To investigate the relationship between different obesity statuses in patients with cardiovascular diseases (CVD) and type 2 diabetes mellitus (T2DM) and the incidence of all-cause dementia and its subtypes.

Based on data from the UK Biobank, study subjects were categorized into five obesity states—underweight, normal weight, simple central or simple generalized obesity, combined overweight, and combined obesity—according to BMI and waist circumference. The Cox proportional hazards regression model was employed to analyze the hazard ratios (HR) and 95% confidence intervals (CI) for dementia incidence among patients with cardiovascular metabolic diseases across different obesity statuses.

A total of 63 066 CVD patients and 33 872 T2DM patients were included in the study. Compared to normal weight CVD patients, underweight individuals exhibited a 135% increased risk of vascular dementia (VD) (HR=2.35, 95%CI: 1.09-5.09). The risk of all-cause dementia and Alzheimer’s disease (AD) in patients with simple central or simple generalized obesity decreased by 26% (0.74, 0.61-0.90) and 30% (0.70, 0.51-0.95),respectively. For combined overweight patients, the risk of all-cause dementia and AD decreased by 28% (0.72, 0.64-0.82) and 29%(0.71, 0.58-0.87), respectively. In combined obesity patients, the risk of all-cause dementia, AD, and VD decreased by 35% (0.65,0.58-0.74), 40% (0.60, 0.49-0.74), and 27% (0.73, 0.57-0.93), respectively. Compared to normal weight T2DM patients, combined overweight patients showed a 39% (0.61, 0.46-0.81) and 46% (0.54, 0.36-0.81) reduction in the risk of all-cause dementia and AD,respectively. The risk of all-cause dementia, AD, and VD in combined obesity patients decreased by 35% (0.53, 0.41-0.69), 40%(0.45, 0.31-0.66), and 27% (0.53, 0.32-0.87), respectively.

There is an “obesity paradox” in dementia risk among patients with cardiovascular metabolic diseases, with a significant reduction in the incidence of dementia among patients with simple central or simple generalized obesity, combined overweight, and combined obesity.

To explore the trends in the burden of multidrug-resistant tuberculosis (MDR-TB) in China and its associated risk factors based on the Global Burden of Disease database (GBD).

Data on the incidence, mortality, and disability-adjusted life years (DALYs) related to MDR-TB in China from 1990 to 2021 were extracted from the GBD 2021 database. The trends in disease burden and risk factors were assessed using the rate of change and annual estimated percentage change.

From 1990 to 2021, the age-standardized incidence rate (ASIR) of MDR-TB in China decreased from 3.4 504(95%UI: 0.9 415 to 9.4 455) per 100 000 to 1.4 932 (95%UI: 0.2 544 to 4.6 586) per 100 000, with an estimated annual percentage change (EAPC) of -6.6 (95%CI: -7.8 to -5.38). The age-standardized DALY rate (ASDR) fell from 40.455 (95%UI:9.522 to 116.1805) per 100 000 to 5.1077 (95%UI: 0.8967 to 15.0293) per 100 000, with an EAPC of -10.07 (95%CI: -11.24 to -8.89). The age-standardized mortality rate (ASMR) decreased from 1.176 (95%UI: 0.2691 to 3.4253) per 100 000 to 0.1469(95%UI: 0.0246 to 0.4272) per 100 000, with an EAPC of -10.03 (95%CI: -11.23 to -8.82). During the same period, the number of new cases decreased by 30.07%, the number of DALYs decreased by 77.44%, and the number of deaths decreased by 71.3%. Additionally, significant age and gender disparities were observed in the burden of MDR-TB in China. From 1990 to 2021, the declines in age-standardized incidence, DALY rates, and mortality rates were more pronounced in females than in males. Furthermore, smoking, alcohol consumption, high fasting blood glucose, and high body mass index were significant contributors to DALYs and mortality related to MDR-TB, with their contributions increasing over time.

There has been a significant downward trend in the burden of MDR-TB in China from 1990 to 2021. Attention should be given to the trends in MDR-TB burden among individuals aged 60 and above and males. Tailored prevention and control policies and measures should be developed based on the characteristics of different age groups and genders, along with the primary risk factors, to effectively reduce the overall disease burden of MDR-TB in China.

To construct a stroke risk scoring tool for middle - aged and elderly Chinese people based on meta-analysis and physical examination data from primary medical institutions.

Cohort studies on risk factors for stroke onset in the Chinese population were retrieved, and predictive factors were determined through meta-analysis. Referring to the construction method of the Framingham 10-year risk scoring tool, a stroke risk scoring tool for middle-aged and elderly Chinese people was established. The Kailuan cohort and the Hongguang physical examination cohort were used as external validation populations. Indicators such as the receiver operator characteristic (ROC) curve, sensitivity, and specificity were used to evaluate the predictive efficacy of the scoring tool.

Thirty-eight studies were included in the meta-analysis, and finally 14 factors were identified as stroke predictive factors: old age, male gender, underweight, overweight, obesity, stage 1 hypertension, history of hypertension, history of diabetes, high total cholesterol, high triglycerides, low-level high-density lipoprotein, history of atrial fibrillation, family history of stroke, and current smoking. The Kailuan cohort included 137 501 people, and 2 351 cases of stroke occurred during the follow-up period. The area under the curve (AUC) was 0.74 (95%CI:0.73-0.75), the sensitivity was 0.78 (95%CI: 0.77-0.80), and the specificity was 0.59 (95%CI: 0.58-0.59). The Hongguang physical examination cohort included 7 194 subjects, and 927 people had strokes during the follow-up period. The AUC was 0.61 (95%CI: 0.59-0.63), and the sensitivity and specificity were 0.52 (95%CI: 0.50-0.56) and 0.65 (95%CI: 0.64-0.66),respectively.

The stroke risk scoring tool has good predictive efficacy in middle-aged and elderly people undergoing physical examinations. It has high feasibility for popularization and application in primary medical institutions, can help identify high-risk populations for stroke, and provide a basis for stroke prevention and intervention strategies.

To analyze the epidemiological characteristics and trends of drug-resistant tuberculosis (DR-TB) patients in Guizhou Province from 2016 to 2023, providing scientific evidence and support for DR-TB prevention and control strategies.

Using the “Tuberculosis Management Information System”, a subsystem of the “Chinese Disease Prevention and Control Information System”, descriptive epidemiological methods were employed to analyze the epidemiological characteristics and trends of DR-TB patients in Guizhou Province.

