To evaluate the predictive value of various TyG-obesity indices (TyG-BMI, TyG-WHR, TyG-LAP, TyG-BRI, TyG-CVAI, TyG-BAI) for hyperuricemia in community residents.

Using data from the 2020 cross-sectional survey of the Southwest China Natural Population Cohort, 960 participants were included. A base model was constructed using the random forest algorithm. The predictive performance of models incorporating different TyG-obesity indices was evaluated using the area under the ROC curve, accuracy, precision, recall, and the F1-score.

Among the TyG-obesity indices, the models incorporating TyG-LAP and TyG-CVAI showed the best predictive performance, both with an AUC of 0.716. The TyG-LAP model had slightly higher accuracy and F1-score(0.667 and 0.543), while the TyG-CVAI model achieved the highest recall (0.807). Feature importance analysis indicated that TyG-obesity indices were the important predictors in models incorporating demographic characteristics and behavioral and lifestyle factors.

TyG-obesity indices, particularly TyG-LAP and TyG-CVAI, demonstrate strong predictive ability for hyperuricemia in community residents and may serve as useful tools for community screening and identification of high-risk groups.

To estimate the healthy life expectancy (HLE) of residents in Hainan Province based on multiple criteria, and to evaluate the health status of the population in Hainan Province.

The monitoring data of death causes of residents in Hainan Province, underreporting survey data on causes of death of residents in Hainan Province, and the data of healthy life expectancy in Hainan Province (HLE_GBD) in the Global Burden of Disease Study (GBD) were collected. The health questionnaire of residents in Hainan Province was compiled by combining Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Global Activity Limitation Indicator (GALI), EuroQol Five Dimensions Questionnaire (EQ-5D) and EuroQol Five Dimensions Visual Analogue Scale (EQ-5DVAS) scales. The disability measurement under each criterion was calculated, and the HLE_ADL, HLE_IADL, HLE_GALI, HLE_EQ-5D and HLE_EQ-5DVAS of Hainan residents were estimated using the Sullivan method.

The life expectancy of Hainan residents in 2021 was 79.50 years. The HLE at birth based on ADL, IADL, GALI, EQ-5D, EQ-5DVAS and GBD standards were 75.42, 73.18,71.22, 76.71, 67.73 and 68.26 years, respectively. The HLE of each age group was EQ-5D > ADL > IADL > GALI > GBD > EQ-5DVAS. With the increase of age, healthy life loss and its proportion under different health standards showed a stepwise upward trend. Among them, the proportion of healthy life loss under GBD and IADL standards was the highest, while EQ-5D standard was the lowest.

HLE estimates based on six health standards show notable variation among Hainan Province residents, with EQ-5D and ADL yielding relatively higher HLE values. These findings highlight the need for strengthened methodological validation and cross-standard consistency assessments to establish a more scientific and comparable HLE estimation framework. Incorporating multidimensional health indicators into routine surveillance, while enhancing functional health maintenance, chronic disease management, and elder care capacity, may help improve the overall health status of Hainan’s population.

To investigate the association between the atherogenic index of plasma(AIP) and the risk of kidney stones in the Chinese population undergoing health examinations, providing evidence-based support for risk stratification and precise prevention and control.

Using cross-sectional data from 88 001 healthy individuals who underwent health examinations at Yangzhou University Affiliated Hospital in 2022, we analyzed the association between AIP and the risk of kidney stones using a multivariable logistic regression model. We also explored the nonlinear relationship using restricted cubic splines and threshold saturation effect models. The robustness of the results was assessed through sensitivity analysis, subgroup analysis, and E-value assessment.

A total of 88 001 participants with complete data were included in this study. The overall prevalence of kidney stones was 6.82%, and the prevalence of kidney stones increased with increasing AIP (P<0.001).Multivariable logistic regression analysis showed that, after adjusting for relevant confounding factors, the highest AIP group had 29% higher odds of kidney stones than the lowest AIP group (OR=1.29; 95% CI: 1.17-1.42; P<0.001). AIP exhibited a nonlinear association with kidney stone risk, with a significant increase in risk when AIP<0.27 (OR=1.89; 95% CI: 1.62-2.19; P<0.001), while the trend of increased risk slowed when AIP≥0.27 (OR=1.23; 95% CI: 1.10-1.37; P<0.001). Stratified analysis revealed that the association between AIP and the risk of kidney stones was more pronounced in subgroups of participants aged ≥60 years, men, and those with diabetes and hypertension. Sensitivity analyses and interaction tests indicated that the positive correlation between AIP and kidney stone risk was stable and consistent across the population (all P>0.05).

This study suggests that AIP is associated with an increased risk of kidney stones. AIP may serve as a practical biomarker for assessing kidney stone risk, particularly guiding early interventions such as lipid control and improving insulin resistance. Future prospective studies are needed to validate its causal mechanisms and threshold intervention effects.

To investigate the health-related quality of life (HRQoL) and its determinants among adults aged 18-69 in three Chinese provinces, providing evidence for targeted health management strategies.

Based on the salt reduction action study conducted from 2022 to 2023 in three provinces of China, a total of 1 440 permanent residents aged 18-69 years were selected as survey participants through multi-stage random sampling. The Five-level EuroQoL five-dimensions (EQ-5D-5L) was used to assess health-related quality of life. Tobit regression and ordinary least squares (OLS) regression were employed to analyze factors influencing the utility scores.

This study included a total of 1 426 participants. The health utility value was 1.00 (-0.20, 1.00), and the Visual Analogue Scale (VAS) score was 88 (80, 94), indicating a generally favorable health status. The Tobit regression analysis revealed that age ≥45 years (β=-0.044, 95% CI: -0.080~-0.009), junior high school education (β=0.045, 95% CI: 0.009-0.081), high school education or above (β=0.095, 95% CI: 0.049-0.141), comorbidities (β=-0.125, 95% CI: -0.187~-0.063), salt intake of 5~<10 g (β=-0.067, 95% CI: -0.114~-0.020), and salt intake ≥10 g (β=-0.085,95% CI: -0.133~-0.038) were significant determinants of health utility values (P<0.05). The OLS regression analysis indicated that age ≥45 years (β=-2.227, 95% CI: -3.601~-0.853), high school education or above (β=2.273, 95% CI: 0.561~3.985),medication use (β=-3.716, 95% CI: -5.833~-1.600), presence of cardiometabolic diseases (β=-1.960, 95% CI: -3.557~-0.363), comorbidities (β=-4.686, 95% CI: -7.514~-1.859), and salt intake of 5~<10g (β=-1.656, 95% CI: -3.290~-0.022)significantly influenced VAS scores (P<0.05).

