To investigate the causal relationship between gestational diabetes mellitus (GDM) and attention deficit hyperactivity disorder (ADHD) using Mendelian randomization to provide genetic evidence supporting the risk of developing ADHD.

Based on pooled data from genome-wide association analyses, MR analysis was conducted using five methods, including the inverse variance weighting method, MR-Egger regression, and the weighted median method. Sensitivity analyses were performed using the MR-Egger regression test, the MR-PRESSO test, the Cochran Q test, and the leave-one-out method. Two-sample MR analyses and validation group analyses explored the existence of a causal relationship between GDM and ADHD, while multivariate Mendelian randomization examined the direct, independent causal effect of GDM on ADHD after adjusting for factors such as obesity and autism spectrum disorder (ASD).

The two-sample MR preliminary analysis (OR=1.209, 95% CI: 1.023-1.423, P=0.026) and the validation group analysis (OR=1.030, 95% CI: 1.006-1.055, P=0.015) indicated that GDM had a positive causal relationship with the risk of ADHD, suggesting that an increased risk of GDM contributing to a higher risk of ADHD. The results of MVMR analysis showed that GDM and ADHD still showed a causal relationship after controlling for Obesity and ASD (OR=1.030, 95% CI:1.008-1.054, P=0.008).

This study confirms the causal relationships between GDM, obesity, and ASD with ADHD from a genetic perspective, providing a reference for future research.

To explore the changes in the quality of life and its influencing factors of elderly people in rural areas of Sichuan province from 2018 to 2023, and to provide a basis for timely adjustment of health intervention measures.

Data from the sixth and seventh health service surveys in Sichuan province in 2018 and 2023 were summarized, and the EQ-5D questionnaire health utility value and visual analogue scale (VAS) score were used to evaluate quality of life.Survey time interaction items were includedin a weighted two-level random intercept model to explore the differences in the effects of influencing factors.

The utility value of elderly people in rural areas of Sichuan province was 0.83±0.22, and the VAS score was 65.53±17.81, both lower than the national average. Analysis showedthat survey year, individual characteristics, lifestyle, chronic disease prevalence, and family medical factors wereinfluencing factors for utility value and VAS score. In addition, in the utility score, the interaction items of over 80 years old (β=0.046, P<0.001), 1-2 times of weekly exercise (β=-0.035, P=0.045), diabetes (β=0.032, P=0.031), and annual family income of over 50 000 (β=0.029, P=0.048) with time were statistically significant; In VAS score, the interaction between time and age of over 80 years old (β=4.647, P<0.001), primary and junior high school education (β=-3.301, P<0.001), alcohol consumption (β=-2.262, P=0.004), diabetes (β=4.946, P<0.001), hypertension (β=2.992, P<0.001), annual family income of more than 50 000 (β=4.322, P<0.001), physical examination in the past year (β=2.925, P<0.001) had statistical significance.

The quality of life of elderly people in rural areas of Sichuan province is relatively low and requires attention. When formulating health intervention measures, full consideration should be given to the changes in the above factors and effects.

To analyze the spatial and temporal distribution characteristics and changing trends of newly reported HIV / AIDS cases aged 50 years and over in Guizhou Province from 2018 to 2023, and to provide scientific basis for ≥50 years old AIDS prevention and control.

Using the database of the AIDS comprehensive prevention and control data information system, the newly reported cases aged 50 years and over from 2018 to 2023 were screened out, and their demographic characteristics were analyzed. Then use ArcGIS software for spatial autocorrelation analysis.

From 2018 to 2023, the proportion of HIV/AIDS cases aged 50 and above in Guizhou Province increased from 46.91% in 2018 to 56.99% in 2023, and the proportion increased year by year(trend χ²=249.968, P<0.001),and the distribution of local areas was concentrated.The global Moran ’s I was between 0.336 3 and 0.395 0(P<0.001). It showed that there was a global spatial autocorrelation in 2018-2023. SatScan showed six clusters, among which Puding, Xixiu, Zhenning, Liuzhi, Zhijin and Guanling were the most likely to gather (RR=2.990, LLR=1 222.719), which was also highly consistent with the results of spatial autocorrelation analysis.

The newly-discovered HIV / AIDS patients aged 50 and above in Guizhou Province in recent years have spatial clustering, mainly concentrated in the central and western and southern regions of Guizhou Province. It is recommended to strengthen the comprehensive prevention and control of AIDS in areas with high incidence of epidemic, especially to carry out targeted preventive measures in time in areas with a trend of spread.

To evaluate the epidemic intensity of scarlet fever in Xinjiang using the Moving Epidemic Method (MEM), and to provide evidences for the classification of early warning of scarlet fever.

Monitoring data on scarlet fever in Xinjiang from 2014 to 2023 were collected, with the weekly incidence rate serving as the research object. The δ value corresponding to the maximum Youden index was selected to establish the MEM model. The epidemic thresholds for the two epidemic seasons of scarlet fever were estimated separately. The effectiveness of the MEM was evaluated through a cross-validation procedure. The epidemic level of scarlet fever in Xinjiang from 2014 to 2023 was assessed, and predictions were made for the spring epidemic season in 2024.

