This study aims to investigate the association between blood glucose control level and the risk of developing gallstone disease (GSD).

Longitudinal cohort data from the UK Biobank (UKB) through 2023 and cohort data from individuals who underwent health examinations at a hospital in Kaizhou District, Chongqing, between 2013 and 2017 were used. Cox proportional hazards models were applied separately in the two cohorts to investigate the associations of fasting blood glucose (FBG), glycosylated hemoglobin (GHb), and the hemoglobin glycation index (HGI) with the risk of incident GSD, and the results from the two cohorts were pooled using meta-analysis. In addition, trajectory analysis was conducted in the Kaizhou hospital cohort to examine the associations of FBG, GHb, and HGI trajectories with the risk of incident GSD.

Meta-analysis integrating data from the UK Biobank and the Kaizhou cohort showed that each 1-unit increase in FBG was associated with an HR of 1.061 (95% CI: 1.054-1.068) for GSD, and each 1-standard deviation (SD) increase in FBG was associated with an HR of 1.076 (95% CI: 1.067-1.085). Compared to individuals with FBG <6.10 mmol/L, those with FBG between 6.10-<7.0 mmol/L (pooled HR=1.151, 95% CI: 1.095-1.210) and those with FBG ≥7.0 mmol/L (pooled HR=1.398,95% CI: 1.336-1.463) had increased GSD risk. Similarly, compared to individuals with GHb <5.7%, those with GHb between 5.7%-<6.5% (pooled HR=1.044, 95% CI: 1.013-1.076) and those with GHb ≥6.5% (pooled HR=1.187, 95% CI: 1.123-1.255)also showed elevated GSD risk. In the low-HGI group, each 1-unit increase in HGI was associated with an HR of 0.689 (95%CI: 0.570-0.834) for GSD, and each 1-SD increase was associated with an HR of 0.911 (95% CI: 0.868-0.955). In the medium-HGI group, the corresponding HRs were 0.737 (95% CI: 0.562-0.967) per 1-unit increase and 0.962 (95% CI: 0.930-0.995)per 1-SD increase. In the high-HGI group, each 1-unit increase in HGI was associated with an HR of 1.067 (95% CI: 1.006-1.131), and each 1-SD increase was associated with an HR of 1.028 (95% CI: 1.003-1.054). Trajectory analysis revealed that compared to the high-level HGI trajectory group, the low-level HGI trajectory group had a lower risk of GSD (HR=0.187, 95%CI: 0.047-0.743). However, the association between different trajectory groups of FBG and GHb and the risk of GSD did not reach a significant level.

There is a correlation between blood glucose control level and the risk of GSD. Poor blood glucose control will significantly increase the incidence probability of GSD. In future clinical practice, emphasis should be placed on the standardized management of blood glucose. Scientific regulation of blood glucose levels may provide an effective means of reducing the risk of incident GSD.

To explore the associations of nine indices related to insulin resistance, lipid metabolism, and obesity,including estimated glucose disposal rate (eGDR), triglyceride glucose index (TyG), metabolic score for insulin resistance(METS-IR), triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C ratio), TyG-waist circumference (TyG-WC),TyG-body mass index (TyG-BMI), TyG-waist-to-height ratio (TyG-WHtR), a body shape index (ABSI), and conicity index(CI), with hyperuricemia (HUA) among middle-aged and elderly individuals in a county in Guangxi, to screen for key indicators, and to validate them through a cohort study.

A combined cross-sectional and prospective cohort study design was employed. Multivariable logistic regression analysis was used to evaluate the association between each index and HUA. Five machine learning models, including XGBoost, were constructed to evaluate the performance of these indices and screen for key indices. In the prospective cohort, modified Poisson regression and restricted cubic splines (RCS) were utilized to analyze the association and dose-response relationship between the most critical index and the risk of incident HUA.

Multivariable logistic regression showed that after adjusting for covariates, TyG, METS-IR, TG/HDL-C ratio, TyG-WC, TyG-BMI, TyG-WHtR, ABSI, and CI were positively associated with HUA, whereas eGDR was negatively associated with HUA (P<0.001). The machine learning model results indicated that the TG/HDL-C ratio was the most critical index for identifying HUA.A non-linear association was observed between the TG/HDL-C ratio and the risk of incident HUA (P<0.001), with a threshold of 2.971 for the TG/HDL-C ratio in relation to HUA.

All nine indices were associated with HUA in middle-aged and elderly people. The TG/HDL-C ratio was the most critical index for identifying HUA, which holds important public health significance for the early identification of individuals with hyperuricemia.

This study aims to investigate the association between an inflammatory score constructed from white blood cell (WBC) count and high-sensitivity C-reactive protein (hs-CRP) and the risk of type 2 diabetes mellitus (T2DM).

Using data from the China Health and Retirement Longitudinal Study (CHARLS) and the U.S. National Health and Nutrition Examination Survey (NHANES), this study performed logistic regression analyses, restricted cubic spline (RCS) analyses, and subgroup analyses to investigate the association between the WBC-hsCRP inflammatory score and T2DM.

Logistic regression analyses indicated that higher WBC-hsCRP inflammatory scores were associated with increased odds of T2DM.After extensive adjustment for potential confounders, each interquartile-range (IQR) increase in the WBC-hsCRP inflammatory score was associated with a 12% and 45% higher odds of T2DM in CHARLS and NHANES, respectively (CHARLS: OR=1.12,95% CI: 1.05-1.19; NHANES: OR=1.45, 95% CI: 1.22-1.72). RCS analyses suggested a nonlinear association in CHARLS but an approximately linear association in NHANES. The robustness of these findings was further confirmed by subgroup analyses.

Our results indicate a positive association between the WBC-hsCRP inflammatory score and T2DM, suggesting its potential utility for identifying individuals at elevated risk of T2DM.

To explore the independent and combined effects of diabetes onset age and disease duration on all-cause and cause-specific mortality.