The overall HRQoL among the study participants was generally favorable. However, HRQoL was significantly reduced in individuals with cardiometabolic multimorbidity. Hence, greater emphasis should be placed on the prevention and management of multimorbidity in health administration. Additionally, more attention is needed for residents who are of advanced age, have lower educational attainment, or consume excessive amounts of salt.

To identify the long-term trajectories of body mass index (BMI) among Chinese adults and analyze their influencing factors, providing a scientific basis for developing precision weight management strategies.

Using longitudinal data from seven waves (2010—2022) of the China Family Panel Studies (CFPS), we included 6 134 adults aged ≥18 years. We used the group-based trajectory model (GBTM) to fit BMI change trajectories and multinomial logistic regression to analyze the influencing factors of each trajectory group.

The GBTM identified four distinct BMI trajectories: stable normal weight (25.29%), progressive overweight (39.73%), persistent overweight (27.47%), and fluctuating obesity (7.52%).Multinomial logistic regression analysis revealed that age 30-44 (RRR=1.476, 95% CI: 1.205-1.807) and 45-59 (RRR=1.478,95% CI: 1.199-1.822), urban residence (RRR=1.252, 95% CI: 1.086-1.443), and physical exercise (RRR=1.292, 95% CI:1.101-1.517) were risk factors for the progressive overweight group, while self-rated unhealthy (RRR=0.593, 95% CI: 0.480-0.733) was a protective factor for this group. For the persistent overweight group, male (RRR=1.202, 95% CI: 1.032-1.401), age 30-44 (RRR=1.649, 95% CI: 1.315-2.067) and 45-59 (RRR=1.527, 95% CI: 1.209-1.929), urban residence (RRR=1.361,95% CI: 1.167-1.587), being married (RRR=1.634, 95% CI: 1.273-2.098), high household income per capita (RRR=1.346,95% CI: 1.113-1.628), physical exercise (RRR=1.359, 95% CI: 1.144-1.614), and having chronic disease(s) (RRR=1.317, 95% CI: 1.059-1.638) were risk factors, whereas self-rated unhealthy (RRR=0.670, 95% CI: 0.532-0.843) was a protective factor.Risk factors for the fluctuating obesity group included urban residence (RRR=1.861, 95% CI: 1.481-2.339), being married(RRR=1.671, 95% CI: 1.136-2.458), alcohol consumption (RRR=1.467, 95% CI: 1.095-1.966), physical exercise (RRR=1.316, 95% CI: 1.024-1.691), and having chronic disease(s) (RRR=1.837, 95% CI: 1.359-2.483).

Chinese adults exhibit significant heterogeneity in BMI trajectories, necessitating focused interventions for the progressive overweight and persistent overweight groups, with targeted strategies for high-risk populations including urban residents, married individuals, physically active adults, middle-aged groups, and chronic disease patients.

To analyze the incidence trend of viral hepatitis in China from 2006 to 2020 and predict future trends, so as to provide evidence and reference for the prevention and control of viral hepatitis in China.

Based on viral hepatitis surveillance data in China from the Public Health Science Data Center between 2006 and 2020, joinpoint regression analysis was used to examine trends in incidence rates. An age-period-cohort model was applied to assess age, period, and birth cohort effects. A Bayesian age-period-cohort model was employed to predict incidence trends from 2021 to 2030.

The overall incidence of viral hepatitis in China showed a significant decreasing trend from 2006 to 2020 (AAPC=-1.63%, P<0.001).Specifically, the incidence of hepatitis A (AAPC=-11.16%) and hepatitis B (AAPC=-2.12%) continued to decline, while hepatitis C exhibited an initial increase followed by stabilization (AAPC=7.04%), and hepatitis E showed fluctuating trends(AAPC=-0.32%). The age-period-cohort analysis revealed a bimodal age distribution for hepatitis B, with the first peak in the 0-4 age group (314.34 per 100 000) and a secondary peak in the 20-24 age group (255.68 per 100 000). The risk of hepatitis C increased with age, reaching a peak in the 75-79 age group (48.17 per 100 000). Period effects indicated that the relative risks(RR) for all types of hepatitis were below 1 during 2016—2020, with the overall RR for viral hepatitis decreasing to 0.81 (95% CI: 0.77-0.86), hepatitis A to 0.64 (95% CI: 0.62-0.67), hepatitis B to 0.83 (95% CI: 0.78-0.89), hepatitis C to 0.91 (95% CI:0.88-0.95), and hepatitis E to 0.88 (95% CI: 0.84-0.92). Birth cohort analysis identified that the highest risk of hepatitis B occurred in the 1931—1935 birth cohort (RR=1.77, 95% CI: 1.15-2.72), while hepatitis C risk was highest in the 1976—1980 birth cohort (RR=1.30, 95% CI: 1.21-1.39). The Bayesian age-period-cohort model predicted that the incidence of viral hepatitis in China would reach 48.25 per 100 000 by 2030, with hepatitis B (42.45 per 100 000) and hepatitis C (5.40 per 100 000) remaining the major burdens.

Significant progress has been made in the prevention and control of viral hepatitis in China. However, hepatitis B and hepatitis C continue to pose major challenges. Future efforts should focus on achieving universal hepatitis B vaccination for newborns, promoting active screening for hepatitis C among the elderly, and implementing multidimensional collaborative prevention and control strategies.

To retrospectively analyze the survival status of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients infected with tuberoulosis (TB) in Baise City from 2005 to 2019, and to provide a scientific basis for better prevention and control of HIV-tuberoulosis (HIV-TB) dual infection.

A retrospective dynamic cohort study was used to download the historical database in the AIDS comprehensive prevention and control information system. HIV/AIDS patients diagnosed from 2005 to 2019 were selected. According to the conditions of gender, age of enrollment,time of diagnosis of AIDS, route of infection, whether to receive antiviral therapy and first CD4⁺ count, the double infected patients diagnosed with tuberculosis infection were selected as the HIV-TB group, and the non-tuberculosis infected HIV/AIDS patients were matched according to the matching condition of 1:1 ratio as the HIV/AIDS group. The Kaplan-Meier method was used to draw the survival curve, the life table method was used to estimate the cumulative survival rate, and the time-dependent Cox regression model was used to analyze the influencing factors of survival.

