To develop a liquid-liquid extraction combined with ultra-high performance liquid chromatography-tandem triple quadrupole mass spectrometry (LLE-UHPLC-MS/MS) method for simultaneous determination of nine monoester phthalate metabolites (mPAEs) in urine.

1 ml urine sample was subjected to enzymatic hydrolysis by the addition of ammonium acetate solution and β-glucuronidase at 37 °C on a shaker for 16 h. Subsequently, 20 μl of formic acid was added and thoroughly mixed. Liquid-liquid extraction was performed with 3 ml of ethyl acetate, then the mixture was centrifuged and the supernatant was concentrated under nitrogen flow. The residue was reconstituted with 0.20 ml of acetonitrile-water solution (50∶50, v/v). Chromatographic separation was performed on a BEH C18 column (2.1 mm×100 mm, 1.7 μm) using a mobile phase of 0.10% acetic acid in acetonitrile and 0.10% aqueous acetic acid. Analytes were ionized via electrospray ionization (ESI) in negative ion mode and detected by multiple reaction monitoring (MRM), and quantification was achieved through the internal standard curves.

Good linear relationship was obtained for the analytes within 0.50 to 200 ng/ml, with correlation coefficients greater than 0.999. When 1 ml of urine sample was utilized for analysis, the detection limits and the quantitation limits of the method were 1.5×10^-3 to 0.29 ng/ml and 4.9×10^-3 to 0.98 ng/ml, respectively. The recovery rates of the method ranged from 87.05% to 111.5%, with intra-day relative standard deviations of 0.31% to 3.05%, and inter-day relative standard deviations of 0.59% to 3.46%. The nine monophthalates in 277 urine samples from healthy individuals were determined by the proposed method. Except for mono-benzyl phthalate (MBzP), which had a detection rate of 87.73%, the detection rates of other monophthalates were 100%. Mono-butyl phthalate (MnBP) had the highest median concentration of 194.10 μg/g creatinine, while MBzP had the lowest median concentration of 3.7×10^-2 μg/g creatinine.

The established method for simultaneous determination of 9 monophthalates in urine samples was simple, sensitive, and accurate, which is suitable for the accurate exposure assessment of these substances in urine.

To comprehensively evaluate the medical quality level of tertiary general hospitals in Guangxi and propose targeted quality improvement strategies.

Through the fuzzy union of entropy-weighted TOPSIS method and RSR method, we evaluated the medical quality of general hospitals in Guangxi cities and towns from 2019 to 2022, and utilized the obstacle degree model for the diagnosis of obstacle factors of medical quality development.

The top three weights of medical quality evaluation indexes were the percentage of special medical service volume (0.334), the number of patients referred downstream (0.216), and the percentage of commented prescriptions (0.107); the medical quality levels of Nanning City, Liuzhou City, and Guilin City were in the forefront, and that of Fangchenggang City, Laibin City, and Hechi City were in the back; the barrier factor diagnosis showed that the medical quality was greatly affected by functional positioning and rational drug use, with the barrier degree of 73.77% and 17.70% respectively, but the barrier degree of functional positioning showed a decreasing trend year by year, and the barrier degree of rational drug use showed a rising trend year by year, in which the barrier degree of rational drug use in Nanning City and Guilin City in 2022 had exceeded that of functional positioning.

The development of healthcare quality is not balanced between cities in Guangxi and the focus of development is different, tertiary general hospitals should clarify their own functional positioning and strengthen the guarantee of rational medication use.

To explore the external influencing factors of undergraduates’degree of satisfaction withthe Bachelors’program in preventive medicine, so as to provide a reference for improving the quality of public health higher education.

Data were obtained from the Ministry of Education’s Yangguang Gaokao information platform. The outcome variables included overall satisfaction, satisfaction with campus facilities, satisfaction with teaching quality, and satisfaction with employment outcomes. Multilevel linear regression models were employed to analyze influencing factors.

