Physical activity is effective in preventing and treating cardiovascular disease (CVD). However, high-level physical activity may pose potential health risks. An elevated resting heart rate is indicative of poor cardiovascular function, yet the safety of physical activity in individuals with high resting heart rates remains unclear. This study aimed to investigate the joint association of resting heart rate and physical activity with CVD risk to provide evidence for individualized exercise guidance.

This study included 5 672 middle-aged and older adults from the China Health and Retirement Longitudinal Study database. Generalized additive models were employed to explore the independent and joint associations of resting heart rate and physical activity with CVD risk. Multiple logistic regression was further used to examine their correlations, while three-dimensional surface plots and two-dimensional slice plots at fixed resting heart rate levels were generated to visualize the nonlinear associations.

A significant nonlinear interaction was observed between resting heart rate, physical activity, and CVD risk (P for interaction <0.001). Compared with the reference group (normal resting heart rate and moderate physical activity), individuals with a resting heart rate >100 beats per minute and low physical activity had the highest risk of CVD (OR=6.223). Among those with high resting heart rate, moderate physical activity was associated with a possible increase in risk (OR=2.059), whereas high physical activity showed no statistically significant association with CVD risk (OR=0.956).

In individuals with a high resting heart rate, high-level physical activity is not associated with an increased risk of CVD. Increasing physical activity represents a universally applicable, low-cost, and effective health promotion strategy.

To analyze the trends in disease burden of Alzheimer's disease and related dementias (ADRD) attributable to smoking in China from 1990 to 2023, and to provide evidence to inform prevention and control strategies for dementia.

Based on Global Burden of Disease (GBD) data from 1990-2023, trends were analyzed using Joinpoint regression, and age-period-cohort (APC) models were applied to decompose age, period, and cohort effects.

Between 1990 and 2023, the number of deaths and DALYs of ADRD attributable to smoking in China increased by 269.002% and 223.932%, respectively. During the same period, the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) showed a slight overall decline, with average annual changes of-0.135% and-0.040%, respectively. Age effect: Disease burden increased significantly with age, rising more slowly after 60 years but remaining at high levels. Period effect: Risk of disease burden continued to increase over time, peaking between 2020 and 2023. Cohort effect: A significant intergenerational decline was observed, more pronounced among females.

Although the age-standardized burden of ADRD attributable to smoking in China has gradually decreased, the absolute burden has increased, with males bearing a significantly higher burden than females. The cumulative effect of long-term smoking before age 60 has markedly increased disease burden, laying the foundation for a peak in older age, highlighting the importance of early-and mid-life interventions. Multi-level strategies, including policy measures, community support, and individual behavior interventions, should focus on middle-aged and older male smokers to reduce long-term disease burden.

To systematically analyze the spatial and temporal evolution patterns of five Category B respiratory infectious diseases (pulmonary tuberculosis (PTB), scarlet fever, measles, meningococcal meningitis (MM) and pertussis) in China (2004-2020) to guide regional prevention strategies.

Based on the National Notifiable Disease Reporting System (NNDRS) data, we integrated spatial autocorrelation analysis, center of gravity migration model and standard deviation ellipse method for multi-dimensional spatio-temporal modelling to reveal the migration paths and clustering characteristics of the morbidity hotspots.

The incidence rates of PTB and MM continued to decline, which measles showed a fluctuating decline. scarlet fever and pertussis rose significantly after 2016, with a tendency to make a comeback. The high-high clustering areas of PTB and measles migrated to the northwest. Scarlet fever showed a northward return, with the high-high clustering stable and locked in Inner Mongolia after 2018 (Moran I=0.354, P<0.01). Pertussis hotspot area shifted southward, and the high-high clustering area focused on Xiang-qian junction in 2020. The incidence of MM continued to be low and spatial aggregation disappeared.

These diseases exhibit westward migration and northward return, necessitating targeted control systems in northwestern China, optimized mobile population monitoring and vaccine persistence strategies.

