To examine the joint association of intrinsic capacity (IC) and long-term fine particulate matter (PM_2.5) exposure with incident cardiovascular disease (CVD) among older Chinese adults.

This prospective cohort study used data from the China Health and Retirement Longitudinal Study (CHARLS). We included 3 241 participants aged ≥60 years who were free of CVD at baseline in 2011 and followed them through 2020. IC was assessed across five domains: locomotion, vitality, sensory function, cognition, and psychological well-being, and categorized by the number of deficits (0, 1, 2, or ≥3). Long-term PM_2.5 exposure was estimated using satellite-based data linked to participants’ residential locations. Cox proportional hazards models were used to estimate the association between IC-PM_2.5 joint exposure groups and incident CVD, with hazard ratios (HRs) and 95% confidence intervals (CIs) reported. In addition, group-based trajectory modelling (GBTM) was applied to identify IC trajectories, and the association between PM_2.5 exposure and CVD risk was further evaluated across different trajectory groups.

During a mean follow-up of 7.9±2.2 years, 697 participants (21.5%) developed incident CVD, with an incidence density of 27.3 per 1 000 person-years (95%CI: 25.3-29.4). Compared with the “high IC + low PM_2.5 exposure” group, the adjustedHRs for incident CVD were 1.53 (95%CI: 1.20-1.96) for the “low IC + high PM_2.5 exposure” group. Three IC trajectories were further identified: “low-level with transient improvement”, “moderate-level with persistent decline”, and “high-level with stable improvement”. In the “low-level with transient improvement” trajectory group, each 10 μg/m³ increase in PM_2.5 exposure was associated with an increased risk of incident CVD (HR=1.20, 95%CI: 1.02-1.42), whereas no statistically significant associations were observed in the other trajectory groups.

Older adults with both lower IC levels and higher long-term PM_2.5 exposure had the highest risk of incident CVD. PM_2.5-related CVD risk also differed across IC trajectory groups.

To systematically investigate the independent factors influencing the life expectancy of patients with dementia enrolled in the Chengdu Long-Term Care Insurance (hereinafter referred to as “LTCI”) system, and to provide high-quality evidence for implementing precision care, developing a risk stratification management system, and optimizing LTCI policies.

A retrospective cohort study design was employed. A total of 10 108 patients with dementia enrolled in Chengdu LTCI from January 2018 to April 2022 were included and followed up until July 2025. Baseline demographic characteristics, comorbidities, adverse events, and assessment data on cognitive function, activities of daily living, and neuropsychiatric behaviors were extracted. Using Python software, descriptive analysis, univariate tests, multicollinearity tests, multivariate logistic regression, Cox proportional hazards regression, and model performance evaluation were conducted.

Among the 10 108 patients, 5 435(53.8%) died. Multivariate logistic regression indicated that age (OR=1.64, 95%CI：1.56-1.72), male gender (OR=1.63, 95%CI：1.47-1.80), mild dysphagia (OR=4.01, 95%CI：3.30-4.88), and >2 comorbidities (OR=1.50, 95%CI：1.31-1.73) were independent risk factors for mortality, while moderate cognitive impairment (OR=0.29, 95%CI：0.18-0.46) and higher education level (OR=0.77, 95%CI：0.64-0.91) were independent protective factors (all P<0.05). Multivariate Cox regression showed that gender (male: HR=1.412, 95%CI:1.336-1.491), age (HR=1.039, 95%CI:1.036-1.042), number of comorbidities (HR=1.226, 95%CI:1.143-1.316), adverse events (HR=1.293, 95%CI:1.141-1.466), and swallowing function (HR=1.092, 95%CI:1.059-1.126) were risk factors for survival, whereas better cognitive function (HR=0.399, 95%CI:0.357-0.446), activities of daily living (HR=0.948, 95%CI:0.911-0.985), higher education level (HR=0.964, 95%CI:0.944-0.985), and history of surgery (HR=0.789, 95%CI:0.661-0.940) were protective factors (all P<0.05). The AUC of the logistic regression model was 0.7315, and the Cox regression model showed good calibration and discrimination (24-month calibration slope=1.084) with strong stability.

The life expectancy of patients with dementia under long-term care is influenced by multidimensional factors. Abnormal swallowing function, advanced age, and male gender are core risk factors, while family care, higher education level, and better functional status are key protective factors. The constructed Cox regression model can be effectively used for clinical risk assessment, and targeted interventions are expected to improve patient prognosis.

To examine the relationship among psychological resilience, perceived social support, and public health literacy among medical students, and to explore the mediating role of psychological resilience.

From December 2024 to June 2025, a multistage stratified convenience sampling method was used to select 1 484 medical students from 10 universities in Shanxi and Sichuan provinces. Data were collected using the Public Health Literacy, Psychological Resilience, and Perceived Social Support scales, and analyzed using Pearson correlation, multiple linear regression, and stepwise regression.