A total of 3 580 DR-TB patients were reported in Guizhou Province from 2016 to 2023; the male-to-female ratio was 2.15:1, with 2 976 cases (77.12%) among the Han ethnic group. The age group of 40-60 years accounted for the highest proportion, with 1 507 cases (42.09%). Compared to 2016, the proportion of patients aged 60 and above increased in 2023 (24.23% vs. 10.56%). Farmers represented the majority of the patients, totaling 1 844 cases (51.51%). The top three regions were Bijie city (676 cases, 18.88%), Guiyang city (571 cases, 15.95%), and Tongren city (531 cases, 14.83%). Compared to 2016, the proportions in Bijie and Tongren cities increased in 2023 (20.52% vs. 9.94%and 11.34% vs. 3.72%, respectively). The predominant drug resistance type was rifampicin resistance (98.41%), while the proportion of multidrug-resistant cases decreased in 2023 compared to 2016 (45.88% vs. 98.14%), and the proportion of pre-extensively drug-resistant cases increased (7.32% vs. 0%). The top three categories of registration were new patients, treatment failures, and relapses, with 1 317 cases (26.79%), 893 cases (24.94%), and 874 cases (24.41%), respectively. Compared to 2016, the proportions of new patients and relapses increased in 2023 (44.85% vs. 6.83% and 30.10% vs. 18.63%).

The prevention and control efforts for DR-TB in Guizhou Province from 2016 to 2023 have achieved certain results, but the situation remains severe. Future work should focus on continuously improving the application of molecular biological testing technologies, reducing relapses, optimizing resource allocation, and strengthening prevention and control measures for key populations and regions, ensuring timely and effective diagnosis and treatment services across all areas.

To investigate the prevalence of behavioral risk factors for chronic diseases among adult residents in Quanzhou city and their clustering patterns, providing a scientific basis for developing chronic disease prevention and control policies and public health measures tailored to different regions of Quanzhou.

A descriptive analysis of the prevalence of behavioral risk factors for chronic diseases was conducted. The research data were analyzed using χ² tests via SPSS 21.0, and K-Means clustering and visualization of behavioral risk factors for chronic diseases across different regions were performed using R 4.4.0.

A total of 14 087 valid samples were collected from the social factor survey among adult residents in Quanzhou city, analyzing five primary behavioral risk factors for chronic diseases. The prevalence rates, from highest to lowest, were insufficient intake of fresh fruits and vegetables (55.86%), overweight or obesity (48.85%), current smoking (18.49%), insufficient sleep (8.03%), and excessive alcohol consumption (6.30%). The clustering patterns of behavioral risk factors for chronic diseases in the city can be categorized into three types: low fruit and vegetable intake (72.49%), health-oriented (14.82%), and excessive smoking and drinking (12.69%).

The prevalence of behavioral risk factors for chronic diseases among adult residents in Quanzhou city is relatively high and exhibits distinct clustering characteristics, predominantly characterized by low fruit and vegetable intake. The proportion of individuals with healthy lifestyles is small, indicating the need for targeted public health interventions to promote healthy lifestyles for the entire population, thereby preventing the occurrence and progression of chronic diseases.

To analyze the public health emergencies caused by infectious diseases in schools in Sichuan Province from 2014 to 2023 and provide references for the prevention and control of infectious diseases in schools.

The relevant information on public health emergencies caused by infectious diseases in schools in Sichuan Province from 2014 to 2023 was collected through the “Reporting and Management Information System for Public Health Emergencies”. Descriptive epidemiological methods were used to analyze the event categories, temporal distribution, regional distribution, school types, etc.,as well as the relationship between the duration of the epidemic and the time interval from discovery.

From 2014 to 2023,a total of 363 public health emergencies caused by infectious diseases were reported in various schools in Sichuan Province, with 21 597 reported cases, 3 deaths, and 1 041 433 affected or exposed people. The incidence rate was 2.07%. The top five infectious diseases in terms of the number of events were varicella, influenza, mumps, other infectious diarrhea diseases, and hand - foot -mouth disease, accounting for 91.46% of the total number of events. In terms of temporal distribution, more events were reported in March and November. In terms of school types, primary schools reported the most events (195 cases), followed by junior high schools (66 cases). The morbidity rates of infectious disease emergencies varied in different regions, with the highest morbidity rate in urban schools. The ways of event discovery included daily monitoring by epidemic management personnel of grass - roots disease prevention and control centers (224 cases, 61.71%), reports from medical institutions (84 cases, 23.10%), reports from schools (23 cases, 6.34%), and notifications from superior or peer departments (14 cases, 3.56%). There was a positive correlation between the time interval from epidemic discovery and the duration of the epidemic (r=0.57, P < 0.001).

Schools are high-risk places for public health emergencies caused by infectious diseases. Targeted prevention and control measures should be taken according to the epidemic characteristics of different schools. The discovery and reporting of epidemics are extremely important for epidemic disposal. The coordination and cooperation mechanism among multiple departments such as education and health should be strengthened to improve the timeliness of monitoring and reporting of public health emergencies caused by infectious diseases in schools and gain the initiative in epidemic disposal.

To investigate the current status of sports equipment disinfection in kindergartens in the urban area of Yinchuan, as well as the awareness and regulations regarding disinfection, providing reference for improving hygiene and epidemic prevention in kindergartens.

Samples were collected from the surfaces of sports equipment, indoor air in sports equipment rooms, and the hands of sports staff, following the “Disinfection and Sanitation Standards for Nurseries and Kindergartens” (DB12/T447-2011) from Tianjin. A self-developed questionnaire was used to survey the usage of disinfectants, the awareness of disinfection practices among management personnel and sports staff, and the disinfection regulations in kindergartens. Statistical analysis of the testing and survey results was conducted using SPSS 18.0.

The average compliance rates for disinfection of sports equipment surfaces, indoor air in sports equipment rooms, and the hands of staff in kindergartens were 63.76%, 62.63%, and 55.29%,respectively, with no statistically significant differences across different types (public, inclusive) and scales (≥300 students large-scale, <300 students small-scale) of kindergartens (P values > 0.05). The average usage rates of disinfectants such as ultraviolet lamps, air disinfectants, hand sanitizers, disinfectant solutions, disinfectant spray bottles, and disinfectant cloths were 26.55%,15.66%, 54.88%, 52.17%, 56.06%, and 51.39%, respectively, with no statistically significant differences across different types and scales of kindergartens (P > 0.05). The average rates of good awareness regarding sports equipment disinfection among management personnel and sports staff were 57.18% and 50.91%, respectively, with statistically significant differences observed across different types of kindergartens (χ² values of 8.74 and 7.97, P < 0.05). The average rates of a well-established disinfection system for sports equipment were 42.58%, 43.57%, and 42.02%, with statistically significant differences noted among different types of kindergartens (χ² values of 7.95, 8.32, and 8.48, P < 0.05).

