To evaluate the efficacy of three treatment modalities, preoperative, postoperative, and combined preoperative and postoperative systemic therapy, in elderly patients with rectal cancer (RC), and to analyze the prognostic factors for elderly RC patients.

Data from 4612 RC patients aged 60 and above were used, sourced from the SEER database between 2011 and 2015. The Overlap Weighting (OW) method based on XGBoost was employed to balance covariate differences between treatment groups and assess the impact of different treatment regimens on the survival prognosis of RC patients. Survival curves were plotted using the Kaplan-Meier method, and Log-rank tests were conducted. Cox regression analysis was utilized to evaluate independent risk factors affecting the survival of RC patients.

After OW weighting, the three treatment groups achieved balance across all covariates. The survival rates among different treatment groups were statistically significant (P<0.001). The 1-year, 3-year, and 5-year survival rates were 94.6%, 82.2%, and 71.6% for the preoperative systemic therapy group, 95.0%, 79.0%, and 67.8% for the postoperative systemic therapy group, and 97.3%, 85.5%, and 73.4% for the combined preoperative and postoperative systemic therapy group, respectively. Multivariate Cox regression analysis revealed that, compared to the preoperative systemic therapy group, the specific death hazard ratio for the postoperative systemic therapy group was 1.216(95% CI: 1.072-1.381). Patients with liver metastasis had a specific death hazard ratio of 1.719(95% CI: 1.253-2.358) compared to those without liver metastasis.

The sequence of systematic treatment has a significant impact on the survival prognosis of elderly RC patients. After controlling for factors such as age and gender, preoperative systemic treatment had a better survival prognosis among the three treatment methods; Liver metastasis may be an independent factor affecting the prognosis of RC patients.

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 relationship between body roundness index (BRI) and new onset arthritis, and provide a new perspective for the prevention and treatment of arthritis.

A cohort study design was adopted, using the data of 2011 and 2020 in the China longitudinal study on the China Health and Retirement Longitudinal Study (CHARLS), taking BRI as the exposure factor, high-density lipoprotein cholesterol (HDL-C), total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C) as the intermediary variables, including demographic characteristics such as age and gender, smoking, alcohol consumption and other health behaviors as confounding factors, and new onset arthritis as the outcome. Statistical analysis was carried out using multiple model logistic regression strategy, restricted cubic spline, subgroup analysis and intermediary analysis. Compared with relevant studies, the main purpose of the dose-response relationship we explored is to study whether there is a nonlinear relationship between exposure and outcome, that is, whether the risk of outcome will change accordingly with the change of exposure level.

A total of 5 166 participants were included, and BRI was positively correlated with arthritis, with an OR value of 1.196 (95% CI: 1.047-1.367). The prevalence of new onset arthritis increased by 19.6% when BRI increased by a quartile range; The dose-response relationship showed that BRI > 3.943 was positively correlated with the incidence of arthritis; Subgroup analysis showed that the positive correlation between BRI and new onset arthritis was not affected by many factors; Mediation analysis showed that HDL-C had a protective effect on arthritis, mediating about 6.84% of the impact of BRI on the incidence of arthritis. The mediation effect of total cholesterol, triglycerides and LDL-C was not significant; The AUC of BRI for predicting new onset arthritis (0.546) was higher than that of BMI (0.527).

The increased level of BRI may lead to an increased risk of arthritis, and HDL-C may alleviate this risk. In the future, its clinical application potential and regulatory strategies should be explored to reduce the incidence of arthritis and improve the prognosis.

This study aimed to identify the dual trajectories of social isolation and depression among middle-aged and older patients with hypertension, discuss the relationship between the dual trajectories, and investigate common influential factors. Method Using data from 2013 to 2020 of the China Health and Retirement Longitudinal Study (CHARLS), a longitudinal cohort was formed for the study. A group-based trajectory model was used to identify trajectories of social isolation and depression in 3 223 middle-aged and older patients with hypertension and the relationship between the dual trajectories. Multi-class logistic regression was used to analyze common influential factors of the dual trajectories.

