This study aims to explore the relationship between serum vitamin B12 levels and the prevalence of chronic liver diseases in the older adults, and then provide clues for the prevention and treatment of chronic liver diseases.

This study was based on the data from the baseline of the West China Health and Aging Cohort Study from May 2022 to November 2023. A total of 4 563 subjects were included in the study. Multivariable logistic regression analysis and restricted cubic spline analysis were employed to explore the association between serum vitamin B12, liver steatosis or liver fibrosis, and chronic liver diseases.

Multivariable Logistic regression analysis showed that compared with the Q1 level of serum vitamin B12, the Q4 level of vitamin B12 would increase the risk of viral hepatitis (OR: 1.96, 95% CI: 1.23-3.19). Compared with the Q1 level, the Q4 level was positively correlated with liver stiffness measurement (LSM) level, and this positive correlation was strengthened with the increase of serum vitamin B12 level (OR: 1.55, 95% CI: 1.20-1.99). No significant correlation between serum vitamin B12 level and controlled attenuation parameter (CAP) value (P>0.05). In addition, linear correlations of serum vitamin B12 levels with both the hepatic steatosis group and the hepatic fibrosis group were found in this study.

This study found that an increase in serum vitamin B12 levels was associated with viral hepatitis in chronic liver diseases, and higher levels of serum vitamin B12 were also observed in patients with liver fibrosis, suggesting a possible complex relationship between vitamin B12 and liver diseases and providing new clues for further exploring the pathogenesis of liver disease.

To explore the influence mechanism of adverse childhood experiences on the depression status of the elderly and test the mediating role of self-care ability between them.

Using data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), 1 811 elderly individuals aged 65 and above were included in the survey. The CES-D10 scale was used to assess the depression score, adverse childhood experiences were quantified through childhood lack of medical treatment and hunger experiences, and the activities of daily living (ADL) limitation index was used to measure self-care ability. Linear regression was used to analyze the direct associations among variables, and Process 4.2 Model 4 was used to analyze the mediating effect of self-care ability between adverse childhood experiences and the depression status of the elderly,while controlling for covariates.

The number of childhood adverse experiences showed a significant positive correlation with depression scores, with a total effect value of 0.461 (95% CI: 0.093-0.830). Self-care ability showed a partial mediating effect, with an mediation effect of 0.050 (95% CI: 0.003-0.108), accounting for 10.90% of the total effect.

Adverse childhood experiences can directly (89.10%) or indirectly through impairing self-care ability (10.90%) jointly increase the depression level of the elderly. It is recommended to implement early intervention throughout the life course, incorporating self-care ability maintenance into the core of elderly mental health services. The intervention measures should focus on vulnerable elderly populations, and through early screening and targeted intervention, improve psychological resilience, strengthen social support, and alleviate the long-term negative effects of childhood adversity.

To reveal fluctuation patterns and cyclical characteristics of viral hepatitis incidence in China and to forecast its short-term trend, thereby supporting the optimization of prevention and control strategies.

Based on the monthly incidence data of viral hepatitis in China from January 2015 to January 2025 by the National Disease Control and Prevention Bureau, this study employed the Census X-13 Seasonal Adjustment Method to analyze the epidemiological patterns and temporal trends of viral hepatitis during this period. The HP filter was applied to dissect the cyclical patterns of incidence.Forecasting was conducted using a machine learning model (long short-term memory, LSTM) and a time-series model(SARIMA), and and the predictive performance of the models was evaluated.

The number of viral hepatitis cases showed an overall increasing trend, with clear seasonal fluctuations observed each year, and the annual peak occurred in March—April. From January 2015 to January 2025, the incidence of viral hepatitis in China was divided into three complete cyclical cycles, with an average cycle length of 40 months. Notably, the amplitude of these cyclical fluctuations was unstable over time.The mean relative prediction errors for the LSTM model and the SARIMA model were 6.37% and 6.71%, respectively. The LSTM model demonstrated lower root mean square error and mean absolute error, indicating superior predictive performance.

Combining cyclical analysis and machine learning models can effectively improve prediction accuracy,contributing to achieving the goal of “Healthy China 2030”.

To analyze the impact of low-density lipoprotein cholesterol (LDL-C) levels on all-cause mortality and cardio-cerebrovascular mortality in patients with hypertension and its comorbidities.

Univariate analyses were performed using the χ² test, and Cox proportional hazards regression models were used to analyze the impact of LDL-C levels on the all-cause and cardio-cerebrovascular mortality risks of patients with hypertension and its comorbidities.

Multivariable Cox regression analysis showed that among patients with hypertension, compared with the first quartile group (Q1)of LDL-C, the risk of all-cause mortality increased by 75% in the third quartile group (Q3) and by 165% in the fourth quartile group (Q4), and the risk of cardio-cerebrovascular death increased by 96.4% in the Q4 group. Among the patients with comorbidities, the all-cause mortality risks of groups Q2, Q3, and Q4 were 1.601 times, 2.082 times, and 2.874 times that of group Q1, respectively. The cardio-cerebrovascular mortality risk of group Q4 was 2.592 times that of group Q1. The restricted cubic spline (RCS) model indicated that the LDL-C level was linearly correlated with the risk of all-cause and cardio-cerebrovascular death in patients with hypertension and its comorbidities. Among them, for patients with hypertension, the risk significantly increased when LDL-C exceeded 2.713 mmol/L (for all-cause mortality) and 2.650 mmol/L (for cardio-cerebrovascular mortality). For patients with comorbidities, the risk increased when LDL-C was higher than 2.016 mmol/L (for all-cause mortality) and 2.020 mmol/L (for cardio-cerebrovascular mortality).

Serum LDL-C levels are an independent risk factor for all-cause and cardio-cerebrovascular deaths in patients with hypertension and its comorbidities.This study reveals the dose-response relationship between LDL-C levels and mortality, providing an important scientific basis for more stringent lipid-lowering intervention strategies in clinical practice.

