the risk of developing hypertension in the high increasing group was 1.51 times (95%CI: 1.20-1.91, P<0.001) compared to the low stable group. However, no significant correlation was found between changes in uric acid trajectories and the occurrence of diabetes. A significant correlation was observed between changes in uric acid trajectories and dyslipidemia; as uric acid levels increased, the incidence of dyslipidemia also rose. After adjusting for confounding factors, the Cox proportional hazards regression analysis revealed that the risk of developing dyslipidemia in the high increasing group was 1.75 times (95%CI: 1.44-2.12, P<0.001) compared to the low stable group.

Among male individuals undergoing health check-ups, there is a correlation between uric acid trajectories and hypertension as well as dyslipidemia, yet no significant correlation with the occurrence of diabetes.

To explore the relationship between uric acid and the risk of hepatic steatosis and non-alcoholic fatty liver disease (NAFLD), providing new insights for the prevention of NAFLD.

Utilizing data from the 2017-2018 NHANES population and summary data from genome-wide association studies (GWAS), the association between uric acid and the risk of hepatic steatosis and NAFLD was analyzed using restricted cubic spline models, generalized linear models, and binary logistic regression models. The inverse variance weighted method was employed as the primary approach for Mendelian randomization (MR) analysis to assess the causal relationship between uric acid and NAFLD. Additional verification of results was conducted using MR Egger regression, weighted median methods, simple models, and weighted models, followed by sensitivity testing.

After adjusting for all covariates, a linear relationship was observed between uric acid and the risks of hepatic steatosis and NAFLD (P_non-linear > 0.05). Populations with higher uric acid levels exhibited increased risks of hepatic steatosis (β=3.559,95%CI: 1.722-5.395, P < 0.001) and NAFLD (OR=1.151, 95%CI: 1.048-1.265, P=0.003). The MR analysis using the inverse variance weighted method indicated a causal relationship between uric acid and NAFLD (OR=1.68, 95%CI: 1.01-2.81, P=0.049),with the other four analytical methods providing similar directional causal inferences. Sensitivity tests suggested no significant heterogeneity or horizontal pleiotropy among instrumental variables (P > 0.05), and the results were not influenced by individual genetic variations.

Uric acid is positively linearly correlated with the risk of hepatic steatosis and NAFLD, indicating that controlling uric acid levels may play a crucial role in the prevention and management of NAFLD.

To analyze and assess the characteristics of the infected population and the disease burden of clonorchiosis in a city of the Pearl River Delta, providing a scientific basis for future prevention and control strategies.

Based on population monitoring and medical institution data from 2019 to 2023 regarding clonorchiosis in the city, infection rates and prevalence proportions were calculated for different genders and age groups. The characteristics of patients seeking medical attention were described, and the disease burden was evaluated using Disability-adjusted Life Years (DALYs).

The overall infection rate for clonorchiosis in the surveyed population from 2019 to 2023 was 8.32%, with a male infection rate of 12.50% and a female infection rate of 4.84%, showing a statistically significant difference (χ²=98.54, P<0.001). The weighted infection rate was 7.87% [95% Confidence Interval (CI): 5.67%-10.06%]. The weighted infection rates across various age groups ranged from 0.09% to 16.18%, with higher rates observed in individuals over 40 years of age. The majority of infections were mild (97.00%), while moderate and severe infections were less common. The annual DALYs lost due to clonorchiosis were 14 399.10 for males and 4 606.71 for females, totaling 19 005.81, equating to a loss of 4.76 DALYs per 1 000 people per year.From 2019 to 2023, a total of 3 193 cases of clonorchiosis sought medical attention, primarily through outpatient services (95.49%). The proportions of complications such as cholelithiasis, cholecystitis, cholangitis, liver cysts, gallbladder polyps, cholecystectomy, gallbladder hypertrophy, and cholangiocarcinoma were 1.16%, 0.60%, 0.53%, 0.22%, 0.06%, 0.06%, 0.00%,and 0.00%, respectively. The average outpatient medical cost was 155.62 yuan, while the average inpatient medical cost was 6 545.97 yuan.

The burden of clonorchiosis in the city of the Pearl River Delta is significant, characterized by a high population infection rate, primarily among males, middle-aged and elderly individuals, and mild infections. Future efforts should focus on public education, screening, and treatment for at-risk populations.

To analyze the current status and trends of the burden of respiratory syncytial virus (RSV) lower respiratory tract infections in China from 1992 to 2021, providing a reference for the prevention and control of RSV infections in the country.

The burden of disease was assessed using disability-adjusted life years (DALYs). Data on DALYs for RSV lower respiratory tract infections in China from 1992 to 2021 were extracted from the 2021 Global Burden of Disease Study database. Join point regression analysis was employed to evaluate trends in disease burden, and an age-period-cohort (APC) model was constructed to explore the impacts of age, period, and birth cohort on disease burden.

In 2021, the DALYs rate for RSV lower respiratory tract infections in China was 3.08 per 100 000, with the highest DALYs number (35 400 person-years) and rate (45.63 per 100 000) observed in the 0-4 age group, followed by those aged 65 and older (5 300 person-years, 2.68 per 100 000). From 1992 to 2021, the DALYs rate for RSV lower respiratory tract infections in China showed a declining trend (AAPC=-12.96%, P<0.001), with the DALYs rate remaining relatively stable from 2012 to 2016 (AAPC=-1.61%, P=0.198), while other intervals exhibited a downward trend, particularly from 2019 to 2021, which had the most significant decline (AAPC=-57.90%, P<0.001). Among different age groups, the 0-4 age group experienced the largest decrease in DALYs rate (AAPC=-12.02%, P<0.001), whereas the decline was the smallest in those aged 65 and older (AAPC=-5.19%, P<0.001). The APC model indicated that age, period, and birth cohort effects influenced the changes in DALYs rates for RSV lower respiratory tract infections in China, with DALYs rates initially decreasing and then increasing with age, while declining with advancing periods and shifting birth cohorts.

