To examine the bidirectional mediating effect of frailty and depression on cognitive impairment.

Data were obtained from a community-based epidemiological survey conducted in Mulei County, Xinjiang Uygur Autonomous Region, in June 2024. Participants were aged 60 years and older. Information on frailty, depression, and cognitive function was collected. Data analysis included descriptive statistics, correlation analysis, regression analysis, and mediation effect analysis using the SPSS PROCESS Macro.

Compared to those with normal cognitive function, older adults with cognitive dysfunction had a higher mean age and a higher prevalence of depression and frailty, alongside lower body mass index (BMI) and reduced physical activity time(P<0.05). Significant correlations were observed among frailty, depression, and cognitive function(P<0.05). Mediation analysis revealed: Frailty partially mediated the relationship between depression and cognitive function (β= -0.076 9, 95% CI: -0.061 4 to -0.016 2), accounting for 19.22% of the total effect; Depression partially mediated the relationship between frailty and cognitive function (β=-0.203 4, 95%CI: -0.312 6 to -0.107 3), accounting for 28.57% of the total effect.

Frailty and depression act as mutual mediators in predicting cognitive dysfunction in older adults. Interventions targeting both physical frailty and psychological well-being may be effective strategies for the prevention and management of cognitive decline in this population.

With the accelerated aging of China’s population, multimorbidity has become a major health challenge for middle-aged and older adults, placing higher demands on clinical care and health management systems. Obesity and insulin resistance are common pathophysiological foundations for multiple chronic diseases. However, there is a lack of large-scale prospective studies systematically evaluating the combined effects of the triglyceride-glucose (TyG) index, traditional obesity indices, and novel obesity indices on the risk of multimorbidity.

To investigate the impact and predictive value of the TyG index combined with traditional and novel obesity indices on the risk of multimorbidity, providing a scientific basis for early identification, risk stratification, and precision nursing interventions for chronic disease comorbidity.

Based on prospective cohort data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, this study included 2 574 middle-aged and older participants aged 45 years or older without chronic diseases at baseline. Traditional and novel obesity indices were calculated, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), weight-adjusted waist index (WWI), a body shape index (ABSI), body roundness index (BRI), and Chinese visceral adiposity index (CVAI). Additionally, the TyG index and its derivatives combined with obesity indices (e.g., TyG-WC, TyG-BRI) were calculated. Cox proportional hazards regression models were used to analyze the associations between these indices and the risk of multimorbidity, while restricted cubic spline analysis was employed to examine dose-response relationships. Receiver operating characteristic (ROC) curves were used to evaluate the predictive performance of these indices.

The overall incidence of multimorbidity was 57.8%. After multivariate adjustment, all obesity indices and TyG-related indices were significantly positively associated with the risk of multimorbidity (P<0.05). Among these, WC showed the strongest association (hazard ratio ［HR］=1.39, 95% confidence interval ［CI］: 1.22-1.57), followed by BMI (HR=1.26, 95%CI: 1.10-1.43). The HRs for WHtR and BRI were both 1.35 (95%CI: 1.18-1.54), while the HRfor CVAI was 1.28 (95%CI: 1.12-1.45). The TyG index alone was significantly associated with the risk of multimorbidity (HR=1.21, 95%CI: 1.06-1.37), and its combination with obesity indices further enhanced the association: TyG-WC had an HRof 1.36 (95%CI: 1.20-1.54), TyG-BRI had an HRof 1.33 (95%CI: 1.17-1.52), and TyG-CVAI had an HRof 1.29 (95%CI: 1.13-1.46). Dose-response analysis revealed that most indices exhibited a nonlinear positive association with multimorbidity risk (all P for nonlinearity<0.05). ROC curve analysis showed that among traditional and novel obesity indices, WHtR and BRI had the best predictive performance (both AUC=0.560). Among TyG derivatives, TyG-BRI had the highest predictive performance (AUC=0.562), followed by TyG-WHtR (AUC=0.561) and TyG-WC (AUC=0.558).The DeLong test revealed that only TyG-WHtR exhibited a significantly higher AUC compared with TyG alone (P=0.038).

The combined use of the TyG index and obesity indices provides a more comprehensive assessment of multimorbidity risk in middle-aged and older adults. Compared with other obesity indexes, TyG-WHtR and TyG-BRI demonstrated superior performance in risk identification, supporting their utility as practical screening indicators in clinical nursing assessments and community health management.

To investigate the association between memory decline and the risk of incident stroke among middle-aged and older adults in China.

Using data from the China Health and Retirement Longitudinal Study (CHARLS), individuals without stroke at baseline were enrolled and followed from 2013 to 2018 to monitor stroke occurrence. Baseline memory status was assessed via subjective memory evaluation, objective memory scores, and history of memory-related diseases.Multivariable Cox regression models were employed to evaluate the association between memory decline and stroke incidence.

The study cohort comprised 14 886 participants.Over an average follow-up of 6.19 years, a total of 893 incident stroke events were recorded, with a 6-year cumulative incidence of 6.0%. After adjusting for demographics, lifestyle, and chronic comorbidities, poor subjective memory (HR=1.20, 95%CI: 1.03~1.39) and memory-related diseases (HR=2.59, 95%CI: 1.89~3.56) were significantly associated with an increased risk of stroke. Subgroup analyses indicated that these associations remained stable across different chronic disease strata (all P for interaction >0.05). No statistically significant association was observed between objective memory scores and stroke incidence.

Memory decline is associated with an increased risk of stroke in middle-aged and older adults. Monitoring the early memory status of this population may facilitate the identification of individuals at high risk for stroke.