To evaluate the causal relationships between gut microbiota, blood metabolites, and pregnancy depression using Mendelian randomization (MR).

Using genome-wide association study data from East Asian populations, a two-sample MR approach was employed to assess the causal effects of 216 species of gut microbiota and 61 blood metabolites on pregnancy depression. Reverse MR analysis evaluated the impact of pregnancy depression on the identified gut microbiota species and blood metabolites, thereby excluding reverse causality bias.

The study identified causal associations between 11 gut microbiota species and 4 blood metabolites with pregnancy depression. Among these, five gut microbiota species(Akkermansia muciniphila, Desulfovibrio piger, Providencia rettgeri, Clostridium phytofermentans, and Ruminococcus obeum) and two blood metabolites (glutamine and α-aminobutyric acid) were identified as protective factors against pregnancy depression.Conversely, 6 gut microbiota species (Streptococcus pneumoniae, Blautia hansenii, Bacteroides xylanisolvens, Eubacterium dolichum, Prevotella veroralis, and Streptococcus vestibularis) and two blood metabolites (aldosterone and phenylalanine) were identified as risk factors. Reverse MR analysis found no evidence of reverse causality.

This study identifies 11 gut microbiota species and 4 blood metabolites that may represent promising therapeutic targets for pregnancy depression in East Asian populations.

To examine the associations between serum uric acid and all-cause, cardiovascular, and cancer mortality among hypertensive adults using diuretics.

We included hypertensive adults who reported diuretic use across 10 cycles (1999—2018) of the National Health and Nutrition Examination Survey (NHANES). Weighted Kaplan-Meier curves,Cox proportional hazards regression models, and restricted cubic splines were applied to examine the associations between serum uric acid levels and all-cause, cardiovascular, and cancer mortality. Subgroup analyses were conducted.

Among 3 744 hypertensive adults treated with diuretics, we prospectively observed a mean follow up of 7.9 years and recorded 1 428 deaths from all causes, including 563 cardiovascular deaths and 248 cancer deaths. Weighted Kaplan-Meier analyses indicated a significantly higher cumulative incidence of all cause, cardiovascular, and cancer mortality in the hyperuricemia group versus the non-hyperuricemia group (P<0.05). After adjustment for covariates, elevated serum uric acid levels were associated with increased risks of all-cause and cardiovascular mortality, with hazard ratios (HRs) of 1.05 (95% CI: 1.01-1.09) and 1.10 (95% CI: 1.02-1.18), respectively. Weighted restricted cubic splines revealed linear dose-response relationships between serum uric acid levels and both all-cause and cardiovascular mortality (P for nonlinear >0.05). Subgroup analyses were consistent and showed no interactions (P>0.05). Uric acid levels were not significantly associated with cancer mortality.

Among hypertensive diuretic users, serum uric acid is linearly and positively associated with risks of all-cause and cardiovascular mortality.

To quantify the health benefits of simulated interventions to residential greenness exposure on the prevalence of hypertension (HTN), and to provide scientific evidence for the construction of a reasonable and effective healthy city planning system.

Based on the normalized difference vegetation index (NDVI) exposure levels at the county level in China, population distribution, and NDVI-HTN relative risk data, the Miettinen formula was used to evaluate the degree of reduction in HTN prevalence caused by equal amounts, static, dynamic and modified intervention NDVI.

The number of prevalent HTN cases decreased by 13.99% (13.97%-14.01%), 25.97% (25.92%-26.02%) and 36.00% (35.88%-36.11%)for every 0.10, 0.20, or 0.30 units increase of NDVI exposure in the study population. When NDVI was elevated to the maximum observation value (0.82) or above P₇₅, 20.84% (17.11%-24.58%) and 6.21% (5.82%-6.59%) of HTN cases could be prevented.

All four greenness intervention schemes can reduce the prevalence of HTN. Among them, the equal intervention effect is better. In the future, a multi-dimensional and collaborative hypertension prevention and control strategy could be developed.

This study aims to identify independent risk factors for pulmonary nodules in a manufacturing workers and to develop and validate a risk prediction model based on key variables. The goal was to provide a quantitative tool for the early identification of high-risk individuals within occupational groups.

A cross-sectional analysis was performed involving 581 employees from a manufacturing enterprise. The cohort comprised 397 individuals without pulmonary nodules and 184 with nodules. Univariate analysis and multivariable logistic regression (forward stepwise method) were used to identify independent predictors and construct the prediction model. The performance of individual variables and the combined model was assessed using receiver operating characteristic (ROC) curve analysis.

Multivariable analysis identified female sex(OR=2.100, 95% CI: 1.163-3.791, P=0.014), smoking (OR=5.757, 95% CI: 3.552-9.332, P<0.001), and years of service (OR=1.113 per year, 95% CI: 1.084-1.143, P<0.001) as significant independent risk factors for pulmonary nodules. The combined prediction model yielded an area under the curve (AUC) of 0.801 (95% CI: 0.762-0.840), with a sensitivity of 62.50% and a specificity of 87.15%.

The risk prediction model, incorporating female sex, smoking history, and longer years of service, exhibits robust discriminative capability. It shows promise as a practical tool for the early screening of pulmonary nodules in occupational populations, such as those in manufacturing. Further external validation in broader and more diverse populations is warranted.

To determine the concentrations of 24 per- and polyfluoroalkyl substances (PAFs) in marine and freshwater shrimp sold in Tianjin and to characterize their pollution profiles.

The concentrations of PFASs in the samples was determined by UPLC-MS/MS. Descriptive statistics were applied, and non-parametric tests were used to compare concentrations.

