To explore the chain-mediated relationship between worker occupation fit (WOF) and occupational stress between occupational fatigue and depressive symptoms.

The method of stratified cluster sampling was used to study the medical staff in Sichuan Province. Pearson correlation analysis, stepwise regression model, and bootstrap method were used to analyze the relationship and chain mediating effect among WOF, occupational stress, occupational fatigue, and depression.

In total 1 988 subjects were enrolled in this study, of which 43.5% (864/1 988) had depressive symptoms, and 6.5%(130/1 988) had severe depressive symptoms; 31.1% (618/1 988) had occupational fatigue symptoms, and the WOF level was 31.6±7.1. Stepwise regression analysis showed that with WOF, WOF type and occupational stress added to the model, the explanation of depressive symptoms in the model increased by 37.3% and 41.4%, respectively. Intermediary effect analysis showed that WOF and occupational stress had chain mediating effect between occupational fatigue and depressive symptoms, and the proportion of chain mediating effect was 1.80% (β = 0.020, bias corrected and accelerated 95%CI: 0.016-0.039).

The occurrence of depressive symptoms in medical staff is not only affected by occupational fatigue but also mediated by WOF and occupational stress.

According to the theory of life course, family environmental factors in early life have influence on individual health. The objective is to understand the influence and importance of family environmental factors in early life and other factors in adulthood on self-rated health of the middle-aged and elderly, so as to provide reference for active aging and healthy aging.

The demographic data, social support, and early family environmental factors of people over 45 years old from Chinese General Social Survey (CGSS) data in 2021 were collected. Chi-square test, binary Logistic regression, and random forest model were used to analyze the influencing factors and importance of self-rated health of the middle-aged and elderly.

Among the 4 311 subjects, 2 427 were unhealthy and 1 884 were healthy. The regression results showed that the middle-aged and elderly people aged 79 and over, working in agriculture, not working, never engaging in social and recreational activities, middle-and lower-middle-level socioeconomic status, and fathers with college education or above had a higher rate of self-rated unhealth (P < 0.05). The self-rated unhealthy rate of the middle-aged and elderly with normal and overweight, non-depression, average family economic level and higher than the average level of BMI was lower (P < 0.05). The order of influencing factors was depression (73.717), family economic level (55.361), nature of work (47.074), personal socio-economic status (42.177), BMI (38.952), age (28.842), frequency of social and recreational activities (28.270), and father’s education level (22.319).

There are many factors affecting the self-rated health of the middle-aged and elderly in China. Depression, family economic level, and the nature of work are important factors affecting the self-rated health of the middle-aged and elderly in China. Attention should be paid to special groups such as depression, low income, perennial farming, and out of work.

To establish a screening model for patients with chronic obstructive pulmonary disease (COPD).

By using the method of multi-stage stratified random sampling, 4 587 permanent residents ≥ 40 years old in Guizhou Province were investigated by questionnaire, physical examination, and pulmonary function examination. Variables to be included into the model were screened by univariate analysis and then further screened by multivariate Logistic regression. Logistic regression (LR), random forest (RF) and support vector machine (SVM) were used to construct the screening model of COPD patients, and the area under the curve (AUC) was used to evaluate the effect of the model. Delong method was used to test the difference of AUC between models.

According to the results of multivariate Logistic regression analysis, age, frequent cough before 14 years old, asthma, daily smoking, cooking fuel and exhaust, and harmful gas exposure were included in LR, RF and SVM models. The AUC of the three model training sets were 73.64%, 87.14%, and 73.30%, respectively, and the AUC of the test set were 76.10%, 70.96%, and 76.08%, respectively, all of which had good screening results. The results of Delong method showed that the screening effects of the three models were different between the training set and the test set.

This study established an economical, rapid, and effective screening model for COPD patients through six simple variables such as age and asthma.

To investigate the relationship between muscle strength and the risk of depression in the middle-aged and elderly, and to provide reference for the prevention and treatment of depression in the middle-aged and elderly in China.

Based on the data of China Health and Retirement Longitudinal Study (CHARLS), the middle-aged and elderly people who participated in the survey in 2015 and 2018 were selected. Firstly, restricted cubic splines (RCS) were used to analyze whether there was a dose-response relationship between upper limb strength (standardized grip strength) and lower limb strength (time to stand up from a chair) and the risk of depression in the middle-aged and elderly. Secondly, the upper and lower limb strength were divided into three groups, and Logistic regression model was used to evaluate the correlation between upper and lower limb strength, overall muscle strength and depression risk in the middle-aged and elderly.

