To analyze the changes in the burden of Disability-Adjusted Life Years (DALY) due to esophageal cancer in China from 1990 to 2021 and to predict the DALY trends over the next 20 years, providing scientific basis for policy-making and public health interventions.

The analysis of DALY changes due to esophageal cancer in China from 1990 to 2021 was conducted using the Global Burden of Disease Study database. Joint point regression analysis was employed to assess the annual percentage change in the DALY rate for esophageal cancer in China, and comparisons were made with North Korea, Japan, South Korea, and the United States. A decomposition analysis was performed to evaluate the contributions of population aging, population growth, and age-specific factors to the changes in esophageal cancer DALY. The Bayesian Age-Period-Cohort (BAPC) model was used to forecast the changes in esophageal cancer DALY over the next 20 years.

In 2021, the total number of DALYs due to esophageal cancer in China was approximately 6.8 987 million years, with a significantly higher burden in males compared to females;individuals aged 65 and older accounted for 52.71% of the total DALYs. Compared to international data, China exhibited a more pronounced declining trend in esophageal cancer DALYs. From 1990 to 2021, the DALY rate decreased, with population aging and growth being the main driving factors for the increase in DALY burden. The BAPC predictive analysis indicated a slow declining trend in the total standardized DALY rate for esophageal cancer in China over the next 20 years.

Over the past 30 years, the burden of DALYs due to esophageal cancer in the Chinese population has shown a significant declining trend, particularly among males and the elderly. Future efforts should focus on enhancing screening coverage and interventions for high-risk populations.

To explore the longitudinal mediating role of cognitive function in the relationship between depression and activities of daily living (ADL) among individuals aged 60 and above in China, as well as the moderating effect of sleep quality.

Data from the China Health and Retirement Longitudinal Study (CHARLS) collected in 2018 (T1) and 2020(T2) were analyzed. The Center for Epidemiologic Studies Depression Scale (CES-D10), the Mini-Mental State Examination (MMSE), and the ADL scale were used for measurement. Descriptive statistics and correlation analyses were conducted using STATA 18.0 and SPSS 26.0, while mediation and moderated mediation models were constructed and analyzed using Model 4 and Model 59 in the Process 4.0 program.

T1 depression significantly negatively predicted T2 ADL (r=-0.247, P <0.01). Both T2 cognitive function and T2 sleep quality significantly positively predicted T2 ADL (r=0.227, P < 0.01; r=0.131,P < 0.01). T2 cognitive function served as a longitudinal mediator between T1 depression and T2 ADL, with a mediation effect value of 0.022 (95%CI: -0.027 to -0.018), accounting for 14.5% of the total effect. T2 sleep quality moderated all paths in the mediation model (β=-0.018, P < 0.05; β=0.040, P < 0.001; β=-0.034, P < 0.001).

Depression reduces the ability of elderly individuals to perform daily activities by affecting cognitive function. Improving sleep quality can enhance the impact of depression on cognitive function, and can mitigate the effects of depression and cognitive function on ADL.

To explore how the subjective life expectancy of patients with chronic diseases affects their medical expenditure and provide a policy intervention perspective for improving the quality of life of patients with chronic diseases.

The data from the China Health and Retirement Longitudinal Study (CHARLS) were used. A total of 9 949 samples with any chronic disease at three time points in 2015 (T1), 2018 (T2), and 2020 (T3) were selected. Information such as subjective life expectancy, annual medical expenditure, frequency of outpatient and inpatient visits from modules including health status, medical service utilization records, family economy, and individual basic information was used. A cross-lagged model was applied to test the interaction between subjective life expectancy and medical expenditure and explore the mediating effect of medical resource utilization.

