Objective To investigate the prevalence and influencing factors of mild cognitive impairment (MCI) in the elderly in China, so as to provide scientific basis for slowing down the decline of cognitive function and improving their quality of life. Methods Based on the theory of health ecology, people aged 65 and above were selected from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). The research subjects with dementia and missing key variables were excluded, and finally 11 157 elderly people were included. Multivariate unconditional Logistic regression was used to analyze the influencing factors of MCI in Chinese elderly. Results In this study, 1 526 people ≥ 65 years old had MCI, and the prevalence rate of MCI was 13.7%. The results of multivariate unconditional Logistic regression showed that female (OR=1.242, 95%CI: 1.061-1.455) and advanced age (80 to 94 years old: OR=1.744, 95%CI: 1.359-2.239; ≥ 95 years old: OR=3.014, 95%CI: 2.272-3.998), self-rated worse health status (OR=2.308, 95%CI: 1.202-4.433), hearing impairment (OR=4.760, 95%CI: 4.129-5.487), no exercise(OR=1.204, 95%CI: 1.006-1.441), low score of healthy diet (1-2) (OR=1.562, 95%CI: 1.288-1.894), no social participation activities (housework, social activities, recreational activities, social activities), long sleep time (> 8 hours) (OR=1.347, 95%CI:1.156-1.569), disability (OR=2.987, 95%CI: 2.246-3.974), instrumental activity of daily living (IADL) impairment (OR=3.347,95%CI: 2.510-4.462), living in elderly care institutions (OR=1.569, 95%CI: 1.136-2.166), and poor economic accessibility of medical services (OR=1.155, 95%CI: 1.005-1.328) were risk factors for MCI among the elderly in China. Conclusion The prevalence of MCI in the elderly in China is grim. Gender, age, self-rated health status, hearing function, exercise, healthy diet score, social participation, sleep duration, ADL, IADL, living style, and accessibility of medical services are the main influencing factors of the disease in Chinese elderly. Multi-dimensional and systematic intervention measures are needed to slow down the cognitive decline of the elderly in China.

Objective To analyze the direct disease economic burden of inpatients with endocrine diseases during pregnancy, to provide a strong basis for optimizing the allocation of health resources and disease cost control in public hospitals, and to strengthen the theory of prevention and treatment of endocrine-related diseases during pregnancy. Methods CRITIC-VIKOR model was used to evaluate the direct disease economic burden of inpatients with endocrine diseases during pregnancy. Results The four endocrine diseases during pregnancy were toxic diffuse goiter, polycystic ovary syndrome, postpartum hypopituitarism, and gestational diabetes. Among them, the economic burden of toxic diffuse goiter was heavy, wih the benefit ratio of 0, and the disease burden of polycystic ovary syndrome was relatively light, with the benefit ratio of 1. The benefit ratios of the remaining two diseases were 0.761 and 0.756, respectively. Conclusion CRITIC-VIKOR model can be used to evaluate the direct economic burden of inpatients with endocrine diseases during pregnancy. We should strengthen the hierarchical management and classification of endocrine diseases during pregnancy, improve early screening and intervention, and further optimize the cost structure of endocrine diseases during pregnancy to reduce economic burden.

Objective To systematically understand the cognitive status of immunization professionals in Jinan on the relevant vaccination guidance in the “National Immunization Program Vaccine Child Immunization Program and Instructions (2021 Edition)”, in order to provide more targeted technical guidance and better improve the immunization program and guidance principles for children. Methods In September 2022, a questionnaire survey was conducted on 15 immunization technical backbones in the district and county CDCs of Jinan, as well as 423 vaccination units (including maternity vaccination rooms)engaged in pre-check and vaccination. The survey data was descriptively analyzed, and χ² tests and multivariate logistic regression analysis were conducted using Excel 2010 and SPSS 18.0 software. The awareness rate of the corresponding knowledge of the survey subjects was calculated based on the accuracy of the answers given by the 15 CDC personnel to the overall knowledge of the immunization program, the knowledge of immunization of children with special health conditions, and the knowledge of simultaneous vaccination. Results The awareness rates of the survey subjects for the overall knowledge of the immunization program, the knowledge of immunization of children with special health conditions, and the knowledge of simultaneous vaccination were 29.91%, 23.29%, and 48.63%, respectively. The results of the multiple-factor logistic regression analysis showed that educational level (OR=1.88, 95%CI: 1.13-3.12), years of preventive vaccination work (OR=1.49, 95%CI:1.01-2.22), and professional qualification category (OR=0.25, 95%CI: 0.068-0.88) were influencing factors of the awareness rate of the immunization program for the survey subjects. Educational level (OR=3.01, 95%CI: 1.63-5.57) and profession (OR=0.24, 95%CI: 0.075-0.78) were influencing factors of the awareness rate of immunization for children with special health conditions. Only gender (OR=0.37, 95%CI: 0.16-0.86) was an influencing factor of the awareness rate of simultaneous vaccination for the survey subjects. Conclusion The cognitive level of immunization clinic staff in Jinan regarding the immunization program, including the vaccination of children with special health conditions and simultaneous vaccination, still needs to be further improved. It is recommended to reasonably increase professional technical training focused on relevant knowledge of immunization. It is also recommended to further improve and refine the guidelines or instructive documents related to the immunization of children with special health conditions and simultaneous vaccination.

