This study aims to analyze the independent, synergistic and interactive effects of adverse childhood experiences (ACE) and intimate partner violence (IPV) on alkyl nitrite inhalant (Rush) use among men who have sex with men (MSM).

A cross-sectional survey was conducted from 2023 to 2024 across three sites in China (Chengdu, Guangzhou, Hohhot) among HIV-negative MSM who had ever had a male intimate partner. An anonymous online questionnaire collected data on sociodemographic factors, ACE, IPV, Rush use, and sexual behaviors. Locally validated instruments were used to measure ACE and IPV. Rush use was defined as use in the past six months. The odds ratio (OR) was calculated using binary logistic regression.

A total of 441 participants were included. The prevalence of Rush use in the past six months was 30.6%. The exposure rates for ACE and IPV were 68.9% and 23.6%, respectively. After adjusting for partial covariates, experiencing any ACE was positively associated with Rush use (OR=2.237, 95% CI: 1.375-3.640). For each additional category of ACE experienced, the strength of association increased by 33.9% (95% CI: 1.195-1.500). Experiencing any IPV was also positively associated with Rush use (OR=2.093, 95% CI: 1.317-3.325). The co-occurrence of ACE and IPV showed a trend toward higher Rush use risk compared with single exposure (P>0.05), but interaction analysis revealed no statistically significant interaction effect between ACE and IPV (interaction P>0.05).

The high prevalence of Rush use is a significant public health concern among MSM in China. Both ACE and IPV are significantly associated with Rush use in this population, and their co-occurrence demonstrates an additive effect trend. It is recommended to strengthen integrated screening for both ACE and IPV for early identification of substance use and related sexual transmission risks and timely intervention among MSM.

To identify the latent classes of health-related quality of life (HRQoL) and explore their influencing factors among patients with Kashin-Beck disease (KBD) in Xi’an.

A cluster sampling method was used to select 251 KBD patients diagnosed at stage I or above according to the “Diagnosis of Kashin-Beck Disease” (WS/T 207-2010) standard from Lintong District, Xi’an City. Surveys were conducted using a general information questionnaire and the Kashin-Beck Disease Quality of Life (KBDQOL) scale. Latent profile analysis (LPA) was employed to identify the latent classes of HRQoL, and multinomial logistic regression was used to explore the influencing factors.

The HRQoL of KBD patients was categorized into three distinct latent classes: the low HRQoL type (13.15%), the medium HRQoL-limited type (39.04%), and the high HRQoL-comprehensive type (47.81%). Regression analysis revealed that age, education level, living alone, disease severity, and disease duration were significant factors influencing the latent HRQoL profiles in KBD patients (all P<0.05). Patients with advanced age, long disease duration, severe disease, or illiteracy were more likely to belong to the “low HRQoL” profile.

Significant population heterogeneity in HRQoL exists among KBD patients in Xi’an. Targeted interventions should be implemented based on the characteristics of the identified latent classes, with particular attention given to alleviating the physical and mental burden of patients in the low and medium HRQoL types, in order to effectively enhance their HRQoL.

By examining the mediating role of rumination between adverse childhood experiences (ACEs) and anxiety, a basis is provided for improving the mental health level of college students.

A convenience sampling method was used to select undergraduate students from Guangxi Medical University as the study subjects. A self-designed general information questionnaire, the Childhood Trauma Questionnaire (CTQ-SF) , the Generalized Anxiety Disorder Scale (GAD-7), and the Ruminative Responses Scale-Chinese Version (RRS-CV) were used to survey 1 050 college students. The Kruskal-Wallis H test and partial correlation analysis were used to examine the relationships between ACEs, general demographic information, anxiety levels, and rumination. Structural equation modeling was applied to analyze the model of the relationships among ACEs, rumination, and anxiety, and the bootstrap method was used to test the mediation effect.

After controlling for gender and family annual income, all dimensions of ACEs were significantly positively correlated with anxiety and rumination (all P<0.001), and rumination fully mediated the relationships of emotional abuse, emotional neglect, and physical neglect with anxiety.

Rumination exerts a full mediating effect between ACEs and anxiety. Universities may reduce rumination by strengthening mental health education, thus attenuating the impact of ACEs on anxiety.

To examine the association between sunshine duration and incident frailty among middle-aged and older adults in China.

Data were obtained from the China Health and Retirement Longitudinal Study (2011—2018), including 5 520 participants aged ≥45 years. City-level sunshine duration was obtained from the National Meteorological Science Data Center. Time-dependent Cox models were used to evaluate the association between sunshine duration and incident frailty, and restricted cubic spline and subgroup analyses were performed to assess nonlinearity and effect modification.

In the fully adjusted model, each 1 h/day increase in sunshine duration was associated with a 15% higher risk of incident frailty (HR=1.15, 95% CI: 1.06-1.24, P<0.001). Restricted cubic spline analysis showed a nonlinear association, with risk increasing markedly when daily sunshine duration was ≥6.63 h/day. Subgroup analyses suggested significant effect modification by sex, education level, urban-rural residence, and work status.

City-level sunshine duration was associated with incident frailty among middle-aged and older adults in China, with a nonlinear pattern and higher risk mainly at higher sunshine levels.

To investigate the association between the comprehensive dietary antioxidant index (CDAI) and the homeostatic model assessment of insulin resistance (HOMA-IR), and to evaluate the mediating effect of obesity in this association.

Data were derived from the 2005—2018 National Health and Nutrition Examination Survey (NHANES). CDAI was calculated via 24-hour dietary recalls. Weighted multivariable linear regression and restricted cubic splines were used to analyze the association between CDAI and HOMA-IR, while mediation analysis assessed the potential role of obesity.

