To investigate the diagnostic value of triglyceride-glucose (TyG) index and its combination with waist circumference (TyG-WC), waist-to-height ratio (TyG-WHtR), body mass index (TyG-BMI) and relative fat mass (RFM) index for nonalcoholic fatty liver disease (NAFLD) in perimenopausal women.

A total of 448 perimenopausal women who visited the Guizhou Hospital of Beijing Jishuitan Hospital from March 2022 to November 2024 were selected. They were divided into the NAFLD group (n=61) and the control group (n=387) based on the results of chest or abdominal CT. The data of age, height, weight, waist circumference (WC), systolic blood pressure, diastolic blood pressure, blood routine, blood biochemistry, fasting blood glucose, etc. were collected. The body mass index (BMI), waist-to-height ratio (WHtR), TyG, TyG-WC, TyG-WHtR, TyG-BMI and RFM index were calculated. According to the results of chest or abdominal CT, the women were divided into NAFLD group and control group. The differences of each index between the two groups were compared by independent sample t test or Mann-Whitney U test. The independent risk factors for NAFLD were analyzed by multivariable logistic regression. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of TyG index, its combined indices and RFM index for NAFLD.

There were statistically significant differences (P<0.05) in weight, BMI, WC, WHtR, systolic blood pressure, diastolic blood pressure, hemoglobin, triglycerides, high-density lipoprotein, fasting blood glucose, TyG, TyG-WC, TyG-WHtR, TyG-BMI, and RFM between the NAFLD group and the control group of perimenopausal women. The results of multivariable logistic regression analysis showed that TyG (OR=2.860, 95% CI: 1.900-4.305), TyG-WC(OR=1.011, 95% CI: 1.008-1.014), TyG-WHtR (OR=3.491, 95% CI: 2.077-5.868), TyG-BMI (OR=1.018, 95% CI: 1.009-1.028), and RFM (OR=1.172, 95% CI: 1.074-1.279) were all independent risk factors for NAFLD in perimenopausal women (P<0.001). The ROC curve showed that the areas under the ROC curve (AUC) for diagnosing NAFLD in perimenopausal women by TyG, TyG-WC, TyG-WHtR, TyG-BMI, and RFM were 0.779 (95% CI: 0.719-0.839), 0.814 (95% CI: 0.769-0.859), 0.804(95% CI: 0.758-0.851), 0.795 (95% CI: 0.746-0.844), and 0.735 (95% CI: 0.675-0.794), respectively, and the optimal cut-off values were 8.888, 687.312, 4.385, 215.743, and 37.104. The AUC values followed the order TyG-related indices > TyG >RFM, and among the TyG-related indices, the AUC values of TyG-WC and TyG-WHtR were the largest (especially TyG-WC), both of which were greater than those of TyG-BMI.

The TyG index and its combined indices, as well as the RFM index, are all good diagnostic indicators for NAFLD in perimenopausal women. Among them, the diagnostic value of the TyG combined indices is greater than that of the TyG index and the RFM index. Among the TyG combined indices, TyG-WC and TyG-WHtR showed the greatest diagnostic value, especially TyG-WC. The results of this study provide a reference for the early diagnosis, prevention, and treatment of NAFLD in perimenopausal women.

This study aims to explore pathways for cultivating public health professionals through medical-preventive integration under the Healthy China Strategy and to construct a public health education system aligned with the demands of the new era.

This paper systematically reviews the practical explorations of medical-preventive integration education reform in domestic universities through case studies. Using West China School of Public Health/West China Fourth Hospital of Sichuan University as a case study, we analyzed its innovative approaches in curriculum design, practical training, and interdisciplinary collaboration.

By leveraging the integrated governance model of university and hospital, the institution has actively explored a training model for interdisciplinary public health professionals through educational reform and innovative practices, including launching an innovative training program in medical-preventive integration, developing specialized courses and a series of textbooks, enhancing comprehensive medical skills training for public health students, and establishing deep-integration research platforms. These measures have produced significant outcomes, yielding replicable and scalable experiences in educational reform.

Under the Healthy China Strategy, fostering public health professionals through medical-preventive integration necessitates breaking down traditional disciplinary barriers, deepening collaboration between preventive and clinical medicine, and building a comprehensive, interdisciplinary, and compound talent cultivation system.

To examine the bidirectional mediating effect of frailty and depression on cognitive impairment.

Data were obtained from a community-based epidemiological survey conducted in Mulei County, Xinjiang Uygur Autonomous Region, in June 2024. Participants were aged 60 years and older. Information on frailty, depression, and cognitive function was collected. Data analysis included descriptive statistics, correlation analysis, regression analysis, and mediation effect analysis using the SPSS PROCESS Macro.

