To comprehensively analyze the epidemiological characteristics and trends of intestinal infectious diseases among the elderly population in eastern China, providing data support for formulating regional strategies for the prevention and control of intestinal infectious diseases.

Data on intestinal infectious disease cases among people aged 60 and above in eastern China from 2008 to 2022 were collected and organized from the China National Notifiable Infectious Disease Reporting System. Descriptive methods were used to analyze the distribution characteristics of intestinal infectious diseases among the elderly, and Joinpoint regression was applied to study the dynamic trends in standardized reported incidence rates.

The annual standardized reported incidence rate of intestinal infectious diseases among the elderly in eastern China was 88.75 per 100 000, with males (95.18 per 100 000) having higher rates than females (83.85 per 100 000). The annual reported incidence rate increased with age, with the lowest in the 60-64 age group (79.82 per 100 000) and the highest in the ≥85 age group (118.05 per 100 000). From 2008 to 2022, the standardized reported incidence rate of intestinal infectious diseases among the elderly in eastern China showed a declining trend, with an average annual percentage change of -2.93% (-4.31%~-1.53%, P<0.001). For males and females, the changes were -4.03% (-5.48%~-2.56%, P<0.001) and-2.47% (-3.85%~-1.07%, P=0.001), respectively. Disease-specific trend analysis showed declining trends in the standardized reported incidence rates for bacterial and amebic dysentery, typhoid/paratyphoid, hepatitis E, and unspecified hepatitis, with average annual percentage changes of -14.39% (-16.46%~-12.26%, P<0.001), -7.87% (-10.24%~-5.43%, P<0.001),-3.33% (-5.22%~-1.41%, P=0.003), and -15.63% (-17.14%~-14.09%, P<0.001), respectively.

From 2008 to 2022, intestinal infectious diseases among the elderly in eastern China showed an overall year-by-year declining trend. Older adults and males should be prioritized in prevention and control efforts, and surveillance, prevention, and control measures for these key populations should be further strengthened.

To investigate the longitudinal association of baseline chronic kidney disease (CKD) status and estimated glomerular filtration rate (eGFR) levels with the risk of incident knee osteoarthritis (KOA) among middle-aged and older Chinese adults, and to provide epidemiological evidence for the pathological crosstalk of the “kidney-bone axis”.

This study utilized longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS, 2011—2018). A total of 4 182 participants aged 45 years and older, free of KOA at baseline and with complete covariate data, were included. Missing data were handled using multiple imputation. The association between baseline CKD [defined as eGFR <60 ml/ (min·1.73m²) ] and incident KOA was analyzed using Kaplan-Meier survival curves and multivariatble Cox proportional hazards regression models. Restricted cubic spline (RCS) modeling was employed to examine the dose-response relationship between eGFR levels and KOA risk. Subgroup analyses and lag analyses were conducted to verify the robustness of the results.

During an average follow-up of 4 years, the cumulative incidence of incident KOA was significantly higher in the CKD group compared to the non-CKD group (Log-rank P<0.001). Multivariable Cox regression analysis demonstrated that, after adjusting for demographics, lifestyle factors, body mass index (BMI), and chronic comorbidities, baseline CKD remained an independent risk factor for incident KOA [hazard ratio (HR) =1.82, 95% confidence interval (CI) : 1.30-2.55, P<0.001]. RCS analysis revealed no significant linear or non-linear dose-response relationship between baseline eGFR levels and KOA risk in the total population (P for overall association =0.348), suggesting a pathological threshold effect of renal function on KOA. Sensitivity analyses confirmed the robustness of these findings.

CKD is an independent risk factor for incident KOA among middle-aged and older Chinese adults, characterized by a potential pathogenic threshold effect at an eGFR of <60 ml/ (min·1.73m²). Integrated management of joint health in CKD patients should be prioritized, employing early screening to achieve comprehensive prevention and treatment of “kidney-bone/joint” comorbidities.

This study systematically analyzed temporal trends in the burden of spinal cord injury (SCI) attributable to falls in China from 1990 to 2021, focusing on incidence, prevalence, and years lived with disability (YLD).

