To establish a method for the determination of 18 phthalates (PAEs) metabolites in urine by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) based on solid-phase support liquid-liquid extraction (SLE) technology.

Urine sample spiked with internal standards was first hydrolyzed by enzyme, then purified on a SLE column. The separation was performed on a BEH C18 column. The detection was performed in multi-reaction monitoring scan under negative mode. Internal standard method was applied for quantitative analysis.

The 18 PAEs metabolites showed good linear relationships in the range of 0.10-80 ng/ml (r>0.999). The average recoveries of 18 PAEs metabolites ranged from 84.0%-113.0% with relative standard deviations between 1.1% and 9.5%. The limits of detection and quantitation of the method were 0.001-0.07ng/ml and 0.002-0.2 ng/ml, respectively. The intra-day and the inter-day precisions were 1.3%-7.0% and 1.0%-8.1%, respectively. 160 urine samples were analyzed with this method. Except for 3 PAEs metabolites that were not detected, the detection rates of the remaining 15 PAEs metabolites ranged from 1.9% to 100%, and the detection rates of 8 PAEs metabolites were 100%. Among them, mono-n-butyl phthalate had the highest concentrations with a median concentration of 126 ng/ml.

This method is simple, sensitive, and accurate, and it is suitable for the determination of 18 PAEs metabolites in large batchs of urine samples.

To explore the effects and mechanisms between chronic pain and depression in middle-aged and older adults in China, and to provide reference for promoting pain management and improving interventions.

13,253 middle-aged and older adults from the fifth issue of the China Health and Retirement Longitudinal Study (CHARLS) were included. Propensity score matching method, logit model, OLS regression and Bootstrap mediation test were used to explain the mediating effects of subjective life expectancy (SLE), sleep duration and Internet use between chronic pain and depression and the moderating role of social participation.

The overall effect size of chronic pain on depression was 0.876 (95%CI=0.781-0.972), with a direct effect of 0.745 (95%CI=0.668-0.822), accounting for 85.05%, and an indirect effect of 0.131 (95%CI=0.094-0.169), accounting for 14.95%. The mediating effects of SLE, sleep duration, and Internet use were 0.087 (95%CI=0.071-0.103), 0.093 (95%CI=0.066-0.121), and -0.049 (95%CI=-0.085--0.013), representing 9.93%, 10.62%, and -5.60% of the total effect respectively. Social participation negatively moderated the relationship between chronic pain and depression（β=-0.095，95%CI=-0.186--0.004）.

Chronic pain not only directly exacerbates depression in middle-aged and older adults but also indirectly worsens depression through SLE and sleep duration. However, Internet use and social participation can have compensatory and alleviating effects. It is recommended that physical and psychological therapies be emphasized and applied simultaneously, with special attention given to key populations such as women, rural dwellers, and chronic patients. Additionally, “Internet plus healthcare” and grassroots communities should be utilized to enhance pain management and intervention for middle-aged and older adults.

To investigate the association between biological aging and cognitive function in middle-aged and elderly Chinese.

The subjects were health check-up personnel over 45 years old from a top three hospital. The general demographic characteristics, covariates and cognitive function status were collected by questionnaire and Montreal cognitive assessment (MoCA). Multivariate linear regression and logistic regression were used to analyze biological aging index (BAI) and biological aging type (BAT) association with MoCA score and risk of mild cognitive impairment (MCI). Subgroup analysis was conducted by the middle-aged group (45-64 years old) and the elderly group (65 years old and above) to explore whether the correlation between biological aging and cognitive function was different in different age groups.

A total of 407 participants were included in this study. The average MoCA score was 23.30±4.30, and the detection rate of MCI was 41.5%. BAI was negatively correlated with MoCA score, and the regression coefficient after adjusting for covariates was -0.135 (95%CI: -0.229--0.042). Compared with those with delayed aging, subjects with premature aging had lower cognitive function scores (β=-0.882，95%CI：-1.566--0.198) and a higher risk of MCI (OR=1.736，95%CI：1.072-2.833). Subgroup analysis found that the association was still present in the middle-aged group, but not in the elderly group.

There is a negative correlation between biological aging and cognitive function in middle-aged and elderly people, and the cognitive function of subjects with premature aging is worse. This effect is more significant in middle-aged group, suggesting that individuals with premature aging should be identified in middle age or even earlier and that intervention measures should be taken to prevent or delay the occurrence of dementia.

To understand the various metal elements content and distribution in crayfish sold in Deyang, and to initial determine the harm of hazardous metallic elements to residents in Deyang.

A total of 102 samples were collected in Deyang using a stratified random sampling approach, the samples was digested by microwave digestion,17 mineral elements and 7 harmful metal elements were detected using inductively coupled plasma optical emission spectroscopy (ICP-OES) and inductively coupled plasma mass spectrometry(ICP-MS).

