To understand the current status of digital health literacy among rural elderly individuals in Shandong Province and analyze the main influencing factors.

A multi-stage stratified cluster random sampling method was employed to select 720 rural individuals aged 60 years and older from the eastern, central, and western regions of Shandong Province for a questionnaire survey. Multiple linear regression analysis was used to explore the factors influencing digital health literacy among the elderly.

The average digital health literacy score of the 720 rural elderly participants was 58.31±16.34. Multiple linear regression revealed that factors associated with higher digital health literacy included normal BMI (β=8.28, P<0.001), low body weight (β=18.61, P<0.001), self-reported good health status (β=6.90, P<0.001), general health status (β=10.20, P<0.001), being married (β=3.49, P=0.001), monthly income between 3 000-4 999 yuan (β=6.75, P<0.001), income ≥5 000 yuan (β=11.48, P<0.001), and having health insurance coverage (urban employee health insurance/rural resident health insurance) (β=5.58, P=0.001).

The level of digital health literacy among rural elderly individuals in Shandong Province needs improvement. Targeted measures should be implemented from five aspects: personal traits, behavioral characteristics, interpersonal relationships, living and working conditions, and policy environment, in order to enhance digital health literacy in this population.

To examine the frequency and distribution patterns of birth defects in Hainan Province between 2016 and 2021, in order to offer insights for the improvement of maternal and child health services in the region.

Data on perinatal birth defect surveillance were gathered and analyzed from 28 weeks of gestation to 7 days postpartum in all monitored hospitals across Hainan Province between January 1, 2016 to December 31, 2021.

The comprehensive dataset revealed a total of 346 425 births recorded in Hainan Province from 2016 to 2021. Of these, 11 000 cases were identified with birth defects, translating to an average incidence rate of 317.53 per 10 000 births. Notably, the incidence of birth defects varied significantly across different demographics. Rural areas exhibited a lower rate (297.90 per 10 000) compared to urban areas (338.88 per 10 000), with a statistically significant difference (χ²=67.977, P<0.001). Additionally, male neonates showed a higher incidence (346.22 per 10 000) than female neonates (281.32 per 10 000), also with a statistically significant difference (χ²=164.878, P<0.001). Maternal age played a crucial role as well, with the 35-year-old and older age group demonstrating the highest incidence (364.81 per 10 000).The five most prevalent birth defects included congenital heart disease (180.99 per 10 000), polydactyly (20.24 per 10 000), talipes equinovarus (12.04 per 10 000), other external ear malformations (10.74 per 10 000), and syndactyly (5.05 per 10 000).Regarding prenatal diagnosis, only 11.72% of birth defects were confirmed prenatally, with clinical and ultrasonic diagnosis accounting for 98.87% of the total diagnoses. In terms of prognosis, a promising 91.92% of fetuses with congenital disorders were live births.

Suggest an increase in the prevalence of perinatal birth abnormalities in Hainan Province from 2016 to 2021. In response to these findings, it is imperative to strengthen the three-level preventive measures of birth defects, aiming to reduce incidence rates.

To understand the current situation of the construction of the integration mechanism of medical treatment and prevention in infectious disease hospitals in China, and to provide data support for the promotion of related work and policy formulation.

Based on the survey data of the construction of the integration mechanism of medical treatment and prevention in infectious disease hospitals in China, a quantitative analysis was conducted on the current situation of the related work of the integration of medical treatment and prevention in 97 secondary and tertiary infectious disease hospitals. A difference analysis was carried out on the current situation of the integration of medical treatment and prevention in different regions. Moreover, the t-SNE algorithm and data visualization were used to cluster the sample institutions for a comparative study at the hospital level.

Among the sample institutions in the eastern region, 46.51% had policy support related to the integration of medical treatment and prevention at the provincial (municipal) level, with an obvious advantage compared to other regions (P=0.001). The proportions of sample institutions in the eastern and central regions that established internal systems for the integration of medical treatment and prevention were higher (P=0.015), accounting for 27.91% and 28.57% respectively. In terms of the proportion of infectious disease hospitals that independently set up public health departments: the eastern region had the highest proportion, accounting for 72.09%; the northeastern region had the lowest proportion, accounting for 20.00%; and there were significant statistical differences among different regions (P=0.001). The t-SNE algorithm grouped the sample institutions into three categories: head tertiary hospitals, typical secondary hospitals and medium-sized hospitals. The construction of the integration mechanism of medical treatment and prevention in the three hospitals in head tertiary hospitals was significantly better than that in the other two categories.

