To construct a stroke risk scoring tool for middle - aged and elderly Chinese people based on meta-analysis and physical examination data from primary medical institutions.

Cohort studies on risk factors for stroke onset in the Chinese population were retrieved, and predictive factors were determined through meta-analysis. Referring to the construction method of the Framingham 10-year risk scoring tool, a stroke risk scoring tool for middle-aged and elderly Chinese people was established. The Kailuan cohort and the Hongguang physical examination cohort were used as external validation populations. Indicators such as the receiver operator characteristic (ROC) curve, sensitivity, and specificity were used to evaluate the predictive efficacy of the scoring tool.

Thirty-eight studies were included in the meta-analysis, and finally 14 factors were identified as stroke predictive factors: old age, male gender, underweight, overweight, obesity, stage 1 hypertension, history of hypertension, history of diabetes, high total cholesterol, high triglycerides, low-level high-density lipoprotein, history of atrial fibrillation, family history of stroke, and current smoking. The Kailuan cohort included 137 501 people, and 2 351 cases of stroke occurred during the follow-up period. The area under the curve (AUC) was 0.74 (95%CI:0.73-0.75), the sensitivity was 0.78 (95%CI: 0.77-0.80), and the specificity was 0.59 (95%CI: 0.58-0.59). The Hongguang physical examination cohort included 7 194 subjects, and 927 people had strokes during the follow-up period. The AUC was 0.61 (95%CI: 0.59-0.63), and the sensitivity and specificity were 0.52 (95%CI: 0.50-0.56) and 0.65 (95%CI: 0.64-0.66),respectively.

The stroke risk scoring tool has good predictive efficacy in middle-aged and elderly people undergoing physical examinations. It has high feasibility for popularization and application in primary medical institutions, can help identify high-risk populations for stroke, and provide a basis for stroke prevention and intervention strategies.

To analyze the epidemiological characteristics and trends of drug-resistant tuberculosis (DR-TB) patients in Guizhou Province from 2016 to 2023, providing scientific evidence and support for DR-TB prevention and control strategies.

Using the “Tuberculosis Management Information System”, a subsystem of the “Chinese Disease Prevention and Control Information System”, descriptive epidemiological methods were employed to analyze the epidemiological characteristics and trends of DR-TB patients in Guizhou Province.

A total of 3 580 DR-TB patients were reported in Guizhou Province from 2016 to 2023; the male-to-female ratio was 2.15:1, with 2 976 cases (77.12%) among the Han ethnic group. The age group of 40-60 years accounted for the highest proportion, with 1 507 cases (42.09%). Compared to 2016, the proportion of patients aged 60 and above increased in 2023 (24.23% vs. 10.56%). Farmers represented the majority of the patients, totaling 1 844 cases (51.51%). The top three regions were Bijie city (676 cases, 18.88%), Guiyang city (571 cases, 15.95%), and Tongren city (531 cases, 14.83%). Compared to 2016, the proportions in Bijie and Tongren cities increased in 2023 (20.52% vs. 9.94%and 11.34% vs. 3.72%, respectively). The predominant drug resistance type was rifampicin resistance (98.41%), while the proportion of multidrug-resistant cases decreased in 2023 compared to 2016 (45.88% vs. 98.14%), and the proportion of pre-extensively drug-resistant cases increased (7.32% vs. 0%). The top three categories of registration were new patients, treatment failures, and relapses, with 1 317 cases (26.79%), 893 cases (24.94%), and 874 cases (24.41%), respectively. Compared to 2016, the proportions of new patients and relapses increased in 2023 (44.85% vs. 6.83% and 30.10% vs. 18.63%).

The prevention and control efforts for DR-TB in Guizhou Province from 2016 to 2023 have achieved certain results, but the situation remains severe. Future work should focus on continuously improving the application of molecular biological testing technologies, reducing relapses, optimizing resource allocation, and strengthening prevention and control measures for key populations and regions, ensuring timely and effective diagnosis and treatment services across all areas.

To explore the relationship between parental emotional expression and depression symptoms in adolescents.