To monitor the epidemiological dynamics of influenza in Guizhou Province from 2022 to 2025 and analyze the resistance of influenza A (H1N1) pdm09 subtype viruses to neuraminidase inhibitors, so as to provide evidence for influenza prevention and control as well as clinical drug therapy.

Influenza-like illness (ILI) surveillance data from sentinel hospitals within Guizhou Province's national influenza surveillance network (2022—2025) were collected and analyzed using descriptive methods. Sixty-four influenza A (H1N1) pdm09 subtype viruses isolated and identified in Guizhou Province from 2022 to 2025 were selected. A fluorescence-based luminescence assay was employed to perform phenotypic drug resistance testing on the selected influenza viruses, and the changes in drug susceptibility to oseltamivir and zanamivir were analyzed. NA gene sequencing of the influenza strains was carried out, and bioinformatics software was used to analyze the amino acid site mutations of relevant drug-resistant genes.

Between 2022 and 2025, influenza viruses in Guizhou Province exhibited an alternating or co-circulation epidemic pattern. All 64 isolated A (H1N1) pdm09 subtype influenza virus strains were sensitive to oseltamivir and zanamivir. The mean IC₅₀ value for oseltamivir was 0.448 nmol/L (range: 0.126–1.013 nmol/L), and for zanamivir, it was 0.308 nmol/L (range: 0.112–0.855 nmol/L). Sequencing was performed on the NA genes of 46 A (H1N1) pdm09 strains. All sequenced viruses were classified into clade 6B.1 and were interspersed on the phylogenetic tree without forming distinct clusters. No mutations were identified at the enzyme active catalytic sites or known resistance sites in the NA gene.

From 2022 to 2025, influenza viruses in Guizhou Province showed an alternating or co-circulation pattern. The A (H1N1) pdm09 subtype remained sensitive to oseltamivir and zanamivir, supporting the continued clinical use of this drug class.

To investigate sleep problems among middle-aged and elderly individuals from ethnic regions in Yunnan Province, China, to identifiy associated factors, and to inform targeted interventions that improve their sleep quality.

Sleep problems were defined as the occurrence of any of the following: (1) rhythm disorders (e.g., late bedtime, early or late waking); (2) insomnia (e.g., difficulty falling asleep, frequent awakenings, nocturia, or <7 hours’ sleep); or (3) hypersomnia (≥9 hours’ sleep). We conducted a stratified random cluster survey among adults aged≥45 years in 9 prefectures/cities in Yunnan Province. Data on sleep, demographics, physical/mental health, behaviors, and social relationships were collected via a self-developed questionnaire. Logistic regression identified associated factors.

Among 5 180 middle-aged and elderly adults, 76.5% reported sleep problems: insomnia (63.8%), rhythm disorders (36.4%), and hypersomnia (21.3%). The Yao group had the highest rates of insomnia and rhythm disorders; the Lisu group had the highest hypersomnia rate. Logistic regression revealed that women from the Jinuo, Lisu, Wa, Nu, and Bulang groups were significantly more likely to report sleep problems (all P<0.05). Chronic conditions increased likelihood of sleep problems in the Han, Jinuo, Yi, and Lisu groups; frequent pain increased likelihood in the Han, Hani, Zhuang, Yao, Jinuo, Yi, and Bulang groups; depressive symptoms increased likelihood in the Han, Yao, Jinuo, Lisu, Lahu, Wa, Nu, and Bulang groups; lack of social activity in the past 30 days increased likelihood in the Han, Hani, Dai, and Yao groups; and daily smoking was associated with lower likelihood in the Han, Yi, Lisu, and Bulang groups (all P<0.05).

Sleep problems are highly prevalent among the middle-aged and elderly individuals in ethnic regions of Yunnan Province. A multitude of factors, including chronic diseases, pain, depression, and health behaviors, are interrelated. It is imperative to develop precise and differentiated sleep intervention strategies in conjunction with the demographic characteristics and health indicators of ethnic groups.

In order to better understand the current situation of malaria epidemic in Suzhou and provide scientific basis for formulating targeted strategies and measures to prevent the re transmission of malaria.