Three trajectories of social isolation were identified: low-stable without social isolation, medium-stable without social isolation, and high-increasing with social isolation. Three depression trajectories were observed: low-stable without depression, medium-increasing with depression, and high-stable with depression. Dual-trajectory analysis showed in middle-aged and older patients with hypertension who were in the medium-stable without social isolation and high-increasing with social isolation trajectory groups, the probability of depression trajectories in the medium-increasing with depression and high-stable with depression groups was 61.84% to 87.46%. In middle-aged and older patients with hypertension who belonged to the medium-increasing with depression and high-stable with depression trajectory groups, the probability of social isolation in the medium-stable without social isolation and high-increasing with social isolation trajectory groups was 70.03% to 91.63%. The level of education(social isolation trajectories in middle school RRR=0.756, 95% CI：0.599-0.954, RRR=0.496, 95% CI: 0.326-0.755; social isolation trajectories in high school or above RRR=0.516, 95% CI: 0.375-0.709, RRR=0.262, 95% CI: 0.137-0.501; depression trajectories in middle school RRR=0.773, 95% CI: 0.622-0.959, RRR=0.728, 95% CI: 0.574-0.994, depression trajectories in high school or above RRR=0.421, 95% CI: 0.309-0.571, RRR=0.439, 95% CI: 0.253-0.763) and sleeping 7-9 hours a night (social isolation trajectories RRR=0.824, 95% CI: 0.681-0.997, RRR=0.596, 95% CI: 0.440-0.806; depression trajectories RRR=0.597, 95% CI: 0.501-0.711, RRR=0.486, 95% CI: 0.362-0.653) were common influential factors of the dual trajectories of social isolation and depression.

There is a high degree of consistency and significant correlation between the social isolation trajectory and the depression trajectory. Interventions targeting the dual trajectories and co-factors of social isolation and depression should be considered to improve their effectiveness.

To analyze the compensation for adverse events following immunization from vaccination under Anhui Province’s National Immunization Program (NIP) from 2012 to 2024.

Data from cases compensated for adverse events following immunization from vaccination in Anhui Province from 2012 to 2024 were collected and analyzed using descriptive NIP demiological methods.

From 2012 to 2024, there were a total of 80 AEFI compensation cases in Anhui Province for NIP vaccines, with the lowest compensation amount being 13 200 yuan and the highest compensation amount being 1.54 million yuan. The total compensation amounted to 35.49 million yuan, with an average compensation of 443 600 yuan per case (ranging from 13 200 yuan to 1.54 million yuan). The number of cases and compensation amount for those under 1 year old were the highest, with 64 cases (80.00%) and 25.29 million yuan (71.26%) respectively. In the vaccine distribution, BCG vaccine had the highest number of AEFI compensation cases and compensation amount, with 33 cases (41.25%) and 1.05 million yuan (29.64%), respectively. In terms of clinical diagnoses, neurological diseases had the highest number of cases and total compensation amount, with 33 cases (41.25%) and 2.03 million yuan (57.26%). In the damage severity classification, Grade IV had the most compensation cases, with 20 cases (25.00%), while Grade II-B had the highest total compensation amount, totaling 7.49 million yuan(21.09%). The average payment time after the investigation and diagnosis conclusion was 252.28 days.

The overall implementation of compensation for adverse events following immunization from vaccination under Anhui Province’s NIP is good, but there is a need for further improvement in compensation procedures and mechanisms.

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.

To explore the association between physical activity level (PAL) and Circadian syndrome (CircS) in Chinese middle-aged and elderly population.

Based on the 2013 China Health and Retirement Longitudinal Study (CHARLS) data, middle-aged and elderly people ≥45 years old with complete key data were selected. The association between PAL and CircS was analysed by multiple logistic regression. In addition, subgroup analyses, interaction tests, smoothed curve fitting, and threshold effect analyses were performed.

A total of 5 851 middle-aged and older adults were included as study subjects, with a prevalence of CircS of 24.18% and PAL of 4 548 (1 732.5, 10 584)(MET-min/w). Fully adjusted multivariate logistic regression showed a significant negative association between PAL and CircS prevalence (OR=0.73, 95% CI: 0.62-0.87; P<0.001). The consistency of this association was confirmed by subset analyses and interaction tests for multiple subgroups. Smoothed curve fitting and threshold effect analyses revealed a nonlinear relationship with a threshold of 3 810 MET-min/w.