A total of 6 245 subjects were enrolled in this study. During the 3-year follow-up period, a total of 2 095 (33.5%) subjects had depressive symptoms.There was a dose-response relationship between upper and lower limb strength and the risk of depression in the middle-aged and elderly. Logistic regression model showed that after adjusting the confounding factors such as sex, age and marital status, stronger upper and lower limb strength could reduce the risk of depression by 24% and 28%, respectively. Compared with the weakest overall muscle strength group, the strongest muscle strength group had a 48% lower risk of depression (OR=0.52,95%CI: 0.41-0.67).

Strong muscle strength can reduce the risk of depression in the middle-aged and elderly.

To investigate the drug resistance and molecular epidemiological characteristics of clinically isolated Staphylococcus aureus in Huai’an city, so as to provide references for the diagnosis, treatment, prevention and control of infection.

Staphylococcus aureus isolated from clinical samples were collected and methicillin-resistant Staphylococcus aureus（MRSA）was detected by cefoxitin or oxacillin resistance phenotype or mecA gene. The drug sensitivity test was carried out by microbroth dilution method. Based on the whole genome sequencing, the strains were analyzed by single nucleotide polymorphism and multi-locus sequence typing. The virulence and drug resistance genes of the strains were identified by online database.

A total of 83 strains of Staphylococcus aureus were isolated from 7 types of clinical specimens, and MRSA accounted for 59.04%. The isolated strains had the highest resistance to penicillin (97.59%) and were sensitive to Nez Olamide, tigecyclines, vancomycin, teicoplanin, and nitrofurantoin, and multiple drug-resistant strains accounted for 57.83%. There were 20 ST types in 83 strains of Staphylococcus aureus, and ST398 (21.69%) was the main type. There were 187 292 SNP loci in 83 genomes. These strains carried 38 kinds of drug resistance genes, among which tet (38), blaZ, arlR, arlS, mgrA, norA, mepA, ErmC,LmrS, and mepR had higher carrying rates. These strains carried 8 enterotoxin genes including sea, seb, sec, sed, seh, selk, sell,and selq, among which selk and selq (both 32.53%) had the highest carrying rate, and ST1 strain carried the largest number of kinds of enterotoxin genes. The carrying rates of lukF-PV and lukS-PV genes encoded by PVL were 49.40% and 6.02%, respectively. The carrying rate of tsst-1 gene encoded by toxic shock syndrome toxin TSST-1 was 3.61%.

The drug resistance of Staphylococcus aureus isolated from Huai’an area is strong and the detection rate of MRSA is high. The ST types of strains are rich, and there is a certain correlation between ST types and pathogenicity.

To investigate the role of RIPK1/MLKL/PGAM5 pathway in traffic-related PM_2.5-induced heart injury in asthmatic mice.

In total 50 male BALB/c mice were randomly divided into control group (NS group), asthma group (OVA group), OVA+ low concentration PM_2.5 group (LPM_2.5, 1.8 mg/ kg ·bw), OVA+ medium concentration PM_2.5 group (MPM_2.5,3.6 mg/ kg ·bw), and OVA+ high concentration PM_2.5 group (HPM_2.5, 7.2 mg/ kg ·bw). OVA asthma model mice were instilled with different concentrations of PM_2.5 suspension through nasal cavity for 10 times. The pathological changes of heart tissue were observed by HE staining, the apoptosis of heart tissue was detected by Tunnel staining, and the protein and mRNA expression levels of RIPK1, RIPK3, MLKL, PGAM5, DRP1, and mRNA in mouse heart tissue were detected by qRT-PCR and Western blot methods.

Compared with NS group, the arrangement of central muscle fibers in PM_2.5 group was obviously disordered, the myocardial fibers in HPM_2.5 group were obviously broken, and the number of apoptotic cells was significantly increased. The protein expression of RIPK1, RIPK3, MLKL, PGAM5, DRP1, and p-DRP1 in HPM_2.5 group was higher than that in NS group (q₁=20.940, P < 0.05; q₂=7.311, P < 0.05; q₃=4.805, P < 0.05; q₄=5.976, P < 0.05; q₅=5.096, P < 0.05; q₆=10.390,P < 0.05). The expression of RIPK1, RIPK3, and DRP1 genes in HPM_2.5 group was significantly higher than that in NS group (q₁=7.952, P < 0.05; q₂=5.172, P < 0.05; q₃=5.430, P < 0.05).

Traffic-related PM2.5 can induce cardiac necrotic apoptosis in asthmatic mice through RIPK1/MLKL/PGAM5 pathway.

To evaluate the effect of EV71 inactivated vaccine on the epidemiological characteristics and reported incidence of hand, foot, and mouth disease (HFMD) in Quzhou city.

The surveillance data of HFMD cases in Quzhou city from 2009 to 2022 were collected by China Infectious Disease Reporting Information Management system, and the epidemiological characteristics were descriptively analyzed. The change trend of reported incidence of HFMD in Quzhou before and after the application of EV71 inactivated vaccine was analyzed by interruption time series design.