The optimal δ value for the spring epidemic peak of scarlet fever in Xinjiang was 2.5. The sensitivity of the model fitting was 0.83, the specificity was 0.91, and the Youden index was 0.74. For the autumn epidemic peak model, the optimal δ value was 2.6, with a sensitivity of 0.90, a specificity of 0.93, and a Youden index of 0.83. In the spring of 2024, the epidemic season entered the low-epidemic level in the 13th week and rose to the medium-epidemic level in the 23rd week, after which it maintained the low-epidemic level. By the 28th week, the epidemic level had fallen below the epidemic threshold, and there were no high or very high epidemic levels observed.

For the bimodal epidemic characteristics of scarlet fever in Xinjiang, the MEM model can be used to determine the epidemic intensity thresholds of different epidemic seasons by splitting the epidemic season, which is proved to be feasible. The model can be used to establish a scarlet fever early warning system, which provides a scientific basis for guiding the classification and early warning of scarlet fever.

To investigate the associations between visceral obesity indices and the co-morbidities of hypertension, diabetes mellitus, and dyslipidemia in steel workers.

This study included 7 318 steelworkers, using multivariate logistic regression to analyze the connection between visceral adiposity-related indices and the co-morbidity of "three highs".

A total of 7 318 steel workers were included, with 1 759 diagnosed with all three conditions, accounting for a 24.04% prevalence rate. After adjusting for age and gender, significant correlations were found between LAP, TyG, and their combined indices with various types of co-morbidities (P<0.001). No interactions were observed between age and these indices in the context of co-morbidities (P_interaction>0.05), except for the TyG-WC index in cases of two diseases co-occurring (P_interaction<0.05), and the LAP index, TyG-WHtR index, and LAP-BMI index when all three diseases co-occurred (P_interaction<0.05).

The LAP index, TyG index, and their combined indices are closely associated with the co-morbidities of hypertension, hyperglycemia, and hyperlipidemia in steelworkers.

To analyze theassociation and interactionof night shift work and unhealthy lifestyle on hyperhomocysteinemia(HHcy), and to provide basis for theHHcy preventionamong railway workers.

Total of 6 926 railway workers who received physical examination in a hospital in Guangzhou from September to December 2021 were selected as study objects. Binary logistic was performed to analyze correlation, the restricted cubic spline (RCS) model was used to assess the dose-response relationship, and the interaction of night shift work and unhealthy lifestyle with HHcy were analyzed.

The prevalence rate of HHcy among railway workers was 23.3%. Logistic regression showed that night shift work lasted 0-2.9 years (OR=1.340, 95% CI:1.120-1.603), night shift work frequency ≤ 1 d/w (OR=1.302, 95% CI:1.029-1.646) or ≥ 4 d/w (OR=1.516, 95% CI:1.248-1.841), smoking (OR=1.516, 95% CI:1.248-1.841), overweight (OR=1.173, 95% CI: 1.030-1.335) were positively correlated with HHcy. Sleep duration > 7 h/d and exercise were negatively correlated with HHcy (P<0.05). RCS model found a nonlinear relationship of night shift work with HHcy (P_total <0.001,P_non-linear=0.001). No multiplicative and additive interaction of night shift work and any unhealthylifestyle with HHcy were found(P> 0.05). Among different night shift conditions, smoking, almost inactive, overweight/obesity, and ≤ 7 h/d sleep had a higher risk of HHcy (P<0.05).

Night shift work and unhealthy lifestyle are risk factors for HHcy. In different night shift work conditions, smoking, almost inactive, overweight/obesity, sleep duration ≤ 7 h/d can increase HHcy risk.

To explore the relationship between dietary fiber intake and cognitive function, providing insights for nutritional interventions to prevent cognitive impairment.

Adults over 50 years old from the 2022 Southwest Population Cohort were selected as study subjects. Multiple linear regression and multivariable logistic regression models were used to analyze the relationship between dietary fiber intake and cognitive impairment. Subgroup analysis was performed to explore the association between dietary fiber intake and cognitive impairment across different age and gender groups.

A total of 1 267 participants were included,the median dietary fiber intake of the participants was 13.3 g/d. The dietary fiber intake of individuals with cognitive dysfunction, specifically those with mild cognitive impairment (11.6 g/d), was significantly lower than that of the normal group (13.7 g/d), and the difference was statistically significant (Z=3.93, P<0.001). After adjusting for age, gender, body mass index, education, smoking, per capita monthly household income, hypertension, diabetes, and daily energy intake, dietary fiber intake was positively correlated with cognitive function scores. The logistic regression analysis showed that, compared to the lowest dietary fiber intake group (Q1), the highest dietary fiber intake group (Q4) had a reduced risk of cognitive dysfunction, with statistically significant OR values of 0.29 (95% CI: 0.16–0.53), 0.27 (95% CI: 0.14–0.49), and 0.39 (95% CI: 0.18–0.84). The impact of dietary fiber intake was more pronounced in males and in individuals aged 63 and above.

There is a negative association between dietary fiber intake and cognitive dysfunction, suggesting that dietary fiber may be a protective factor against cognitive dysfunction, with this association being particularly significant in males and individuals aged 63 years and older.

To explore the potential relationship between dietary carotenoid intake and neurodegenerative diseases based on NHANES data.

A multifactorial logistic regression model was used to analyze the relationship between dietary carotenoid intake and neurodegenerative diseases and to explore the association between dietary carotenoid intake and neurodegenerative diseases in different gender and age subgroups, using the NHANES database of people aged 40 years and older from 2003-2018 as the study population.