A total of 5 555 adult patients with diabetes from the National Health and Nutrition Examination Survey (NHANES) database between 1999 and 2018 were included. The associations of age at onset and disease duration of diabetes with all-cause and cause-specific mortality were analyzed using weighted Cox proportional hazards models and restricted cubic spline analysis.

Multivariable analysis showed that diabetic patients with onset age of 60 years or older had lower all-cause mortality, cardiovascular disease mortality, and diabetes-related mortality than those with onset age under 45 years [hazard ratio (HR) and 95% confidence interval (CI): 0.55 (0.46-0.65), 0.65 (0.49-0.88), 0.34 (0.19-0.64),respectively]. Patients with a disease duration of ≥17 years had higher all-cause mortality, cardiovascular disease mortality, and diabetes-related mortality than those with a disease duration of <4 years [HR (95% CI): 1.85 (1.51-2.27), 1.66 (1.22-2.26),4.82 (2.11-8.69), respectively]. Compared with patients with onset age <45 years and disease duration ≥17 years, the subgroups with onset age of 45-<60 years and onset age ≥60 years (both with disease duration of 0-17 years) had a lower mortality risk[HR (95% CI): 0.37 (0.19-0.70), 0.59 (0.40-0.87), 0.72 (0.56-0.93), 0.55 (0.43-0.71), 0.59 (0.46-0.74), 0.72 (0.57-0.90),respectively].

Age at onset and disease duration have non-linear associations with mortality in diabetic patients,and the coexistence of the two factors further increases the risk of mortality.

To analyze the dynamic trajectory of the CD4/CD8 ratio and its influencing factors in human immunodeficiency virus (HIV)-infected patients after initiating antiretroviral therapy (ART), and to explore its association with risk of mortality.

Data were obtained from HIV-infected patients who initiated ART between 2005 and 2023 in Wuxi.A latent class trajectory model was adopted to identify distinct trajectories of CD4/CD8 ratio. A multivariable logistic regression model was applied to analyze the factors influencing the trajectories of CD4/CD8 ratio, while a generalized linear mixed model tree (GLMMT) was employed to explore population characteristics associated with trajectory group membership. Furthermore,the Cox proportional hazards regression model was used to assess the association between trajectories and mortality.

A total of 3 808 HIV-infected patients were included. Two distinct trajectories of CD4/CD8 ratio were identified: a gradual recovery group(28.02%, 1 067/3 808) and a sustained inversion group(71.98%, 2 741/3 808). Multivariable logistic regression analysis revealed that patients who were male(OR=1.29, 95% CI: 1.01-1.64), infected through homosexual contact (OR=1.25,95% CI: 1.04-1.49), initiated ART more than 30 days after diagnosis (OR=1.70, 95% CI: 1.47-1.97), had baseline CD4 count <200 cells/μl (OR=1.21, 95% CI: 1.03-1.43), and had baseline CD4/CD8 ratio <1 (OR=2.24, 95% CI: 1.59-3.17) were more likely to belong to the sustained inversion group. GLMMT analysis showed that the prevalence of sustained CD4/CD8 ratio inversion was 77.72% (1 427/1 836) among HIV-infected individuals with ART initiation >30 days and a baseline CD4/CD8 ratio <1, and 73.85% (401/543) among those with ART initiation ≤30 days who were male and had a baseline CD4 count <200 cells/μl. Furthermore, individuals in the sustained inversion group had a significantly increased risk of acquired immunodeficiency syndrome (AIDS)-related death (HR=4.90, 95% CI: 1.52-15.83), but no significant association was found with non-AIDS-related death.

The persistent inversion of the CD4/CD8 ratio is common among people living with HIV. A comprehensive assessment of immune status and disease progression should, therefore, include not only the CD4 count but also the CD4/CD8 ratio, while fully considering the influence of demographic and behavioral factors.

To investigate the relationship between different uric acid-to-high-density lipoprotein cholesterol ratios (UHR) and new-onset diabetes in middle-aged and older individuals, providing a reference basis for diabetes prevention and treatment in this population.

Using data from the China Health and Retirement Longitudinal Study (CHARLS), we selected middle-aged and older adults who participated in five waves of the survey from 2011 to 2020. Restricted cubic spline (RCS) analysis was employed to examine the potential nonlinear associations of baseline UHR and cumulative UHR with diabetes risk. The UHR trajectory was categorized into three classes using the k-means clustering algorithm: low-level increasing class (Class 1), moderate-level increasing class (Class 2), and high-level decreasing class (Class 3). Cox proportional hazards regression models were then used to analyze the association between different UHR parameters and new-onset diabetes. Further subgroup analyses were conducted by sex, age, and household registration type, with interaction terms included to test for interactions. Logistic regression sensitivity analyses were performed to validate the robustness of the findings.

This study included 4 638 participants, with 342 new cases of diabetes (7.37%)occurring during the 5-year follow-up period. RCS analysis revealed that higher baseline UHR and cumulative UHR levels were associated with increased diabetes risk in middle-aged and older adults. After adjusting for confounders, diabetes risk significantly increased in Class 2 and Class 3 groups compared to Class 1, with HRs of 1.42 (95% CI: 1.10-1.83) and 1.79 (95% CI: 1.27-2.53),respectively. Furthermore, compared with the lowest tertile group (T1) of baseline UHR and cumulative UHR, the adjusted HRs for the highest tertile group (T3) were 1.64 (95% CI: 1.21-2.23) and 1.60 (95% CI: 1.18-2.18), respectively.

Elevated UHR levels increase the risk of developing diabetes. Continuous monitoring of UHR and early intervention can help reduce the incidence of diabetes in middle-aged and older adults.

To explore the influence of regional light climate levels (light levels) on myopia in children and adolescents and the differences among different populations.

Two kindergartens, two primary schools and two junior high schools were randomly selected from each of the 187 districts (counties) in Sichuan Province. In each school, students (at least 80 students) were selected from the entire class of each grade for vision examination, and questionnaires were conducted among primary school students in grades 4 to 6. The χ² test was used for the differential comparison of myopia rates. The logistic regression model was used to study the influence of regional light climate levels on myopia.