Compared to those with normal cognitive function, older adults with cognitive dysfunction had a higher mean age and a higher prevalence of depression and frailty, alongside lower body mass index (BMI) and reduced physical activity time(P<0.05). Significant correlations were observed among frailty, depression, and cognitive function(P<0.05). Mediation analysis revealed: Frailty partially mediated the relationship between depression and cognitive function (β= -0.076 9, 95% CI: -0.061 4 to -0.016 2), accounting for 19.22% of the total effect; Depression partially mediated the relationship between frailty and cognitive function (β=-0.203 4, 95%CI: -0.312 6 to -0.107 3), accounting for 28.57% of the total effect.

Frailty and depression act as mutual mediators in predicting cognitive dysfunction in older adults. Interventions targeting both physical frailty and psychological well-being may be effective strategies for the prevention and management of cognitive decline in this population.

With the accelerated aging of China’s population, multimorbidity has become a major health challenge for middle-aged and older adults, placing higher demands on clinical care and health management systems. Obesity and insulin resistance are common pathophysiological foundations for multiple chronic diseases. However, there is a lack of large-scale prospective studies systematically evaluating the combined effects of the triglyceride-glucose (TyG) index, traditional obesity indices, and novel obesity indices on the risk of multimorbidity.

To investigate the impact and predictive value of the TyG index combined with traditional and novel obesity indices on the risk of multimorbidity, providing a scientific basis for early identification, risk stratification, and precision nursing interventions for chronic disease comorbidity.

Based on prospective cohort data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, this study included 2 574 middle-aged and older participants aged 45 years or older without chronic diseases at baseline. Traditional and novel obesity indices were calculated, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), weight-adjusted waist index (WWI), a body shape index (ABSI), body roundness index (BRI), and Chinese visceral adiposity index (CVAI). Additionally, the TyG index and its derivatives combined with obesity indices (e.g., TyG-WC, TyG-BRI) were calculated. Cox proportional hazards regression models were used to analyze the associations between these indices and the risk of multimorbidity, while restricted cubic spline analysis was employed to examine dose-response relationships. Receiver operating characteristic (ROC) curves were used to evaluate the predictive performance of these indices.

The overall incidence of multimorbidity was 57.8%. After multivariate adjustment, all obesity indices and TyG-related indices were significantly positively associated with the risk of multimorbidity (P<0.05). Among these, WC showed the strongest association (hazard ratio ［HR］=1.39, 95% confidence interval ［CI］: 1.22-1.57), followed by BMI (HR=1.26, 95%CI: 1.10-1.43). The HRs for WHtR and BRI were both 1.35 (95%CI: 1.18-1.54), while the HRfor CVAI was 1.28 (95%CI: 1.12-1.45). The TyG index alone was significantly associated with the risk of multimorbidity (HR=1.21, 95%CI: 1.06-1.37), and its combination with obesity indices further enhanced the association: TyG-WC had an HRof 1.36 (95%CI: 1.20-1.54), TyG-BRI had an HRof 1.33 (95%CI: 1.17-1.52), and TyG-CVAI had an HRof 1.29 (95%CI: 1.13-1.46). Dose-response analysis revealed that most indices exhibited a nonlinear positive association with multimorbidity risk (all P for nonlinearity<0.05). ROC curve analysis showed that among traditional and novel obesity indices, WHtR and BRI had the best predictive performance (both AUC=0.560). Among TyG derivatives, TyG-BRI had the highest predictive performance (AUC=0.562), followed by TyG-WHtR (AUC=0.561) and TyG-WC (AUC=0.558).The DeLong test revealed that only TyG-WHtR exhibited a significantly higher AUC compared with TyG alone (P=0.038).

The combined use of the TyG index and obesity indices provides a more comprehensive assessment of multimorbidity risk in middle-aged and older adults. Compared with other obesity indexes, TyG-WHtR and TyG-BRI demonstrated superior performance in risk identification, supporting their utility as practical screening indicators in clinical nursing assessments and community health management.

To investigate the association between memory decline and the risk of incident stroke among middle-aged and older adults in China.

Using data from the China Health and Retirement Longitudinal Study (CHARLS), individuals without stroke at baseline were enrolled and followed from 2013 to 2018 to monitor stroke occurrence. Baseline memory status was assessed via subjective memory evaluation, objective memory scores, and history of memory-related diseases.Multivariable Cox regression models were employed to evaluate the association between memory decline and stroke incidence.

