To analyze the characteristics of infectious disease outbreaks reported in Gansu Province from 2004 to 2023 in the “Public Health Emergency Management Information System” providing a basis for effective prevention and control of infectious disease outbreaks in the province.

A descriptive analysis was conducted on infectious disease outbreaks reported in Gansu Province from 2004 to 2023, utilizing ArcGIS 10.5 and GeoDa 1.6 software to explore hotspot areas.

From 2004 to 2023, Gansu Province reported a total of 1 184 infectious disease outbreaks, with a total of 46 352 reported cases and an affected population of 2 616 380, resulting in an incidence rate of 1.77%. A total of 69 deaths were reported, yielding a case fatality rate of 0.15%. General-level events accounted for 1 173 cases (99.07%), while larger-scale events accounted for 11 cases (0.93%). The majority of reported events were caused by Category B infectious diseases, totaling 729 cases (61.57%). The top three reported diseases were chickenpox, mumps, and hand, foot, and mouth disease. Reports peaked in April to June and October to December, accounting for 49.9% and 38.3% of annual reports, respectively. Lanzhou city had the highest number of reported events at 339 (28.63%), with hotspot areas concentrated in Gaolan County, Yuzhong County, and Anning District. Outbreaks primarily occurred in primary schools (593 cases, 50.08%) and childcare institutions (179 cases, 15.12%).

From 2004 to 2023, the primary infectious disease outbreaks in Gansu Province were chickenpox, mumps, and hand, foot, and mouth disease, with peaks in April to June and October to December. It is essential to strengthen infectious disease prevention and control in hotspot areas, particularly in primary schools and childcare institutions.

To construct a risk prediction model for short-term poor prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and to explore the influencing factors of poor short-term prognosis in these patients, providing a basis for early prediction and intervention.

AECOPD patients admitted to the Department of Respiratory Medicine at Cangzhou People’s Hospital in Hebei Province from October 2020 to September 2021 were selected as the study subjects. After 90 days, patients were divided into case group (n=167) and control group (n=250) based on prognosis outcomes. Patient demographics, disease conditions, the Modified Medical Research Council (mMRC) dyspnea scale, and the COPD Assessment Test (CAT) were collected at different time points. Binary logistic regression was used for factor analysis, and a nomogram prediction model was established. The diagnostic efficacy and calibration of the nomogram model were evaluated using ROC curves and calibration curves, while DCA was used to assess clinical utility.

Multivariate analysis indicated that marital status (OR=2.111, 95%CI:1.076-4.141), severity of illness (OR=5.322, 95%CI: 2.908-9.740), history of frequent acute exacerbations (OR=8.217, 95%CI:4.569-14.778), nutritional risk (OR=2.463, 95%CI: 1.141-5.319), and PCT (OR=2.039, 95%CI: 1.116-3.727) were independent risk factors for poor short-term prognosis in AECOPD patients. The nomogram prediction model had an AUC of 0.894 (95%CI: 0.868-0.929), and the calibration curve demonstrated good consistency between predicted probabilities and actual outcomes, indicating high predictive accuracy.

The nomogram model can accurately identify the risk of poor short-term prognosis in AECOPD patients, providing a theoretical basis for personalized clinical management of AECOPD patients.

To explore the impact of the COVID -19 pandemic and the prevention and control measures on the epidemic trend of hand, foot, and mouth disease in Bao’an District, Shenzhen.

Based on the incidence data of hand, foot, and mouth disease in Bao’an District, Shenzhen from 2014 to 2019 (pre-pandemic) and from 2020 to 2022 (pandemic and “Class A Infectious Disease Management for Class B Infectious Diseases” period), counterfactual models were established respectively using the seasonal autoregressive integrated moving average (SARIMA) model to predict the incidence of hand, foot, and mouth disease in 2020 to 2023 and 2023 (continuous epidemic and “Class B Infectious Disease Management” stage), followed by comparison with the actual incidence.

Compared with the predicted results, the actual incidence scale of hand, foot, and mouth disease from 2020 to 2022 decreased by 45.29% to 85.71%, and the characteristics of time distribution changed. The incidence of hand, foot, and mouth disease rebounded rapidly in 2023, and the annual incidence scale increased by 125.73% compared with the predicted value based on the “Class A Infectious Disease Management for Class B Infectious Diseases” period, but was lower than the predicted value based on the data before the COVID-19 pandemic.

The COVID-19 pandemic and prevention and control measures significantly affected the epidemic trend of hand, foot, and mouth disease in Bao’an District, Shenzhen, reducing the incidence in the short term, but the lack of immune stimulation in the long term may lead to an increase in the incidence. It is recommended to continuously monitor the epidemic trend of hand, foot, and mouth disease, and especially strengthen vaccination when prevention and control measures are relaxed to protect public health.

To investigate the association between anxiety disorders and the risk of developing non-alcoholic fatty liver disease (NAFLD) in Caucasians.