To explore the association of the weight-adjusted waist index (WWI) and the comorbidities of hypertension, diabetes, and dyslipidemia, and to provide evidence for prevention and control of comorbidities of hypertension, diabetes, and dyslipidemia.

Data were obtained through questionnaires, physical examinations, and laboratory tests based on the programme of screening and intervention subjects with high risk cardiovascular diseases in Hai’an, Nantong city from 2015 to 2024. Statistical analysises included F-tests, chi-square tests, and multivariate logistic regression models.

Male, current smoking, drinking, unmarried and individuals with high age, waist circumference, body weight, body mass index, systolic blood pressure, diastolic blood pressure, blood glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol, and individuals with low high-density lipoprotein cholesterol had a higher incidence of comorbidities of hypertension, diabetes, and dyslipidemia. Multivariate logistic regression analysis showed a positive association between WWI and the comorbidities of hypertension, diabetes, and dyslipidemia (OR=1.31, 95%CI: 1.27-1.36). Compared to individuals aged ≥60 years, the positive association between WWI and the comorbidities of hypertension, diabetes, and dyslipidemia was stronger in individuals aged <60 years (OR=1.26 vs. OR=1.46, interaction test P<0.001).

WWI is positively associated with the comorbidities of hypertension, diabetes, and dyslipidemia, and the positive association is stronger in individuals aged <60 years old.

To investigate the causal relationship between plasma lipidome and Crohn’s disease (CD), and further reveal the potential mediating role of inflammatory factors in the lipid-CD pathogenesis mechanism by integrating genome-wide association study (GWAS) data of inflammatory factors.

Based on GWAS summary statistics from GeneRISK (n=7 174), SCALLOP (n=14 824), and FinnGen (n=395 179), a two-sample Mendelian randomization (MR) study design was adopted. Using single nucleotide polymorphisms (SNPs) as instrumental variables, the total causal effects of 179 plasma lipid metabolites on CD were first evaluated. Subsequently, a stepwise MR and intersection screening strategy was employed to explore the regulatory pathways involving 91 circulating inflammatory factors. The main statistical method used was the inverse variance weighting (IVW) method, supplemented by sensitivity analyses and multiple testing correction.

The initial MR screening identified 19 lipid phenotypes significantly associated with CD risk. Further analysis pinpointed Phosphatidylcholine (PC 18:1_20:4) as a significant protective factor against CD, with elevated levels robustly causally associated with reduced CD risk. In exploring the mechanism, it was found that this lipid significantly downregulated the expression level of the T-cell surface glycoprotein CD6 (β=-0.054, P<0.05), while genetically elevated CD6 levels significantly increased CD risk (β=0.179, P<0.05). Mediation effect analysis indicated that the CD6-mediated effect direction was consistent with the total effect, accounting for approximately 6.9% of the effect (indirect effect β indirect=-0.010, P=0.396). Reverse MR analysis did not support a reverse causal effect of CD on this lipid.

This study provides genetic evidence confirming the significant protective effect of Phosphatidylcholine (PC 18:1_20:4) against Crohn’s disease. CD6 is identified as a key downstream responder molecule that is negatively regulated by this lipid and promotes CD risk. The results suggest that “phosphatidylcholine—CD6—CD” may be a potential biological pathogenic axis, offering new theoretical foundations for in-depth analysis of the immunometabolic mechanisms of CD and the exploration of intervention targets.

To analyze how population aging affects HIV/AIDS incidence and mortality, and to explore the modifying role of socioeconomic factors in this association.

Data on reported HIV/AIDS incidence and mortality, demographic structure, and socioeconomic indicators were collected from 31 provinces in mainland China between 2004 and 2020. A Bayesian spatio-temporal model was constructed with the proportions of different age groups as key explanatory variables. Covariates included per capita gross domestic product (GDP), number of health institutions, population density, sex ratio, education leveland annual mean temperature. The modifying effects of socioeconomic indicators were also analyzed.

At the national level, each 1% increase in the proportion of the population aged 0-14 years was associated with a 1.1% increase in the relative risk of HIV/AIDS mortality (95%CI: 1.001-1.021). Each 1% increase in the proportion of the population aged ≥65 years was associated with a 2.0% increase in the relative risk of HIV/AIDS incidence (95%CI: 1.006-1.033) and a 1.8% increase in the relative risk of HIV/AIDS mortality (95%CI: 1.004-1.033).The effect modification analysis showed that, across different strata of sex ratio and education level, population aging was significantly positively associated with HIV/AIDS incidence and mortality, while the linear trends of sex ratio and education level on incidence and mortality were not significant.

The progression of population aging increases the relative risk of HIV/AIDS incidence and mortality, and sex ratio and education level may partially modify the association between aging and HIV/AIDS.

To investigate whether m⁶A modification promotes arsenic-induced malignant phenotype of skin cells by inhibiting SHIP2 protein expression.

Human skin keratinocytes were continuously exposed to 1 μmol/L sodium arsenite for 22 weeks, and cells were harvested at 0, 4, 8, and 22 weeks of exposure to establish the long-term arsenic treatment cell models. 3-deazaadenosine (DAA) was used to inhibit the m⁶A modification in cells. The SHIP2 protein expression level was detected by ELISA kit, the m⁶A modification level of SHIP2 mRNA was detected by m⁶A-IP-qPCR, the binding levels of m⁶A reader to specific m⁶A regions of SHIP2 mRNA was detected by RIP-qPCR, and the malignant phenotype of cells was detected by CCK-8 assay, scratch healing assay and soft agar colony formation assay, respectively.