The burden of RSV lower respiratory tract infections in China showed a downward trend from 1992 to 2021, predominantly affecting children and the elderly.

To analyze the external exposure levels of nitrate in rural drinking water in Guangdong Province and provide technical support for the safety management of rural water supply.

Monitoring was conducted on the finished water and terminal water from rural drinking water supply units in Guangdong Province from 2018 to 2022. The compliance of nitrate levels in water quality was evaluated according to the Standards for Drinking Water Quality (GB 5749-2022). The Kolmogorov-Smirnov test was used to determine the normality of the data. For non-normally distributed data, the median was used for description. The chisquare test or Fisher’s exact test was employed to analyze differences in rates between groups. The Mann-Whitney U test was used to compare nitrate exposure levels between two groups, and the Kruskal-Wallis H test was applied for comparisons among multiple groups.

A total of 62 998 water samples were monitored, with an overall compliance rate of 99.52%. The nitrate exposure levels ranged from 0.001 to 63.80 mg/L. Significant differences in nitrate exposure levels were observed across different years (H=445.586, P<0.01), regions (H=2 050.151, P<0.01), water source types (Z=-5.268, P<0.01), sample types (Z=-11.888, P<0.05), water supply capacities (Z=-33.794, P<0.01), water treatment methods (H=27.750, P<0.01), and the presence or absence of advanced treatment (Z=-2.121, P<0.05).

The overall compliance rate of nitrate levels in rural drinking water in Guangdong Province is relatively high. However, special attention should be paid to nitrate pollution in certain areas of western and eastern Guangdong, groundwater sources, decentralized and small-scale centralized water supplies, as well as the high exposure risks for infants and young children.

To investigate the association between blood ethylene oxide exposure levels and sleep disorders.

Utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2015-2018, this study selected adults aged 18 and older. The relationship between blood ethylene oxide exposure levels and sleep disorders was analyzed using multivariable logistic regression, subgroup analysis, interaction analysis, and restricted cubic spline analysis.

A total of 2 579 participants were included, with a median blood ethylene oxide exposure concentration of 21.76 pmol/g Hb, and 753 (29.2%) individuals reported sleep disorders. Multivariable logistic regression indicated that compared to the lowest quartile, the risk of sleep disorders increased by 94% in the highest quartile of blood ethylene oxide exposure (OR=1.94, 95%CI: 1.27-2.95, P=0.012). Subgroup analysis revealed a significant association between ethylene oxide exposure and sleep disorders among women, individuals aged 40 to 59, those of other races, individuals with a poverty ratio of 1.3 to 3.5, those with an education level of high school or below or possessing a college degree, individuals engaging in moderate physical activity, and the unmarried population.Interaction analysis showed that these factors did not exhibit interaction effects on sleep. Restricted cubic spline analysis indicated no nonlinear association between ethylene oxide exposure levels and the occurrence of sleep disorders (P_non-linear=0.09).

There is a significant positive correlation between high blood ethylene oxide exposure levels and sleep disorders.

To explore the influence and lag effects of different groups of relative humidity, temperature, atmospheric pollutants and their interactions on respiratory disease mortality in a basin city in southwest China under a subtropical humid climate.

Daily meteorological, air pollutant and respiratory-related mortality data of residents in a city in southwest China from 2018 to 2022 were collected, and time-series analysis was carried out using the distributed lag-wise nonlinear model (DLNM) with quasi-Poisson distribution and the generalized additive model (GAM).

A total of 11 779 people died of respiratory diseases in this city. At lag15, when the SO₂ concentration increased by 10 μg/m³, the impact on the respiratory disease mortality of the population was the greatest, with RR=1.055 (95%CI: 0.993-1.120). In the single-factor grouped lag model, in the extremely high-temperature group (≥P₉₅), when the temperature increased by 1 °C, the impact on respiratory disease mortality was the greatest at lag0, which was 1.710(95%CI: 1.209-2.418). In the multi-factor model, when SO₂ and NO₂ were taken as synergistic factors, the impact of relative humidity on respiratory mortality was the greatest at lag18, which was 1.026 (95%CI: 1.000-1.053), and the RR of temperature on mortality was the greatest at lag0, which was 1.024 (95%CI: 1.010-1.038). Interaction analysis showed that there were interactions among relative humidity, temperature and various pollutants, and the mortality risk generated by the interaction between 60%-80% humidity level and SO₂ and NO₂ was the greatest.

Each factor has an independent influence and lag effect on respiratory disease mortality.The interactions between different humidity levels and pollutants have different impacts on respiratory disease mortality and may have synergistic or antagonistic effects. Among them, the mortality risk generated by the interaction between medium humidity level and pollutants is the greatest, while the impact generated by the interaction between high humidity and pollutants is instead reduced.

To analyze the status of antiretroviral therapy (ART), survival outcomes, and influencing factors among HIV-infected children in Guangxi.

A retrospective cohort study was conducted, incorporating data from HIV-infected children aged ≤14 years in Guangxi, including treatment status, survival time, and influencing factors. Logistic regression and Cox proportional hazards regression models were employed for statistical analysis.

