To analyze the correlation between the age at menarche(AAM) and the incidence of hypertension.

Based on the baseline data of 1 499 women from a national key research and development program “Natural population cohort study of heavy air pollution in Sichuan basin” in Rongchang District, 4 townships were randomly selected in 2018. Questionnaire survey, physical examination, and blood biochemical tests were carried out among the people aged 30 to 79 who were registered in the selected townships. The correlation and sensitivity between AAM and hypertension were analyzed by logistic regression model and restricted cubic spline was drawn by software R4.1.1.

The AAM of 1 499 female subjects was 14.31±2.06 years old, and the prevalence rate of hypertension was 36.62%. The prevalence rates of hypertension of ≤ 12 years old, 13 years old, 14 years old, 15 years old, and ≥ 16 years old were 22.88%, 27.02%, 33.33%, 45.61%, and 52.63%, respectively, showing an upward trend (trend χ²=52.198, P<0.001). After adjusting the confounding factors, compared with the 14 years old group in the control group, ≤ 12 years old (OR=0.793, 95%CI: 0.684-0.918), 13 years old (OR=0.865, 95%CI: 0.468-0.935), 15 years old (OR=1.513, 95%CI: 1.117-2.050), and ≥ 16 years old (OR=1.801, 95%CI: 1.483-2.118) were associated with hypertension. The restriction cubic spline showed that there was a non-linear dose-response relationship between AAM and hypertension (P<0.001), and the later AAM was associated with the high risk of hypertension. Sensitivity analysis showed that the correlation between AAM and hypertension still existed in different birth cohorts and BMI groups.

The later AAM may increase the risk of hypertension in adults. Strengthening health education and improving behavior and lifestyle are beneficial to the prevention and treatment of hypertension in women.

To investigate the cardiovascular health status and influencing factors of children and adolescents aged 7 to 17 in five provinces and cities of China.

From April to November 2022, 9 schools (including 4 primary schools and 5 middle schools) were selected from Beijing, Hebei, Shandong, Jiangxi, and Hunan provinces. In total 2 166 students from the third grade of primary school to the third grade of senior high school were enrolled in the study. The methods of data collection included questionnaire, physical measurement, and laboratory test. According to the revised American Heart Association standard, cardiovascular health was evaluated by four health behavior indicators (smoking, BMI, physical exercise, and dietary evaluation) and three health factors (total cholesterol, blood pressure, and fasting blood glucose). The indicators were divided into ideal, moderate, and poor levels. The total average score of 7 indexes was calculated and divided into low, medium, and high-risk grades according to the score. Multiple logistic regression model was used to analyze the influencing factors of cardiovascular health status of children and adolescents.

Students with 7 ideal cardiovascular health behaviors and factors accounted for 1.8%, and those with more than 5 ideal cardiovascular health behaviors and factors accounted for 48.7%. The proportion of girls with 2 or 4 cardiovascular health behaviors was significantly higher than that of boys (P=0.025). The proportion of children and adolescents from township and rural areas with 2 to 4 cardiovascular health behaviors, 2 to 3 cardiovascular health factors, and 4 to 7 cardiovascular health behaviors and factors were significantly higher than those from urban areas (P< 0.05). There were significant differences in the total average scores of cardiovascular health indexes among age, sex, sleep duration, urban and rural areas, regions, and income levels (P<0.05). Multiple logistic regression analysis showed that long sleep time, female, rural area, and family income were positively correlated with the decrease of cardiovascular risk of children and adolescents, while the increase of age and the decrease of cardiovascular risk of children and adolescents in the south were negatively correlated.

The cardiovascular health of children and adolescents aged 7 to 17 in five provinces and cities of China is generally at the middle level, and the proportion of 7 ideal cardiovascular health behaviors and factors is low. In the future, attention should be paid to the prevention and control of children and adolescents aged 12 to 17 years with short sleep time, urban, southern, and low family income, so as to improve cardiovascular health.

To investigate the current situation of behavioral problems of senior primary school students in Guizhou Province, and to explore the influence of family-related factors on primary school students’ behavioral problems.

