To analyze the correlation between the Geriatric Nutritional Risk Index (GNRI) and the risk of all-cause and cardiovascular disease (CVD) mortality in elderly populations, and to investigate whether the Cardiovascular-Kidney-Metabolic Syndrome (CKM) modulates this association.

This study was based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) cohort data from 2014 to 2018. The baseline was set in 2014, and participants were prospectively followed for 4 years until the follow-up ended in 2018. Participants were divided into two groups according to the Geriatric Nutritional Risk Index (GNRI): the nutritionally normal group (GNRI ≥ 98) and the malnutrition group (GNRI < 98). Kaplan-Meier analysis and log-rank tests were used to assess differences in survival rates between the groups. Restricted cubic spline (RCS) analysis was employed to explore the non-linear relationship between GNRI and survival risk. Cox proportional hazards models were used to evaluate the associations of GNRI and CKM stratifications with survival risk and to investigate the interaction effect of CKM staging.

A total of 1 725 elderly participants were included, and during the 4-year follow-up, 530 cases of all-cause mortality and 160 cases of CVD mortality were recorded. Significant differences in survival probabilities of all-cause and CVD mortality were observed among different GNRI groups (both P<0.001). GNRI showed a linear negative correlation with both all-cause and CVD mortality risks (P<0.001, P for non-linearity>0.05). After adjusting for confounding factors, compared to the nutritionally normal group, the elderly in the poor nutrition group had a 63% higher risk of all-cause mortality (HR=1.63, 95%CI: 1.34 - 1.97) and a 45% higher risk of CVD mortality (HR=1.45, 95%CI: 1.01 - 2.07). Additionally, CKM staging had a significant modulating effect on the association between GNRI and all-cause mortality risk (P for interaction < 0.05), but it did not have a significant modulating effect on the association between GNRI and CVD mortality risk (P for interaction > 0.05).

GNRI is an independent predictor of all-cause and CVD mortality risk in elderly populations, and its protective effect against all-cause mortality risk is more pronounced in patients with earlier CKM staging.

To investigate the protective effect of folic acid on the epithelial-mesenchymal transition (EMT) induced by N-methyl-N ’-nitro-n-nitroguanidine (MNNG) and its signaling mechanism.

SD rats were randomly divided into blank group, model group, low-dose, medium-dose and high-dose folate groups (1.25, 2.5, 5 mg/kg), control group was given 10 mL/kg normal saline, and other groups were given 25 mg/kg MNNG.All were administered with free drinking water once a day for 12 weeks. After 12 weeks, the expression of E-cadherin and N-cadherin protein was observed by immunohistochemistry. The expressions of E-cadherin, ZO-1, N-cadherin and Vimentin were detected by Western blot. In vitro (0.1, 0.2, 0.4 μg/mL), the concentration of folic acid was treated with 20 μmol/L MNNG for 24 h, and the mRNA transcription levels of E-cadherin, ZO-1, N-cadherin, Vimentin, TGF-β, Wnt/β-catenin, JAK/STAT 3 signaling pathways were detected by RT-qPCR. The expressions of E-cadherin, ZO-1, N-cadherin and Vimentin were detected by Western blot.

Compared with the model group, folic acid could improve the precancerous lesions caused by MNNG, up-regulate the expression of E-cadherin (F=90.3，P<0.001) and ZO-1 protein (F=188.9，P<0.001), and down-regulate the expression of N-cadherin (F=68.9，P<0.001) and Vimentin protein (F=82.6，P<0.001). The results of cell Western blot showed that compared with the control group, the expression levels of E-cadherin and ZO-1 were decreased, decreasing to 63.7% (95%CI: 0.589-0.675, P<0.001) and 57.1% (95%CI: 0.494-0.706, P<0.001) of the control group. Cell RT-qPCR results showed that compared with the model group, E-cadherin mRNA levels were increased (F=8.5, P=0.007), the expression of ZO-1 mRNA increased (F=31.5, P<0001), N-cadherin mRNA levels were decreased (F=34.1, P<0.001), and the expression of Vimentin mRNA decreased (F=17.8, P<0.001).Cell RT-qPCR confirmed that MNNG can promote the transcription of key mRNA in TGF-β signaling pathway, Wnt/β-Catenin signaling pathway, and JAK/STAT 3 signaling pathway. The downstream transcription factors snail and ZEB1 mRNA transcription were activated, while folic acid could antagonize the process.

Folic acid has certain protective ability against MNNG induced esophageal epithelial-mesenchymal transformation, which may be related to inhibiting the activation of JAK/ STAT3 signaling pathway.