The compliance rates for sports equipment disinfection, the usage rates of disinfectants, and the rates of good awareness among management personnel and sports staff in kindergartens in Yinchuan are relatively low, and the disinfection system for sports equipment is inadequate, which impacts the hygiene and safety of sports equipment. Enhanced supervision, monitoring, and technical guidance are necessary.

To assess the burden of stroke and its subtypes attributable to dietary factors in China from 1990 to 2021.

Utilizing the Global Burden of Disease (GBD) 2021 database, we analyzed the trends of stroke and its subtypes (ischemic stroke, hemorrhagic stroke, subarachnoid hemorrhage) caused by dietary factors in China using the Join point regression model and estimated annual percentage change (EAPC).

In 2021, the number of stroke deaths attributable to dietary factors in China was 1 077 762, with an age-standardized mortality rate (ASMR) of 21.59 per 100 000. From 1990 to 2021, both the ASMR and age-standardized disability-adjusted life years (DALYs) rate (ASDR) due to dietary factors showed a declining trend, with EAPCs of -2.69 and -2.74, respectively. Ischemic stroke presented the heaviest burden, with an ASMR of 11 per 100 000. Excess sodium intake was identified as the primary dietary risk factor, with an ASMR of 8.77 per 100 000 for ischemic stroke attributable to excess sodium and an ASMR of 10.6 per 100 000 for hemorrhagic stroke. The burden of disease was significantly higher in males and individuals aged 70 and above, with mortality rates more than twice that of other age groups.

Over the past 32 years, the burden of stroke attributable to dietary factors in China has decreased, yet the overall numbers remain substantial.Future public health policies should focus on controlling high-sodium diets and increasing the intake of grains and fruits, particularly targeting high-risk populations such as elderly males, to further reduce the burden of stroke.

To explore the relationship between parental emotional expression and depression symptoms in adolescents.

A random cluster sampling method was employed to select 13 240 adolescents from Pidu District, Chengdu. A general demographic questionnaire, the Chinese version of the Emotional Expression Scale, and the Chinese version of the Kutcher Adolescent Depression Scale were used for investigation and psychological assessment. Binary logistic regression analysis was conducted to examine the association between parental emotional expression and adolescent depression symptoms, with subgroup analysis based on factors such as gender, region, family economic status, only-child status, and primary caregiver.

The study found that 2 726 adolescents (20.6%) exhibited depression symptoms. Among the participants, 6 697 adolescents (50.6%) reported high levels of parental emotional expression. The incidence of depression symptoms was significantly higher in the group with high parental emotional expression compared to the group with low parental emotional expression (P < 0.001). Logistic regression analysis indicated that high parental emotional expression was a risk factor for depression symptoms in adolescents, even after controlling for multiple confounding factors (OR=2.08, 95%CI: 1.87-2.30). Subgroup analysis did not reveal any interaction between parental emotional expression and factors such as gender, region, or family economic status (P_interaction > 0.05).

Adolescent depression symptoms are closely associated with high parental emotional expression. Reducing negative emotional expression from parents may improve depression symptoms in adolescents and promote their psychological well-being.

To develop a Fertility-Friendly Perception Scale for reproductive-aged women and to test its reliability and validity.

Based on the social ecological system theory, a preliminary scale was created through literature review, semi-structured interviews, expert consultations, and a pilot survey. A convenience sampling method was employed to select 608 reproductive-aged women for the reliability and validity testing.

The Fertility-Friendly Perception Scale consisted of 6 dimensions and 40 items. The split-half reliability of the total scale was 0.885, and the Cronbach’s α coefficient was 0.912. The overall content validity index of the scale was 0.85, with item-level content validity indices ranging from 0.80 to 1.00. Exploratory factor analysis revealed a total of 6 common factors, with a cumulative variance contribution rate of 60.766%.Confirmatory factor analysis indicated χ²/v=1.921, a root means square error of approximation of 0.055, IFI of 0.909, CFI of 0.908, and TLI of 0.900.

The Fertility-Friendly Perception Scale for reproductive-aged women demonstrates good reliability and validity, making it an effective tool for measuring the fertility-friendly perceptions of this population.

To investigate the childhood traumatic experiences, mental health symptoms, and well-being of middle school students, analyze the associations among the three, explore the mechanism by which childhood traumatic experiences and mental health symptoms affect well-being, and provide reference for improving the well-being of middle school students.

From September to November 2023, a total of 1 294 students were selected by convenience sampling and stratified sampling from two middle schools as the survey subjects. The Childhood Trauma Questionnaire, Symptom Checklist 90, and EPOCH Well-being Scale were used for the questionnaire survey. SPSS 25.0 was used for descriptive analysis, t-test, chi-square test, and Pearson correlation analysis. The plug-in process was used to explore the mediating role of mental health symptoms between childhood traumatic experiences and well-being.

There were significant differences in well-being scores among factors such as gender, school stage, household registration, parental education level, parental marital status, and“who to live with” (t=2.813, 7.11, 3.459, 9.723, 6.923, 2.515, and 20.253, P < 0.05). In this study, 90.2% of middle school students had one or more childhood traumatic experiences. The detection rates of physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse were 15.1%, 61%, 42.8%, 81.9%, and 10%, respectively. There were significant differences in childhood traumatic experiences among only-child status, school stage, parental education level, marital status, and family structure (t=-4.082, 5.415, 10.144, -3.032, 9.467, and -2.003, P < 0.05). All dimensions of childhood traumatic experiences and mental health symptoms were negatively correlated with well-being; except for sexual abuse, all dimensions of childhood traumatic experiences were positively correlated with mental health symptoms (r=0.301, P < 0.05). Mental health symptoms played a partial mediating role between childhood traumatic experiences and well-being, and the proportion of the mediating effect was 37.5%.

Childhood traumatic experiences and mental health symptoms negatively predict the well-being of middle school students, and mental health symptoms play a mediating role between childhood traumatic experiences and well-being. Against the background of a relatively high incidence of childhood traumatic experiences among middle school students, the well- being of middle school students can be improved by improving their mental health and reducing the impact of childhood traumatic experiences on well-being.

To clarify the causal relationship between body image comparison on social media and perinatal depression in pregnant women.