Data were obtained from the Global Burden of Disease (GBD) 2021 database, using publicly available national estimates of fall-related SCI in China from 1990 to 2021. Descriptive analyses were conducted to characterize changes in incidence, prevalence, and YLD. Temporal trends were further examined using Joinpoint regression and age-period-cohort (APC) models.

In 2021, the number of prevalent cases of fall-related SCI in China was estimated at 1 480 074, with 62 724 incident cases. The age-standardized prevalence rate (ASPR) was 80.21 per 100 000 population and the age-standardized incidence rate (ASIR) was 3.76 per 100 000 population. Total YLDs reached 397 472 years, corresponding to an age-standardized YLD rate (ASYR) of 21.74 per 100 000 population. Sex-based analysis showed a substantially higher disease burden in males than in females. Joinpoint regression indicated a modest increase in ASIR during 1995—2000 (APC=1.89), a marked decline during 2000—2005 (APC=-6.12), followed by a rapid increase during 2010—2021 (2010—2015: APC=5.90; 2015—2021: APC=4.59). Similarly, ASPR showed a slight increase during 1990—2001 (APC=0.55), a significant decline during 2001—2005 (APC=-8.58), and a renewed rapid increase during 2010—2021 (APC=5.08). YLDs remained relatively stable from 1990 to 2000, declined during 2000—2007 (APC=-9.94), and increased during 2010—2021 (APC=4.68). Overall trends were comparable between males and females. APC analysis revealed a pronounced increase in SCI risk with advancing age, while period and cohort effects fluctuated but showed an overall upward pattern, suggesting that economic development, improvements in healthcare, and population aging may jointly contribute to the increasing burden.

From 1990 to 2021, the disease burden of SCI in China has increased substantially, with males and older adults experiencing markedly higher risks than females and younger populations. Targeted public health strategies addressing population aging and risk management among high-risk groups are urgently needed to mitigate the long-term health and societal impacts of SCI.

To investigate the prevalence and influencing factors of comorbidity of hypertension, diabetes and dyslipidemia among residents aged 18 years and above in Wenzhou City, and to provide a reference basis for the targeted implementation of “triple management” of hypertension, diabetes and dyslipidemia.

From June 2023 to August 2024, a multi-stage random cluster sampling method was used for sampling. A total of 38 593 subjects were surveyed through questionnaires, physical examinations and laboratory tests. χ² test and multivariable unconditional logistic regression analysis were conducted using SPSS 23.0.

The prevalence of hypertension, diabetes, and dyslipidemia among residents aged 18 and above in Wenzhou was 30.61%, 12.98%, and 39.75%, respectively. The comorbidity rate of hypertension, diabetes and dyslipidemia was 5.31%. Multivariable unconditional logistic regression analysis revealed that advanced age (compared with the 18-29 age group, 30-39 years: OR=5.069, 95% CI: 2.009-12.791; 40-49 years: OR=19.138, 95% CI: 7.750-47.258; 50-59 years: OR=71.447, 95% CI: 28.777-177.391; 60-69 years: OR=298.825, 95% CI: 119.102-749.750; 70-79 years: OR=570.190, 95% CI: 225.190-1 443.740; ≥80 years: OR=549.523, 95% CI: 202.033-1 494.686), regular alcohol consumption (compared with never drinking, OR=1.461, 95% CI: 1.148-1.860), excessive salt intake (OR=1.346, 95% CI: 1.150-1.575), overweight (OR=2.332, 95% CI: 1.980-2.747), obesity (OR=4.440, 95% CI: 3.453-5.710), central obesity (OR=2.909, 95% CI:2.468-3.429), family history of hypertension (OR=2.727, 95% CI: 2.333-3.187), and family history of diabetes (OR=2.900, 95%CI: 2.438-3.450) were risk factors for the coexistence of hypertension, diabetes, and dyslipidemia. High school or technical secondary education (compared with primary school and below, OR=0.715, 95% CI: 0.552-0.926), college education or above (OR=0.401, 95% CI: 0.287-0.562), and annual household income ≥200 000 CNY (compared with <50 000 CNY, OR=0.641, 95% CI: 0.439-0.937) were protective factors against the coexistence of these three conditions.