A total of 472 HIV-infected children were included, with 27 deaths reported. All children received ART. Factors such as age and clinical stage at diagnosis influenced the risk of delayed initiation of treatment. Survival analysis revealed that baseline CD4+ T-cell levels, clinical stage, and treatment regimen were key determinants of survival time. Children with baseline CD4+ T-cell counts >350 cells/μL had longer survival time compared to those with counts <200 cells/μL (aHR=0.31, 95%CI: 0.13-0.74). Children in WHO clinical stage IV had shorter survival times than those in stage I (aHR=3.22, 95%CI: 1.24-12.2). Additionally, children treated with the 3TC+ABC+LPV/r regimen had shorter survival time than those treated with the 3TC+AZT+EFV regimen (aHR=4.26, 95%CI: 1.16-15.61).

The coverage of ART among HIV-infected children in Guangxi is high, with relatively favorable survival rates. However, efforts should be intensified to educate caregivers and initiate treatment early, optimize treatment regimens, and improve quality of life.

To explore the mediating role of self-efficacy between social support and coping styles in female patients with stress urinary incontinence (SUI) and to provide a reference for clinical interventions.

A total of 128 female SUI patients admitted to the People’s Hospital of Xinjiang Uygur Autonomous Region from January 2022 to January 2024 were selected. General information was collected using a self-designed questionnaire. The Perceived Social Support Scale (PSSS) was used to assess social support, the General Self-Efficacy Scale (GSES) to evaluate self-efficacy, and the Simplified Coping Style Questionnaire (SCSQ) to measure coping styles. Correlation analysis and structural equation modeling were employed to analyze the mediating effect of self-efficacy.

Patients aged ≤60 years had higher GSES scores, positive SCSQ scores, total PSSS scores, and scores on its three subscales compared to those aged >60 years, while their negative SCSQ scores were lower (P < 0.05). Correlation analysis revealed that GSES scores were positively correlated with PSSS scores and positive SCSQ scores but negatively correlated with negative SCSQ scores in both age groups (r=-0.601, P < 0.05). PSSS scores were positively correlated with positive SCSQ scores (r=0.650, P < 0.05) and negatively correlated with negative SCSQ scores in both age groups. The Amos 24.0 maximum likelihood estimation method was used to construct a mediation model, showing that self-efficacy had a positive effect on positive coping styles (effect values: 0.62 and 0.56 for ≤60 and >60 years, respectively) and a negative effect on negative coping styles (effect values: -0.50 and -0.45, respectively). Social support positively influenced self-efficacy (effect values: 0.59 and 0.65, respectively), while positive coping styles positively influenced social support (effect values: 0.57 and 0.60, respectively), and negative coping styles negatively influenced social support (effect values: -0.40 and-0.51, respectively).

Self-efficacy mediates the relationship between social support and coping styles in female SUI patients, and age significantly affects self-efficacy and coping styles. Enhancing patients’ social support and self-efficacy can promote the adoption of positive coping styles, thereby improving clinical outcomes.

To construct a structural equation model to explore the pathways of factors influencing fertility behavior among nulliparous couples of reproductive ages, providing direction for medical interventions aimed at fertility pathways.

A cross-sectional study was conducted using convenience sampling, selecting 400 nulliparous couples of reproductive ages from the permanent residents of Chengde city, Hebei Province. Data were collected through general demographic questionnaires, the Childbirth Fear Scale, the Social Support Rating Scale, the Fertility Motivation Questionnaire, and the Fertility Intention-Behavior Questionnaire. Path analysis and mediation effect testing were performed using structural equation modeling.

The constructed structural equation model demonstrated good overall fit. Childbirth fear negatively predicted fertility motivation, intention, and behavior (β values of -0.245, -0.120, and -0.123, respectively), while social support positively predicted fertility motivation, intention, and behavior (β values of 0.247, 0.145, and 0.149, respectively). Fertility motivation positively predicted fertility intention (β value of 0.816), and fertility intention positively predicted fertility behavior (β value of 0.760).

Childbirth fear and social support among nulliparous couples of reproductive ages can indirectly influence fertility behavior through fertility motivation and intention. Medical institutions should strengthen collaboration with community efforts to develop targeted intervention measures that alleviate childbirth concerns among the reproductive population and promote positive fertility behaviors.

To understand the epidemiological characteristics of cervical cancer mortality among women in Jinan city, providing reference for the prevention and control of cervical cancer.

Data on cervical cancer mortality among women in Jinan from 2011 to 2023 were collected. Using SPSS 20.0 software, mortality rates were calculated for urban and rural areas, age-standardized mortality rates for women aged 35 to 64, cumulative mortality rates for those aged 0 to 74, and years of life lost (YLL) due to premature death. The annual average percentage change (AAPC) was employed to analyze trends in cervical cancer mortality.

From 2011 to 2023, the cervical cancer mortality rate for women was 3.05 per 100 000, with a standardized mortality rate of 1.83 per 100 000 and an average age at death of 61.65 years. The truncated mortality rate was 3.36 per 100 000, and the cumulative mortality rate was 0.20%. The mortality rate, standardized mortality rate, proportion of total malignant tumors, truncated mortality rate, and cumulative mortality rate for cervical cancer all exhibited an upward trend, while the age at death showed a downward trend. Mortality rates gradually increased after the age of 30, peaking in the 75 to 79 age group. The cervical cancer mortality rate and YLL rate among women aged 45 to 59 in urban areas and those over 60 in rural areas also showed increasing trends.

The cervical cancer mortality rate in Jinan city is on the rise, with notable urban-rural disparities. Targeted tertiary prevention measures should be implemented to effectively reduce the incidence and mortality rates of cervical cancer.

