To analyze the relationship between different combinations of chronic diseases and health-related quality of life (HRQoL) among rural patients with chronic diseases in Shandong Province, and to provide references for improving the HRQoL of patients with chronic diseases.

A multi-stage random sampling method was used to select 531 patients with chronic diseases in Shandong Province for face-to-face questionnaires. The EuroQol five-dimensional five-level questionnaire (EQ-5D-5L) was used to evaluate the patients’ HRQoL. The Tobit regression model was used to analyze the influencing factors of patients’HRQoL.

Among rural patients with chronic diseases, the combinations of chronic diseases with relatively high prevalence rates were arthritis + other diseases (excluding digestive system diseases), pure metabolic diseases, and stroke + metabolic diseases or stroke + metabolic diseases + heart disease, accounting for 27.68%, 19.59%, and 12.81% respectively. The results of the Tobit model showed that the influencing factors of the health utility value of rural patients with chronic diseases were age ≥ 75 years, the course of multiple chronic diseases exceeding 10 years, and disease combinations: patients with any one of digestive system diseases, arthritis, or stroke as part of multiple chronic diseases had significantly lower HRQoL than those with other combinations of chronic diseases.

There are significant differences in the HRQoL of rural patients with chronic diseases with different combinations of chronic diseases. Attention should be paid to health promotion among rural residents, and early screening and prevention should be carried out for high-risk patients with digestive system diseases, arthritis, and stroke to improve the HRQoL of rural residents.

To understand the prevalence and influencing factors of Chronic Obstructive Pulmonary Disease (COPD) among middle-aged and elderly residents in the community, and to construct and validate a Nomogram prediction model to provide a theoretical basis for the prevention of COPD onset and deterioration.

This cross-sectional study involved 3 250 middle-aged and elderly community residents in Chengdu Eastern New District. Basic information and risk factors for COPD were collected through pulmonary function tests, physical examinations, and questionnaires. The study population was divided into training and validation sets. Elastic net analysis was performed in the training set to select coefficients, and LASSO regression and random forest models were utilized to analyze the influencing factors of COPD and severe COPD, leading to the establishment of a Nomogram prediction model.

The detection rates of COPD and severe COPD among community residents in Chengdu were 26% and 5.38%, respectively. LASSO regression indicated that age, male, being unmarried, low income, childhood pneumonia hospitalization, childhood cough, and parental respiratory disease history were common risk factors for COPD and severe COPD. Unique risk factors for COPD included low BMI, occupation, dust exposure, allergy history, workplace smoking, family smoking, and personal smoking.Unique risk factors for severe COPD included low educational level, waist-to-hip ratio, and maternal smoking during pregnancy. A Nomogram risk prediction model for COPD and severe COPD was established based on these indicators, with AUC values of 69.34%(95%CI: 66.90%-71.79%) and 76.81% (95%CI: 72.71%-80.90%), respectively, demonstrating good predictive performance. Internal validation through 1 000 bootstrap resampling showed that the calibration curves of the Nomogram model closely matched the actual occurrence of COPD and severe COPD, indicating a good fit.

Gender, age, educational level, marital status, family income, waist-to-hip ratio, childhood pneumonia hospitalization history, childhood cough, maternal smoking, paternal respiratory disease history, and maternal respiratory disease history are independent risk factors for COPD and severe COPD among community residents in Chengdu. The constructed Nomogram prediction model can provide a concise and intuitive personalized risk assessment for COPD and severe COPD for community residents and high-risk populations.

To use the multi-state model to study the risks of developing Parkinson’s disease and death after stroke and explore their influencing factors, so as to provide a scientific basis for the prognosis of stroke patients and the prevention of Parkinson’s disease.

This study was based on 345 585 participants registered in the UK Biobank database from 2006 to 2010, with follow-up until November 30, 2021. The multi-state model was used to analyze the risks of developing Parkinson’s disease and death in stroke patients.

Among the six outcome paths, the cumulative risk from stroke to death was the highest, followed by that of Parkinson’s disease and from the baseline to death. The risk probability of developing Parkinson’s disease after stroke was 2.25 times that of the baseline state, and the death probability of stroke patients was 11.36 times that of the baseline population. The results of the influencing factors in the multi-state model showed that advanced age (over 60 years old), male, depression, smoking, alcohol consumption, and childhood obesity were all risk factors for the transition of the baseline population to the three states (stroke, Parkinson’s disease, and death). In the transition path from stroke to Parkinson’s disease, advanced age (over 60 years old) was a risk factor, while alcohol consumption and female gender were protective factors for stroke patients to develop Parkinson’s disease (HR=0.569, 95%CI: 0.357-0.909), (HR=0.521, 95%CI: 0.344-0.788). In the path from stroke to death, advanced age (over 50 years old), depression (HR=1.980, 95%CI: 1.656-2.369), smoking (HR=1.504,95%CI: 1.358-1.647), and a family history of stroke could increase the risk of stroke to death, while alcohol consumption was a protective factor (HR=0.872, 95%CI: 0.774-0.984). Advanced age (over 60 years old), depression (HR=1.783, 95%CI: 1.295-2.451), and smoking (HR=1.781, 95%CI: 1.397-2.295) were risk factors for the death of Parkinson’s patients, and the mortality rate of female patients was lower than that of male patients (HR=0.797, 95%CI: 0.686-0.926).

Advanced age (over 60 years old), male gender, smoking, depression, and childhood obesity are risk factors for stroke, Parkinson’s disease, and death in the baseline population; advanced age, male, smoking, depression, and a family history of stroke are risk factors for stroke patients to develop Parkinson’s disease and die. The multi-state model can be used to demonstrate the influencing factors and extent of disease transitions, revealing the patterns of disease progression.