This study was a prospective cohort study based on the UK Biobank database.Individuals who were not Caucasian, had missing racial information, had liver disease at baseline, had alcohol/drug use disorders or missing relevant diagnosis dates, or developed NAFLD within two years of follow-up were excluded, resulting in a total of 465 621 participants for analysis. The baseline survey conducted from 2006 to 2010 served as the starting point for follow-up, with NAFLD incidence, loss to follow-up, death, or end of follow-up as the endpoints. A multivariable Cox proportional hazards regression model was used to explore the association between anxiety disorders and the risk of developing NAFLD.

The participants accumulated 6 058 222 person-years of follow-up, with a median follow-up time of 13.50 years. There were 5 184 cases of NAFLD, with an incidence density of 8.56 cases per 10 000 person-years. After adjusting for covariates, the risk of developing NAFLD in individuals with anxiety disorders was increased by 0.75 times compared to those without anxiety disorders (HR=1.75, 95%CI: 1.32-2.32).

Anxiety disorders are associated with an increased risk of developing NAFLD in Caucasians, highlighting the need for enhanced clinical monitoring and prevention of NAFLD in patients with anxiety disorders.

To investigate the impact of different levels of cardiorespiratory fitness on the occurrence of stroke.

This study was based on the Kailun cohort study, which included a total of 37 547 participants, followed up until December 31, 2019.Cardiorespiratory fitness (Estimated cardiorespiratory fitness, eCRF) was estimated using a non-exercise algorithm, and the average eCRF values from measurements taken in 2006, 2008, and 2010 were calculated, standardized, and grouped according to gender-specific tertiles. Cox regression models were employed to explore the relationship between varying levels of eCRF and the incidence of stroke and its subtypes.

During a median follow-up of 9.05 (8.67, 9.33) years, a total of 2 100 cases of stroke (5.59%) were observed, including 1 899 (5.06%) ischemic strokes and 226 (0.60%) hemorrhagic strokes. After adjusting for confounding factors, compared to the low average eCRF group, the high eCRF group exhibited a 28% reduction in stroke risk (HR=0.72, 95%CI: 0.62-0.82), a 23% reduction in ischemic stroke risk (HR=0.77, 95%CI: 0.67-0.89), and a 40% reduction in hemorrhagic stroke risk (HR=0.60, 95%CI: 0.39-0.91).

Higher levels of cardiorespiratory fitness can reduce the risk of stroke and its subtypes.

To analyze the impact of temperature on stroke mortality among residents in Wuhan city.

Stroke mortality data, meteorological data, and environmental monitoring data from 2014 to 2019 in Wuhan were collected. A distributed lag nonlinear model (DLNM) was used to assess the impact of temperature on stroke mortality. Stratified analyses were conducted based on gender and age to identify vulnerable populations.

The temperature-stroke mortality relationship in Wuhan exhibited an inverted “J” shape. High temperatures (P_97.5=32 °C) had the strongest immediate effect on stroke mortality on the same day, with the cumulative effect peaking on the 14^th day (relative risk [RR]=1.410, 95%CI: 1.219-1.630 compared to the minimum mortality temperature [MMT]). Low temperatures (P_2.5=1 °C) showed a delayed effect, beginning on the second day after exposure and reaching the maximum cumulative effect on the 21^st day (RR=1.553, 95%CI:1.161-2.079). Stratified analysis revealed that the cumulative effect of low temperatures on stroke mortality was the highest on the 21^st day for males (RR=1.786, 95%CI: 1.195-2.670), on the 7^th day for individuals aged <65 years (RR=1.607, 95%CI:1.151-2.243), and on the 14^th day for those aged ≥65 years (RR=1.627, 95%CI: 1.251-2.116). For high temperatures, the cumulative effect peaked on the 14^th day for males (RR=1.347, 95%CI: 1.104-1.645), individuals aged <65 years (RR=1.559,95%CI: 1.117-2.176), and those aged ≥65 years (RR=1.401, 95%CI: 1.204-1.631), while for females, it peaked on the 21^st day (RR=1.507, 95%CI: 1.188-1.912).

Both low and high temperatures can increase the risk of stroke mortality. High temperatures exhibit a more acute effect, while low temperatures show significant delayed and cumulative effects. Females andindividuals aged <65 years are at higher risk of stroke mortality under high temperatures, whereas males and those aged ≥65 years are more vulnerable under low temperatures. Protective measures should be strengthened for these high-risk populations.

To explore the causal relationship between six dietary-derived antioxidants and telomere length through a two-sample Mendelian randomization analysis.

The research utilized genome-wide association data concerning vitamin C,vitamin E, vitamin D, carotenoids, retinol, urate, and telomere length. Various sensitivity analyses were conducted using inverse variance weighted (IVW) method, MR-Egger regression, weighted median method, weighted model, MR-lap, and MR-PRESSO. The effectiveness of genetic instruments was assessed using F-statistics, Q-statistics, and the MR-Egger intercept test.