The comorbidity rate of hypertension, diabetes and dyslipidemia among adult residents in Wenzhou City is at a relatively high level. Interventions should be strengthened for high-risk groups, and a healthy lifestyle should be advocated to control weight and waist circumference, and reduce the risk of comorbidity of the three diseases.

To understand the epidemic characteristics and predominant pathogenic bacterial groups of meningococcal meningitis in Anhui Province from 2006 to 2024, and to provide a basis for the prevention and control of meningococcal meningitis and the adjustment of immunization strategies.

Data on the incidence of meningococcal disease and pathogen detection in Anhui Province from 2006 to 2024 were collected through the Chinese Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the epidemiological characteristics and bacterial distribution of meningococcal disease. The Joinpoint software was used to analyze the incidence from 2006 to 2024.

From 2006 to 2024, a total of 1 014 cases of meningococcal meningitis were reported in Anhui Province, with an average annual incidence rate of 0.09 per 100 000. Joinpoint regression analysis showed that the incidence of meningococcal meningitis overall decreased from 2006 to 2024 [average annual percent change (AAPC) =-27.66%, P<0.001], with a significant decrease in the number of cases from 2008 to 2015 [annual percent change (APC) =-45.36%, P<0.001]. The top three reporting regions with the average annual incidence rate were Hefei City (0.34 per 100 000), Bengbu City (0.17 per 100 000), and Huainan City (0.12 per 100 000). The cases were mainly concentrated from November to the following April, accounting for 89% of the total. The male-to-female ratio was 1.43 (597/417); the age group with the highest incidence was 15-19 years old (26.53%), 10-14 years old (24.46%), and the 0-4 age group (15.48%); the occupation was mainly students (55.23%). From 2006 to 2024, a total of 170 cases of bacterial surveillance were reported in Anhui Province. The bacterial strain changes showed a trend of a decrease in the proportion of C strain and an increase in the proportion of B strain year by year. In terms of age distribution, the 0-4 age group was mainly dominated by the B strain (43.75%), while the 10-19 age group was mainly dominated by the W135 strain, A strain, and C strain with diversified high incidence.

The incidence of meningococcal disease in Anhui Province is currently at a low level. The peak incidence ages are concentrated in the 10-19 years old and 0-4 years old groups. The predominant strain is Group B. The prevention and control of meningococcal disease faces new challenges. It is recommended to provide an additional dose of meningococcal vaccine for adolescents aged 10-19 years old.

This study aims to investigate the association between the metabolic score for insulin resistance (METS-IR) and the risk of gallstone disease (GSD).

Data were collected from participants who underwent health examinations at four hospital health management centers in Chongqing and Beijing between 2015 and 2020. Multivariable logistic regression analysis was employed to examine the correlation between METS-IR and GSD risk across different centers, and a meta-analysis was conducted to pool the results from each hospital.

A total of 543 371 participants were included in this study, with a GSD prevalence of 8.05%. Multivariable logistic regression analysis revealed a positive correlation between METS-IR and GSD risk, with each unit increase in METS-IR associated with a 3.5% increase in GSD prevalence (OR=1.035, 95% CI:1.027-1.042). After converting METS-IR into categorical variables based on quartiles, the results indicated that the prevalence of GSD in the highest quartile group was 2.268 times that of the lowest quartile group (OR=2.268, 95% CI:1.827-2.709). In various subgroups categorized by age, gender, and gallstone subtype, METS-IR remained significantly positively correlated with the risk of GSD.

Insulin resistance significantly increases the risk of GSD. In the future, screening should be implemented for high-risk populations with insulin resistance to enable early detection and reduce the disease burden of gallstone disease.

To systematically evaluate the application effects of different types of machine learning (ML) models in predicting intensive care unit length of stay (ICULOS) in adult patients.