Of the 23 108 study participants included in this study, 216 had Parkinson’s disease dementia (PD) and 183 had Alzheimer’s disease (AD). The carotenoid intake of PD patients (7,597.9 mcg/d) was significantly lower than that of the normal population (8,719.8 mcg/d) and the difference was statistically significant, while that of AD patients (7 189.8 mcg/d) was significantly lower than that of the normal population (8,721.4 mcg/d) and the difference was statistically significant. After adjusting for age, sex, body mass index, race, education, alcohol consumption, smoking, household poverty-to-income ratio, hypertension, diabetes mellitus, Cardiovascular disease and the NHANES cycle, the prevalence of PD was significantly lower in the highest tertile group compared with the lowest tertile group (OR=0.65, 95% CI: 0.44-0.98), and the risk of AD was significantly lower in the Q2 group (OR=0.65, 95% CI: 0.43-0.99). In subgroup analyses, a lower risk of PD was observed in the group with the highest dietary carotenoid intake in those aged 70 years or older (OR=0.52, 95% CI: 0.30-0.96); the protective effect of dietary carotenoid intake on AD was demonstrated in the Q4 group of women (OR=0.49, 95% CI: 0.26-0.93).

There is a negative association between carotenoid intake and the risk of developing neurodegenerative diseases, and carotenoids may be a protective factor against neurodegenerative diseases, a relationship that varies by age, sex, and whether or not the individual has hypertension or diabetes.

To investigate the differences in gut microbiota and energy metabolism among individuals with varying body mass index (BMI) levels, and to provide insights for the prevention and treatment of overweight and obesity.

A total of 98 healthy adults were recruited from Chengdu, categorized into four groups based on BMI: overweight (n=16), obesity (n=15), underweight (n=16), and normal weight (n=51). Participants underwent questionnaire surveys, physical examinations, body composition analysis, biochemical tests, and energy expenditure measurements. Fecal samples were collected for 16S rDNA sequencing and gas chromatography-mass spectrometry (GC-MS) metabolomics analysis. Univariate analysis of variance and chi-square tests were performed to compare differences in gut microbiota structure and energy metabolism among the four groups.

Gut microbiota structure analysis: Significant differences were observed in the gut microbiota structure among the four groups, with statistical significance in ACE and Chao1 indices (P=0.003, P=0.003). The normal weight group exhibited higher ACE and Chao1 indices compared to other groups, indicating a higher species richness. The relative abundance of different bacteria varied across groups. Compared to the normal weight group, the overweight, obese, and underweight groups showed reduced species richness and lower relative abundance of beneficial bacteria such as Bifidobacterium. Functional metabolic pathways of the gut microbiota were altered in these groups, with significant differences in the synthesis and metabolism of various amino acids, including glycine, in the overweight and obese groups (P=0.009, P=0.032).Correlation with BMI and energy expenditure indicators: The gut microbiota structure was associated with different levels of energy metabolism indicators. Bifidobacterium was positively correlated with cold-induced thermogenesis (CIT) (P=0.011), while Bifidobacterium animalis was negatively correlated with BMI and basal energy expenditure (BEE) (P<0.001), and positively correlated with CIT (P=0.029).

There are differences in gut microbiota structure and functional metabolic pathways among individuals with different BMI levels. The gut microbiota structure is associated with various energy metabolism indicators at different levels. These findings suggest that gut microbiota may play a role in energy metabolism and could be a potential target for interventions aimed at preventing and treating overweight and obesity.

Toinvestigate whether maternal vitamin D deficiency (VDD) prevents normal placental development through the Wnt/β-catenin signalling pathway during preconception and pregnancy, which in turn triggers adverse pregnancy outcomes.

Four-week-old female SD rats were randomly divided into two groups according to body mass, Ctrl group fed with standard rat chow and VDD group fed with vitamin D deficiency chow. After eight weeks of feed intervention and successful construction of the VDD rat model, blood was taken from the orbits, male and female were co-caged. The females were executed at 18 days of gestation (GD18).Tissue samples were collectedfor later experiment.

At eight weeks of modelling,the serum 25(OH)D levels of female rats in VDD group were significantly lower compared with those of the Ctrl group(P<0.001). At GD18, measured the placental 25(OH)D, 1,25(OH)₂D, and VDR levels, these indexes in the VDD group were (6.75 ± 1.40) ng/ml, (24.23 ± 8.31) ng/L, (74.46±27.54) nmol/L, which were significantly lower than indexes in the Ctrl group: (16.76±3.12) ng/ml, (36.19±4.27) ng/L, and (137.52±26.25) nmol/L(P<0.01). Placenta diameter, weight, syncytial trophoblast area, and foetal weight were measured at GD18. There was a significant difference between the two groups. At GD18, compared with the Ctrl group, the number of implanted fetuses and live fetuses per litter decreased, but the number of absorbed fetuses increased in the VDD group. The level of β-catenin hosphorylation was significantly increase in the placental tissues of pregnant rats in the VDD group.

Maternal vitamin D deficiency before and during pregnancy is an important cause of placental dysplasia, which in turn can induce adverse pregnancy outcomes, and the mechanism may involve the Wnt/β-catenin signalling pathway.

To examine the frequency and distribution patterns of birth defects in Hainan Province between 2016 and 2021, in order to offer insights for the improvement of maternal and child health services in the region.

