To analyze the factors influencing overweight and obesity among middle school students and to establish a nomogram for predicting the risk of overweight and obesity in this population.

From September to November 2024, a random cluster sampling method was used to select 5 135 middle school students from 20 schools in Tongren city for physical examinations and questionnaire surveys. Lasso regression was employed to identify factors affecting overweight and obesity, and a nomogram prediction model was established and validated.

The prevalence of overweight and obesity among middle school students was 25.02%. Multivariate logistic regression analysis revealed that being female (OR=0.430, 95%CI: 0.371-0.499),boarding at school (OR=0.582, 95%CI: 0.500-0.678), engaging in moderate to high-intensity physical activity for one hour daily (OR=0.730, 95%CI: 0.630-0.847), having non-obese parents (OR=0.466, 95%CI: 0.404-0.538), and external eating triggers (OR=0.945, 95%CI: 0.935-0.956) were protective factors against overweight and obesity. Conversely, consuming fresh fruits and vegetables at every meal (OR=1.308, 95%CI: 1.103-1.549), restrictive eating (OR=1.100, 95%CI: 1.089-1.111), and emotional eating (OR=1.091, 95%CI: 1.079-1.103) were identified as risk factors. The areas under the curve (AUC) for the training and validation sets were 0.790 (95%CI: 0.775-0.806) and 0.765 (95%CI: 0.731-0.799), respectively, indicating good discrimination of the nomogram prediction model. The Brier score was 0.15, and the Hosmer-Leeshawn test suggested good model fit (χ²=10.984, P=0.203).

The nomogram model established in this study effectively predicts the risk of overweight and obesity, providing a reference for screening high-risk students and implementing personalized prevention strategies.

To investigate the status and influencing factors of social frailty in elderly patients on Maintenance Hemodialysis (MHD) and to construct a nomogram prediction model.

A survey was conducted among 340 elderly MHD patients using a general information questionnaire, social frailty scale, hemodialysis self-management scale, Toronto Alexithymia Scale, Family Care Index, and Social Support Rating Scale. Independent influencing factors were identified, and a nomogram prediction model was constructed and evaluated.

The prevalence of social frailty among elderly MHD patients was 28.82%. Binary logistic regression analysis revealed that a history of falls in the past year (OR=3.117, 95% CI: 1.249-7.778), self-care ability (OR=4.058, 95% CI: 2.002-8.228), alexithymia (OR=1.073, 95% CI: 1.009-1.141), family care level (OR=0.744, 95%CI: 0.612-0.903), and social support (OR=0.886, 95% CI: 0.801-0.981) were significant influencing factors for social frailty in elderly MHD patients (all P<0.05). The area under the receiver operating characteristic curve for the constructed model was 0.921(95% CI: 0.893-0.950), with the maximum Youden index being 0.688, an optimal cutoff value of 0.330, sensitivity of 83.7%, and specificity of 85.1%, indicating high discrimination of the model. The Hosmer-Leeshawn test yielded χ²=10.465, P=0.234,suggesting good model fit. Internal validation calibration curves indicated satisfactory calibration of the model. Decision curve analysis demonstrated high clinical utility of the model.

The nomogram prediction model developed in this study is a practical and convenient tool that aids in predicting the risk of social frailty in elderly MHD patients.

To explore the relationship between sleep duration, its changes, and the activities of daily living (ADL) in the elderly.

Utilizing data from the China Health and Retirement Longitudinal Study, participants who took part in the surveys conducted in 2018 and 2020 were selected. Based on sleep duration, participants were categorized into three groups: short sleep (<7 hours), adequate sleep (7-9 hours), and long sleep (>9 hours). The study employed restricted cubic spline analysis to examine the dose-response relationship between sleep duration and ADL, and a Cox proportional hazards regression model to analyze the relationship between dynamic changes in sleep duration and ADL.

A total of 3 923 participants were included in this study, with 1 162 (29.6%) experiencing ADL impairment during the follow-up period. The Cox proportional hazards regression model indicated that individuals who consistently maintained short sleep and those who transitioned from adequate sleep to short sleep had a 50% and 39% increased risk of ADL impairment, respectively, with hazard ratios (HR) and 95% confidence intervals (CI) of 1.50(1.27-1.78) and 1.39 (1.14-1.71). Additionally, those with a significant reduction in sleep duration (< -2 hours) had a 20% increased risk of ADL impairment (HR=1.20, 95%CI: 1.01-1.41).