The work on the integration of medical treatment and prevention for infectious diseases in China is still in the stage of exploration and breakthrough. All regions should explore the models and paths for the integration of medical treatment and prevention for infectious diseases in combination with local actual situations. The pilot construction of the integration of medical treatment and prevention of infectious diseases at both the "regional" and "hospital" levels should be coordinated，in order to promote infectious disease hospitals to better fulfill their public health functions, and take this as a breakthrough to open up the effective integration and interconnection of personnel, information and resources between medical institutions and disease control institutions.

To construct the evaluation index system of public hospital operation management to provide a reference tool for administrative departments and public hospitals to grasp the public hospital operation management situation.

Based on the balanced scorecard theory, the evaluation index system of public hospital operation management was initially constructed through literature analysis, the final evaluation index system was determined by Delphi method, and the index weight was calculated by AHP method.

The response rate of expert consultation for the secondround was 100%, the authority coefficient was 0.840 and the coordination coefficients of the importance, feasibility and relevance of the indicators were 0.210, 0.181 and 0.196, respectively (P<0.001). The final evaluation index system consisted of 4 first-level indicators, 16 second-level indicators and 39 third-level indicators. The top 3 indicators of combined weight were inpatient satisfaction(0.0979), outpatient satisfaction(0.0682) and the proportion of medical service income(0.0494).

The public hospital operation management evaluation index system constructed by this research had high scientific, rational and practical guiding significance and was an effective tool to analyze and evaluate the operation management of public hospitals.

To analyze the impact of DIP payment reform on total hospitalization costs, drug costs, and treatment costs of hospitalized patients with chronic lung disease, and to provide a decision-making reference for the deepening reform of DIP.

Using the first national DIP pilot cities as a sample area, case data of 10 058 chronic lung patients hospitalized in provincial hospitals in the area were extracted for the study, and the causal effects of DIP on total patient costs, drug costs and treatment costs were estimated by the PSM-DID model.

After the DIP payment reform, the total cost for patients with chronic obstructive pulmonary disease decreased by 5.9% (P=0.001), were 1 162.92 yuan; the cost of medication decreased by 8.83% (P=0.003), were 477.21 yuan; and the cost of treatment decreased by 27.3% (P=0.001), were 152.54 yuan.

The DIP payment reform has achieved short-term reform effects on reducing total hospitalization costs, drug costs, and treatment costs for patients hospitalized with chronic obstructive pulmonary disease. In order to guarantee the continuous implementation of DIP, the medical insurance department should also continue to strengthen the supervision of the diagnosis and treatment process of medical institutions to maintain the long-term continuation of the effect of fee-control; medical institutions should further promote the refinement of management.

To study the effect and mechanism of nicotinamide mononucleotide (NMN) in alleviating silica-induced lung injury, and to provide a new option for the adjuvant treatment of silicosis.

The male C57BL/6 mice were randomly divided into control group, SiO₂ group, and NMN intervention group according to body weight, with 10 mice in each group. Mice were given SiO₂ (50 mg/ml, 80 μl) by tracheal instillation to construct a mouse model of silicosis, and NMN (1 000 mg/kg) was given by gavage for 7 days and 28 days. Histopathological staining was used to assess lung lesions, and transcriptomic sequencing was used to analyze gene expression and screen for key genes.

NMN intervention alleviated SiO₂-induced lung injury. Gene clustering results showed that NMN intervention improved SiO₂-induced gene expression disorders to a certain extent, and the improvement effect of 28 days was better than 7 days of NMN intervention. After 7 and 28 days of SiO₂ exposure, 1 163 genes were up-regulated in the SiO₂ group compared with the control group, and were down-regulated in the NMN group compared with the SiO₂ group, of which 445 were differential genes. Similarly, 1 657 genes were down-regulated in the SiO₂ group compared with the control group, and were up-regulated in the NMN group compared with the SiO₂ group, of which 571 were differential genes. The main GO term of the above differential genes was RNA polymerase and transcriptional regulation, and main KEGG pathways were IL-17 signaling pathway (P<0.001), cytokine-cytokine receptor interaction (P<0.001), Th17 cell differentiation (P<0.001), TNF signaling pathway (P<0.001). According to the number of pathways involved in the regulation of differential genes, the TOP8 hub genes were Mapk11, Mapk12, Il1b, H2-Ob, Csf2, Shc2, Mmp9, Ccl25.

NMN alleviates lung injury in silicosis mice by regulating immunity.

To investigate the associations between visceral obesity indices and the co-morbidities of hypertension, diabetes mellitus, and dyslipidemia in steel workers.