A total of 1 188 cases were enrolled in the observation cohort, with 594 cases in the HIV-TB group and 594 cases in the HIV/AIDS group. There were 251 and 183 deaths in HIV-TB group and HIV/AIDS group, respectively. The mortality rates were 42.26% and 30.81%,respectively. The median follow-up time was 108 (IQR: 70-150) months and 106 (IQR: 67-147) months, respectively. The median survival time was 130 (95% CI: 108.283-152.411) months and >180 months, respectively. The 1-, 5-, 10-, and 15-year cumulative survival rates were 89.23%, 72.87%, 53.29%, 40.65% and 91.08%, 80.60%, 65.44%, 56.40%, respectively. The results of multivariate time-dependent Cox regression model analysis showed that the risk of death in HIV-TB group was 1.391 times higher than that in HIV/AIDS group (95% CI: 1.115-1.735). Among males (HR=1.394, 95% CI: 1.105-1.758), participants aged <45 years (HR=1.411, 95% CI: 1.020-1.951), farmers (HR=1.557, 95% CI: 1.198-2.024), those with junior high school education or below (HR=1.426, 95% CI: 1.130-1.799), those not receiving antiviral therapy (HR=2.004, 95% CI: 1.267-3.169), and those with a first CD4⁺ count <200 cells/μL (HR=1.480, 95% CI: 1.137-1.926), HIV-TB patients had a higher risk of death than HIV/AIDS patients.

Compared with HIV/AIDS patients, the survival time of HIV-TB patients is significantly shorter, especially those who are male, younger, with low education level, without receiving antiviral therapy and with low immune level. It is necessary to carry out targeted publicity and education, strengthen health monitoring and management of high-risk groups, achieve early detection, early diagnosis and early treatment, reduce the risk of death of HIV-TB co-infected patients, and improve the survival time of HIV-TB co-infected patients.

To analyze the change of disease burden of liver cancer caused by several major etiologies in Inner Mongolia Autonomous Region from 1990 to 2021.

Data from the Global Burden of Disease 2021(GBD2021) study for the Inner Mongolia Autonomous Region were collected and analyzed. Using the Joinpoint software, the annual percent change(APC) and the average annual percentage change (AAPC) corresponding to the incidence and mortality rates of liver cancer caused by hepatitis B virus (HBV), hepatitis C virus (HCV), alcohol, non-alcoholic steatohepatitis (NASH), and other factors were calculated.

From 1990 to 2021, the AAPC of liver cancer incidence rates caused by HBV, HCV, alcohol, NASH and other factors in the Inner Mongolia Autonomous Region was 3.41%, 4.58%, 5.01%, 5.14% and 2.99%, respectively (all P values <0.05). The AAPC of liver cancer mortality rates caused by these etiologies was 2.79%, 4.26%, 4.51%, 4.82%, and 2.57%, respectively (all P values <0.05).

From 1990 to 2021, the standardized incidence rate and standardized mortality rate of liver cancer have shown a downward trend, indicating that the prevention and control efforts have achieved initial success. HBV and HCV infections remain the major causes of severe liver cancer burden in Inner Mongolia Autonomous Region. In future, more targeted prevention and control strategies should be developed based on viral infections.

To investigate the association between peripheral blood inflammatory markers and carotid atherosclerotic plaque in an elderly population.

A cross-sectional study was conducted, including 6 569 participants from the West China Elderly Cohort who met inclusion criteria between May 2022 and November 2023. Unconditional Logistic regression was used to examine the relationship between inflammatory markers and carotid atherosclerotic plaque, with stratified and interaction analyses conducted for further insights. Multinomial Logistic regression was applied to explore the associations between inflammatory markers and the severity of carotid atherosclerotic plaques (single/multiple).

Unconditional Logistic regression revealed significant associations between plaque formation risk and white blood cell count (OR=1.06, 95% CI: 1.03-1.10, P<0.001), neutrophils count (OR=1.06, 95% CI: 1.02-1.11, P=0.002), monocytes (OR=2.95, 95% CI: 2.02-4.32, P<0.001), and SIRI (OR=1.13, 95% CI: 1.05-1.22, P<0.001). Stratified analysis identified platelets as significantly associated with plaque formation in elderly individuals with diabetes, with a multiplicative interaction observed (P=0.023).Multinomial Logistic regression revealed that monocytes were specifically associated with the risk of single plaques (OR=2.14,95% CI: 1.33-3.43, P=0.002), whereas white blood cells, neutrophils, monocytes, platelets, neutrophil-lymphocyte ratio (NLR),systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI) were linked to the risk of multiple plaques (P<0.05).

Peripheral blood inflammatory markers are closely related to the formation and severity of carotid atherosclerotic plaques in the elderly, providing valuable insights for assessing carotid atherosclerosis risk.

To investigate the correlation between daily dietary diversity and nutritional status among community-dwelling older adults.

Data were collected from April to October 2024 from 4 578 elderly individuals (aged≥60 years)in the four towns of Jiading District, Shanghai, employing a multistage cluster random sampling approach. A Dietary Diversity Score (DDS) was constructed based on nine food groups: cereals, vegetables, fruits, livestock meat, fish/shrimp, eggs, milk/dairy products, legumes/legume products, and oils/fats. Nutritional status was assessed using the Mini Nutritional Assessment (MNA).Ordinal logistic regression analysis was employed to examine the relationship between DDS and nutritional status, as well as the impact of specific food group intake on nutritional status.

The malnourished group exhibited characteristics including older age (63.46%), primary school education or less (69.23%), non-married status (51.92%), and underweight status (25.00%).DDS was a protective factor for nutritional status in older adults (OR=1.986, 95% CI:1.649-2.392, P<0.001). The well-nourished group reported significantly higher intake frequencies than the malnourished group for fruits (χ²=50.507, P<0.001),vegetables (χ²=17.496, P<0.001), legumes (χ²=20.340, P<0.001), milk/dairy products (χ²=50.472, P<0.001), eggs (χ²=81.994,P<0.001), fish/seafood (χ²=9.825, P=0.007), and meat (χ²=52.414, P<0.001). Intake of fruits, legumes, milk/dairy products,eggs, and meat significantly increased the probability of improved nutritional status (P<0.05). The effect sizes were most pronounced for meat (OR=1.170, 95% CI: 1.470-2.718) and eggs (OR=1.123, 95% CI:1.499-2.358).