Among the 87 included universities, the average overall satisfaction score was 3.94±0.41, with employment satisfaction receiving the lowest average score of 3.61±0.52. Institutions in the eastern region reported the highest levels of satisfaction, while those in the western region reported the lowest. Regression analysis revealed that universities with preventive medicine subjects ranked in the top 50% had significantly lower levels of overall satisfaction (β=-0.299, 95% CI: -0.545 to -0.053), campus facilities satisfaction (β=-0.273, 95% CI: -0.523 to -0.022), and employment satisfaction (β=-0.379, 95% CI: -0.671 to -0.087). In models incorporating interaction terms, the development level of the Healthy China initiative in eastern regions was found to have a significantly negative effect on satisfaction compared to the western region (overall satisfaction: β=-0.861, 95% CI: -1.655 to -0.067), whereas per capita GDP had a significantly positive effect on satisfaction (overall satisfaction: β=0.089, 95% CI: 0.013 to 0.166).

Institutional preventive medicine ranking was negatively associated with student satisfaction. The provincial health system and economic levels showed varying influences on student satisfaction across different regions.

To explore the relationship between screen time and mental health problems of adolescents using restricted cubic spline model.

A questionnaire survey was conducted among 3 960 junior and senior high school students in Jinan, Weifang and Qingdao cities of Shandong Province from February to March 2023. Logistic regression model and restricted cubic spline model were used to analyze the correlation strength and dose-response relationship between screen time and psychological problems. Result 46.41% of adolescents in middle and high school had mental problems, and 29.70% reported that screen time(ST)>2 h/d. There was a nonlinear dose-response relationship between mild psychological problems and ST on rest day (P_nonlinear＝0.003, P_overall＝0.003), and the curve was approximately "J" shaped, and the risk increased beyond 1.5 h/d. ST>2 h/d on rest days was associated with mild psychological problems (OR=1.300, 95% CI;1.085-1.558). Stratified analysis showed that there was a nonlinear correlation between ST on rest day and mild mental problems (P_nonlinear<0.001), and a linear correlation between ST and moderate mental problems (P_nonlinear>0.05)(P_overall<0.001). Only smartphones and tablets were linearly associated with mild mental health problems (P_overall＝0.004), with increased risk beyond 2.0 h/d.

The average screen time over 1.5 h/d increases the risk of psychological problems. It is suggested to lighten students'study burden after class and reduce the use of electronic devices on rest days.

Toanalyze epidemiological characteristics and influencing factors of mumps in Qinghai Province from 2014 to 2023 and provide reference for the prevention and control of mumps.

The incidence data of Mumps in Qinghai Province from 2014 to 2023 were collected, and the descriptive method was used to analyze the change changing pattern of Mumps incidence. Geographically and temporally weighted regression (GTWR) was established, the mean regression coefficients were calculated, and different factors (Social factors: GDP per capita, number of students in schools; Natural factors: annual average temperature, annual average wind speed, annual total precipitation, annual total sunshine hours) on the incidence of Mumps.

From 2014 to 2023, a total of 14 278 cases of Mumps were reported in Qinghai Province, with an average annual incidence rate of 24.06/100 000, of which the highest in 2019 (65.62/100 000) and the lowest in 2016 (8.28/100 000). The seasonal index showed that Mumps showed a bimodal epidemic trend in winter and summer. The male-to-female sex ratio was 1.2:1, the highest number of cases was found in 5-<15 years old (40.66%) and 15-<25 years old (35.94%); and the occupation was dominated by students (69.15%). The incidence rate was the highest in Xining City (29.29/100 000 people) and the lowest in Yushu Prefecture (8.49/100 000 people). The GTWR model results showed that there were positive associations between annual average temperature, per capita GDP, annual total precipitation and the incidence of Mumps; and negative associations between the number of students in schools, annual average wind speed, and annual total sunshine hours with the incidence rate of Mumps.

The reported incidence of Mumps in Qinghai showed an overall downward trend. Focus on children and students aged 5 to 25 in Xining; social and natural factors have spatial heterogeneity on the incidence of Mumps, and regional prevention and control measures can be formulated in each region according to the actual situation.

To explore the potential causal relationship between gut microbiota and female infertility using the Mendelian randomization (MR) method and to determine the role of blood metabolites as potential mediators.