A total of 2 568 participants were included in this study. After fully adjusting for confounding factors, weighted multivariable linear regression analysis revealed a negative association between CDAI and HOMA-IR levels (β=-0.05, 95% CI: -0.07~-0.02, P<0.001). Compared with the lowest quartile of CDAI, the highest quartile showed a reduction in HOMA-IR levels (β=-0.39, 95% CI:-0.67~-0.12, P=0.007). Mediation analysis indicated that obesity had no significant mediating effect on this association (P=0.28).

Higher CDAI levels are independently associated with lower HOMA-IR. The absence of a significant mediating effect of obesity suggests that the protective effect of CDAI may be achieved through direct biological pathways, such as reducing oxidative stress and improving insulin signaling, independent of body weight. Further longitudinal studies are warranted to verify causality.

To investigate the combined effect of PM_2.5 and temperature variability (TV) on years of life lost (YLL) among residents in Taiyuan, and to project future health risks under different climate change scenarios.

Based on cardiovascular disease (CVD) mortality data in Taiyuan from 2013 to 2019, a generalized additive model (GAM) was used to evaluate the joint risk of PM_2.5 and TV. Segmented linear regression and a synergy index were applied to identify their synergistic interaction, and future risks were projected under the 6th Phase of the Coupled Model Intercomparison Project (CMIP6) scenarios.

During 2013—2019, the average concentrations of PM_2.5 and PM₁₀ were 78.81 μg/m³ and 120.40 μg/m³, respectively, with a mean TV of 7.5 °C. GAM showed that elevated TV exacerbated PM_2.5-related health risks. A PM_2.5 concentration threshold of 21.9 μg/m³ was identified, above which its impact on YLL increased significantly. High TV (>4.4 °C) combined with high PM_2.5 (>21.9 μg/m³) exhibited a significant synergistic effect on YLL (SI=8.51, 95% CI: 2.38-30.45). Future predictions indicated that under the SSP5-8.5 scenario, PM_2.5 pollution was most severe (65.3 μg/m³), and compound high TV-high PM_2.5 events yielded the highest median daily attributable YLL (8.39 person-years/day).

TV substantially amplifies the health hazards of PM_2.5. Controlling high-emission pathways is critical to reducing the future disease burden from such compound events.

To evaluate the temporal variations in short-term mortality risks associated with ozone (O₃) exposure for circulatory and respiratory diseases in the Sichuan Basin under the Clean Air Action, and to provide evidence for regional air pollution control and public health interventions.

Mortality data for circulatory and respiratory diseases were obtained from Sichuan Provincial Center for Disease Control and Prevention, and air pollution data (O₃, NO₂, and PM_2.5) were obtained from the China High Air Pollutants dataset. A two-stage analysis was applied to estimate the short-term risks of circulatory, respiratory, and combined circulatory-respiratory mortality associated with O₃ exposure during 2014—2022. In the first stage, quasi-Poisson generalized linear models were used to estimate the county-specific associations between O₃ and mortality. In the second stage, random-effects meta-analysis was used to pool the estimates. Longitudinal meta-regression with a nonlinear time term was further used to assess temporal variations in risk. Two-pollutant models and subgroup analyses were conducted to examine the effects of co-pollutants and population heterogeneity on these temporal variations.

Short-term mortality risks associated with O₃ exhibited significant nonlinear temporal variations across all three mortality outcomes (P<0.001), with an increase during 2014—2016, a decline during 2017—2019, and a subsequent rise after 2020. For combined circulatory-respiratory mortality, the excess risk (ER) associated with each 10 μg/m³ increase in O₃ rose from 0.86% (95% CI: 0.52%-1.20%) in 2014 to 1.51% (1.30%-1.72%) in 2016, then decreased to 0.93% (0.75%-1.11%) in 2019, and increased again to 1.58% (1.37%-1.79%) in 2022. This trend remained significant (P<0.01) in two-pollutant models, although the effects during 2016—2018 were attenuated, particularly for respiratory mortality. Subgroup analyses by sex and age showed similar temporal patterns, with overall higher risks in females and individuals aged ≥65 years.

From 2014 to 2022, short-term mortality risks associated with O₃ in the Sichuan Basin showed a pattern of increase, decline, and re-increase. The post-2020 rebound suggests that future air quality management should strengthen coordinated control of PM_2.5, NO₂, and O₃, and implement more targeted public health interventions in the context of population aging and climate change.

To investigate the effect of BRCA1 gene silencing on the repair of DNA double-strand breaks (DSBs) induced by lead acetate in human lymphoblastoid TK6 cells.

A stable BRCA1-silenced TK6 cell model was established using lentivirus-mediated shRNA technology. Cells were divided into four groups: normal group (untreated control group), control group (empty vector control group), shRNA-NC group (negative control lentivirus group), and shRNA-BRCA1 group (BRCA1 knockdown group). All exposed groups were treated with 480 μmol/L lead acetate for 24 h. Silencing efficiency was confirmed by qPCR and Western blot. DNA damage was assessed by immunofluorescence staining for γ-H2AX foci. Cell cycle and apoptosis were analyzed by flow cytometry. The expression of key proteins in the homologous recombination (HR) and non-homologous end joining (NHEJ) repair pathways and DNA damage response (DDR) signaling molecules was detected by Western blot.