A total of 67 samples of marine shrimp and 105 samples of freshwater shrimp were tested. A total of 14 kinds of PFASs were detected in marine shrimp, and the ∑PFASs concentration ranged from 0.160 to 43.4 μg/kg. The overall detection rate of PFASs pollutants was 100%. 17 kinds of PFASs were detected in freshwater shrimp, and the ∑PFASs concentration ranged from 0.135 to 27.9 μg/kg. The overall detection rate of PFASs pollutants was 99%. The main detected components in the two types of shrimp aquatic products were all long-chain PFASs. The number of PFASs detected in a single sample of marine shrimp ranged from 1 to 11, while that in a single sample of freshwater shrimp ranged from 0 to 13. Among them, PFOS, PFOA and PFNA were the main pollutant components, while 6:2Cl-PFESA and 8:2Cl-PFESA were both detected to a certain extent. Through comparison, it was found that the pollution of river shrimp among freshwater shrimp was relatively serious.

There is a certain degree of PFASs pollution in the shrimp aquatic products sold in Tianjin. In-depth research, attention and strengthened management should be carried out.

To investigate the epidemiological characteristics and trends of foodborne disease outbreaks in Guizhou Province from 2012 to 2024, providing evidence for scientific prevention and control.

Data on foodborne disease outbreaks in Guizhou Province from 2012 to 2024 were collated and subjected to descriptive analysis. The Joinpoint model was employed to analyse long-term trends in incidence and mortality from foodborne diseases. Seasonal patterns were revealed using the coefficient of concentration (M) and circular distribution analysis.

Between 2012 and 2024, Guizhou Province recorded 4 951 foodborne disease outbreaks, with an annual incidence rate of 4.10 per 100 000 population and a case fatality rate of 0.67%. The overall incidence rate showed a persistent upward trend,while the mortality rate exhibited a persistent downward trend. The average annual percentage change (AAPC) for both indicators equalled the annual percentage change (APC), at 13.37% and -14.42%, respectively (P<0.05). The incidence was notably high and increasing among individuals aged 20-59 years. Tongren, Zunyi, and Qiandongnan prefectures exhibited higher incidence rates with an upward trend, showing AAPCs of 12.82%, 13.76%, and 13.19%, respectively (P<0.05). The highest number of cases occurred in 2023, exhibiting seasonal patterns (M=0.443) with a peak date on 2 July and a peak period from 18 April to 15 September.The incidence of foodborne diseases caused by poisonous mushrooms and toxic plants showed an upward trend, with AAPCs of 21.91% and 17.37%, respectively (P<0.05).

From 2012 to 2024, Guizhou Province witnessed an overall upward trend in the incidence rate of foodborne disease outbreaks, accompanied by a downward trend in mortality rates. Incidence patterns varied across different regions and causative agents. Given the seasonal nature of foodborne disease outbreaks, it is recommended that targeted prevention and control measures be implemented prior to peak incidence periods.

To investigate the relationship of children’s sleep quality and consumption behavioral intention of sugar-sweetened beverages in Chengdu. Based on the theory of planned behavior (TPB), this study explores the parallel mediating effects of behavioral attitude, subjective norm and perceived behavioral control on the relationship between children’s sleep quality and consumption behavioral intention of sugar-sweetened beverages.

The Pittsburgh Sleep Quality Index(PSQI) was used, based on the TPB and relevant literature on the influencing factors about children’s consumption behavior of sugar-sweetened beverages, a survey questionnaire was developed to investigate the behavioral attitude, subjective norm,perceived behavioral control and behavioral intention of children’s consumption of sugar-sweetened beverages. In October 2024, a multi-stage stratified cluster random sampling method was used to select 2021 students from grades 3-5 of four schools in Chengdu as the research subjects. Pearson correlation analysis was used to investigate the relationship between children’s PSQI, behavioral attitude, subjective norm, perceived behavioral control and consumption behavioral intention of sugar-sweetened beverages. Under the control of gender, grade and region, the Bootstrap method was run using SPSS PROCESS component Model 4 to examine the mediating effects of attitude, subjective norm, and perceived behavioral control on the relationship between children’s PSQI and intention to consume sugar-sweetened beverages.

There were differences in the scores of children’s consumption behavioral intention of sugar-sweetened beverages among different gender, grade and region. There was a significant positive correlation between children’s consumption behavioral intention of sugar-sweetened beverages and their behavioral attitude, subjective norm, perceived behavioral control, PSQI (r=0.588, r=0.624, r=0.552, r=0.165; P<0.001). Under the control of gender, grade and region, the mediating effect of children’s attitude, subjective norm, and perceived behavioral control towards sugar-sweetened beverages consumption behavior between PSQI and behavioral intention was significant, with an indirect effect of 0.136, accounting for 68.69% of the total effect.

Sleep quality affects children’s consumption behavior intention of sugar-sweetened beverages, and attitude, subjective norm and perceived behavioral control of children’s sugar-sweetened beverages consumption behavior have parallel mediating effects between sleep quality and behavioral intention.

To investigate the trends and influencing factors of vitamin D nutritional status among primary and secondary school students in Guizhou Province from 2012 to 2023, providing scientific basis for formulating nutritional improvement measures.

A multi-stage cluster sampling method was adopted to select one primary and one secondary school from each of the survey sites implementing the “Nutrition Improvement Program for Rural Compulsory Education Students” in Guizhou Province. A total of 9 830 students were surveyed with questionnaires and had their blood samples tested.The prevalence rates of each year were standardized using the population age structure of 2023. The Mann-Whitney U test was used to compare the differences in vitamin D levels between different genders, and the Kruskal-Wallis H test was used to compare the differences among different age groups. The Bonferroni method was used to correct the significance level for two-group comparisons. The Spearman rank correlation analysis was used to test the trend of vitamin D levels over the years. The quantile regression model was used to examine whether there were differences in the trend of vitamin D levels among different subgroups.