Objective To evaluate the pilot hospitals of modern hospital management system in Sichuan Province, so as to provide reference for strengthening the construction of modern hospital management system. Methods The index weight, comprehensive evaluation, ranking and grading of the pilot hospitals were carried out by criteria importance through inter-criteria correlation (CRITIC), technique for order preference by similarity to ideal solution (TOPSIS), and rank-sum ratio (RSR). Results The range of RSR (Ci) of pilot hospitals in 2021 was 0.409 to 0.611, and 3, 14, 14, and 2 hospitals were graded as good, relatively good, average, and poor. The grading results were statistically significant, and the proportion of medical service income was the main influencing factor of the evaluation results. Conclusion The pilot project of modern hospital management system in Sichuan Province has achieved initial results, and the level of rational drug use in each pilot hospital has been improved, but there is still a gap in operation quality and safety, medical service price adjustment, and outpatient service management.

Objective To explore the research hotspots and development trends of health management (physical examination)centers, providing reference and ideas for further research in health management (physical examination) centers in China. Methods A total of 7 516 articles published by health management (physical examination) centers and included in the China National Knowledge Infrastructure (CNKI) and PubMed databases were analyzed using CiteSpace software to analyze and visualize the knowledge map of keywords and publishing institutions. Results Since 1995, the number of research articles from health management (physical examination) centers had been increasing, with the highest numbers of published Chinese and English articles in the journals “Chinese Journal of Health Management” (164 articles) and “Medicine” (112 articles), respectively. The most frequen keywords in Chinese and English articles were influencing factors (242 times) and risk factors (113 times), and the research hotspots of health management (physical examination) centers also focused on cardiovascular metabolic diseases and common malignant tumors. “Elderly people,” “health management,” and “intestinal flora” were emerging persistent keywords until 2023. The density of the network map of collaboration among Chinese research institutions was relatively low, with few connections between institutions. Conclusion The number of research articles from health management (physical examination) centers in China has been increasing year by year, and research on health management, intestinal flora, and related topics is at the forefront of research in health management (physical examination) centers, with elderly people as the main research subjects.These studies will provide epidemiological theory and practical experience for the prevention and control of chronic diseases, but further multi-center and interdisciplinary cooperation and comprehensive implementation of medical service charges for health management are needed to promote the long-term development of health management.

Objective To investigate the impact of social and family elderly care on the social participation (labor participation, social recreational activities) of the elderly. Methods A multi-stage stratified random sampling method was employed to conduct a questionnaire survey on the elderly in five urban districts of Xuzhou city. Totally 1 000 elderly individuals aged 60 and above were selected as the study subjects. Descriptive analysis and χ² test were performed using Stata 18.0. A binary logistic regression model was utilized to explore the influence of social and family elderly care on the social participation of the elderly. A significance level of α=0.05 was set for the tests. Results Among the 1 000 elderly individuals, 217 were engaged in labor, and 623 participated in recreational activities, with participation rates of 21.7% and 62.3%, respectively, indicating relatively low participation rates. A higher level of elderly care was associated with a lower probability of labor participation among the elderly. Elderly individuals with higher economic support from their children had a higher probability of labor participation. Moreover, compared to elderly individuals without material support from their children, those receiving such support had a higher probability of participating in recreational activities. Conclusion Family and social elderly care are important influencing factors for the social participation of the elderly. It is essential to further improve the elderly care system, enhance the level of social participation among the elderly, to achieve the goal of active aging.

Objective To explore the influencing factors of falls in the elderly and to provide evidence for the prevention of falls. Methods The study was based on a large sample of 179 141 individuals in Shanghai, with a final inclusion of 40 244 participants. Firstly, independent variables including basic demographics, living environment, health status, and lifestyle habits were selected, with falls as the dependent variable, and univariate and multivariate logistic regression analyses were conducted. Secondly, negative emotions were considered as independent variables, and multivariate logistic regression analysis was performed. Results The fall incidence rate in the elderly within 90 days was 19.55%. Living alone (fall within 30 days: OR=1.161, 95%CI:1.051-1.282; fall between 31-90 days: OR=1.173, 95%CI: 1.070-1.287), unclean living environment (OR=1.775, 95%CI:1.331-2.367; OR=1.117, 95%CI: 1.037-1.203), having ≥3 chronic diseases (OR=2.024, 95%CI: 1.763-2.322; OR=2.089,95%CI: 1.835-2.379), using urine or stool pads (OR=1.581, 95%CI: 1.351-1.850; OR=1.445, 95%CI: 1.239-1.685), and low frequency of outdoor activities (occasional outdoor activitie: OR=1.458, 95%CI: 1.171-1.816; OR=1.359, 95%CI: 1.114-1.658;rarely going out: OR=2.084, 95%CI: 1.673-2.596; OR=2.053, 95%CI: 1.682-2.506) were identified as risk factors for falls within 30 days and 31 to 90 days. Advanced age (70-79 years: OR=1.179, 95%CI: 1.063-1.308; 80 years and above: OR=1.159, 95%CI: 1.040-1.292), abnormal vision (OR=1.235, 95%CI: 1.079-1.414), and needing assistance with household chores (partially completed by others: OR=1.572, 95%CI: 1.139-2.169; fully completed by others: OR=1.649, 95%CI: 1.269-2.143)were risk factors for falls within 30 days. There was no collinearity between the independent variables. Compared with those who did not feel negative emotions, the elderly who frequently felt fatigued had a lower risk of falling (fall within 30 days: OR=0.886, 95%CI: 0.811-0.968; fall between 31-90 days: OR=0.900, 95%CI: 0.828-0.977), while the elderly who frequently felt angry had a higher risk of falling (fall within 30 days: OR=1.491, 95%CI: 1.248-1.782; fall between 31-90 days: OR=1.270,95%CI: 1.067-1.513). Conclusion Elderly individuals living with others, maintaining a clean and tidy indoor environment, having a flat and clutter-free floor, and maintaining a good emotional state have a reduced risk of falling. For elderly individuals with relatively good activities of daily living (ADL) and cognitive function, it is advisable to encourage appropriate outdoor activities and engage in moderate-intensity and frequency physical activities to prevent falls.