Mineral elements in all parts of the crayfish were detected and the content varies, in terms of total minerals, crayfish brain> crayfish intestine> crayfish gills> crayfish meat> crayfish hepatopancreas. For harmful metals, there was no exceedance in crayfish meat, As, Cu, Cd in crayfish hepatopancreas exceeded the standard rate of 97.0%, 2.97%, 27.7%, Hg, Pb, Cr did not exceed the standard, As, Cu, Pb, Cr and Al were all exceeded the standard in the non-edible parts by 2.17% to 100%. The enrichment pattern of all metal elements in crayfish in Deyang and Hubei was consistent, but the contents varied. In different sampling sessions, none of the harmful metal elements in crayfish meat exceeded the standard; As, Cu, Cd in crayfish hepatopancreas exceeded the standard rate of 2.8%-97%, and the rest of the elements did not exceed the standard. In different growth stages, except for As, there was no significant difference in the accumulation of hazardous metal elements between green and red crayfish.

Crayfish have a high mineral content and abundant nutrients, and local residents in Deyang City have a lower risk of heavy metal hazards in their daily intake of crayfish.

To explore the causal relationship between obstructive sleep apnea and atherosclerosis which is not clear through Mendelian randomization.

Genome-wide associations of different subtypes of obstructive sleep apnea and atherosclerosis were selected from the data published on the IEU Open GWAS (https://gwas.mrcieu.ac.uk/) website. Inverse variance weighting method (IVW), MR-Egger regression, simple model, weighted model and weighted median method were used to determine the causal correlation between them. A variety of sensitivity analysis and calculating F values were used to verify the accuracy of the results.

Five single nucleotide polymorphisms (Single nucleotide polymorphism, SNP) strongly associated with obstructive sleep apnea were included in the study, and the F values were all greater than 10. The results of IVW method showed that coronary atherosclerosis (OR:1.321,95%CI:1.150-1.518,P=8.3×10^-5) had significant statistical significance, while cerebral atherosclerosis(OR:0.331,95%CI:0.071-1.536,P=0.158) and peripheral atherosclerosis (OR:1.204,95%CI:0.962-1.508,P=0.106) had no statistical significance. The results of heterogeneity test, horizontal multiplicity analysis, sensitivity analysis and MR-PRESSO analysis made the causal relationship of Mendelian randomized analysis more reliable.

There is a causal correlation between obstructive sleep apnea and coronary atherosclerosis, and there is a positive correlation between obstructive sleep apnea and coronary atherosclerosis; there is no causal relationship between obstructive sleep apnea and cerebral atherosclerosis and peripheral atherosclerosis; reverse MR analysis found no causal correlation between selected atherosclerosis and obstructive sleep apnea.

To study the risk factors for health-related quality of life (HRQoL) changes in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) under different multimorbidity patterns.

AECOPD patients in five hospitals in Shanxi Province were selected from September 2021 to September 2023, and 214 patients were finally included. The minimal clinically important differences(MCID) of St George’s Respiratory Questionnaire (SGRQ) was combined to assess the HRQoL of the patients. This study started from multimorbidity (refer to ICD-10), multimorbidity patterns stratification was performed based on latent class analysis (LCA), and then ordered logistic regression analysis was used to analyze the risk factors affecting the change of SGRQ score at 3 months after discharge of patients with different multimorbidity patterns.

Patients were divided into “cardiovascular disease group” and “cor pulmonale low burden group” through potential category analysis. Ordered logistic regression results showed that at 3 months after discharge, the probability of clinically significant increased in SGRQ in patients with high BMI (OR=2.96, 95%CI: 1.09-8.34, P=0.035) and patients with high direct bilirubin (OR=2.96, 95%CI: 1.07-8.35, P=0.037) in the cardiovascular disease group were 2.96 times higher than that of normal patients; the probability of clinically significant increased in SGRQ in patients with high direct bilirubin (OR=3.25, 95% CI:1.35-7.97, P=0.009) and patients with low oxygen saturation (OR=2.35, 95%CI:1.05-5.55, P=0.043) in the cor pulmonale low burden group were 3.25 and 2.35 times higher than those of normal patients (P<0.05).

The prognostic risk factors of AECOPD patients with different multimorbidity patterns are different, and regardless of the multimorbidity patterns, high direct bilirubin is an independent risk factor for HRQoL changes in patients with AECOPD. Moreover clinicians should closely detect in the the abnormal changes in BMI in AECOPD patients with cardiovascular disease.

To explore the incidence, time of occurrence and influencing factors of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in stable chronic obstructive pulmonary disease (COPD) patients within one year.

Retrospectively collected information on COPD case home page visits in Yunnan Province from 2016 to 2022, establishing a longitudinal observation cohort based on patients’ names and ID numbers. The incidence rate, time of occurrence and average number of AECOPD within one year of COPD were calculated, and the relationship between patients’ exposure factors and the number of AECOPD within one year was analyzed by using multivariate linear regression, and the exposure factors affecting AECOPD within one year of COPD patients were analyzed by using Cox regression.

The mean age of 405 428 COPD patients was（70.75±10.95）years, the mean number of comorbidities was 1.14±1.15, the incidence of AECOPD within one year was 17.55%, the mean duration of occurrence was（4.58±3.64）months, and the mean number of AECOPD per patient was 0.27. The regression results showed that gender (HR=1.473, 95%CI: 1.446-1.500), age (HR=1.011, 95%CI: 1.010-1.012), number of comorbidities (HR=1.083, 95%CI: 1.076-1.090), medical insurance type (HR=1.481, 95%CI: 1.394-1.574), and admission season (HR=1.115, 95%CI: 1.090-1.140) were the influencing factors for acute exacerbation in patients with COPD within one year.