Maintaining adequate and stable sleep duration over the long term can reduce the risk of ADL impairment in the elderly.

Based on the known interaction between OPC-167832 and the DprE1 protein, this study aims to establish an evaluation method for the antituberculosis drug activity targeting the key metabolic enzyme DprE1 of Mycobacterium tuberculosis.

First, the DprE1 protein was expressed using the pET28a-Rv3790 vector, and the molecular chaperone CPN60.2 of Mycobacterium tuberculosis was expressed using the pGro7-Rv0440 vector. Both vectors were co-transformed into E. coli BL21 for DprE1 protein expression. The target protein was purified via Ni-NTA affinity chromatography and identified using LC-MS mass spectrometry. Secondly, the direct interaction between the DprE1-targeting inhibitor and DprE1 was assessed using isothermal titration calorimetry (ITC). Finally, computational simulation techniques were employed to dock OPC-167832 with the DprE1 protein.

The pET28a-Rv3790 and pGro7-Rv0440 expression vectors were successfully constructed, leading to the expression and purification of soluble DprE1 protein. ITC results indicated a significant heat change upon the binding of DprE1 to OPC-167832. Molecular docking results revealed that the hydrogen bond binding site of OPC-167832 with DprE1 was primarily located at Pro316, while the binding sites for the fluorinated hydrogen bond were His132 and Asn364.

The soluble DprE1 protein was successfully expressed, and its interaction with OPC-167832 resulted in a measurable heat change. This confirms the successful establishment of an evaluation method for the antituberculosis drug activity targeting the key metabolic enzyme DprE1 of Mycobacterium tuberculosis. This study provides an experimental basis and methodological support for the activity evaluation of DprE1-targeting inhibitors against Mycobacterium tuberculosis.

To investigate the factors influencing Guangzhou residents’ willingness to use “Internet + pharmaceutical services”, providing references for optimizing related service platforms.

A questionnaire was designed based on the UTAUT model, and from January to May 2024, residents of Guangzhou were surveyed. Structural equation modeling was utilized to test the path relationships and mediating effects, constructing a model of the influencing factors on residents’ willingness to use“Internet + pharmaceutical services”.

Social influence (β=0.319, P<0.001), effort expectancy (β=0.264, P<0.05), and performance expectancy (β=0.256, P<0.001) positively impacted the willingness of Guangzhou residents to use “Internet +pharmaceutical services”. Social influence had a significant positive effect on performance expectancy (β=0.764, P<0.001), and performance expectancy partially mediated the positive effect of social influence on willingness to use. Facilitating factors (P>0.05) did not have a significant effect on willingness.

Performance expectancy, effort expectancy, and social influence are the main factors affecting Guangzhou residents’willingness to use “Internet + pharmaceutical services”. Related platforms should innovate and improve their design based on residents’ needs, ensuring the practicality and usability of services to enhance user experience. Additionally, promoting and publicizing “Internet + pharmaceutical services” should be strengthened to leverage social influence, thereby increasing public recognition and willingness to use.

To analyze the impact of the implementation of high-quality development policies for public hospitals on the structure of medical expenses in public hospitals in Shanghai, providing a reference for controlling medical costs.

The structural change method was employed to analyze the changes in inpatient expense structures in various levels of public hospitals in a district of Shanghai from October 2019 to October 2023. A segmented time series analysis was conducted to examine the structural levels and trend changes in inpatient expenses before and after the policy implementation.

Following the implementation of the high-quality development policies, the proportion of drug costs and medical service fees in secondary and tertiary hospitals showed a decreasing trend, while the proportion of health materials costs increased. Conversely, in traditional Chinese medicine hospitals, the proportion of health materials costs and medical service fees decreased, while the proportion of drug costs increased. The inpatient expenses in tertiary hospitals, secondary hospitals, and traditional Chinese medicine hospitals decreased by 37.8%, 3.4%, and 9.4%,respectively.

The implementation of high-quality development policies for public hospitals has reduced inpatient expenses across various levels of hospitals in Shanghai; however, it does not impact the long-term effects on inpatient costs. There is a need for long-term monitoring of expense structures, scientific and reasonable calculations of medical service project costs, and the establishment of a more rational fiscal compensation mechanism to promote the high-quality development of public hospitals.

To investigate the implementation effects of the DIP payment reform on rehabilitation inpatients, providing empirical support for assessing the applicability of current medical insurance payment reform to rehabilitation inpatients.