To explore the relationship between sleep quality and depression among elderly individuals in Shanghai’s communities, as well as the mediating role of physical activity.

A multi-stage cluster sampling method was employed to survey 2 500 elderly individuals aged 60 and above in Hongkou District, Shanghai. A self-developed demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Physical Activity Scale for the Elderly (PASE), and the Geriatric Depression Scale (GDS) were used for data collection. Pearson correlation analysis and linear regression analysis were conducted to investigate the relationships among sleep quality, physical activity, and depression, while the mediating effect of physical activity was tested using the PROCESS macro in SPSS 27.0.

The average sleep quality score among community-dwelling elderly in Shanghai was 6.11±2.90, the physical activity level score was 156.23±96.67, and the depression score was 4.01±5.40. A positive correlation was identified between sleep quality and depression (r=0.488, P < 0.001), while a negative correlation existed between physical activity level and depressive symptoms (r=-0.414, P < 0.001). Physical activity partially mediated the relationship between sleep quality and depression, accounting for 8.79% of the total effect.

Sleep quality and depression are closely related among community-dwelling elderly in Shanghai, with physical activity playing a partial mediating role. Enhancing sleep quality and physical activity levels among the elderly may help prevent and alleviate depression.

To explore the relationship between body mass index (BMI) trajectories and cognitive impairment and cognitive function in the elderly in China.

Based on data from the China Health and Retirement Longitudinal Study (CHARLS) from 2005 to 2018, a sample of 6 423 elderly individuals was selected. Group-based trajectory modeling was employed to construct BMI trajectories, and Cox proportional hazards regression models were used to analyze the relationship between BMI trajectories and the risk of cognitive impairment. Generalized linear models were applied to examine the relationship between BMI trajectories and cognitive function.

Three BMI trajectory groups were identified among males: “Normal-Stable Group (57.59%)”, “Normal-Overweight Group (36.27%)”, and “Overweight-Stable Group (6.13%)”. Among females, three BMI trajectory groups were identified:“Normal-Stable Group (68.14%)”, “Normal-Overweight Group (26.70%)”, and “Overweight-Obese Group (5.16%)”. Using the Normal-Stable Group as reference, after adjusting for confounding factors, the risk of cognitive impairment for males in the Normal-Overweight Group and Overweight-Stable Group was [HR (95%CI)] 0.76 (0.64-0.91), P<0.01 and 0.65 (0.43-0.99), P<0.05,respectively. For females, the risk of cognitive impairment in the Normal-Overweight Group and Overweight-Obese Group was [HR(95%CI)] 0.74 (0.63-0.87), P<0.001 and 0.70 (0.50-0.99), P<0.05, respectively. Cognitive function scores for males in the Normal-Overweight Group and Overweight-Stable Group increased by 0.66 (0.42-0.89) points, P<0.001 and 0.78 (0.32-1.24) points, P<0.01,respectively. For females, cognitive function scores in the Normal-Overweight Group and Overweight-Obese Group increased by 1.19(0.91-1.46) points, P<0.001 and 1.44 (0.91-1.96) points, P<0.001, respectively.

There is heterogeneity in the BMI trajectories of the elderly in China, and the classification of BMI trajectories is significantly associated with cognitive impairment and cognitive function. Trajectories of increasing BMI are associated with a reduced risk of cognitive impairment, and cognitive function is generally higher in populations where BMI remains at normal levels.

To clarify the current status of diabetes management and services in primary healthcare institutions, explore the factors influencing their diabetes service capacity, and provide theoretical references for enhancing this capacity.

In-depth interviews were conducted involving 28 participants, including administrators, medical staff, and diabetic patients from four primary healthcare institutions in a district of Chengdu. Grounded theory was employed to summarize and refine the factors affecting diabetes service capacity in these institutions.

Through three-level coding, 24 initial categories, 7 main categories, and 3 core categories were identified, leading to the construction of a theoretical framework for the"Influencing Factors Model of Diabetes Service Capacity in Primary Healthcare Institutions." The current status of the sample institutions was analyzed across three dimensions: resource allocation, policy support, and daily operations.

The diabetes service capacity of primary healthcare institutions in the studied district of Chengdu is influenced by resource allocation, policy support, and daily operations. To enhance this capacity, measures such as strengthening daily operations, improving policy support mechanisms, and optimizing the allocation of human and material resources should be implemented.

To analyze the impact of smart healthcare on the health of middle-aged and elderly individuals and to provide references for exploring pathways to healthy aging.

The smart city pilot programs were treated as a quasi-natural experiment for smart healthcare. Utilizing data from the China Health and Retirement Longitudinal Study, this research employed the difference-in-differences approach and an improved mediation effect model to examine the impact of smart healthcare on the health of middle-aged and elderly individuals and the mechanisms involved.

Smart healthcare significantly improved the health levels of middle-aged and elderly individuals (P<0.05). Enhancing self-health management and promoting the utilization of medical services were important mechanisms through which smart healthcare improved health outcomes.

Smart healthcare has a positive impact on the health of middle-aged and elderly individuals, with variations observed among different subgroups. It is essential to eliminate barriers to the application of smart technologies, bridge the digital divide among the elderly population, and advance equitable access to healthcare services.

To explore the effects of self-rated health and self-care ability, as well as their interaction, on depression symptoms in the elderly.

Based on data from the 2020 China Health and Retirement Longitudinal Study, relevant data from 8 948 individuals aged 65 and above were collected. Statistical analyses were conducted using chi-square tests and multivariate logistic regression, followed by interaction analysis using an additive model.