By using the method of multi-stage stratified cluster random sampling, a total of 2 698 subjects were selected from one primary school in each of three urban areas with different levels of economic development in Guizhou Province. The parents of primary school students were investigated with self-made questionnaire and Achenbach Child Behavior Checklist (CBCL). The χ² test was used to compare the differences, and the logistic regression analysis was used to analyze the relationship between family-related factors and pupils’ behavior problems.

The detection rate of behavior problems in senior primary school students was 11.60%, which was 11.79% in boys and 11.40% in girls, respectively, with no significant gender difference (P>0.05). The detection rate of behavior problems in students of grades 4 to 6 was 13.36%, 12.49%, and 9.30%, respectively, and the difference between grades was statistically significant (P<0.05). The top behavioral problem was obsessive-compulsive behavior (4.92%) and hyperactive behavior (3.44%) in 6-11-year-old boys and girls, respectively. The top behavioral problem was hyperactive behavior(2.66%) and aggressive behavior (15.30%) in 12-16-year-old boys and girls, respectively. The results of Logistic regression analysis showed that parents’ introverted personality, mother’s poor health status, and mother’s neglected rearing style were positively correlated with primary school students’ behavior problems (OR=1.52, 1.54, 1.74, and 2.22), while father’s college education, no bad life habits of parents, and father’s democratic rearing style were inversely correlated with primary school students’ behavior problems (OR=0.43, 0.66, 0.64, and 0.59).

The detection rate of behavioral problems among primary school students in Guizhou Province is still at a high level, which is related to various family factors. Parents should improve their own self-quality and improve the family environment to reduce the occurrence of behavioral problems in primary school students.

To compare the fitting effect of ARIMA model and grey model (GM) (1,1) in the under five mortality rate(U5MR) in Shenzhen, and to predict the U5MR in Shenzhen in the next 3 years, so as to provide scientific basis for the formulation of child health care plan.

Taking the U5MR in Shenzhen from 2005 to 2022 as the original data, ARIMA model and GM (1,1) model were constructed to fit the child mortality rate. The mean absolute error (MAE) and mean absolute percentage error (MAPE) were used to compare the fitting effect of the two models.

From 2005 to 2022, the U5MR in Shenzhen showed a downward trend, lower than the national average. The MAE of the constructed ARIMA model and GM (1,1) model was 0.30 and 0.24, respectively, and the MAPE was 11.53% and 8.73%, respectively. The fitting effect of the GM (1,1)model was good. The U5MR in Shenzhen from 2023 to 2025 would be 1.27 ‰, 1.18 ‰, and 1.09 ‰, respectively, predicted by GM (1,1) model.

The fitting effect of GM (1, 1) model on U5MR in Shenzhen is better than that of ARIMA model, and it is predicted that the U5MR in Shenzhen will decrease year by year in the next 3 years.

To explore the mediating effect of self-perceived aging on the relationship between digital health literacy and technophobia of the rural elderly.

By using the method of multi-stage sampling, 503 rural elderly in Hebei Province were investigated by general data questionnaire, technophobia scale, simplified self-perceived aging scale, and digital health literacy assessment scale from July to August, 2023. The mediating effect test program was used for mediating analysis and Bootstrap test was used for verification.

The scores of technophobia, self-perceived aging, and technophobia of the elderly in rural areas of Hebei Province were 36.40±10.22, 51.99±8.24, and 39.76±13.82, respectively. Pearson correlation analysis showed that digital health literacy was negatively correlated with technophobia and self-perceived aging (r=0.433, P < 0.001; r=0.454, P < 0.001), while self-perceived aging was positively correlated with technophobia (r=0.401, P < 0.001). The mediating effect test results showed that self-perceived aging had mediating effect between digital health literacy and technophobia of the rural elderly, and the mediating effect accounted for 40.0%.

Digital health literacy and self-perceived aging of the elderly directly affect technophobia. At the same time, digital health literacy can also indirectly affect technophobia through self-perceived aging.