The scores of public health literacy, psychological resilience, and perceived social support were 4.36±0.56, 103.84±15.23, and 70.92±12.07, respectively. Public health literacy was positively correlated with psychological resilience (r=0.722, P<0.01) and perceived social support (r=0.598, P<0.01), and psychological resilience was also positively correlated with perceived social support (r=0.716, P<0.01). Multiple linear regression identified academic level (t=-2.877, P=0.004), major category (t=4.280, P<0.001), public health courses (t=2.194, P=0.028), career intention (t=-2.607, P=0.009; t=-2.259, P=0.024), policy awareness (t=3.750, P<0.001), mental health status (t=-2.032, P=0.042), perceived social support (t=6.276, P<0.001), and psychological resilience (t=21.506, P<0.001) as associated factors. Mediation analysis showed that perceived social support was positively associated with public health literacy (β=0.598, t=28.715, P<0.001) and psychological resilience (β=0.716, t=39.527, P<0.001). After psychological resilience was included, both perceived social support (β=0.166, t=6.524, P<0.001)and psychological resilience (β=0.603, t=23.742, P<0.001)remained positively associated with public health literacy. Psychological resilience partially mediated this association, with the indirect effect accounting for 72.20%.

Medical students had relatively high public health literacy. Psychological resilience and perceived social support were associated factors, and psychological resilience played a partial mediating role.

To investigate the effects of shift work and remnant cholesterol (RC) on renal impairment among steel workers and to analyze the mediating role of RC in this association.

A cohort study was conducted involving 4 113 workers from a steel enterprise in Tangshan. Participants were enrolled in 2017 and followed up until 2023 to record incident cases of renal impairment. Shift work status was assessed to calculate the Weighted Shift Index (WSI), and RC levels were determined based on fasting lipid profiles. Cox regression was used to analyze risk associations, the Bootstrap method was employed to examine the mediating effect of RC, and sensitivity analyses were conducted to evaluate the robustness of the findings.

A total of 626 participants (15.2%) developed renal impairment. Compared with those who never worked shifts, former and current shift workers had a 3.267-fold (95%CI: 2.399-4.449) and 2.910-fold (95%CI: 2.163-3.914) increased risk of renal impairment, respectively. Each IQR increase in WSI was associated with a 29.4% increase in risk. Participants in the high RC group (≥ 0.71 mmol/L) had a 1.762-fold (1.364-2.277) higher risk compared to those in the low RC group (<0.34 mmol/L). Mediation analysis revealed that RC partially mediated the association between shift work and renal impairment, accounting for 12.4% (former shift work), 10.6% (current shift work), and 6.1% (WSI) of the effect, respectively.

Higher shift work load and elevated RC levels were both significantly associated with an increased risk of renal impairment, with RC playing a partial mediating role in this relationship.

To investigate the role and mechanism of FABP5 in pulmonary inflammation associated with silicosis by analyzing multi-omics data in conjunction with a silicosis mouse model.

Single-cell sequencing was performed to analyze the potential role of FABP5 in occupational respiratory diseases; a silicosis mouse model was used to validate the relationship between FABP5 and pulmonary inflammation in silicosis; intra-abdominal injection of FABP5 inhibitors to modulate FABP5 function; and employed hematoxylin-eosin staining, immunohistochemistry, Western blotting, real-time quantitative PCR, and transcriptomic sequencing to investigate the role and potential mechanisms of FABP5 in silica-induced lung tissue inflammation in mice.

Single-cell sequencing revealed that FABP5 expression was elevated by 3.10-fold (P<0.01) and 4.71-fold (P<0.05) in lung tissue from patients with pneumoconiosis and in a mouse model of silicosis, respectively, and was highly enriched in macrophages; Transcriptomic sequencing revealed that, compared to the silicosis model group, inhibition of FABP5 downregulated the expression of inflammatory genes such as TNF, IL-1α, and IL-1β, with the relative protein expression levels of TNF-α and IL-1β decreasing by 4.67-fold (P<0.001) and 0.25-fold (P<0.01), respectively.

FABP5 is a key pathogenic factor in silicosis-induced pulmonary inflammation. In vivo inhibition of FABP5 alleviates pulmonary tissue inflammation in silicosis, providing insights for research into the mechanisms and clinical management of silicosis.

To develop an Integrated Measurement Model (IMM) for occupational stress by utilizing the cross-culturally adapted Job Content Questionnaire (JCQ-22adj) to measure occupational stress and its related factors, manifestations, and effects.

A cluster sampling method was employed to select 807 workers undergoing occupational health examinations as the study subjects. Data on demographic characteristics, occupational stress, insomnia, self-reported symptoms, and related factors and effects were collected using a basic information questionnaire, the JCQ-22adj, the brief Athens Insomnia Scale (AIS-5), and the Symptom Checklist-90. Factor analysis and principal component analysis were applied to integrate physical examination indicators for constructing the IMM and calculating the Stress-related Health Risk Index (SHRI) to assess the risk of stress-related health outcomes.

The constructed IMM comprised three core dimensions: occupational stress, insomnia, and self-reported symptoms, with economic security and work environment as external factors. The subjective and objective health outcomes were represented by perceived workplace comfort and changes in physical examination indicators, respectively. The SHRI calculation formula was derived from the model, yielding a mean score of 19.06. SHRI demonstrated a significant negative correlation with subjective workplace comfort (r=-0.25, P< 0.001). The area under the receiver operating characteristic curve for predicting stress-related diseases was 0.67 (P<0.001), indicating a moderate level of predictive validity and confirming its effectiveness in reflecting the comprehensive health risk associated with occupational stress.