The BRCA1 silencing model was successfully constructed, with significantly lower levels of BRCA1 mRNA and protein in the shRNA-BRCA1 group compared to the control and shRNA-NC groups (P<0.05). Under lead exposure, the shRNA-BRCA1 group showed a significantly higher positive rate of γ-H2AX (26.94±2.93)%, a higher proportion of G1 phase cells (65.31±1.13)%, and a higher apoptosis rate (52.84±1.21)% compared to all other groups (P<0.05), while the proportion of S phase cells (8.59±0.45)% was further reduced. Protein analysis revealed that, compared to the control and shRNA-NC groups, the expression of the HR key protein Rad51 was decreased (0.52±0.10) in the shRNA-BRCA1 group, while the expression levels of the NHEJ pathway protein 53BP1 (9.73±0.87) and the DDR signaling molecules ATM (6.10±0.48), ATR (6.25±0.92), CHK1 (2.35±0.46), and DNA-PKcs (3.85±0.93) were significantly increased (P<0.05).

BRCA1 silencing inhibits homologous recombination repair, exacerbates lead-induced DNA double-strand breaks, arrests the G1/S phase progression, and intensifies apoptosis. The mechanism may be related to the activation of the ATM/ATR-CHK1 pathway and compensatory upregulation of the NHEJ repair pathway.

Circadian rhythm syndrome (CircS) is an emerging syndrome integrating metabolic disorders, sleep disturbances, and depressive symptoms, which is highly prevalent among occupationally exposed populations such as those working in shifts. This study aims to construct and validate a CircS risk prediction model suitable for occupational populations, providing a quantitative tool for its early identification.

Based on three rounds of follow-up data (from 2021 to 2025) from the Southwest Occupational Population Cohort, 26 693 employees without CircS at baseline were included. The population was randomly divided into a training set and a validation set at a ratio of 7:3. Predictive factors were screened from 35 candidate factors (demographic, behavioral, psychological, and clinical indicators) using Lasso-Cox regression, and a nomogram was constructed. The model’s discrimination (area under the receiver operating characteristic curve, AUC), calibration, and other metrics were evaluated.

During a median follow-up period of 4 years, a total of 5 540 cases (20.76%) of new-onset CircS occurred. The final model incorporated 14 predictive factors, including age, body mass index (BMI), glycosylated hemoglobin, white blood cell count, uric acid, fatty liver, marital status, smoking, alcohol consumption, sleep quality, and well-being. The model demonstrated good predictive performance in the validation set, with an AUC of 0.771 (95% CI: 0.758-0.784) for the nomogram total score, outperforming risk prediction models based solely on demographic factors (AUC=0.590) or behavioral and psychological factors (AUC=0.602). The calibration curve showed a high degree of consistency between predicted and actual risks. After grouping the nomogram total score according to quartiles, the incidence risk in the highest risk group (Q4) was 16.00 times higher than that in the lowest risk group (Q1) (HR=16.00, 95% CI: 12.54-20.42).

This study constructed and validated a nomogram model integrating multidimensional indicators to predict the risk of CircS, demonstrating good performance and providing a scientific basis for achieving precise prevention and graded management of CircS.

To investigate the associations of monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA) with mitochondrial DNA copy number (mtDNA-CN) and telomere length (TL) in an arsenic-exposed population.

A cross-sectional study was conducted involving 78 workers from a coke oven plant and their fellow villagers from the same village in Southern Yunnan Province,China. Questionnaire surveys and biological sample collection were performed. Concentrations of inorganic arsenic (iAs), MMA, and DMA in urine were determined using hydride generation-flame atomic absorption spectrometry. mtDNA-CN and TL were measured by quantitative real-time polymerase chain reaction (PCR). Multiple linear regression analysis was performed with mtDNA-CN and TL as dependent variables and log-transformed iAs, MMA, and DMA as independent variables.

After adjusting for confounders in the multiple linear regression model, MMA showed a significant positive association with mtDNA-CN (, P=0.017), while DMA showed a significant negative association (, P=0.007). To address potential multicollinearity and assess model stability, the relationships of arsenic methylation indices, including the primary methylation index (PMI) and secondary methylation index (SMI), with mtDNA-CN were further analyzed. The results showed that PMI was significantly negatively associated with mtDNA-CN (, P=0.041), whereas SMI showed no significant association. Furthermore, no statistically significant associations were observed between MMA or DMA and TL(P>0.05).

A negative correlation was observed between PMI and mtDNA-CN during arsenic metabolism. This may be attributed to the combined effects of arsenic-induced mitochondrial oxidative stress damage and potential insufficiency in mtDNA synthesis resulting from the disproportionate allocation of methyl resources due to highly active arsenic methylation.

Phenotypic age acceleration is an important risk phenotype for multiple chronic diseases. Nutrient supplements are widely used among middle-aged and older adults, often in combination, as a potential strategy to address age-related health concerns. However, the associations between supplement combinations and phenotypic age acceleration remain insufficiently evaluated. This study aims to examine the associations of supplement use and common combinations with phenotypic age acceleration.

A cross-sectional analysis was conducted using baseline data from the UK Biobank, including 415 636 participants aged 40-69 years. Multivariable linear regression and restricted cubic spline models were applied to assess the associations between supplement use and phenotypic age acceleration.

Regular supplement users accounted for 50.6% of participants, and had lower phenotypic age acceleration than non-users (β=-0.18 years, 95% CI: -0.21~-0.15). Phenotypic age acceleration decreased non-linearly with increasing number of supplements. Use of glucosamine, fish oil, or multivitamins alone was associated with lower phenotypic age acceleration, with the strongest association observed for glucosamine (β=-0.39 years, 95% CI: -0.47~-0.30). The association was stronger for the combination of glucosamine and fish oil (β=-0.60 years, 95% CI: -0.69~-0.52). Adding vitamin C or calcium to this combination also showed negative associations, whereas combinations containing zinc showed no clear association.