A random cluster sampling method was employed to select 13 240 adolescents from Pidu District, Chengdu. A general demographic questionnaire, the Chinese version of the Emotional Expression Scale, and the Chinese version of the Kutcher Adolescent Depression Scale were used for investigation and psychological assessment. Binary logistic regression analysis was conducted to examine the association between parental emotional expression and adolescent depression symptoms, with subgroup analysis based on factors such as gender, region, family economic status, only-child status, and primary caregiver.

The study found that 2 726 adolescents (20.6%) exhibited depression symptoms. Among the participants, 6 697 adolescents (50.6%) reported high levels of parental emotional expression. The incidence of depression symptoms was significantly higher in the group with high parental emotional expression compared to the group with low parental emotional expression (P < 0.001). Logistic regression analysis indicated that high parental emotional expression was a risk factor for depression symptoms in adolescents, even after controlling for multiple confounding factors (OR=2.08, 95%CI: 1.87-2.30). Subgroup analysis did not reveal any interaction between parental emotional expression and factors such as gender, region, or family economic status (P_interaction > 0.05).

Adolescent depression symptoms are closely associated with high parental emotional expression. Reducing negative emotional expression from parents may improve depression symptoms in adolescents and promote their psychological well-being.

To assess the burden of stroke and its subtypes attributable to dietary factors in China from 1990 to 2021.

Utilizing the Global Burden of Disease (GBD) 2021 database, we analyzed the trends of stroke and its subtypes (ischemic stroke, hemorrhagic stroke, subarachnoid hemorrhage) caused by dietary factors in China using the Join point regression model and estimated annual percentage change (EAPC).

In 2021, the number of stroke deaths attributable to dietary factors in China was 1 077 762, with an age-standardized mortality rate (ASMR) of 21.59 per 100 000. From 1990 to 2021, both the ASMR and age-standardized disability-adjusted life years (DALYs) rate (ASDR) due to dietary factors showed a declining trend, with EAPCs of -2.69 and -2.74, respectively. Ischemic stroke presented the heaviest burden, with an ASMR of 11 per 100 000. Excess sodium intake was identified as the primary dietary risk factor, with an ASMR of 8.77 per 100 000 for ischemic stroke attributable to excess sodium and an ASMR of 10.6 per 100 000 for hemorrhagic stroke. The burden of disease was significantly higher in males and individuals aged 70 and above, with mortality rates more than twice that of other age groups.

Over the past 32 years, the burden of stroke attributable to dietary factors in China has decreased, yet the overall numbers remain substantial.Future public health policies should focus on controlling high-sodium diets and increasing the intake of grains and fruits, particularly targeting high-risk populations such as elderly males, to further reduce the burden of stroke.

To investigate the status of aggressive behavior in first-episode schizophrenia patients and further explore the related influencing factors and their gender differences.

A total of 224 first-episode schizophrenia patients admitted to Beijing Anding Hospital from December 2019 to September 2022 were consecutively selected as study subjects.The Revised Hostility Scale was used to assess the occurrence of aggressive behavior in patients. Univariate analysis and binary logistic regression analysis were employed to explore the influencing factors of aggressive behavior in first-episode schizophrenia patients of different genders.

The detection rate of aggressive behavior in first-episode schizophrenia patients was 34.13%, with detection rates of 24.49% for male patients and 27.27% for female patients. For female first-episode schizophrenia patients, independent predictors of aggressive behavior included ethnicity (OR=0.009, 95%CI: 0.001-0.154),history of suicide attempts (OR=57.347, 95%CI: 5.152-638.353), lack of crisis coping (OR=1.113, 95%CI: 1.001-1.238),temperament (OR=3.059, 95%CI: 1.373-6.813), and hopelessness (OR=0.891, 95%CI: 0.796-0.998). For male patients, independent predictors included age (OR=0.951, 95%CI: 0.908-0.996), living alone (OR=6.130, 95%CI: 1.935-19.420), value conflict (OR=0.912, 95%CI: 0.843-0.987), disparity between desires and reality (OR=1.108, 95%CI: 1.044-1.177),temperament (OR=1.599, 95%CI: 1.062-2.408), and hopelessness (OR=1.101, 95%CI: 1.032-1.175).

The detection rate of aggressive behavior in first-episode schizophrenia patients is relatively high, and the influencing factors exhibit gender differences. During clinical screening and treatment, personalized intervention measures should be developed based on the characteristics of the patients to more effectively prevent and manage the occurrence of aggressive behavior.