IMM and the SHRI provide a holistic approach to assessing the impact of occupational stress and its composite state on health. They offer valuable insights for formulating targeted intervention strategies for occupational stress and for the assessment and prevention of comprehensive stress-related health risks.

To analyze the detection status and associated factors of ocular abnormalities among on-the-job welders from Jiangsu Province in 2024, so as to provide scientific evidence for ocular health protection and surveillance among welders.

Based on the Occupational Disease and Health Hazard Factors Information Monitoring System, occupational health examination data of 76 111 on-the-job welders from Jiangsu Province in 2024 were collected for a cross-sectional study. Pearson’s χ² test was used to compare the detection rates of ocular abnormalities among welders with different occupational characteristics. Multivariate logistic regression analysis was used to analyze factors associated with conjunctival, corneal, lens, and fundus abnormalities, and trend analysis was performed for length of service.

The detection rates of conjunctival, corneal, lens, and fundus abnormalities were 0.88%, 1.08%, 1.47%, and 1.09%, respectively. Multivariate logistic regression analysis showed that, compared with welders with ≤5 years of service, >20 years of service was an independent risk factor for conjunctival abnormalities (OR=1.82, 95%CI: 1.29-2.61), corneal abnormalities (OR=4.20, 95%CI: 3.01-5.91), lens abnormalities (OR=2.63, 95%CI: 2.03-3.42), and fundus abnormalities (OR=2.36, 95%CI: 1.82-3.06), all P<0.001. Trend analysis showed that with increasing length-of-service category, the risks of conjunctival, corneal, lens, and fundus abnormalities increased by 16%, 46%, 26%, and 23% respectively, all P<0.001.

The overall detection rates of ocular abnormalities among on-the-job welders from Jiangsu Province in 2024 were relatively low. Longer length of service was an independent risk factor for conjunctival, corneal, lens, and fundus abnormalities. Welders with long service duration should be considered a key population for occupational ocular health surveillance, health education, and protective intervention.

To explore the influencing factors of occupational stress and their relationships among workers in key industries of Bijie City, so as to provide scientific reference for the construction of occupational health intervention system.

A total of 1 986 workers from 8 key industries in Bijie City were enrolled by stratified random sampling. Relevant information on occupational stress was collected by the National Key Population Occupational Health Literacy Monitoring Questionnaire. SPSS 26.0 was used to screen influencing factors, and GeNIe 4.0 was adopted to construct a Bayesian network model for backward reasoning and sensitivity analysis.

The detection rate of occupational stress among workers in key industries of Bijie City was 29.88%.Multivariate analysis showed that females (OR=1.335, 95%CI:1.005-1.774), employees in private enterprises (OR=2.467, 95%CI:1.362-4.469), night shift workers (OR=1.876, 95%CI:1.478-2.382), workers with self-rated general health status (OR=1.710, 95%CI:1.098-2.662), and those lacking occupational health literacy (OR=2.562, 95%CI:2.004-3.276) had an increased risk of occupational stress. The Bayesian network model consisted of 9 nodes and 14 directed edges. Industry category, enterprise nature, weekly working hours, night shift, health status and occupational health literacy were direct influencing factors, while gender was an indirect influencing factor. The classification accuracy of the model was 77.12%, with an AUC of 0.823 (95%CI:0.80-0.85), indicating good predictive efficiency and model fitting performance. Backward reasoning identified 6 core risk nodes, and industry category was the most sensitive variable.

Industry category, enterprise nature, weekly working hours, night shift, health status and occupational health literacy can be taken as the intervention targets for the prevention and control of occupational stress.

To investigate the spatiotemporal inequity and determinants of maternal healthcare service levels across Chinese provinces.

Based on panel data from 31 provinces in China (2010—2020), a composite maternal healthcare service index was constructed using the entropy weight method. Spatial Gini coefficient, spatiotemporal cluster, and outlier analyses were employed to reveal the evolution of spatial inequity and geographical agglomeration patterns. The Bayesian spatiotemporally varying coefficients (BSTVC) model and spatiotemporal variance partitioning index (STVPI) were then applied to quantify the spatiotemporally heterogeneous effects of socioeconomic and environmental factors.

Persistent spatial inequity exists in China’s maternal healthcare services, exhibiting a solidified pattern of “high in the north, low in the west, and rising in the central region.” Socioeconomic factors contributed 59.66% to the overall spatiotemporal disparity, making them the dominant drivers, among which illiteracy rate accounted for 36.69% as the most critical inhibitory factor.

Although the overall equity of maternal healthcare services in China has improved, significant regional disparities persist. Time- and location-specific interventions are required to promote balanced development of maternal health services.

To develop a comprehensive evaluation index system for community-based rehabilitation interventions tailored to China, addressing various adverse outcomes among patients with severe mental disorders, and to provide an assessment tool for improving the community-based rehabilitation management system at the grassroots level.

The indicator system was developed based on the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) framework, in conjunction with China’s guidelines for the management and treatment of severe mental disorders. Using the Delphi expert consultation method, we conducted two rounds of expert consultations with 15 experts to select the evaluation indicators, and then applied the Analytic Hierarchy Process (AHP) to calculate the weights of each indicator, thereby establishing an indicator system.