Exposure to NaAsO₂ for 22 weeks led to a significant decrease in SHIP2 protein expression (P<0.001). This reduction of SHIP2 protein expression was accompanied by increased m⁶A modification levels on SHIP2 mRNA at three specific regions (SHIP2-1: P=0.019; SHIP2-2: P=0.024; SHIP2-3: P=0.007), and enhanced binding levels of m⁶A reader YTHDF2 to SHIP2 mRNA (SHIP2-1: P=0.004; SHIP2-2: P=0.015; SHIP2-3: P<0.05). Conversely, DAA treatment upregulated SHIP2 protein expression (P<0.001), significantly reduced the m⁶A modification levels on SHIP2 mRNA (SHIP2-1: P=0.030; SHIP2-2: P=0.034; SHIP2-3: P=0.002), and downregulated the binding levels of YTHDF2 to SHIP2 mRNA (SHIP2-1: P=0.002; SHIP2-2: P=0.004; SHIP2-3: P<0.001). HaCaT cells exposed to NaAsO₂ for 22 weeks showed increased efficiency of migration and soft agar colony formation (migration: P<0.001; colony formation: P<0.001), and the cell migration rate, proliferation rate and soft agar colony formation rate were all reduced after DAA treatment (migration: P<0.001; proliferation: P<0.001; colony formation: P<0.001).

Long-term arsenic exposure time-dependently upregulates the total m⁶A modification levels of cells and the specific m⁶A modification levels on SHIP2 mRNA, which enhances the binding of the m⁶A reader YTHDF2 to SHIP2 mRNA, thereby inhibiting SHIP2 protein expression and ultimately promoting the malignant phenotype of human keratinocytes.

To investigate the ameliorative effect and underlying molecular mechanism of Periplaneta americana extract (PAK) on silica-induced lung tissue injury in mice, so as to provide ideas and experimental evidence for the prevention and treatment of silicosis.

A silica-induced mouse model of silicosis was established. Using in vivo animal experiments combined with pathological staining, immunohistochemistry, toxicological evaluation of major organs, transcriptome sequencing, quantitative reverse transcription polymerase chain reaction (qRT-PCR), and 16S ribosomal DNA high-throughput sequencing, we systematically evaluated the efficacy and underlying mechanisms of Periplaneta americana extract in ameliorating silica-induced pulmonary lesions.

At the experimental dose of 400 mg/kg/d, PAK alleviated inflammatory injury and collagen deposition in lung tissue of mouse models, and downregulated the expression of fibrosis-related proteins, with no obvious organ toxicity observed at this dose. Transcriptomic analysis revealed that PAK targeted 149 silica-induced toxicological genes, which were mainly enriched in inflammatory pathways such as the IL-17 pathway. Further qRTPCR assays confirmed that PAK inhibited the Il17a/f mediated inflammatory pathway and downregulated the expression of Tnf-α, Il6 and other proinflammatory factors. Meanwhile, PAK increased the relative abundance of beneficial bacteria including Akkermansia, and ameliorated intestinal flora dysbiosis in silicosis mice, which may be associated with the attenuation of lung tissue damage.

PAK can inhibit the IL17 signaling pathway and improve intestinal flora, thereby alleviating silicainduced pulmonary inflammation and injury, which provides a reference for further research on PAK and the clinical diagnosis and treatment of pneumoconiosis.

To investigate the association between long-term PM₁₀ exposure and dyslipidemia, including its subtypes, and to explore effect heterogeneity across populations.

Data were from the Guizhou Population Health Cohort Study, with baseline in 2010 and follow-up from 2016-2020, including 2 503 adults. Annual PM₁₀ exposure during 2005-2010 was estimated using a high-resolution spatial model. Time-dependent Cox models estimated hazard ratios (HR) and 95% confidence intervals (CI) for dyslipidemia and its subtypes. Subgroup analyses were conducted by age, sex, ethnicity, occupation, smoking, alcohol use, and indoor air conditions.

Over 17 333.5 person-years (median follow-up 6.63 years), 852 dyslipidemia cases occurred (49.15/1 000 person-years). Each 1 SD increase in PM₁₀(5.90 μg/m²) was associated with HR=1.204 (95%CI: 1.106-1.310) for dyslipidemia, remaining robust in dual- and multi-pollutant models. PM₁₀ was mainly associated with elevated LDL-C (HR=1.649, 95%CI: 1.424-1.909). Stronger associations were observed among ethnic minorities, manual laborers, and participants using no clean fuel or lacking ventilation (P for interaction<0.05).

Long-term PM₁₀ exposure increases dyslipidemia risk, especially elevated LDL-C, with stronger effects in ethnic minorities, manual laborers, and those with poor indoor air conditions, emphasizing the need for targeted air pollution control for susceptible populations.

To explore the mediating role of social activity in the relationship between community environment and loneliness.

Convenience sampling was used to select 324 community-dwelling older adults in Guiyang City as study participants between February and July 2025. Data collection tools included a general information questionnaire, the DJGLS Loneliness Scale, the Community Social Environment Perception Evaluation Questionnaire, and the Community Built Environment Perception Evaluation Questionnaire. Mediation effect analysis was conducted using Model 4 in the SPSS PROCESS macro program.

Spearman correlation analysis showed that community social environment(r= -0.560, P<0.001).community built environment (r=-0.605, P<0.001) and social activity (r= -0.627, P<0.001) were negatively correlated with loneliness; Social activity was positively correlated with community social environment (r=0.441, P<0.001) and community built environment (r= 0.472, P<0.001). The results of the mediation effect test showed that social activity partially mediated the relationship between community social environment, community-built environment, and loneliness, with mediation effects accounting for 29.29% and 25.18%, respectively.