Promoting dietary diversity among community-dwelling older adults may help mitigate the risk of deteriorating nutritional status.

To investigate the contamination status of foods in and around schools in Nanjing and to assess the health risks of different contaminants, so as to provide scientific evidence for ensuring school food safety and strengthening supervision.

From 2020 to 2024, 458 samples of foods from in and around campuses, covering four categories, were collected and tested, based on the occurrence of additives and acrylamide in diverse food. Health-based guidance values and benchmark doses were used to construct a risk-ranking matrix that incorporated contaminant toxicity characteristics and population food consumption patterns to evaluate health risks.

The results of the analysis showed that the overall exceeding standard rate of pollutants for food in and around the campuses in Nanjing was 4.59%. The issue of acrylamide and aluminum-containing additives in puffed food was serious particularly, with the exceeding standard rate of acrylamide and aluminum-containing additives reaching an alarming 10.6% and 4.3%, respectively, and the exceeding standard rates of sorbic acid and sodium cyclamate in prepared beverages were both 1.59%.

Risk ranking results indicated that aluminum-containing additives and acrylamide in puffed foods, as well as sodium cyclamate in freshly prepared beverages, posed elevated health risks. Particular attention should be paid to health risks in puffed foods and prepared beverages especially among populations with high and frequent consumption of these foods. The findings provide a scientific foundation for identifying potential hazards and regulatory priority of food safety in food around schools.

This study aims to investigate the association between weight status and the atherogenic index of plasma(AIP) among adolescents in Liangshan Prefecture, with the goal of providing evidence for the prevention of atherosclerosis in this population.

In October 2021, a sample of middle school students from three schools in Liangshan Prefecture was selected. Follow-up survey was conducted in March 2023. General demographic characteristics were collected via structured questionnaires. Anthropometric measurements, including height, weight, and waist circumference(WC), were obtained. Fasting blood samples were collected to measure serum triglycerides(TG) and high-density lipoprotein cholesterol (HDL-C). The associations between baseline body mass index(BMI) and WC with follow-up atherogenic index of plasma (AIP) were assessed using a linear regression model incorporating restricted cubic splines (RCS). A mediation analysis model was employed to evaluate the potential mediating role of baseline AIP in the relationship between baseline BMI (or WC) and follow-up AIP.Furthermore, the association between baseline weight and WC categories and changes in AIP from baseline to follow-up was examined using logistic regression.

The median baseline age of the 1 023 participants was 14.0 years, with 43.7% being male. The RCS curve indicated that baseline BMI was linearly associated with follow-up AIP (P_general<0.001, P_nonlinearity=0.108). In contrast, baseline WC exhibited a nonlinear association with follow-up AIP (P_general<0.001, P_nonlinearity=0.002). Mediation analysis revealed that baseline AIP fully mediated the association between baseline BMI (or WC) and follow-up AIP (BMI: P_direct=0.06,P_indirect<0.001; WC: P_direct=0.13, P_indirect<0.001). Compared with adolescents with normal BMI, those who were overweight or obese at baseline had significantly higher odds of persistent elevated AIP levels (OR=3.570, P<0.001). Similar findings were observed when WC was used as the indicator of weight status (OR=3.388, P<0.001).

Both elevated BMI and increased WC in adolescents are associated with an increased short-term risk of high AIP. Preventive strategies targeting middle school students should be implemented to mitigate the early onset of atherosclerosis.

To explore the association between nighttime social media use, sleep duration, and executive function decline in pregnant women, as well as the isotemporal substitution effect.

Pregnant women attending the obstetric outpatient department of Qilu Hospital in Jinan, Shandong Province were recruited using the convenience sampling method for a questionnaire survey. Single-factor, partition and isotemporal substitution models were used to analyze the relationship between nighttime social media use, sleep duration, and executive function decline in pregnant women.

A total of 628 pregnant women were included in the study. After adjusting for confounding factors, both the single model and the partition model indicated that nighttime social media use duration was significantly positively correlated with scores in total executive function decline (β=0.980; β=0.965), memory (β=0.595; β=0.585), and inhibitory control dimension (β=0.385; β=0.379) (all P<0.01). In contrast, sleep duration was significantly negatively correlated with scores in total executive function decline (β=-0.414; β=-0.402), memory (β=-0.255; β=-0.248), and inhibitory control dimension (β=-0.159; β=-0.154) (all P<0.05). The isotemporal substitution model showed that increasing sleep by 30 minutes to replace an equivalent amount of nighttime social media use was associated with a decrease in the total score of executive function decline among pregnant women (β=-2.047, P<0.001). The improvement in the memory dimension (β=-1.261, P<0.001) was greater than that in the inhibitory control dimension (β=-0.786, P<0.001).

Replacing 30 minutes of nighttime social media use with sleep is associated with reduced executive function decline in pregnant women. It is recommended that sleep management and digital behavior adjustment be incorporated into clinical interventions and health education to promote cognitive health in pregnant women and improve maternal and neonatal outcomes.

To investigate the characteristic changes and co-occurrence phenomenon of oral and intestinal fungal communities in children with asthma, and to explore the relationship between fungi and metabolism in asthma pathogenesis.

Thirty asthmatic children and thirty healthy controls were enrolled. Oral swabs and fecal samples were collected for metagenomic sequencing analysis of oral and intestinal fungal communities. Untargeted metabolomics was used to detect fecal metabolites. Multivariate statistical analysis and network models were employed to decipher microbe-metabolite associations.

Compared with healthy controls, asthmatic children showed significant alterations in α-diversity and β-diversity (Bray-Curtis distance) of oral and intestinal fungi. In the oral cavity, the relative abundance of genera such as Hanseniaspora and Jimgerdemannia was elevated, while that of genera such as Beauveria was reduced. In the gut, the relative abundance of the phylum Ascomycota was elevated, while genera such as Mucor showed a reduction in relative abundance. The co-occurrence network revealed shared fungi like Candida_f_Debaryomycetac along the oral-gut axis in the asthma group. Metabolomics identified significantly elevated ceramides and decreased α-linolenic acid and lysophosphatidylcholine in the asthmatic group,with Emmonsia showing a positive correlation with ceramides.