To understand the current situation of adult tobacco prevalence in each sub-district and township of Dingzhou city, Hebei Province, provide data support for formulating grass-roots tobacco control policies, and provide a reference for estimating tobacco prevalence indicators at the county-district level.

A multi-stage stratified cluster sampling method and Probability Proportional to Size (PPS) sampling method were used to conduct a questionnaire survey among permanent residents aged 15 and above in Dingzhou city. The survey data were cleaned, weighted, and analyzed using SAS 9.4. The current smoking rate, quitting rate, and second-hand smoke exposure rate in Dingzhou city were reported. The Small Area Estimation (SAE) method was used to estimate the above-mentioned indicators for each sub-district and township.

A total of 7 660 valid questionnaires were collected in this survey, with an overall response rate of 68.70%. In 2023, the current smoking rate among people aged 15 and above in Dingzhou city was 22.27%, the quitting rate was 9.60%, and the second-hand smoke exposure rate among non-smokers was 36.84%. The estimation results of the SAE model showed that there were differences in tobacco prevalence monitoring indicators among different sub-districts and townships. Townships such as Xingyi Town, Liqinggu Town, and Dongliuchun Township in the southern part of Dingzhou city had relatively high current smoking rates (25%-35%). Some townships in the northwest and southeast regions had relatively low quitting rates (less than 10%), while the sub-districts and townships with relatively high second-hand smoke exposure rates were more scattered, with the rates in Dongting Town and Xizhong Town exceeding 50%.

The SAE model can be used to estimate tobacco prevalence monitoring indicators at the county-district and even sub-district and township levels. Currently, the tobacco prevalence situation in some sub-districts and townships of Dingzhou city is relatively severe. Targeted grass-roots tobacco control work should be carried out, the construction of smoke-free environments should be strengthened, and grass-roots smoking cessation services should be promoted.

To explore whether the newly proposed cardiovascular health indicator LE8 provides greater predictive value for adverse cardiovascular events (ACE) than LS7 in the Chinese population.

Based on the China Health and Nutrition Survey (CHNS), 5 772 participants who had not experienced ACE prior to the 2009 survey were included. The cardiovascular health indicators LE8 and LS7 were calculated, and the Kaplan-Meier method and Cox proportional hazards model were used to estimate the 5-year risk of ACE occurrence. The differences in predictive value for ACE occurrence between the two indicators were compared using C statistics.

For LE8, the participants in the highest percentile had a 5-year ACE risk of 2.3%,whereas those in the lowest percentile had a risk approximately six times higher. The results of the Cox proportional hazards model indicated that the C statistic for LS7 was 0.728 (95%CI: 0.706-0.75), while that for LE8 was 0.726 (95%CI: 0.703-0.748), with no statistically significant difference (P=0.51).

In the Chinese population, both LE8 and LS7 are associated with new ACE. However, LE8 incurs higher collection costs and has not demonstrated superior predictive value; therefore, LS7, which is easier to implement in clinical practice, is recommended as the risk prediction indicator for new cardiovascular events.

To analyze the epidemiological characteristics of Hepatitis B Virus (HBV) in the Xinjiang Uygur Autonomous Region from 2005 to 2023 and to predict the incidence trend from 2024 to 2026, thereby providing scientific basis for the prevention and control of Hepatitis B.

Data on HBV incidence were extracted from the Chinese Disease Prevention and Control Information System for descriptive analysis, and the gray prediction model was employed to forecast the incidence trends.Visualization of the data was performed using Origin 2022 software.

From 2005 to 2023, a total of 724 286 cases of HBV were reported in the Xinjiang Uygur Autonomous Region, with an average annual incidence rate of 172.97 per 100 000 population. Cases were reported across various prefectures and cities, with the highest cumulative incidence observed in Kashgari Prefecture (171 395 cases), Urumqi city (132 256 cases), and Aksu Prefecture (90 145 cases). Among the reported cases, males (401 266 cases) outnumbered females (323 020 cases), with the primary affected demographic being individuals aged 20-39 years. The GM (1,1) model predicted a declining incidence trend for Hepatitis B in the Xinjiang Uygur Autonomous Region from 2024 to 2026, with projected rates of 104.809, 97.406, and 90.065 per 100 000 population, respectively.

The overall incidence level of Hepatitis B in the Xinjiang Uygur Autonomous Region is relatively high; however, a downward trend in incidence is anticipated from 2024 to 2026.It is recommended to enhance the promotion of Hepatitis B vaccination, strengthen prevention and control efforts in key populations and areas, and improve public awareness of Hepatitis B to achieve the goal of eliminating its prevalence.

To analyze the changes in the burden of Disability-Adjusted Life Years (DALY) due to esophageal cancer in China from 1990 to 2021 and to predict the DALY trends over the next 20 years, providing scientific basis for policy-making and public health interventions.

The analysis of DALY changes due to esophageal cancer in China from 1990 to 2021 was conducted using the Global Burden of Disease Study database. Joint point regression analysis was employed to assess the annual percentage change in the DALY rate for esophageal cancer in China, and comparisons were made with North Korea, Japan, South Korea, and the United States. A decomposition analysis was performed to evaluate the contributions of population aging, population growth, and age-specific factors to the changes in esophageal cancer DALY. The Bayesian Age-Period-Cohort (BAPC) model was used to forecast the changes in esophageal cancer DALY over the next 20 years.

In 2021, the total number of DALYs due to esophageal cancer in China was approximately 6.8 987 million years, with a significantly higher burden in males compared to females;individuals aged 65 and older accounted for 52.71% of the total DALYs. Compared to international data, China exhibited a more pronounced declining trend in esophageal cancer DALYs. From 1990 to 2021, the DALY rate decreased, with population aging and growth being the main driving factors for the increase in DALY burden. The BAPC predictive analysis indicated a slow declining trend in the total standardized DALY rate for esophageal cancer in China over the next 20 years.