A total of 330 132 students were included. Among them, 5.9% were from Category II areas (45>Eq≥40klx）, 9.8% from Category III areas (40>Eq≥35klx）,15.1% from Category IV areas (35>Eq≥30klx), and 69.2% from Category V areas (Eq<30klx). The myopia rates of children and adolescents in Class II, Class III, Class IV and Class V areas were 30.4%, 29.0%, 33.9% and 43.1%, and increased with the decrease of light climate levels (the increase of type codes). After controlling for covariates, with the type II area (high light level) as the reference, the risk effect of myopia was observed in the type III, type IV, and type V areas (OR=1.433, 95% CI:1.331-1.543; OR=1.543, 95% CI: 1.437-1.656; OR=1.325, 95% CI: 1.238-1.418, all P<0.001). Stratified analysis showed that the same effect was observed in both male and female students, as well as in regions with good and poor economic levels (P<0.001).

The level of natural light in a region may affect the prevalence of myopia among children and adolescents.It is recommended to ensure adequate light intensity in reading and writing environments, provide supplementary artificial lighting when necessary, and further increase the duration of outdoor activities.

This study aims to investigate the impact of dietary quality on musculoskeletal age acceleration(MuscAgeAccel) in middle-aged and older adults, providing a scientific basis for dietary interventions to slow musculoskeletal aging.

A cross-sectional study was conducted involving 3 765 adults aged 45 years and above from the West China Health and Aging Cohort Study and the West China Bone Health Cohort. Diet quality was assessed by calculating the Chinese Healthy Eating Index (CHEI), using a simplified food frequency questionnaire (FFQ-25). MuscAgeAccel was calculated as the difference between musculoskeletal biological age predicted from clinical indicators and chronological age. Multiple linear regression models were used to examine the association between the CHEI and MuscAgeAccel, while adjusting for demographic characteristics, lifestyle factors, and chronic diseases. Subgroup analyses were then conducted.

The CHEI score was negatively associated with MuscAgeAccel (r_s=-0.09). Compared with participants in the lowest CHEI score group, those in the highest score group exhibited a 0.31-year reduction in MuscAgeAccel (β=-0.31, 95% CI:-0.51~-0.10). Subgroup analyses revealed that the beneficial effect of higher dietary quality on slowing musculoskeletal aging was more pronounced in males, those with body mass index (BMI) > 24 kg/m², and non-smokers (all P for interaction <0.05).

Adherence to the healthy dietary pattern recommended by the Chinese Dietary Guidelines may attenuate musculoskeletal age acceleration and reduce the risk of diseases related to musculoskeletal aging.

To investigate the pollution status of heavy metals (Cr, As, Pb, Cd, and Hg) in rice produced in Wuxi City and assess their potential health risks.

From 2021 to 2024, 157 rice samples were collected from rice planting areas A and B under the jurisdiction of Wuxi. Inductively coupled plasma mass spectrometry (ICP-MS) was used to detect target elements. Single factor pollution index (Pi) and Nemerow comprehensive pollution index method were used to evaluate the pollution level of rice produced in Wuxi City, and health risks were evaluated by environmental health risk assessment model.

The annual average concentrations of various heavy metals were within the standard limits, with the mean values ranging from high to low as Cr>As>inorganic As>Pb>Cd>Hg. The coefficient of variation for each element ranged from 33.12%to 352.94%. The single factor pollution index and comprehensive pollution index of Cr, As, Pb, Cd, and Hg in areas A and B were all less than 0.6, indicating a safe level. The total carcinogenic risk of heavy metals was 3.51×10^-4, with inorganic As having the highest carcinogenic risk of 2.68×10^-4. The individual non-carcinogenic risks of heavy metals and the combined health risk index of multiple heavy metals were all less than 1, with inorganic As having the highest non-carcinogenic risk of 5.95 × 10^-1.

The heavy metal pollution in rice produced in Wuxi was at a safe level, and the distribution of heavy metal pollution in the samples was uneven. The carcinogenic and non-carcinogenic risks of heavy metals from rice produced in Wuxi were at acceptable levels.

To analyze the dietary patterns and their influencing factors in Ali area, and to provide reference for the prevention and control of chronic diseases via dietary intervention in underdeveloped high altitude areas.

A stratified cluster sampling method was used to select 606 adult residents in Ali from June to August 2021 for investigation. The food frequency questionnaire was used to collect data on food consumption over the past year. Factor analysis was employed to construct dietary patterns, and stepwise multinomial logistic regression was applied to identify the factors affecting dietary patterns.

Five dietary patterns were extracted. Logistic regression analysis showed that the dried fruit beverage pattern was positively correlated with non-married (P=0.043), other occupations (P=0.027), smoking (P=0.023), weight gain >2.5 kg in the past year (P=0.019), non-clean fuel (P=0.006), and poor self-rated health (P=0.001). The Tibetan pattern was positively correlated with education level (P<0.001) but negatively correlated with non-cadre (P=0.002) and non-clean fuel (P<0.001).The highly processed unhealthy pattern was positively correlated with age (P<0.001) and poor self-rated health (P=0.027),while negatively correlated with non-married (P=0.019), non-cadre (P=0.039), family living standards (P=0.002), smoking (P=0.003), tea drinking (P=0.022), weight gain >2.5 kg in the past year (P=0.004), and non-clean fuel (P=0.004). The modern meat-dominant pattern was positively correlated with age (P=0.011), non-married (P=0.003), non-cadre (P=0.020) and tea drinking (P=0.005), but negatively correlated with drinking (P<0.001), amateur physical exercise (P=0.004) and non-clean fuel(P=0.042). The dietary fiber pattern was positively correlated with non-clean fuel (P=0.030), but negatively correlated with high family living standards (P=0.002) and tea drinking (P=0.018).

