To explore the impact of combined trajectories of sleep duration and sleep quality on diabetes risk among middle-aged and older adults, providing evidence for precision prevention and control of diabetes.

Data of the China Health and Retirement Longitudinal Survey from 2011 to 2015 were analyzed to identify the combined trajectories of sleep duration and sleep quality, employing group-based multi-trajectory modeling (GBMTM). The prevalence of diabetes among middle-aged and older adults was tracked using data from 2015 to 2020. The effect of different combined trajectories of sleep duration and sleep quality on diabetes risk was examined using Cox proportional hazards regression models. Meanwhile, subgroup analyses were conducted.

A total of 8 735 middle-aged and older adults were included. Four combined trajectories of sleep duration and sleep quality were identified: increasing sleep duration-limited improvement in sleep quality trajectory (n=1 200, 13.74%, trajectory group 1), stable short sleep duration-stable poor sleep quality trajectory (n=828, 9.48%, trajectory group 2), stable normal sleep duration-stable good sleep quality trajectory (n=5 505, 63.02%, trajectory group 3), and decreasing sleep duration-deteriorating sleep quality trajectory (n=1 202, 13.76%, trajectory group 4). Cox proportional hazards regression modeling showed that, compared with the trajectory group 3, trajectory group 1 (HR=1.29, 95% CI: 1.03-1.63), trajectory group 2 (HR=1.54, 95% CI: 1.19-1.98), trajectory group 4 (HR=1.42, 95% CI: 1.14-1.78) had a higher risk of diabetes. In the subgroup analyses, there was an interaction between sleep duration and sleep quality trajectories and gender (P=0.047).

Among middle-aged and older adults, individuals in trajectory group 1, trajectory group 2, and trajectory group 4 had an increased risk of diabetes.

To analyze the prevalence and usage of smart health and eldercare devices among middle-aged and older adults in Yunnan Province, and to compare disparities across different groups.

A stratified random cluster sampling method was employed. Face-to-face questionnaire surveys were conducted among adults aged 45 and above from 6 prefectures (cities) in Yunnan Province, yielding 2 595 valid questionnaires. Data were analyzed using Stata 15.1.

The prevalence of devices ranked as follows: smartphones (83.55%), smart TVs (77.88%), video surveillance (36.30%), etc., with fall alarms being the lowest (1.19%). A notable decline was observed from device ownership rate to usage rate and proficiency rate, indicating an “ownership-usage-proficiency” efficacy decay. Smartphones had the highest prevalence (83.55%) and regular usage rate (60.42%), while smart TVs had the highest proficient usage rate (49.83%). Fall alarms had the lowest rates in prevalence (1.19%), regular usage (0.35%), and proficient usage (0.19%). Significant differences in device prevalence, regular usage rate, and proficient usage rate were found across ethnic and age groups, whereas no significant differences were observed between genders.

The prevalence and use of smart health and eldercare devices (except for smart cell phones and TVs) among the middle-aged older adults in Yunnan Province are low overall, and there are significant ethnic and age differences.

To explore the longitudinal evolutionary trajectories of active health behaviors among older adults with multiple chronic conditions, analyze the impact of different evolutionary patterns on healthcare utilization, and provide evidence for formulating healthy aging policies.

Based on the China Health and Retirement Longitudinal Study (CHARLS, 2011—2020), participants who were aged ≥60 years at baseline, had ≥2 comorbid chronic diseases, and provided complete follow-up data were included. A 5-dimensional active health index (AHI), covering physical activity, social participation, and other dimensions, was constructed, and latent transition analysis (LTA) was used to classify the trajectories. Generalized linear mixed models (GLMMs) and multivariable logistic regression were employed to analyze the associations, and subgroup and sensitivity analyses were conducted to verify the robustness of the results.

A total of 96 628 participants were enrolled and categorized into three AHI trajectory groups: 19.9% in the “sustained improvement group”, 32.5% in the “long-term stable group”, and 47.6% in the “gradual decline group”. Compared with the gradual decline group, the sustained improvement group had fewer outpatient visits (negative binomial regression coefficient β=-0.21, P<0.001), a lower hospitalization risk [odds ratio (OR) =0.82, 95% confidence interval (CI) : 0.78-0.86, P<0.001], and reduced annual medical expenses (log-normal regression coefficient β=-0.33, P<0.001). A similar trend was observed in the long-term stable group (outpatient visits: β=-0.13;hospitalization: OR=0.87, 95% CI: 0.83-0.91; medical expenses: β=-0.20;all P<0.001). These associations remained robust after stratified analysis, with slightly stronger effects observed in females and urban residents.