Over the past 30 years, the burden of DALYs due to esophageal cancer in the Chinese population has shown a significant declining trend, particularly among males and the elderly. Future efforts should focus on enhancing screening coverage and interventions for high-risk populations.

To investigate the molecular mechanism by which Astragal side IV (ASV) combined with Quercetin (QUE) inhibits silica (SiO₂)-induced macrophage proptosis activation.

An in vitro co-culture system was established using rat alveolar macrophages (NR8383) and rat fibroblasts (RFL-6). The experiment was divided into six groups: control group, drug group, SiO₂ group, SiO₂ + drug group, SiO₂ + Balmacaan (Bel) group, and SiO₂ + drug + Bel group. After 24 hours of intervention, cell and supernatant samples were collected. The levels of transforming growth factor β1 (TGF-β1), tumor necrosis factor alpha (TNF-α), and high mobility group box-1 (HMGB1) in the supernatant were measured using ELISA. The protein levels of α-SMA,Vimentin, and E-Cadherin (E-cad) in RFL-6 cells were detected using Western blot. The mRNA and protein expression levels of Caspase-1, interleukin-1β (IL-1β), and IL-18 in NR8383 cells were assessed using PCR and Western blot, respectively.

Compared to the control group, the levels of TGF-β1, TNF-α, and HMGB1 in the supernatant of the SiO₂ group were significantly increased (P<0.05), the protein levels of α-SMA and Vimentin in RFL-6 cells were elevated, while E-cad protein levels were reduced. The expression levels of (Cleaved-) Caspase-1, IL-1β, and IL-18 mRNA and protein in NR8383 cells were also significantly increased (P<0.05). Compared to the SiO₂ group, the levels of TGF-β1, TNF-α, and HMGB1 in the supernatants of the SiO₂ + drug group, SiO₂ + Bel group, and SiO₂ + drug + Bel group were significantly decreased (P<0.05). The protein levels of α-SMA and Vimentin in RFL-6 cells were reduced, and E-cad protein levels were elevated. The expression levels of (Cleaved-) Caspase-1, IL-1β, and IL-18 mRNA and protein in NR8383 cells were also significantly decreased (P<0.05).

ASV combined with QUE may reduce the secretion of inflammatory factors by inhibiting the proptosis levels of macrophages exposed to SiO₂ in the co-culture system, thereby suppressing the fibrosis levels in fibroblasts.

To investigate the effects of nickel cobalt manganese lithium (NCM) on the metabolic pathways of human bronchial epithelial cells (BEAS-2B).

The MTS assay was employed to assess the impact of NCM on the viability of BEAS-2B cells, determining exposure concentrations of 0, 50, 100, and 200 μg/ml. Cell samples were collected after 48 hours of exposure. Intracellular metabolites were analyzed using ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS), and partial least squares discriminant analysis (PLS-DA) was utilized to investigate changes in the metabolic profile. Differential metabolites were selected based on a variable importance in projection (VIP) value >1, followed by pathway enrichment analysis. Transmission electron microscopy and JC-1 fluorescence probes were used to assess the effects of NCM on cellular ultrastructure and mitochondrial membrane potential (MMP).

Compared to the control group, exposure to different concentrations of NCM resulted in a dose-dependent decrease in the viability of BEAS-2B cells. A total of 788 substances were detected in the metabolomic samples; 281, 284, and 274 differential metabolites were identified at exposure concentrations of 50, 100, and 200 μg/ml, respectively. Among these, 82 differential metabolites were common across all exposure groups, with the highest proportion being lipid metabolites. The differential metabolites were significantly enriched in metabolic pathways such as coenzyme Q biosynthesis, riboflavin metabolism, and very long-chain fatty acid oxidation. NCM exposure led to mitochondrial swelling, reduced cristae, and fragmentation in BEAS-2B cells, significantly decreasing MMP levels.

NCM exposure has a pronounced impact on the metabolic profile of BEAS-2B cells and induces mitochondrial damage, with the toxicological pathways primarily involving coenzyme Q biosynthesis.

To explore the relationship between gaseous air pollutants and inflammatory indices in patients with schizophrenia (SCZ).

A total of 866 hospitalized SCZ patients were included from October 2020 to December 2023.The daily average exposure values of gaseous air pollutants (SO₂, NO₂, O₃, CO) for the seven days prior to hospitalization were estimated using Kriging interpolation. Based on the biochemical test results on the day of admission, four inflammatory indices were calculated for the SCZ patients: Platelet to Lymphocyte Ratio (PLR), Neutrophil to Lymphocyte Ratio (NLR), Systemic Immune Inflammation Index (SII), and Systemic Inflammation Response Index (SIRI). Spearman correlation and multiple linear regression models were employed to analyze the association between individual gaseous air pollutants and inflammatory indices;Bayesian Kernel Machine Regression (BKMR) was used to assess the joint effects of mixed gaseous air pollutants on inflammatory indices.

The daily average exposure values of SO₂, NO₂, and CO in the seven days prior to hospitalization showed a positive correlation with PLR（r_SO-PLR=0.08;r_NO-PLR= 0.069; r_CO-PLR=0.078）、NLR（r_SO-NLR=0.075; r_NO-NLR= 0.077; r_CO-NLR=0.069） and SII（r_SO-SII=0.081; r_NO-SII=0.072; r_CO-SII=0.075）, with statistical significance (all P<0.05). The multiple linear regression results indicated a positive correlation between the daily average NO₂ exposure and NLR levels, with β=0.006(95%CI: 0.001-0.011). The BKMR analysis revealed that when the daily averages of the four gaseous air pollutants exceeded their 50^th percentile (P₅₀) in the seven days prior to hospitalization, the mixture of SO₂, NO₂, CO, and O₃ had a positive joint effect on the NLR and SII of SCZ patients.