Gut microbiota data from 18 340 participants in 24 cohorts published by the MiBioGen Consortium, blood metabolite data from the Canadian Longitudinal Study of Aging (CLSA) cohort and Finnish R10 database on female infertility were used. The inverse variance weighting, weighted median, and MR-Egger regression method were used to investigate the causal relationship between 211 gut microbiota and 1 091 blood metabolites with female infertility. A two-step Mendelian randomization method was used to explore the potential mediating role of blood metabolites between gut microbiota and female infertility.

IVW results showed that 2 phyla, 1 class, 2 orders, 2 families, 12 genera of known gut microbiota were significantly causally associated with the female infertility. Among them, genus Lachnospira (OR=0.589, 95% CI: 0.361-0.961, P=0.035), genus Ruminococcus torques group (OR=0.756, 95% CI: 0.613-0.923, P=0.007), etc. showed a significant negative correlation with female infertility. Order Burkholderiales (OR=1.174, 95% CI: 1.062-1.284, P=0.001), genus Coprococcu2 (OR=1.174, 95% CI: 1.062-1.297, P=0.002), etc. showed a significant positive correlation with female infertility. Mediation analysis revealed that five blood metabolites could mediate the relationship between five gut microbiota and female infertility.

This study indicates that certain blood metabolites can mediate the relationship between gut microbiota and female infertility. Further investigations are warranted to explore the potential mechanisms underlying these associations.

To explore the association between multimorbidity patterns and new-onset depressive symptoms in a community population in Sichuan.

Based on the follow-up data of a Southwest cohort, multimorbidity patterns were identified among 16 long-term diseases using latent class analysis. Logistic regression model was used to investigate the associations of multimorbidity status, number of multimorbidity, and specific multimorbidity patterns with new-onset depressive symptoms. Differences in these associations within subgroups of age, sex, frequency of alcohol consumption, smoking status, and level of green space were compared by stratified analyses.

Multimorbidity status and number of multimorbidity were significantly associated with the risk of new-onset depressive symptoms with OR values of 1.46 (95% CI: 1.13-1.88) and 1.19 (1.09-1.29), respectively. Compared with hypertension multimorbidity pattern, hyperlipidemia multimorbidity and metabolic-skeletal multimorbidity were associated with the risk of depression onset with OR values of 1.69 (95% CI: 1.01-2.61) and 2.90 (95% CI: 1.47-5.71).

Multimorbidity can increase the risk of depression, and metabolic-skeletal multimorbidity has a higher risk of depression compared to hyperlipidemic multimorbidity.

To investigate the overall association between co-exposure to metals and phthalates (PAEs) and blood lipid indicators, as well as the role of metabolic disturbances and endogenous metabolites as mediators in this association.

A total of 74 residents from Guangzhou (n=35) and Qingyuan (n=39) were randomly selected, and their urine samples were analyzed for 15 metal elements and 9 PAE metabolites. Generalized linear models and generalized weighted quantile sum (gWQS) regression models were used to assess the association between individual pollutants, combined exposure, and blood lipid levels. Non-targeted metabolomics, meet-in-the-Middle (MITM) approach, and mediation analysis were performed to identify endogenous metabolites and metabolic pathways linking combined exposure with blood lipid changes, and to explore the mediating effects of metabolites.

The concentrations of seven metals, including arsenic and cadmium, and four PAE metabolites, including mono-isobutyl phthalate (MiBP), were significantly positively correlated with increased total cholesterol (TC). The weighted quantile sum (WQS) index, which represented the overall load of metal and PAE combined exposure, showed a dose-dependent relationship with TC increase. For each one-unit increase in the WQS index, TC increased by 0.43 (95% CI: 0.05-0.82) mmol/L. Eight metabolites, including perilla acid, dehydroepiandrosterone, octanoylcarnitine, arachidonic acid, estrone, kynurenine, glucose-6-phosphate, and ferulic acid, were significantly associated with the WQS index and TC levels, and exhibited significant mediating effects, and the corresponding mediation effects were 0.09 (95% CI: 0.02-0.27)，0.18 (95% CI: 0.04-0.35)、0.21 (95% CI: 0.02-0.44)、0.12 (95% CI: 0.02-0.24)、0.08 (95% CI: 0.02-0.21)、0.08 (95% CI: 0.01-0.20) and 0.09 (95% CI: 0.01-0.19), respectively. The biosynthesis pathway of steroid hormones was significantly enriched.