This study included 7 318 steelworkers, using multivariate logistic regression to analyze the connection between visceral adiposity-related indices and the co-morbidity of "three highs".

A total of 7 318 steel workers were included, with 1 759 diagnosed with all three conditions, accounting for a 24.04% prevalence rate. After adjusting for age and gender, significant correlations were found between LAP, TyG, and their combined indices with various types of co-morbidities (P<0.001). No interactions were observed between age and these indices in the context of co-morbidities (P_interaction>0.05), except for the TyG-WC index in cases of two diseases co-occurring (P_interaction<0.05), and the LAP index, TyG-WHtR index, and LAP-BMI index when all three diseases co-occurred (P_interaction<0.05).

The LAP index, TyG index, and their combined indices are closely associated with the co-morbidities of hypertension, hyperglycemia, and hyperlipidemia in steelworkers.

To analyze the risk factors for cognitive impairment in patients with multimorbidity.

Studies on the occurrence of cognitive impairment in patients with multimorbidity were identified by searching Chinese and foreign databases: PubMed, Web of Science, Embase, Cochrane library, CNKI, Wan Fang Data, VIP, SinoMed. The search period was from database inception to July 1, 2024, meta-analysis was performed using RevMan5.4 and Stata18.0 software.

A total of 12 studies were included, comprising 1 137 737 patients. The meta-analysis indicated that smoking (OR=1.11，95% CI=1.05-1.18), low social activity (OR=1.52，95% CI=1.06-2.17), having two chronic diseases (OR=1.15，95% CI=1.05-1.26), having three chronic diseases (OR=1.37，95% CI=0.96-1.94), having four or more chronic diseases (OR=1.67，95% CI=1.49-1.87), having two cardiovascular metabolic diseases (OR=1.72，95% CI=1.42-2.07), having three or more cardiovascular metabolic diseases (OR=2.53，95% CI=1.41-4.54), and eight multimorbidity models were the neuropsychiatric (OR=2.05，95% CI=1.83-2.29), cancer/sensory impairment (OR=1.32，95% CI=1.18-1.47) diabetes/heart disease (OR=2.17，95% CI=1.68-2.08) diabetes/stroke (OR=2.92，95% CI=1.49-5.71), diabetes/hypertension (OR=1.93，95% CI=1.72-2.17), hypertension/heart disease (OR=1.56，95% CI=1.40-1.74), stroke/heart disease (OR=2.65，95% CI=1.89-3.71), and stroke/diabetes-heart disease (OR=3.95，95% CI=2.81-5.56) showed statistically significant differences (all P<0.05).

Current evidence suggests that smoking, low social activity, number of chronic diseases, and different patterns of multimorbidity are all risk factors for cognitive impairment in patients with multimorbidity, and that early clinical screening and intervention is warranted to reduce the progression of cognitive impairment in patients with multimorbidity.

To explore the potential relationship between dietary carotenoid intake and neurodegenerative diseases based on NHANES data.

A multifactorial logistic regression model was used to analyze the relationship between dietary carotenoid intake and neurodegenerative diseases and to explore the association between dietary carotenoid intake and neurodegenerative diseases in different gender and age subgroups, using the NHANES database of people aged 40 years and older from 2003-2018 as the study population.

Of the 23 108 study participants included in this study, 216 had Parkinson’s disease dementia (PD) and 183 had Alzheimer’s disease (AD). The carotenoid intake of PD patients (7,597.9 mcg/d) was significantly lower than that of the normal population (8,719.8 mcg/d) and the difference was statistically significant, while that of AD patients (7 189.8 mcg/d) was significantly lower than that of the normal population (8,721.4 mcg/d) and the difference was statistically significant. After adjusting for age, sex, body mass index, race, education, alcohol consumption, smoking, household poverty-to-income ratio, hypertension, diabetes mellitus, Cardiovascular disease and the NHANES cycle, the prevalence of PD was significantly lower in the highest tertile group compared with the lowest tertile group (OR=0.65, 95% CI: 0.44-0.98), and the risk of AD was significantly lower in the Q2 group (OR=0.65, 95% CI: 0.43-0.99). In subgroup analyses, a lower risk of PD was observed in the group with the highest dietary carotenoid intake in those aged 70 years or older (OR=0.52, 95% CI: 0.30-0.96); the protective effect of dietary carotenoid intake on AD was demonstrated in the Q4 group of women (OR=0.49, 95% CI: 0.26-0.93).

There is a negative association between carotenoid intake and the risk of developing neurodegenerative diseases, and carotenoids may be a protective factor against neurodegenerative diseases, a relationship that varies by age, sex, and whether or not the individual has hypertension or diabetes.