Short-term exposure to a mixture of gaseous air pollutants may influence the inflammatory response in SCZ patients.

To study the association between the food environment and the risk of diabetes among residents and the mediating role of dietary intake.

Based on the data from the surveillance and investigation of chronic diseases and risk factors in Hubei Province from 2018 to 2020, buffers with different radii were constructed centered on the residential areas of the study subjects, and the densities of fast-food restaurants, dessert shops, supermarkets, vegetable markets, and convenience stores in each buffer were calculated to measure the food environment. A multilevel logistic regression model was used to analyze the association between the food environment and the risk of diabetes among residents, as well as the mediating effect of different types of food intake.

A total of 24 467 adults were included in this study, and the prevalence of diabetes was 12.1%. Regression analysis showed that the density of vegetable markets was positively correlated with the risk of diabetes (OR=1.018, 95%CI: 1.004-1.031). The results of the mediating analysis showed that the density of vegetable markets could reduce the risk of diabetes by increasing fruit intake, and the proportion of the mediating effect was 1.32%. Sub-group analysis showed that in the population under 60 years old, the density of supermarkets was negatively correlated with the risk of diabetes (OR=0.962, 95%CI: 0.937-0.988).

The density of vegetable markets is positively correlated with the risk of diabetes among residents, but a higher density of vegetable markets can reduce the risk of diabetes by increasing fruit intake. Optimizing the layout of the food environment and improving the availability of healthy foods can help reduce the risk of diabetes among residents.

To explore the alterations in gut microbiota following the oral administration of pomegranate peel extract (PPE) in vanadium-exposed mice, providing new insights into the mechanisms of vanadium toxicity and its prevention and treatment.

Male C57BL/6J mice were used as subjects and randomly divided into a control group, a model group, and three PPE dosage groups, with 10 mice in each group. Mice were administered sodium metavanadate solution via intraperitoneal injection (3 mg/kg, once every 2 days) for modeling, and PPE was injected intraperitoneally at doses of 100, 200, and 400 mg/kg every 2 days. The control group received physiological saline. At the end of 12 weeks, fecal samples were collected to extract gut bacterial genomic DNA for amplification and sequencing of the 16S rDNA. Statistical analysis was conducted using one-way ANOVA and the SNK (Student-Newman-Keuls) test.

Long-term vanadium exposure resulted in a decrease in gut bacterial abundance, with a reduction in OTU numbers (P < 0.05).The α-diversity indices, including Shannon, Simpson, ACE, and Chao1, significantly decreased (P < 0.05). The β-diversity analysis, represented by PCoA and NMDS plots, showed significant differentiation. The relative abundances of Actinobacteria, Verrucomicrobia, and Akkermansiaceae significantly increased (P < 0.05), while the relative abundance of Ruminococcaceae significantly decreased (P < 0.05).However, low and medium doses of PPE were able to partially restore the reduction in gut microbiota abundance and diversity caused by vanadium exposure (P < 0.05), bringing the abundance of affected characteristic bacterial groups back to normal levels (P < 0.05).

Vanadium exposure leads to a decrease in the abundance and diversity of gut microbiota in mice, while low and medium doses of PPE intervention can effectively improve the gut microbiota disorder induced by vanadium exposure.

To explore the relationship between the romantic status of vocational school students in Guizhou Province and their engagement in non-suicidal self-injury (NSSI), as well as the mediating role of difficulties in emotion regulation, providing a reference for the prevention of adolescent NSSI behaviors.

A questionnaire survey was conducted from October to December 2023, utilizing a multi-stage stratified cluster random sampling method to select students from nine vocational schools in Guizhou Province. The Chinese version of the Adolescent Non-Suicidal Self-Injury Assessment Questionnaire (ANSAQ) and the Difficulties in Emotion Regulation Scale (DERS) were used to measure NSSI behaviors and emotion regulation difficulties among vocational students. The mediating effect of difficulties in emotion regulation was examined using categorical variable mediation methods.

The prevalence of NSSI among vocational students in Guizhou Province was 27.4%. The standardized relative direct effect of experiencing a breakup on NSSI was 0.575 (95%CI: 0.104 to 0.258), and the relative mediating effect was 0.421 (95%CI: 0.062 to 0.203), with the mediating effect accounting for 26.8% of the total effect. Difficulties in emotion regulation fully mediated the relationship between being in a romantic relationship and NSSI, with the mediating effect constituting 47.3% of the total effect. For students who had previously been in a relationship but were now in the post-breakup phase, the standardized relative direct effect on NSSI was 0.008 (95%CI: -0.021 to 0.037), and the standardized relative mediating effect was 0.011 (95%CI: -0.001 to 0.024), both of which were not significant.

Differences in emotion regulation abilities across various romantic statuses partially explain the occurrence of individual NSSI behaviors. Enhancing adolescents’ emotion regulation skills can help them establish healthy emotional perspectives and positive interpersonal relationships, thereby effectively reducing the incidence of NSSI behaviors and positively impacting adolescent mental health within the public health domain while fostering harmonious social relationships.

To analyze the current situation of sleep quality and its relationship with diabetes among elderly Bai people in rural areas of Dali, Yunnan.

A multi - stage stratified random sampling method was used to select 1 418 rural Bai elderly people aged ≥60 years in Dali city, Yunnan Province for questionnaire surveys and physical examinations. Binary multi-factor Logistic regression was used to analyze the relationship between sleep quality and the prevalence of diabetes.