Altered oral-gut fungal community abundance and characteristic metabolic profile changes were associated with childhood asthma. The "oral-gut" co-occurrence of fungal communities may synergistically contribute to airway inflammation in conjunction with lipid metabolism dysregulation.

To analyze the regional disparities and spatial distribution characteristics of human resource allocation in county-level medical and health sub-centers in Sichuan Province, and to provide a basis for optimizing the allocation of primary health resources.

The Dagum Gini coefficient, Health Resource Density Index (HRDI), and Health Resource Agglomeration Degree(HRAD) were used to evaluate the current status and regional disparities in resource allocation, combined with exploratory spatial data analysis to examine spatial distribution characteristics.

From 2021 to 2023, the overall Gini coefficient for health human resources in Sichuan’s sub-centers decreased from 0.309 to 0.280, indicating an improvement in the equity of resource allocation. However, regional disparities remained prominent. The HRDI in Northeast Sichuan was 1.757, 4.71 times that of Northwest Sichuan. Structural imbalances were evident, with the density of general practitioners in Northwest Sichuan being only 20.3% of that in the Chengdu Plain. In terms of agglomeration, a mismatch was observed between geographical and population distribution. Chengdu showed a high level of geographical agglomeration, while the three autonomous prefectures had an HRAD<1. Based on population distribution, Chengdu had an HRAD/population agglomeration degree(PAD) <1, indicating a relative shortage of resources, whereas Aba and Ganzi were relatively well-resourced. Spatial analysis further revealed significant clustering of resources, forming a polarized pattern with Ziyang-Suining-Meishan as a “High-High” clustering zone and Ganzi-Liangshan as a “Low-Low” clustering zone.

The total quantity and allocation equity of human resources in sub-centers have improved annually, but regional disparities and spatial clustering contradictions persist. Measures such as targeted financial investment, cultivation of local talent, and promotion of resource sharing can help address structural imbalances and promote balanced development of regional health services.

To evaluate the effects of China’s centralized drug procurement policy and provide references for the healthy development of the pharmaceutical industry and policy optimization.

A framework was constructed based on policy instrument theory. Content analysis was used to quantify 27 national-level policy documents from 2000 to 2024, and fuzzy-set qualitative comparative analysis (fsQCA) was applied to conduct configuration analysis of 21 typical cases.

The structure of policy instruments was imbalanced, with environmental instruments accounting for 46.69%, while demand-type instruments constituted only 26.03%. Five core necessary conditions (consistency>0.9) were identified: drug procurement,procurement behavior regulation, drug price adjustment, industry standards, and drug regulation, with consistency scores of 0.966, 0.934, 1.000, 0.963, and 0.948, respectively. Two configuration paths were distilled: a regulation-core-driven path and a comprehensive safeguard path characterized by multi-instrument synergy.

An optimization framework of"institutional rigidity-dynamic adaptation" is proposed. Recommendations include optimizing the structure of policy instruments, promoting synergy between regulation and the market, and improving incentive mechanisms to advance the continuous refinement of centralized drug procurement policies.

To investigate the influencing factors of outpatient expenses for diabetic patients and conduct case-mix grouping and expenses estimation, providing evidence for the reform of outpatient medical insurance payment methods.

Outpatient medical insurance settlement data of diabetic patients from tertiary hospitals in Lanzhou between January 2022 and December 2023 were collected. Univariate analysis and multivariable linear regression models were used to analyze the influencing factors of total outpatient medical expenses. Subsequently, a decision tree model was applied for ambulatory patient groups(APG) classification, and relevant indicators were employed to evaluate APGs and estimate expenses.

A total of 48 948 valid records were included. The total outpatient medical expenses of diabetic patients were associated with gender (Z=-5.702, P<0.001), ethnicity (Z=-2.180, P=0.029), age (Z=1 096.615, P<0.001), type of diabetes (Z=1 463.467, P<0.001), complications (Z=-13.593, P<0.001), medication use (Z=-10.370, P<0.001), diagnostic testing (Z=-4.676, P<0.001), and medical consumables usage (Z=-16.509, P<0.001). Higher outpatient expenses were observed in male patients, other ethnic groups, individuals aged <45 years, type 2 diabetes cases, and patients with complications, medication use, diagnostic testing, and medical consumables usage. Based on the decision tree model, 13 APGs were established. The number of cases per APG group ranged from 114(APG8) to 11 619(APG5), with significant differences among groups based on a nonparametric test(H=3 266.675, P<0.001). The reduction in variance (RIV) was 0.945, the coefficient of variation (CV) ranged from 0.93 (APG2)to 1.56 (APG12), the relative weight (RW) ranged from 0.44 (APG11) to 1.69 (APG1), the standardized cost ranged from 58.55 CNY (APG12) to 324.83 CNY (APG1), and the excess cost ratio ranged from 1.81%(APG1) to 8.93% (APG3).

The economic burden of outpatient diabetes in tertiary hospitals is substantial, with significant cost variations among different patient subgroups. The decision tree-based case-mix grouping performed well, demonstrating strong inter-group heterogeneity and good intra-group homogeneity. It is recommended to strengthen outpatient security and precise cost control, optimize diagnosis and treatment as well as precise classification of disease groups, and build a diversified and precise payment system, so as to promote the optimization of outpatient medical insurance payment methods and reduce the medical burden of diabetic patients.

This study aims to explore the association between social relationships and the risk of death among older adults in China.

The research subjects were 5 642 older people aged 65 and above who participated in the China Longitudinal Healthy Longevity Survey from 2011 to 2018. Social relationships were defined using the social relations model and its subdimensions: social activities, social networks, and social support. The Cox proportional hazards regression model was used to estimate the association between social relationships and the risk of death among older adults.

Compared with a medium-level social relationship, a high-level social relationships (HR: 0.73, 95% CI: 0.64-0.84) was inversely associated with the risk of death among older adults in China. Compared with moderate levels of social activities and social support, high-level social activities (HR: 0.64, 95% CI: 0.40-0.96) and high-level social support (HR: 0.91, 95% CI: 0.74-0.98) were inversely associated with the risk of death among older adults in China, but the relationship between social networks and the risk of death among older adults in China was not significant.