This study demonstrates that differences in the distribution of the five dietary patterns among residents of Ali are closely associated with demographic characteristics,socioeconomic status, and lifestyle factors, and some patterns are significantly associated with body weight changes and self-rated health status. Targeted dietary interventions should be implemented based on the local dietary culture and living habits to support the prevention and control of chronic diseases in underdeveloped high-altitude areas.

To assess the nitrite exposure level and associated risk from typical foods consumed by residents in Sichuan Province.

Based on the nitrite content data of 969 samples of typical foods and the food consumption survey data of 4 504 residents aged 2-96 years in Sichuan Province, a probabilistic assessment method was adopted to evaluate nitrite exposure using 0.07 mg/(kg BW·d) as the acceptable daily intake (ADI).

The over-standard rate of nitrite in typical foods was 1.96% (19/969). Among them, the over-standard rates of pickled vegetables and meat products were 2.78% (9/324)and 3.09% (10/324). A total of 78.31% of the surveyed population consumed the typical foods; the average daily intake of meat products was the highest (17.50 g/d). The intake of pickled vegetables was relatively higher among residents aged ≥60 years,while the intake of meat products was relatively higher among those aged 18-59 years. The average nitrite exposure of the total population was 0.002 5 mg/(kg BW·d), accounting for 3.57% of the ADI. Meat products were the main source of nitrite,contributing 65.52% to the total exposure, and 0.25% of the population had exposure exceeding the ADI.

The health risk of nitrite exposure from typical foods among residents in Sichuan Province is generally low, but there is a potential risk for a small number of extreme consumers of typical foods. Meat products are the primary contributor to nitrite exposure.

To investigate the longitudinal association of dynamic trajectories and cumulative changes of the geriatric nutritional risk index (GNRI) with all-cause mortality risk in the elderly.

Based on the cohort data of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2012 and 2014, GNRI change indicators were constructed. With 2014 as the baseline, a 4-year prospective follow-up was conducted until 2018. K-means clustering was used to classify GNRI trajectory categories and calculate individual cumulative GNRI. Multivariable Cox proportional hazards models were used to examine the association with all-cause mortality. Restricted cubic spline (RCS) was used to explore the dose-response relationship, and time-dependent receiver operating characteristic curves were used to evaluate predictive performance.

A total of 1 102 participants were included, and 339 deaths occurred during follow-up (30.76%).Trajectory analysis showed that compared with the low-low group, the all-cause mortality risk was reduced by 47% (HR=0.53,95% CI: 0.37-0.77) in the high-high group and 39% (HR=0.61, 95% CI: 0.44-0.84) in the low-high group. In the cumulative GNRI quartile groups, the mortality risk of the Q3 and Q4 groups was reduced by 36% (HR=0.64, 95% CI: 0.45-0.91) and 54%(HR=0.46, 95% CI: 0.31-0.68) compared with the Q1 group. Cumulative GNRI was non-linearly and negatively associated with all-cause mortality risk, with AUC values of 0.692, 0.694, 0.720 and 0.712 at 12, 24, 36 and 48 months, respectively.

GNRI trajectories and cumulative GNRI were significantly associated with all-cause mortality risk among the elderly population. Cumulative GNRI has a good predictive value for all-cause mortality risk.

To explore the applicability and interventional value of integrating transfer cognition and environmental factors into the health action process approach (HAPA) model for understanding hygienic dietary behaviors associated with echinococcosis among Tibetan adolescents.

Using cluster random sampling, four schools in Nagchu Prefecture, Tibet were selected. Students from these schools completed a self-designed questionnaire. Structural equation modeling was employed to analyze the HAPA model integrated with transfer cognition and environmental factors.

This study included 2 934 adolescents. The qualified rate for hygienic dietary behaviors was 52.4%. Mediation analysis revealed that the indirect effect of action self-efficacy → intention for hygienic dietary behavior → action planning → hygienic dietary behavior was the largest (β=0.060, P<0.05), followed by action self-efficacy →maintenance self-efficacy → action planning → hygienic dietary behavior (β=0.014, P<0.05). Transfer cognition could indirectly influence hygienic dietary behaviors by affecting behavioral intention (β=0.013, P<0.05), action planning (β=0.010, P<0.05), and maintenance self-efficacy (β=0.007, P<0.05). Environmental factors influenced hygienic dietary behaviors either indirectly through action planning (β=0.008, P<0.05) or directly (β=0.15, P<0.05).

The HAPA model integrated with transfer cognition and environmental factors is applicable for explaining hygienic dietary behaviors related to echinococcosis among Tibetan adolescents. This provides a theoretical basis for the prevention and control of echinococcosis in Tibetan areas.

This study aims to assess the trends in the disease burden of birth defects (BDs) in China from 1990 to 2023, to inform evidence-based optimization of prevention and control strategies.

Data on the standardized incidence rate, standardized disability-adjusted life year (DALY) rate, and standardized mortality rate for total BDs and 10 major subtypes were extracted from the Global Burden of Disease Study (GBD) 2023 for China. Temporal trends were analyzed using Joinpoint regression to estimate the average annual percentage change (AAPC). Pairwise comparisons were conducted to examine differences by sex.

From 1990 to 2023, the disease burden of total BDs in China showed a significant downward trend,with AAPCs of -0.39%, -4.31%, and -4.84% for each indicator, respectively (all P<0.001). Stage-specific analysis showed that during the low-middle sociodemographic index (SDI) stage, all three indicators exhibited significant decreasing trends,with AAPCs of -0.92%, -2.13%, and -2.32%, respectively (all P<0.001). During the middle SDI stage, the standardized incidence rate showed a slight increase (AAPC=0.24%, P<0.05), whereas the standardized DALY rate and standardized mortality rate continued to decline more markedly, with AAPCs of -8.40% and -9.40%, respectively (both P<0.001). The disease burden of total BDs was consistently higher in males than in females; the decline in standardized incidence rate was faster in females than in males, whereas the declines in standardized DALY rate and standardized mortality rate were faster in males than in females (all P<0.001). Congenital musculoskeletal and limb anomalies had the highest standardized incidence rate in both 1990 and 2023. Congenital heart disease had the highest standardized DALY rate and standardized mortality rate in both years. The most marked declines were observed for neural tube defects (AAPCs:-3.85%, -7.87%, -8.50%) and cleft lip and palate (AAPCs: -1.58%, -9.38%, -12.89%) (all P<0.001).