Objective To investigate whether there is a mediating effect of cognitive function between social participation and frailty. Methods Using the China Health and Retirement Longitudinal Survey (CHARLS) database, three rounds of survey data in 2011, 2013, and 2015 were selected for the study. The data in 2011 were the baseline data, and the ID number was used to match the participants in the follow-up in 2013 and 2015. A total of 3 139 people were enrolled in this cohort study. Cox regression model and simple mediating effect model were used to analyze the relationship among social participation, cognitive function, and frailty. Results A total of 259 patients had frailty during the follow-up period. The results of multivariate Cox regression model adjusting social demography and lifestyle showed that social participation (HR=0.641, 95%CI: 0.496-0.829)and cognitive function (HR=0.952, 95%CI: 0.928-0.977) were associated with frailty. The results of the intermediary model with relevant covariates showed that cognitive function has a significant mediating effect between social participation and frailty. Conclusion Social participation and cognitive function are associated with frailty, and cognitive function has some mediating effect between social participation and frailty.

Objective To explore the correlation between sleep and depression in middle-aged and elderly people in Chinese community, so as to provide references for improving sleep quality, mental health and quality of life of middle-aged and elderly people. Methods The data of this study were collected from the China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2018. After screening the data, 6 312 participants were included in the study, and they were divided into groups according to their nocturnal sleep duration. The multivariate linear regression model and multivariate logistic regression model were constructed, and the covariates were adjusted to analyze the relationship between nocturnal sleep duration and depression. Results There were 76.81% of the patients having too short or too long sleep at night (7 to < 8 hours was the normal sleep time).The scores and detection rates of depression in 2018 were significantly different among different night sleep length groups (F=30.127, χ²=67.928, P<0.001). There was a negative correlation between night sleep time and depression score (β=-0.278, P<0.001). After further consideration of covariates, short sleep duration (≤ 5 h) was a risk factor for depression (OR=1.621, 95%CI:1.371-1.918), and the risk of depression was higher in women than in men (OR=1.673, 95%CI: 1.363-2.054 in women; OR=1.501, 95%CI: 1.120-2.012 in men). Conclusion The nocturnal sleep of the middle-aged and elderly is related to depression and is affected by demographic, socio-economic factors, health behavior factors and other covariables, and middle-aged and elderly women have a higher risk than men and older age. Attention should be paid to sleep health and mental health of the middle-aged and elderly, so as to improve their quality of life.

Objective To investigate the toxic effect of nano-copper oxide on copper death in mouse alveolar macrophages. Methods MTT assay was used to detect the survival rate of mouse alveolar macrophages (MH-S) treated with nano-copper oxide, transmission electron microscope to observe the morphology of MH-S cells, Western Blot to detect the expression of copper death protein FDX1 and DLAT, transcriptional group sequencing to explore the changes of cell gene expression and key signal pathways in the process of copper death induced by nano-copper oxide, and one-way ANOVA to analyze the difference. Results Copper oxide nanoparticles with 40nm size could enter MH-S cells, decrease the dose-response survival rate of MH-S cells (P < 0.001), increase the concentration of Cu²⁺ in MH-S cells, and induce the expression of FDX1 (P=0.004) and DLAT protein (P < 0.001). However, the administration of copper death inhibitor tetra thiomolybdate (TTM) reduced the cytotoxicity, decreased the level of intracellular Cu²⁺ (P=0.0038), and decreased the expression of FDX1 (P=0.012) and DLAT (P < 0.05).The sequencing results showed that nano-copper oxide could activate IL-17 inflammatory pathway, while TTM could inhibit IL-17 signal pathway. Conclusion Nano-copper oxide can induce the death of copper in mouse MH-S cells, which provides a new clue for the study of the toxic mechanism of nano-copper oxide.