Data on perinatal birth defect surveillance were gathered and analyzed from 28 weeks of gestation to 7 days postpartum in all monitored hospitals across Hainan Province between January 1, 2016 to December 31, 2021.

The comprehensive dataset revealed a total of 346 425 births recorded in Hainan Province from 2016 to 2021. Of these, 11 000 cases were identified with birth defects, translating to an average incidence rate of 317.53 per 10 000 births. Notably, the incidence of birth defects varied significantly across different demographics. Rural areas exhibited a lower rate (297.90 per 10 000) compared to urban areas (338.88 per 10 000), with a statistically significant difference (χ²=67.977, P<0.001). Additionally, male neonates showed a higher incidence (346.22 per 10 000) than female neonates (281.32 per 10 000), also with a statistically significant difference (χ²=164.878, P<0.001). Maternal age played a crucial role as well, with the 35-year-old and older age group demonstrating the highest incidence (364.81 per 10 000).The five most prevalent birth defects included congenital heart disease (180.99 per 10 000), polydactyly (20.24 per 10 000), talipes equinovarus (12.04 per 10 000), other external ear malformations (10.74 per 10 000), and syndactyly (5.05 per 10 000).Regarding prenatal diagnosis, only 11.72% of birth defects were confirmed prenatally, with clinical and ultrasonic diagnosis accounting for 98.87% of the total diagnoses. In terms of prognosis, a promising 91.92% of fetuses with congenital disorders were live births.

Suggest an increase in the prevalence of perinatal birth abnormalities in Hainan Province from 2016 to 2021. In response to these findings, it is imperative to strengthen the three-level preventive measures of birth defects, aiming to reduce incidence rates.

To construct the evaluation index system of public hospital operation management to provide a reference tool for administrative departments and public hospitals to grasp the public hospital operation management situation.

Based on the balanced scorecard theory, the evaluation index system of public hospital operation management was initially constructed through literature analysis, the final evaluation index system was determined by Delphi method, and the index weight was calculated by AHP method.

The response rate of expert consultation for the secondround was 100%, the authority coefficient was 0.840 and the coordination coefficients of the importance, feasibility and relevance of the indicators were 0.210, 0.181 and 0.196, respectively (P<0.001). The final evaluation index system consisted of 4 first-level indicators, 16 second-level indicators and 39 third-level indicators. The top 3 indicators of combined weight were inpatient satisfaction(0.0979), outpatient satisfaction(0.0682) and the proportion of medical service income(0.0494).

The public hospital operation management evaluation index system constructed by this research had high scientific, rational and practical guiding significance and was an effective tool to analyze and evaluate the operation management of public hospitals.

To construct an evaluation indicator system for the development of occupational disease clinical specialties, providing a basis for the construction and evaluation of occupational disease clinical specialties.

An initial expert consultation questionnaire was developed through literature research and group discussions. The Delphi method was applied to conduct two rounds of expert consultations with 34 experts in the field of occupational diseases from 13 provinces (autonomous regions and municipalities) including Beijing, Sichuan, and Henan. The final evaluation indicator system for occupational disease clinical specialties was formed, and the hierarchical weights of each index were determined using the priority diagram method.

The response rates for the two rounds of expert consultations were 97.14% and 94.12%. The expert authority coefficients were 0.856 and 0.860, and the Kendall’s concordance coefficients of the experts were 0.18 and 0.12 (P<0.01). The final occupational disease clinical specialty evaluation indicator system consisted of 5 first-level indicators, 17 second-level indicators, and 67 third-level indicators.

The enthusiasm, authority, and consistency of the two rounds of expert consultations were high. This evaluation indicator system is scientifically sound and reliable, providing a reference for the construction and high-quality development of occupational disease clinical specialties.

To understand the current situation of the construction of the integration mechanism of medical treatment and prevention in infectious disease hospitals in China, and to provide data support for the promotion of related work and policy formulation.

Based on the survey data of the construction of the integration mechanism of medical treatment and prevention in infectious disease hospitals in China, a quantitative analysis was conducted on the current situation of the related work of the integration of medical treatment and prevention in 97 secondary and tertiary infectious disease hospitals. A difference analysis was carried out on the current situation of the integration of medical treatment and prevention in different regions. Moreover, the t-SNE algorithm and data visualization were used to cluster the sample institutions for a comparative study at the hospital level.

Among the sample institutions in the eastern region, 46.51% had policy support related to the integration of medical treatment and prevention at the provincial (municipal) level, with an obvious advantage compared to other regions (P=0.001). The proportions of sample institutions in the eastern and central regions that established internal systems for the integration of medical treatment and prevention were higher (P=0.015), accounting for 27.91% and 28.57% respectively. In terms of the proportion of infectious disease hospitals that independently set up public health departments: the eastern region had the highest proportion, accounting for 72.09%; the northeastern region had the lowest proportion, accounting for 20.00%; and there were significant statistical differences among different regions (P=0.001). The t-SNE algorithm grouped the sample institutions into three categories: head tertiary hospitals, typical secondary hospitals and medium-sized hospitals. The construction of the integration mechanism of medical treatment and prevention in the three hospitals in head tertiary hospitals was significantly better than that in the other two categories.