To understand the current status of varicella vaccination among age-eligible children in Chuxiong Prefecture and its influencing factors, in order to provide a reference basis for improving the varicella vaccination rate among age-eligible children throughout the prefecture.

Using multi-stage stratified random sampling, a questionnaire survey was conducted from May to August 2023 among guardians of children aged 1-14 years in three counties and cities of Chuxiong Prefecture, which included basic information, varicella vaccination information, varicella, and knowledge of varicella vaccine. To analyze the influencing factors of varicella vaccination in age-eligible children.

A total of 1 924 questionnaires were collected and 1 921 questionnaires were valid, with a validity rate of 99.84%. 1 918 study participants were finally included in the analysis, with a varicella vaccination rate of 35.82% among children and an overall knowledge rate of varicella and varicella vaccine among guardians of 58.33%. The results of multifactorial analysis showed that living in the city (OR=2.00, 95%CI: 1.62-2.48), per capita monthly family income >10 000 (vs. per capita monthly family income <2 000, OR=2.47, 95%CI: 1.33-4.59), and parental occupation of medical personnel or retired (vs. occupation of housework and inactive work, OR=1.63, and 95%CI: 1.03-2.58), and future willingness to be vaccinated against varicella (OR=5.06, 95%CI: 3.39-7.56) had higher varicella vaccination rates among age-eligible children.

The varicella vaccination rate is low among age-eligible children in Chuxiong Prefecture, and publicity and education on vaccination should be strengthened to increase the willingness of parents of age-eligible children to receive the vaccine, thereby increasing the varicella vaccination rate.

To analyze the alarm information of monitoring platform for vaccine cold chain in Shandong Province and to provide scientific basis for improving the cold chain guarantee level of vaccines.

We have collected data on overtemperature and blackout alarms from January 1 to December 31, 2024 in Shandong Province through the cold chain monitoring platform, and descriptive analysis was conducted by season, region, and unit type.

The cold chain monitoring platform in Shandong Province is equipped with 5 463 data recording devices and 25 159 data collection devices, which monitor in real-time the temperature of vaccine storage and transportation in 16 cities’ Centers for Disease Control and Prevention and vaccination units throughout the province. The summer month of July has the highest number of alarm information, with an average of 4.2 for overtemperature and 2.0 for blackout alarm. The winter month of December has the lowest number of alarm information, with an average of 1.1 for both overtemperature and blackout alarms. The average number of overtemperature alarms in Tai’an City, Rizhao City, and Heze City exceeds 40, while the average number of overtemperature alarms in Jining City is at least 17.6. The average number of blackout alarms in Binzhou City, Liaocheng City, Heze City, and Dezhou City exceeds 20, while Jinan City has the lowest number of blackout alarms, with an average of 10.1. The CDC has the highest number of overtemperature alarms, with an average of 59.7 alarms. The routine vaccination clinic has the highest number of blackout alarms, with an average of 19.8 alarms. The average number of overtemperature alarms and blackout alarms in the rabies exposure prevention and treatment outpatient department are relatively high, with 48.2 and 18.8 alarms, respectively.

There are seasonal, regional, and unit type differences in vaccine cold chain alarms, and targeted measures should be taken to strengthen vaccine cold chain management and ensure vaccine safety.

To determine the optimal cut-off point of the General Self-Efficacy Scale (GSES) among middle school students and to establish a precise criterion for evaluating their self-efficacy.

A convenience sampling method was conducted a total of 2 494 junior high school students from grades 7-9 in two junior high schools in Guangzhou were selected for a questionnaire survey. The questionnaire includes demographic characteristics such as students’ gender, grade, and age, general self-efficacy, sleep, family functioning, and smartphone dependence. The latent profile analysis (LPA) was used to classify students’ self-efficacy, and the optimal cut-off point was determined based on the Receiver Operator Characteristic curve (ROC) and the Volume Under the ROC Surface (VUS).