Regular nutrient supplement use was associated with lower phenotypic age acceleration, with a non-linear decrease as the number of supplements increased. Associations varied across combinations, and those containing glucosamine and fish oil showed more consistent associations.

To examine the association between dietary patterns and emotional distress among medical students through a cross-sectional analysis, providing scientific evidence for promoting mental health in this population.

A cross-sectional survey was conducted among 1 305 medical students from medical colleges in Tianjin from January 2022 to February 2023 using the Symptom Checklist-90 and a food frequency questionnaire. Principal component analysis was used to identify dietary patterns, and the factor scores of each dietary pattern were categorized into T1, T2, and T3 groups according to tertiles. Multivariable logistic regression was used to analyze the association between different dietary patterns and emotional distress.

The proportion of medical students with emotional distress was 16.7%. Three distinct dietary patterns were derived from the analysis: a diverse diet, a beverages-snacks-pickled foods diet, and a nuts-fruits-beans diet. Among them, high intake of the beverages-snacks-pickled foods pattern (T3) was positively associated with emotional distress (OR=1.812, 95% CI: 1.238-2.651, P<0.05), and this association persisted after adjustment (OR=1.992, 95% CI: 1.336-2.971, P<0.05). In contrast, moderate intake of this pattern (T2) was inversely related to emotional distress (OR=0.618, 95% CI: 0.389-0.982, P<0.05). Other associations were non-significant after adjustment (P>0.05).

There is an association between dietary patterns and emotional distress. Medical students should optimize their daily dietary structure and reasonably control sugar and salt intake to prevent emotional distress.

To investigate the current status of emotional eating behaviors during pregnancy, construct a network model to analyze symptoms and influencing factors, and provide targets for precision intervention.

Pregnant women were recruited from a maternal and child health hospital in Ningxia using convenience sampling. Emotional eating behaviors were measured using the revised Dutch Eating Behavior Questionnaire (DEBQ). The symptom network of emotional eating behaviors and its relationship with influencing factors were analyzed using the “bootnet” package in R 4.4.3.

The mean score of emotional eating behaviors in pregnant women was 19.82±7.68. “Craving food when disappointed” was the core symptom, with the strongest association observed between “craving food when disappointed” and “craving food when fearful” (edge weight=0.48). In the influencing factor network, the restrictive eating behavior cluster showed the strongest association with the emotional eating behavior cluster (mean edge=0.05), while psychological resilience exhibited a negative correlation with “craving food when fearful” (edge=-0.05). Within the restrictive-emotional eating behavior network, “considering the relationship between body weight and food” and “craving food when bored” demonstrated the strongest connections (edge=0.09).

The core symptom of emotional eating in pregnant women is “eating when disappointed”. Eating behaviors triggered by fear and goal frustration, as well as cognition about the relationship between body weight and food, are key influencing factors.

To explore the relationship between postpartum depression and intimate partner psychological violence during pregnancy and childbirth among postpartum women in rural poverty-stricken areas, as well as the role of social support in this process.

A total of 467 women of childbearing age within one year after childbirth in rural poverty-stricken areas were selected and investigated using the general demographic data questionnaire, the Edinburgh Postnatal Depression Scale, the Abuse Assessment Questionnaire, and the Social Support Rating Scale. Spearman correlation analysis was used to test the relationship between variables, and the Process 4.1 plugin in SPSS was used to test the mediating effect.

The detection rate of postpartum depression symptoms among postpartum women was 32.76%. Intimate partner psychological violence during pregnancy and childbirth was positively correlated with postpartum depression (r_s=0.367, P<0.001), while social support and its various dimensions were negatively correlated with postpartum depression (r_s=-0.389, P<0.001). Social support played a partial mediating role between the two, explaining 15.89% of the total effect.

Both intimate partner psychological violence during pregnancy and childbirth and social support are factors associated with postpartum depression among postpartum women, and social support plays a partial mediating role in this process.

To analyze the compliance of urban populations at high risk of breast cancer in Nanchang City from 2021 to 2023 and explore potential influencing factors, in order to provide a scientific basis for improving screening participation rates and optimizing screening strategies.

Permanent registered residents aged 45-74 years in Nanchang City were selected for a breast cancer risk factor survey and risk assessment. Individuals assessed as high-risk for breast cancer were recommended to undergo combined breast ultrasound and X-ray examinations at designated hospitals. SPSS 25.0 was used to perform χ² analysis to compare screening participation rates across groups with different characteristics. Multivariable logistic stepwise regression analysis was also conducted to identify factors associated with screening participation.

A total of 9 138 high-risk individuals for breast cancer were enrolled, of whom 4 228 participated in breast cancer screening, yielding an overall participation rate of 46.27%. Multivariable logistic stepwise regression analysis showed that higher education level (OR=1.235, 95% CI: 1.052-1.450), current smoking (OR=1.519, 95% CI: 1.296-1.779), exposure to secondhand smoke (OR=1.784, 95% CI: 1.621-1.964), history of childbirth (OR=2.631, 95% CI: 2.141-3.233), history of benign breast disease (OR=1.846, 95% CI: 1.683-2.025), and family history of breast cancer in blood relatives (OR=1.560, 95% CI: 1.406-1.731) were facilitating factors for screening participation (P<0.05). In contrast, age 65-74 years (OR=0.572, 95% CI: 0.508-0.645), screening in 2022 (OR=0.644, 95% CI: 0.573-0.724) and 2023 (OR=0.709, 95% CI: 0.637-0.789), engaging in physical exercise ≥3 times per week (OR=0.763, 95% CI: 0.691-0.844), and history of breastfeeding (OR=0.882, 95% CI: 0.803-0.970) were inhibiting factors for screening participation (P<0.05).