Vitamin D levels among primary and secondary school students in Guizhou Province fluctuated between 2012 and 2023, but showed an overall upward trend (r_s=0.048, P<0.001), rising from 21.1 ng/ml in 2012 to 22.6 ng/ml in 2023.The vitamin D levels of males were consistently higher than those of females (P<0.05). With increasing age, vitamin D levels showed a downward trend(P<0.05). Except for 2015, the serum 25(OH)D concentrations of the 12-14 and 15-17 age groups were lower than those of the 6-8 age group. The prevalence of vitamin D deficiency (VDD) and vitamin D inadequacy (VDI) was consistently higher in females than in males. The prevalence of VDD and VDI in each age group fluctuated, and in 2023, the prevalence of VDD and VDI in each age group was lower than in 2012. The quantile regression model results indicated that the rate of improvement in vitamin D levels over time was significantly slower in males than in females (β=-0.118, P=0.016). The average annual improvement rate in vitamin D levels was significantly higher in the 6-8 age group than in the 15-17 age group(β=0.261, P<0.001).

The prevalence of VDD and VDI among primary and secondary school students in Guizhou Province remains at a relatively high level. Specifically, targeted nutritional intervention strategies should be developed for females and older males to improve their vitamin D nutritional status.

To investigate the awareness rate and influencing factor of weight management knowledge, and the prevalence of abnormal body mass index (BMI) among junior high school students in Yinchuan, analyze the correlation between weight management knowledge awareness and abnormal BMI, and provide a theoretical basis for the implementation of weight-related health education among children and adolescents.

Between March 12 and April 26, 2025, a multi-stage stratified cluster random sampling method was employed to recruit 2 485 students from Grade 7 to Grade 9 across 9 junior high schools in Yinchuan as study participants. A self-developed structured questionnaire was administered to assess participants’awareness of comprehensive weight management knowledge (including nutrition, physical activity, etc.) and its associated influencing factors. Abnormal BMI was screened using a bioelectrical impedance analysis (BIA) body composition analyzer. In accordance with the national standards Screening for Malnutrition in School-age Children and Adolescents (WS/T456-2014)and Screening for Overweight and Obesity in School-age Children and Adolescents (WS/T586-2018) issued by the National Health and Family Planning Commission of China, students with emaciation, overweight, or obesity were classified by gender and age.

The overall awareness rate of weight management knowledge among junior high school students in Yinchuan was 57.34%. The highest awareness rate was observed in the dimension of “prevention cognition” (51.75%), while the lowest was in “scientific weight control” (35.57%). No statistically significant difference was detected across different grades (P>0.05),whereas the awareness rate among female students was significantly higher than that among male students (P<0.05).Multivariable logistic regression analysis revealed that female gender (OR=0.53), Grade 9 enrollment (OR=1.21), urban residency (OR=0.78), being an only child (OR=1.31), parental education level of college or above (OR=1.18), cohabitation with parents (OR=2.21), normal guardian weight (OR=0.84), school-based health education implementation (OR=1.33), and teacher-delivered weight management knowledge (OR=2.61) were significant influencing factors of weight management knowledge awareness among junior high school students (all P<0.05). The prevalence of abnormal BMI among the study population was 29.86%, with emaciation, overweight, and obesity accounting for 8.09%, 14.29%, and 7.48% of the total sample, respectively.The awareness rate of weight management knowledge was significantly negatively correlated with emaciation (r=-0.712),overweight (r=-0.723), and obesity (r=-0.756), with all P<0.05.

The overall awareness rate of weight management knowledge among junior high school students in Yinchuan is relatively low, while the prevalence of abnormal BMI is notably high. A significant negative correlation exists between weight management knowledge awareness and abnormal BMI, which warrants serious attention.

To explore the chain mediation role of social withdrawal and self-esteem in the relationship between childhood trauma and depression among junior high school students, to inform youth mental health interventions.

From June to August 2025, a stratified sampling survey was conducted among 2 630 students from five junior high schools in Tai’an, Shandong. Core variables were assessed using the social withdrawal dimension of the Youth Self-Report, the Self-Esteem Scale, the Childhood Trauma Questionnaire, and the Depression Screening Questionnaire. Pearson correlation tested associations among variables. Multiple linear regression tested effects on depression. Mediation models with bootstrapping tested the chain mediation of social withdrawal and self-esteem.

All trauma dimensions were positively related to social withdrawal and depression, and negatively to self-esteem. Social withdrawal was negatively related to self-esteem and positively to depression. Self-esteem was negatively related to depression. Further analysis showed that all trauma dimensions directly predicted higher depression (β=0.335, 0.113, 0.237, 0.152, 0.175; all P<0.001), and indirectly predicted higher depression via social withdrawal (β=0.196, 0.110, 0.172, 0.138, 0.176; Boot 95% CI excluded 0) and via the chain “trauma →social withdrawal → low self-esteem → depression” (β=0.020, 0.010, 0.025, 0.014, 0.026; Boot 95% CI excluded 0). Self-esteem also significantly mediated the associations between emotional abuse, emotional neglect, physical neglect, and depression (β=0.021, 0.037, 0.025; Boot 95% CI excluded 0).

Social withdrawal and low self-esteem play a chain mediation role in the relationship between childhood trauma and depression among junior high school students. Timely interrupting risk factors and developing protective factors are crucial for improving the mental health of adolescents.

To explore the reference values of percentage body fat (PBF) for obesity screening in children and adolescents, in order to provide a reference for the development of rapid assessment tools for obesity among primary and secondary school students, and the promotion of obesity screening work among children and adolescents.

A stratified cluster sampling method was used to include subjects from Putuo District, Shanghai in September 2024. Basic information and anthropometric data were collected from 2 270 primary and secondary school students. The χ² test and rank-sum test were used for data analysis with SPSS 29.0. Fitted curves were used to analyze the trend of PBF across sex and age, and optimal cut-points for obesity screening were determined by plotting receiver operating characteristic (ROC) curves.

The students were aged 7-17 years, with a mean age of 11.85±3.10 years. The detection rate of simple obesity was 16.8%, and the rate of central obesity was 22.1%. With increasing age, PBF in boys first increased and then decreased, whereas that in girls showed a general upward trend. Sex differences in PBF emerged after the age of 10 years (P<0.05). ROC curve analysis showed that the model fitting values were all >0.5, and the AUCs of PBF for obesity screening exceeded 0.900 across sex and age groups, with both sensitivity and specificity generally >80%.