Among the elderly, 3 616 (40.41%) exhibited depression symptoms. After adjusting for gender, age, education level, marital status, living area, exercise habits, and sleep conditions, the regression model indicated that self-rated health (OR=2.60, 95%CI: 2.34-2.89) and self-care ability (OR=2.32, 95%CI: 2.10-2.56) were independent risk factors for depression symptoms in the elderly (P<0.001). The interaction analysis revealed a synergistic additive interaction between self-rated health and self-care ability (OR=5.98, 95%CI: 5.27-6.79),with the excess relative risk, attributable proportion of interaction, and interaction index being 1.92 (95%CI: 1.65-2.71), 0.32(95%CI: 0.21-0.41), and 1.63 (95%CI: 1.34-1.97), respectively.

Poor self-rated health and impaired self-care ability both increase the risk of depression in the elderly, and there is a synergistic additive interaction between the two. Efforts to prevent and treat depression in the elderly should focus on improving their self-rated health and self-care ability.

To investigate the current situation of resource allocation for early diagnosis and treatment of upper gastrointestinal cancers in public hospitals at different levels in Sichuan Province, and to provide suggestions for further promoting the early diagnosis and treatment projects of upper gastrointestinal cancers and improving the screening quality.

A questionnaire survey was conducted on public hospitals in Sichuan Province that undertook opportunistic screening for upper gastrointestinal cancers in 2023, and the diagnosis and treatment capabilities, hardware capabilities and staffing situations of upper gastrointestinal cancer early diagnosis and treatment in hospitals at different levels were compared and analyzed.

The average annual total number of gastroscopy diagnosis and treatment in 78 hospitals was 8 400.82 person-times. In total 96.15% of the hospitals had an independent endoscopy department, and 87.18% of the hospitals had an independent pathology department. On average, there were 3.29 endoscopy hosts, 10.19 gastroscopes, with an average of 6.97 endoscopy physicians, 4.14 pathologists and 5.41 endoscopy nurses. The higher the hospital level, the higher the relevant indicators of diagnosis and treatment capabilities, hardware capabilities and staffing.

The overall situation of resource allocation for early diagnosis and treatment in public hospitals in Sichuan Province is good, but it is necessary to strengthen the construction of pathology departments and focus on optimizing the resource allocation for early diagnosis and treatment of upper gastrointestinal cancers in secondary hospitals.

To explore the impact of follow-up management on blood pressure control in hypertensive patients in Sichuan Province, so as to improve the blood pressure control rate in the population.

Based on the data of the Seventh National Health Service Survey in Sichuan province, 3 587 hypertensive patients were included. Descriptive statistical analysis was used to analyze the follow-up management situation, demographic characteristics, lifestyle behaviors and health status of patients. Combined with the multivariate logistic regression model, the follow-up management factors affecting blood pressure control were explored.

The blood pressure control rate was 68.9%. Among the effectively controlled patients, the rate of taking medications regularly as prescribed was 84.6%, the proportion of those with a follow-up frequency of ≥4 was 71.4%, and the rate of family doctor-signed home visits was 48.1%. Among the patients not effectively controlled, the rate of taking medications regularly as prescribed was 73.4%, the proportion of those with a follow-up frequency of ≥4 was 67.6%, and the rate of family doctor-signed home visits was 45.2%. Multivariate Logistic regression analysis showed that not taking medications regularly as prescribed (OR=1.742, 95%CI:1.453-2.089), a follow-up frequency of <4 (OR=1.287, 95%CI: 1.057-1.567) and other follow-up methods (OR=1.286, 95%CI:1.092-1.516) had significant negative impacts on the blood pressure control effect of patients.

Follow-up management of hypertension is beneficial to blood pressure control. The follow-up frequency should be optimized, drug compliance should be improved, and the interaction between the signed doctor and the patient should be enhanced.

To explore the bidirectional relationship between depression symptoms and physical functional impairment trajectories in Chinese elderly individuals.

Utilizing data from four waves of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011, 2013, 2015, and 2018, we employed group-based trajectory modeling to identify distinct trajectory groups for depression symptoms and physical functional impairment among the elderly. A dual trajectory model was then used to assess the degree of association between these trajectory groups.

The group-based trajectory model categorized depression symptoms into four groups: consistently low depression symptoms, decreasing depression symptoms, increasing depression symptoms, and consistently high depression symptoms. Physical functional impairment was classified into four groups: no physical functional impairment, worsening physical functional impairment, improving physical functional impairment, and high physical functional impairment. Dual trajectory analysis revealed that 44.86% of individuals in the decreasing depression symptoms group followed the improving physical functional impairment trajectory; conversely, 37.58% of individuals in the increasing depression symptoms group followed the worsening physical functional impairment trajectory. Among those in the worsening physical functional impairment group, 47.8% followed the increasing depression symptoms trajectory, while 41.9% of individuals in the improving physical functional impairment group followed the decreasing depression symptoms trajectory.

In most cases, there is a positive correlation between the trajectories of depression symptoms and physical functional impairment. A decrease in depression symptoms is typically associated with an improvement in physical functional impairment, while an increase in depression symptoms corresponds with a worsening of physical functional impairment, and vice versa.

To analyze the relationship between residual cholesterol (RC) and metabolically associated fatty liver disease (MAFLD) in the elderly population of Zhongshan, and to explore the potential application value of RC in the diagnosis of MAFLD in older adults.