There is a negative association between the PAL and the risk of developing CircS. Moderate physical activity may allow early intervention in individuals at risk for CircS.

To explore the mechanism of Mycobacterium tuberculosis (Mtb) resistance to fluoroquinolones (FQs) drugs at the genetic level, the whole genome sequencing of fluoroquinolone-resistant Mtb induced in vitro and clinical isolates was conducted.

Mtb standard strain H37Rv was induced into standard levofloxacin (LFX) resistant strain and high-level drug-resistant strain in LJ medium by concentration gradient induction method in vitro. The induced strains and drug-free control strains of each generation were collected and preserved. FQs-resistant strains in clinical isolates were screened, and the sensitivity of the induced strains and clinical isolates to 14 anti-tuberculosis drugs was detected by liquid microplate method, and then the whole genome was sequenced and analyzed.

The analysis of LFX-resistant Mtb model found that the resistance of Mtb to FQs drugs may be related to gene mutations, gyrB (Ala504Thr, Asp461Asn), gyrA (Ala90Val), PE_PGRS31 (Ala395fs), panB (Asp184_Ala187del), aroD (Asp61Asn), devS (Gly348Arg) and rv3446c (Ala178Thr). GWAS analysis of clinical isolates detected 17 new mutation sites that may be related to FQs drug resistance, namely gyrA(p.Glu21Gln, p.Gly668Asp, p.Ser95Thr, p.Glu213Asp, p.His280Arg, p.Ala384Val), gyrB(er132Ala, p.Met291Ile), PE_PGRS31(p.Ser365Phe, p.Pro254Leu, p.Thr252Ile, p.Val352Ile), rv3446c(p.Arg284Pro, p.Leu389Phe, p.Ala164Val) anddevS(p.Val307Ala, p.Ile283Thr).

The LFX-resistant Mtb model constructed in this study provides an ideal biological model for exploring the mechanism of Mtb drug resistance to FQs. Whole genome sequencing has analyzed the mechanism of Mycobacterium tuberculosis resistance to fluoroquinolones from the gene level, and the obtained new mutation sites related to fluoroquinolone resistance still need to be further studied and verified.

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 understand the prevalence and influencing factors of Chronic Obstructive Pulmonary Disease (COPD) among middle-aged and elderly residents in the community, and to construct and validate a Nomogram prediction model to provide a theoretical basis for the prevention of COPD onset and deterioration.

This cross-sectional study involved 3 250 middle-aged and elderly community residents in Chengdu Eastern New District. Basic information and risk factors for COPD were collected through pulmonary function tests, physical examinations, and questionnaires. The study population was divided into training and validation sets. Elastic net analysis was performed in the training set to select coefficients, and LASSO regression and random forest models were utilized to analyze the influencing factors of COPD and severe COPD, leading to the establishment of a Nomogram prediction model.

The detection rates of COPD and severe COPD among community residents in Chengdu were 26% and 5.38%, respectively. LASSO regression indicated that age, male, being unmarried, low income, childhood pneumonia hospitalization, childhood cough, and parental respiratory disease history were common risk factors for COPD and severe COPD. Unique risk factors for COPD included low BMI, occupation, dust exposure, allergy history, workplace smoking, family smoking, and personal smoking.Unique risk factors for severe COPD included low educational level, waist-to-hip ratio, and maternal smoking during pregnancy. A Nomogram risk prediction model for COPD and severe COPD was established based on these indicators, with AUC values of 69.34%(95%CI: 66.90%-71.79%) and 76.81% (95%CI: 72.71%-80.90%), respectively, demonstrating good predictive performance. Internal validation through 1 000 bootstrap resampling showed that the calibration curves of the Nomogram model closely matched the actual occurrence of COPD and severe COPD, indicating a good fit.

Gender, age, educational level, marital status, family income, waist-to-hip ratio, childhood pneumonia hospitalization history, childhood cough, maternal smoking, paternal respiratory disease history, and maternal respiratory disease history are independent risk factors for COPD and severe COPD among community residents in Chengdu. The constructed Nomogram prediction model can provide a concise and intuitive personalized risk assessment for COPD and severe COPD for community residents and high-risk populations.