To analyze the causal association between glucosamine and the risk of fracture using the two-sample Mendelian randomization (MR) method.

This study was based on the summary data of genome-wide association studies of glucosamine and fracture in the European population. First, univariate MR analysis was performed using the inverse-variance weighted method,MR-Egger regression method, weighted median method, and MR-PRESSO. Sensitivity analysis was conducted by excluding palindromic instrumental variables, leave-one-out analysis, and reverse MR to verify the robustness of the results. Finally, multivariate MR analysis was used to evaluate the independent effect of glucosamine on fracture occurrence.

The results of the univariate inverse-variance weighted method showed that genetically predicted glucosamine was associated with a reduced risk of fracture (OR=0.94, 95%CI: 0.90-0.99, P=0.015). In addition, the results obtained by the MR-Egger regression method, weighted median method, and MR-PRESSO were consistent with those of the inverse-variance weighted method. Sensitivity analysis further verified the stability of the results. In the multivariate MR analysis, after adjusting for the potential effects of chondroitin, vitamin supplements, and osteoarthritis, the results still supported a negative causal relationship between glucosamine and the risk of fracture (adjusted for chondroitin: OR=0.61, 95%CI: 0.46-0.80, P=4.1×10^-4; adjusted for vitamins: OR=0.87, 95%CI: 0.81-0.93, P=1.1×10^-4;adjusted for osteoarthritis: OR=0.46, 95%CI: 0.29-0.73, P=9.7×10^-4).

Glucosamine can reduce the risk of fracture.

To develop and validate a questionnaire based on the Transtheoretical Model (TTM) for assessing the stages of behavior change in patients with Chronic Obstructive Pulmonary Disease (COPD) (COPD-TTM questionnaire), which can be used to evaluate patients’ behavioral stages and provide a basis for personalized interventions.

A preliminary COPD-TTM questionnaire was constructed through literature review and expert consultation, consisting of five primary dimensions and 15 secondary items. The structural validity was verified by measuring 171 COPD patients, while content validity was assessed through expert ratings. A retest was conducted two weeks later to validate the test-retest reliability.

Five factors were extracted from the 15 items, cumulatively explaining 68.5% of the total variance, with item loadings for each factor not less than 0.65, indicating alignment of the questionnaire items with the expected TTM stages. The CFA results showed a χ²/v value of 1.85, CFI of 0.98, RMSEA of 0.045, and SRMR of 0.05,demonstrating good structural validity of the questionnaire. The S-CVI was 0.93, with all I-CVI values above 0.80, indicating strong content validity. The Cronbach’s α coefficient for the COPD-TTM questionnaire was 0.980, and the test-retest reliability ICC was 0.961(95%CI: 0.935-0.977), suggesting good reliability and validity.

The COPD-TTM questionnaire can be used to assess the stages of behavior change in patients, providing a basis for further development of individualized intervention plans. Future research should focus on a broader range of factors influencing behavior change to optimize personalized interventions.

To investigate the prevalence of behavioral risk factors for chronic diseases among adult residents in Quanzhou city and their clustering patterns, providing a scientific basis for developing chronic disease prevention and control policies and public health measures tailored to different regions of Quanzhou.

A descriptive analysis of the prevalence of behavioral risk factors for chronic diseases was conducted. The research data were analyzed using χ² tests via SPSS 21.0, and K-Means clustering and visualization of behavioral risk factors for chronic diseases across different regions were performed using R 4.4.0.

A total of 14 087 valid samples were collected from the social factor survey among adult residents in Quanzhou city, analyzing five primary behavioral risk factors for chronic diseases. The prevalence rates, from highest to lowest, were insufficient intake of fresh fruits and vegetables (55.86%), overweight or obesity (48.85%), current smoking (18.49%), insufficient sleep (8.03%), and excessive alcohol consumption (6.30%). The clustering patterns of behavioral risk factors for chronic diseases in the city can be categorized into three types: low fruit and vegetable intake (72.49%), health-oriented (14.82%), and excessive smoking and drinking (12.69%).