A cluster sampling method was employed to select elderly individuals aged 60 and above who underwent health check-ups at two community hospitals in Zhongshan, Guangdong Province. Baseline data were collected through questionnaire surveys, physical examinations, and laboratory tests. Multivariable logistic regression analysis was used to assess the association between RC and MAFLD, and a restricted cubic spline model was utilized to further analyze the dose-response relationship between RC and MAFLD.

A total of 6 756 elderly individuals were recruited, with an overall prevalence of MAFLD at 31.0%, higher in females (35.0%) than in males (24.7%). After adjusting for confounding factors, logistic regression analysis indicated that RC, treated as a continuous variable (OR: 1.70, 95%CI: 1.47-1.97), was positively associated with the risk of MAFLD. As a categorical variable, the highest RC group (OR: 2.13, 95%CI: 1.72-2.63) also showed a positive correlation with MAFLD risk. A non-linear relationship was observed between RC levels and MAFLD (P _overalltrend <0.001, P _{non-linearity} < 0.05), with a more pronounced risk increase in males (male OR: 1.83, 95%CI: 1.42-2.38 vs. female OR: 1.64,95%CI: 1.36-1.96).

RC is an independent risk factor for MAFLD in the elderly, and there exists a non-linear dose-response relationship between the two. The impact of RC levels on MAFLD risk is particularly significant in elderly males. Monitoring and managing RC is of great clinical significance in the prevention and treatment of MAFLD in older adults.

To conduct genetic typing of Mycobacterium tuberculosis (MTB) in Guizhou Province using the MLVA technique based on 24 VNTR loci, to identify VNTR typing loci suitable for Guizhou MTB strains, and to establish a high-resolution, user-friendly MLVA typing model for MTB. This model will provide technical means for tracing the sources, transmission, and prevention and control of tuberculosis in Guizhou Province.

A total of 124 MTB strains were collected from Guizhou Province. PCR amplification was performed using 24 internationally recognized VNTR loci for MTB, followed by analysis of the amplification products using capillary electrophoresis. The number of repeats at each locus was counted, and allele polymorphism and the discriminatory index for each locus were calculated. Clustering analysis of the tested strains was conducted using BIONUMERICS 8.0 to explore the typing characteristics of MTB in Guizhou Province based on 24-VNTR, 15-VNTR, 12-VNTR, and 8-VNTR.

The allele polymorphism and discriminatory index of the 24 VNTR loci indicated that seven loci, including QUB-11b, had high discriminatory power, eleven loci, including MIRU-10, had moderate power, and six loci, including MIRU-20, had low power. Furthermore, clustering analysis revealed that the 24-VNTR typing exhibited the highest discriminatory ability at 95.16% (118/124), approaching the level of single strain identification, followed by 15-VNTR at 91.13% (113/124), 12-VNTR at 90.32% (112/124), and 8-VNTR at 83.06% (103/124). All four VNTR typing models successfully categorized the 124 MTB strains into four clusters.

This study identified six high-resolution loci, including QUB-11b, as the preferred VNTR loci for MLVA typing of MTB strains in Guizhou Province, with other loci ranked according to their discriminatory power as supplementary typing methods. The 24-VNTR, 15-VNTR, and 12-VNTR methods demonstrated high typing capabilities, providing technical support for molecular tracing of tuberculosis in Guizhou Province.

To explore whether N⁶-methyl adenosine (m⁶A) is involved in arsenic-induced tau protein phosphorylation.

Neuroblastoma (SH-SY5Y) cells were treated with 0, 1, 5, 10 μmol/L sodium arsenate for 24 hours. Then, the intracellular m⁶A level was detected, the mRNA expression levels of m⁶A-related enzymes in the cells were detected by qPCR,and the total tau protein expression level, phosphorylated tau protein level and m⁶A-related enzyme expression levels in the cells were detected by Western Blot. After inhibiting the intracellular m⁶A level with 3-deoxyadenosines, the changes in the intracellular m⁶A level and tau protein phosphorylation level were verified. SPSS was used for analysis of variance of the experimental results, with α=0.05.

After SH-SY5Y cells were treated with various concentrations of arsenic for 24 hours, there was no significant difference in the total tau protein level in the cells (F=3.047, P > 0.05). After the cells were treated with 5 μmol/L arsenic for 24 hours, the intracellular m⁶A level increased by 31.4% (F=4.511, P < 0.05), and the phosphorylated tau protein (at site T231) level increased by 42.6% (95%CI: 0.165-0.689, P < 0.01). The level of phosphorylated tau protein (at sites S202 + T205) increased with the increase in arsenic concentration, and the highest increase was 55.2%(95%CI: 0.050-0.409, P < 0.05) after treatment with 10 μmol/L arsenic for 24 hours. As the arsenic treatment concentration increased, the METTL3 mRNA expression in the cells increased, with the highest increase of 73.2% (95%CI: 0.201-1.423, P < 0.05) at a concentration of 10 μmol/L. The mRNA expression levels of METTL14, WTAP and FTO decreased, and they decreased to 65.4% (95%CI:-1.055 to-0.337, P < 0.01), 64.8% (95%CI:-0.389 to -0.111, P < 0.05) and 85.4% (95%CI: -0.030 to -0.010, P < 0.01) of the control group respectively after treatment with 10 μmol/L arsenic. The ALKBH5 mRNA expression first increased and then decreased, with an increase of 27.5% (95%CI: 0.033-0.147, P < 0.05) after treatment with 1 μmol/L arsenic for 24 hours; while it decreased by 30.7% (95%CI:-1.62 to -0.038, P < 0.01) after treatment with 10 μmol/L arsenic. Arsenic treatment led to an increase in METTL3 protein expression, with the highest increase of 107.1% (95%CI: 0.331-1.009, P < 0.01) after treatment with 5 μmol/L arsenic for 24 hours, while the protein expression levels of METTL14, WTAP and ALKBH5 decreased to 20.4% (95%CI: -0.788 to -0.509, P < 0.001), 23.5% (95%CI:-1.371 to -0.685, P <0.001) and 49.2% (95%CI:-0.423 to -0.183, P < 0.001) of the control group respectively after treatment of SH-SY5Y cells with 10 μmol/L arsenic for 24 hours. The FTO protein expression level showed a decreasing trend with the increase in arsenic concentration, with the lowest decrease of 45.3% (95%CI:-0.709 to -0.413, P < 0.001) after treatment with 10 μmol/L arsenic for 24 hours. After DAA inhibited the intracellular m⁶A level, the phosphorylated tau protein levels were significantly decreased (P < 0.05).