Statistical description of the prevalence and distribution characteristics of malaria cases reported in Suzhou City from 2005 to 2024, the comparison of rates or proportions was performed using the chi-square test or Fisher's exact test.

From 2005 to 2024, a total of 629 cases of malaria were reported in the city, including 456 domestic cases and 173 imported cases from abroad; Before 2011, the case reports were mainly domestic cases, and since 2012, all case reports have been imported cases from abroad and no secondary cases have occurred. The peak of domestic cases is concentrated from July to October in summer, while the seasonal characteristics of imported cases are not obvious, and the difference is statistically significant (χ²=110.335, P<0.05). The top three regions with the highest number of domestic cases are Kunshan, Changshu, and Gusu, while the top three regions with the highest number of imported cases are Zhangjiagang, Gusu, and Xiangcheng. The distribution differences between regions are statistically significant (χ²=144.831, P<0.05). The gender ratio of domestic cases is 1.49: 1, and the age of patients is mainly concentrated between 20-59 years old. There is no statistically significant difference in the gender ratio between patients in different age groups (0-19 years old, 20-39 years old, 40-59 years old, ≥60 years old, the same below)(χ²=2.044, P>0.05); The gender ratio of imported cases is 20.6: 1, and the age distribution is mainly concentrated between 20-59 years old. The number of male patients in each age group is higher than that of females, and the proportion of male patients in the 40-59 age group is the highest (98.77%), which is statistically significant compared with other age groups (χ²=9.918, P<0.05). The main categories of domestic case populations are migrant workers, laborers, and farmers; The main categories of imported cases are workers, farmers, domestic workers and unemployed individuals, and commercial services. The main species composition of domestic cases is Plasmodium vivax (379/456); The main species composition of imported cases is Plasmodium falciparum (125/173). The vast majority of imported cases come from African countries.

Although malaria has been eliminated in Suzhou, imported cases from abroad continue to occur sporadically, we should improve the diagnosis and treatment level of cases, strengthen epidemic monitoring and case management, and enhance the self-protection awareness of key populations against malaria.

This study aims to examine the relationship between indoor ventilation frequency and depression levels among older adults, and further test the mediating effects of anxiety and self-rated health in this relationship, as well as the chained mediating pathways.

Using data from the 2018 China Longitudinal Health and Longevity Study (CLHLS), older adults aged≥60 years were selected as the study subjects, resulting in a final sample of 10 306 participants. Depression levels were measured using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Anxiety status was assessed via the 7-item Generalized Anxiety Disorder Scale (GAD-7). The relationship between indoor ventilation frequency and depression levels in older adults was examined, with further investigation into the mediating effects of anxiety and self-rated health on this relationship.

Indoor ventilation frequency showed significant negative correlations with both anxiety and depression levels (r=-0.062, P<0.01; r=-0.163, P<0.01), but a significant positive correlation with self-rated health (r=0.067, P<0.01). Anxiety was negatively correlated with self-rated health (r=-0.276, P<0.01) and significantly positively correlated with depression levels (r=0.529, P<0.01); self-rated health was significantly negatively correlated with depression levels (r=-0.444, P<0.01). The direct effect of indoor ventilation frequency on depression levels in the elderly was statistically significant (effect size=-0.327, 95%CI: -0.374--0.280, Bootstrap samples=5 000); Mediation factors played a statistically significant mediating role between indoor ventilation frequency and depression levels in the elderly (effect size=-0.013, 95%CI: -0.020--0.007, Bootstrap samples=5 000).

Increasing indoor ventilation frequency not only directly improves depression levels among the elderly but also indirectly influences depression through anxiety and self-rated health. Enhancing ventilation frequency alleviates anxiety symptoms and improves self-rated health, thereby effectively reducing depression levels in the elderly.

To investigate the association between altitude and the prevalence of hypertension among residents of Tibet, and to analyze potential mediating factors.