The screening rate among urban populations at high risk of breast cancer in Nanchang City was relatively low and influenced by multiple factors, including education level, smoking history, childbirth history, breastfeeding history, physical exercise, and family history of breast cancer. It is recommended to adopt targeted health education, strengthen social support networks, and focus on subgroups with low screening participation in future efforts to improve screening coverage and enhance prevention and control outcomes.

To understand the prenatal screening results and genotype distribution features of thalassemia among pregnant women in Zunyi area, and to provide a scientific basis for the development and optimization of thalassemia prevention and control strategies.

A retrospective analysis was conducted on the clinical data of 1 876 pregnant women who underwent prenatal check-ups at the First People’s Hospital of Zunyi from February 2023 to September 2023. All 1 876 pregnant women were initially screened for thalassemia using red blood cell indices and hemoglobin electrophoresis. Thalassemia gene detection based on third-generation sequencing technology was performed for screening-positive pregnant women and 228 voluntarily tested screening-negative pregnant women. The positive rate of thalassemia screening, the rate of genetic diagnosis and the distribution features of genotypes were analyzed.

Among 1 876 pregnant women, 178 cases (9.49%) were positive for thalassemia screening, and 67 cases (37.64%) were diagnosed with thalassemia through genetic testing, including 41 cases of α-thalassemia and 26 cases of β-thalassemia. A total of 228 pregnant women with negative thalassemia screening voluntarily underwent thalassemia gene testing, and 14 cases of thalassemia carriers were detected (with a carrier rate of 6.14%), all of whom were α-thalassemia carriers. A total of 55 cases (67.90%) of α-thalassemia and 26 cases (32.10%) of β-thalassemia were detected in this study, and the carrier rate of α-thalassemia was higher than that of β-thalassemia. Among them, the main genotypes of α-thalassemia were --^SEA/αα (30.91%) and -α^3.7/αα (27.27%). The main genotypes of β-thalassemia were CD17/N (38.46%) and CD41-42/N (26.92%).

The carrier rate of thalassemia among pregnant women in Zunyi area is relatively high, with α-thalassemia being predominant. The main genotypes are --^SEA/αα (α-thalassemia), -α^3.7/αα (α-thalassemia), CD17/N (β-thalassemia), and CD41-42/N (β-thalassemia), and a certain proportion of missed cases in the initial screening and rare genotypes were observed.

To investigate the current status and influencing factors of job competency among personnel with public health-related responsibilities in community health service centers within the context of the integration of medical care and disease prevention.

Using a mixed research design approach, the quantitative research employed a multistage sampling method. Based on the job competency assessment scale, self-assessment of job competency was conducted through self-evaluation. For the qualitative study, one-on-one interviews were conducted, and three-level coding based on grounded theory was used to explore the influencing factors of job competency among personnel with public health-related responsibilities.

The quantitative research indicated a job competency score of 4.15±0.50. Across the three dimensions, the self-rated scores in descending order were: professional values (4.40±0.56), personal efficacy (4.20±0.58), and professional literacy (3.86±0.67). Educational attainment was identified as the primary factor influencing the total competency score (P<0.05). Although age and years of work experience did not significantly affect the total score, they showed significant differences in the dimensions of professional literacy and professional values, respectively (P<0.05). The qualitative analysis extracted six influencing factors: professional capability, organizational environment, social responsiveness, comprehensive skills, institutional safeguards, and resource systems. Among these, professional capability (27.35%) and organizational environment (24.63%) accounted for the highest proportions.

The overall job competency score of personnel with public health-related responsibilities in community health service centers in Chengdu was 4.15, demonstrating a structural pattern characterized by “high professional values yet relatively insufficient professional literacy”. Competency is influenced by multidimensional factors. Systematic efforts should be directed toward enhancing professional training, optimizing the organizational environment, and improving institutional safeguards to comprehensively strengthen personnel competency.

To explore the current status of delayed medical care behavior and its influencing factors among the elderly in China, in order to provide a reference for further improving the health outcomes of older adults.

Data were derived from the 2021 Chinese General Social Survey (CGSS). Participants aged 60 years and older were enrolled in this study. Grounded in Andersen’s behavioral model of health care utilization, binary logistic regression combined with decision tree analysis was employed to identify key influencing factors.

Binary logistic regression revealed that delayed medical care behavior was significantly less likely among adults aged ≥81 years (OR=0.486), married older adults (OR=0.118), individuals with general high school or vocational education (OR=0.426), college graduates (OR=0.249), participants with high health literacy (OR=0.191), rural residents (OR=0.591), individuals from higher household economic backgrounds (OR=0.420), older adults receiving social support (OR=0.291), regular health check-up attendees (OR=0.228), and participants reporting strong self-efficacy (OR=0.553). Conversely, significantly higher risks were observed among older adults with poor communication skills with medical professionals (OR=3.104), individuals with ≥3 chronic conditions (OR=2.211), participants experiencing anxiety regarding healthcare accessibility (OR=2.122), and older adults reporting anxiety concerning medical affordability (OR=3.363), all P<0.05. The decision tree model identified seven predictive factors (P<0.05), with marital status showing the strongest association with delayed medical care behavior among older adults.