Community environment not only directly influences older adults’loneliness but also indirectly influences it through social activity. Efforts should be accelerated to build elderly-friendly community environments, organize elderly activities based on communities, enhance older adults’social activity, and reduce the incidence of loneliness.

To investigate quinolone antibiotic residues in fresh/frozen aquatic animals in Shanghai and assess dietary intake and health risks for local adults.

A total of 8 857 samples were collected from breeding, circulation and catering links in Shanghai during 2017-2024. Fourteen quinolone antibiotics were detected by high performance liquid chromatography-tandem mass spectrometry. Combined with “2023 Shanghai Residents’Diet and Health Status Monitoring”data, point and probability estimation were used to evaluate health risks.

The total detection rate of quinolone antibiotics was 26.40% with a total over-limit rate of 4.36%. Enrofloxacin (including ciprofloxacin) had the highest detection rate (26.21%) and over-limit rate (3.91%), while other quinolones had detection and over-limit rates <1%. Top 3 for highest average total quinolone antibiotic residues: freshwater fish, freshwater shrimp, marine fish. Point assessment showed food safety indexes <1 for both general and highly exposed populations, indicating low health risks. Probability assessment revealed P50 and P95 exposure levels of enrofloxacin (including ciprofloxacin) were 1.89 ng/(kg·bw·d) and 139.00 ng/(kg·bw·d), respectively.

Enrofloxacin (including ciprofloxacin) was the main detected quinolone in Shanghai’s fresh/frozen aquatic animals, with freshwater fish more contaminated. However, health risks of quinolone intake via these products for Shanghai adults were relatively low.

This study investigated the potential anti-obesity mechanisms of betaine by examining its effects on gut microbiota composition, intestinal hormone secretion, and visceral fat metabolism in rats fed a high-fat diet.

18 male SD rats were randomly divided into 3groups: the normal chow diet group (NCD), the high-fat diet group(HFD), and the high-fat diet + betaine group(HBE). Eight weeks later, the rats were sacrificed, and blood was collected to evaluate lipid metabolism and intestinal hormone secretion. 16SrRNA sequencing and reverse transcription quantitative PCR (RT-qPCR) were used to analyze the structure of the intestinal flora and the expression levels of adipocyte genes in rat feces.

Compared with the high-fat diet group, betaine intervention significantly reduced the body weight (P=0.024) and epididymal white adipose tissue weight (P=0.001) of the rats, decreased the serum TG level (P=0.010), and increased the HDL-C (P=0.004) , PYY(P=0.001) and CCK (P=0.026) levels. In addition, linear regression analysis showed that the betaine-induced changes in the β-diversity of the intestinal flora could explain 22.43% of the changes in serum PYY levels (R²=0.224, P=0.047), and 25.09% of the changes in serum CCK levels (R²=0.251, P=0.034). Gene expression analysis showed that betaine intervention down-regulated the expression levels of Fabp3(P=0.019) and Akt1 (P<0.001) and up-regulated the expression of Abcd1 and Trem2 (P=0.010,0.035).

The changes in the intestinal microbiota induced by betaine intervention may improve obesity-related metabolic damage by regulating lipid metabolism and the secretion of intestinal hormones in the host.

To understand the current status of nutrition and health knowledge among primary and secondary school students in Anhui Province, analyze its influencing factors, and provide a basis for conducting nutrition and health education.

In 2024, a multistage stratified cluster random sampling method was used to investigate grades 4 to 6 and junior middle school students in 8 counties/districts in Anhui Province. The total score of the questionnaire was 100. The total of 75 or above indicated having knowledge of nutrition and health.A score of over 75% in each dimension was required to be considered as having nutritional health knowledge in that dimension. Binary logistic regression was used to analyze the influencing factors of nutrition and health knowledge among students.

A total of 2 225 primary and secondary school students were surveyed, including 1 074 girls (48.27%) and 1 018 primary school students (grades 4 to 6) (45.75%). The awareness rate of middle school students was relatively low in the two dimensions of dietary recommendations (24.58%) and food classification and characteristics (46.61%). Multivariate analysis showed that female (OR=1.346, 95%CI: 1.136-1.595), urban students (OR=1.224, 95%CI: 1.018-1.471), junior high school students (OR=1.500, 95%CI: 1.265-1.778), and having a mother with a college degree or above (OR=1.881, 95%CI: 1.347-2.627) were the positively correlated factors of students’ nutritional health knowledge.

Anhui Province’s primary and secondary school students have lower awareness rates of nutrition and health knowledge in the dimensions of dietary recommendations and food classification and characteristics. Gender, urban-rural residence, grade level, and the mother’s educational level are the main factors influencing students for the awareness rate of nutrition and health knowledge among primary and secondary school students. Health education should be conducted for different students and in different aspects of nutrition and health knowledge.

Toinvestigate population preferences and willingness to pay for colorectal cancer diagnostic strategies, andto provide evidence to optimize the initial screening and diagnosis service pathway and develop intervention strategies.

A discrete choice experiment was designed incorporating six attributes: appointment waiting time, number of healthcare visits, pre-diagnostic preparation, invasiveness, diagnostic accuracy, and out-of-pocket cost. In a central urban district of Shanghai, respondents were presented with a hypothetical scenario in which they had tested positive in an initial screening for colorectal cancer. Based on this scenario, their preferences for diagnostic strategies were elicited. A mixed logit model was subsequently employed to analyze population preferences and willingness to pay (WTP).