The biosynthesis pathway of steroid hormones and metabolites such as dehydroepiandrosterone and androstenone may mediate the overall association between combined exposure to metals and PAEs and the increase in TC levels, providing the metabolic perspective for the overall effect on blood lipids of co-exposure to metals and PAEs.

To analyze the trend of Colon and rectum cancer (CRC) burden attributable to low physical activity in China from 1990 to 2021, and to provide a reference for the development of effective public health strategies and healthcare resource allocation.

Relying on the Global Burden of Disease Study 2021 database, this study focused on the data of CRC burden attributable to low physical activity, including death and disability-adjusted life years (DALYs), among people ≥25 years old in China. Joinpoint regression was used to analyze the trends and turning points of disease burden changes, age, period and cohort effects of mortality were estimated with the age-period-cohort model, and autoregressive integral moving average (ARIMA) model was used to predict the disease burden dynamics in 2022-2030.

Between 1990 and 2021, the number of deaths, crude death rate, number of DALYs, and crude DALY rate attributable to low physical activity for CRC in China increased, with the number of deaths rising from 5 735 to 16 698, and the crude death rate from 0.78/100 000 to 1.53/100 000; the number of DALYs increased from 128 353 to 320 464 years. Crude DALY rate increased from 17.55/100 000 to 29.44/100 000.Joinpoint analysis showed that the mortality and DALY rates were increasing; the total population had a fluctuating downward trend in the standardized mortality rate and the standardized DALY rate, with an average annual percentage change of -0.21%(P>0.05) and -0.29(P<0.05) for males and females, respectively. Gender differences were observed in age-standardized mortality and DALY rate trends. The age effect showed that the CRC mortality rate attributable to low physical activity basically increased with age in China, and the relative risk (RR) ranged from 0.04 to 10.75 in each age group; the period effect showed that the mortality rate monotonically increased with the period, and the RR ranged from 0.69 to 1.59 in each period; and the cohort effect showed that the mortality rate progressively decreased with the development of birth cohorts, and the RR of each birth cohort ranged from 0.25 to 5.23. The differences in the effects between genders were not significant.The ARIMA model showed that the burden will continue to increase in China from 2022 to 2030.

The burden of CRC attributable to low physical activity in China showed a significant upward trend from 1990 to 2021, with gender differences. The age, period, and cohort effects of its mortality risk are evident. Targeted measures are urgently needed to effectively curb the rising disease burden.

To construct and validate a prediction model for high-risk sexual behaviors among rural residents aged 50 and above, in order to achieve early identification of high-risk groups and provide a scientific basis for the formulation of precise intervention measures.

From February to April 2024, 50-year-old and above permanent residents were conveniently sampled in rural areas of Luzhou City, Sichuan Province as the modeling group. From May to June, residents of the same age group were selected in rural areas of Liangshan Yi Autonomous Prefecture using the same method as the validation group. LASSO regression was used to screen variables, and then Logistic regression analysis was conducted on the screened variables. Variables with a P value less than 0.05 were used to construct a prediction model, and its predictive performance was evaluated.

The incidence rate of high-risk sexual behavior in this study was 28.52% (154/540).The predictive model included five predictive factors: gender, sexual behavior under the influence of alcohol, history of sexually transmitted disease infection, having a regular sexual partner, and social support, providing a scientific basis for the prediction of high-risk sexual behavior. The area under the ROC curve of the predictive model in the modeling group and the validation group was 0.940(95% CI:0.914-0.965) and 0.971(95% CI:0.951-0.992), respectively. The calibration curves showed good consistency, and the P values of the Hosmer-Lemeshow test were all greater than 0.05.The DCA had high positive yield between 1%-93% and 2%-98%, respectively.

The prediction model based on LASSO-Logistic regression analysis demonstrated good predictive performance and potential for practical application.