The disease burden of BDs in China has declined markedly, with notable sex-based differences. Significant progress has been made in the prevention and control of neural tube defects and cleft lip and palate. Future efforts should focus on congenital musculoskeletal and limb anomalies and congenital heart disease, with an emphasis on primary prevention and life-cycle health management.

This study investigates the healthcare-seeking intentions and influencing factors related to weight loss among overweight/obese individuals in communities against the backdrop of the “Weight Management Year”.

From January to June 2025, a stratified random sampling method was used to select 535 overweight or obese residents from 4 community service centers in Cangzhou City. Sociodemographic characteristics and willingness to seek medical care for weight loss were investigated. Univariate analysis and multivariable logistic regression analysis were used to identify the influencing factors.

A total of 535 questionnaires were distributed in the study, with 528 returned, yielding an effective response rate of 98.69%. The willingness to seek medical care for weight reduction among overweight/obese individuals in the community was generally low, at only 33.71%. Univariate analysis revealed statistically significant differences in medical-seeking intentions among individuals based on gender, education level, household monthly income, BMI classification, self-reported health status, and prior weight reduction experience (P<0.05). Multivariable logistic regression analysis further demonstrated that women exhibited higher willingness to seek weight reduction-related medical care than men (OR=1.628, 95% CI: 1.323-2.041). Participants with higher education levels, including postgraduate or above (OR=2.402, 95% CI: 1.204-4.785), an associate or bachelor’s degree (OR=1.853, 95% CI: 1.256-2.745), and high school or vocational high school education (OR=1.521, 95% CI: 1.126-2.053), had significantly higher intentions than those with junior high school education or below. Obesity was associated with a higher intention than overweight (OR=2.113, 95% CI: 1.453-3.072). Prior weight reduction experience was also associated with a higher intention (OR=1.681, 95% CI: 1.156-2.465). Self-reported good health status (OR=0.584,95% CI: 0.396-0.867) and average health status (OR=0.436, 95% CI: 0.285-0.679) were associated with lower intentions compared to poor self-rated health status. Subgroup analysis revealed that the promoting effect of higher education was only significant among women and individuals with weight loss experience (P<0.05), while the inhibitory effect of self-rated good or average health was only significant in obese populations (P<0.05).

The willingness to seek medical care for weight reduction among overweight/obese individuals in communities is low, influenced by factors such as gender, education level, BMI classification, prior weight loss experience, and self-reported health status. It is essential to enhance awareness of the disease attributes of obesity among males, individuals with lower education levels, and those who self-rate their health as good or average, and to guide them toward scientific weight management.

To explore the association between multimorbidity trajectories and intrinsic capacity (IC) impairment among community-dwelling older adults.

Based on hospital information system (HIS) data from Jiading District, Shanghai, from 2018 to 2023 and a community survey conducted in 2024, 2 406 participants aged ≥60 years who completed the five-domain IC assessment and had ≥3 medical records cumulatively were included. Multimorbidity was defined as having ≥2 chronic diseases simultaneously. IC was assessed across five domains according to WHO recommendations, and impairment in any domain was defined as IC impairment. A group-based trajectory model (GBTM) was used to identify multimorbidity trajectories, and logistic regression was employed to analyze the association with IC impairment.

GBTM identified three trajectories: low-level stable (31.5%), medium-level slow-growth(52.8%), and high-level stable (15.6%). The prevalence of IC impairment was 55.0% in 2024. After full adjustment, multimorbidity was associated with IC impairment (OR=1.23, 95% CI: 1.03-1.48), and the risk significantly increased when the number of chronic diseases was ≥4. Compared with the low-level stable group, the risks of IC impairment were elevated in the medium-level slow-growth group (OR=1.28, 95% CI: 1.06-1.55) and the high-level stable group (OR=1.65, 95% CI: 1.26-2.18). Age significantly modified the association (P=0.036), with a more pronounced association in the group aged 70-79 years.

Multimorbidity burden is substantial among community-dwelling older adults, with heterogeneous trajectories. Higher trajectory levels are associated with greater risk of IC impairment. High-risk populations should be identified through trajectory analysis, and IC assessment should be incorporated into community follow-up to support early intervention.

To assess physician selection preferences and willingness to pay among social media users in direct-to-consumer teleconsultations for minor common conditions.

A discrete choice experiment was conducted among users of WeChat and Rednote who had used at least one medical app and logged into social media ≥3 times in the past three months.Snowball sampling covered East, South, Southwest, and Northwest China. An orthogonal design generated choice sets with five attributes: consultation price, hospital level, physician gender, professional title, and post-consultation rating. A mixed logit model estimated preference coefficients and willingness to pay.

A total of 190 valid responses from 42 cities were analyzed, of which 73.68% were from participants aged 18-24 years. Participants preferred physicians with positive ratings (vs.neutral/negative, β=0.70, P<0.001), lower consultation prices (per ￥1 increase, β=-0.52, P<0.001), associate chief physicians(vs. chief/attending, β=0.43, P<0.001), and physicians from tertiary grade A hospitals (vs. hospitals below the tertiary grade A level, β=0.30, P<0.001). Physician gender showed no significant effect (P>0.05). Willingness to pay premiums was ￥103.43(95% CI: 39.94-166.92) for positively rated physicians, ￥64.55 (95% CI: 36.01-93.09) for associate chief physicians, and￥44.60 (95% CI: 26.49-62.72) for physicians from tertiary grade A hospitals.

In teleconsultations for minor common conditions, the influence of traditional medical signals is attenuated, while post-consultation ratings become the primary determinant of user choice.

To evaluate the long-term cost-effectiveness of a Mediterranean diet compared with a conventional low-fat diet for the secondary prevention of coronary heart disease (CHD) in China.

