To investigate the death trend of HIV/AIDS patients in Shandong Province from 2013 to 2022, andto explore the related influencing factors.

A total of 25 181 HIV/AIDS patients living in Shandong Province from 2013 to 2022 were selected as the study objects, demographic characteristics, antiretroviral therapy and causes of death were collected. Study objects were divided into three groups: survival, AIDS-related death and non-AIDS-related death. Kruskal-Wallis test and χ² test were conducted for inter group comparison, Joinpoint regression model was used to analyze the trend change of mortality, and unordered multicategorical logistic regression was used to analyze HIV/AIDS death and its influencing factors.

From 2013 to 2022, a total of 1 187 HIV/AIDS patients deaths were reported in Shandong Province, among which AIDS-related deaths accounted for 34.63% and non-AIDS-related deaths accounted for 65.37%. The mortality rates showed a decreasing trend (APC was -13.58, -20.29, and -9.67, respectively, all P<0.05). Unordered multicategorical logistic regression analysis showed that the time from diagnosis to ART initiation greater than 30 days, WHO clinical stage Ⅱ, Ⅲ, and Ⅳ were the risk factors for AIDS-related death of HIV/AIDS patients, and the OR (95% CI) values were 1.74(1.41-2.16), 1.93(1.38-2.70), 2.61(1.87-3.63) and 4.81(3.71-6.23); the time from diagnosis to ART initiation greater than 30 days, male, farmer and heterosexual transmission were the risk factors for non-AIDS-related death of HIV/AIDS patients, with OR (95% CI) values of 2.10(1.79-2.46), 1.75(1.38-2.20), 1.60(1.28-2.01), and 1.75(1.48-2.08).

From 2013 to 2022, the case fatality rate of HIV/AIDS patients in Shandong Province has shown a downward trend after the start of ART, the age of death increased, and the case fatality rate of non-AIDS-related deaths is generally higher than that of AIDS-related deaths. There are differences in the influencing factors for AIDS-related and non-AIDS-related deaths, and targeted interventions should be developed.

To analyse the epidemiological characteristics and spatial-temporal distribution features of viral hepatitis in China from 2009 to 2019, explore the dynamic distribution of its spatial-temporal aggregation, and provide scientific basis for optimizing the prevention and control strategies of viral hepatitis.

Case data on viral hepatitis from 2009 to 2019 were extracted from the Public Health Data Centre, and spatiotemporal epidemiological analysis of surveillance data on viral hepatitis in China from 2009 to 2019 was performed using descriptive epidemiology and spatial autocorrelation analysis methods.

From 2009 to 2019, a cumulative total of 13 915 842 cases of viral hepatitis were reported nationwide, with an average annual incidence rate of 93.08/10⁵, showing an overall decreasing trend. Spring (March—May) was the peak of the incidence of hepatitis C and hepatitis B. The incidence curve of hepatitis E over the years showed a single-peak pattern, and the incidence of hepatitis A had no obvious seasonal pattern. The high incidence of hepatitis C, hepatitis B and hepatitis E was concentrated in the age group of 30-70 years old, and the high incidence of hepatitis A changed from the age group of 2-10 years old to the age group of 65 years old and above. Xinjiang Uygur Autonomous Region (XUAR), Qinghai Province and Gansu Province in the western region were the high prevalence areas of hepatitis C, B and A, while the high prevalence areas of hepatitis E were mainly concentrated in the eastern region. The results of global spatial autocorrelation showed that the incidence of hepatitis C (except for 2009 and 2019) and hepatitis A showed a positive spatial correlation (Moran I value of 0.13-0.66, P<0.05), and the incidence of hepatitis B and hepatitis E mainly showed a random distribution (Moran I value of 0.01-0.31, P>0.05).

From 2009 to 2019, viral hepatitis incidence in China has obvious spatial and temporal aggregation. In the future, different provinces should tailor their interventions to the spatio-temporal epidemiological characteristics of viral hepatitis and develop scientific prevention and control measures.

To investigate the causal relationship and mechanisms between obesity and bone mineral density using Mendelian randomization (MR).

Using genome-wide association study (GWAS) datasets of body mass index (BMI), body fat percentage, and total body bone mineral density, univariate two-sample MR analysis was conducted to explore the causal relationship between obesity and bone mineral density. A multivariate MR method was also employed to adjust for variables such as lean mass and body weight to investigate the underlying mechanisms.