PBF is highly valuable as an obesity screening indicator and can accurately and intuitively reflect body fat content and its changes in children.

To investigate the prevalence of dental caries among primary and secondary school students in an ethnic minority region of Sichuan, and to examine the relationship between dental caries and nutritional status, with the aim of providing a foundation for effective prevention and control strategies for dental caries in ethnic minority areas.

A stratified cluster random sampling method was employed to select 13 899 primary and secondary school students from this ethnic minority region for inclusion in the study. Comprehensive oral and physical examinations were conducted, along with the administration of questionnaires. The χ² test was utilized to compare differences, while logistic regression analysis was performed to investigate the association between dental caries and nutritional status.

In 2024, the caries rate of primary and secondary school students in an ethnic minority area in Sichuan was 74.17%, and 77.63%, 74.29%, and 57.26% for Tibetans, Qiangs, and Han Chinese, respectively. Statistically significant differences were observed in caries rates based on various factors, including gender (χ²=170.20, P<0.001), ethnicity (χ²=364.64, P<0.001), school segment (χ²=93.77, P<0.001),topography (χ²=675.45, P<0.001), overweight and obesity status (χ²=106.85, P<0.001), as well as daily milk consumption (χ²=22.49, P<0.001) among students. The difference in caries rates among students of different ages was statistically significant (χ²=174.82, P<0.001). Overweight and obesity were protective factors for caries among primary and secondary school students in an ethnic minority area of Sichuan (OR=0.696, 0.587, respectively, both P-values<0.001).

The caries rate of primary and secondary school students in an ethnic minority area in Sichuan is high, and overweight and obesity are closely related to caries. It is recommended that an integrated intervention system addressing “environment-nutrition-behavior” be established to prevent dental caries effectively while safeguarding students’ oral health.

To explore the impact of collaborative intervention by village doctors and village cadres on the knowledge, attitudes, and testing behaviors regarding HIV/AIDS among middle-aged and elderly high-risk populations in rural areas.

Using purposive sampling, 64 middle-aged and elderly individuals with high-risk characteristics for HIV/AIDS in M Village, Luzhou City, were selected as study subjects. A self-controlled before-and-after study design was adopted, and a collaborative intervention model involving village doctors and village cadres was implemented. The subjects underwent a 3-week (once a week, totaling 3 sessions) intensive educational intervention followed by a 4-week maintenance intervention. At five time points, including baseline (T0), after one intervention (T1), after two interventions (T2), after three interventions (T3), and after the maintenance phase (T4), the following indicators were assessed: HIV/AIDS knowledge awareness rate, discriminatory attitudes, condom use self-efficacy, HIV self-testing willingness, and testing behaviors.

After the intervention, the study subjects showed improvements in their awareness of HIV/AIDS knowledge, discriminatory attitudes, self-efficacy in condom use, willingness for HIV self-testing, and testing behaviors (all P<0.05). The intervention demonstrated cumulative effects, with all indicators in T3 reaching optimal levels and remaining stable in T4 (P<0.05).

Collaborative intervention by village doctors and village cadres can effectively enhance the knowledge level of HIV/AIDS, self-efficacy of condom use,reduce discriminatory attitudes towards HIV/AIDS, and promote testing behaviors among middle-aged and elderly high-risk populations in rural areas.

To explore the diagnosis related group(DRG) grouping model of traditional Chinese medicine diseases and syndromes under the mode of traditional Chinese medicine disease and syndrome and Western medicine diagnosis, and provide references for relevant medical insurance departments to improve DRG of Zhejiang Province(ZJ-DRG) scheme and enhance its applicability in traditional Chinese medical institutions.

Discharged patients, from 2020 to 2023, in a tertiary TCM hospital of Zhejiang were selected, and their medical record homepage and the DRG grouping data were collected. Hemorrhoids(ICD-10 code: I84.0-I84.9) were selected as the target disease type for dominant diseases in traditional Chinese medicine. A multilayer perceptron (MLP) neural network and K-prototypes clustering algorithm were used to screen categorical node variables, and decision tree model was used to group hemorrhoids inpatients. The between-group heterogeneity and within-group homogeneity of the established model were evaluated through the coefficient of variation (CV) and the reduction in variance (RIV).

The 4 663 hemorrhoids inpatients in this study were divided into 6 DRGs according to the ZJ-DRG scheme, and the heterogeneity between these groups (RIV: 1.92%) and the homogeneity within these groups (CV: 9.34%-26.29%) were moderate. Through the K-P clustering algorithm based on “Primary diagnosis-Primary symptom-Main Surgery or procedure”, 10 DRGs were formed, with the RIV increasing to 9.05% and the CV ranging between 17.14% and 22.99%. By further integrating traditional Chinese medicine specific indicators and complications, under the decision tree model (CRT algorithm), the RIV increased to 34.59%.

The constructed DRGs grouping model of traditional Chinese medicine diseases and syndromes has improved grouping efficiency and enhanced the heterogeneity between these groups. It can provide a reference for establishing a hierarchical and segmented disease group incentive mechanism for target dominant diseases in traditional Chinese Medicine.

To construct a TOPSIS-RSR-Markov chain model to comprehensively evaluate the current situation of traditional Chinese medicine service ability in Shanxi Province and predict the dynamic evolution trend.

Based on the data of public traditional Chinese medicine hospitals in 11 prefecture-level cities in Shanxi Province from 2021 to 2023, an evaluation system containing two first-class and ten second-class indicators was constructed. TOPSIS method and RSR method were used to rank the ability, and Markov model was used to predict the change trend from 2024 to 2025.

TOPSIS showed that Yuncheng (C=0.88), Jinzhong (C=0.75), Taiyuan (C=0.75) ranked the top three, and Shuozhou (C=0.10) ranked the bottom. The RSR method ranked Taiyuan (RSR=0.818) and Changzhi (RSR=0.75) in the highest grade. The two methods were moderately consistent (Spearman r=0.56). Markov prediction showed that the short-term capacity differentiation, the head agglomeration effect was enhanced, and some low- and medium-level cities were at risk of being downgraded. The proportion of low-level cities was stable at 25%. Sensitivity analysis confirmed that the core conclusions were robust, optimistic and structural optimization scenarios could increase the proportion of high-level cities, and pessimistic scenarios exacerbated the Matthew effect.