Based on the clinical data from the CORDIOPREV trial, we developed a decision-tree Markov model to estimate the total costs and quality-adjusted life years(QALYs) associated with two dietary interventions from a societal perspective. Finally, the incremental cost-effectiveness ratio(ICER) and incremental net monetary benefit (INMB) were calculated. The willingness-to-pay (WTP) threshold was set at 1-3 times China’s per capita GDP in 2024. Model robustness was tested with one-way and probabilistic sensitivity analyses.

Over 20 years, the Mediterranean diet group incurred a cumulative total cost of 534 194.73 yuan per patient and gained 9.89 QALYs, whereas the low-fat diet group incurred a total cost of 466 877.72 yuan per patient and gained 9.55 QALYs. The ICER was 196 360.67 yuan/QALY, between 1 and 3 times the per capita GDP. At a threshold of three times China’s per capita GDP, the INMB was 31 071.64, and probabilistic sensitivity analysis demonstrated that the Mediterranean diet had a 57.68%probability of being cost-effective.

The Mediterranean diet is more cost-effective than the low-fat diet for secondary prevention of CHD in China, supporting its inclusion in secondary prevention strategies for CHD in China.

To explore the coupling coordination level and limiting factors of the health expenditure input system, the medical resource allocation system, and the health service efficiency system and to provide references for promoting the high-quality development of health services in China since the new healthcare reform.

The coupling coordination model and obstacle degree model were used to analyze the coupling coordination degree and the evolution of obstacle factors among the three systems in 31 provinces of China from 2010 to 2023.

The average coupling coordination degree increased from 0.06 in 2010 to 0.52 in 2023, showing a slow upward trend but not reaching a moderate coordination level (<0.6). Qinghai only increased from 0.02 to 0.31. The average obstacle degree of the key obstacle factors rose from 0.10 to 0.32. The key obstacle factors gradually shifted from multiple input-related indicators, such as limited government investment and inadequate development of the healthcare workforce, to two efficiency-related indicators: relatively high average outpatient and inpatient costs.

The coupling coordination level of the three systems needs further improvement. The key obstacle factors have evolved from multiple input-based indicators to two efficiency-based ones. It is necessary to further enhance the coordinated development of those systems by diversifying strategies, such as perfecting adaptive policies to address shortcomings in coordinated development, optimizing the structure of medical services to reduce medical costs, and improving health expenditure input and utilization mechanisms through market mechanisms.

To delineate the evolutionary trajectory of China’s mental health policies from 2001 to 2025 and to further explore the underlying driving forces behind this evolution.

Taking 298 policy documents as the research object, a “three-stage independent latent Dirichlet allocation (LDA) + cosine similarity + Sankey diagram” analytical framework was constructed to identify the key focus areas and evolutionary pathways of mental health work across three stages, combined with a literature review to analyze the driving factors of policy change.

A total of 7, 6, and 4 latent topics were extracted from the three stages, respectively. The policies exhibited a transition from system exploration to legal standardization and then to psychological services. The driving forces behind policy changes primarily stemmed from multiple dimensions, including resource allocation, institutional changes, public events, and social demands.

Over the past 25 years, China’s mental health policy has undergone a paradigm shift from disease treatment to social psychological services. Resource allocation (e.g., the 686 Program, professional institution construction) directly gave rise to early policy themes. Major institutional events (the enactment of the Mental Health Law, the elevation of mental health to a national strategy)promoted the formation of legal standardization and social psychological service themes. Public events (SARS, the Wenchuan earthquake)catalyzed the transformation of service models. Changes in social demands (the shift from focusing on the management and control of severe mental disorders to the promotion of mental health for the entire population) constituted the most fundamental driving force.

This study aims to construct age-stratified parametric survival models of disability risk based on intrinsic capacity (IC) using nationwide longitudinal data and to establish a simplified IC grading system.

Using longitudinal data from CHARLS 2011—2020 for individuals aged 60 years and older, IC scores were calculated using six commonly used methods, and five parametric survival models were constructed within each age group. The optimal model was selected based on the concordance index (C-index) and Akaike Information Criterion (AIC), and reference thresholds for IC grading were determined according to the quartiles of predicted disability risk.

A total of 3 272 older adults were included, with a median age of 65.00 (62.00-70.00) years. IC scores calculated by the 100-score scaling method combined with the log-normal parametric survival model showed the best predictive performance in most age groups, particularly for the 60-69 years (AIC=13 497.80, C-index=0.648 7), 70-79 years (AIC=5 306.87, C-index=0.624 8), and ≥80 years (AIC=804.73, C-index=0.643 9) age groups. The survival risk model revealed that IC grading thresholds decreased with increasing disability risk, with variations observed across age groups, sexes and numbers of chronic diseases. Older adults, females and those with more chronic diseases had lower IC thresholds. For instance, at the median disability risk level among those without chronic diseases, IC thresholds were 55.80 and 51.60 for males and females aged 60-69 years, respectively, decreasing to 45.10 and 34.80 for those aged ≥80 years.

IC scores calculated using the 100-score scaling method combined with the log-normal parametric survival model showed the best predictive performance for disability risk among Chinese older adults. The established IC grading thresholds may provide a reference for health assessment and graded interventions among Chinese older adults.

To explore the association between hearing impairment and depressive symptoms among middle-aged and older adults, as well as the moderating role of sleep duration.

Data from four waves of the China Health and Retirement Longitudinal Study (2013—2020) were analyzed. Multivariable Cox regression was used to conduct interaction tests and stratified analyses to verify the association and moderating effect.

In the overall population, hearing impairment was associated with a significantly higher risk of depression (HR=1.29, 95% CI: 1.08-1.55). Stratified analysis revealed that such association existed in the short sleep group (HR=1.35) and long sleep group (HR=1.78), whereas no significant association was observed in the normal sleep group. Interaction analysis indicated that only prolonged sleep significantly exacerbated the association between hearing impairment and depression (HR=1.69). Subgroup analysis showed that the association was more prominent in females with short sleep and males with long sleep, and the effect was significant among individuals aged 60 years and above.