Arsenic can increase the m⁶A level in SH-SY5Y cells by increasing the expression level of the m⁶A methylase METTL3 and decreasing the expression levels of the m⁶A demethylases FTO and ALKBH5, thereby inducing the phosphorylation of tau protein in the cells.

To understand the epidemiological characteristics of public health emergencies in Qinghai Province from 2009 to 2023, providing a basis for decision-making in the prevention and control of such events.

Data on incidents from 2009 to 2023 in Qinghai Province were collected and organized from the “Public Health Emergency Report Management Information System”. Descriptive epidemiological methods were used to analyze the characteristics of these incidents.

A total of 311 public health emergencies were reported in Qinghai Province from 2009 to 2023, with 9 099 cases of illness affecting a total of 480 213 individuals, resulting in 46 deaths. Join point analysis revealed a turning point in infectious disease incidents, with a statistically significant upward trend from 2012 to 2023 (P=0.001). In contrast, non-infectious disease incidents exhibited a notable downward trend, with an annual percentage change (APC) of -8.30% (95%CI: -14.91% to -2.86%, P=0.003). Global spatial autocorrelation results indicated that, except for 2015 when public health emergencies in Qinghai showed a spatial negative correlation (Moran’s I=-0.321, Z=-1.557, P=0.035), no statistical differences were observed in other years (P>0.05). Pearson correlation analysis revealed a positive correlation between the reporting time of incidents and the duration of infectious disease outbreaks (r=0.43, P<0.05), indicating that longer reporting intervals were associated with longer outbreak durations.

There is a correlation between incident reporting and outbreak duration in Qinghai Province. It is recommended to enhance the awareness of timely reporting among medical institutions at all levels and to strengthen epidemic monitoring in key gathering places, such as primary schools, to reduce the occurrence of public health emergencies.

To analyze the transmission characteristics of the CRF105_0108 subtype in Luzhou, aiming to provide a scientific basis for effective control of its spread in the region.

Genetic sequences obtained from drug-resistant testing of antiretroviral therapy failures among AIDS/HIV patients in Luzhou from 2017 to 2023 were collected for subtype and genotype resistance analysis. The molecular transmission network of CRF105_0108 was constructed using genetic distance methods, and factors influencing network inclusion were analyzed.

A total of 61 CRF105_0108 gene sequences were obtained. A molecular transmission network was constructed at a 1.5% genetic distance, achieving an inclusion rate of 80.33%(49/61), forming 3 molecular clusters and 247 edges. A high-resolution molecular transmission network was constructed at a 0.6% genetic distance, with an inclusion rate of 40.98% (25/61), forming 9 molecular clusters and 22 edges. Univariate analysis indicated a statistically significant difference in network inclusion based on different residential locations (χ²=12.739, P=0.025), while differences in gender and other factors were not statistically significant. The genotype resistance rate for the CRF105_0108 subtype was 54.10% (33/61), with 8 samples exhibiting dual resistance to NRTI and NNRTI.

The transmission of the CRF105_0108 subtype in Luzhou may have formed a large transmission cluster. It is recommended to conduct genetic subtype monitoring and pre-treatment resistance testing for newly reported AIDS/HIV patients, to dynamically monitor the constructed transmission network, and to implement timely intervention measures for high-risk transmitters, thereby enhancing the specificity of antiretroviral therapy and improving the precision of prevention and control efforts.

To understand the influencing factors of lumbar disc herniation (LDH) among adult residents of different ethnic groups in Gansu Province, providing foundational data for targeted prevention and control measures.

From May to July 2022,a stratified cluster sampling method was employed based on the altitude of residence (≤1 500 meters, 1 500 to 3 500 meters, >3 500 meters) in Gansu Province. All participants underwent questionnaire surveys, physical examinations, and assessments of blood glucose and lipid levels. A non-conditional binary logistic regression model was used to analyze the influencing factors of LDH prevalence among different ethnic groups.

A total of 4 545 participants were included, with an overall LDH prevalence of 22.8%. The prevalence was highest among the Tibetan population at 30.6%, with significant differences observed among ethnic groups (P<0.05). For the Han ethnic group, a residence duration of less than 36 months, non-drinking, or residing at altitudes of 1 500-3 500 meters were associated with an increased risk of LDH. Conversely, being younger than 30 years, holding a position as a cadre, or residing at altitudes below 1 500 meters were associated with a reduced risk. Among the Tibetan population, low physical activity intensity, an education level of primary school or below, and a residence duration of 24-36 months were linked to an increased risk of LDH, while being male, engaging in low-intensity activities, and being unmarried were associated with a decreased risk. For the Hui ethnic group, a residence duration of 6-23 months or an age range of 30-59 years were related to an increased risk of LDH.