The rate of delayed medical care among older adults in China is high, and differentiated and targeted preferential healthcare policies should be implemented for older adults, the medical security system should be improved, health education activities should be actively carried out, and older adults should be guided to seek medical care appropriately.

To explore the impact of subjective economic status on the mental health of the elderly and provide a basis for improving their mental health.

Based on the data from the China Family Panel Studies in 2022, this study was conducted using descriptive analysis, one-way ANOVA, Spearman correlation analysis, multiple linear regression, and heterogeneity analysis.

The proportions of participants who self-rated their economic status as difficult, average, and good were 24.94%, 42.48%, and 32.58%, respectively. There were significant differences in depression levels and life satisfaction among the elderly with different subjective economic statuses (P<0.001). Subjective economic status was significantly negatively correlated with depression levels (r=-0.126, P<0.001), and significantly positively correlated with life satisfaction (r=0.322, P<0.001). Compared with the elderly who self-rated their economic status as difficult, those with an average economic status had significantly lower depression levels (B=-0.568, P=0.002), and significantly higher life satisfaction (B=0.179, P<0.001). Those with a good economic status had significantly lower depression levels (B=-0.430, P=0.037), and significantly higher life satisfaction (B=0.456, P<0.001). The results of the heterogeneity analysis showed that the negative impact of subjective economic status on depression levels was significant among the older adults aged 60-64 years and ≥75 years. The positive impact on life satisfaction was significant in all age groups, with the most prominent effect among older adults aged 65-69 years and a significant effect among those aged ≥75 years only when economic status was good.

A high subjective economic status can significantly reduce depression levels and improve life satisfaction among the elderly, and this impact shows significant group heterogeneity. It is necessary to strengthen the economic security of the elderly, alleviate their life pressure, and thereby improve their mental health status to promote active aging.

Horticultural therapy (HT), a widely adopted non-pharmacological intervention, mitigates depressive symptoms among older adults. Given China’s aging population, examining the effect of HT on depressive symptoms among older adults in nursing homes is of practical significance.

Based on three-wave longitudinal panel data from 2022 to 2024 among older adults in Shanghai J Nursing Group facilities, propensity score matching was employed to control for confounding variables and analyze the mechanism of HT’s effect on depressive symptoms among older adults in nursing homes.

HT had a significant predictive effect on depressive symptoms among older adults in nursing homes (β=-1.582, P<0.001). Psychological resilience partially mediated the relationship between HT and depressive symptoms (β=-0.501, 95% CI: -0.772~-0.287), accounting for 31.7% of the total effect. Sleep quality moderated the impact of HT on psychological resilience (β=0.077, P<0.05).

Government departments should promote the integration of HT into standard elderly care protocols and establish a combined model focusing on horticultural therapy, psychological resilience, and sleep health management to improve psychological well-being among older adults in nursing homes.

To explore the mediating role of health empowerment in the relationship between emotional resilience and health-promoting behaviors in patients with chronic heart failure (CHF), and to provide a basis for developing targeted rehabilitation interventions.

A total of 235 CHF patients admitted to the Department of Emergency Medicine and the Department of Cardiology of Wuhan First Hospital from January 2022 to January 2025 were selected. According to the inclusion and exclusion criteria, 220 patients were finally included. They were surveyed using the General Information Questionnaire, the Emotional Resilience Scale, the Health Empowerment Scale for Elderly Patients with Chronic Diseases, and the Health-Promoting Lifestyle Profile (HPLP). Partial correlation analysis was performed using SPSS 26.0, and the mediating effect was tested using the macro program Process 4.2.

All 220 CHF patients were included. The scores for emotional resilience, health empowerment, and health-promoting behaviors were 36.41±5.39, 91.89±9.32, and 110.21±7.62, respectively. Partial correlation analysis showed that emotional resilience was positively correlated with health empowerment (r=0.233, P<0.001) and health-promoting behaviors (r=0.399, P<0.001). Health empowerment was also positively correlated with health-promoting behaviors (r=0.439, P<0.001). The mediation analysis results indicated that emotional resilience had a significant positive effect on health empowerment (β=0.402, t=3.535, P<0.05) and on health-promoting behaviors (β=0.564, t=6.428, P<0.001). After adding health empowerment, emotional resilience still exerted a significant positive effect on health-promoting behaviors (β=0.444, t=5.323, P<0.001). Further verification using the Bootstrap method showed that the direct effect of emotional resilience on health-promoting behaviors accounted for 78.7% (95% CI: 0.280-0.608) of the total effect, while the indirect effect accounted for 21.3% (95% CI: 0.046-0.214).

Emotional resilience can directly affect health-promoting behaviors in CHF patients and can also indirectly affect them through health empowerment, so improving patients’ emotions and health empowerment may have a better effect on patients’ health-promoting behaviors.

To establish a one-tube assay based on reverse transcription recombinase polymerase amplification (RT-RPA) and clustered regularly interspaced short palindromic repeats and CRISPR-associated protein system (CRISPR/Cas12a) (OTRRC).

An OTRRC-based detection workflow for influenza A H1N1 virus was established and optimized. According to different signal readout modes, two detection formats were developed, including fluorescence-based detection (OTRRC-FD) and lateral flow immunoassay-based detection (OTRRC-LFIA). The sensitivity and specificity of both methods were systematically evaluated using plasmids and pseudoviruses as templates, followed by validation using clinical samples.