A convenience sampling method was employed to select pregnant women attending prenatal check-ups at a tertiary hospital in Hefei, Anhui Province, from September 2023 to April 2024. A longitudinal survey was conducted during late pregnancy (T1) and six weeks postpartum (T2) using a general information questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), and a body image comparison scale for social media. Data analysis was performed using SPSS 23.0 and Mplus 8.3 statistical software. Pearson correlation analysis was conducted to examine the relationship between body image comparison on social media and depression scores at T1 and T2, while a cross-lagged model was constructed using Mplus 8.3 to explore the causal relationship between body image comparison and perinatal depression.

A total of 277 pregnant women were included in the study, with depression rates of 34.30% and 21.66% at T1 and T2, respectively. A positive correlation was found between body image comparison on social media and depression scores at both T1 and T2 (P < 0.010). Body image comparison at T1 positively predicted depression at T2 (β=0.237, P=0.001).

Pre-pregnancy body image comparison on social media can predict postpartum depression.

To explore the mediating role of depression symptoms in the relationship between bullying and suicide risk, and to analyze the moderating effect of emotional intelligence.

A stratified cluster sampling method was employed to select 16 388 students from 20 primary and secondary schools in the Pidu District of Chengdu, who completed self-administered questionnaires. Structural equation modeling was established to test the mediating and moderated mediating effects.

Among the participants, 28.5% were involved in bullying, and 29.2% exhibited a high risk of suicide. The direct effect between bullying and suicide risk was 0.154 (95%CI: 0.136-0.173, P < 0.001), while the mediating effect of depression symptoms was 0.164 (95%CI: 0.153-0.175, P < 0.001). Emotional intelligence negatively moderated the mediating pathway: at low levels of emotional intelligence, the mediating effect (bullying → depression symptoms → suicide risk) was 0.157 (95%CI: 0.144-0.169),whereas at high levels of emotional intelligence, the mediating effect was 0.114 (95%CI: 0.103-0.126).

There is a positive association between bullying and suicide risk among children and adolescents, with bullying indirectly influencing suicide risk through depression symptoms. Additionally, emotional intelligence negatively moderates the mediating effect of depression symptoms. Interventions aimed at alleviating depression symptoms and enhancing emotional intelligence may be effective strategies to mitigate the adverse effects of bullying on the psychological and behavioral health of children and adolescents.

To explore the relationship between the cumulative effect of overweight and obesity in children and the occurrence of elevated blood pressure, providing a basis for better prevention of hypertension in children.

Data were derived from the “Zigong School-Based Cardiovascular Metabolic Risk Cohort Study” conducted from 2012 to 2018. The survey included a questionnaire and physical examinations. The “overweight and obesity years” metric was calculated to assess the cumulative effect of overweight and obesity in children. Multivariable-adjusted linear regression and logistic regression models were employed to analyze the relationship between the cumulative effect of overweight and obesity, blood pressure levels and their changes, and the occurrence of elevated blood pressure.

The study included 1 637 children who were not hypertensive at baseline and had undergone at least four surveys, with an average age of 6.43 years, of which 50.00% were male. After an average follow-up of 4.57 years, 447 children developed elevated blood pressure, resulting in a cumulative incidence rate of 27.31%. During the follow-up, 381 children exhibited a cumulative effect of overweight and obesity (non-zero cumulative overweight and obesity years). The cumulative overweight and obesity years were positively correlated with endpoint systolic blood pressure, endpoint diastolic blood pressure, the difference between endpoint and baseline systolic blood pressure, and the difference between endpoint and baseline diastolic blood pressure (β₁=0.25, β₂=0.19, β₃=0.19, β₄=0.11, all P<0.05). Additionally, cumulative overweight and obesity years (OR=1.05, P<0.001),the degree of cumulative overweight and obesity (OR=1.04, P<0.001), and the duration of cumulative overweight and obesity (OR=1.14, P=0.014) were all positively correlated with the occurrence of elevated blood pressure in children.

The cumulative effect of overweight and obesity in children increases the risk of developing elevated blood pressure. Dynamic monitoring and timely intervention for overweight and obese children are crucial for preventing hypertension.

To investigate the care service needs of disabled elderly individuals in Weifang city and analyze the influencing factors on the willingness to utilize care services among elderly individuals with varying degrees of disability, aiming to provide better care services for this population.

A care service needs questionnaire was developed based on the Anderson model as a theoretical framework. A convenience sampling method was employed to select 1 322 disabled elderly individuals in Weifang city, and a questionnaire survey was conducted to assess their care service needs. Logistic regression models were utilized to analyze the influencing factors affecting the care service needs of elderly individuals with mild, moderate, and severe disabilities.

Among the disabled elderly in Weifang city, those with mild and moderate disabilities had the highest demand for general care services (59.2%), while those with severe disabilities had the highest demand for medical care services (45.0%). Comprehensive analysis using three models revealed that factors such as “gender” (OR=0.778, 95%CI: 0.604-0.961), “educational level” (OR=0.598, 95%CI:0.511-0.701), “economic status” (OR=0.789, 95%CI: 0.640-0.961), “source of income” (OR=1.251, 95%CI: 1.084-1.444), “type of health insurance” (OR=1.870, 95%CI: 1.291-2.710), “number of chronic disease medications” (OR=0.767, 95%CI: 0.692-0.852),and “hearing status” (OR=0.833, 95%CI: 0.699-0.994) were significant factors influencing the care service needs of disabled elderly individuals.

Elderly individuals with varying degrees of disability have different demands for care service items, and these needs are influenced by factors such as gender, educational level, economic status, source of income, type of health insurance, number of chronic disease medications, and hearing status. Government, market, and societal sectors should play an active role in meeting the care service needs of disabled elderly individuals, aiming to ensure that high-quality care services genuinely benefit this population.

To explore the mortality trend and years of life lost due to bladder cancer among residents in Pudong New Area, Shanghai from 2002 to 2022.

The data were derived from the cause-of-death monitoring database of registered residents in Pudong New Area, and the demographic data were provided by the Public Security Bureau of Pudong New Area.The crude mortality rate (CMR), age-standardized mortality rate (ASMR), potential years of life lost (PYLL), potential years of life lost rate (PYLLR), average years of life lost (AYLL), standardized potential years of life lost (SPYLL), standardized potential years of life lost rate (SPYLLR) and probability of premature death were calculated. The Join point software was used to analyze the annual percent change (APC), and the differential analysis method was used to evaluate the influence of population age-structure factors on bladder cancer mortality.