Hearing impairment is a significant risk factor for depressive symptoms among older adults, and sleep duration plays a moderating role in this relationship. Maintaining a normal sleep duration may alleviate and offset the increased risk of depression attributable to hearing impairment, thereby providing a novel intervention target for the mental health protection of middle-aged and older adults with hearing impairment.

To investigate the status of secondhand smoke (SHS) exposure and hazard cognition among current non-smokers aged ≥15 years in Ningxia, analyze its main influencing factors, and provide scientific evidence for developing effective tobacco control intervention strategies and measures.

This study selected current non-smokers from the 2024 National Adult Tobacco Surveillance data for Ningxia as the study population. The National Adult Tobacco Surveillance employed a stratified, multistage sampling method with probability proportional to size (PPS). Between March and October 2024, the survey covered 5 districts (urban sites) and 5 counties/cities (rural sites), comprising 30 townships/subdistricts and 60 neighborhood committees/villages (sub-districts). Within each sub-district, 120 households were randomly selected, and one permanent resident aged 15 years or older was randomly selected from each household to participate in a face-to-face questionnaire survey. SPSS 27.0 software was used to perform descriptive analysis and statistical inference on the weighted data derived from the complex sampling design.

A total of 7 200 questionnaires were completed during this survey. After data cleaning, 6 259 valid questionnaires remained, resulting in a valid response rate of 86.93%. This study included 4 821 current nonsmokers as study subjects. In 2024, the overall prevalence of secondhand smoke exposure among current nonsmokers aged ≥15 years in Ningxia was 47.1% (95% CI: 41.8-52.5). Among indoor venues, restaurants had the highest rate of secondhand smoke exposure at 53.2% (95% CI: 40.1-65.8). The overall level of comprehensive awareness regarding the hazards of secondhand smoke was 54.8% (95% CI: 43.1-66.0). Multivariable logistic regression analysis showed that regarding population exposure to secondhand smoke, urban residents (OR=0.733, P<0.05) had lower exposure rates than rural residents.Compared to the ≥65 age group, the 25~<45 age group (OR=1.905, P<0.01) and the 45~<64 age group (OR=1.864, P<0.001)had higher risks of exposure to secondhand smoke. Regarding the overall level of awareness of the hazards of secondhand smoke, men (OR=0.788, P<0.05) had lower awareness than women, and individuals with an education level of primary school or below (OR=0.338, P<0.001) had lower awareness than the reference group with a college degree or higher. Compared with those in other occupational groups, workers in agriculture, forestry, animal husbandry, fisheries, and water conservancy (OR=0.556, P<0.01), employees in enterprises, commerce, and services (OR=0.672, P<0.05), and the unemployed (OR=0.715, P<0.01) had lower levels of comprehensive awareness of the hazards of secondhand smoke.

The SHS exposure rate among non-smokers in Ningxia is relatively high. Males, individuals with low education level, and specific occupational groups have insufficient cognition of SHS hazards. Tobacco control interventions should be strengthened in rural areas and among different occupational groups to reduce SHS exposure.

To investigate the effects of subchronic exposure to butylparaben (BuP) on the gut microbiota of adult male zebrafish.

Four-month-old wild-type AB male zebrafish were randomly divided into a solvent control group(NC), a 2.5 μM BuP group, and a 5 μM BuP group, with 15 fish per group. After 60 days of subchronic exposure, intestinal tissues and contents were collected. Gut microbial diversity, community structure, and functional pathways were analyzed using 16S rRNA high-throughput sequencing.

Compared with the NC group, BuP exposure significantly decreased Chao1,ACE, Simpson, and Shannon indices (all P<0.001). β-diversity revealed distinct separation of microbial community structure.At the phylum level, the relative abundance of Fusobacteriota was increased (P<0.001), while Proteobacteria and Actinobacteriota were decreased (P<0.001). At the genus level, Cetobacterium, Aeromonas, and Plesiomonas were enriched (P<0.001), whereas f_Rhodobacteraceae_unclassified and Pedomicrobium were reduced (P<0.001). Functional prediction indicated that BuP exposure disturbed microbial metabolic pathways, including lipid metabolism and immune regulation.

Subchronic BuP exposure reduces gut microbial diversity, reshapes community structure, impairs metabolic function, and disrupts intestinal microecological homeostasis in zebrafish.

To understand the epidemiological characteristics of adult human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients who have not received antiretroviral therapy (ART) in Jilin Province.

A total of 830 HIV/AIDS patients who had not received ART and were cumulatively reported in Jilin Province from 2004 to 2025 in the China Disease Prevention and Control Information System were selected. The patients were divided into two groups based on the year of diagnosis: 2004—2015 and 2016—2025. The χ² test was used for intergroup comparison and stratified analysis.

Among the 830 untreated patients, males accounted for 84.6%. The age groups of 45-59 years and ≥60 years accounted for 33.9% and 34.0%, respectively. Those with junior high school education or below accounted for 63.4%.Unmarried individuals accounted for 68.3%. Homemakers, unemployed, and those waiting for employment accounted for 42.2%.The main transmission routes were homosexual transmission (48.2%) and heterosexual transmission (45.3%). Testing among other patients accounted for 42.0%, while testing and counseling accounted for 25.3%. The proportion of patients with a first CD4⁺T lymphocyte count <200 cells/μl was 62.5%. Compared with the 2004—2015 group, the 2016—2025 group showed increases in the proportions of individuals aged 25-44 years, those with college education or above, unmarried individuals,homosexual transmission cases, and cases identified through testing and counseling. Cross-analysis of age and transmission route showed that homosexual transmission accounted for 58.3% in the <25-year-old group and 63.4% in the 25-44-year-old group. In the 45-59-year-old group, heterosexual transmission accounted for 50.2%. In the ≥60-year-old group, heterosexual transmission accounted for 51.1% (χ²=50.583, P<0.001). Stratified analysis by CD4⁺T level showed that the proportions of patients with CD4⁺T <200 cells/μl in the ≥60-year-old group (67.4%) and the 45-59-year-old group (66.2%) were significantly higher than the proportion in the <25-year-old group (20.8%) (χ²=39.320, P<0.001). Regarding transmission routes, the proportion of CD4⁺T <200 cells/μl in the homosexual transmission group (66.5%) showed no statistically significant difference from that in the heterosexual transmission group (60.1%) (χ²=11.092, P=0.086). Stratified by sample source, the highest proportion of CD4⁺T <200 cells/μl was found in the group tested among other patients (77.9%), while the proportion in the testing and counseling group was 54.3% (χ²=83.910, P<0.001).