By searching China National Knowledge Infrastructure (CNKI), Wanfang Database, and English databases PubMed and Web of Science, we collected studies on machine learning to predict ICULOS in adult patients published from the establishment of the database to October 2025, screened the included literature, and performed Meta-analysis using RStudio.

A total of 40 articles were included, among which the three most frequently used models were random forest (RF), extreme gradient boosting (XGBoost), and gradient boosting machine (GBM) models. The overall prediction performance was good, with a combined area under curve (AUC) of 0.82 (95% CI: 0.79-0.85). Among the prediction models for ICULOS in adult patients with cardiovascular-related diseases, XGBoost had the best prediction effect (AUC=0.88, 95% CI: 0.86-0.93). Among the prediction models for ICULOS in adult patients with central nervous system-related diseases, mixed models showed the best predictive performance (AUC=0.90). In the prediction models of ICULOS of adult patients with other diseases and undifferentiated disease types, RF had the best prediction effect (AUC_{other specific diseases}=0.89, 95% CI: 0.84-0.94; AUC_{undifferentiated diseases}=0.95).

ML showed good performance in predicting ICULOS of adult patients. In the prediction of ICULOS of adult patients with different diseases, the appropriate ML model should be selected in combination with the specific disease and data structure.

To examine the effects of the residential built environment on obesity among adults, and to provide evidence to inform built environment optimization for the prevention and control of overweight and obesity.

This cross-sectional study included individuals who underwent health examinations at the Health Management Center of Renmin Hospital of Wuhan University between May and August 2023. Of 1 672 examinees, 1 349 participants who met the inclusion criteria and had complete data were included in the analysis. Information on long-term residential address, residential floor, sex, age, and body mass index (BMI) was collected, and spatial analysis methods were applied to quantify environmental characteristics surrounding participants’ residential locations. Least Trimmed Squares (LTS) regression and logistic regression models were used to assess the associations between environmental factors and BMI, as well as overweight/obesity status. Generalized linear mixed models (GLMMs) were employed to examine the relationship between residential floor level and the likelihood of overweight/obesity.

Among the 1 349 participants, the prevalence of overweight and obesity was 36.4% and 11.0%, respectively. Higher accessibility to transportation facilities (coef=0.324, P<0.001) and dining facilities (coef=0.233, P=0.006) were associated with increased BMI. Greater accessibility to transportation facilities (OR=1.141, 95% CI:1.000-1.302) and exercise facilities (OR=1.177, 95% CI: 1.017-1.362) were associated with a higher risk of overweight/obesity. As residential floor level increased, the probability of overweight/obesity first increased and then decreased, reaching a peak at around the 14th floor.

BMI and the likelihood of overweight/obesity were associated with multiple environmental factors. Residential floor level affected the probability of overweight/obesity, which may be related to stair-related physical activity and the indirect influence of individual characteristics across different floor levels.

To investigate the associations between single and mixed exposure to per- and polyfluoroalkyl substances (PFAS) and the metabolic score for insulin resistance (METS-IR), and to explore the modifying effects of sex, age, and body mass index (BMI).

Data on serum concentrations of perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and METS-IR were obtained from 2 345 participants aged 20-80 years in the National Health and Nutrition Examination Survey (NHANES) 2013—2018. We employed weighted linear regression and restricted cubic splines to examine linear and nonlinear associations of single PFAS exposure with METS-IR. The joint effects and key driver components of PFAS mixtures were assessed using weighted quantile sum regression, quantile g-computation, and Bayesian kernel machine regression. Subgroup analyses were conducted to assess potential effect modification by sex, age, and BMI.

All five PFAS were inversely associated with METS-IR, with PFHxS exhibiting a nonlinear relationship with METS-IR (q_nonlinear=0.021). A higher mixed PFAS exposure index was inversely associated with METS-IR (β^=-0.329, 95% CI: -0.583~-0.08, P=0.001), with PFDA being the primary driver (w=0.625). The mixture effect was significant in males, the elderly, and individuals with obesity (all q<0.05).

PFAS exposure is inversely associated with METS-IR, with PFDA being the key component driving the joint effect. Future prospective cohort studies are needed to validate these findings and elucidate the underlying mechanisms.