The prevalence of behavioral risk factors for chronic diseases among adult residents in Quanzhou city is relatively high and exhibits distinct clustering characteristics, predominantly characterized by low fruit and vegetable intake. The proportion of individuals with healthy lifestyles is small, indicating the need for targeted public health interventions to promote healthy lifestyles for the entire population, thereby preventing the occurrence and progression of chronic diseases.

To investigate the childhood traumatic experiences, mental health symptoms, and well-being of middle school students, analyze the associations among the three, explore the mechanism by which childhood traumatic experiences and mental health symptoms affect well-being, and provide reference for improving the well-being of middle school students.

From September to November 2023, a total of 1 294 students were selected by convenience sampling and stratified sampling from two middle schools as the survey subjects. The Childhood Trauma Questionnaire, Symptom Checklist 90, and EPOCH Well-being Scale were used for the questionnaire survey. SPSS 25.0 was used for descriptive analysis, t-test, chi-square test, and Pearson correlation analysis. The plug-in process was used to explore the mediating role of mental health symptoms between childhood traumatic experiences and well-being.

There were significant differences in well-being scores among factors such as gender, school stage, household registration, parental education level, parental marital status, and“who to live with” (t=2.813, 7.11, 3.459, 9.723, 6.923, 2.515, and 20.253, P < 0.05). In this study, 90.2% of middle school students had one or more childhood traumatic experiences. The detection rates of physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse were 15.1%, 61%, 42.8%, 81.9%, and 10%, respectively. There were significant differences in childhood traumatic experiences among only-child status, school stage, parental education level, marital status, and family structure (t=-4.082, 5.415, 10.144, -3.032, 9.467, and -2.003, P < 0.05). All dimensions of childhood traumatic experiences and mental health symptoms were negatively correlated with well-being; except for sexual abuse, all dimensions of childhood traumatic experiences were positively correlated with mental health symptoms (r=0.301, P < 0.05). Mental health symptoms played a partial mediating role between childhood traumatic experiences and well-being, and the proportion of the mediating effect was 37.5%.

Childhood traumatic experiences and mental health symptoms negatively predict the well-being of middle school students, and mental health symptoms play a mediating role between childhood traumatic experiences and well-being. Against the background of a relatively high incidence of childhood traumatic experiences among middle school students, the well- being of middle school students can be improved by improving their mental health and reducing the impact of childhood traumatic experiences on well-being.

To analyze the treatment enrollment status and influencing factors for rifampicin-resistant pulmonary tuberculosis patients in Guizhou Province, providing a basis for improving prevention and control strategies.

Based on case data, drug resistance screening records, and information on drug-resistant patients in Guizhou Province from 2016 to 2023, the enrollment rate (%) of rifampicin-resistant patients was described to characterize their distribution. Chi-square tests and binary logistic regression models were employed to analyze influencing factors.

The average annual enrollment rate for rifampicin-resistant pulmonary tuberculosis patients in Guizhou Province from 2016 to 2023 was 56.00%, increasing from 35.71% in 2016 to 88.20% in 2023 (trend χ²=729.839, P<0.001). An upward trend was observed across gender, age groups (<20 years, 20-39 years, 40-59 years, and ≥60 years), and nine municipalities (P<0.05 for all). Analysis of influencing factors indicated that compared to patients who were <20 years old, local, new cases, those with reports from designated multidrug-resistant tuberculosis hospitals, and those without diagnosis delays, the following were identified as risk factors for treatment enrollment: age ≥60 years (OR=0.471, 95%CI: 0.296-0.750), migrant status (OR=0.503, 95%CI: 0.391-0.646), initial treatment positive at 2/3 months (OR=0.676, 95%CI: 0.464-0.983), reports from general tuberculosis hospitals (OR=0.080,95%CI: 0.063-0.102) and from the disease control center (OR=0.048, 95%CI: 0.040-0.057), and diagnosis delays (OR=0.551,95%CI: 0.048-0.648) (P<0.05 for all).

The treatment enrollment status of rifampicin-resistant pulmonary tuberculosis patients in Guizhou Province has gradually improved, but continued attention is necessary. It is recommended to strengthen interventions for key populations, including those aged ≥60 years, migrants, initial treatment positive at 2/3 months, patients with reports from non-multidrug-resistant designated tuberculosis hospitals, and those experiencing diagnosis delays, to further enhance treatment enrollment rates.