The results of the standardized cross-lagged analysis showed that the subjective life expectancy T1 of patients with chronic diseases significantly negatively predicted the medical expenditure T2 (β=-0.043, P < 0.01), and the medical expenditure T2 significantly negatively predicted the subjective life expectancy T3 (β=-0.043, P < 0.01); the medical expenditure T1 of patients with chronic diseases significantly negatively predicted the subjective life expectancy T2 (β=-0.034, P < 0.05), and the subjective life expectancy T2 significantly negatively predicted the medical expenditure T3 (β=-0.043, P < 0.01). Medical resource utilization had a mediating effect in this process (β=-0.02, P < 0.05).

There is a complex interaction mechanism between the subjective life expectancy and medical expenditure of patients with chronic diseases. There may be a vicious cycle in which health anxiety leads to the deterioration of the condition and an increase in medical expenditure, which further aggravates anxiety, as well as the phenomenon of excessive medical treatment due to pessimistic health expectations. This indicates the value of formulating differentiated psychological intervention policies for different groups to improve the quality of life of patients with chronic diseases.

To investigate the effects of nickel cobalt manganese lithium (NCM) on the metabolic pathways of human bronchial epithelial cells (BEAS-2B).

The MTS assay was employed to assess the impact of NCM on the viability of BEAS-2B cells, determining exposure concentrations of 0, 50, 100, and 200 μg/ml. Cell samples were collected after 48 hours of exposure. Intracellular metabolites were analyzed using ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS), and partial least squares discriminant analysis (PLS-DA) was utilized to investigate changes in the metabolic profile. Differential metabolites were selected based on a variable importance in projection (VIP) value >1, followed by pathway enrichment analysis. Transmission electron microscopy and JC-1 fluorescence probes were used to assess the effects of NCM on cellular ultrastructure and mitochondrial membrane potential (MMP).

Compared to the control group, exposure to different concentrations of NCM resulted in a dose-dependent decrease in the viability of BEAS-2B cells. A total of 788 substances were detected in the metabolomic samples; 281, 284, and 274 differential metabolites were identified at exposure concentrations of 50, 100, and 200 μg/ml, respectively. Among these, 82 differential metabolites were common across all exposure groups, with the highest proportion being lipid metabolites. The differential metabolites were significantly enriched in metabolic pathways such as coenzyme Q biosynthesis, riboflavin metabolism, and very long-chain fatty acid oxidation. NCM exposure led to mitochondrial swelling, reduced cristae, and fragmentation in BEAS-2B cells, significantly decreasing MMP levels.

NCM exposure has a pronounced impact on the metabolic profile of BEAS-2B cells and induces mitochondrial damage, with the toxicological pathways primarily involving coenzyme Q biosynthesis.

To explore the trends in cognitive function and depression symptoms over time among middle-aged and older adults in China, and to identify populations with differing trajectories of cognitive function and depression symptoms, thereby providing a scientific basis for formulating targeted prevention and control measures.

A total of 11 863 individuals aged 45 and above from the China Health and Retirement Longitudinal Study (CHARLS) were included. The Group-based Dual Trajectory Model (GBDTM) was employed to identify the developmental trajectories of cognitive function and depression symptoms, and multinomial logistic regression analysis was utilized to examine the influencing factors of different trajectories.

The GBDTM identified four trajectory groups: “Poor cognitive function but mild depression symptoms” (Group 1, 32.9%),“Poor cognitive function and severe depression symptoms” (Group 2, 10.8%), “Good cognitive function and mild depression symptoms” (Group 3, 40.5%), and “Moderate cognitive function and moderate depression symptoms” (Group 4, 15.7%). Factors associated with a higher likelihood of being classified in the“Poor cognitive function and severe depression symptoms” group included being female (OR=4.70, 95%CI: 3.82-5.78), unmarried (OR=2.09, 95%CI: 1.67-2.60), residing in rural areas (OR=4.26,95%CI: 3.59-5.07), smoking (OR=1.26, 95%CI: 1.02-1.56), having activities of daily living (ADL) disabilities (OR=1.92, 95%CI:1.39-2.65), and having instrumental activities of daily living (IADL) disabilities (OR=7.43, 95%CI: 5.90-9.35).