Univariate MR analysis showed a significant protective effect of BMI on total body bone mineral density (β=0.06, 95% CI:0.03-0.09) with consistent results across sex-specific studies, while no significant causal effect was found between body fat percentage and total body bone mineral density (β=-0.01, P=0.13). After adjusting for lean mass (β=0.04, P=0.06) and weight (β=0.03, P=0.48) using multivariate MR, the protective effect of BMI on total body bone mineral density disappeared. In contrast, a significant negative causal effect was observed between body fat percentage and total body bone mineral density after adjusting for lean mass (β=-0.02, 95% CI:-0.03-0.00) and weight (β=-0.05, 95% CI:-0.07--0.02).

Obesity primarily exerts a protective effect on bone mineral density through mechanically-related indicators such as weight and lean mass, while body fat itself has a detrimental effect on bone mineral density.

To investigate the association between obesity and non-alcoholic fatty liver disease (NAFLD) in the occupational population, and the mediating role played by hyperuricemia in the association, to provide reference for the prevention and intervention strategies of NAFLD in the occupational population.

Multistage cluster sampling was used to survey occupational population in Chongqing Municipality, Sichuan Province, and Guizhou Province to obtain social and demographic indicators, lifestyle and health status indicators, and to collect physical examination indicators from the survey respondents. The correlation between obesity and NAFLD was analyzed by Spearman’s rank correlation coefficient and multivariable adjusted Logistic regression. The mediating effect of hyperuricemia in the association between obesity and NAFLD was explored by mediating effect model.

A total of 15 029 study participants who met the inclusion criteria were enrolled, including 1 190 patients with NAFLD. The results of Logistic regression showed that, after adjusting for covariates such as age and gender, obesity increased the risk of NAFLD (OR=3.37, 95% CI: 2.78 to 4.09) and was associated with higher risk of NAFLD in those aged <45 years (OR=3.93, 95% CI: 3.12 to 4.94) and female subgroups (OR=3.65, 95% CI: 1.98 to 6.71) had greater effect values for the effect of obesity on NAFLD. The mediation analysis found that hyperuricemia mediated 11.72% of the effect between obesity and NAFLD, and in the subgroup analysis, the mediation effect of hyperuricemia was higher in the female subgroups (23.81%).

Obesity is strongly associated with the incident of NAFLD, with a greater effect in younger and female groups, and affects NAFLD through hyperuricemia. Strengthening the preventive education of obesity and hyperuricemia and advocating a healthy lifestyle may be effective in reducing NAFLD caused by obesity and hyperuricemia.

To study the causal relationship between tea intake and the incidence of colorectal cancer using two-sample Mendelian randomization.

Using the colorectal cancer genome-wide association analysis data (GWAS ID: ieu-b-4965) and tea intake genome-wide association analysis data (GWAS ID: ukb-b-6066) in the IEU OPEN GWAS public database, we summarized and screened the two data sets for single nucleotide polymorphisms (SNPs) which were closely related to and independent of tea intake as instrumental variables (IVs). By using MR-Egger and inverse variance weighting in two-sample Mendelian randomization, Five methods (IVW), weighted median method (Weighted Median), simple model (Simple Mode) and weighted model (Weighted Mode) were used to determine the causal analysis between tea intake and the incidence of colorectal cancer. OR and 95% CI were used to examine the causal relationship between tea intake and the incidence of colorectal cancer. MR-PRESSO was used for outlier testing. IVW (Cochran Q test) and MR-Egger (Rücker Q test) were used for heterogeneity analysis. Egger-intercept was used for pleiotropy test, sensitivity analysis was performed by leave-one-out method, and funnel plot was used to analyze the presence of potential bias.

39 SNPs were finally included, and MR-PRESSO found no outlier SNPs, P=0.237>0.05; in terms of causality determination: IVW (OR=0.996, 95% CI:0.990-1.002, P=0.293), MR-Egger (OR=0.992, 95% CI:0.977-1.007, P=0.293), Weighted Median (OR=0.997, 95% CI: 0.987-1.007, P=0.479), Simple Mode (OR=0.996, 95% CI: 0.976-1.017, P=0.724), Weighted Mode (OR=0.996, 95% CI: 0.985-1.007, P=0.473). The above results showed that there was no causal relationship between tea intake and the incidence of colorectal cancer. In the heterogeneity test, P=0.181>0.05 in Cochran Q test and P=0.167>0.05 in Rucker Q test. There was no significant heterogeneity. The Egger-intercept test showed that P=0.489>0.05 and was not pleiotropic. The leave-one-out method was removed one by one, and no SNPs significantly affecting the results were found. The funnel plot was basically symmetrical, indicating that the main results were reliable.

There is no causal relationship between tea intake and the incidence of colorectal cancer.

To understand the relationship between dietary vitamins A, vitamin C and vitamin E and glioma in Chinese population.