Residents aged 18 and above who had lived in Tibet for 6 months or longer were selected through a multi-stage stratified cluster random sampling method to participate in questionnaire surveys, physical measurements, and laboratory tests. Multivariable logistic regression was employed to explore the association between altitude and hypertension. The mediating roles of hemoglobin were further analyzed.

A total of 3 085 participants were included, among whom 1 062(34.42%) were diagnosed with hypertension. After adjusting for covariates, the multivariable logistic regression showed that for every 1 000 m increase in altitude, the risk of hypertension increased by 42% (OR=1.42, 95%CI: 1.16-1.73, P<0.05). Compared with residents living at altitudes below 3 500 m, those at 3 500-<4 000 m and≥4 000 m had ORs of 1.37 and 1.61 for hypertension risk, respectively, with a significant linear trend (P for trend <0.05). Mediation analysis indicated that hemoglobin significantly mediated the association between altitude and hypertension, with mediation effect proportions of 17.80% (95%CI: 3.10%-32.60%, P<0.05).

Altitude is positively associated with the risk of hypertension among residents in Tibet. It is recommended to strengthen the monitoring of blood pressure and hemoglobin levels in populations living at high altitudes, in order to reduce the risk of hypertension.

Analyzing and evaluating the association between estimated glucose disposal rate (eGDR) and metabolic syndrome (MetS) among coal miners.

A cross-sectional study design was employed, with 8 102 employees from coal mining groups who underwent occupational health examinations in 2023 serving as the study subjects. Individual eGDR values were calculated based on waist circumference, hypertension status, and glycated hemoglobin levels, with MetS defined according to the criteria outlined in the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2020 Edition). Unconditional logistic regression models and restricted cubic spline (RCS) models were employed to investigate the association and dose-response relationship between eGDR and MetS, whilst also analyzing the interaction between eGDR and occupational factors on MetS.

The mean age of enrolled employees was (48.7±5.4) years, with 2 932 individuals diagnosed with MetS (prevalence: 36.1%). Fully adjusted unconditional logistic regression analysis revealed that each standard deviation increases in eGDR (SD=2.23) reduced the risk of MetS to 0.52. The high eGDR group exhibited significantly lower MetS risk than the low eGDR group (OR=0.01), with no significant evidence of occupational factor interaction. RCS modeling revealed a strong nonlinear negative dose-response relationship between eGDR and MetS prevalence (P<0.001).

Among coal miners, eGDR exhibits a significant association with Mets, presenting a non-linear negative dose-response relationship, and no occupational factor interactions have been identified.

To investigate the impact of urban community built environments on residents' quality of life, and offer empirical support for health-oriented urban planning.

This study employed a multi-stage random cluster sampling method to survey the permanent residents in 1 401 households across 26 communities and 49 residential areas. Based on the research objectives, 2 086 adult participants were included for analysis. The study integrated multi-source geospatial data and utilized linear mixed-effects model to investigate the association between the built environment and residents' quality of life.

The mental component summary (MCS) score of residents was 49.16±11.58, and the physical component summary (PCS) score was 49.99±10.12. Linear mixed-effects model results showed that green view index (β=2.428, P<0.05), motor vehicle ratio (β=3.180, P<0.05), public transport stop density (β=2.113, P<0.05), road intersection density (β=2.854, P<0.05) and park green space ratio (β=3.048, P<0.01) were positively correlated with MCS; road network density (β=-2.963, P<0.01) and floor area ratio (β=-3.075, P<0.05) were negatively correlated with MCS. For PCS, green view index (β=1.154, P<0.05), motor vehicle ratio (β=2.197, P<0.01) and building density (β=2.018, P<0.05) were positively correlated, while floor area ratio (β=-1.761, P<0.05) was negatively correlated. Additionally, road network density interacted with building density (β=0.979, P<0.05) and green view index (β=-1.112, P<0.05) in affecting PCS.

The built environment of urban communities is closely linked to residents' quality of life. In urban spatial governance, emphasis should be placed on the systematic optimization and synergistic enhancement of various built environment elements to promote community residents' well-being.