From 2002 to 2022, there were 2 244 deaths from bladder cancer among residents in Pudong New Area, Shanghai. The average annual CMR was 3.81 per 100 000, showing an upward trend (APC=2.24%, Z=4.607, P < 0.001). The average annual Chinese-standardized mortality rate was 1.77 per 100 000, showing an overall downward trend (APC=-1.54%, Z=-3.236, P=0.002). The mortality rate of bladder cancer in men was higher than that in women (Z_CMR=24.370, P < 0.001; χ²=1 143.000, P < 0.001). The mortality rate increased with age (χ²=9 324.374, P < 0.001),and the mortality rates in the 60 to >70-year-old group (APC=-3.36%, Z=-3.263, P=0.002) and the 70 to >80-year-old group (APC=-1.99%, Z=-3.229, P=0.015) decreased significantly. The PYLL due to bladder cancer death among residents in Pudong New Area was 9 120 person-years, and the AYLL was 4.06 years per person. The PYLL and AYLL in men were higher than those in women. The population age-structure factor was a risk factor for promoting bladder cancer mortality.

The mortality rate of bladder cancer increases with age, and the death burden of bladder cancer in men is heavier than that in women. Men over 60 years old should be regarded as a high-risk group. The population age-structure factor is the main reason affecting the bladder cancer mortality rate, and active measures should be taken to cope with the impact of aging. The probability of premature death in women shows an upward trend, and the prevention and control of bladder cancer in women need to be strengthened.

To explore the relationship between self-efficacy, belief perception, and pain coping strategies in community-dwelling elderly patients with chronic pain, providing a theoretical basis and guidance for targeted nursing interventions.

A stratified sampling method was used to select 363 community-dwelling elderly patients with chronic pain. The Chronic Pain Self-Efficacy Scale, Pain Beliefs and Perception Questionnaire, and Coping Strategies Questionnaire-Revised were employed for the survey. Pearson correlation analysis was conducted to analyze the correlations among variables, and multiple linear regression analysis was performed to identify factors influencing pain coping strategies.

The self-efficacy score among the 363 patients was 73.70±8.92, the belief perception score was -4.69±13.67, and the pain coping strategies score was 73.96±8.60. Univariate analysis indicated statistically significant differences in coping strategy scores based on age, marital status, educational level, payment method for medical expenses, previous occupation, monthly income level, religious belief, physical exercise, duration of pain, number of comorbid chronic diseases, and primary caregiver (P<0.05). Correlation analysis showed a positive correlation between coping strategy scores and self-efficacy scores (r=0.517, P<0.01), and a negative correlation between coping strategy scores and belief perception scores (r=-0.443, P<0.01). Multiple linear regression analysis revealed that religious belief, educational level, belief perception scores, and self-efficacy scores were influencing factors for community-dwelling elderly patients with chronic pain.

Healthcare professionals should develop rational intervention strategies based on the study results to help patients enhance their self-efficacy, establish correct belief perceptions, and guide them in adopting proactive pain coping strategies, ultimately improving their quality of life.

To conduct a quantitative evaluation of China’s Huimin insurance policy texts, provide references for the formulation and improvement of future Huimin insurance policies, and promote the further improvement of the multi-level medical security system.

Based on the text mining method, 14 Huimin insurance policies issued at the national and provincial levels were processed. A PMC index model was constructed to conduct an overall and surface chart analysis of the 14 Huimin insurance policies, and a comparison was made between Policy P10 and Policy P7.

The results of the PMC index model showed that the average PMC index score of the 14 Huimin insurance policies was 6.98, all at an acceptable level or above. Among them, 6 policies were rated as excellent, and 8 policies were rated as acceptable. The policies scored relatively high in policy content (0.87) and policy nature (0.81), and relatively low in policy perspective (0.61), incentive and restraint (0.60), and policy timeliness (0.33).

China’s Huimin insurance policies are generally at an acceptable level. They can be improved by strengthening the top - level design of Huimin insurance policies, improving the incentive and restraint mechanism, and optimizing policy timeliness.

To evaluate the balance of bed allocation in hospital rehabilitation departments across different regions of China, providing policy recommendations for establishing a rehabilitation health service system that aligns with socioeconomic development and public health needs.

The number of rehabilitation department beds in hospitals across 31 provinces from 2012 to 2021 was selected. The Dagum Gini coefficient, concentration degree, and kernel density estimation methods were employed to measure the balance of bed allocation and analyze its temporal and spatial evolution characteristics.

From 2012 to 2021, the total number of rehabilitation department beds in Chinese hospitals increased by 196 120, with a growth rate of 270%. The concentration matching levels among provinces gradually narrowed, although there remained significant interprovincial allocation disparities within regions. The density estimation curve indicated a polarization phenomenon in the central region. The Dagum Gini coefficient results revealed that the differences in balance primarily stemmed from the contribution rates between regions, with the contribution rate within regions rising annually from 28.84% to 30.06% by 2021.

The balance of rehabilitation department bed resource allocation in Chinese hospitals improved from 2012 to 2021,with significant impacts from both interregional and intraregional allocation disparities on overall balance. Therefore, it is recommended to scientifically plan the number of rehabilitation department beds in hospitals across regions, enhance the regional bed coordination and sharing mechanism through information technology, and optimize resource allocation patterns.Additionally, further coordinated efforts should be made to promote balanced bed distribution through targeted assistance and optimizing total capacity, thereby better meeting the health service needs of the public.

To explore the comorbidity patterns in middle-aged and older adults and their relationship with subjective life expectancy, as well as to investigate the mediating role of depression.

Using data from the 2020 CHARLS, latent class analysis (LCA) was employed to identify comorbidity patterns in individuals aged 45 and older. Ordered logistic regression was used to analyze the association between comorbidity patterns and subjective life expectancy, while stepwise regression and the KHB method were utilized to assess the mediating effect of depression.

A total of 13 815 middle-aged and older participants were included, with a comorbidity rate of 48.17%. LCA identified four comorbidity patterns: relatively healthy, gastrointestinal-arthritis, cardiovascular-metabolic, and respiratory system. The gastrointestinal-arthritis (OR=0.652, 95%CI: 0.592 to 0.717), cardiovascular-metabolic (OR=0.727, 95%CI: 0.669 to 0.791), and respiratory system (OR=0.518, 95%CI: 0.592-0.717) patterns were negatively associated with subjective life expectancy. Depression acted as a mediator, with heterogeneity in the mediating effect across different comorbidity patterns; the strongest effect was observed in the gastrointestinal-arthritis group, with an indirect effect value of -0.110 (-0.144 to -0.076), accounting for 27.72% of the mediating effect, followed by the cardiovascular-metabolic group (18.05%).

Compared to the relatively healthy group, the other three comorbidity patterns were associated with more negative subjective life expectancy, with depression mediating the relationship between comorbidity patterns and subjective life expectancy.