An interrupted time series analysis was conducted using data from the discharge summaries of rehabilitation inpatients at a large tertiary public hospital in Chengdu from 2019 to 2023.

A total of 2 143 rehabilitation inpatient cases were included in this study. After the reform, indicators reflecting the operational efficiency of the rehabilitation department showed a positive trend, with the average monthly inpatient visits steadily increasing (β = 0.395, P < 0.001). The average length of stay decreased but not significantly (β < 0, P > 0.05). The treatment costs, reflecting the technical labor value of rehabilitation physicians, significantly decreased (β = -45.251, P < 0.05), while drug costs increased (β = 2.36, P < 0.05). The changes in patient financial burden indicators were minimal, with out-of-pocket expenses showing a slight increase (β = 1.818, P > 0.05).

The results indicate that the DIP payment reform has weak control over the length of stay for rehabilitation patients. After the reform, the out-of-pocket expenses for patients did not decrease, and their medical needs were not adequately met. Future efforts should focus on establishing a patient demand-oriented payment method for rehabilitation medical insurance.

To explore the potential pathways influencing self-management behaviors among community patients with peptic ulcers, providing a basis for interventions aimed at enhancing self-management in this population.

From March to August 2024, a stratified cluster sampling combined with convenience sampling was employed to randomly select 640 community patients with peptic ulcers from five administrative districts in Hengyang city for a questionnaire survey. Data analysis was conducted using SPSS 26.0 for t-tests, ANOVA, and partial correlation analysis, and a chain mediation model was constructed using Process 4.0 plugin model 6.

Health literacy had a significant direct effect on self-management (b=0.322, 95%CI: 0.254-0.390); the mediating effects of social support and self-efficacy between health literacy and self-management were 0.067 (95%CI: 0.043-0.098) and 0.100 (95%CI: 0.069-0.135), respectively. The chain mediating effect of social support and self-efficacy was also significant (b=0.016, 95%CI: 0.008-0.025).

Enhancing the level of health literacy among community patients with peptic ulcers is beneficial for improving social support and increasing self-efficacy, thereby enhancing self-management levels.

The medical service price index is a key reference indicator reflecting changes in medical service prices in a region. This study aims to analyze the variations in medical service prices and subgroup indices across different levels of medical institutions in Leshan city to guide pricing strategy optimization and promote reforms in medical service pricing.

Using a fixed-weight method, the medical service price index (MSPI) for all public medical institutions (36 in total) in Leshan city for the years from 2022 to 2023 was calculated in detail, with data sourced from the medical institution records provided by the Leshan Bureau of Human Resources and Social Security.

Following the reforms in 2023, the overall medical service prices in Leshan city rose, with the total price index reaching 100.38%. Notably, the price indices for medical technical diagnosis, clinical diagnosis, and traditional and ethnic medicine services increased, while the price indices for surgical treatments, acupuncture, and massage therapy saw significant rises. Conversely, the price indices for laboratory tests and medical imaging categories declined, and the comprehensive medical service price index remained unchanged.

The 2023 reforms in Leshan city have effectively optimized the existing structure of medical service prices. Furthermore, the study found that calculating the medical service price index for tertiary medical institutions, which have higher weights, can to some extent reflect the overall medical service price index situation.

To analyze the degree of coupling and coordination between child health care services and pediatric medical resource allocation in Guangdong Province from 2012 to 2020, providing a reference for promoting the coordinated development.

Data on relevant indicators of child health care services and pediatric medical resource allocation from 2012 to 2020 were selected. A comprehensive evaluation was conducted using a comprehensive development index and relative development degree. The coupling coordination model was employed to analyze the coupling coordination between the two systems. Cold and hot spot analysis was utilized to explore the spatial and temporal clustering characteristics of the two systems.

There were significant regional differences in the development levels of child health care services and pediatric medical resources in Guangdong Province from 2012 to 2020, with the relative development degree consistently exceeding 1.2, indicating a lagging configuration of pediatric medical resource allocation. The coupling coordination type transitioned from a severely unbalanced and declining state to a barely coordinated state. Hotspot analysis revealed that from 2012 to 2020, the hotspot areas for the coupling coordination degree of the two systems included Guangzhou, Dongguan, and Shenzhen, with the clustering effect gradually strengthening and expanding southward.

It is essential to enhance the precision of pediatric resource allocation and reduce the disparities in development levels among regions. A macro perspective on the overall structure of child health care services should be adopted to achieve coordinated development between child health care services and pediatric medical resource allocation.