To investigate the changes and influencing factors of health literacy level of rural residents in Chongqing from 2018 to 2021, and to predict the health literacy level of this population from 2022 to 2024, so as to provide a basis for formulating health promotion strategies in rural areas of Chongqing in the future.

Using the national unified health literacy questionnaire, the health literacy monitoring data of rural residents in Chongqing from 2018 to 2021 were analyzed, and the health literacy status of 73 478 residents from 39 districts and counties in the city were investigated. Multi-variable logistic regression method was used to analyze the influencing factors of residents’ health literacy. The grey prediction model GM (1,1) was used to predict the health literacy level of rural residents in Chongqing from 2022 to 2024.

From 2018 to 2021, the health literacy level of rural residents in Chongqing showed a steady upward trend (χ²_trend =280.989, P<0.001). The four-year health literacy levels were 17.14%, 21.68%, 22.50%, and 24.15%, respectively. Multivariate regression analysis showed that the older age was associated with lower level of health literacy: 45-59 years old: OR=0.761 (95%CI: 0.725-0.800); 60-69 years old: OR=0.455 (95%CI: 0.426-0.485). Higher education level was associated with higher level of health literacy: junior high school: OR=2.551 (95%CI: 2.432-2.675); senior high school/vocational high school/ technical secondary school: OR=4.435(95%CI: 4.145-4.746); college/undergraduate and above: OR=6.890 (95%CI: 6.261-7.582). The forecast result of GM (1,1) showed that the total health literacy of rural residents in Chongqing would rise to 28.54% by 2024. The three aspects of health literacy showed an upward trend. Among the six aspects of health literacy, four aspects of health literacy continued to rise: the literacy of infectious disease prevention and treatment (up to 37.54%), health information literacy (32.39%), chronic disease prevention literacy (29.88%), basic medical literacy (28.59%). Two aspects of health literacy continued to decline with scientific health literacy decreasing to 33.42% and safety and first aid literacy decreasing to 38.57%.

The health literacy of rural residents in Chongqing continued to improve from 2018 to 2021. There is an urgent need to take targeted intervention measures to improve health literacy of the elderly, low-educated, and low-income rural residents. The forecast results show that the literacy level of scientific health concept, safety and first aid literacy will decline in the next three years, so we should pay more attention to it.

To analyze the cost-effectiveness of the expanded HIV testing strategy in Luzhou from 2018 to 2020, and to provide a basis for implementing or adjusting the strategy according to local conditions.

The cost data of HIV testing institutions at all levels were collected by self-made cost collection tools, and the number of tested people and newly reported cases were obtained from China Disease Prevention and Control Information system. The number of potential HIV infections averted by the sexual transmission route was estimated using the Bernoulli-process model, and the cost-effectiveness ratio was analyzed.

From 2018 to 2020, the cumulative investment cost of Luzhou city in the HIV expansion testing was 151.76 million yuan after discounting, and the average cost in the three years was 50.58 million yuan. A total of 5.60 million people received HIV test in the past three years, with 7 318 new cases detected, and the average cost was 27.1 yuan per test. According to the Bernoulli-process model, the number of new infections prevented by sexual transmission in Luzhou city was 545 (67-7 373). Cost effectiveness analysis showed that from 2018 to 2020, the cost for identifying each new HIV-infected person was 21 000 yuan, and 92 000 yuan (7 000- 755 000) for preventing each HIV infection.

The expanded HIV testing strategy implemented in Luzhou from 2018 to 2020 accords with the cost-effectiveness principle and has economic effects. The cost-effectiveness of testing varies greatly in different regions, so the expanded testing strategy should be implemented according to the epidemic situation of different regions.

To explore the causal relationship among depressive symptoms in young men who have sex with men young (YMSM) in central China.

A total of 349 eligible YMSM who were recruited in Wuhan, Changsha, and Nanchang in 2017 and completed three rounds of follow-up in 2018 and 2019 were selected as research subjects. The depressive symptoms of the subjects were measured by the center for epidemiological survey-depression scale (CES-D), and the longitudinal network structure of depression was analyzed by cross-lag network.

