To analyze the internal structure and influencing factors of hospitalization expenses for rare disease patients at different medical levels in Jiangxi Province’s “Health Expenditure Accounting System 2011” (SHA2011) sentinel hospitals, providing references for rare disease treatment in Jiangxi Province and its healthcare institutions.

Data on rare disease patients from 2018 to 2022 were collected from the sample hospitals in Jiangxi Province. Structural variation analysis and grey correlation analysis were employed to examine changes in the internal composition of hospitalization expenses and their interrelationships, while a random forest model was used to identify factors influencing the average total cost per hospitalization case.

From 2018 to 2022, the average hospitalization costs per case were 19 082.70 yuan (provincial), 8 175.29 yuan (municipal), and 6 586.23 yuan (county/district). The random forest model revealed that medication fees and diagnostic examination fees were key factors affecting rare disease hospitalization costs, with structural variation values of -3.15, -1.79, and 5.30 for medication fees, and -3.86, 5.48, and 2.16 for diagnostic examination fees at provincial, municipal, and county/district levels, respectively. Grey correlation analysis showed that surgical fees and nursing fees had low correlation degrees with hospitalization costs across all levels, ranking between 7th and 8th.

From 2018 to 2022, hospitalization expenses at all levels exhibit fluctuating trends but remained generally high. Medication fees and diagnostic examination fees are critical influencing factors, though their structural variation trends and contribution rates differed significantly across hospital tiers. Additionally, surgical and nursing fees demonstrate consistently low correlation with hospitalization costs at all levels.

To construct a set of MCI identification toolkit suitable for the elderly and their families, and to provide reference for guiding the elderly to self-identify MCI.

Using the corpus research method, through reviewing the literature, guidelines, books and other materials, a list of tools was formed, and the first draft of the identification toolkit wasconstructed. After expert consultation and demonstration, the final draft of the identification toolkit was formed by incorporating identification tools with an expert recognition rate of more than 70%. Descriptive statistical analysis was used to analyze the application results of the identification tool.

After expert consultation and demonstration, the effective recovery rate of the questionnaire was 83.33 %, and the expert authority coefficient was 0.875. A family identification toolkit including the mini-mental state examination (MMSE) and the elderly cognitive decline informer questionnaire (IQCODE) was formed. Among the 781 respondents, 256 elderly people had mild cognitive impairment, with an overall prevalence of 32.78 %.

The constructed family identification toolkit for MCI in the elderly is suitable for the elderly, family members and caregivers, and can provide a reference for guiding families to self-identify MCI in the elderly.

To identify potential drug targets related to preeclampsia and explore their public health value in precision prevention based on gene expression–associated genetic variants and Mendelian randomization.

By integrating genome-wide association studies (GWAS) and expression quantitative trait loci (eQTL) data, potential druggable genes for preeclampsia were identified using Summary data-based Mendelian Randomization (SMR), Transcriptome-Wide Association Study (TWAS), and colocalization analysis. Drug annotation and potential side effect assessments were conducted using public drug databases, and Phenome-wide Mendelian Randomisation (MR-PheWAS) was applied to evaluate potential causal associations between the identified genes and 783 disease traits.

Seven potential drug targets were identified: ALDH2, BCAR1, IL27, MUTYH, PABPC1, SULT1A1 and SULT1A2. Among them, IL27 and SULT1A1 showed consistent and significant associations across multiple analyses. ALDH2 and MUTYH were identified as strong candidates with known involvement in oxidative stress and DNA repair pathways. Several genes were linked to existing drugs, suggesting potential for drug repurposing in preeclampsia.

Drug-target Mendelian randomization provides novel insights into the molecular mechanisms of preeclampsia and facilitates the identification of therapeutic targets. The findings offer a promising foundation for early screening, genetic risk stratification, and individualized prevention, contributing to the development of precision public health strategies for pregnancy-related disorders.

To investigate the variations in the species composition and functional attributes of intestinal microbiota in individuals suffering from metabolic fatty liver disease in Tibetan regions, and to provide a research basis for the prevention and treatment of metabolic fatty liver disease in Tibetan population.

Based on the follow-up survey data of the Southwest region natural population in Lhasa, a total of 103 subjects were included for follow-up analysis according to the guidelines for the prevention and treatment of metabolic-associated (non-alcoholic) fatty liver disease (2024 edition). The demographic information, anthropometric indicators, blood biochemical indicators, and fecal samples were collected, and DNA was extracted for metagenomic sequencing analysis. The composition of intestinal flora in patients with metabolic fatty liver disease and healthy people was compared by bioinformatics methods. The metabolic pathways and their coding genes were analyzed by genome encyclopedia (KEGG) . Linear discriminant analysis was used to screen the differential flora, and Spearman rank correlation and linear regression were used to explore its relationship with related phenotypes.