The OTRRC-FD method detected as low as 2.8×10^-1 copies/μl of standard plasmid template within 20 min and 1.71×10⁰ copies/μl of pseudovirus template within 30 min. The OTRRC-LFIA method detected 10¹ copies/μl of standard plasmid template within 25 min and 10¹ copies/μl of pseudovirus template within 35 min. No cross-reactivity was observed with SARS-CoV-2, IBV-Victoria or respiratory syncytial virus (RSV). In clinical sample testing, the sensitivities of the OTRRC-FD and OTRRC-LFIA methods were 95% and 90%, respectively, with a specificity of 100% for both methods. The agreements with real-time quantitative polymerase chain reaction (RT-qPCR) were 97.19% for OTRRC-FD and 94.56% for OTRRC-LFIA.

In this study, an OTRRC method for the detection of influenza A H1N1 virus was successfully established, and visual readout was achieved using lateral flow strips. This method features rapid detection, high sensitivity, and good specificity, and demonstrated favorable applicability in clinical sample testing. The detection results showed good agreement with the gold standard RT-qPCR, highlighting the potential of this assay as an efficient point-of-care testing (POCT) tool.

To analyze and compare the Salmonella serotyping methods based on multiplex quantitative polymerase chain reaction (multiplex qPCR) and whole-genome sequencing (WGS), and to evaluate the serotyping capability and application scenarios of each method.

A total of 242 Salmonella strains isolated in our province, covering 96 serotypes, were subjected to whole-genome sequencing. The serotypes of these strains were predicted using SeqSero2 and SISTR, followed by a concordance analysis of the results. Meanwhile, multiplex qPCR was employed for the identification of each serotype, so as to assess the accuracy and applicability of this method.

Three methods were used to detect 96 Salmonella serovars. The overall concordance rates of SeqSero2 and SISTR were both 87.50% (84/96), which were significantly higher than that of multiplex qPCR (52.08%, 50/96). For the 242 Salmonella strains, the discordance rates of SeqSero2 and SISTR were 2.48% (6/242) and 7.85% (19/242), respectively. The multiplex qPCR method could only accurately distinguish common serotypes. The main reasons for the discordance of the SeqSero2 method included the deletion or error of O antigen genes. The main reasons for partial concordance were the interference from the similarity of H antigen alleles and the inability to distinguish some serovars in the C2 serogroup that differ only in the O6 antigen. The main reasons for the discordance of the SISTR method were cgMLST cluster misclassification, O antigen gene deletion, and the inability to distinguish monophasic variant strains.

The WGS-based serotyping method exhibits high accuracy and can replace the traditional serum agglutination test for Salmonella serotyping in numerous application scenarios. Although the multiplex qPCR method has limitations with a lower concordance rate than WGS-based methods, it features a short detection time and can accurately identify common serotypes, thus being suitable for emergency rapid detection.

To investigate the characteristics of the molecular transmission network among newly reported human immunodeficiency virus type 1 (HIV-1) cases in Qingbaijiang District of Chengdu from 2022 to 2024, and to provide guidance for local HIV/AIDS prevention and control.

A total of 283 anticoagulated blood samples and demographic information from newly reported HIV-1 cases in Qingbaijiang District from 2022 to 2024 were collected. The HIV-1 pol region gene sequences were amplified by reverse transcription polymerase chain reaction (PCR) and nested PCR, followed by sequencing. A molecular network was constructed based on a genetic distance threshold of 1.5%. The patterns of the molecular transmission network were analyzed, and binary logistic regression was used to analyze factors influencing entry into the network.

A total of 277 valid sequences were obtained. Nine genetic subtypes were identified, with CRF07_BC (197 cases, 71.11%) and CRF01_AE (63 cases, 22.74%) being predominant. Under a genetic distance threshold of 1.5%, the network entry rate was 50.18% (139/277), forming 33 molecular clusters, with the number of cases in each cluster ranging from 2 to 16. Multivariable logistic regression analysis indicated that individuals aged ≥50 years (OR=44.138, 95% CI: 4.474-435.459), and those infected with CRF01_AE (OR=10.434, 95% CI: 1.981-54.966) or CRF07_BC (OR=10.371, 95% CI: 2.078-51.760) subtypes were more likely to be included in the network (P<0.05). High-risk infected individuals (degree ≥4) exhibited significant differences across various occupations, education levels, genetic subtypes, and current residences (P<0.05), and those residing in FH Town (OR=44.138, 95% CI: 4.474-435.459) had a significantly higher risk.

Among newly reported HIV-1 infections in Qingbaijiang District, the predominant genetic subtypes were CRF07_BC and CRF01_AE. Individuals infected with CRF01_AE or CRF07_BC subtypes and aged ≥50 years were more likely to enter the molecular transmission network. Certain townships showed a higher transmission risk among infected individuals. Therefore, it is recommended to establish a molecular transmission network for long-term surveillance in the region and implement targeted interventions in key towns/streets and among high-risk populations to curb the spread of the HIV/AIDS epidemic.

Based on social ecosystem theory (SET), this study investigated parents’ willingness to vaccinate their children with non-expanded program on immunization (non-EPI) vaccines and its influencing factors.

In August 2024, a cross-sectional study was conducted using a self-designed questionnaire based on the core framework of SET through an online questionnaire to assess the willingness of parents in Chengdu to vaccinate children aged 0-6 years with non-EPI vaccines. Multivariable logistic regression analysis was employed to identify factors influencing willingness to vaccinate children with non-EPI vaccines.