A total of 2 494 middle school students were surveyed in this study. There were 1 285(51.52%) boys and 1 209(48.48%) girls. The self-efficacy of boys was 27(22-31) and that of girls was 24 (20-29), which is statistically significant different (Z=-7.86, P<0.01). LPA identified three categories of self-efficacy: low (862, 34.56%), medium (1 166, 46.75%), and high (466, 18.69%) self-efficacy types. The VUS method determined the optimal cut-off points for the GSES scale to be 22 and 32 points, respectively.The results of the ordinal logistic regression analysis showed that females (OR=1.58, 95%CI: 1.34-1.86), mild family dysfunction (OR=2.86, 95%CI: 2.38-3.44), severe family dysfunction (OR=4.46, 95%CI: 3.51-5.68), mobile phone addiction (OR=1.58, 95%CI :1.1-1.64), and lack of regular exercise (OR=1.75, 95%CI: 1.43-2.15) were positively associated with low self-efficacy, while sleeping time ≥9 hours (OR=0.78, 95%CI: 0.66-0.93) and outdoor activity time ≥1 hour (OR=0.8, 95%CI: 0.65-0.97) were negatively correlated with low self-efficacy among middle school students.

This study provides a clear and scientific assessment criterion for evaluating the self-efficacy level of middle school students through the combination of LPA and VUS methods, offering a powerful tool for more accurate assessment of middle school students’ self-efficacy.

To develop an evaluation index system for public health emergency response capacity of county-level centers for Disease control and Prevention (CDC) to promote the construction of public health emergency response system and improve the emergency response capacity of county-level CDC in China.

The index system framework was developed based on a literature review and group discussions. The Delphi method was applied to select the evaluation indicators through two rounds of expert consultation involving 26 experts, and the weights of the indicators were determined using the Analytic Hierarchy Process (AHP).

The system included 6 primary indicators, 21 secondary indicators, and 69 tertiary indicators. The weights of each indicator were calculated using the Analytic Hierarchy Process (AHP). The weight of first-level indicators from high to low were emergency response capacity (0.212), emergency system construction (0.199), emergency support capacity (0.175), monitoring and early warning capacity (0.170), emergency team (0.161), information communication and departmental collaboration (0.083). Among the second-level indicators, the weights of training exercise (0.490), early warning and prediction (0.490), and emergency fund guarantee (0.490) were in the top three. The consistency ratio (CR) values for the first-level, second-level, and third-level indicators were all below 0.1, which met the standard requirements of consistency test, and the weight division of indicators was reasonable.

This study provides indicator guidance for improving the emergency response capacity of county CDC, and promote the construction of public health emergency response system in China and the improvement of emergency response capacity of county CDC.

To investigate the current status of tuberculosis(TB) infection prevention and control in primary health care institute in Chongqing.

According to evaluation criterion of the Guideline on tuberculosis infection prevention and control in primary health care institute,the survey was conducted on 146 community health service centers and 506 township health centers in Chongqing. The data of tuberculosis infection prevention and control was collected and analyzed, including organizational management, outpatient settings and workflow, ventilation and disinfection, and personal respiratory protection. SPSS 25.0 soft for descriptive statistical analysis.

In organizational management measures, the proportion of infection control work included in the situation, training and assessment, plan formulation, and system establishment were all above 90%. There were statistically significant difference in the proportion of implementing regular evaluation mechanisms, establishing regular physical examination systems, and equipping tuberculosis infection control related facilities and items in different regions(P<0.05). In the setting and workflow of outpatient clinics, the proportion of online direct reporting (95.71%) and pre-examination triage system (90.18%) was relatively high, the proportion of institutions with separate tuberculosis waiting areas, consultation rooms, and supervision drug rooms/health management rooms (40.34%), as well as prominent signs, notices, directional signs (46.47%), was relatively low. There were statistically significant differences in the proportion of institutions with separate TB waiting areas, consulting rooms and supervision drug rooms/health management rooms in different regions, establishing a pre-screening triage system, and arranging priority for patients with suspected symptoms of TB or suspected TB patients or tuberculosis patients(P<0.05). 82.36% of institutions had good ventilation, and 61.04% of institutions mainly used mobile UV disinfection vehicles for UV disinfection. There was no statistically significant difference in ventilation, disinfection, and personal respiratory protection measures(P>0.05).

The prevention and control of tuberculosis infection in primary health care institute in Chongqing is generally good, but there are still weak links. It is necessary to further strengthen the outpatient setting of primary health care institute, the allocation of health resources in Wuling Mountain Area in southeast Chongqing, establish a regular physical examination system for tuberculosis, improve environmental facilities, enhance the personal protection awareness of medical personnel, and reduce the risk of tuberculosis infection.

To understand the current status of medication adherence in patients with HIV/AIDS who have failed antiretroviral therapy and to analyze the mediating effect of anxiety in the influence of family care on medication adherence.

A total of 600 patients with HIV/AIDS who failed antiretroviral therapy were included as study subjects, and data on patients’ demographic characteristics, behavioral characteristics, anxiety, family caring and medication adherence were collected through telephone interviews, and mediation analyses were used to analyze the mediating effect of anxiety on the relationship between family caring and medication adherence.