A high level of social relationships is significantly inversely associated with the risk of death among older adults in China. Policy interventions should create and promote social activity platforms suitable for the elderly, and support and consolidate family-based social support systems.

To explore the mediating role of sleep duration and anxiety in the association between dietary diversity and depression in older adults, so as to inform improvements in their mental health.

This study utilised data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), selecting 7 744 participants. Spearman’s correlation analysis was employed to investigate the relationships between dietary diversity, sleep duration, anxiety, and depression among older adults. The mediating effects of sleep duration and anxiety on the association between dietary diversity and depression were analysed using Model 6 of the Process 4.2 plugin in SPSS.

There was a statistically significant direct effect of dietary diversity on depression in older adults (β=-0.348，95% CI: -0.408~-0.288), a statistically significant separate mediated effect of sleep duration (β=-0.027，95% CI: -0.037~-0.018), a statistically significant separate mediated effect of anxiety (β=-0.181，95% CI: -0.220~-0.142), and a statistically significant chain mediated effect of sleep duration and anxiety (β=-0.016，95% CI:-0.022~-0.011).

Dietary diversity can directly and negatively affect the level of depression in older adults, or it can affect the level of depression in older adults through the separate or chain-mediated effects of sleep duration and anxiety.Therefore, it is recommended that the dietary structure of the elderly should be improved, nutritional intake should be guaranteed, and attention should be paid to sleep regulation to alleviate the anxiety of the elderly, thereby alleviating their depressive conditions.

To construct an evaluation index system for fall management capability in elderly care institutions and evaluate its applicability, aiming to provide a reference for assessing and improving fall management in such settings.

Guided by the 4R crisis management theory, a preliminary evaluation index system was constructed through qualitative research, literature research, Delphi expert consultation, and analytic hierarchy process(AHP). Subsequently, a survey was conducted in six elderly care institutions in Guangdong to evaluate the applicability of the index system.

Two rounds of expert consultations were conducted, with questionnaire response rates of 83.3% and 92.0%, and the expert authority coefficients were 0.892 and 0.896. Kendall W values ranged from 0.175 to 0.237 in the first round, and from 0.217 to 0.339 in the second round (P<0.001). The final index system consisted of four first-level indicators, including reduction, readiness,response, and recovery management capabilities, as well as 13 second-level indicators and 41 third-level indicators. Fourteen managers from the six institutions participated in the study and considered the system comprehensive and practical.

The constructed evaluation index system for fall management capability in elderly care institutions is comprehensive, scientific and practical, providing a valuable reference for relevant health authorities and elderly care institution managers to periodically assess fall management capability.

To explore the influencing factors and pathways of 13-valent pneumococcal conjugate vaccine (PCV13) vaccination intention among parents of eligible children in China.

A multi-stage stratified random sampling method was used to conduct an electronic questionnaire survey among parents of age-eligible children in China. Based on the Behavioral and Social Drivers(BeSD)framework, descriptive statistics, univariate χ² test, Wilcoxon rank-sum test, analysis of variance, multivariable logistic regression, and partial least squares structural equation modeling(PLS-SEM) were applied to analyze vaccination intention, its determinants, and the pathways through which these determinants influence vaccination intention.

The PCV13 vaccination intention rate among parents was 64.0%. Notably, 29.8% of parents believed vaccination could impair immune function, and 51.4% perceived the newer PCV13 as riskier than PCV7. Binary Logistic regression and PLS-SEM identified the following promoting factors: single-child families, prior influenza vaccination in the past three years, higher parental knowledge and education, stronger perceived disease susceptibility and severity, social recommendations (from healthcare providers or peers), and greater perceived benefits of vaccination and sense of responsibility. PLS-SEM showed that perceived benefits and parental responsibility exhibited the strongest direct effects on vaccination intention.

Parental distrust in vaccine safety persists. Perceived benefits and responsibility are the most critical drivers of vaccination intention, while external social influences (e.g., peer behavior) outweigh internal factors (e.g., education level) in shaping decision-making.

To investigate whether resveratrol has a protective effect against reproductive toxicity induced by nano titanium dioxide (Nano-TiO₂) in male mice.

A total of 50 healthy male ICR mice were randomly divided into the control group, Nano-TiO₂ group, and mixed groups with Nano-TiO₂ plus low-, medium-, and high-dose resveratrol. After 28 days of continuous gavage, epididymal tissue was collected for semen quality measurement, and testicular tissue was used to evaluate pathological changes, testicular tissue-specific functional enzymes, and oxidative damage related indicators.

After exposure to Nano-TiO₂, the testicular and epididymal coefficients of mice decreased significantly (P<0.05), sperm density and vitality decreased significantly (P<0.05), sperm deformity rate increased significantly (P<0.05), the number of spermatogenic cells in the testicular seminiferous tubules decreased, and the Johnsen score decreased significantly (P<0.05).The activities of acid phosphatase, alkaline phosphatase, lactate dehydrogenase, glutathione peroxidase (GPx), superoxide dismutase, catalase, and reduced glutathione all decreased significantly (P<0.05), and the level of malondialdehyde increased significantly (P<0.05). After intervention with resveratrol, compared with the Nano-TiO₂ exposed group, the testicular and epididymal coefficients increased, semen quality and pathological tissue damage improved significantly (P<0.05), acid phosphatase and lactate dehydrogenase activities were significantly increased (P<0.05), and malondialdehyde levels in testicular tissue decreased significantly, while superoxide dismutase, glutathione peroxidase, and catalase activities increased significantly (P<0.05). After correlation analysis, it was found that there was a significant correlation between antioxidant enzymes and malondialdehyde and the indicators of semen quality and testicular function enzymes.

Resveratrol has a protective effect against reproductive toxicity induced by Nano-TiO₂ in male mice.

This study aims to analyze the phenotypic and genotypic resistance to antibiotics and disinfectants in Salmonella isolated from fresh pork sold in Chengdu in 2021, and to investigate their regional distribution and phylogenetic relationships based on whole-genome sequencing (WGS). The findings provide scientific evidence for clinical treatment guidance, disinfectant selection in fresh markets, and foodborne disease prevention and control, while also supporting traceability investigations for Salmonella-related public health emergencies.