The alpha diversity of patients with metabolic fatty liver was significantly reduced (W=858, P<0.001). The abundance of Bacteroidetes in the intestinal tract of patients with metabolic fatty liver was significantly lower than that of normal people (H=8.990, P=0.003). These include Bacteroides uniformis, Bacteroides fragilis, Bacteroides ovatus, and the butyrate-producing Porphyromonas Phocaeicola salanitronis (LDA>3, P<0.050). Fusobacterium varium (LDA=2.16, P=0.024) was significantly enriched in MAFLD population and positively correlated with multiple disease phenotypes. Glucose and lipid metabolism-related pathways and KO genes were also significantly enriched in patients with metabolic fatty liver.

The intestinal microbiota and metabolic function of Tibetan patients with metabolic fatty liver disease are significantly changed, and the disruption of intestinal flora balance may also have a close association with the onset and progression of metabolic fatty liver disease among Tibetan patients.

To assess the public awareness of tuberculosis (TB) prevention and control knowledge in high-altitude Xizang during the 13th Five-Year Plan period (2016-2020) and provide evidence for optimizing regional TB health education strategies.

A multistage stratified cluster random sampling method was employed to select study participants aged 15 years and older who had resided in the Xizang region for over six months. Data ware managed using EpiData 3.1 and analyzed with IBM SPSS Statistics 24.0.

Among 1 191 participants, awareness rates of the five core TB prevention indicators were 32.58% (388/1 191), 78.51% (935/1 191), 77.25% (920/1 191), 62.05% (739/1 191), and 47.69% (568/1 191), respectively. The overall awareness rate was 59.61% (3550/5 955), while the full-awareness rate (all five messages) reached 11.50% (137/1 191).

Xizang’s overall TB core knowledge awareness rate (59.61%) falls below the 85% target set by the National TB Control Plan (2016-2020). Tailored interventions are recommended, including Tibetan-Chinese bilingual health campaigns targeting agricultural/pastoral workers, individuals with limited education, and employees of government agencies/enterprises. Concurrent efforts should enhance livelihood support and bilingual training for grassroots workers in high-altitude regions.

Exacerbations of chronic obstructive pulmonary disease (ECOPD) represent a critical prognostic factor for COPD patients, significantly impacting health outcomes and imposing substantial economic burdens on families and society.This review aims to summarize current knowledge on ECOPD epidemiology to inform prevention and control strategies.

We conducted a comprehensive literature review focusing on the epidemiological characteristics, risk factors, and preventive measures of ECOPD.

Global ECOPD prevalence shows a persistent upward trend with consistently high mortality rates. Significant variations exist across countries, time periods, and populations, influenced by multiple factors including environmental exposures, comorbidities, and healthcare accessibility. Key risk factors include smoking, air pollution, respiratory infections, and poor medication adherence. Effective preventive strategies encompass smoking cessation, vaccination programs, air quality improvement, and optimized disease management.

ECOPD remains a major public health challenge requiring urgent attention. Enhanced understanding of its epidemiological patterns and risk factors is crucial for developing targeted interventions to reduce disease burden and improve patient outcomes.

To investigate the association between alpha-1-acid glycoprotein (AGP) and prediabetes prevalence in US adults.

We analyzed data from 2 926 participants (age ≥18 years) in the National Health and Nutrition Examination Survey (2017-2023). Participants were classified into prediabetes and non-prediabetes groups. AGP levels were measured and analyzed both as continuous and quartile-categorized variables. Weighted logistic regression models were employed to assess this relationship after adjusting for covariates.

The prediabetes group showed significantly higher AGP levels (0.79±0.02) versus controls (0.78±0.01; P<0.001). In fully adjusted models, each unit increase in AGP was associated with 7.8% higher prediabetes risk (OR=1.08, 95%CI:1.453-1.842). Quartile analysis revealed progressively increasing risks from Q2 to Q4 versus Q1 (all P<0.05). Subgroup analyses showed stronger associations in females (OR=1.01,95%CI:1.095-2.778, P=0.043) and younger adults (18-39 years; OR=1.22, 95%CI:1.182-7.965, P=0.008).

Elevated AGP levels are consistently associated with increased prediabetes risk, suggesting its potential as a novel biomarker for early risk identification.