Significant heterogeneity exists in the evolution of active health behaviors among older adults with multiple chronic conditions. Long-term stability or improvement of these behaviors can reduce healthcare utilization and alleviate economic burden. Behavior-based health promotion strategies are feasible approaches to achieve healthy aging and optimize the allocation of medical resources.

To investigate the prognostic value of cytoplasmic poly (A)-binding protein 1 (PABPC1) expression, alone and in combination with Ki-67 and P53, in evaluating chemotherapy prognosis in patients with triple-negative breast cancer (TNBC).

A retrospective analysis was conducted on the clinicopathological data of 155 patients diagnosed with and treated for TNBC at the Affiliated Hospital of Southwest Medical University between January 2014 and December 2021. Immunohistochemistry was employed to detect the expression levels of PABPC1, Ki-67, and P53 in tumor tissues. Their correlations with patient overall survival (OS) and disease-free survival (DFS) were subsequently analyzed.

Among the 155 patients included in the study, high PABPC1 expression was observed in 59 cases (38.1%), Ki-67 positivity in 119 cases (76.8%), and P53 positivity in 70 cases (45.2%). PABPC1 expression, patient age, and pathological stage significantly influenced the postoperative survival of TNBC patients. In contrast, tumor location, clinical stage, lymph node metastasis, HER-2 expression, Ki-67 expression, and P53 expression were not significantly associated with survival. In the patient subgroup with high PABPC1 expression, those who received postoperative chemotherapy demonstrated improved OS compared to those who did not, although this difference did not reach statistical significance. However, within the subgroup of patients exhibiting both high PABPC1 expression and Ki-67 positivity, those who received postoperative chemotherapy had a significantly longer OS compared to their counterparts who did not undergo chemotherapy.

TNBC patients with low PABPC1 expression exhibit favorable survival outcomes, irrespective of whether they receive chemotherapy. Conversely, patients with high PABPC1 expression have a poorer prognosis. The combined assessment of PABPC1 and Ki-67 holds clinical significance, as patients displaying both high PABPC1 expression and Ki-67 positivity may derive substantial benefit from postoperative adjuvant chemotherapy.

Based on the social cognitive theory, this study aimed to examine the mediating role of outcome expectations in the relationship between physician-patient trust and medication adherence among older adults living with HIV, so as to provide evidence for developing effective intervention strategies.

A cross-sectional survey was conducted from July to October 2024 in six districts (counties, county-level cites) of Xiangyang City, using a stratified random sampling method. Data were collected using the Morisky Medication Adherence Scale, the Physician-Patient Trust Scale, and the Outcome Expectations Scale. Hierarchical regression analysis was employed to test the mediating effect of outcome expectations.

A total of 203 valid samples were obtained. The analysis revealed that factors such as gender, place of residence, average monthly household income, occupational status, alcohol consumption, and adverse drug reactions had significant effects on medication adherence (P<0.05). Physician-patient trust and outcome expectations were significantly positively correlated with antiretroviral medication adherence (r=0.37, P<0.001). Outcome expectations played a partial mediating role between physician-patient trust and medication adherence, with a mediation effect of 10%.

Physician-patient trust can significantly improve medication adherence in older adults with HIV by enhancing their positive outcome expectations. It is recommended that antiretroviral therapy programs for this population focus on strengthening patients’ positive perceptions of treatment benefits to improve their medication adherence.

Based on the surveillance data of brucellosis in Hubei from 2010 to 2023, this study explores its epidemiological characteristics and contributing factors. The findings may serve as a decision-making reference for developing targeted prevention and control mechanisms and optimizing current intervention strategies.

The data in this research were obtained from the National Notifiable Infectious Disease Surveillance Platform (China CDC Information System). Data organization and preliminary analysis were carried out using Excel, statistical analyses were performed with SPSS 25.0, and spatial geographic distribution maps were generated via ArcGIS 10.2 to visually present the epidemic distribution.