A total of 3 448 valid questionnaires were collected, with 46.1% of parents expressing willingness to vaccinate children with non-EPI vaccines. At the micro level, perceived benefits were positively associated with parental willingness to vaccinate their children with non-EPI vaccines (OR=2.60, 95% CI: 2.20-3.07), while risk underestimation was negatively associated with parental willingness (OR=0.68, 95% CI: 0.58-0.79). At the meso level, favorable economic conditions (OR=1.25, 95% CI: 1.07-1.46), good vaccine service accessibility (OR=2.70, 95% CI: 2.31-3.15), and peer recommendations (OR=1.30, 95% CI: 1.11-1.52) were positively associated with parental willingness. Conversely, healthcare workers’ recommendations were negatively associated with parental willingness (OR=0.82, 95% CI: 0.69-0.97). At the macro level, trust in media reports of vaccine-related negative news was negatively associated with parental willingness (OR=0.79, 95% CI: 0.68-0.92), while preferential vaccination policies were positively associated with parental willingness (OR=2.13, 95% CI: 1.75-2.60).

Parents’ willingness to vaccinate children with non-EPI vaccines is influenced by factors at micro, meso and macro levels. Future interventions aimed at increasing vaccination rates for non-EPI vaccines should consider multi-level coordinated interventions.

To evaluate the incidence of adverse reactions in age-eligible people after post-marketing vaccination with the groups A, C, Y, and W135 meningococcal polysaccharide conjugate vaccine (MPCV-ACYW135).

Individuals who received MPCV-ACYW135 vaccination were recruited in Luohu District, Shenzhen. Active surveillance was conducted to collect adverse reactions occurring within 0-30 days after vaccination, and the incidence of adverse reactions was analyzed.

A total of 468 participants were enrolled. The overall incidence of adverse reactions post-vaccination was 25.64%. The incidences of local reactions and systemic reactions were 12.39% and 18.38% (χ²=23.356, P<0.001), respectively. The overall incidences of grade 1, 2, and 3 adverse reactions were 14.53%, 10.68%, and 0.43% (χ²=63.639, P<0.001), and no grade 4 adverse reactions were observed. The incidences of adverse reactions at <30 minutes and 30 minutes - 24 hours after vaccination were 7.69% and 17.95% (χ²=97.099, P<0.001).

The incidence of adverse reactions within 30 days after MPCV-ACYW135 vaccination in the study population was consistent with the results of pre-marketing clinical trials. Adverse reactions were mainly mild to moderate, and most occurred within 24 hours after vaccination, indicating that the vaccine has good safety.

To explore the association between different complete blood count (CBC)-derived inflammation indices and the risk of osteoporotic fracture.

A retrospective analysis was performed based on clinical data from 3 560 patients hospitalized in the Department of Osteoporosis at West China Fourth Hospital, Sichuan University. Based on the presence or absence of osteoporotic fracture, the patients were classified into cases and controls. Binary logistic regression, restricted cubic splines, and subgroup analyses were employed to examine the associations of neutrophil / lymphocyte ratio (NLR), monocyte /lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), the product of platelet count and neutrophil count (PPN), systemic immune-inflammation index (SII), aggregate index of systemic inflammation (AISI) and systemic inflammatory response index (SIRI) with fracture. The performance of the model was evaluated using the receiver operating characteristic curve.

Levels of NLR, MLR, SII, AISI, and SIRI were higher in the case group compared to the control group (P<0.05). After adjusting for age, sex, BMI, bone density, diabetes, coronary heart disease, hypertension and C-reactive protein (CRP), PPN was negatively associated with osteoporotic fracture risk (OR=0.93, 95% CI: 0.86-1.00). Subgroup analysis revealed that the negative association between PPN and osteoporotic fracture was predominantly observed in women and non-diabetic patients. Among patients with diabetes, MLR (OR=1.47, 95% CI: 1.15-1.88), NLR (OR=1.24, 95% CI: 1.00-1.54), and SIRI (OR=1.37, 95% CI: 1.07-1.74) were significantly positively correlated with osteoporotic fracture risk. The incorporation of MLR, NLR, and SIRI into the traditional risk factor model significantly improved its discriminatory ability.

Elevated PPN levels are associated with a reduced fracture risk in patients with osteoporosis, suggesting that PPN may be a potential protective factor. Among patients with comorbid diabetes, NLR, MLR, and SIRI were significant risk factors and provided valuable incremental information, improving the discriminative ability of the model. This study suggests that CBC-derived inflammation indices can serve as a useful supplement for fracture risk assessment and assist in the early identification and stratification of high-risk populations.

To optimize the undergraduate talent cultivation model for public health in local medical colleges and universities, so as to provide practical solutions for enhancing professional identity and cultivating application-oriented talents.

A survey was carried out among undergraduates majoring in preventive medicine from the 2018 to 2024 grades of our university, as well as public health service institutions and educational institutions. The influencing factors of students’ professional identity were analyzed, and the effect of the optimized talent cultivation model on improving professional identity was evaluated.

Preventive medicine students with higher grades (P=0.013), non-first-choice majors (P=0.007), poor academic performance (P=0.018), low satisfaction with curriculum content arrangement (P=0.001), low satisfaction with teachers’ teaching quality (P=0.027), low satisfaction with the academic performance evaluation system (P=0.017), and low evaluation of salary (P=0.003) had a relatively low level of professional identity. A “Five-Dimension Integrated” training model for public health talents was constructed. Through the implementation of reforms such as optimizing talent training objectives, improving curriculum system design, enhancing teaching methods, perfecting the quality assessment system, and refining the continuous improvement mechanism, the overall average score of students’ professional identity increased to 3.35±0.65 points.

After the reform, the professional identity of undergraduates majoring in preventive medicine reached a moderate level. The “Five-Dimension Integrated” public health talent training model is conducive to improving students’ professional identity.