To investigate the prevalence and influencing factors of scoliosis among middle school students in Anhui Province, providing a reference for scoliosis prevention and control.

From September to November 2022, a stratified cluster random sampling method was used to select 104 022 middle school students in Anhui Province for spinal curvature abnormality screening and questionnaire surveys. Logistic regression models were employed to analyze the influencing factors of scoliosis.

The detection rate of scoliosis among middle school students in Anhui was 2.46%, with thoracolumbar, lumbar, and thoracic scoliosis detection rates of 1.74%, 1.56%, and 1.45%, respectively. The detection rate of scoliosis generally increased with grade (χ²_trend=28.535, P_trend < 0.001), and high school students had a higher detection rate than junior high school students (2.76% vs. 2.21%, P < 0.001). Multivariate logistic regression analysis showed that among junior high school students, suburban residence (OR=0.65, 95%CI: 0.58-0.72) and overweight/obesity (OR=0.66, 95%CI: 0.58-0.75) were protective factors, while underweight (OR=1.30, 95%CI: 1.01-1.66) was a risk factor. Among high school students, suburban residence (OR=0.67, 95%CI: 0.59-0.76), overweight/obesity (OR=0.73, 95%CI: 0.65-0.83), correct reading/writing posture (OR=0.68, 95%CI: 0.52-0.89), moderate-to-vigorous physical activity ≥3 days/week (OR=0.85, 95%CI: 0.74-0.96), daytime outdoor activity ≥1 h/day (OR=0.88, 95%CI: 0.78-0.99), and adequate sleep (OR=0.80, 95%CI: 0.68-0.93) were protective factors, whereas underweight (OR=1.37, 95%CI: 1.08-1.75) was a risk factor.

Residential area, nutritional status, reading/writing posture, physical activity, and sleep are influencing factors of scoliosis among middle school students. Targeted interventions based on these factors should be implemented across different school stages to reduce the occurrence of scoliosis.

To systematically compare the performance of seven machine learning algorithms in constructing prediction models for tuberculosis (TB) recurrence among newly treated patients in Kashgar, Xinjiang, providing data support for optimizing recurrence intervention strategies in high-burden areas.

We analyzed 69 476 successfully treated new TB patients from 2016 to 2022 in Kashgar, with follow-up through 2023. Independent predictors were selected through multivariate logistic regression. Seven models (logistic regression, decision tree, random forest, multilayer perceptron, XGBoost, LightGBM, and elastic net) were developed and validated. The optimal model was interpreted using SHapley Additive exPlanations (SHAP).

Among 69 476 cases, 9 444 (13.59%) experienced recurrence by 2023. Fourteen independent predictors were identified. The seven models showed AUC values ranging from 0.705 to 0.762 in the training set, with the decision tree model performing best (AUC=0.762, 95%CI: 0.758-0.766) and demonstrating good calibration. SHAP analysis revealed sputum culture results at diagnosis, local TB burden, and treatment modality as the top three predictive factors.

The decision tree model based on routine surveillance data shows high predictive performance for TB recurrence, with interpretable features that can facilitate early identification of high-risk individuals in clinical practice.

To evaluate the effectiveness of salt reduction intervention on knowledge, attitudes, and practices (KAP) regarding salt intake among residents in six provinces of China.

This cluster randomized controlled trial employed multistage cluster random sampling to select residents aged 18 to 75 years from six provinces (Hebei, Heilongjiang, Jiangxi,Hunan, Sichuan, and Qinghai). A comprehensive salt reduction intervention targeting multiple populations and settings was implemented, followed by questionnaire surveys and physical examinations. Difference-in-differences analysis combined with multilevel logistic regression models was used to assess the net intervention effect.

A total of 2 269 participants were included (control group: 1 096; intervention group: 1 173). The intervention significantly improved knowledge, including awareness of daily salt intake recommendations (OR=6.124), the association between high salt intake and hypertension (OR=2.652), the misconception that low salt intake causes weakness (OR=2.469), awareness of low-sodium salt (OR=1.650), and understanding of salt content on food labels (OR=2.486). Positive attitudes toward salt reduction also increased, including willingness to choose low-salt diets (OR=2.717) and confidence in maintaining low-salt diets (OR=2.067). Behavioral improvements were observed in the use of low-sodium salt (OR=1.774), reduced consumption of pickled foods (OR=1.300), and reduced intake of salty snacks (OR=1.997)(all P < 0.05). Sensitivity analyses yielded consistent results.

The salt reduction intervention effectively enhanced salt-related knowledge and attitudes, while promoting certain salt-reducing behaviors among residents in six provinces.