The study cohort comprised 14 886 participants.Over an average follow-up of 6.19 years, a total of 893 incident stroke events were recorded, with a 6-year cumulative incidence of 6.0%. After adjusting for demographics, lifestyle, and chronic comorbidities, poor subjective memory (HR=1.20, 95%CI: 1.03~1.39) and memory-related diseases (HR=2.59, 95%CI: 1.89~3.56) were significantly associated with an increased risk of stroke. Subgroup analyses indicated that these associations remained stable across different chronic disease strata (all P for interaction >0.05). No statistically significant association was observed between objective memory scores and stroke incidence.

Memory decline is associated with an increased risk of stroke in middle-aged and older adults. Monitoring the early memory status of this population may facilitate the identification of individuals at high risk for stroke.

To explore the association of the weight-adjusted waist index (WWI) and the comorbidities of hypertension, diabetes, and dyslipidemia, and to provide evidence for prevention and control of comorbidities of hypertension, diabetes, and dyslipidemia.

Data were obtained through questionnaires, physical examinations, and laboratory tests based on the programme of screening and intervention subjects with high risk cardiovascular diseases in Hai’an, Nantong city from 2015 to 2024. Statistical analysises included F-tests, chi-square tests, and multivariate logistic regression models.

Male, current smoking, drinking, unmarried and individuals with high age, waist circumference, body weight, body mass index, systolic blood pressure, diastolic blood pressure, blood glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol, and individuals with low high-density lipoprotein cholesterol had a higher incidence of comorbidities of hypertension, diabetes, and dyslipidemia. Multivariate logistic regression analysis showed a positive association between WWI and the comorbidities of hypertension, diabetes, and dyslipidemia (OR=1.31, 95%CI: 1.27-1.36). Compared to individuals aged ≥60 years, the positive association between WWI and the comorbidities of hypertension, diabetes, and dyslipidemia was stronger in individuals aged <60 years (OR=1.26 vs. OR=1.46, interaction test P<0.001).

WWI is positively associated with the comorbidities of hypertension, diabetes, and dyslipidemia, and the positive association is stronger in individuals aged <60 years old.

To investigate the causal relationship between plasma lipidome and Crohn’s disease (CD), and further reveal the potential mediating role of inflammatory factors in the lipid-CD pathogenesis mechanism by integrating genome-wide association study (GWAS) data of inflammatory factors.

Based on GWAS summary statistics from GeneRISK (n=7 174), SCALLOP (n=14 824), and FinnGen (n=395 179), a two-sample Mendelian randomization (MR) study design was adopted. Using single nucleotide polymorphisms (SNPs) as instrumental variables, the total causal effects of 179 plasma lipid metabolites on CD were first evaluated. Subsequently, a stepwise MR and intersection screening strategy was employed to explore the regulatory pathways involving 91 circulating inflammatory factors. The main statistical method used was the inverse variance weighting (IVW) method, supplemented by sensitivity analyses and multiple testing correction.

The initial MR screening identified 19 lipid phenotypes significantly associated with CD risk. Further analysis pinpointed Phosphatidylcholine (PC 18:1_20:4) as a significant protective factor against CD, with elevated levels robustly causally associated with reduced CD risk. In exploring the mechanism, it was found that this lipid significantly downregulated the expression level of the T-cell surface glycoprotein CD6 (β=-0.054, P<0.05), while genetically elevated CD6 levels significantly increased CD risk (β=0.179, P<0.05). Mediation effect analysis indicated that the CD6-mediated effect direction was consistent with the total effect, accounting for approximately 6.9% of the effect (indirect effect β indirect=-0.010, P=0.396). Reverse MR analysis did not support a reverse causal effect of CD on this lipid.

This study provides genetic evidence confirming the significant protective effect of Phosphatidylcholine (PC 18:1_20:4) against Crohn’s disease. CD6 is identified as a key downstream responder molecule that is negatively regulated by this lipid and promotes CD risk. The results suggest that “phosphatidylcholine—CD6—CD” may be a potential biological pathogenic axis, offering new theoretical foundations for in-depth analysis of the immunometabolic mechanisms of CD and the exploration of intervention targets.

To analyze how population aging affects HIV/AIDS incidence and mortality, and to explore the modifying role of socioeconomic factors in this association.

Data on reported HIV/AIDS incidence and mortality, demographic structure, and socioeconomic indicators were collected from 31 provinces in mainland China between 2004 and 2020. A Bayesian spatio-temporal model was constructed with the proportions of different age groups as key explanatory variables. Covariates included per capita gross domestic product (GDP), number of health institutions, population density, sex ratio, education leveland annual mean temperature. The modifying effects of socioeconomic indicators were also analyzed.