The service ability of traditional Chinese medicine in Shanxi Province is characterized by “dynamic evolution in gradient differentiation”. It is necessary to implement the differentiation strategy of “leading by the head city-breakthrough by the central city-bottom out by the tail city” to accelerate the development of traditional Chinese medicine in Shanxi Province.

To develop a scientific and systematic evaluation indicator system for the operation of the Health Vice Principal Program, addressing the current lack of standardized assessment tools for evaluating its effectiveness, and to provide a basis for objectively measuring and continuously improving the program.

An initial pool of items for the operation of the Health Vice Principal Program was constructed using literature research, questionnaire surveys, and expert interviews. Two rounds of expert consultations were conducted using the Delphi method to refine the indicator system based on expert feedback.The analytic hierarchy process was applied to determine the weights of indicators at all levels.

A comprehensive evaluation indicator system for the operation of the Health Vice Principal Program was successfully established, consisting of 5 first-level indicators, 19 second-level indicators, and 57 third-level indicators.

The construction process of this indicator system is scientific and reliable, demonstrating a high degree of expert consensus and consistency. It provides a practical and quantitative measurement tool for systematically evaluating the effectiveness of the Health Vice Principal Program, thereby promoting the standardization and high-quality development of school health work.

To analyze the influence of family structure on health literacy of prevention and treatment of infectious diseases among female residents in Qingdao, in order to provide scientific basis for formulating and improving health intervention strategies for infectious disease prevention.

This study conducted a multi-stage stratified random sampling survey among female permanent residents aged 15-69 in Qingdao in 2022. A logistic regression model was used to analyze its influencing factors, and subsequently, a decision tree algorithm was employed to establish a predictive model to identify key stratification variables.

Multivariable logistic regression model showed that after adjusting urban or rural areas, household registration, age, educational level, marital status, occupation and other factors, the health literacy of prevention and control of infectious diseases among women with 2 family members and 3 or more family members were higher than those living alone (OR=1.528, 95% CI: 1.512-1.545; OR=1.514, 95% CI: 1.499-1.530), women who did not care for or raise minors had a lower level of infectious disease prevention and control health literacy (OR=0.890, 95% CI: 0.886-0.895). The chi-squared automatic interaction detector(CHAID) decision tree model screened six significant factors influencing female residents’ infectious disease prevention and control, which were educational level, urban or rural areas, occupation, family size, whether caring for minors and age. Among women with low education level, those living alone in rural areas and those raising minors in urban areas had lower health literacy in the prevention and treatment of infectious diseases.

Whether live alone or raise minors affects female residents’ infectious disease prevention and control. We suggest to focus on women living alone and low-education women living in urban areas who are caring for or raising minors, so as to promote the overall improvement of female health literacy in the prevention and control of infectious diseases.

To investigate the current status of oral health knowledge, attitudes and practices (KAP) of middle-aged and elderly populations in Guizhou Province, to identify their influencing factors, and to provide a reference basis for oral health promotion strategies among middle-aged and elderly populations.

A multistage stratified cluster random sampling method was employed to select 2 040 middle-aged people aged 35-44 years and 2 023 elderly people aged 65-74 years. The χ² test and non-parametric test were used to analyse status of oral health KAP. The Spearman test was used to assess their correlations, while a negative binomial regression model was applied to examine associated factors.

Levels of knowledge and attitudes were lower than the national average, and the frequency of consuming sweets was lower than the national average. Knowledge was positively correlated with attitudes and oral hygiene practices (r=0.511, r=0.174), and attitudes were positively correlated with oral hygiene practices (r=0.140). After adjustment for multiple variables, gender, age, economic region, education, and type of health insurance were identified as significant factors influencing knowledge and positive attitudes. Dietary behaviour scores were associated with females (OR=1.015, 95% CI: 1.002-1.028), those aged 65-74 (OR=1.038, 95% CI: 1.024-1.052), those with ≤9 years of education (OR=1.099, 95% CI: 1.052-1.149), and rural residents (OR=1.051, 95% CI: 1.028-1.075), while negatively associated with residents in Category III regions (OR=0.971, 95% CI: 0.944-0.998). Oral hygiene behaviour scores showed a positive association with female gender (OR=1.087, 95% CI: 1.056-1.119) and Category III regions (OR=1.080, 95% CI: 1.012-1.152), and a negative association with those aged 65-74 (OR=0.930, 95% CI: 0.902-0.959), rural residents (OR=0.929, 95% CI: 0.879-0.981), and residents with basic medical insurance (OR=0.852, 95% CI: 0.816-0.890).

The level of oral health knowledge, attitudes and practices of the middle-aged and elderly populations in Guizhou Province has distinctive characteristics. Strengthening age-appropriate health education and optimizing oral disease insurance policies are essential to promote the effective translation of knowledge and attitudes into positive health practices among middle-aged and elderly populations.

To investigate the association between reproductive years and sarcopenia, and to assess the mediating role of depression in this relationship.

The study population was drawn from Hongguang Subdistrict, Pidu District, Chengdu City, Sichuan Province.Demographic data were collected through face-to-face interviews. Reproductive years were calculated based on the age at menarche and menopause. Muscle mass was assessed using the Inbody 770 analyzer, and grip strength and walking speed were measured to determine the presence of sarcopenia according to established guidelines. Multivariable logistic regression models were used to explore the association between reproductive years and sarcopenia. Mediation analysis was conducted to assess the mediating effect of depression on this association.