The sleep disorder rate in the surveyed population was 48.4%, with 41.1% in men and 54.9% in women. The sleep disorder rate in women was higher than that in men (χ²=26.818, P < 0.001).The prevalence of diabetes was 15.9%, with 15.2% in men and 16.6% in women. The sleep disorder rate increased with age (χ²_trend =4.607,P < 0.05). The results of multi-factor Logistic regression showed that the elderly with sleep disorders were more likely to suffer from diabetes than those without sleep disorders (OR=1.425, 95%CI: 1.059-1.916).

Sleep disorder is an important risk factor for diabetes in the elderly. Strengthening sleep management for the elderly is helpful for the prevention of diabetes.

To explore the influence of social activity on cognitive ability among middle-aged and elderly people in rural China and the mediating role of depression.

Based on the data from the 2020 China Health and Retirement Longitudinal Study, 7 058 rural middle-aged and elderly people aged 45 and above were selected as the research subjects. Social activity was measured by the types and frequency of social activities. Cognitive ability was evaluated by the Mini- Mental State Examination (MMSE), and depression was measured by the (CES-D 10) scale. Descriptive statistics and partial correlation analysis were used for data analysis, and the Process macro program was used to test the mediating effect.

The mediating effect test showed that social activity among rural middle-aged and elderly people had a direct effect on cognitive ability (β=0.066, 95%CI: 0.039-0.093), accounting for 92.96% of the total effect. Depression (β=0.005, 95%CI: 0.001-0.010), accounting for 7.04% of the total effect, played a mediating role between them.

Improving the social activity of rural middle-aged and elderly people may effectively relieve their depression and promote the protection of cognitive function. Support and promotion of social activities for rural middle-aged and elderly people should be strengthened to improve their mental health and cognitive ability.

To understand the successful aging rate of middle-aged and elderly people in China， to explore the association between sleep duration and successful aging of middle-aged and elderly people in China，and to provide reference for promoting the health and quality of life of middle-aged and elderly people.

Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS)， a longitudinal study was conducted to analyze sleep duration， successful aging scores and successful aging rates among individuals aged 45 and above from 2011 to 2020. Generalized estimating equations were used to examine the associations of naptime sleep duration，nighttime sleep duration and total sleep duration with successful aging scores in middle-aged and older adults.

The successful aging rates were 4.26%，16.82%，11.62%，10.08%，and 16.47% in 2011，2013，2015，2018，and 2020，respectively. Nighttime sleep duration (β₁=0.377，P<0.001; β₂=-0.023，P<0.001) and total sleep duration (β₁=0.345，P<0.001；β₂=-0.020，P<0.001) showed inverted U-shaped associations with successful aging in China’s middle-aged and elderly. Naptime duration and successful aging showed an inverted U-shaped association in the middle-aged population aged 45-59 years (β₁=0.083，P=0.008; β₂=-0.042，P<0.001)， and a linear association in the elderly population aged 60 years and above (β₁=0.074，P=0.011).

Maintaining a moderate length of sleep is conducive to the development of successful aging in China middle-aged and older adults，and either too short or too long a sleep period may have a detrimental effect on middle-aged and older adults.

To explore how the subjective life expectancy of patients with chronic diseases affects their medical expenditure and provide a policy intervention perspective for improving the quality of life of patients with chronic diseases.

The data from the China Health and Retirement Longitudinal Study (CHARLS) were used. A total of 9 949 samples with any chronic disease at three time points in 2015 (T1), 2018 (T2), and 2020 (T3) were selected. Information such as subjective life expectancy, annual medical expenditure, frequency of outpatient and inpatient visits from modules including health status, medical service utilization records, family economy, and individual basic information was used. A cross-lagged model was applied to test the interaction between subjective life expectancy and medical expenditure and explore the mediating effect of medical resource utilization.

The results of the standardized cross-lagged analysis showed that the subjective life expectancy T1 of patients with chronic diseases significantly negatively predicted the medical expenditure T2 (β=-0.043, P < 0.01), and the medical expenditure T2 significantly negatively predicted the subjective life expectancy T3 (β=-0.043, P < 0.01); the medical expenditure T1 of patients with chronic diseases significantly negatively predicted the subjective life expectancy T2 (β=-0.034, P < 0.05), and the subjective life expectancy T2 significantly negatively predicted the medical expenditure T3 (β=-0.043, P < 0.01). Medical resource utilization had a mediating effect in this process (β=-0.02, P < 0.05).

There is a complex interaction mechanism between the subjective life expectancy and medical expenditure of patients with chronic diseases. There may be a vicious cycle in which health anxiety leads to the deterioration of the condition and an increase in medical expenditure, which further aggravates anxiety, as well as the phenomenon of excessive medical treatment due to pessimistic health expectations. This indicates the value of formulating differentiated psychological intervention policies for different groups to improve the quality of life of patients with chronic diseases.

To understand the focus and central aspects of government attention allocation in provincial-level infant and toddler care service policies in China to reveal the characteristics of provincial governments’ attention to various issues related to infant and toddler care services, providing a basis for rational allocation of government attention in the next phase and optimizing policy resources for these services.

A total of 87 provincial-level government policies on infant and toddler care services issued from April 2018 to July 2023 were selected as the research subjects. The study primarily employed word frequency analysis and semantic network analysis to measure the direction and center of government attention allocation in the policy texts.

The direction of government attention allocation in infant and toddler care policies across different regions was relatively consistent, with the top ten high-frequency words including “service”, “care”, “institution”, “infant and toddler”, “care”,“elderly”, and “health”. The central focus of attention allocation in the eastern, central, and western regions was “institution”,while the northeastern region showed a different central focus. The node with the highest intermediary centrality was “service”,followed by “infant and toddler” and “elderly” as secondary central nodes.

Provincial governments have placed excessive emphasis on services provided by care institutions, necessitating greater attention to the diversity of infant and toddler care service types. There is also a need to enhance focus on inclusive infant and toddler care services, with the northeastern region particularly requiring innovative models for the coordinated development of elderly and infant and toddler care services.