Appointment waiting time, pre-diagnostic preparation, invasiveness, diagnostic accuracy and out-of-pocket cost had significant effects on respondents’ choices of diagnostic strategies. Diagnostic accuracy was the most important attribute, accounting for 53.61% of relative importance. This was followed by pre-diagnostic preparation and invasiveness, which together accounted for 26.33%. Respondents were willing to pay an additional 623.50 RMB to switch from an invasive to a non-invasive diagnostic option.

Preferences for colorectal cancer diagnostic strategies are primarily driven by diagnostic accuracy, with trade-offs involving the absence of pre-diagnostic preparation, non-invasiveness, shorter appointment waiting times, and lower out-of-pocket costs. It is recommended that communities further strengthen health education on the accuracy of colonoscopy diagnosis, provide non-invasive diagnostic alternatives, and improve referral efficiency. These measures may enhance population adherence to diagnostic procedures, thereby improving the effectiveness of colorectal cancer screening programs and maximizing population health benefits.

To explore the impact of family doctor contract service utilization on the choice of primary medical institutions among elderly patients with multimorbidity, and to provide a reference for improving the family doctor contract service system.

Based on the 2023 China Longitudinal Aging Social Survey (CLASS) data, propensity score matching was employed for analysis.

The utilization rate of contracted family doctor services was 23.8%, and the proportion of choosing primary healthcare institutions was 48.7%. The propensity score matching results showed that under the three matching methods—nearest neighbor matching, radius matching, and kernel matching—the average treatment effects on the treated (ATT) of contracted family doctor service utilization on the choice of primary healthcare institutions were 0.126 1, 0.128 6, and 0.117 9, respectively (all P<0.01). Heterogeneity analysis showed that the improvement effect of family doctor contract service utilization was stronger in urban participants than in rural participants, and the effect increased with the number of chronic diseases.

The utilization of contracted family doctor services significantly increases the likelihood that older adults with multimorbidity will choose primary healthcare institutions.Service provision should be precisely optimized according to the characteristics of different groups to further increase their utilization rate of primary healthcare services.

To investigate the distribution of pathogenic bacteria in community-acquired pneumonia among the elderly population, to construct a risk assessment model for high-risk groups of community-acquired pneumonia, and to provide a basis for clinical prevention and control of pneumonia.

A total of 163 elderly patients with community-acquired pneumonia who were hospitalized in Chongqing Fuling Hospital, School of Medicine, from January 2020 to January 2025 were included as the pneumonia group, and another 180 elderly people with normal physical examinations during the same period were selected as the control group. By comparing the baseline data of the two groups of patients, logistic multivariate analysis was used to identify the independent risk factors for the occurrence of community-acquired pneumonia in the elderly. Based on the results of the factor analysis, a nomogram prediction model was constructed. The model’s efficacy was evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and Hosmer-Lemeshow goodness-of-fit test.

A total of 172 pathogenic bacteria were isolated from 163 patients with community-acquired pneumonia, with Candida albicans (41.10%) and Klebsiella pneumoniae (31.29%) accounting for the highest proportion. The results of the logistic analysis showed that smoking history (OR=1.971, 95%CI: 1.396 - 2.783), cerebrovascular disease (OR=1.300, 95%CI: 1.013 - 1.668), anemia (OR=1.281, 95%CI: 1.014 - 1.618), liver and kidney dysfunction (OR=2.037, 95%CI: 1.008 - 4.118), septic shock (OR=2.299, 95%CI: 1.074 - 4.922), consciousness disorder (OR=1.635, 95%CI:1.074 - 2.488), animal breeding (OR=1.901, 95%CI: 1.364 - 2.648), and dust exposure (OR=1.478, 95%CI: 1.048 - 2.085) were all independent risk factors for community-acquired pneumonia in the elderly（P<0.05）. The ROC curve of the nomogram showed that the AUC=0.710 (95%CI: 0.661 - 0.759), the sensitivity was 0.702, and the specificity was 0.813. The Hosmer-Lemeshow test result showed:P=0.36 (P > 0.05).

Smoking history, cerebrovascular disease, anemia, liver and kidney dysfunction, etc. are all independent risk factors for community-acquired pneumonia in the elderly. Early prevention and control of these risk factors should be strengthened to reduce the risk of pneumonia occurrence.

This study is based on the current status of the construction of a team of disease control supervisors in medical institutions, analyzes the difficulties in building a team of disease control supervisors in medical institutions, and proposes optimization strategies accordingly to provide reference for the collaborative construction of a team of disease control supervisors in medical institutions.

Based on the SFIC model, the dilemma of collaborative construction of the disease control supervisor team in medical institutions was analyzed from four aspects: starting conditions, catalytic leadership, system design, and collaborative process.

The resource endowment of the starting conditions is unbalanced and the foundation of collaboration is weak, the overall authority of the catalytic leadership is missing and the driving mechanism fails, the rule system of the institutional design is fragmented and operable, and the interactive mechanism of the collaborative process is blurred and closed-loop management is missing.

It is recommended to consolidate the resource base and reconstruct collaborative motivation, establish overall coordination authority and improve professional incentives, build a unified framework and clear rules, deepen trust interaction and realize closed-loop operation as strategies for collaboratively building a team of disease control supervisors in medical institutions.

To explore the correlation patterns and group differences between college students’ mental health and sleep quality using network analysis methods, providing empirical evidence for targeted interventions.

A total of 428 college students were selected as the research subjects, and surveys were conducted using the General Health Questionnaire (GHQ-20) and the Pittsburgh Sleep Quality Index (PSQI). The mental health-sleep quality network was constructed using the qgraph package in R software, and centrality indicators of each node were calculated. The Network Comparison Test (NCT) was used to analyze the influence of gender and military status on this network.