To investigate the status of aggressive behavior in first-episode schizophrenia patients and further explore the related influencing factors and their gender differences.

A total of 224 first-episode schizophrenia patients admitted to Beijing Anding Hospital from December 2019 to September 2022 were consecutively selected as study subjects.The Revised Hostility Scale was used to assess the occurrence of aggressive behavior in patients. Univariate analysis and binary logistic regression analysis were employed to explore the influencing factors of aggressive behavior in first-episode schizophrenia patients of different genders.

The detection rate of aggressive behavior in first-episode schizophrenia patients was 34.13%, with detection rates of 24.49% for male patients and 27.27% for female patients. For female first-episode schizophrenia patients, independent predictors of aggressive behavior included ethnicity (OR=0.009, 95%CI: 0.001-0.154),history of suicide attempts (OR=57.347, 95%CI: 5.152-638.353), lack of crisis coping (OR=1.113, 95%CI: 1.001-1.238),temperament (OR=3.059, 95%CI: 1.373-6.813), and hopelessness (OR=0.891, 95%CI: 0.796-0.998). For male patients, independent predictors included age (OR=0.951, 95%CI: 0.908-0.996), living alone (OR=6.130, 95%CI: 1.935-19.420), value conflict (OR=0.912, 95%CI: 0.843-0.987), disparity between desires and reality (OR=1.108, 95%CI: 1.044-1.177),temperament (OR=1.599, 95%CI: 1.062-2.408), and hopelessness (OR=1.101, 95%CI: 1.032-1.175).

The detection rate of aggressive behavior in first-episode schizophrenia patients is relatively high, and the influencing factors exhibit gender differences. During clinical screening and treatment, personalized intervention measures should be developed based on the characteristics of the patients to more effectively prevent and manage the occurrence of aggressive behavior.

To understand the disconnection between knowledge and action regarding HIV Pre-Exposure Prophylaxis (Pr EP) among university students with multiple sexual partners in Nanning, Guangxi, and analyze its influencing factors.

A cross-sectional survey was conducted in Nanning from November 19 to December 4, 2023, recruiting young university students who had at least one sexual partner in the past six months to investigate their knowledge and usage behaviors related to Pr EP. Students with only one sexual partner were used as a control group. Multivariate logistic regression models were employed to analyze the influencing factors of the knowledge-action disconnection.

A total of 5 630 university students with at least one sexual partner were surveyed, among which 4 494 (79.8%) had one partner, 572 (10.2%) had 2-3 partners, and 564 (10.0%) had four or more partners. The occurrence of knowledge-action disconnection among students with one sexual partner was 1 558 (34.7%), among those with 2-3 partners was 201 (35.1%), and among those with four or more partners was 144 (25.5%). The multivariate logistic regression results indicated that sexual orientation (gay or bisexual) (OR=1.436, 95%CI: 1.150-1.793), testing frequency of less than six months (OR=1.423, 95%CI: 1.198-1.691), and testing frequency of more than six months (OR=1.386, 95%CI: 1.113-1.725) were factors influencing the knowledge-action disconnection regarding PrEP.

There is a significant disconnection between knowledge and action regarding PrEP among university students in Nanning with multiple sexual partners. PrEP education should focus on gay individuals and HIV testing behaviors to enhance the willingness to use PrEP and promote its actual implementation, thereby reducing the occurrence of knowledge-action disconnection.

To investigate the relationship between the weight-adjusted waist index (WWI) and chronic kidney disease (CKD) among the middle-aged and elderly population in China.

This study included 5 630 individuals aged 45 and older who participated in the China Health and Retirement Longitudinal Survey (CHARLS) in 2011 and 2015. The Cox proportional hazards regression model was employed to analyze the association between WWI, treated as a continuous variable and categorized into quartiles, and the risk of CKD. Additionally, a restricted cubic spline (RCS) model was used to explore the dose-response relationship between WWI and CKD.

During the four-year follow-up, 187 participants developed CKD,resulting in an incidence rate of 3.32%. After adjusting for all covariates, each unit increase in WWI was associated with a 33%increase in the risk of CKD (HR: 1.33, 95%CI: 1.10-1.62). In the highest quartile of WWI, the risk of CKD was 2.30 times greater compared to the lowest quartile (HR=2.30, 95%CI: 1.37-3.86). The RCS curve indicated a nonlinear dose-response relationship between WWI and CKD (P_{fornon-linear} < 0.05).

There is a positive correlation between WWI and the risk of CKD among the middle-aged and elderly population in China, exhibiting a significant nonlinear dose-response relationship.

To explore the relationship between substance use, problematic internet use, and their co-occurring behaviors with unintentional injuries among college students.

A cross-sectional study design was employed, with a questionnaire survey conducted among 1 700 enrolled students from two ordinary higher education institutions in Beijing. The CRAFFT scale was used to assess substance use, while the Internet Addiction Test (IAT) evaluated problematic internet use. Information on unintentional injuries and related influencing factors was also collected. Multivariate binary logistic regression was utilized to analyze the association between substance use, problematic internet use, co-occurring behaviors, and unintentional injuries, as well as to explore the influencing factors of unintentional injuries in the co-occurring behavior population.

A total of 1 626 valid questionnaires were collected. The prevalence of substance use was 35.85% (583 cases), the prevalence of problematic internet use was 52.34% (851 cases), and the co-occurrence prevalence was 20.05% (326 cases). The prevalence of unintentional injuries was 16.91% (275 cases). After adjusting for confounding factors, the multivariate logistic regression analysis indicated that compared to the control group, the odds ratio for unintentional injuries in the co-occurring behavior group was 1.57 (95%CI: 1.054-2.340), while neither substance use (aOR=1.117, 95%CI: 0.717-1.741) nor problematic internet use (aOR=1.098, 95%CI: 0.758-1.589) showed significant correlation with unintentional injuries. Among the co-occurring behavior population, suicidal ideation was identified as an independent risk factor for unintentional injuries (aOR=2.118, 95%CI: 1.184-3.787).

The simultaneous presence of substance uses and problematic internet use significantly increases the risk of unintentional injuries among college students. It is crucial to focus on high-risk populations exhibiting co-occurring behaviors, especially those with suicidal ideation, and to implement targeted preventive interventions.

To investigate the ameliorative effects of ursolic acid on gut microbiota and inflammation in high-fat diet-induced obese mice.