To conduct a quantitative analysis of national-level hypertension prevention and control policies and provide suggestions for the improvement and optimization of these policies.

Hypertension prevention and control policies from 2009 to 2023 were retrieved. A three-dimensional analytical framework of policy tools, policy intensity, and four-level prevention was constructed. Content analysis was used to conduct single-dimension and cross-analysis of policies related to hypertension prevention and control.

A total of 68 policy texts were included in this study, forming 110 coding units.The proportions of environmental, supply-based, and demand-based policy tools were 56.4%, 25.5%, and 18.2%, respectively.The average score of policy intensity was 3.1 (score range: 1-6). The proportions of policy texts for zero-level prevention, primary prevention, secondary prevention, and tertiary prevention were 27.3%, 20.9%, 45.5%, and 6.4%, respectively. Crossanalysis showed that there were significant differences in policy intensity among different types of policy tools. The policy intensity of prevention strategies at all levels was relatively balanced. The environmental policy tools had the highest proportion among prevention strategies at all levels. There were significant differences in supply-based and demand-based policy tools among different prevention strategies.

There is a lack of internal balance in hypertension prevention and control policy tools, and the use of supply-based and demand-based tools needs to be strengthened. The overall policy intensity is relatively weak. Attention should be paid to the overall relevance of policy content. It is urgent to move forward the prevention threshold of hypertension and strengthen the synergistic effect of four-level prevention.

To explore the relationship between oral health-related quality of life (OHRQoL) and dental care-seeking behavior among the elderly in Sichuan Province, while analyzing the impact of income on this relationship.

A total of 744 elderly individuals aged 65 to 74 years from Sichuan Province were included in this study through multi-stage stratified random sampling during the Fourth National Oral Health Epidemiological Survey conducted from 2015 to 2016. A questionnaire was used to assess the participants’ income levels, dental care-seeking behavior, and OHRQoL. Stratified logistic regression was employed to examine the relationship between dental care-seeking behavior and OHRQoL, as well as the moderating effect of income.

Among the 744 participants, 552 (74.2%) reported engaging in dental care-seeking behavior. Lower overall (β=-0.040, P < 0.001), functional (β=-0.028,P=0.002), pain-related (β=-0.037, P < 0.001), and psychological (β=-0.029, P=0.002) dimensions of OHRQoL were associated with an increased likelihood of dental care-seeking among the elderly. Additionally, income had a positive moderating effect only on the relationship between oral health-related psychological discomfort and dental care-seeking behavior; specifically, lower income was associated with a weaker correlation between psychological discomfort related to oral health and dental care-seeking behavior (β=-0.007,P=0.039).

The utilization of oral health services among the elderly in Sichuan Province is suboptimal, with poor OHRQoL being a primary driving factor for dental care-seeking behavior. High income only facilitates dental visits when oral health issues lead to psychological discomfort. Public health efforts targeting oral health among the elderly should focus on updating their perceptions of oral health and addressing the psychological impacts associated with oral health.

To understand the healthy life expectancy (HLE) of residents aged 18 and above in Nanjing under various standards and evaluate the health status of the population.

Using data from the 2023 Jiangsu Provincial Health Commission’s survey on per capita life expectancy and the health expectancy survey of Nanjing residents, we calculated disability measures based on four health standards: self-rated health, reported health, GALI (Global Activity Limitation Indicator), and EQ-5D. The Sullivan method was employed to estimate the healthy life expectancy for Nanjing under these different standards.

In 2023, the life expectancy (LE) for residents aged 18 in Nanjing was 63.05 years. The HLE under the four health standards for 18-year-old residents were 49.35 years, 42.39 years, 55.08 years, and 60.95 years, respectively.The HLE across all age groups followed the order of EQ-5D > GALI > self-rated health > reported health. Notably, HLE for males under 85 years was lower than that for females, although males exhibited a relatively higher quality of life compared to females at all age levels.

There are certain discrepancies in the results derived from the four standards; however, the observed age trends and gender patterns are consistent. The differences in results may be attributed to the dimensions of health evaluation and the methods used for calculating disability measures, necessitating further research.

To explore the longitudinal mediating role of cognitive function in the relationship between depression and activities of daily living (ADL) among individuals aged 60 and above in China, as well as the moderating effect of sleep quality.

Data from the China Health and Retirement Longitudinal Study (CHARLS) collected in 2018 (T1) and 2020(T2) were analyzed. The Center for Epidemiologic Studies Depression Scale (CES-D10), the Mini-Mental State Examination (MMSE), and the ADL scale were used for measurement. Descriptive statistics and correlation analyses were conducted using STATA 18.0 and SPSS 26.0, while mediation and moderated mediation models were constructed and analyzed using Model 4 and Model 59 in the Process 4.0 program.

T1 depression significantly negatively predicted T2 ADL (r=-0.247, P <0.01). Both T2 cognitive function and T2 sleep quality significantly positively predicted T2 ADL (r=0.227, P < 0.01; r=0.131,P < 0.01). T2 cognitive function served as a longitudinal mediator between T1 depression and T2 ADL, with a mediation effect value of 0.022 (95%CI: -0.027 to -0.018), accounting for 14.5% of the total effect. T2 sleep quality moderated all paths in the mediation model (β=-0.018, P < 0.05; β=0.040, P < 0.001; β=-0.034, P < 0.001).

Depression reduces the ability of elderly individuals to perform daily activities by affecting cognitive function. Improving sleep quality can enhance the impact of depression on cognitive function, and can mitigate the effects of depression and cognitive function on ADL.

To assess the association between the trajectories of depression symptoms and the risk of stroke in the elderly.

Data from four waves of the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018 were utilized.Group-based trajectory modeling was employed to identify the trajectories of depression symptoms, and logistic regression models were used to evaluate the relationship between these trajectories and stroke.