The prevalence of LDH varies among different ethnic groups in Gansu Province, and the influencing factors also differ.

To investigate the impact of serum free fatty acids (FFA) on serum uric acid (SUA) levels in young and middleaged hyperuricemia (HUA) patients with different body mass indexes (BMI).

A total of 144 young and middle-aged male patients first diagnosed with HUA at Zhu Xianyi Memorial Hospital of Tianjin Medical University from March 2018 to May 2020 were selected. They were divided into three groups based on BMI: normal group (18.5 kg/m² ≤ BMI < 24.0 kg/m², n=42), overweight group (24.0 kg/m² ≤ BMI < 28.0 kg/m², n=58), and obese group (BMI ≥ 28 kg/m², n=44). Additionally, they were categorized into tertiles based on FFA levels: low tertile group (FFA ≤ 0.37 mmol/L, n=48), middle tertile group (0.37 mmol/L < FFA < 0.7 mmol/L, n=48),and high tertile group (FFA ≥ 0.7 mmol/L, n=48). General information and laboratory data, including FFA and SUA levels, were collected and statistically analyzed.

As BMI increased, FFA levels in the normal, overweight, and obese groups showed a significant upward trend (P < 0.05). SUA levels also increased, with statistically significant differences between the normal and obese groups and between the overweight and obese groups (P < 0.05), but no significant difference was observed between the normal and overweight groups (P > 0.05). With increasing FFA levels, BMI and SUA levels in the low, middle, and high FFA tertile groups also increased. Significant differences were observed between the low and high tertile groups and between the middle and high tertile groups (P < 0.05), but no significant difference was found between the low and middle tertile groups (P > 0.05). Two-way ANOVA revealed an interaction between FFA and obesity on the SUA levels (F=2.701, P=0.033), indicating that their combined effect further elevated SUA levels. Spearman correlation analysis showed a positive correlation between FFA and SUA levels in the obese group (r=0.428, P=0.004). However, no such correlation was observed in the normal and overweight groups (P > 0.05).

In young and middle-aged HUA patients, those with obesity and high FFA levels exhibit higher SUA levels. The effects of FFA and obesity on SUA levels are both additive and interactive.

To explore the association between the systemic immune-inflammation index (SII) and adult obesity, and to provide insights for the prevention and early diagnosis of obesity.

This study was based on the survey data of the National Health and Nutrition Examination Survey (NHANES). A binary logistic regression model was used to evaluate the relationship between the systemic immune-inflammation index and obesity (general obesity, central obesity) by calculating the odds ratio (OR) and its 95% confidence interval (CI). In addition, stratified analysis was performed by age (< 60 years old and ≥ 60 years old) and gender.

After adjusting all covariates, when general obesity was taken as the outcome variable, compared with the subjects in the lowest quartile (Q1) of SII, the risk of general obesity in the subjects in the third quartile (Q3) increased by 0.374 times (OR=1.374, 95%CI: 1.111-1.699); the risk of general obesity in the subjects in the fourth quartile (Q4) increased by 0.843 times (OR=1.843, 95%CI: 1.490-2.281). When central obesity was taken as the outcome variable, compared with the subjects in Q1, the risk of central obesity in the subjects in Q3 increased by 0.542 times (OR=1.542, 95%CI: 1.189-2.000); the risk of central obesity in the subjects in Q4 increased by 1.036 times (OR=2.036, 95%CI: 1.553-2.670). In addition, the results of stratified analysis showed that the relationship between SII and obesity was different among different ages and was only significant in the population aged <60 years old.

SII is positively correlated with the risk of adult obesity, and the higher the SII, the higher the risk of obesity. In addition, the relationship between SII and obesity may be age-specific.

To evaluate the effectiveness of an all-English small class inquiry-based teaching model for basic theories and practices in epidemiology, providing a reference for further improving the quality of all-English instruction in preventive medicine courses.

Based on the undergraduate course “Basic Theory and Case Study of Epidemiology” at Sichuan University, surveys were conducted before and after the course for students in both small and large all-English classes.A comparative analysis was performed between the two class sizes and within the same class before and after the intervention to explore whether the small class inquiry-based teaching model is more advantageous than traditional large class teaching in enhancing students’ all-English professional competence.

Prior to the all-English instruction, there were significant differences in English reading and writing abilities, as well as listening and speaking skills, between students in large and small classes, with small class students demonstrating superior skills (reading and writing: small class 57.1% vs. large class 26.8%;listening and speaking: small class 50.0% vs. large class 20.5%) (P<0.05). Most students in both class sizes lacked experience in delivering presentations and writing research papers in English before the instruction; however, small class students were more willing to attempt all-English oral presentations in class compared to their large class counterparts (small class 92.9% vs.large class 60.7%) (P<0.05). Following the all-English instruction, a significant improvement was observed in English reading and writing abilities, professional knowledge, mastery of English terminology, and participation in group discussions or projects for students in both classes. Overall, small class students exhibited better listening and speaking skills than those in large classes post-instruction, with 50.0% of small class students demonstrating good English listening and speaking skills compared to 14.1% in large classes, reflecting an overall improvement from pre-instruction levels. Small class students reported increased confidence in writing English research papers and more experiences with all-English presentations compared to large class students. Moreover, over 60% of students from both classes expressed a willingness to participate in international conferences and deliver all-English presentations, showing an increase from pre-instruction levels.

The all-English small class inquiry-based teaching model demonstrates greater advantages over large class teaching in enhancing students’ all-English professional competence, contributing to improved international competitiveness for employment and further studies.Implementing this model for undergraduate students in preventive medicine is both feasible and effective.