The questionnaire response rate was 100% in both rounds of expert consultation, with an expert authority coefficient of 0.85. The final indicator system comprises 4 first-level indicators, 13 second-level indicators, and 22 third-level indicators. The first-level indicators, ranked by weight from highest to lowest, are: risk behaviors (0.389 0), disease status (0.273 4), social functions (0.224 6), and mental functions (0.113 0).

The indicator system developed in this study focuses on the comprehensive rehabilitation levels of patients with severe mental disorders across multiple dimensions of adverse outcomes. It demonstrates good scientific validity and reliability and can serve as an assessment tool for evaluating community-based rehabilitation outcomes and improving services.

To investigate the association of teeth number and hearing difficulty with mild cognitive impairment (MCI) among community-dwelling older adults (≥60 years) in Henan Province, and to analyze their independent and joint effects on MCI.

Data were obtained from the 2023 Henan Healthy Aging Survey, which used a multistage stratified probability-proportional-to-size (PPS) sampling method to recruit 9 180 residents aged ≥60 years across 17 cities in Henan Province. Information was collected via questionnaires, physical examinations, and biochemical tests. Weighted multivariate logistic regression models were used to analyze the independent effects of tooth number and hearing difficulty on MCI. Multiplicative and additive interactions between the two factors were assessed using the multiplicative interaction term, along with relative excess risk of interaction (RERI), attributable proportion of interaction (API), and synergy index (SI).

Among 9 147 older adults, totally 24.6% was with MCI. The results revealed a significant association between the number of teeth and MCI. Compared to older adults with <10 teeth, those with more teeth had successively lower odds of MCI: 10-19 teeth (OR=0.76, 95%CI:0.60-0.95,P=0.015), 20-27 teeth (OR=0.71, 95%CI=0.58-0.88,P=0.001), and ≥28 teeth (OR=0.66, 95%CI: 0.53-0.83,P<0.001). Hearing difficulty was also significantly associated with MCI. Compared to older adults without hearing difficulties, those with hearing difficulties have a higher likelihood of developing MCI, with this association being more pronounced in individuals with bilateral hearing difficulties (unilateral: OR=1.41, 95%CI: 1.15-1.75,P=0.001; bilateral: OR=1.78, 95%CI: 1.50-2.11,P<0.001). The interaction results showed that there was no multiplicative interaction between the number of teeth and hearing difficulty on MCI (OR=0.83, 95%CI: 0.62-1.11,P=0.203), nor an additive interaction (RERI, API, and SI of the interaction were -0.17 (95%CI:-0.56-0.21), -0.09(95%CI: -0.29-0.10), 0.83 (95%CI: 0.60-1.26), respectively).

Maintaining more teeth and no hearing difficulty contributed to improve cognitive function. It is recommended to conduct simultaneous screening for oral and hearing health, enhance health education and encourage regular check among the elderly population, and the inclusion of early screening in basic public health services is recommended for decelerating the progression of cognitive decline.

To analyze the association between the sleep quality and daily living activity ability (ADL) of community-dwelling elderly in Jiading District, Shanghai, and to explore the mediating role of intrinsic capacity (IC).

: A multi-stage cluster random sampling method was used to conduct a questionnaire survey among 4 462 community-dwelling elderly aged 60 and above in Jiading District. The Pittsburgh Sleep Quality Index (PSQI), IC assessment tool, Basic Activities of Daily Living (BADL), and Instrument Activities of Daily Living (IADL) scale were used for evaluation. Pearson correlation analysis, linear regression models, and the Bootstrap method were used for statistical analysis.

: The scores of BADL and IADL were (98.12±7.72) and (7.60±1.25) respectively. The detection rate of sleep disorders was 32.52%, and the impairment rate of IC was 83.03%. The PSQI score was negatively correlated with the BADL/IADL scores (BADL:r=-0.13,P<0.01; IADL:r=-0.17,P<0.01). The IC score was also negatively correlated with the BADL/IADL scores (BADL:r=-0.32,P<0.01; IADL:r=-0.40,P<0.01). IC played a partial mediating role in the relationship between sleep quality and BADL/IADL, with the mediating effect accounting for 41.40% and 28.57% respectively.

: The sleep quality of community-dwelling elderly is closely related to their ADL, and IC plays a partial mediating effect. Improving sleep quality and enhancing IC may help delay functional decline and promote healthy aging.

To analyze the spatial distribution characteristics and equity of methadone maintenance treatment (MMT) resources in Guangdong Province from 2017 to 2022，and to provide evidence for optimizing resource allocation.

Kernel density analysis was used to analyze the spatial distribution characteristics. The Gini coefficient, Lorenz curve, and Health resource agglomeration degree (HRAD) was employed to evaluate the overall and inter-regional equity of MMT resource allocation in Guangdong Province.