The untreated HIV/AIDS patients in Jilin Province were predominantly middle-aged and elderly, with low educational levels and late diagnosis. However, the proportions of young and middle-aged adults, those with high educational levels, and those infected through homosexual transmission have increased in recent years. Two distinct subgroups exist within the untreated population: the middle-aged and elderly group,predominantly infected through heterosexual transmission and with more severe immune damage, and the young and middle-aged group, predominantly infected through homosexual transmission. Differentiated intervention strategies are needed for the two groups to increase the proportion receiving treatment.

To construct an influenza composite index for Guizhou Province and predict the epidemic threshold and graded thresholds for influenza.

Winter-spring influenza surveillance data from the 2017/2018 to 2024/2025 influenza seasons in Guizhou Province were selected. The influenza composite index was constructed using three indicators: the influenza-like illness percentage, influenza nucleic acid positivity rate, and influenza-like illness outbreak count. The moving epidemic method (MEM) was applied to predict the epidemic threshold and graded thresholds for the 2025/2026 influenza season in Guizhou Province. The model performance was evaluated using sensitivity, specificity, and the Youden index.

A total of six influenza seasons (2017/2018, 2018/2019, 2019/2020, 2021/2022, 2023/2024, and 2024/2025) were finally included for constructing the MEM model and conducting early warning analysis. The sensitivity, specificity, and Youden index of the model were 0.90, 0.96, and 0.86, respectively. For the 2025/2026 influenza season, the pre-epidemic threshold was 0.73,the epidemic start week was week 45 of 2025, the end week was week 9 of 2026, and the estimated epidemic duration was 17 weeks.

The constructed influenza composite index demonstrates good performance in assessing influenza epidemic levels in Guizhou Province and can provide a scientific basis for influenza surveillance and early warning in the region.

To explore the implementation effect and influencing factors of low-end venue female sex workers promoting and distributing human immunodeficiency virus (HIV) urine test kits to clients and mobilizing them for self-testing,providing references for the formulation of intervention strategies for both groups.

From April to June 2023, 100 female sex workers were recruited in a city in Guangxi. They were asked to invite clients to participate in a brief survey,distribute HIV urine test kits, and encourage the clients to perform self-testing. Data from the survey and tests were collected and analyzed to identify factors influencing the promotion of HIV testing.

A total of 66 (66.0%) female sex workers participated in the promotion of testing. There were differences between the promotion group and the non-promotion group in terms of household registration, educational level, number of clients served daily, and age of clients (P<0.05). A total of 504 clients accepted urine test kits for HIV transmission testing, among which 403 people voluntarily accepted self-testing and 101 were tested by peer volunteers. Two cases were positive for HIV antibodies, with a positive rate of 0.40%. The results of the multivariable unconditional logistic regression analysis showed that, among the client population, those who had received commercial sexual services for more than one year (OR=5.601, 95% CI: 2.815-11.144), sought commercial sexual services outside massage parlors (OR=4.301, 95% CI: 1.576-11.737), used condoms during commercial sexual activities (OR=3.794,95% CI: 1.456-9.889), and regularly underwent HIV testing (OR=6.699, 95% CI: 2.279-19.690) were more willing to accept the HIV transmission testing model. The results of the willingness survey showed that 89 female sex workers (89.0%) were willing to proactively offer HIV test kits to their clients, and 336 clients (66.7%) believed that the model of HIV transmission testing was effective and worth promoting.

The intervention model in which female sex workers provide HIV transmission testing to clients is feasible. Clients with a higher awareness of AIDS prevention and a habit of regular testing are more likely to accept the intervention form of transmission tests. Comprehensive intervention and transmission testing for highly active clients who have purchased commercial sexual services over a long period, together with strengthened training to improve the mobilization ability of female sex workers, can be regarded as an innovative strategy to prevent HIV transmission through commercial heterosexual contact.

To investigate the therapeutic effect of Hanfangji formula on silica particle-induced pulmonary fibrosis in mice and to explore its potential mechanisms.

A mouse model of silicosis was established by a single intratracheal instillation of silica suspension. Seventy C57 mice were randomly divided into a blank control group, exposure group, low-,medium-, and high-dose Hanfangji groups, drug safety group, and positive control group (nintedanib). Mice were administered drugs by gavage for 56 days after exposure. Body weight, lung weight coefficient, and peripheral blood leukocyte counts were measured. Flow cytometry was used to determine the proportion of CD86⁺ macrophages in lung and spleen tissues. Western blot was performed to detect the expression of α-SMA and GSDMD-NT proteins in lung tissues. Histopathological changes and collagen deposition were assessed by HE staining and Masson staining.

Following silica exposure, the Ashcroft score of lung tissue in mice increased from 0.48±0.20 points in the control group to 6.72±0.28 points (P<0.01). The proportion of CD86⁺macrophages increased from 17.0%±1.6% to 40.2%±5.0% (P<0.001), accompanied by significant upregulation of α-SMA and GSDMD-NT protein expression. After intervention with Hanfangji Formula, all of the above indicators were markedly improved.Among them, the Ashcroft score in the medium-dose group decreased to 1.68±0.24 points(P<0.01).

Hanfangji formula can alleviate silica-induced pulmonary fibrosis in mice, which may be associated with inhibition of inflammatory responses, regulation of macrophage polarization, and reduction of GSDMD-mediated pyroptosis.