There is a partially “joint development” trajectory relationship between cognitive function and depression symptoms in middle-aged and older adults. Early intervention targeting the influencing factors of different trajectory groups is crucial.

To explore the relationship between gaseous air pollutants and inflammatory indices in patients with schizophrenia (SCZ).

A total of 866 hospitalized SCZ patients were included from October 2020 to December 2023.The daily average exposure values of gaseous air pollutants (SO₂, NO₂, O₃, CO) for the seven days prior to hospitalization were estimated using Kriging interpolation. Based on the biochemical test results on the day of admission, four inflammatory indices were calculated for the SCZ patients: Platelet to Lymphocyte Ratio (PLR), Neutrophil to Lymphocyte Ratio (NLR), Systemic Immune Inflammation Index (SII), and Systemic Inflammation Response Index (SIRI). Spearman correlation and multiple linear regression models were employed to analyze the association between individual gaseous air pollutants and inflammatory indices;Bayesian Kernel Machine Regression (BKMR) was used to assess the joint effects of mixed gaseous air pollutants on inflammatory indices.

The daily average exposure values of SO₂, NO₂, and CO in the seven days prior to hospitalization showed a positive correlation with PLR（r_SO-PLR=0.08;r_NO-PLR= 0.069; r_CO-PLR=0.078）、NLR（r_SO-NLR=0.075; r_NO-NLR= 0.077; r_CO-NLR=0.069） and SII（r_SO-SII=0.081; r_NO-SII=0.072; r_CO-SII=0.075）, with statistical significance (all P<0.05). The multiple linear regression results indicated a positive correlation between the daily average NO₂ exposure and NLR levels, with β=0.006(95%CI: 0.001-0.011). The BKMR analysis revealed that when the daily averages of the four gaseous air pollutants exceeded their 50^th percentile (P₅₀) in the seven days prior to hospitalization, the mixture of SO₂, NO₂, CO, and O₃ had a positive joint effect on the NLR and SII of SCZ patients.

Short-term exposure to a mixture of gaseous air pollutants may influence the inflammatory response in SCZ patients.

To assess the association between the trajectories of depression symptoms and the risk of stroke in the elderly.

Data from four waves of the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018 were utilized.Group-based trajectory modeling was employed to identify the trajectories of depression symptoms, and logistic regression models were used to evaluate the relationship between these trajectories and stroke.

Four trajectories of depression symptoms were identified:low stable (n=2 392, 60.7%), moderate decreasing (n=762, 20.2%), moderate increasing (n=416, 12.3%), and high stable (n=250, 6.8%).During the period from 2015 to 2018, a total of 305 respondents experienced a stroke. Compared to participants with the low stable depression symptom trajectory, those following the moderate decreasing (OR=1.48, 95%CI: 1.09-2.02), moderate increasing (OR=2.22,95%CI: 1.58-3.11), and high stable depression symptom trajectories (OR=1.78, 95%CI: 1.12-2.83) had a higher risk of stroke.

Over time, elderly individuals following moderate decreasing, moderate increasing, and high stable trajectories of depression symptoms exhibited an increased risk of stroke. Long-term depression symptoms may serve as a strong predictor for stroke.

To understand the focus and central aspects of government attention allocation in provincial-level infant and toddler care service policies in China to reveal the characteristics of provincial governments’ attention to various issues related to infant and toddler care services, providing a basis for rational allocation of government attention in the next phase and optimizing policy resources for these services.

A total of 87 provincial-level government policies on infant and toddler care services issued from April 2018 to July 2023 were selected as the research subjects. The study primarily employed word frequency analysis and semantic network analysis to measure the direction and center of government attention allocation in the policy texts.