The spatial distribution of MMT clinics in Guangdong Province showed significant clustering, mainly concentrated in the Pearl River Delta (PRD) region, Jieyang and Shantou City in the eastern region, and Zhanjiang and Maoming City in the western region of the province. From 2017 to 2022, the number of MMT participants in Guangdong Province decreased from 8 237 to 3 630, whereas the number of MMT clinics increased from 66 to 75. During the same period, the Gini coefficient increased from 0.22 in 2017 to 0.29 in 2021, and then decreased to 0.23 in 2022. The HRAD of MMT resource increased from 1.65 to 5.23, and then declined to 2.08 in 2022, with marked variation across regions. Taking the year 2020 as an example, HRAD across cities in Guangdong Province ranged between 0.46 to 73.79. Specifically, the western region had an HRAD closest to 1 (0.87), while the eastern region had the highest value of 18.13, followed by the northern region (6.03) and the PRD (1.65), respectively.

From 2017 to 2022, MMT resources in Guangdong Province showed a clustering distribution, mainly in PRD region. The overall allocation of MMT resource was relatively equitable; however, a significant inter-regional disparities remained, suggesting an oversupply in eastern and northern Guangdong. MMT resource allocation should therefore be dynamically adjusted according to the local scale and changing trends of MMT participants in order to improve equity and utilization efficiency.

To analyze the structural characteristics and core influencing factors of health literacy among residents in Sichuan Province during the 14th Five-Year Plan period (2021-2025), and provide empirical evidence for formulating health literacy optimization strategies for the 15th Five-Year Plan period.

Based on the health literacy surveillance data of Sichuan residents in 2021, 2023 and 2025, Chi-square test was used to analyze the structural characteristics of literacy on six categories of health issues, multivariate Logistic regression was applied to identify the influencing factors, and stepwise regression method was adopted to test the mediating effect of education level.

During the 14th Five-Year Plan period, the overall health literacy rate of Sichuan residents increased from 24.10% to 33.80%, with a cumulative increase of 9.70 percentage points, and the level in 2025 was slightly higher than the national average. The literacy on six categories of health issues presented the characteristics of prominent strengths, obvious weaknesses, and peaking then declining in some dimensions: scientific health concept and safety & first aid were dominant fields, while chronic disease prevention and control, infectious disease prevention and control were core weaknesses. Education level of college degree or above (OR=5.467，95%CI=5.453-5.481) and occupation as medical staff (OR=1.796，95%CI=1.790-1.802) were strong promoting factors, while rural household registration, people aged 65-69 years and farmers were main risk factors. The mediating effect of education level accounted for 35.2% and 42.6% of the association between urban-rural status, farmer occupation and health literacy, respectively.

The health literacy of Sichuan residents has achieved significant improvement, but prominent problems such as structural imbalance, regional and population disparities still exist. Education level is the core mediating variable. Targeted optimization strategies should be implemented to promote the transformation of health literacy to qualitative optimization.

To analyzes the influencing factors of outpatient and inpatient service utilization among middle-aged and elderly people in China based on the Andersen model.

Using the 2020 Chinese Health and Aging Tracking Survey Database as the basis, the study focused on middle-aged and elderly individuals aged 45 and above. Chi-square test, binary logistic regression, and CHAID decision tree were employed to predict the influencing factors.

The outpatient utilization rate among middle-aged and elderly people was 20.32%, and the inpatient utilization rate was 16.78%. Logistic regression showed that the main influencing factors for outpatient utilization were self-assessed health (general OR=0.310, 95%CI: 0.242-0.397 or good OR=0.611, 95%CI: 0.512-0.730), the number of chronic diseases (≥ 2 types OR=2.288, 95%CI: 1.877-2.790 or having 1 type OR=1.510, 95%CI: 1.272-1.794), and being affected by medical treatment during the epidemic (OR=2.755, 95%CI: 2.292-3.313). Urban employee medical insurance (OR=0.577, 95%CI: 0.361-0.923), having internet access in the past month (OR=1.198, 95%CI: 1.025-1.401), age 60-69 years old (OR=1.188, 95%CI: 1.007-1.401), and having running water (OR=0.739, 95%CI: 0.584-0.937). The main influencing factors for inpatient utilization were self-assessed health (general OR=0.238, 95%CI: 0.182-0.311 or good OR=0.400, 95%CI: 0.331-0.482), the number of chronic diseases (≥ 2 types OR=2.410, 95%CI: 1.957-2.967 or having 1 type OR=1.628, 95%CI: 1.352-1.959), IADL impairment (OR=1.346, 95%CI: 1.103-1.643), being affected by medical treatment during the epidemic (OR=1.657, 95%CI: 1.351-2.031), having internet access in the past month (OR=0.776, 95%CI: 0.653-0.922), and being elderly (70-79 years old OR=1.292, 95%CI: 1.017-1.641; ≥ 80 years old OR=1.476, 95%CI: 1.005-2.169). The CHAID decision tree further revealed that being affected by medical treatment during the epidemic was the primary stratification factor for outpatient utilization, and self-assessed health was the primary stratification factor for inpatient utilization. Both models demonstrated good predictive performance, with similar values of the area under the ROC curve.

Logistic regression and CHAID decision tree can complementarily analyze the influencing mechanisms of health service utilization. Policies should focus on middle-aged and elderly people with poor self-assessed health, chronic disease comorbidity, IADL impairment, and high age, and establish a medical service guarantee mechanism for the elderly in the event of a public health emergency.