The antibacterial susceptibility of Salmonella isolated from fresh pork markets across Chengdu districts was tested against 14 antibiotics and 8 disinfectants using the broth microdilution method. WGS and bioinformatics analysis were performed on 114 strains for MLST typing, antibiotic resistance gene (ARG) profiling, and disinfectant resistance gene (DRG) distribution. Crystal violet staining was used to assess biofilm eradication.

Resistance rates were highest for tetracycline(TET, 87.72%) and trimethoprim-sulfamethoxazole(SXT, 67.54%). Significant regional variations were observed for resistance to ampicillin (AMP), ampicillin-sulbactam (AMS),cefazolin (CFZ), gentamicin (GM), ciprofloxacin (CIP), azithromycin (AZM), and SXT. High-tech Zone exhibited the highest resistance (55.95%), followed by Chenghua District (42.86%). All isolates tolerated 25% glutaraldehyde (GD), whereas the isolates were relatively susceptible to cetylpyridinium chloride monohydrate (CCM), and CCM could effectively disrupt Salmonella biofilms. A total of 38 ARGs spanning 10 classes were detected, with all strains carrying aac(6’)-Iaa (not phenotypically correlated), followed by tet(A) (84.21%). Significant phenotype-genotype correlations were identified for BlaTEM-1B, tet(A), floR,cmlA1, sul3, and dfrA12. The disinfectant resistance gene (DRGs) qacE was detected in 29.82% of isolates, with 83.33%concentrated in High-tech Zone. 94.12% of DRG-positive strains were multidrug-resistant (MDR). ST469 was the dominant sequence type (ST), widely distributed across Chengdu.

Salmonella from pork in Chengdu exhibits widespread and high antibiotic resistance, with increasing MDR trends. In retail fresh pork markets, CCM is recommended over GD (aldehyde-based disinfectants). ST469 was the predominant sequence type, indicating a substantial risk of cross-regional transmission.

To characterize H3N8 virus contamination and molecular evolution in poultry and environmental samples from the live poultry markets associated with Hunan Province’s first human H3N8 avian influenza virus (AIV) case, providing evidence for avian influenza epidemic prevention and control.

Active surveillance for H3N8 avian influenza virus was implemented over 17 months (April 2022—December 2023) in live poultry markets associated with Hunan Province’s first human case. We collected 837 samples, including poultry oropharyngeal/cloacal swabs, feces, air, sewage, drinking water, cage swabs, and other surface swabs. Samples were screened for H3N8 nucleic acid using real-time PCR. Positive specimens underwent high-throughput sequencing. Hemagglutinin (HA) and neuraminidase (NA) gene sequences were analyzed by BLAST, with amino acid alignment and phylogenetic tree construction performed using BioEdit and MEGA-X, respectively.The statistical analysis method for nucleic acid test results was Fisher’s exact test.

The overall H3N8 nucleic acid positivity rate was 2.63% (22/837). The highest positivity rate (18.37%) occurred in the month of the human case (May 2022),significantly higher than in the other 16 months (χ²=49.159, P<0.001). Viral nucleic acid was detected in six sample types, with cage swabs showing the highest positivity rate (8.43%, χ²=14.437, P=0.011). Three H3N8 viruses were successfully sequenced from poultry drinking water and chicken oropharyngeal/cloacal swabs. Their HA and NA genes exhibited the highest nucleotide similarity (99.71-99.89%) to the human-origin strain (A/China/CSKFQ-22-5/2022). The HA protein cleavage site (residues 340-348) was PEKQTRGLF, and the receptor-binding site residues (242 and 244) were Q and G, indicating low pathogenicity and avian receptor-binding specificity. No neuraminidase inhibitor resistance mutations (H273Y, R291K) were detected in the NA protein. Phylogenetic analysis revealed that the HA and NA genes of all three viruses belonged to the Eurasian lineage and formed a distinct subclade with H3N8 viruses of human, chicken, and environmental origin from China.

The level of H3N8 virus contamination in live poultry markets shows an association with human infection cases. Enhanced surveillance of H3N8 virus contamination in these markets is warranted.

To investigate the predictive value of machine learning methods for non-alcoholic fatty liver disease(NAFLD) in non-obese populations and to analyze the risk factors for NAFLD within this group.

Data on 43 variables,including body composition, medical history, and laboratory test results, were retrospectively collected and screened from 1 517 non-obese subjects at the Physical Examination Center of Xiyuan Hospital, China Academy of Chinese Medical Sciences,between January 2021 and December 2024. The outcome indicator was the diagnosis of NAFLD by abdominal ultrasonography,based on which subjects were stratified into NAFLD and non-NAFLD groups. Predictors were screened using univariate analysis, lasso regression, and multivariable logistic regression analysis. Seven machine learning methods including logistic regression, decision tree, random forest, extreme gradient boosting (XGBoost), light hradient boosting machine(LightGBM),support vector machine(SVM), and artificial neural network(ANN), were employed to develop and validate prediction models for NAFLD in non-obese individuals. The shapley additive explanations (SHAP) method was used to interpret variable contributions.

Among the 1 517 included subjects, 215 (14.2%) were diagnosed with NAFLD. Ten independent predictors were identified. The area under the curve (AUC) values for the seven prediction models on the validation set ranged from 0.876 to 0.924. The model based on XGBoost demonstrated the best discriminative ability (AUC=0.924, 95% CI: 0.895-0.949). The SHAP value-based variable importance ranking identified phase angle, the ZJU index, and UHR as the top three significant predictors.

The XGBoost model, constructed using routine physical examination data, exhibits high predictive performance for NAFLD incidence in non-obese populations. Its interpretable features facilitate the clinical prioritization of high-risk individuals.

To investigate the association between metabolic syndrome (MetS) and its components with cognitive frailty (CF) in older adults, and to analyze variations in this association across different population subgroups, thereby providing a scientific basis for targeted interventions.

Guided by the health ecology theory, this study utilized data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 2 695 participants aged 60 years or older were included.MetS was diagnosed according to the Chinese Guidelines for Type 2 Diabetes Prevention and Treatment (2020 edition), while CF was assessed using the Frailty Phenotype (FP) combined with the Mini-Mental State Examination (MMSE). Logistic regression models and subgroup analyses were employed to evaluate the association between MetS and CF.