The IVW method indicated a negative correlation between urate levels and telomere length (β_IVW: -0.050; 95%CI: -0.070 to -0.031; P_IVW=4.93×10^-7), a finding supported by the other three sensitivity analyses. Additionally, after removing outlier SNPs using MR-PRESSO, the results remained robust (P=2.28×10^-7). No statistically significant causal effects were observed for the other five dietary-derived antioxidants concerning telomere length.

There exists a causal relationship between serum urate levels and telomere length.

To analyze the incidence and epidemiological characteristics of congenital heart disease (CHD) in perinatal infants in Xinjiang from January 2016 to December 2022.

A retrospective analysis was conducted on the data of perinatal infants diagnosed with congenital heart disease from various birth defect monitoring hospitals between 2016 and 2022.

A total of 591 849 perinatal infants were monitored in Xinjiang, among which 3 531 cases of congenital heart disease were identified, resulting in an overall incidence rate of 59.66 per 100 000. There were statistically significant differences in annual incidence rates (χ²=754.466, P < 0.001), showing a general upward trend (χ²_trend =592.218, P < 0.001). The most common types of congenital heart disease were atrial septal defect (43.72 per 100 000), patent ductus arteriosus (25.53 per 100 000), ventricular septal defect (8.69 per 100 000), atrioventricular septal defect (3.25 per 100 000), and tetralogy of Fallot (0.79 per 100 000). The survival rate of perinatal infants with congenital heart disease showed an upward trend (χ²_trend =11.239, P=0.001).

The overall incidence of congenital heart disease in perinatal infants in Xinjiang is on the rise. It is recommended to further strengthen tertiary prevention measures to reduce the risk of congenital heart disease and improve the prognosis of surviving infants.

To preliminarily evaluate the effects of three online intervention models— “Health Education,”“Subsidy,” and “Relay Vaccination”—on HPV vaccination rates among female adolescents aged 15 to 18 in China, as well as the willingness of guardians to delay vaccination and their confidence in vaccines.

Eight secondary schools in Chengdu and Nanjing were recruited using convenience sampling and divided into three groups: “Health Education” (health education video + postcards), “Subsidy” (financial assistance), and “Relay Vaccination” (health education video + postcards +financial assistance). The study subjects were high school girls aged 15 to 18 who had not yet received the HPV vaccine and one guardian per participant. The primary outcome was the rate of first HPV vaccination among high school girls within one-month post-intervention; secondary outcomes included changes in guardians’ willingness to delay vaccination and their confidence in vaccines before and after the intervention.

A total of 238 pairs of participants were included. Within one-month post-intervention, the vaccination rates were 43.9% for the “Relay Vaccination” group, 43.1% for the “Subsidy” group, and 16.7%for the“Health Education” group. The willingness to delay vaccination significantly decreased in the “Relay Vaccination”group (57.89% vs. 46.49%, P=0.004) and the “Health Education” group (50.00% vs. 33.33%, P=0.001), while there was no significant change in the “Subsidy” group (51.72% vs. 48.28%, P=0.688). Prior to the intervention, guardians in all three groups had high confidence in vaccines, and no statistically significant changes were observed post-intervention (P>0.05).

The “Relay Vaccination” and “Subsidy” groups exhibited superior effects on increasing vaccination rates compared to the“Health Education” group. The health education information included in the intervention strategies helped reduce the willingness to delay vaccination. The study conclusions require further validation with a larger sample size.

To understand the health poverty vulnerability of the elderly in rural areas of Sichuan Province in the post-poverty-alleviation era and analyze its main influencing factors.

From July to August 2022, a multi-stage sampling method was used to conduct a questionnaire survey on 601 rural elderly people in Sichuan. The three-stage generalized least-squares method was used to calculate the health poverty vulnerability index of rural elderly people in Sichuan, and the influencing factors of health poverty vulnerability were explored through multivariate logistic regression.

Among the 601 people, 35 were in a state of health poverty vulnerability (health poverty vulnerability index ≥ 0.29),and the health poverty vulnerability rate was 5.82%. There were statistically significant differences in the health poverty vulnerability rates among the elderly with different genders (OR=3.69, 95%CI: 1.28-10.61), educational levels (OR=0.14,95%CI: 0.05-0.35), proportions of out-of-pocket medical expenses to income (OR=49.10, 95%CI: 15.99-150.91), and living types (taking living alone as the reference, living only with a spouse: OR=0.09, 95%CI: 0.03-0.29; living with children: OR=0.15, 95%CI: 0.05-0.44) (P < 0.05).

The overall health poverty vulnerability of rural elderly people in Sichuan Province in the post-poverty-alleviation era is at a relatively low level. Rural elderly women, those with low educational levels, those with a large proportion of out-of-pocket medical expenses to income, and those living alone are at a higher risk of falling into health poverty in the future and need to be given key attention.