The work on the integration of medical treatment and prevention for infectious diseases in China is still in the stage of exploration and breakthrough. All regions should explore the models and paths for the integration of medical treatment and prevention for infectious diseases in combination with local actual situations. The pilot construction of the integration of medical treatment and prevention of infectious diseases at both the "regional" and "hospital" levels should be coordinated，in order to promote infectious disease hospitals to better fulfill their public health functions, and take this as a breakthrough to open up the effective integration and interconnection of personnel, information and resources between medical institutions and disease control institutions.

To analyze the impact of DIP payment reform on total hospitalization costs, drug costs, and treatment costs of hospitalized patients with chronic lung disease, and to provide a decision-making reference for the deepening reform of DIP.

Using the first national DIP pilot cities as a sample area, case data of 10 058 chronic lung patients hospitalized in provincial hospitals in the area were extracted for the study, and the causal effects of DIP on total patient costs, drug costs and treatment costs were estimated by the PSM-DID model.

After the DIP payment reform, the total cost for patients with chronic obstructive pulmonary disease decreased by 5.9% (P=0.001), were 1 162.92 yuan; the cost of medication decreased by 8.83% (P=0.003), were 477.21 yuan; and the cost of treatment decreased by 27.3% (P=0.001), were 152.54 yuan.

The DIP payment reform has achieved short-term reform effects on reducing total hospitalization costs, drug costs, and treatment costs for patients hospitalized with chronic obstructive pulmonary disease. In order to guarantee the continuous implementation of DIP, the medical insurance department should also continue to strengthen the supervision of the diagnosis and treatment process of medical institutions to maintain the long-term continuation of the effect of fee-control; medical institutions should further promote the refinement of management.

To explore the association between physical activity level (PAL) and Circadian syndrome (CircS) in Chinese middle-aged and elderly population.

Based on the 2013 China Health and Retirement Longitudinal Study (CHARLS) data, middle-aged and elderly people ≥45 years old with complete key data were selected. The association between PAL and CircS was analysed by multiple logistic regression. In addition, subgroup analyses, interaction tests, smoothed curve fitting, and threshold effect analyses were performed.

A total of 5 851 middle-aged and older adults were included as study subjects, with a prevalence of CircS of 24.18% and PAL of 4 548 (1 732.5, 10 584)(MET-min/w). Fully adjusted multivariate logistic regression showed a significant negative association between PAL and CircS prevalence (OR=0.73, 95% CI: 0.62-0.87; P<0.001). The consistency of this association was confirmed by subset analyses and interaction tests for multiple subgroups. Smoothed curve fitting and threshold effect analyses revealed a nonlinear relationship with a threshold of 3 810 MET-min/w.

There is a negative association between the PAL and the risk of developing CircS. Moderate physical activity may allow early intervention in individuals at risk for CircS.

This study aimed to identify the dual trajectories of social isolation and depression among middle-aged and older patients with hypertension, discuss the relationship between the dual trajectories, and investigate common influential factors. Method Using data from 2013 to 2020 of the China Health and Retirement Longitudinal Study (CHARLS), a longitudinal cohort was formed for the study. A group-based trajectory model was used to identify trajectories of social isolation and depression in 3 223 middle-aged and older patients with hypertension and the relationship between the dual trajectories. Multi-class logistic regression was used to analyze common influential factors of the dual trajectories.

Three trajectories of social isolation were identified: low-stable without social isolation, medium-stable without social isolation, and high-increasing with social isolation. Three depression trajectories were observed: low-stable without depression, medium-increasing with depression, and high-stable with depression. Dual-trajectory analysis showed in middle-aged and older patients with hypertension who were in the medium-stable without social isolation and high-increasing with social isolation trajectory groups, the probability of depression trajectories in the medium-increasing with depression and high-stable with depression groups was 61.84% to 87.46%. In middle-aged and older patients with hypertension who belonged to the medium-increasing with depression and high-stable with depression trajectory groups, the probability of social isolation in the medium-stable without social isolation and high-increasing with social isolation trajectory groups was 70.03% to 91.63%. The level of education(social isolation trajectories in middle school RRR=0.756, 95% CI：0.599-0.954, RRR=0.496, 95% CI: 0.326-0.755; social isolation trajectories in high school or above RRR=0.516, 95% CI: 0.375-0.709, RRR=0.262, 95% CI: 0.137-0.501; depression trajectories in middle school RRR=0.773, 95% CI: 0.622-0.959, RRR=0.728, 95% CI: 0.574-0.994, depression trajectories in high school or above RRR=0.421, 95% CI: 0.309-0.571, RRR=0.439, 95% CI: 0.253-0.763) and sleeping 7-9 hours a night (social isolation trajectories RRR=0.824, 95% CI: 0.681-0.997, RRR=0.596, 95% CI: 0.440-0.806; depression trajectories RRR=0.597, 95% CI: 0.501-0.711, RRR=0.486, 95% CI: 0.362-0.653) were common influential factors of the dual trajectories of social isolation and depression.

There is a high degree of consistency and significant correlation between the social isolation trajectory and the depression trajectory. Interventions targeting the dual trajectories and co-factors of social isolation and depression should be considered to improve their effectiveness.

To explore the effects of individual smoking cessation cognition and spousal support on married smokers’ smoking cessation behavior, and to analyse the role of gender differences on smoking cessation behavior.