To evaluate the textual quality of China’s provincial public health emergency response plans from a central-local comparative perspective, to analyze the differences in plan quality across regions, and to provide empirical evidence for plan revision.

An evaluation framework integrating feature words, text similarity, and the PMC index was constructed to assess the textual quality of the national and provincial public health emergency response plans.

A total of 28 plans were included. The high-frequency feature words reflected the main structural framework of the plans, with terms such as “Party Committee”, “Command Headquarters”, and “Joint Prevention and Control” appearing frequently. With the national plan as the benchmark, the similarity of provincial plans was classified into high, medium, and low levels. The overall PMC index of the plans was 5.99, with scores ranging from 2.56 to 8.35. The results of text similarity and the PMC index were mutually validated.

China’s concept for compiling health emergency plans has been upgraded. Plan contents differ in their emphasis on completeness versus local characteristics. Text similarity reflects the balance between “normativity” and “autonomy” in provincial plans, which extends the understanding of inter-governmental differences in plan textual quality and offers a new perspective for understanding such differences. Provincial plans should remain consistent with the national framework while incorporating localized interpretations based on local conditions, so as to effectively guide regional health emergency practices.

To analyze the spatiotemporal distribution and equity evolution of psychiatric health resources and service levels in China from 2014 to 2023.

Equity was measured using the Gini coefficient and Lorenz curve, the sources of inequality were decomposed by the Theil index, and spatial clustering characteristics were analyzed via global and local Moran I.

From 2014 to 2023, the compound annual growth rates for psychiatric beds, outpatient and emergency visits, and discharges were 13.86%, 9.17%, and 11.67%, respectively. The Gini coefficient for outpatient and emergency visits based on population decreased from 0.332 to 0.198, indicating continuous improvement, while all indicators based on geographical area remained above 0.65. Theil index decomposition showed that population-based inequality was mainly driven by intra-regional differences, whereas geography-based inequality was dominated by inter-regional disparities. Spatial analysis revealed significant positive autocorrelation for beds and outpatient/emergency visits, with high-high clusters in the Yangtze River Delta and persistent low-low clusters in northwestern China.

Over the past decade, China has experienced rapid growth in psychiatric resources and significant improvement in population-based equity, yet geographical accessibility remains weak. Future policies should balance population needs with geographical reach, narrowing inter-regional gaps and addressing intra-regional imbalances through regional collaboration and telemedicine.

To investigate the interaction between leisure-time physical activity (LTPA) and sex on sleep quality among rural older adults in Chengdu.

Observational analysis was conducted based on data from a cluster randomized controlled trial. The Physical Activity Scale for the Elderly (PASE) was used to assess the level of LTPA; a higher PASE score indicates a higher level of LTPA. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality; a higher PSQI score indicates poorer sleep quality. A linear mixed model was used to analyze the interaction between LTPA and sex on sleep quality, and stratified and joint analyses were further conducted.

A total of 511 participants were included in this study, with a mean age of 70.94 years, of whom 284 were female. The interaction between LTPA and sex on sleep quality was significant (P=0.001). Stratified by LTPA level, female PSQI scores were significantly higher than those of males in the low, relatively low, and relatively high LTPA groups (low level: β=2.66, P=0.003; relatively low level: β=2.78, P<0.001; relatively high level: β=1.51, P=0.006). Stratified by sex, only in females did the relatively high and high LTPA groups have significantly lower PSQI scores compared with the low LTPA group (relatively high level: β=-0.61, P=0.050; high level: β=-0.98, P=0.003). Joint analysis showed that using the "low LTPA level + female" group as the reference, males had significantly lower PSQI scores than the reference group across all LTPA levels (all P<0.001), whereas females had significantly lower PSQI scores than the reference group only in the relatively high and high LTPA groups (relatively high level: β=-0.65, P=0.021; high level: β=-1.01, P<0.001).

There is a significant interaction between LTPA and sex on sleep quality among rural older adults in Chengdu. It is suggested that future sleep intervention programs should be tailored according to sex and LTPA level.

To investigate the prevalence characteristics of motor-cognitive risk syndrome (MCR) among community-dwelling elderly aged ≥65 and analyze its related factors, providing evidence forMCR early prevention and intervention.

A total of 5 659 community-dwelling elderly aged ≥65 years were selected from the HMACS cohort. MCR was assessed through questionnaires, physical examinations, and neuropsychological evaluations. The epidemiological characteristics were described, and multivariate logistic regression analysis was conducted to identify influencing factors, with stratified analysis by sex and age.

Among the 5 659 older adults, 719 were diagnosed with MCR, with a crude prevalence rate of 12.71%. After standardization based on the data of the 7th National Population Census in 2020, the total standardized prevalence rate was 18.52%. The prevalence rate of MCR increased with age, which was higher in females (14.13%) than in males (11.32%), and higher in rural areas (30.17%) than in urban areas (6.72%). After adjusting for confounding factors,multivariate logistic regression analysis showed that medium SES (OR=0.371, 95%CI: 0.289-0.474), high SES (OR=0.361, 95%CI: 0.279-0.464), close neighborhood relationships (OR=0.648, 95%CI: 0.538-0.780), a balanced diet (OR=0.709, 95%CI: 0.569-0.887), and intellectual activities (OR=0.671, 95%CI: 0.551-0.817) were associated with a lower prevalence of MCR. Advanced age, female gender, living alone, and cardiometabolic comorbidities were associated with a higher prevalence of MCR (P<0.05). Stratified analysis showed that cardiovascular metabolic comorbidities were only associated with a high MCR prevalence in men (OR=1.523, 95%CI: 1.167-1.987), while living alone was only associated with a high MCR prevalence in women (OR=1.515, 95%CI: 1.085-2.059).