Four trajectories of depression symptoms were identified:low stable (n=2 392, 60.7%), moderate decreasing (n=762, 20.2%), moderate increasing (n=416, 12.3%), and high stable (n=250, 6.8%).During the period from 2015 to 2018, a total of 305 respondents experienced a stroke. Compared to participants with the low stable depression symptom trajectory, those following the moderate decreasing (OR=1.48, 95%CI: 1.09-2.02), moderate increasing (OR=2.22,95%CI: 1.58-3.11), and high stable depression symptom trajectories (OR=1.78, 95%CI: 1.12-2.83) had a higher risk of stroke.

Over time, elderly individuals following moderate decreasing, moderate increasing, and high stable trajectories of depression symptoms exhibited an increased risk of stroke. Long-term depression symptoms may serve as a strong predictor for stroke.

To explore the association between sleep duration and fall incidents among middle-aged and elderly individuals in China.

A cross-sectional analysis was conducted using data from the 2020 China Health and Retirement Longitudinal Study (CHARLS), involving 18 515 participants aged 45 and older. Demographic characteristics, behaviors, lifestyle factors, and health status of the subjects were collected, and logistic regression and restricted cubic spline (RCS) models were employed to investigate the relationship between sleep duration and fall risk.

The incidence of falls among middle-aged and elderly individuals in China over two years was 17.20%, with an average sleep duration of (6.11 ± 1.86) hours. The fall incidence for those sleeping less than 5 hours per night was 26.39%, for 5 to less than 7 hours was 16.39%, for 7 to less than 9 hours was 13.04%, for 9 to less than 11 hours was 15.99%, and for those sleeping 11 hours or more was 30.00%. Multivariate logistic regression results indicated that the fall risks for individuals with sleep durations of less than 5 hours, 5 to less than 7 hours, and 11 hours or more were 1.46,1.15, and 2.01 times higher respectively compared to those sleeping 7 to less than 9 hours (P < 0.05). Analysis using the restricted cubic spline model revealed a U-shaped non-linear dose-response relationship between sleep duration and falls (overall trend P <0.05, non-linear test P < 0.05), with the lowest risk of falls occurring at approximately 7.5 hours of sleep.

Falls are significantly associated with both short and long sleep durations, with the optimal sleep duration being around 7.5 hours. Intervention measures should be implemented for middle-aged and elderly individuals with poor sleep quality to reduce their fall risk.

To explore the trends in cognitive function and depression symptoms over time among middle-aged and older adults in China, and to identify populations with differing trajectories of cognitive function and depression symptoms, thereby providing a scientific basis for formulating targeted prevention and control measures.

A total of 11 863 individuals aged 45 and above from the China Health and Retirement Longitudinal Study (CHARLS) were included. The Group-based Dual Trajectory Model (GBDTM) was employed to identify the developmental trajectories of cognitive function and depression symptoms, and multinomial logistic regression analysis was utilized to examine the influencing factors of different trajectories.

The GBDTM identified four trajectory groups: “Poor cognitive function but mild depression symptoms” (Group 1, 32.9%),“Poor cognitive function and severe depression symptoms” (Group 2, 10.8%), “Good cognitive function and mild depression symptoms” (Group 3, 40.5%), and “Moderate cognitive function and moderate depression symptoms” (Group 4, 15.7%). Factors associated with a higher likelihood of being classified in the“Poor cognitive function and severe depression symptoms” group included being female (OR=4.70, 95%CI: 3.82-5.78), unmarried (OR=2.09, 95%CI: 1.67-2.60), residing in rural areas (OR=4.26,95%CI: 3.59-5.07), smoking (OR=1.26, 95%CI: 1.02-1.56), having activities of daily living (ADL) disabilities (OR=1.92, 95%CI:1.39-2.65), and having instrumental activities of daily living (IADL) disabilities (OR=7.43, 95%CI: 5.90-9.35).

There is a partially “joint development” trajectory relationship between cognitive function and depression symptoms in middle-aged and older adults. Early intervention targeting the influencing factors of different trajectory groups is crucial.

To elucidate antibacterial effects and mechanism of Rosa sertata×Rose rugosa methanol extraction (RME) against extended-spectrum β-lactamases producing Klebsiella pneumoniae (ESBL-KP).

Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of RME against various ESBL-KP strains were determined by micro broth dilution method. Impact of RME on the growth, cell membrane and extended-spectrum β-lactamases (ESBLs) activity of ESBL-KP was evaluated by growth and time-kill curves, scanning electron microscopy and nitrocefin hydrolysis test, seperately. Components of the extracts were analyzed using Ultra-High Performance Liquid Chromatography-Quadrupole Time-of-Flight Mass Spectrometry (UHPLC-Q-TOF MS).

The MIC of RME was 1 mg/ml for standard strains and 8-32 mg/ml for ESBL-producing strains. Concentrations of RME at 1/4 MIC, 1/2 MIC, and MIC could inhibit bacterial growth, with higher concentrations showing stronger effects. For D141 strain, treatment with RME at 4MIC concentration for 4 hours resulted in cell membrane collapse, bacterial agglutination, and a 77.49% inhibition rate of ESBLs activity; no bacterial growth was observed after 24 hours of this treatment. Totally, 1 550 compounds were identified in RME, with quinic acid, tricoumaroyl spermidine, thioetheramide-PC, and kaempferol-3-O-rutinoside being the predominant components.

RME can inhibit and kill ESBL-KP through disrupting its cell membrane and inhibiting the enzymatic activity of ESBLs, which provided a scientific basis for further research on Rosa sertata × Rosa rugosa.