In this survey 29.33% of the population had family care disorder, 15.8% were in anxiety and 56.0% had good medication adherence. The mean score of medication adherence was moderate at 7.15±1.38. Anxiety in HIV/AIDS antiretroviral treatment failure patients fully mediated the effect of family care on medication adherence. The mediating effect (0.033) (95%CI: 0.017-0.053) accounted for 47.8% of the total effect (0.069) (95%CI: 0.033-0.105).

The percentage of local HIV/AIDS patients with good adherence to medication in patients who have failed antiretroviral therapy is relatively low. By increasing the level of family care and helping patients to alleviate anxiety, medication adherence can be effectively improved and treatment outcomes can be improved.

To investigate the relationship between different obesity statuses in patients with cardiovascular diseases (CVD) and type 2 diabetes mellitus (T2DM) and the incidence of all-cause dementia and its subtypes.

Based on data from the UK Biobank, study subjects were categorized into five obesity states—underweight, normal weight, simple central or simple generalized obesity, combined overweight, and combined obesity—according to BMI and waist circumference. The Cox proportional hazards regression model was employed to analyze the hazard ratios (HR) and 95% confidence intervals (CI) for dementia incidence among patients with cardiovascular metabolic diseases across different obesity statuses.

A total of 63 066 CVD patients and 33 872 T2DM patients were included in the study. Compared to normal weight CVD patients, underweight individuals exhibited a 135% increased risk of vascular dementia (VD) (HR=2.35, 95%CI: 1.09-5.09). The risk of all-cause dementia and Alzheimer’s disease (AD) in patients with simple central or simple generalized obesity decreased by 26% (0.74, 0.61-0.90) and 30% (0.70, 0.51-0.95),respectively. For combined overweight patients, the risk of all-cause dementia and AD decreased by 28% (0.72, 0.64-0.82) and 29%(0.71, 0.58-0.87), respectively. In combined obesity patients, the risk of all-cause dementia, AD, and VD decreased by 35% (0.65,0.58-0.74), 40% (0.60, 0.49-0.74), and 27% (0.73, 0.57-0.93), respectively. Compared to normal weight T2DM patients, combined overweight patients showed a 39% (0.61, 0.46-0.81) and 46% (0.54, 0.36-0.81) reduction in the risk of all-cause dementia and AD,respectively. The risk of all-cause dementia, AD, and VD in combined obesity patients decreased by 35% (0.53, 0.41-0.69), 40%(0.45, 0.31-0.66), and 27% (0.53, 0.32-0.87), respectively.

There is an “obesity paradox” in dementia risk among patients with cardiovascular metabolic diseases, with a significant reduction in the incidence of dementia among patients with simple central or simple generalized obesity, combined overweight, and combined obesity.

To explore the relationship between substance use, problematic internet use, and their co-occurring behaviors with unintentional injuries among college students.

A cross-sectional study design was employed, with a questionnaire survey conducted among 1 700 enrolled students from two ordinary higher education institutions in Beijing. The CRAFFT scale was used to assess substance use, while the Internet Addiction Test (IAT) evaluated problematic internet use. Information on unintentional injuries and related influencing factors was also collected. Multivariate binary logistic regression was utilized to analyze the association between substance use, problematic internet use, co-occurring behaviors, and unintentional injuries, as well as to explore the influencing factors of unintentional injuries in the co-occurring behavior population.

A total of 1 626 valid questionnaires were collected. The prevalence of substance use was 35.85% (583 cases), the prevalence of problematic internet use was 52.34% (851 cases), and the co-occurrence prevalence was 20.05% (326 cases). The prevalence of unintentional injuries was 16.91% (275 cases). After adjusting for confounding factors, the multivariate logistic regression analysis indicated that compared to the control group, the odds ratio for unintentional injuries in the co-occurring behavior group was 1.57 (95%CI: 1.054-2.340), while neither substance use (aOR=1.117, 95%CI: 0.717-1.741) nor problematic internet use (aOR=1.098, 95%CI: 0.758-1.589) showed significant correlation with unintentional injuries. Among the co-occurring behavior population, suicidal ideation was identified as an independent risk factor for unintentional injuries (aOR=2.118, 95%CI: 1.184-3.787).

The simultaneous presence of substance uses and problematic internet use significantly increases the risk of unintentional injuries among college students. It is crucial to focus on high-risk populations exhibiting co-occurring behaviors, especially those with suicidal ideation, and to implement targeted preventive interventions.