In the overall network, daytime dysfunction (a7), anxiety (b3), and subjective sleep quality (a1) were core nodes, while anxiety (b3), daytime dysfunction (a7), and depression (b2) served as core bridges between modules. Gender differences were reflected in higher global connectivity strength in males (s=0.960,P=0.048), with statistically significant edge association differences between sleep disorders and daytime dysfunction (P=0.005), and between daytime dysfunction and self-denial (P=0.045). Military status only had a moderating effect on the association between subjective sleep quality and sleep efficiency (P=0.018), with no significant difference in the overall network.

Network analysis reveals the correlation characteristics between college students’ sleep and mental health, providing a scientific path for targeted services.

To explore the relationship between social support, hypoglycemic fear (FoH) and quality of life in elderly patients with type 2 diabetes mellitus (T2DM), and to test its mediating effect.

By using the method of convenience sampling, elderly patients with type 2 diabetes mellitus (T2DM) who visited Nanjing Hospital Affiliated to Nanjing Medical University were selected as the research subjects. The Social Support Rating Scale (SSRS), the Chinese version of the Hypoglycemia Fear Questionnaire-Worry Scale (CHFSⅡ-WS), the Diabetes Specific Quality of Life Scale (DSQL), and a general questionnaire were used to investigate elderly patients with type 2 diabetes mellitus (T2DM). A structural equation model was established for the SSRS, CHFSⅡ-WS, and DSQL scores of elderly T2DM patients, and the mediating effect was tested through Bootstrap post hoc tests.

The effective sample size of this study was 115 cases. The total score of SSRS for elderly patients with T2DM was (38.71±6.25) points, and the score of CHFSⅡ-WS was (26.44±4.28) points; the total score of DSQL was (52.33±13.56) points (Higher DSQL scores mean worse quality of life). The results of the mediating effect test showed that FoH had a direct negative predictive effect on social support in elderly patients with T2DM (β=-0.696, P<0.001), social support had a direct negative predictive effect on quality of life (β=-0.532, P<0.001), indicating that higher levels of social support were associated with better quality of life and lower DSQL scores, and FoH had a direct positive predictive effect on quality of life (β=0.381, P<0.001); The mediating effect value was β=0.370, and the total effect value was β=0.751. The proportion of the mediating effect of social support was 49.27%, and the mediating effect was established.

There is a close correlation among social support, FoH and quality of life in elderly patients with type 2 diabetes mellitus (T2DM). Social support has a partial mediating effect between FoH and quality of life, and the proportion of the mediating effect is 49.27%.

To explore the association between alcohol consumption and the risk of diabetes mellitus (DM) in adult males.

This study utilized data from the Guizhou Natural Population Cohort Study. The cohort was established between November 2010 and December 2012, and a follow-up survey was conducted on the baseline participants from April 2016 to October 2020. Participants were divided based on their baseline alcohol consumption including daily alcohol consumption, drinking frequency, and type of alcohol consumed. Cox proportional hazards regression model were employed to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (95%CIs) for evaluating the association between alcohol consumption and the risk of DM. Restricted cubic spline analysis was performed to characterize the dose-response relationship between daily alcohol consumption and the incidence of DM. Additionally,subgroup analysis was conducted for different baseline variables.

A total of 3 232 participants were enrolled in this study, and 346 cases of DM were identified during a median follow-up period of 6.64 years. The incidence rate of DM in this study population was 15.03/1 000 person-years. Compared with non-drinking participant, those with moderate alcohol consumption(aHR=1.40, 95%CI=1.04-1.89), heavy alcohol consumption(aHR=1.47, 95%CI=1.09-2.00), drinking 1-7 times per week(aHR=1.33,95%CI=1.01-1.73), drinking >7 times per week(aHR=1.57, 95%CI=1.12-2.19), consuming high degree liquor (aHR=1.58, 95%CI=1.15-2.17) had a higher risk of incident DM. A linear relationship was observed between daily alcohol consumption and the risk of DM, with an increased risk of DM found at all levels of alcohol consumption exceeding 22.13g/d. Subgroup analysis revealed that heavy alcohol consumption, drinking >7 times per week, consumption of high degree liquor in individuals aged <45 years, smoking, BMI ≥24 kg/m², and low physical activity were significantly associated with the risk of DM.

Alcohol consumption is closely associated with the incidence of DM. Hence, reducing alcohol consumption can be used as a measure for DM prevention.

To investigate the current situation of health self-help behavior of the elderly in communities in Hunan, Qinghai and Zhejiang provinces and analyze its influencing factors, so as to provide reference for taking targeted measures to improve the level of health self-help behavior of the elderly in communities.

Adopting the convenience sampling method, this study selected 628 community elderly individuals from 7 communities in Hunan, Zhejiang and Qinghai Provinces as research subjects. Questionnaires were administered mainly using the scales of healthy self-help behavior, intergenerational support for children, fear of technology, and daily age discrimination. Hierarchical multiple linear regression was employed to analyze the influencing factors of healthy self-help behavior.

The total score of the healthy self-help behavior scale for the community elderly was 96.98±19.67. Hierarchical multiple linear regression analysis showed that living with a spouse (P<0.001; β=0.257), living with a spouse and children (P=0.001; β=0.147), being in the first marriage (P=0.021;β=0.123), monthly per capita income (P<0.001;β=0.220), and intergenerational support for children (P<0.001;β=0.260) were protective factors; having all male children (P<0.001;β=-0.155), fear of technology (P<0.001;β=-0.306), and daily age discrimination (P=0.027;β=-0.100) were risk factors.