This cross-sectional study shows that the prevalence of MCR among community-dwelling elderly aged 65 and above is relatively high. Its occurrence is independently associated with various social, lifestyle, and health factors, and exhibits significant differences across gender and age strata. Therefore, early screening should be conducted for high-risk populations, and comprehensive interventions should be implemented to slow the progression of MCR and maintain the physical and mental health of the elderly.

To investigate the mediating role of health-promoting behaviors in the relationship between eHealth literacy and depressive symptoms among university freshmen，and to provide a reference for the early prevention of depressive symptoms in this adolescent group undergoing a transitional phase.

A multistage cluster random sampling method was employed to survey 2 382 first-year undergraduate students from three public full-time universities in Guiyang, Guizhou Province. The General Information Questionnaire, the eHealth Literacy Scale, the Health-Promoting Lifestyle Profile II-Revised Scale, and the Patient Health Questionnaire-9 were used to conduct a questionnaire survey. SPSS 27.0 was used for descriptive statistics and correlation analyses, while PROCESS 4.1 was applied for mediation effect analysis.

eHealth literacy among university freshmen in Guiyang City showed a positive correlation with health-promoting behaviors and a negative correlation with depressive symptoms (r=0.480, -0.361,P<0.001), while health-promoting behaviors were negatively correlated with depressive symptoms (r=-0.416,P<0.001). The link between eHealth literacy and depressive symptoms was partly mediated by health-promoting behaviors (β=-0.145,P<0.001), explaining 53.14% of the total effect.

Health-promoting behaviors partially mediated the relationship between eHealth literacy and depressive symptoms among university freshmen, supplying a reference basis for implementing early prevention of depressive symptoms in this demographic.

To analyze the changing trends in gonorrhea incidence in China from 2005 to 2024, evaluate the influence of age, period, and birth cohort factors, and provide a basis for the development of gonorrhea prevention and control strategies.

Gonorrhea incidence data from 2005 to 2025 were extracted from the China Public Health Science Data Center and the China Health Statistical Yearbook. A Joinpoint regression model was used to calculate the annual percentage change (APC) and the average annual percentage change (AAPC) to describe the incidence trends. An age-period-cohort model was constructed to evaluate the effects of age, period, and birth cohort on the incidence rate.

From 2005 to 2024, the overall incidence rate of gonorrhea in China showed a declining trend (AAPC=-3.47%, P<0.001). The age effect followed an “S-shaped” curve, with an increasing trend in the 15-29-year age group and decreasing trends in the 0 to 14-year and 30-84-year age groups. The period effect decreased over the years. The cohort effect generally showed an “M-shaped” decline, with an increasing trend from 1925-1929, a fluctuating decline from 1930-1994, a rapid increase from 1995—2009 reaching a peak, and a rapid decline from 2010-2020.

The overall incidence rate of gonorrhea in China is declining. Attention should be focused on high-incidence areas such as the Zhejiang Province and Yunnan Province, as well as key populations in the 15-34-year age group. Health education on gonorrhea prevention and control should be strengthened, and active screening in high-risk areas and among key populations should be promoted to achieve early diagnosis and early treatment.

To investigate the epidemiological characteristics, disease burden, and risk factors for severe tetanus in non-neonatal patients in Suzhou, Jiangsu Province.

A retrospective study was conducted on 72 tetanus inpatients admitted to medical institutions in Suzhou, 2013-2025. Patients were divided into severe and non-severe groups according to the Ablett classification. Intergroup comparisons and multivariate logistic regression analysis were performed.

The median age of patients was 59.0 years, with males accounting for 65.3%. The peak incidence occurred in summer (June-August), accounting for 36.1% of cases. The proportion of severe cases in patients aged ≥65 years (72.4%) was higher than that in the 0-40 years group(22.2%) and the 41-64 years group (44.1%) (P=0.011). The median incubation period in the severe group was 8.0 days, shorter than 11.0 days in the non-severe group, and the median total hospitalization cost (￥125 641.5) was 5.42 times that of the non-severe group (P=0.007). Multivariate logistic regression showed that age ≥65 years (OR=3.10, 95%CI: 1.05-9.65) was an independent risk factor for severe tetanus.

Non-neonatal tetanus in Suzhou peaks in summer, predominantly affects the elderly, and severe cases have shorter incubation periods and higher treatment costs. Enhanced health education and immunization targeting the elderly are needed to reduce their risk of severe disease and death.

To analyze the changes in the disease burden of lower respiratory tract infections (LRIs) in China from 1990 to 2023 and predict future trends.

Based on the Global Burden of Disease Study 2023, the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life year (DALYs) rate (ASDR) of LRIs in China from 1990 to 2023 were described; the Joinpoint model was used to analyze the temporal trend; the age-period-cohort (APC) model was applied to decompose age, period and cohort effects; the R programming was performed to analyze the correlation with the Socio-demographic Index (SDI), the changing characteristics of pathogens, and the trend over the next 12 years.