In 2010, the first case of human brucellosis was reported in Hubei. A total of 2 176 cases were reported from 2010 to 2023. The incidence showed a phased fluctuation trend: a budding phase in the initial period (2010—2013), followed by a significant increase in the early stage (2013—2016), a gradual decline in the mid-term (2016—2020), and a resurgence in the later period (2020—2023). The cases exhibited distinct seasonal clustering, and 67.2% of cases occurred between March and August. In terms of spatial distribution, except for Shennongjia, cases were reported in the other 16 cities (prefectures) of the province, and core high-incidence areas included Suizhou City, Jingmen City, Xiangyang City, Xianning City, and Huanggang City. The coverage rate of cases in counties and districts reached 93.2%. Demographic analysis revealed that people aged 40 to 69 accounted for 72.6% of cases, with a male-to-female ratio of 2.4:1. Occupational distribution was dominated by farmers (69.1%). The median diagnostic delay period (interval from symptom onset to diagnosis) was 9 days, showing a gradual shortening trend over the years. Suspected cases were most concentrated in Guangshui City and Suixian. A structural shift in case reporting sources was observed: the proportion of cases reported by municipal medical institutions increased, while the share from county-level institutions increased initially before declining. In contrast, the contribution from disease control centers saw a significant drop.

From 2016 to 2020, the incidence of human brucellosis in Hubei continued to decline, indicating partial success in its ovine brucellosis eradication campaign launched in early 2015. However, a significant resurgence occurred post-2020, with the epidemic demonstrating geographical expansion from northern Hubei to southern Hubei and from eastern Hubei to western Hubei. It is imperative to establish a coordinated mechanism for zoonotic diseases through cross-sectoral collaboration to enhance the surveillance, prevention, and control of brucellosis.

To understand the epidemiological characteristics of syphilis among people aged 60 years and above in Hebei Province from 2015 to 2024, and to provide a basis for formulating prevention and control strategies.

Data on syphilis cases reported in Hebei Province from 2015 to 2024 were collected through the Chinese Disease Prevention and Control Information System, and descriptive epidemiological methods were used for analysis.

The number of syphilis cases reported among people aged 60 and above in Hebei Province increased from 2 261 to 3 570, and the reported incidence rate rose from 21.32 per 100 000 to 22.19 per 100 000. The reported incidence rate of primary syphilis showed a downward trend, while that of secondary syphilis showed an initial increase followed by a decrease. The reported incidence rate of tertiary syphilis did not show a linear trend change. The number of reported cases of latent syphilis showed an upward trend. The proportion of primary and secondary syphilis decreased from 26.54% to 6.00%, while the proportion of latent syphilis cases increased from 72.76% to 93.56%. During the ten years, the number of reported cases and the incidence rate among men were higher than those among women each year. The highest average annual incidence rate was observed in the age group of 85 years and older (34.19 per 100 000 population).

The number of syphilis cases reported among people aged 60 and above in Hebei Province has been increasing year by year from 2015 to 2024, with a high proportion of latent syphilis showing an upward trend. This suggests that we should further pay attention to the sexual health of the elderly, and implement targeted prevention and control measures based on their disease characteristics.

To analyze the epidemiological and etiological characteristics of influenza-like illness (ILI) in Jinhua City, Zhejiang Province, during the 2017—2024 surveillance years, and to provide a scientific basis for influenza prevention and control in the city.

ILI surveillance data from sentinel hospitals in Jinhua City during 2017—2024 surveillance years (from week 14 of the current year to week 13 of the following year) were collected through the Chinese Influenza Surveillance Information System and analyzed using descriptive epidemiological methods.

During the 2017—2024 surveillance years, a total of 7 748 309 outpatient and emergency visits were reported, including 426 013 ILI cases, with an overall ILI proportion (ILI%) of 5.50%. The highest ILI% was observed in the 2022 surveillance year (8.75%), while the lowest was recorded in the 2024 surveillance year (2.66%). Marked inter-annual fluctuations in ILI activity were noted: single winter peaks occurred in the 2017—2019 surveillance years. The 2021 surveillance year exhibited multiple cross-seasonal peaks. The 2022 surveillance year showed two peaks, one in summer and the other in late winter and early spring. A single winter peak reappeared in the 2023 surveillance year, and no significant epidemic peaks were detected in the 2020 or 2024 surveillance years. ILI cases were predominantly concentrated in the 0-4 years age group, accounting for 53.45% of all reported cases. A total of 18 911 ILI specimens were tested for influenza virus, of which 3 025 were positive, yielding an overall positive rate of 16.00%. Influenza A and B viruses accounted for 71.17% and 28.56% of positive detections, respectively. Among the identified subtypes and lineages, A (H3N2) accounted for 40.89%, followed by A (H1N1) pdm09 (30.28%), B/Victoria lineage (27.17%), and B/Yamagata lineage (1.39%). No B/Yamagata virus was detected after the 2020 surveillance year. Mixed infections accounted for 0.26%. The ILI% was significantly positively correlated with the influenza virus positivity rate in the 2017, 2018, 2019, 2022, and 2023 surveillance years (P<0.001).