Based on the case-control study of 1:1 individual matched, a questionnaire survey was carried out on 343 patients with glioma and 343 healthy controls. The intake of three dietary vitamins was evaluated through the food frequency questionnaire, and the intake of dietary vitamins and gloima was analyzed by logistic regression, and explored the dose-response relationship between the two.

Compared with the lowest quantile, the highest quantile of dietary vitamin A intake was associated with a decrease in overall glioma risk (OR=0.10, 95% CI: 0.04-0.30), astrocytoma risk (OR=0.71, 95% CI: 0.59-0.86), glioblastoma risk (OR=0.86, 95% CI: 0.78-0.96), low-grade glioma risk (OR=0.65, 95% CI: 0.47-0.91), and high-grade glioma risk(OR=0.87, 95% CI: 0.80-0.94).The highest quantile of dietary vitamin C intake was associated with a decrease in overall glioma risk (OR=0.02, 95% CI: 0.01-0.08), astrocytoma risk (OR=0.69, 95% CI: 0.54-0.87), glioblastoma risk (OR=0.82, 95% CI: 0.74-0.91), low-grade glioma risk (OR=0.75, 95% CI: 0.62-0.91) and high-grade glioma risk (OR=0.79,95% CI: 0.72-0.86). However, dietary vitamin E intake was only associated with an increased risk of astrocytoma (OR=2.99, 95% CI: 1.23-7.30).There was a significant linear dose-reaction relationship between the two, but the results of vitamin E were inconsistent and should be treated with caution.

High intake of dietary vitamin A and vitamin C may be associated with a reduced risk of glioma, but the impact of vitamin E on different clinical subtypes of glioma is not consistent. In the future, prospective studies should be conducted to further verify the association between these dietary vitamins and glioma.

To evaluate the intervention effect of nutritional intervention measures on the supply of various foods, energy, and nutrients for lunch among students in Wenzhou, as well as the rate of leftover food.

From 2021 to 2022, a middle school was randomly selected from 13districts in Wenzhou City. Before and after the intervention, the school was surveyed for a continuous week using weighing and accounting methods to investigate the supply of various types of food in the cafeteria and the daily number of diners. Leftovers were classified and weighed. Intervention measures include nutritional meal support and nutritional health education. The results were evaluated based on the "Student Dietary Nutrition Guidelines" and the "Reference Intakes of Dietary Nutrients for Chinese Residents (2013 Edition)".

After the intervention, the food supply in the cafeteria of junior high schools in Wenzhou reached 80.00% of the recommended amount, including grains, potatoes, fish, and shrimp. The food supply below 80.00% of the recommended amount was vegetables, fruits, eggs, and milk. The food supply above 120.00% of the recommended amount was poultry and animal meat, vegetable oil, and salt. The supply of fruits, fish, and shrimp was significantly improved (t=2.342, P=0.029; t=-1.914, P=0.070). In terms of nutrient supply, nutrients that reach 60.00% of the recommended amount include energy, calcium, vitamin B1, vitamin B2, and carbohydrate energy supply ratio. Nutrients that are lower than 60% of the recommended amount include vitamin A, dietary fiber, protein, zinc, iron, vitamin C, and fat energy supply ratio. Among them, zinc, vitamin A, vitamin C supply and fat energy supply ratio have been significantly improved (t=2.280, P=0.0340; t=-3.261, P=0.004; U=-2.638, P=0.008; t=-2.173, P=0.041). The rate of leftover staple and vegetarian dishes decreased significantly (χ²=4.828, P=0.028; χ²=15.813, P<0.001).

Based on schools, adopting nutritional meal support and implementing nutritional health education interventions can to some extent improve the supply of lunch food, energy, and nutrients in school canteens, and reduce the rate of leftover food and vegetables among students.

To understand the relationship between cognitive impairment in old people and the mental status of their childhood caregivers, and to provide new ideas for screening and prevention of key population with cognitive impairment.

Samples aged 60 and above in the China Health and Elderly Care Longitudinal Survey Database in 2014 and 2018 were selected as research subjects (n=6 991), and the cognitive status of old people in China was evaluated by using the simple mental status examination scale. χ²test was used for single factor analysis, and binary logistic model was used for stepwise regression analysis.

The detection rate of cognitive impairment in old people aged 60 and above in China was 16.08%. Older adults with poorer mental health among caregivers during childhood (OR=1.03, P<0.05) were more likely to suffer from cognitive impairment. In addition, old people who are male, married, non rural household registration, having social activity and having mild physical activity were less likely to have cognitive impairment. Old people with middle age, advanced age, smoking, and mild disability were more likely to suffer from cognitive impairment.

There is a significant relationship between cognitive impairment in old people and the mental state of their childhood caregivers. We should increase the screening and prevention of cognitive function among old people who have been exposed to adverse mental conditions of their caregivers during childhood.