Eighteen C57BL/6J mice were acclimatized for one week and then randomly divided into three groups: control group (CON), high-fat diet group (HFD), and unsolid acid group (UA). The CON group was fed standard diet, the HFD group was fed high-fat diet, and the UA group received high-fat diet along with daily gastric gavage of 100 mg/kg ursolic acid. The experiment lasted for 12 weeks, during which weekly measurements of body weight and food intake were recorded. At the end of the experiment, fecal samples were collected aseptically, and blood serum was obtained after anesthesia.The liver and epididymal fat were collected post-euthanasia. Pathological observations of the liver and fat tissues were conducted using hematoxylin-eosin staining. Biochemical indices and inflammatory factor levels in serum and liver were measured using kits. The microbial diversity in the feces of C57BL/6J mice was assessed using 16S rDNA sequencing.Comparisons between groups were performed using t-tests for pairwise comparisons and one-way ANOVA or Kruskal-Wallis tests for multiple comparisons. Spearman correlation analysis was used to assess the relationship between dominant bacterial genera and inflammatory factors.

During the experiment, the body weight of the HFD group significantly increased compared to the CON group (P<0.05), while the UA group showed a significant reduction in body weight compared to the HFD group (P<0.05), with no correlation between weight change and food intake (P>0.05). Compared to the CON group, the HFD group exhibited increased serum and liver biochemical indices, including triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), and inflammatory factors such as tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) (P<0.05),along with decreased high-density lipoprotein (HDL) levels (P<0.05), all of which improved following UA intervention (P<0.05). Pathological observations revealed normal morphology of liver and fat tissues in the CON group, swelling of hepatocytes with numerous lipid vacuoles in the HFD group, and reduced hepatocyte size and lipid vacuoles in the UA group compared to the HFD group. The gut microbiota composition varied among groups at the phylum and genus levels, with higher relative abundances of Akkerman Sia and unclassified Muribaculaceae. Correlation analysis indicated that Akkerman Sia, unclassified Muribaculaceae, and Ligi lactobacillus were negatively correlated with serum and liver TNF-α and IL-1β (P<0.05), while Olsen Ella showed a positive correlation with TNF-α and IL-1β (P<0.05).

A high-fat diet promotes obesity by inducing dysbiosis and elevating inflammatory factor levels in mice. Ursolic acid intervention can regulate gut microbiota and inflammatory responses, thereby improving obesity.

To investigate whether sub chronic exposure to Benz[a]pyrene (BaP) induces ferroptosis in mouse hepatocytes, leading to liver injury, thereby providing a basis for further study of the hepatic toxicity mechanisms of BaP.

Forty-eight male C57BL/6 mice aged three weeks were randomly divided into six groups: control group (corn oil),low-dose BaP group (2.5 mg/kg), medium-dose BaP group (5 mg/kg), high-dose BaP group (10 mg/kg), ferroptosis inhibitor Fer-1 group (3-amino-4-cyclohexylaminobenzoic acid ethyl ester, 1 mg/kg), and high-dose BaP + Fer-1 group (10 mg/kg + 1 mg/kg). BaP was administered via gastric gavage dissolved in corn oil, and Fer-1 was injected intraperitoneally every other day for 90 days. Hepatic structure and collagen fiber deposition were observed using HE and Masson staining, while transmission electron microscopy (TEM) was used to examine the ultrastructure of hepatocytes. The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in mouse liver tissues, as well as tissue iron, malondialdehyde (MDA), glutathione (GSH) content, and glutathione peroxidase (GSH-Px) activity, were measured using kits. Western blotting was employed to detect the levels of glutathione peroxidase 4 (GPX4) and acyl-CoA synthetase long-chain family member 4 (ACSL4) in mouse liver tissues.

Compared to the control group, the high-dose BaP group exhibited a decrease in body weight (t=4.921, P=0.006) and a reduction in liver coefficient in both medium and high-dose BaP groups (t _medium=4.967, P<0.05; t _high=6.568, P=0.001). The ALT and AST levels in liver tissues of BaP-treated mice were elevated (F _ALT=218.200, P<0.001; F _AST=421.200, P<0.001). HE staining revealed varying degrees of hepatocyte disarray, sinusoidal dilation, congestion, and inflammatory infiltration in the liver of BaP-treated mice, while Masson staining indicated collagen fiber deposition. Iron content in the liver tissues of BaP-treated mice increased (W=41.730, P<0.001), and both GSH concentration and GSH-Px activity decreased (W _GSH=49.640, P<0.001; F _GSH-Px=252.400, P<0.001), with an increase in MDA concentration (F=207.700, P<0.001). The expression level of GPX4 protein in the liver of BaP-treated mice decreased (F=56.790, P<0.001), while the expression level of ACSL4 protein increased (F=429.400, P<0.001). Compared to the high-dose BaP group, the high-dose BaP + Fer-1 group showed improvements in body weight changes (t=5.970, P<0.001), liver coefficient (t=11.510, P<0.001), morphological changes in the liver, and levels of ALT (q=21.730, P<0.001), AST (q=32.870, P<0.001), tissue iron (t=5.045, P=0.009), GSH (t=10.600,P<0.001), GSH-Px (q=9.977, P<0.001), MDA (q=21.580, P<0.001), as well as the expression levels of ACSL4 (q=8.629, P<0.001) and GPX4 (q=5.146, P=0.03) proteins.

Sub chronic exposure to BaP can induce ferroptosis in mouse hepatocytes, resulting in liver injury.

To analyze the treatment enrollment status and influencing factors for rifampicin-resistant pulmonary tuberculosis patients in Guizhou Province, providing a basis for improving prevention and control strategies.

Based on case data, drug resistance screening records, and information on drug-resistant patients in Guizhou Province from 2016 to 2023, the enrollment rate (%) of rifampicin-resistant patients was described to characterize their distribution. Chi-square tests and binary logistic regression models were employed to analyze influencing factors.

The average annual enrollment rate for rifampicin-resistant pulmonary tuberculosis patients in Guizhou Province from 2016 to 2023 was 56.00%, increasing from 35.71% in 2016 to 88.20% in 2023 (trend χ²=729.839, P<0.001). An upward trend was observed across gender, age groups (<20 years, 20-39 years, 40-59 years, and ≥60 years), and nine municipalities (P<0.05 for all). Analysis of influencing factors indicated that compared to patients who were <20 years old, local, new cases, those with reports from designated multidrug-resistant tuberculosis hospitals, and those without diagnosis delays, the following were identified as risk factors for treatment enrollment: age ≥60 years (OR=0.471, 95%CI: 0.296-0.750), migrant status (OR=0.503, 95%CI: 0.391-0.646), initial treatment positive at 2/3 months (OR=0.676, 95%CI: 0.464-0.983), reports from general tuberculosis hospitals (OR=0.080,95%CI: 0.063-0.102) and from the disease control center (OR=0.048, 95%CI: 0.040-0.057), and diagnosis delays (OR=0.551,95%CI: 0.048-0.648) (P<0.05 for all).