Influenza activity in Jinhua City during the 2017—2024 surveillance years exhibited distinct seasonal fluctuations and pronounced inter-annual variability. Influenza activity was markedly suppressed during the implementation of non-pharmaceutical interventions (NPIs) against COVID-19 and rebounded following their relaxation. The predominant strains alternated across surveillance years, with A (H3N2) accounting for the highest proportion, while B/Yamagata lineage was no longer detected after 2020. Further optimization of the influenza sentinel surveillance system, including strengthening multi-pathogen co-surveillance and integrated data analysis, is needed to provide scientific evidence for precision influenza prevention and control.

To analyze the association between empirical dietary inflammatory pattern (EDIP) and breast cancer risk in women.

From 2013 to 2014, 718 patients with primary breast cancer diagnosed in Wuxi City, Jiangsu Province were included in the case group, and 849 women from the same area, age-matched within ±5 years and with no history of cancer, were included in the control group. A food frequency questionnaire was used to collect information on the types, frequencies, and quantities of food consumed by the subjects in the past 12 months. This study used a multivariable conditional logistic regression model to assess the influence of EDIP on the risk of breast cancer among females, and to calculate the corresponding odds ratio (OR) and 95% confidence interval (CI). The restricted cubic spline (RCS) method was also applied to explore the potential dose-response relationship between EDIP and breast cancer risk. Subgroup analyses were conducted to assess the interactions between EDIP and stratification variables such as age and physical activity.

The median age of the case group was 53 years, with 74.1% of the participants being postmenopausal; while the median age of the control group was also 53 years, and 58.2% of the participants in this group were postmenopausal. Following adjustment for potential confounders, the multivariable conditional logistic regression analysis indicated that the risk of breast cancer increased by 17% (OR=1.17, 95% CI: 1.05-1.31) for each one-standard deviation increase in EDIP. Using the T1 group as the reference, the risk of breast cancer increased by 35% in the T3 group (OR=1.35, 95% CI: 1.03-1.76). There was a positive linear dose-response relationship between EDIP and breast cancer risk (P for overall <0.05, P for nonlinearity >0.05). The association between EDIP and breast cancer was stronger in the subgroups of individuals with low levels of physical activity (P for interaction <0.05).

Elevated EDIP was associated with an increased risk of breast cancer in Chinese women, but further validation in prospective studies is still needed.

To investigate the association between the high-density lipoprotein cholesterol to cystatin C ratio (HDL-C/CysC) and the risk of chronic kidney disease (CKD) in middle-aged and older Chinese populations.

Utilizing demographic statistics, disease history, physical examination, and blood test data from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2020, we excluded individuals with missing key indicators, pre-existing CKD at baseline, or renal dysfunction. Participants were categorized into quartiles based on HDL-C/CysC ratios. A Cox proportional hazards regression model was employed to examine the relationship between HDL-C/CysC ratio levels and CKD risk, with subgroup analyses conducted by age, sex, and body mass index (BMI).

The study included 6 429 subjects with an age distribution of 59.00 (53.00-66.00) and a 9-year follow-up period. During follow-up, 1 007 incident CKD cases were identified, yielding an incidence density of 20.46 per 1 000 person-years. After adjusting for potential confounding factors, using the lowest quartile (Q1) of HDL-C/CysC ratio as reference, the hazard ratios (HRs) and 95% confidence intervals (CIs) for CKD risk in Q2, Q3, and Q4 were 0.81 (0.68-0.97), 0.50 (0.41-0.61), and 0.22 (0.16-0.29), respectively. A significant inverse association was observed between increasing HDL-C/CysC quartiles and CKD risk (P<0.001).

In middle-aged and older Chinese adults, the HDL-C/CysC ratio is independently and significantly associated with CKD risk. A higher HDL-C/CysC ratio may be a protective factor for CKD.