A total of 2 857 postmenopausal women were included in the final analysis. According to the Asian Working Group for Sarcopenia 2019 consensus on the diagnosis and treatment of sarcopenia, 1 098 participants (38.43%) were classified as having “possible sarcopenia”,463 (16.21%) as having “sarcopenia”, and 345 (12.08%) as having “severe sarcopenia”. Multivariable logistic regression showed that reproductive years were negatively associated with sarcopenia (OR=0.85, 95% CI: 0.75-0.96) and severe sarcopenia (OR=0.76, 95% CI: 0.67-0.85). Mediation analysis indicated that depression mediated the relationship between reproductive years and sarcopenia, with a mediation proportion of 9.67%. For severe sarcopenia, the mediation proportion was 6.34%.

Longer reproductive years are associated with a reduced risk of sarcopenia, and depression plays a mediating role in this association. Given the significant mediating effect of depression, more attention should be paid to the mental health of postmenopausal women to reduce the risk of sarcopenia potentially linked to low estrogen levels.

To explore the relationship between physical activity and cardiometabolic multimorbidity (CMM) among older adults in the community.

Using data from the 2020 China Health and Retirement Longitudinal Study(CHARLS), 9 076 older participants were included. Propensity score matching was employed to control for confounding factors in analyzing the association between physical activity and the number of cardiometabolic diseases. Multivariable logistic regression and restricted cubic spline models were used to evaluate the relationship between physical activity level (PAL) and CMM risk.

Propensity score matching showed that sufficient physical activity was associated with an average reduction of 0.20 in the number of cardiometabolic diseases (ATT: -0.187~-0.225). Logistic regression indicated that a PAL ≥1 800 MET-min/week was significantly associated with lower CMM risk (1 800<PAL≤3 000: OR=0.814, 95% CI: 0.682-0.972; PAL≥3 000: OR=0.647, 95% CI: 0.572-0.732). The restricted cubic spline model revealed a nonlinear dose-response relationship between PAL and CMM risk (P for nonlinear <0.05). The risk of CMM decreased notably at a PAL around 3 800 MET min/week, and the association plateaued when PAL exceeded 8 000 MET min/week.

Physical activity is associated with a reduction in the number of cardiometabolic diseases. Maintaining an adequately high level of physical activity may have a positive effect on preventing CMM in older adults.

The infectivity of plasma from blood donors with occult hepatitis B virus infection (OBI) in human hepatocyte cells was investigated through an in vitro hepatitis B virus (HBV) infection model using the L-02 hepatocyte cell line.

Among 54 446 blood donors, 28 OBI plasma samples were collected as the experimental group, and 28 plasma samples from hepatitis B surface antigen (HBsAg)-positive blood donors were randomly selected as the control group.The control group samples were used to infect L-02 hepatocytes to establish an in vitro hepatocyte infection model. The infectivity of the experimental group samples to L-02 hepatocytes was studied using the same experimental method.

Except for one case, HBV DNA was detected in the lysate of L-02 hepatocytes in all 27 specimens of the control group after infection. In contrast, only one of the 28 OBI specimens had detectable HBV DNA in the lysate of hepatocytes.

The probability of OBI donor plasma infecting hepatocyte cells is much lower than that of HBsAg-positive donor plasma, but there is still a risk of HBV transmission through blood transfusion. The presence of high-titer hepatitis B surface antibodies may be one of the key factors in preventing HBV transmission through blood transfusion from OBI.

To analyze the epidemic patterns of public health emergencies in schools in Zhejiang Province from 2019 to 2024, and to provide references for the prevention and control strategies of such events in the future.

The information of public health emergencies in schools in Zhejiang Province from 2019 to 2024 was collected from the Public Health Emergency Management Information System of China Disease Prevention and Control Information System, and the descriptive epidemiological method was used to analyze the data in terms of time, space, type of school and the effect of event control. Descriptive statistical analyses and spatial autocorrelation analyses were performed using R 4.3.1 software.

A total of 2 067 public health emergencies in schools were reported in Zhejiang Province from 2019 to 2024, with a total number of 66 441 reported cases, and an average attack rate of 2.94%. There were no deaths during the period. The largest number of reported events was 651 in 2023, accounting for 31.49% of the total number of events. The peak time of incidence was from November to December and from March to April. The global spatial autocorrelation analysis showed that there was no significant spatial aggregation in the spatial distribution of public health emergencies in schools (P values were all >0.05). The main locations where public health emergencies occurred in schools were in primary schools (1 088 cases), accounting for 52.64%. The second was in kindergartens (488 cases), accounting for 23.61%. The attack rate was the highest in kindergartens(5.79%), and the lowest in colleges and universities (0.67%). There was a significant difference in the attack rate among different schools (χ²=7 938.143, P<0.001). The attack rate in rural schools was significantly higher than that in county, town and urban schools (P<0.001). The intervention time of school public health emergencies was positively correlated with the duration (r₁=0.830, P₁<0.001), and the duration of the event was positively correlated with the number of cases (r₂=0.607, P₂<0.001).

Public health emergencies in schools in Zhejiang Province are mainly intestinal and respiratory infectious diseases, with a peak period in winter and spring. Prevention and control should be focused on young children. Communication and collaboration between family, schools and health departments should be strengthened. Early intervention and handling could shorten the duration of the events and reduce the scale of the outbreak.

To evaluate the health status of residents in the chronic diseases comprehensive control and prevention demonstration areas, and provide empirical evidence for optimizing chronic disease control and prevention strategies.

Three demonstration areas established before 2014 in Jinan were selected as the research subjects, and three districts/counties without established demonstration areas were chosen as the control group for comparison. Death registration data of the registered population from 2013 to 2023 were collected, and SPSS 20.0 software was used for statistical analysis. For the first time, this study integrated healthy-adjusted life expectancy(HALE), age standardized mortality rate (ASMR), years of life lost(YLL) rate, and premature death probability with the construction of demonstration areas. Using Joinpoint regression models,the average annual percentage change(AAPC) was calculated to compare the trends between the demonstration and non-demonstration areas.