The direction of government attention allocation in infant and toddler care policies across different regions was relatively consistent, with the top ten high-frequency words including “service”, “care”, “institution”, “infant and toddler”, “care”,“elderly”, and “health”. The central focus of attention allocation in the eastern, central, and western regions was “institution”,while the northeastern region showed a different central focus. The node with the highest intermediary centrality was “service”,followed by “infant and toddler” and “elderly” as secondary central nodes.

Provincial governments have placed excessive emphasis on services provided by care institutions, necessitating greater attention to the diversity of infant and toddler care service types. There is also a need to enhance focus on inclusive infant and toddler care services, with the northeastern region particularly requiring innovative models for the coordinated development of elderly and infant and toddler care services.

To analyze the epidemiological characteristics of Hepatitis A (HA) and Hepatitis E (HE) in Huai’an City,Jiangsu Province from 2004 to 2023, providing a scientific basis for infectious disease prevention and control in the region.

Case report data for HA and HE from 2004 to 2023 in Huai’an city were extracted from the Chinese Disease Prevention and Control Information System for descriptive analysis.

From 2004 to 2023, a total of 1 956 cases of HA were reported in Huai’an city, accounting for 4.14% of viral hepatitis cases, with an average annual incidence rate of 1.97 per 100 000 population.Join point regression analysis indicated a significant overall declining trend in HA incidence from 2004 to 2023, with an Average Annual Percentage Change (AAPC) of -12.816% (P=0.016), with inflection points identified in 2006, 2015, and 2018. The peak months for HA cases were March to June and August; the male-to-female incidence ratio was 2.04, with the highest number of cases reported in the age group of 50 to <55 years. Farmers constituted the largest occupational group, accounting for 72.65% (1 421 cases). During the same period, a total of 3 097 cases of HE was reported, accounting for 6.55% of viral hepatitis cases, with an average annual incidence rate of 3.12 per 100 000 population. Join point regression analysis showed a significant overall increasing trend in HE incidence from 2004 to 2023, with an AAPC of 9.266% (P=0.001) and inflection points in 2011 and 2020.The peak months for HE cases were January to May; the male-to-female incidence ratio was 2.93, with the highest number of cases reported in the age group of 55 to <60 years. Farmers also represented the highest occupational group, accounting for 74.91%(2 320 cases).

From 2004 to 2023, HA showed a declining trend while HE exhibited an increasing trend in Huai’an city. Future efforts should focus on implementing vaccination strategies and prioritizing farmers as a key population for comprehensive prevention and control measures to effectively manage the spread of HA and HE.

To explore the relationship between oral health-related quality of life (OHRQoL) and dental care-seeking behavior among the elderly in Sichuan Province, while analyzing the impact of income on this relationship.

A total of 744 elderly individuals aged 65 to 74 years from Sichuan Province were included in this study through multi-stage stratified random sampling during the Fourth National Oral Health Epidemiological Survey conducted from 2015 to 2016. A questionnaire was used to assess the participants’ income levels, dental care-seeking behavior, and OHRQoL. Stratified logistic regression was employed to examine the relationship between dental care-seeking behavior and OHRQoL, as well as the moderating effect of income.

Among the 744 participants, 552 (74.2%) reported engaging in dental care-seeking behavior. Lower overall (β=-0.040, P < 0.001), functional (β=-0.028,P=0.002), pain-related (β=-0.037, P < 0.001), and psychological (β=-0.029, P=0.002) dimensions of OHRQoL were associated with an increased likelihood of dental care-seeking among the elderly. Additionally, income had a positive moderating effect only on the relationship between oral health-related psychological discomfort and dental care-seeking behavior; specifically, lower income was associated with a weaker correlation between psychological discomfort related to oral health and dental care-seeking behavior (β=-0.007,P=0.039).

The utilization of oral health services among the elderly in Sichuan Province is suboptimal, with poor OHRQoL being a primary driving factor for dental care-seeking behavior. High income only facilitates dental visits when oral health issues lead to psychological discomfort. Public health efforts targeting oral health among the elderly should focus on updating their perceptions of oral health and addressing the psychological impacts associated with oral health.