From 1990 to 2023, the ASIR, ASMR and ASDR of LRIs in China decreased significantly (EAPC: -3.46%, -6.42%, and -9.29%, respectively,P<0.001). Joinpoint analysis indicated that affected by non-pharmaceutical interventions during the COVID-19 pandemic, ASIR reached a trough in 2020, while ASMR and ASDR bottomed out in 2021, followed by a rebound. APC results indicated that the net drift values for ASIR, ASMR, and ASDR of -2.16%, -4.94%, and -4.93%, respectively (P<0.05), driven by the combined effects of age, period, and cohort. The disease burden of all age groups decreased significantly, but the age group with the heaviest disease burden changed from <5 age group to ≥70 age group. The trend of ASDR attributed to various pathogens was consistent with the overall trend. Bacteria were the main pathogens, among which Streptococcus pneumoniae was dominant. Projections indicate that by 2035, the ASIR, ASMR, and ASDR of LRIs in China would decrease to 1 282.49, 6.30, and 91.24 per 100 000 population, respectively.

From 1990 to 2023, the disease burden of LRIs and pathogen-related burden in China decreased significantly. Although the burden will continue to decline over the next 12 years, bacterial infections and the elderly population remain the long-term priorities for prevention and control.

To analyze the independent risk factors for early postoperative recurrence in patients with primary liver cancer under the one-stop integrated management mode from hepatopathy to liver cancer, and to provide basis for optimizing clinical diagnosis, treatment, and integrated management strategies.

From June 2023 to October 2023, 184 patients with primary liver cancer who treated in West China Hospital of Sichuan University and enrolled in the one-stop integrated management mode. All patients were followed up for 2 years after operation, and their early recurrence status was analyzed. The Kaplan-Meier survival analysis was used to estimate recurrence-free survival time and recurrence-free survival rates, with the Log-rank test employed for comparison. To identify independent risk factors, Cox proportional hazards regression was performed.

The early recurrence rate was 40.76% among the 184 patients. Cox proportional hazards regression model analysis revealed that preoperative living alone for nearly one year (HR=3.661, 95%CI: 1.475-9.089), total hepatic portal occlusion time exceeding 15 minutes (HR=1.874, 95%CI: 1.047 -3.354), and positive microvascular invasion (HR=1.787, 95%CI: 1.011-3.158) were independent risk factors for early postoperative recurrence in patients with primary liver cancer.

Preoperative living alone for nearly one year, a total hepatic portal occlusion time exceeding 15 minutes, and positive microvascular invasion are independent risk factors for early postoperative recurrence in patients with primary liver cancer. Future integrated management from hepatopathy to liver cancer should prioritize these factors, implementing risk stratification and intensified management strategies to improve patient prognosis.

To systematically compare the relative effects of different exercise interventions on grip strength, timed up and go test (TUGT), balance function, and skeletal muscle mass in older adults with sarcopenia and frailty.

PubMed, Embase, Cochrane Library, Web of Science, CINAHL, CNKI, Wanfang Data, and VIP Database were searched from inception to January 17, 2026 for randomized controlled trials. A random-effects network meta-analysis was conducted to estimate standardized mean differences (SMDs) and 95% confidence intervals (95%CIs).

Nineteen randomized controlled trials were included (18 entered the network meta-analysis), involving 1 838 participants. For grip strength, active resistance/strength-endurance training showed the greatest benefit ［SMD=1.18, 95%CI (0.75 to 1.61)］, followed by mixed intensive training; Yijinjing and Baduanjin were superior to education/attention control. After TUGT stratification, some single and mixed interventions showed statistically significant effects, but the confidence intervals were wide. No stable evidence of superiority was observed for balance function or skeletal muscle mass.

The effects of different exercise interventions were outcome-specific. Current evidence supports active resistance/strength-endurance training for improving grip strength. For TUGT, some single or mixed interventions may confer benefit, but these findings should be interpreted only within their respective subnetworks. Stable evidence is still lacking for balance function and skeletal muscle mass.

To systematically evaluate the prevalence and influencing factors of cognitive impairment among people living with HIV (PLWH) in China.

We searched Chinese and English databases for studies on cognitive impairment among Chinese PLWH, from inception to August 2025. Meta-analysis was performed using Stata 18.0.

A total of 27 studies involving 11 076 PLWH were included. The meta-analysis showed that the pooled prevalence of cognitive impairment (including screening-positive cases) in Chinese PLWH was 42.3%, with extremely high heterogeneity (I²=99.4%). The pooled estimate should be interpreted as an approximate range rather than an exact value. Subgroup analysis revealed significant differences across assessment tools, gender, age and education level (P<0.05), and residual heterogeneity remained high, suggesting unmeasured confounding factors. College or above education was a protective factor, while comorbid depression and efavirenz-containing regimens were risk factors.

Given the limitations of high heterogeneity and inconsistent assessment tools, cognitive impairment remains prevalent among Chinese PLWH. Strengthened screening and comprehensive management for high-risk groups are needed to reduce adverse prognostic impacts.