From 2013 to 2023, the HALE of residents in the demonstration areas increased from 69.20 years to 71.32 years, with an average annual increase of 0.32% (P<0.05). The ASMR decreased by an average of 1.96% per year (P<0.05). The YLL rate declined by an average of 0.92% annually (P<0.05). The premature death probability was reduced by an average of 2.22% each year (P<0.05). Among the major diseases, the ASMR, YLL rate and premature death probability of the four major malignant tumors (lung cancer, stomach cancer, liver cancer and esophageal cancer) and chronic obstructive pulmonary disease(COPD) among the residents in the demonstration areas all showed a downward trend. For ischemic heart disease(IHD), the four major malignant tumors, and COPD, the rate of decline in the premature death probability among residents in the demonstration areas was not only faster than the decline in their ASMR, but also significantly exceeded the rate of decline in the premature death probability in the non-demonstration areas. However, there was no significant downward trend in the ASMR and YLL rate for IHD, the YLL rate and premature death probability for cerebral infarction(CI), and none of the indicators for respiratory infections showed a clear declining trend.

The construction of the demonstration areas in Jinan has achieved remarkable results, especially in the prevention and control of some malignant tumors and COPD. The working-age population has benefited more. However, IHD, CI and respiratory infections will be the key points of control and prevention in the future.

To investigate the detection of 22 respiratory pathogens among 7 244 acute respiratory infection (ARI)cases in Qinghai Province during 2024—2025, characterize their epidemiological patterns, and provide evidence for local prevention and control.

From February 2024 to August 2025, 7 244 ARI specimens were collected from six sentinel hospitals in five prefectures of Qinghai. Multiplex real-time PCR was used to detect 22 respiratory pathogens, and statistical analyses were performed using SPSS 28.0.

The overall positive rate for the 22 pathogens was 52.32%. The five most frequently detected pathogens were Haemophilus influenzae (33.02%), Streptococcus pneumoniae (26.99%), influenza A virus(10.48%), rhinovirus (9.40%), and SARS-CoV-2 (7.10%). Among 3 790 positive specimens, 60.82% were single infections and 39.18 % were mixed infections. The positive rate in influenza-like illness (ILI) cases (55.73%) was higher than in severe acute respiratory infection (SARI) cases (45.94%), and both the single infection rate (χ²=12.231, P<0.001) and the multiple infection rate (χ²=33.674, P<0.001) differed significantly between ILI and SARI cases. Pathogen detection rates varied across six age groups among ARI cases, peaking in children aged 4-7 years (68.06%) and lowest in adults ≥60 years (39.34%).

ARI in Qinghai Province shows a clear winter-spring peak. Haemophilus influenzae, Streptococcus pneumoniae, influenza A virus, rhinovirus, and SARS-CoV-2 are the predominant pathogens, and mixed infections are common. Detection rates of the 22 pathogens vary by age, season, and region. Therefore, targeted prevention and control measures should be implemented for key populations in different seasons.

To characterize the comorbidity profile of hepatitis C patients in Nanchang and evaluate its association with the efficacy of direct acting antivirals (DAAs) therapy.

We conducted a retrospective cohort study of 596 hepatitis C patients treated with DAAs in Nanchang between 2019 and 2024. Demographic data, comorbid conditions, and laboratory parameters were extracted from the hospital information system. The primary endpoint was sustained virological response 12 weeks post-treatment. Multivariable logistic regression models were used to examine the effect of comorbidities on treatment outcomes.

A total of 596 patients were included, with a mean age of 55.1±13.6 years, and 60.9% were male (363/596).The overall prevalence of comorbidities was 34.2% (204/596). The four most common comorbidities were hypertension (18.8%,112/596), liver cirrhosis (13.6%, 81/596), diabetes (7.4%, 44/596), and hepatitis B virus (HBV) co-infection (3.5%, 21/596).Multivariable analysis showed that the presence of comorbidities was independently associated with DAA treatment failure (aOR=2.68, 95% CI: 1.31-5.49). In terms of specific comorbidities, concurrent hepatitis B virus infection (OR=4.80, 95% CI: 1.65-14.78) and diabetes mellitus (OR=2.43, 95% CI: 1.09-5.30) were identified as independent risk factors for antiviral treatment failure.

Hepatitis C patients in Nanchang bear a substantial comorbidity burden, which independently compromises DAA efficacy. We recommend a multidisciplinary care model integrating hepatology and endocrinology to strengthen integrated management of comorbidities and improve antiviral outcomes.

Systemic inflammation and immune status play critical roles in carcinogenesis. However, evidence regarding the association between the lymphocyte-to-monocyte ratio (LMR) and the risk of breast cancer (BC) remains limited.This study aims to investigate the relationship between LMR and BC risk.

A total of 13 519 participants with complete LMR and BC data were identified from the U.S. National Health and Nutrition Examination Survey (NHANES) 2005—2018. Multivariable weighted logistic regression models, restricted cubic spline analyses, and subgroup analyses were conducted to evaluate the independent association between LMR and BC risk. Sensitivity analyses were performed to assess the robustness of the findings.

A significant U-shaped association was observed between LMR and BC risk, with an inflection point at 1.82. When LMR was ≤1.82, it was inversely associated with BC risk, with each one-unit increase in LMR corresponding to a 76% reduction in BC risk (OR=0.24, 95% CI: 0.18-0.31). Above this threshold, the association was no longer statistically significant. In the LMR quartile groups, the highest quartile (Q4) showed a significant reduction in breast cancer risk of approximately 47% compared to the Q1 group (OR=0.53, 95% CI: 0.38-0.74). Likelihood ratio tests indicated that the piecewise linear model provided a better fit than the linear model. Subgroup and interaction analyses revealed significant differences in the association between LMR and BC risk between participants with and without diabetes.

This study is the first to demonstrate a non-linear (broad U-shaped) association between LMR and BC risk,indicating that both low and high LMR levels are associated with an increased risk of BC. Maintaining LMR within a stable range may help prevent and slow the development and progression of breast cancer. Further large-scale prospective cohort studies are warranted to validate these findings.