At the national level, each 1% increase in the proportion of the population aged 0-14 years was associated with a 1.1% increase in the relative risk of HIV/AIDS mortality (95%CI: 1.001-1.021). Each 1% increase in the proportion of the population aged ≥65 years was associated with a 2.0% increase in the relative risk of HIV/AIDS incidence (95%CI: 1.006-1.033) and a 1.8% increase in the relative risk of HIV/AIDS mortality (95%CI: 1.004-1.033).The effect modification analysis showed that, across different strata of sex ratio and education level, population aging was significantly positively associated with HIV/AIDS incidence and mortality, while the linear trends of sex ratio and education level on incidence and mortality were not significant.

The progression of population aging increases the relative risk of HIV/AIDS incidence and mortality, and sex ratio and education level may partially modify the association between aging and HIV/AIDS.

To investigate whether m⁶A modification promotes arsenic-induced malignant phenotype of skin cells by inhibiting SHIP2 protein expression.

Human skin keratinocytes were continuously exposed to 1 μmol/L sodium arsenite for 22 weeks, and cells were harvested at 0, 4, 8, and 22 weeks of exposure to establish the long-term arsenic treatment cell models. 3-deazaadenosine (DAA) was used to inhibit the m⁶A modification in cells. The SHIP2 protein expression level was detected by ELISA kit, the m⁶A modification level of SHIP2 mRNA was detected by m⁶A-IP-qPCR, the binding levels of m⁶A reader to specific m⁶A regions of SHIP2 mRNA was detected by RIP-qPCR, and the malignant phenotype of cells was detected by CCK-8 assay, scratch healing assay and soft agar colony formation assay, respectively.

Exposure to NaAsO₂ for 22 weeks led to a significant decrease in SHIP2 protein expression (P<0.001). This reduction of SHIP2 protein expression was accompanied by increased m⁶A modification levels on SHIP2 mRNA at three specific regions (SHIP2-1: P=0.019; SHIP2-2: P=0.024; SHIP2-3: P=0.007), and enhanced binding levels of m⁶A reader YTHDF2 to SHIP2 mRNA (SHIP2-1: P=0.004; SHIP2-2: P=0.015; SHIP2-3: P<0.05). Conversely, DAA treatment upregulated SHIP2 protein expression (P<0.001), significantly reduced the m⁶A modification levels on SHIP2 mRNA (SHIP2-1: P=0.030; SHIP2-2: P=0.034; SHIP2-3: P=0.002), and downregulated the binding levels of YTHDF2 to SHIP2 mRNA (SHIP2-1: P=0.002; SHIP2-2: P=0.004; SHIP2-3: P<0.001). HaCaT cells exposed to NaAsO₂ for 22 weeks showed increased efficiency of migration and soft agar colony formation (migration: P<0.001; colony formation: P<0.001), and the cell migration rate, proliferation rate and soft agar colony formation rate were all reduced after DAA treatment (migration: P<0.001; proliferation: P<0.001; colony formation: P<0.001).

Long-term arsenic exposure time-dependently upregulates the total m⁶A modification levels of cells and the specific m⁶A modification levels on SHIP2 mRNA, which enhances the binding of the m⁶A reader YTHDF2 to SHIP2 mRNA, thereby inhibiting SHIP2 protein expression and ultimately promoting the malignant phenotype of human keratinocytes.

To investigate the ameliorative effect and underlying molecular mechanism of Periplaneta americana extract (PAK) on silica-induced lung tissue injury in mice, so as to provide ideas and experimental evidence for the prevention and treatment of silicosis.

A silica-induced mouse model of silicosis was established. Using in vivo animal experiments combined with pathological staining, immunohistochemistry, toxicological evaluation of major organs, transcriptome sequencing, quantitative reverse transcription polymerase chain reaction (qRT-PCR), and 16S ribosomal DNA high-throughput sequencing, we systematically evaluated the efficacy and underlying mechanisms of Periplaneta americana extract in ameliorating silica-induced pulmonary lesions.

At the experimental dose of 400 mg/kg/d, PAK alleviated inflammatory injury and collagen deposition in lung tissue of mouse models, and downregulated the expression of fibrosis-related proteins, with no obvious organ toxicity observed at this dose. Transcriptomic analysis revealed that PAK targeted 149 silica-induced toxicological genes, which were mainly enriched in inflammatory pathways such as the IL-17 pathway. Further qRTPCR assays confirmed that PAK inhibited the Il17a/f mediated inflammatory pathway and downregulated the expression of Tnf-α, Il6 and other proinflammatory factors. Meanwhile, PAK increased the relative abundance of beneficial bacteria including Akkermansia, and ameliorated intestinal flora dysbiosis in silicosis mice, which may be associated with the attenuation of lung tissue damage.

PAK can inhibit the IL17 signaling pathway and improve intestinal flora, thereby alleviating silicainduced pulmonary inflammation and injury, which provides a reference for further research on PAK and the clinical diagnosis and treatment of pneumoconiosis.