A convenience sampling method was used to recruit married smokers from Jiangsu and Shandong to conduct an online questionnaire survey to collect information on demographic characteristics, smoking and cessation, individual smoking cessation cognition and spousal support. Binary logistic regression was used to analyse the relationships between smoking cessation cognition, spousal support, smoking cessation attempts, and the willingness to quit smoking with family support.

715 married smokers completed the questionnaire. After controlling for potential confounders, the results showed that perceived risk of smoking-related diseases (aOR=1.29, 95% CI: 1.05–1.59) and positive outcome expectations for quitting (aOR=1.27, 95% CI: 1.06–1.51) were positively associated with smoking cessation attempts among married male smokers, whereas no statistical associationwas found between smoking cessation cognition and smoking cessation attempts among women. Regardless of gender, perceived risk of smoking-related diseases, self-efficacy, smoking cessation plan, and spousal emotional support were positively associated with the willingness to quit smoking; negative outcome expectations for quitting (aOR=0.78, 95% CI: 0.65–0.93) were negatively associated with the willingness to quit smoking among male smokers, while no statistically significant associationwas found among female smokers.

Perceived risk of smoking-related diseases and positive outcome expectations for quitting are protective factors for smoking cessation attempts among married male smokers, while female smokers’ smoking cessation cognition failed to translate into actual quitting behavior. Additionally, negative outcome expectations for quitting are risk factors for willingness to quit smoking among married male smokers. Therefore, individualized smoking cessation intervention strategies should be developed taking into account gender differences.

To understand the current status of digital health literacy among rural elderly individuals in Shandong Province and analyze the main influencing factors.

A multi-stage stratified cluster random sampling method was employed to select 720 rural individuals aged 60 years and older from the eastern, central, and western regions of Shandong Province for a questionnaire survey. Multiple linear regression analysis was used to explore the factors influencing digital health literacy among the elderly.

The average digital health literacy score of the 720 rural elderly participants was 58.31±16.34. Multiple linear regression revealed that factors associated with higher digital health literacy included normal BMI (β=8.28, P<0.001), low body weight (β=18.61, P<0.001), self-reported good health status (β=6.90, P<0.001), general health status (β=10.20, P<0.001), being married (β=3.49, P=0.001), monthly income between 3 000-4 999 yuan (β=6.75, P<0.001), income ≥5 000 yuan (β=11.48, P<0.001), and having health insurance coverage (urban employee health insurance/rural resident health insurance) (β=5.58, P=0.001).

The level of digital health literacy among rural elderly individuals in Shandong Province needs improvement. Targeted measures should be implemented from five aspects: personal traits, behavioral characteristics, interpersonal relationships, living and working conditions, and policy environment, in order to enhance digital health literacy in this population.

To explore the mechanism of Mycobacterium tuberculosis (Mtb) resistance to fluoroquinolones (FQs) drugs at the genetic level, the whole genome sequencing of fluoroquinolone-resistant Mtb induced in vitro and clinical isolates was conducted.

Mtb standard strain H37Rv was induced into standard levofloxacin (LFX) resistant strain and high-level drug-resistant strain in LJ medium by concentration gradient induction method in vitro. The induced strains and drug-free control strains of each generation were collected and preserved. FQs-resistant strains in clinical isolates were screened, and the sensitivity of the induced strains and clinical isolates to 14 anti-tuberculosis drugs was detected by liquid microplate method, and then the whole genome was sequenced and analyzed.

The analysis of LFX-resistant Mtb model found that the resistance of Mtb to FQs drugs may be related to gene mutations, gyrB (Ala504Thr, Asp461Asn), gyrA (Ala90Val), PE_PGRS31 (Ala395fs), panB (Asp184_Ala187del), aroD (Asp61Asn), devS (Gly348Arg) and rv3446c (Ala178Thr). GWAS analysis of clinical isolates detected 17 new mutation sites that may be related to FQs drug resistance, namely gyrA(p.Glu21Gln, p.Gly668Asp, p.Ser95Thr, p.Glu213Asp, p.His280Arg, p.Ala384Val), gyrB(er132Ala, p.Met291Ile), PE_PGRS31(p.Ser365Phe, p.Pro254Leu, p.Thr252Ile, p.Val352Ile), rv3446c(p.Arg284Pro, p.Leu389Phe, p.Ala164Val) anddevS(p.Val307Ala, p.Ile283Thr).

The LFX-resistant Mtb model constructed in this study provides an ideal biological model for exploring the mechanism of Mtb drug resistance to FQs. Whole genome sequencing has analyzed the mechanism of Mycobacterium tuberculosis resistance to fluoroquinolones from the gene level, and the obtained new mutation sites related to fluoroquinolone resistance still need to be further studied and verified.

To study the effect and mechanism of nicotinamide mononucleotide (NMN) in alleviating silica-induced lung injury, and to provide a new option for the adjuvant treatment of silicosis.

The male C57BL/6 mice were randomly divided into control group, SiO₂ group, and NMN intervention group according to body weight, with 10 mice in each group. Mice were given SiO₂ (50 mg/ml, 80 μl) by tracheal instillation to construct a mouse model of silicosis, and NMN (1 000 mg/kg) was given by gavage for 7 days and 28 days. Histopathological staining was used to assess lung lesions, and transcriptomic sequencing was used to analyze gene expression and screen for key genes.