The self-help health behavior ability of the elderly in this community is at a relatively high level. Particular attention should be paid to the elderly who do not live with their spouses, are not in a marital status, have all children of male gender, or have a lower monthly per capita income. Their health self-help behavior ability can be improved by helping them effectively reduce technological fear and daily age discrimination, as well as by enhancing intergenerational support from their children.

To investigate the epidemiological characteristics of sarcopenic obesity (SO) among community-dwelling older adults aged 60 years and above, to analyze the associations between physical activity and other influencing factors with SO, and to explore their predictive effects, providing evidence for the prevention and management of sarcopenic obesity.

Community-dwelling adults aged ≥60 years in Chengdu, Sichuan Province, were recruited using cluster random sampling and convenience sampling. Physical activity data were collected through questionnaires and body composition assessments, and physical activity levels were categorized accordingly. Based on the diagnostic criteria of the Asian Working Group for Sarcopenia (AWGS), participants were classified into an SO group and a non-SO sarcopenia group.Multivariable logistic regression and restricted cubic spline analyses were conducted to examine the association between physical activity and SO.

A total of 7 862 participants were included, comprising 941 individuals with SO (11.97%) and 1 339 with non-SO sarcopenia (17.03%). The SO group had the lowest weekly physical activity level (3 360.00 ［1 680.00, 5 880.00］ MET-min/week), with the highest proportion of low physical activity (91.4%) and the lowest proportion of high physical activity (2.1%). Subgroup analysis by sex revealed that moderate physical activity was a protective factor against SO in women (OR=0.58, 95%CI=0.35-0.96).

Physical activity may be associated with sarcopenic obesity. Increasing physical activity levels could reduce the risk of SO and play an important role in its prevention.

To analyse the rifampicin and isoniazid resistance patterns and mutation sites in 793 clinical isolates of Mycobacterium tuberculosis from Garze Tibetan Autonomous Prefecture, Sichuan Province, collected between September 2018 and August 2025, so as to provide scientific basis for local tuberculosis prevention and control.

DNA microarray gene chips were used to perform rapid molecular detection of rifampicin and isoniazid resistance genes in collected M. tuberculosis isolates. The drug resistance and mutation of resistance genes in the region were analyzed, and chi square analysis was used to compare the drug resistance of different genders, ages, and agricultural landscape areas.

The overall resistance rate of 793 cases of Mycobacterium tuberculosis to rifampicin and isoniazid was 18.16%, with a rifampicin resistance rate of 12.99%, isoniazid resistance rate of 10.7%, and multidrug resistance rate of 5.55%. According to statistical analysis, there was no significant difference in drug resistance rates between patients of different genders. The overall drug resistance rate (21.67%), isoniazid resistance rate (14.28%), and multidrug resistance rate (6.90%) were highest in patients aged 0-<20, and the rifampicin resistance rate (14.56%) was highest in the 40-<60 age group. Differences in overall resistance, rifampicin resistance, isoniazid resistance and multidrug resistance between age groups were not statistically significant. Drug resistance rates were higher in semi-agricultural/semi-pastoral areas than in purely agricultural or pastoral areas. However, no statistically significant differences were observed between overall drug resistance and rifampicin resistance. A statistically significant difference was found between isoniazid resistance and multidrug resistance(χ²=9.089，13.680，P<0.05). The predominant rifampicin resistance mutation site was rpoB531(C->T) (33.01%), followed by 516(G->T) (25.24%) and 511(T->C) (18.45%). Isoniazid resistance was predominantly mediated by katG gene mutations (92.94%), comprising katG315(G->C) (84.71%) and katG315(G->A) (8.24%), while inhA gene mutations accounted for 8.24%. Multidrug resistance was predominantly mediated by rpoB(516(G->T) katG(315(G->C) mutations, accounting for 52.27%.

Rifampicin and isoniazid resistance in tuberculosis cases from Garze Tibetan Autonomous Prefecture is severe. Resistance is more pronounced in the 0-<20 age group compared to other age cohorts, and is more prevalent in semi-agricultural/semi-pastoral areas than in purely agricultural or pastoral regions. Resistance mutations predominantly involve high-level resistance sites for both rifampicin and isoniazid. The region requires enhanced tuberculosis drug resistance testing and detection, strengthened standardised treatment and management of patients, and reduced generation and transmission of drug-resistant tuberculosis, and pay special attention to tuberculosis drug resistance prevention and control among low-age groups and people living in semi-agricultural and semi-pastoral areas.

To characterize the functional epitope distribution of the Artemisia vulgaris allergen Art v 4 and to investigate its potential cross-reactive epitopes with the peach allergen Pru p 4.

Immunoinformatics approaches were used to predict B-cell and T-cell epitopes of Art v 4, followed by spatial localization analysis based on its three-dimensional structure. Potential shared cross-reactive epitopes between Art v 4 and Pru p 4 were screened by sequence alignment. Candidate peptides were synthesized, and their inhibitory effects on the binding of patients’ serum IgE to the natural allergen were evaluated by inhibitory Dot-Blot assay.

Multiple potential linear B-cell epitopes were identified in Art v 4, among which the 13-20 aa and 108-116 aa regions showed high overlap across different prediction algorithms. Among the predicted dominant CD4^＋ T-cell epitopes, the 101-115 aa region showed a high tendency for MHC II binding. Art v 4 and Pru p 4 exhibited high sequence homology in multiple regions, and some dominant T-cell epitopes were highly conserved. The 31-45 aa and 101-115 aa peptides significantly inhibited the binding of patients’ serum IgE to the natural allergen.