After adjusting for multiple factors, it was found that MetS was associated with CF (OR=1.169, 95% CI: 1.016-1.346). Component analysis showed that central obesity was independently associated with CF (OR=1.233, 95% CI: 1.057-1.416). As the number of MetS components increased, the OR for its association with CF also correspondingly increased. Subgroup analysis found a statistical interaction effect of fall history in the association between MetS and CF (P=0.02). In addition, among individuals who were unmarried, had an education level below primary school, were retired, or had depression, the strength of the association between MetS and CF was numerically higher.

MetS was significantly associated with CF, and this association was modified by factors such as fall history. These findings suggest that targeted interventions addressing MetS and its key components (e.g., central obesity) are crucial for CF prevention.

To investigate the chain mediating role of sleep duration and depressive symptoms in the relationship between chronic disease comorbidities and health-related quality of life among older adults, and to provide evidence for promoting healthy aging.

Based on data from the 2020 China Health and Retirement Longitudinal Survey (CHARLS),a total of 6 673 older adults aged ≥60 years were included. Health-related quality of life and depressive symptoms were measured using the EQ-5D-3L and CESD-10 scales, respectively. The chain mediating effect between sleep duration and depressive symptoms was examined using Model 6 of the Process 4.1 plugin in SPSS.

The prevalence of comorbidities of chronic diseases among older adults over 60 years old was 57.9%, and comorbidities of chronic diseases were significantly negatively associated with health-related quality of life (β=-0.279, P<0.001). Sleep duration was positively correlated with health-related quality of life (β=0.035, P<0.05). Depressive symptoms were significantly negatively associated with health-related quality of life (β=-0.525, P<0.001), and the chain mediating effect of sleep duration and depressive symptoms between chronic disease comorbidity and health-related quality of life was significant (β=-0.004, 95% CI: -0.006~ -0.003). The total mediating effect and the chain mediating effect accounted for 40.1% and 4.1% of the total effect, respectively.

Sleep duration and depressive symptoms play a chain mediating role between chronic disease comorbidities and the health-related quality of life of the older adults. Paying attention to the sleep quality and mental health management of elderly patients with chronic disease comorbidities can effectively improve their quality of life and promote the process of healthy aging.

Based on the National Health and Nutrition Examination Survey (NHANES) database, this study investigates the association between the monocyte-to-albumin ratio (MAR) and all-cause and cardiovascular disease (CVD)mortality among individuals with diabetes mellitus.

Using NHANES 1999—2018 data linked to mortality outcomes from the National Death Index (NDI), we conducted a study among adults with diabetes mellitus. Weighted Cox proportional-hazards regression, Kaplan-Meier survival curves, restricted cubic spline regression, subgroup analyses, and interaction tests were employed to examine the associations of the monocyte-to-albumin ratio (MAR) with all-cause and CVD mortality among individuals with diabetes mellitus.

A total of 4 558 patients with diabetes mellitus were enrolled in this study. During follow-up, 1 250 all-cause deaths and 429 CVD-specific deaths were documented. MAR was categorized into tertiles. After adjusting for multiple confounding factors, compared with the lowest tertile group (Q1: MAR<0.011), the highest tertile group(Q3: MAR≥0.015) exhibited significantly increased risks of both all-cause mortality (HR=1.44, 95% CI: 1.21-1.71) and CVD mortality (HR=1.44; 95% CI: 1.01-2.05). Kaplan-Meier survival analysis demonstrated that the survival probability in the highest MAR tertile was markedly lower than that in the lowest tertile, with a statistically significant difference (P<0.001).

MAR is positively associated with both all-cause and CVD mortality in patients with diabetes and represents an independent risk factor for these outcomes.

To investigate the relationship between Cardiovascular-Kidney-Metabolic (CKM) syndrome stages and fall risk among middle-aged and older Chinese adults, providing evidence for early risk identification.

Utilising longitudinal data from the China Health and Retirement Longitudinal Study (2015 and 2018), 7 861 participants aged 45 and older were included after excluding those with missing baseline anthropometric, blood, or key questionnaire data. CKM syndrome was staged according to the American Heart Association scientific statement. The outcome was self-reported falls within the past three years assessed in 2018. Modified Poisson regression models estimated incidence rate ratios (IRR) and 95%confidence intervals (CI), adjusting for demographics, lifestyle, physical and sensory function, cognitive and mental health,other health conditions, and the living environment. Subgroup analyses tested interactions with physical and sensory functions.

During 3 years follow-up, 1 438 (18.3%) participants reported at least one fall. At baseline, CKM Stage 2 was the most prevalent (5 241; 66.7%), followed by Stage 4 (1 746; 22.2%), Stage 3 (472; 6.0%), and Stage 1 (402; 5.1%). Compared with Stage 1, CKM Stage 3 was associated with a 32% increased risk of falls (IRR=1.32, 95% CI: 1.03-1.69). No significant interactions were observed between CKM stages and grip strength, balance, hearing, and visual function (P for interaction >0.05).

CKM syndrome staging is positively associated with fall risk in middle-aged and older adults. CKM Stage 3 may represent a critical window for fall prevention interventions.

To study the current situation and influencing factors of the core competencies for the doctor of public health in China, and to provide a scientific basis for improving the training system of the doctor of public health.

A cross-sectional study design was adopted in March 2025. Through the stratified cluster sampling method, 189 doctors of public health who were currently enrolled from 2021 to 2024 from 7 universities were selected as the research subjects in China. T-test and one-way analysis of variance were used to compare the core competencies scores of different characteristic groups, and multivariable linear regression analysis was used to analyze the influencing factors.

The total score of core competencies for the doctor of public health was (84.07±10.91) points. There were statistically differences in core competencies scores across public health practitioner certificates, public health working experience, mode of study, grade, guidance method of the supervisor and frequency of communication with classmates (P<0.15). The multivariable linear regression analysis showed that public health practitioner certificates and the guidance method of the supervisor were factors influencing core competencies.

Obtaining professional qualification certification and a supervisory approach in which the supervisor participates in research projects and specifies the topic selection can enhance the core competencies of doctor of public health.There is still some room for improvement in the core competencies for the doctor of public health. Standardized and applicable training programs can be formulated to enhance the core competencies for the doctor of public health in China.