The treatment enrollment status of rifampicin-resistant pulmonary tuberculosis patients in Guizhou Province has gradually improved, but continued attention is necessary. It is recommended to strengthen interventions for key populations, including those aged ≥60 years, migrants, initial treatment positive at 2/3 months, patients with reports from non-multidrug-resistant designated tuberculosis hospitals, and those experiencing diagnosis delays, to further enhance treatment enrollment rates.

To provide a scientific basis for the formulation of effective prevention and control strategies by assessing the risk of dengue fever importation and local transmission in Guangxi from ASEAN countries by 2025.

Relevant information was collected and organized. The risk of dengue case importation from ASEAN countries was calculated using the Poisson distribution. Based on previous studies on local transmission risk assessment indicators for dengue fever, various factors influencing local transmission were assigned values. The local transmission risk was analyzed and evaluated through quantitative indicators, and the severity of local transmission consequences was qualitatively assessed using an expert consultation method.

There were significant regional differences in the risk of dengue cases being imported from ASEAN countries across the 14 prefecture-level cities in Guangxi from January to December. Nanning and Guilin had a year-round risk of “high” or “very high” for external importation;five cities, including Qinzhou, had “medium” or “high” risk; five cities, including Liuzhou, had “low” or “medium” risk; and Hezhou and Laibin had “very low” or “low” risk. If cases were imported, the risk of local transmission in the 14 prefecture-level cities in Guangxi was assessed as “low” for January to March and December; in April, all cities except Baise were “low”, while others were“medium”; from May to October, the risk was “medium”; in November, four cities including Liuzhou were “low”, while the others were “medium”. Based on comprehensive expert consultations, the risk of dengue importation and local transmission in Guangxi’s 14 prefecture-level cities was assessed as “medium” for 2025.

Due to its geographical location and close exchanges with ASEAN countries, Guangxi faces a higher risk of dengue fever importation and local transmission. The 14 prefecture-level cities should develop dengue prevention and control measures based on the characteristics of dengue importation and the dynamic changes in monitoring indicators, tailored to local conditions and timing, to effectively manage dengue outbreaks.

To analyze the causal association between glucosamine and the risk of fracture using the two-sample Mendelian randomization (MR) method.

This study was based on the summary data of genome-wide association studies of glucosamine and fracture in the European population. First, univariate MR analysis was performed using the inverse-variance weighted method,MR-Egger regression method, weighted median method, and MR-PRESSO. Sensitivity analysis was conducted by excluding palindromic instrumental variables, leave-one-out analysis, and reverse MR to verify the robustness of the results. Finally, multivariate MR analysis was used to evaluate the independent effect of glucosamine on fracture occurrence.

The results of the univariate inverse-variance weighted method showed that genetically predicted glucosamine was associated with a reduced risk of fracture (OR=0.94, 95%CI: 0.90-0.99, P=0.015). In addition, the results obtained by the MR-Egger regression method, weighted median method, and MR-PRESSO were consistent with those of the inverse-variance weighted method. Sensitivity analysis further verified the stability of the results. In the multivariate MR analysis, after adjusting for the potential effects of chondroitin, vitamin supplements, and osteoarthritis, the results still supported a negative causal relationship between glucosamine and the risk of fracture (adjusted for chondroitin: OR=0.61, 95%CI: 0.46-0.80, P=4.1×10^-4; adjusted for vitamins: OR=0.87, 95%CI: 0.81-0.93, P=1.1×10^-4;adjusted for osteoarthritis: OR=0.46, 95%CI: 0.29-0.73, P=9.7×10^-4).

Glucosamine can reduce the risk of fracture.

To develop and validate a questionnaire based on the Transtheoretical Model (TTM) for assessing the stages of behavior change in patients with Chronic Obstructive Pulmonary Disease (COPD) (COPD-TTM questionnaire), which can be used to evaluate patients’ behavioral stages and provide a basis for personalized interventions.

A preliminary COPD-TTM questionnaire was constructed through literature review and expert consultation, consisting of five primary dimensions and 15 secondary items. The structural validity was verified by measuring 171 COPD patients, while content validity was assessed through expert ratings. A retest was conducted two weeks later to validate the test-retest reliability.

Five factors were extracted from the 15 items, cumulatively explaining 68.5% of the total variance, with item loadings for each factor not less than 0.65, indicating alignment of the questionnaire items with the expected TTM stages. The CFA results showed a χ²/v value of 1.85, CFI of 0.98, RMSEA of 0.045, and SRMR of 0.05,demonstrating good structural validity of the questionnaire. The S-CVI was 0.93, with all I-CVI values above 0.80, indicating strong content validity. The Cronbach’s α coefficient for the COPD-TTM questionnaire was 0.980, and the test-retest reliability ICC was 0.961(95%CI: 0.935-0.977), suggesting good reliability and validity.

The COPD-TTM questionnaire can be used to assess the stages of behavior change in patients, providing a basis for further development of individualized intervention plans. Future research should focus on a broader range of factors influencing behavior change to optimize personalized interventions.

To investigate whether there are differences in anxiety status and influencing factors between health examination populations undergoing first-time and non-first-time low-dose spiral computed tomography (LDCT).

This retrospective study involved individuals who underwent health examinations at a tertiary health management center from January to December 2023 (including LDCT and anxiety self-assessment scales). Participants were divided into first-time LDCT examination group and non-first-time LDCT examination group based on whether it was their first examination at this hospital. Univariate analysis utilized independent two-sample t-tests or χ² tests. Four models were established for the overall population: Model 1 did not adjust for confounding factors; Model 2 adjusted for age, gender, examination type, occupation, education level, and alcohol history; Model 3 further adjusted for previous history of pulmonary nodules, diabetes, and hypertension; Model 4 included Body Mass Index (BMI) adjustments based on the same variables in Model 3.

A total of 19 892 participants were included in this study, with an overall anxiety detection rate of 12.31%. The anxiety detection rate in the non-first-time LDCT examination group (14.27%) was higher than that in the first-time LDCT examination group (8.9%), with a statistically significant difference (χ²=122.878, P<0.05). After adjusting for the aforementioned confounding factors, the anxiety risk for those undergoing non-first-time LDCT was 1.519 times that of those undergoing first-time LDCT (OR=1.519, 95%CI: 1.374-1.68, P<0.001).

The non-first-time LDCT examination is an independent risk factor for anxiety in health examination populations.