The average reported incidence of HFMD in Quzhou from 2009 to 2022 was 200.02/100 000. After the application of EV71 inactivated vaccine in Quzhou, the instantaneous change of HFMD reported incidence was -30.296/100 000 (t=0.30, P=0.773), the slope changes was-75.694/100 000 (t=5.43, P < 0.001), and the slope was -33.923 (β₁+β₃=33.923). The proportion of reported cases aged 0 to 4 years in all age groups decreased from 97.72% in 2009—2015 to 90.93% in 2016—2022.

The EV71 vaccine has achieved good prevention and control effect in a short time after coming into the market in Quzhou city, but the incidence rate is still high. It is necessary to strengthen the vaccination of children of school age, especially those less than 12 months old.

To analyze the effect of serum uric acid (UA) on cognitive function in patients with Alzheimer’s disease (AD).

The cognitive function of 259 patients with AD who were followed up more than 3 times in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) follow-up cohort were measured by Mini-Mental State Examination (MMSE). The trajectory analysis model was used to classify the subjects according to the changing trend of MMSE scores during the follow-up period. Taking different trajectory groups as dependent variables and serum UA as independent variables, multi-classification Logistic regression analysis was used to explore the effect of serum UA on cognitive function in patients with different types of AD after adjusting various confounding factors.

According to the trajectory model, the subjects were divided into three subgroups: cognitive sudden decline group, cognitive slow decline group, and cognitive stationary group. There was significant difference in serum UA among different trajectory subgroups (F=4.910, P=0.008). After adjusting for the influence of bio-behavioral-disease potential confounding factors, multi-classification Logistic regression found that serum UA was an independent risk factor for the outcome of cognitive slow decline group (cognitive slow decline group: OR=1.35, 95%CI: 1.03-1.77).With each increase of 10 mg/L in UA level, the risk of cognitive decline in AD patients in cognitive slow decline group was 35%higher than that in cognitive stable group. In the cognitive sudden decline group, there was no risk association between UA and cognitive function.

Compared with those with stable cognitive development, high level of serum UA is a risk factor for slow cognitive decline in patients with AD.

To investigate the related factors of death in patients with drug-resistant tuberculosis in Henan Province.

The data of tuberculosis patients diagnosed in all 18 prefecture-level cities and 2 directly administered counties in Henan Province from 2011 to 2021 were selected. The patients with complete course of treatment and treatment outcome were selected. The cumulative survival rate was calculated by Kaplan-Meier method, and Cox proportional hazard regression was used to identify the factors affecting the survival time of patients.

Among the 1 078 patients with drug-resistant tuberculosis, a total of 66 patients (6.1%) died, and the cumulative survival rate within 30 months was 90.1%. In total 50% of the patients died within 10 months. After controlling other factors, age (HR=1.053, 95%CI: 1.029-1.087), XDR-TB patients (HR=3.032, 95%CI: 1.584-5.767), smoking (HR=1.879, 95%CI: 1.006-3.509) and BMI (HR=0.294, 95%CI: 0.088-0.978) were the main risk factors for death of tuberculosis patients during treatment.

Among drug-resistant tuberculosis patients in Henan Province, elderly patients, XDR-TB patients, smoking patients and patients with BMI less than 18.5 have a relatively higher risk of death. Additional support should be provided for the treatment of these patients to reduce mortality.

To describe the distribution characteristics of the duration of respiratory events in patients with obstructive sleep apnea (OSA) and analyze the predictive factors of nocturnal minimum blood oxygen saturation.

A total of 265 OSA patients who underwent polysomnography (PSG) in the Sleep Medicine Center of the West China Fourth Hospital of Sichuan University from January to December 2022 were divided into mild, moderate, and severe groups according to their Apnea Hyponea Index (AHI) values. The differences of basic information and sleep parameters dominated by respiratory events were described. The correlation factors of nocturnal lowest oxygen saturation were selected, and the factors with r > 0.3 were included in the multiple linear regression model.

With the aggravation of OSA, the proportion of male, smoking and drinking increased, neck circumference, apnea index, longest apnea time, snoring index, and maximum systolic blood pressure increased (P < 0.05). The lowest oxygen saturation at night was correlated with sex, age, BMI, apnea index, longest apnea time, and average apnea time. Multiple linear regression results showed that the longest apnea time, apnea index, BMI, and the highest systolic blood pressure were negatively correlated with the lowest nocturnal oxygen saturation (P < 0.05). The longest apnea time was the strongest predictor of the lowest nocturnal oxygen saturation (standardized β=-0.516, P < 0.05, 95%CI: -0.579 to-0.453).

The longest apnea time plays an important role in evaluating the severity of OSA and predicting the lowest blood oxygen saturation at night.