Art v 4 contains multiple candidate epitopes, and the regions 31-45 aa and 101-115 aa may represent cross-reactive epitope regions worthy of further investigation.

To analyze the current status and influencing factors of patient delay and diagnosis delay among pulmonary tuberculosis patients aged 60 and above in Gansu Province, and to provide a reference for developing targeted tuberculosis prevention and control strategies for the elderly.

Based on pulmonary tuberculosis case data in Gansu Province from 2019 to 2022, descriptive statistical analysis and multivariable logistic regression analysis were used to investigate the current status and influencing factors of patient delay and diagnosis delay among elderly pulmonary tuberculosis patients.

Among 9 934 pulmonary tuberculosis patients aged ≥60 years, 7 143 cases (71.90%) experienced patient delay, and 1 073 cases (10.80%) experienced diagnosis delay. Among patients with delay, 3 278 cases (45.89%) had a patient delay time ≥7 weeks, and 315 cases (29.36%) had a diagnosis delay time ≥7 weeks. Multivariable logistic regression analysis showed that Tibetan ethnic group, Hui ethnic group, retreatment, and bacteriologically positive status were protective factors for patient delay, while Dongxiang ethnic group, manual laborers, retirees/other occupations, initial diagnosis at the municipal level, and presence of symptoms were risk factors for patient delay. Age ≥70 years, manual laborers, retirees/other occupations, and current diagnosis at the municipal level were protective factors for diagnosis delay, while Hui ethnic group and retreatment were risk factors for diagnosis delay.

The current situation of patient delay among pulmonary tuberculosis patients aged ≥60 years in Gansu Province is particularly severe. It is recommended to establish regionally tailored and differentiated prevention and control strategies, while promoting the decentralization of medical services to enable patients to access care closer to their places of residence, thereby reducing patient delay and diagnosis delay.

To analyze the temporal trends of the burden of musculoskeletal disorders (MSDs) attributable to high body mass index (BMI) in China and globally from 1990 to 2021.

This study utilized the publicly available database of the Global Burden of Disease Study 2021 (GBD 2021). The temporal trends of the burden of MSDs attributable to high BMI in China and globally were evaluated by calculating the annual estimated percentage change and joinpoint analysis. The Das Gupta decomposition method was used to quantify the contributions of population growth, aging, and epidemiological changes to the increase in disease burden.

In 2021, the years lived with disability(YLDs)due to MSDs attributable to high BMI in China was 239 person-years, an increase of 353.92% compared to 1990, significantly higher than the global increase of 184.03% during the same period. The burden of MSDs attributable to high BMI in both China and globally showed an upward trend. The estimated average percentage change (EAPC) in China was 2.69%, and the average annual percentage change (AAPC) was 2.35%. The EAPC globally was 1.18%, and the AAPC was 1.11%. Compared with the global trend, the burden of MSDs attributable to high BMI in China increased at a faster rate and showed a phased fluctuating growth trend. The disease burden of MSDs was higher in females than in males in both China and globally. Decomposition analysis indicated that population aging and population growth were the main reasons for the increase in the prevalence of MSDs in the population.

The burden of MSDs attributable to high BMI in China increased at a faster rate than globally from 1990 to 2021. It is recommended that health departments focus on middle-aged and elderly women, and through strengthening weight management and early intervention, slow down the upward trend of the burden of MSDs.

To investigate the association between baseline atherogenic index of plasma (AIP) and incident metabolic dysfunction-associated fatty liver disease (MAFLD) risk in non-obese individuals.

This cohort study enrolled 62 868 participants who underwent health examinations in 2006—2007. Participants were stratified into quartiles(Q1-Q4)based on AIP values. Multivariable Cox regression calculated hazard ratios (HRs) and 95%CIs for MAFLD risk across quartiles.

During a mean follow-up of 14.34±5.03 years, there were 25 848 cases of new MAFLD. There were 4 892, 5 758, 6 736 and 8 462 cases in group Q1-Q4, respectively, and the incidence density was 25.23/1 000, 31.15/1 000, 38.77/1 000 and 55.04/1 000 years, respectively. In multivariate Cox regression analysis, compared with Q1, the HR(95%CI)for new-onset MAFLD in Q2-Q4 was 1.16(1.12-1.21), 1.37(1.32-1.43)and 1.80(1.73-1.87) (all P values<0.001).

Elevated baseline AIP is an independent risk factor for incident MAFLD in non-obese individuals.

To investigate the current status and influencing factors of avoidable hospitalization among diabetic patients in Xinjiang.

Using survey data from sample institutions in the Xinjiang Health Expenditure Accounting and Monitoring Agency database for 2021-2023, alongside macro-level statistical data, we constructed multilevel logistic regression model to analyze the relationship between avoidable hospital admissions and individual characteristics and healthcare resources.

There were 45 667 patients who experienced avoidable hospitalizations for diabetes. Regression results showed that male patients, those located in Southern Xinjiang and Northern Xinjiang, those receiving care at city-level hospitals, and diabetic patients in areas with a low average number of hospital beds per 10 000 people or low-to-medium average number of health institutions per 10 000 people were more likely to experience avoidable hospitalizations.

Avoidable hospitalizations for diabetes in Xinjiang are influenced by multiple factors. Future policy development should focus on guiding patients to make appropriate choices regarding the level of healthcare facilities, improving the balanced distribution of medical resources across regions, and optimizing resource allocation to reduce the incidence of avoidable hospitalizations.