During the period from baseline to the first round of follow-up, the statistical value of output centrality of loneliness was 3.541, which had the highest impact on other symptoms, followed by dislike for themselves (1.196). The central statistical value of unhappy input was 2.175, followed by boredom (1.124) and bitterness (1.093), indicating that these symptoms were most easily predicted by other symptoms. During the first round of follow-up to the second round of follow-up, unfriendliness (2.440) was the symptom with the highest impact on output expectations, followed by inability to perform daily work (1.708) and dislike for themselves (1.119). Fear (2.437), arduous work (1.374), and hopelessness (1.278) were the most easily predicted by other symptoms. In the YMSM depressive symptom network, loneliness (3.541), unfriendliness (2.440), and dislike for themselves (1.196) constituted a small symptom group, which occupied the core position of the network.

Interpersonal relationship plays an important role in the network structure of depressive symptoms in YMSM population. Future interventions should fully consider this and reduce YMSM depression by promoting social interaction and social integration of YMSM groups.

To explore the causal relationship of postoperative fall fear, anxiety, and depression in elderly patients with hip fracture, and to provide reference basis for preventing fall fear and formulating individualized and phased intervention measures in elderly patients with hip fracture.

A total of 367 elderly patients with hip fracture hospitalized in the Department of Orthopedics of a tertiary hospital in Zhengzhou from January to July 2023 were selected by cluster sampling. The patients were investigated with the use of Falls Efficacy Scale-International (FES-I), the Generalized Anxiety Disorder 7 (GAD-7), and the Patient Health Questionnaire 9 (PHQ- 9) at the first time of getting out of bed after operation (T0), 3 months after operation (T1), and 6 months after operation (T2). Mplus 8.3 was used for cross-lagged analysis to explore the causal relationship and action direction among fall fear, anxiety, and depression.

(1) Postoperative fall fear, anxiety, and depression in elderly patients with hip fracture decreased. Fall fear was positively correlated with anxiety and depression, and anxiety and depression were also positively correlated. (2) T0 fall fear positively predicted T1 anxiety, and T1 fall fear significantly predicted T2 anxiety (β₁=0.113, P<0.01; β₂=0.278, P<0.01). (3) T0 fall fear significantly positively predicted T1 depression, and T1 fall fear significantly predicted T2 depression (β₃=-0.133, P<0.05; β₄=-0.124, P<0.05). (4) T0 anxiety significantly positively predicted T1 depression, and T1 anxiety significantly positively predicted T2 depression (β₅=-0.119, P<0.05; β₆=-0.136, P<0.05).

There is a causal relationship between postoperative fall fear, anxiety, and depression in elderly patients with hip fracture. Prevention of depression can start with their fall fear by actively helping elderly patients with hip fracture reduce fall fear, which is beneficial to their physical and mental health after operation.

To explore the relationship between sleep disorder, depression, and health-related quality of life in the elderly, and the mediating effect of depression on sleep disorder and health-related quality of life.

In total 3 612 elderly people over 60 years old in Hebei Province were selected by stratified random sampling, and the related data were collected with the use of Pittsburgh sleep quality index (PSQI), the simplified geriatric depression scale (GDS-15), and concise health quality of life scale (SF-36).

There was a positive correlation between sleep disorder and depression in the elderly (r = 0.39, P < 0.001), and a negative correlation between sleep disorder, depression, and health-related quality of life (r = -0.43 and -0.40, P < 0.001). Sleep disorders and depression in the elderly had negative predictive effects on health-related quality of life (β =-0.26, -0.194,-0.43, and -0.520), and depression played a mediating role between sleep disorders and physical health-related quality of life in the elderly, accounting for 39.29% of the total effect. Depression played a mediating role between sleep disorders and mental health-related quality of life in the elderly, and the intermediary effect accounted for 51.57% of the total effect.

The health-related quality of life of the elderly with sleep disorder and depression is poor. Sleep disorder of the elderly not only directly affects the health-related quality of life, but also indirectly affects the physical and mental health-related quality of life of the elderly through depression.