NMN intervention alleviated SiO₂-induced lung injury. Gene clustering results showed that NMN intervention improved SiO₂-induced gene expression disorders to a certain extent, and the improvement effect of 28 days was better than 7 days of NMN intervention. After 7 and 28 days of SiO₂ exposure, 1 163 genes were up-regulated in the SiO₂ group compared with the control group, and were down-regulated in the NMN group compared with the SiO₂ group, of which 445 were differential genes. Similarly, 1 657 genes were down-regulated in the SiO₂ group compared with the control group, and were up-regulated in the NMN group compared with the SiO₂ group, of which 571 were differential genes. The main GO term of the above differential genes was RNA polymerase and transcriptional regulation, and main KEGG pathways were IL-17 signaling pathway (P<0.001), cytokine-cytokine receptor interaction (P<0.001), Th17 cell differentiation (P<0.001), TNF signaling pathway (P<0.001). According to the number of pathways involved in the regulation of differential genes, the TOP8 hub genes were Mapk11, Mapk12, Il1b, H2-Ob, Csf2, Shc2, Mmp9, Ccl25.

NMN alleviates lung injury in silicosis mice by regulating immunity.

To assess Hantaan virus infection risk across districts in Sichuan Province, providing a scientific basis for prevention and intervention measures for Hemorrhagic Fever with Renal Syndrome (HFRS) and data for evaluating their effectiveness.

This study utilized open-source databases and mathematical modeling. HFRS case report data were collected to analyze epidemic status and spatial distribution using traditional epidemiological methods, while a Bayesian spatiotemporal model examined temporal effects, spatial effects, spatiotemporal interactions, and the impact of meteorological, socioeconomic, and healthcare factors on regional risk levels.

From 2015 to 2021, HFRS incidence in Sichuan showed temporal variation and seasonality, with Yanyuan County reporting the highest cases. Spatial analysis indicated that most districts had risk values consistent with the provincial average, with high-risk areas in the southern, northeastern and central regions. Relative risk declined overall from 2015 to 2020, with a 41.7% decrease in 2020 compared to 2015, although a slight increase occurred in 2021 (0.22 per 100 000). Yanyuan County had the highest relative risk (2.66 [1.64, 4.57]), while other regions aligned with the provincial average. Urbanization rate and humidity affected HFRS incidence negatively, and precipitation affected HFRS incidence positively.

HFRS incidence in Sichuan Province is generally low, with higher rates in specific districts, highlighting spatial risk variability. Meteorological, socioeconomic, and healthcare factors influence infection risk. Monitoring relevant indicators and implementing timely interventions are essential to prevent increased human infection risk.

To compare the prediction effect of SARIMA and its combined models on the incidence of hand foot and mouth disease (HFMD), and to explore the influence of COVID-19 on the SARIMA model.

The incidence trend of HFMD in Shenzhen was analyzed through the time series decomposition method. A SARIMA model was established based on the monthly incidence of HFMD from 2011 to 2023. The optimal model was selected by comparing the performance of MAE, MSE, RMSE, and MAPE, and was used to construct a combined model with the SVR model and the XGBoost model. The incidence from January to July 2024 was predicted using the optimal model.

The incidence trend of HFMD in Shenzhen from 2011 to 2023 was seasonal, and the peak was from May to June and September to October each year. The SARIMA model that did not include incidence data during the COVID-19 pandemic outperformed the included model. Based on MAE, MSE and RMSE indicators, the combined model performed better than the single SARIMA model when the prediction time exceeded 4 months. The SARMI-SVR model wassuperior to the SARMI-XGBoost model in overall performance, especially in the performance of MAPE.

Including the incidence data during the COVID-19 epidemic will degrade the performance of the SARIMA model. The prediction effect of SARMI-SVR model is better than SARIMA model and SARMI-XGboost model, which can be used to predict the incidence of HFMD and provide a reference for disease surveillance and early warning.

To analyze the compensation for adverse events following immunization from vaccination under Anhui Province’s National Immunization Program (NIP) from 2012 to 2024.

Data from cases compensated for adverse events following immunization from vaccination in Anhui Province from 2012 to 2024 were collected and analyzed using descriptive NIP demiological methods.

From 2012 to 2024, there were a total of 80 AEFI compensation cases in Anhui Province for NIP vaccines, with the lowest compensation amount being 13 200 yuan and the highest compensation amount being 1.54 million yuan. The total compensation amounted to 35.49 million yuan, with an average compensation of 443 600 yuan per case (ranging from 13 200 yuan to 1.54 million yuan). The number of cases and compensation amount for those under 1 year old were the highest, with 64 cases (80.00%) and 25.29 million yuan (71.26%) respectively. In the vaccine distribution, BCG vaccine had the highest number of AEFI compensation cases and compensation amount, with 33 cases (41.25%) and 1.05 million yuan (29.64%), respectively. In terms of clinical diagnoses, neurological diseases had the highest number of cases and total compensation amount, with 33 cases (41.25%) and 2.03 million yuan (57.26%). In the damage severity classification, Grade IV had the most compensation cases, with 20 cases (25.00%), while Grade II-B had the highest total compensation amount, totaling 7.49 million yuan(21.09%). The average payment time after the investigation and diagnosis conclusion was 252.28 days.

The overall implementation of compensation for adverse events following immunization from vaccination under Anhui Province’s NIP is good, but there is a need for further improvement in compensation procedures and mechanisms.

To evaluate the efficacy of three treatment modalities, preoperative, postoperative, and combined preoperative and postoperative systemic therapy, in elderly patients with rectal cancer (RC), and to analyze the prognostic factors for elderly RC patients.