To compare the effects of different sample pretreatment methods on the determination of six elements [iron (Fe),copper (Cu), manganese (Mn), nickel (Ni), zinc (Zn), and strontium (Sr)] in whole blood by ICP-MS, so as to optimize the pretreatment process of whole blood samples and improve the accuracy and reliability of detection.

Appropriate amounts of whole blood samples were taken. The collision mode was applied to eliminate interference, and quality control samples were used for quality control. The detection effects of sample pretreatment methods including microwave digestion, protein precipitation with 5% nitric acid followed by centrifugation, direct dilution with 0.1% HNO₃ + 0.01% Triton X-100, and dilution with 0.1% HNO₃ + 0.01% Triton X-100 followed by centrifugation were compared.

When the samples were pretreated by protein precipitation with 5% nitric acid followed by centrifugation, the detection results of iron, manganese, nickel, zinc and strontium in the centrifuged supernatant were found to be low, and the effects on iron, manganese and nickel were the most significant. In addition, when the HNO₃ concentration was 0.2% - 1% (V/V), the measured contents of iron, manganese, nickel, zinc and strontium after dilution followed by centrifugation were all lower than those by direct dilution method and microwave digestion method. When the HNO₃ concentration was 0.1% (V/V),there was no significant difference between the results of direct dilution and dilution followed by centrifugation of the six elements compared with the microwave digestion method. Finally, dilution with 0.1% HNO₃ + 0.01% Triton X-100 (V/V) followed by centrifugation was used as the pretreatment condition. The method detection limits of the six elements were between 0.10 μg/L and 0.24 mg/L, the correlation coefficients r was all greater than 0.999, and the measured values of the quality control samples were consistent with the standard reference values.

Compared with other pretreatment methods, using 0.1% HNO3 +0.01% Triton X-100 (V/V) dilution followed by centrifugation as the pretreatment condition is simple, fast and accurate, and can be applied to the determination of iron, copper, manganese, nickel, zinc and strontium in whole blood.

To analyze the epidemiological characteristics of Hepatitis A (HA) and Hepatitis E (HE) in Huai’an City,Jiangsu Province from 2004 to 2023, providing a scientific basis for infectious disease prevention and control in the region.

Case report data for HA and HE from 2004 to 2023 in Huai’an city were extracted from the Chinese Disease Prevention and Control Information System for descriptive analysis.

From 2004 to 2023, a total of 1 956 cases of HA were reported in Huai’an city, accounting for 4.14% of viral hepatitis cases, with an average annual incidence rate of 1.97 per 100 000 population.Join point regression analysis indicated a significant overall declining trend in HA incidence from 2004 to 2023, with an Average Annual Percentage Change (AAPC) of -12.816% (P=0.016), with inflection points identified in 2006, 2015, and 2018. The peak months for HA cases were March to June and August; the male-to-female incidence ratio was 2.04, with the highest number of cases reported in the age group of 50 to <55 years. Farmers constituted the largest occupational group, accounting for 72.65% (1 421 cases). During the same period, a total of 3 097 cases of HE was reported, accounting for 6.55% of viral hepatitis cases, with an average annual incidence rate of 3.12 per 100 000 population. Join point regression analysis showed a significant overall increasing trend in HE incidence from 2004 to 2023, with an AAPC of 9.266% (P=0.001) and inflection points in 2011 and 2020.The peak months for HE cases were January to May; the male-to-female incidence ratio was 2.93, with the highest number of cases reported in the age group of 55 to <60 years. Farmers also represented the highest occupational group, accounting for 74.91%(2 320 cases).

From 2004 to 2023, HA showed a declining trend while HE exhibited an increasing trend in Huai’an city. Future efforts should focus on implementing vaccination strategies and prioritizing farmers as a key population for comprehensive prevention and control measures to effectively manage the spread of HA and HE.

To explore the potential causal relationship between Sjögren’s syndrome (SS) and thyroid diseases using a two-sample bidirectional Mendelian randomization (MR) approach.

Data were sourced from genome-wide association studies (GWAS), obtaining samples and single nucleotide polymorphisms (SNPs) related to SS and thyroid diseases, which included hyperthyroidism, hypothyroidism, goiter, Hashimoto thyroiditis (HT), Graves’ Disease (GD), and thyroid carcinoma (THCA). The inverse variance weighting (IVW) method was employed as the primary analysis approach, supplemented by the weighted median method (WME) and MR-Egger regression model for MR analysis, along with sensitivity analyses to ensure the robustness of results. The Bonferroni method was used to correct for multiple testing, with a correction threshold set at P=0.008(0.05/6), considering P-values between 0.008 and 0.05 as potentially relevant.

Genetically predicted SS was found to have a positive causal relationship with the risk of hypothyroidism (IVW: OR=1.372, 95%CI: 1.124-1.674) and HT (IVW: OR=1.254, 95%CI: 1.142-1.377). SS was not associated with an increased or decreased risk of hyperthyroidism (IVW: OR=1.435,95%CI: 1.012-2.036), goiter (IVW: OR=0.933, 95%CI: 0.838-1.040), GD (MR-Egger: OR=4.094, 95%CI: 2.818-5.947), or THCA (IVW: OR=1.057, 95%CI: 0.866-1.29). Hyperthyroidism (IVW: OR=1.950, 95% CI: 0.776-1.163), hypothyroidism (IVW: OR=1.149, 95%CI: 0.93-1.42), goiter (IVW: OR=0.992, 95%CI: 0.85-1.157), HT (IVW: OR=1.532, 95%CI: 1.055-2.225), GD (IVW: OR=1.041, 95%CI: 0.728-1.488), and THCA (IVW: OR=0.987, 95%CI: 0.874-1.114) were not found to increase or decrease the risk of SS.

Genetically predicted SS is a risk factor for hypothyroidism and HT. There is no association between SS and the risk of hyperthyroidism, goiter, GD, or THCA.