The incidence of AECOPD in COPD patients in Yunnan Province within one year is 17.55%. We should start from various risk factors and focus on male, elderly, patients with multiple comorbidities, those admitted in spring and winter seasons, and non-resident medical insurance patients. Take corresponding preventive measures and strengthen the management of AECOPD.

To comprehensively understand the incidence of metabolic syndrome (MS) and its potential risk elements in middle-aged and elderly people in Tibet, and to provide a scientific and reliable reference for the development and implementation of precise prevention and control strategies for MS in Tibet.

Between June 2021 and December 2022, 6 286 middle-aged and elderly people were strictly screened in Tibet by multi-stage stratified cluster random sampling. The data were organized and analyzed by using SPSS27.0 software, and the differences in MS prevalence among different groups were compared by using the chi-square test and the trend chi-square test, and further analyses of the factors affecting the prevalence of MS were conducted using logistics regression.

Among 6 286 middle-aged and elderly participants, a total of 1 409 patients were screened, with an overall prevalence of metabolic syndrome of 22.41%, the older the age, the higher the prevalence of MS (χ² = 49.694, P < 0.001); the prevalence of MS in men was 27.8%, higher than that in women, which was 18.21%, with a statistically significant difference (P < 0.001). Multifactorial unconditional logistic regression analysis revealed that the main risk factors for the prevalence of MS were advanced age (OR=2.053, 95% CI: 1.545-2.728) for those aged 70 years and above, a family history of hypertension (OR=2.691, 95% CI: 2.293-3.158), a family history of diabetes (OR=4.480, 95% CI: 2.066-9.716) and a body mass index (BMI)≥24.0 kg/m² (OR=14.148, 95%CI: 11.778-16.995), however, female (OR=0.508, 95%CI: 0.443-0.584) and alcohol consumption (OR=0.628, 95%CI: 0.487-0.812) were protective factors for the development of MS. In addition, among the various combinations of abnormal components of MS, the aggregation pattern of “abnormal glucose + abnormal blood pressure +central obesity” was the most prevalent, involving a total of 340 cases, with a prevalence rate of 5.41%.

The prevalence of MS in middle-aged and elderly people in Tibet is at a high level, in which males, elderly people, people with a family history of hypertension or diabetes, and overweight or obese people should be regarded as the priority targets for MS prevention and control. This study provides a basic reference for the prevention and control of MS in Tibet, so that precise prevention and control measures can be taken according to the high-risk groups.

To explore the construction of the training system for preventive medical professionals and train high-level public health talents.

West China School of Public Health, Sichuan University, has deeply promoted the reform of talent education and teaching for undergraduate students in preventive medicine, exploring from aspects such as training objectives, curriculum and teaching material systems, practical ability training, and the cultivation of medical prevention integration capabilities. We have reconstructed the talent cultivation program, innovated the talent cultivation mode, and explored the new paradigm of cultivating top-notch and innovative talents for the preventive medicine specialty.

We have revised and completed the general training plan for public health and preventive medicine, constructed a modernized curriculum system of preventive medicine, strengthened the development and application of digital education, actively explored the in-depth cooperation with practice teaching bases, and taken the lead in the country in launching the innovative class of hospital infection management, the dual bachelor’s degree of preventive medicine and software engineering, and the micro-specialty of health insurance.

Under the strategic background of Healthy China, professional education of preventive medicine is the key path for the cultivation of public health talents in China. Colleges and universities should actively explore the innovation and development of the cultivation of preventive medicine professional talents, so as to contribute to the construction of Healthy China in the new era.

To investigate the causal relationship between four lipid parameters—triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)—and uterine leiomyoma (UL) using a two-sample Mendelian randomization (MR) analysis approach.

Genome-wide association study (GWAS) data for UL and the four lipid parameters were obtained from the IEU open GWAS database. Single nucleotide polymorphisms (SNPs) strongly associated with the lipid parameters were selected as instrumental variables. Two-sample MR analyses were conducted using methods such as inverse variance weighted (IVW) analysis. Subsequently, reverse MR analysis was performed to assess whether there was a reverse causal relationship between the lipid parameters and UL.

The IVW method indicated a negative correlation between TG and the risk of UL (OR=0.996, 95%CI: 0.994-0.998, P<0.001) and a positive correlation between HDL-C and the risk of UL (OR=1.002, 95%CI: 1.000-1.003, P=0.012). No correlation was found between TC or LDL-C and the incidence of UL (P>0.05). Reverse MR analysis did not reveal any reverse causal relationship between the lipid parameters and UL (P>0.05). No horizontal pleiotropy was detected in the above studies (P>0.05).

The level of TG in the body is negatively correlated with the incidence of UL, while the level of HDL-C is positively correlated with the incidence of UL. There is no reverse causal relationship between the four lipid parameters and UL.