Data from 4612 RC patients aged 60 and above were used, sourced from the SEER database between 2011 and 2015. The Overlap Weighting (OW) method based on XGBoost was employed to balance covariate differences between treatment groups and assess the impact of different treatment regimens on the survival prognosis of RC patients. Survival curves were plotted using the Kaplan-Meier method, and Log-rank tests were conducted. Cox regression analysis was utilized to evaluate independent risk factors affecting the survival of RC patients.

After OW weighting, the three treatment groups achieved balance across all covariates. The survival rates among different treatment groups were statistically significant (P<0.001). The 1-year, 3-year, and 5-year survival rates were 94.6%, 82.2%, and 71.6% for the preoperative systemic therapy group, 95.0%, 79.0%, and 67.8% for the postoperative systemic therapy group, and 97.3%, 85.5%, and 73.4% for the combined preoperative and postoperative systemic therapy group, respectively. Multivariate Cox regression analysis revealed that, compared to the preoperative systemic therapy group, the specific death hazard ratio for the postoperative systemic therapy group was 1.216(95% CI: 1.072-1.381). Patients with liver metastasis had a specific death hazard ratio of 1.719(95% CI: 1.253-2.358) compared to those without liver metastasis.

The sequence of systematic treatment has a significant impact on the survival prognosis of elderly RC patients. After controlling for factors such as age and gender, preoperative systemic treatment had a better survival prognosis among the three treatment methods; Liver metastasis may be an independent factor affecting the prognosis of RC patients.

To analyze the risk factors for cognitive impairment in patients with multimorbidity.

Studies on the occurrence of cognitive impairment in patients with multimorbidity were identified by searching Chinese and foreign databases: PubMed, Web of Science, Embase, Cochrane library, CNKI, Wan Fang Data, VIP, SinoMed. The search period was from database inception to July 1, 2024, meta-analysis was performed using RevMan5.4 and Stata18.0 software.

A total of 12 studies were included, comprising 1 137 737 patients. The meta-analysis indicated that smoking (OR=1.11，95% CI=1.05-1.18), low social activity (OR=1.52，95% CI=1.06-2.17), having two chronic diseases (OR=1.15，95% CI=1.05-1.26), having three chronic diseases (OR=1.37，95% CI=0.96-1.94), having four or more chronic diseases (OR=1.67，95% CI=1.49-1.87), having two cardiovascular metabolic diseases (OR=1.72，95% CI=1.42-2.07), having three or more cardiovascular metabolic diseases (OR=2.53，95% CI=1.41-4.54), and eight multimorbidity models were the neuropsychiatric (OR=2.05，95% CI=1.83-2.29), cancer/sensory impairment (OR=1.32，95% CI=1.18-1.47) diabetes/heart disease (OR=2.17，95% CI=1.68-2.08) diabetes/stroke (OR=2.92，95% CI=1.49-5.71), diabetes/hypertension (OR=1.93，95% CI=1.72-2.17), hypertension/heart disease (OR=1.56，95% CI=1.40-1.74), stroke/heart disease (OR=2.65，95% CI=1.89-3.71), and stroke/diabetes-heart disease (OR=3.95，95% CI=2.81-5.56) showed statistically significant differences (all P<0.05).

Current evidence suggests that smoking, low social activity, number of chronic diseases, and different patterns of multimorbidity are all risk factors for cognitive impairment in patients with multimorbidity, and that early clinical screening and intervention is warranted to reduce the progression of cognitive impairment in patients with multimorbidity.

To explore the relationship between body roundness index (BRI) and new onset arthritis, and provide a new perspective for the prevention and treatment of arthritis.

A cohort study design was adopted, using the data of 2011 and 2020 in the China longitudinal study on the China Health and Retirement Longitudinal Study (CHARLS), taking BRI as the exposure factor, high-density lipoprotein cholesterol (HDL-C), total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C) as the intermediary variables, including demographic characteristics such as age and gender, smoking, alcohol consumption and other health behaviors as confounding factors, and new onset arthritis as the outcome. Statistical analysis was carried out using multiple model logistic regression strategy, restricted cubic spline, subgroup analysis and intermediary analysis. Compared with relevant studies, the main purpose of the dose-response relationship we explored is to study whether there is a nonlinear relationship between exposure and outcome, that is, whether the risk of outcome will change accordingly with the change of exposure level.

A total of 5 166 participants were included, and BRI was positively correlated with arthritis, with an OR value of 1.196 (95% CI: 1.047-1.367). The prevalence of new onset arthritis increased by 19.6% when BRI increased by a quartile range; The dose-response relationship showed that BRI > 3.943 was positively correlated with the incidence of arthritis; Subgroup analysis showed that the positive correlation between BRI and new onset arthritis was not affected by many factors; Mediation analysis showed that HDL-C had a protective effect on arthritis, mediating about 6.84% of the impact of BRI on the incidence of arthritis. The mediation effect of total cholesterol, triglycerides and LDL-C was not significant; The AUC of BRI for predicting new onset arthritis (0.546) was higher than that of BMI (0.527).

The increased level of BRI may lead to an increased risk of arthritis, and HDL-C may alleviate this risk. In the future, its clinical application potential and regulatory strategies should be explored to reduce the incidence of arthritis and improve the prognosis.