To explore the chain mediating roles of adult socioeconomic status and depression in the relationship between childhood friendship experiences and cognitive function in the elderly.

Based on the panel data of China Health and Retirement Tracking Survey (CHARLS) in 2014, 2018, and 2020, Partial correlation analysis was used to explore the correlation among childhood friendship experience, adult socioeconomic status, depression, and cognitive function of the elderly. The SPSS’s Process 4.1macro program was used to analyze the chain mediation effect, and Bootstrap method was used to verify the mediation variables.

The direct effect of childhood friendship experiences on cognitive function in the elderly was significant(β=0.226, 95% CI: 0.109-0.343). The simple mediating effects of adult socioeconomic status and depression between childhood friendship experiences and cognitive function were significant (β=0.095, 95% CI: 0.067-0.126; β=0.023,95% CI:0.009-0.040). The chain mediating effect of adult socioeconomic status and depression between childhood friendship experiences and cognitive function was significant (β=0.006, 95% CI:0.003-0.010). The total mediating effect and the chain mediating effect respectively account for 35.33% and 1.71% of the total effect.

Childhood friendship experience can directly and positively influence cognitive function in the elderly, and also can influence cognitive function in the elderly through the separate and chain mediating effects of socioeconomic status and depression in adulthood.

To investigate the effect of subchronic benzo[a]pyrene (BaP) toxicity on tau protein phosphorylation and mild cognitive dysfunction in HAPOE4 mice.

24 male C57BL/6 wild-type and HAPOE4 mice were used in this study, 12 of each type. The mice were randomly divided into three groups: vehicle group (olive oil), low-dose BaP-treated group (2.5 mg/kg), and high-dose BaP-treated group (6.25 mg/kg), with 8 mice in each group. The mice were injected with BaP via the peritoneal cavity and weighed before and after injection. The exposure period was 90 days. The Morris water maze test was used to detect the mice’s learning and memory abilities, the tail suspension test was used to detect the mice’s depressive state, the silver glycinate dip staining was used to observe the neurofibrillary tangles in mouse brain tissue sections, and immunohistochemistry was used to detect the protein expression of APOE, LRP1, tau, p-tau (Ser199), and p-tau (Ser396) in the hippocampus of the mice. ANOVA was used for the comparison of the above count data, the two-sample t-test was used for the comparison between genotypes, and the factorial analysis method was used to verify the interaction between the treatment and genotype.

The results of the water maze behavior experiment: the results of the positioning navigation experiment: the escape latency length of each group decreased with the increase of training days, and the escape latency of HAPOE4 mice with the same dose of poison was higher than that of WT type. There were differences in escape latency between groups on the 4th and 5th days. Both genotype and toxicity could lead to a decrease in the number of crossings of the platform and the residence time in the target quadrant, but there was no significant interaction between genotype and toxicity. The results of tail suspension experiment: genotype and poisoning had an interactive effect on the immobility time of mice, and both of them would lead to an increase in the immobility time of mice. The results of silver glycinate dipping experiment: both genotype and poisoning would cause the dyeing to deepen and increase in mice. The results of immunohistochemistry showed that genotype and poisoning had an interactive effect on the MOD values of APOE, LRP1, tau, p-tau (ser199) and p-tau (ser396), and all of them led to an increase in MOD values.

BaP and APOE4 genes affected spatial learning and memory ability and depression in mice, and BaP and APOE4 genes interacted with the immobility time of tail suspension experiments, indicating that the combined effect of BaP and APOE4 genes may have an effect on the depressed state of mice; and BaP and APOE4 genes interacted with abnormal phosphorylation of tau protein in mice, indicating that subchronicBaP infection could lead to tau protein phosphorylation and mild cognitive dysfunction in mice with HAPOE4 genotype, which may be caused by the combined effect of BaP and APOE4 genes resulting in the increase of APOE and LRP1 in mice.

To measure and evaluate the compatibility between the level of outpatient chronic special disease coverage under the basic health insurance and the level of healthcare resource service utilization in Shanxi Province, so as to provide reference for the coordinated development of the level of outpatient chronic special disease coverage under the basic health insurance and the level of healthcare resource service utilization in Shanxi Province.

Taking 11 cities in Shanxi Province as the study object, the fitness between the two was measured using the entropy weight-TOPSIS method and gray correlation analysis.

From the perspective of utilization level, the numerical intervals of breadth and depth of healthcare resource service utilization in Shanxi Province were 0.161-0.751 and 0.000-1.000, respectively, with a wide span of the intervals; from the perspective of protection level, the numerical intervals of breadth, width, and sustainability of outpatient chronic and special disease protection of the basic healthcare insurance in Shanxi Province were 0.761-0.994, respectively, 0.518-0.938 and 0.445-1.000; Taiyuan City had a comprehensive score of 0.734, which was the city with the highest degree of suitability.

This can be done by consolidating the stability of basic medical and healthcare human resources, enhancing the balance of medical resource allocation, strengthening the synergy between the breadth and depth of healthcare insurance coverage, and reinforcing the linkage between healthcare insurance policies and healthcare resources, so as to improve the level of coverage for outpatient chronic and special illnesses under the basic healthcare insurance scheme in Shanxi Province, as well as the level of utilization of healthcare resources and the degree of appropriateness of the two.

To assess the dietary nutrition status of patients with liver cirrhosis and to explore the relationship between dietary fiber and micronutrient intake and the prevalence of sarcopenia, providing a theoretical foundation for sarcopenia prevention in this patient population.

The current study was conducted among patients with liver cirrhosis in the gastroenterology department of Sichuan Provincial People’s Hospital by purposive sampling from September 2022 to December 2023. The 24-hour dietary recall method was used to collect information on the types and quantities of food consumed by the patients. Whole-body muscle mass was measured using bioelectrical impedance analysis (BIA), and sarcopenia was diagnosed in combination with handgrip strength and 6-meter walking speed. Multiple logistic regression analysis was used to analyze the correlation between energy and nutrient intake and sarcopenia.

A total of 203 patients with cirrhosis were included in the analysis, including 40.4% with sarcopenia. Negative correlations were observed between sarcopenia prevalence and the intake of dietary fiber (OR=0.85, 95% CI: 0.75-0.96), vitamin A (OR=0.87, 95% CI: 0.77-0.98), vitamin C(OR=0.91, 95% CI: 0.86-0.97), potassium (OR=0.88, 95% CI: 0.80-0.97), magnesium (OR=0.93, 95% CI: 0.87-0.99) and copper (OR=0.31, 95% CI: 0.14-0.67). Additionally, an interactive effect was identified between age and the intake of vitamin C, phosphorus, and iron (Pfor interaction<0.05).

Dietary fiber and micronutrient intake are closely related to sarcopenia in patients with cirrhosis. It is crucial to enhance nutritional education for patients with liver cirrhosis and their families, and to consider the use of nutritional supplements when necessary to prevent sarcopenia, particularly in the elderly.

To analyze the disease burden and trend of anxiety disorders in adolescents aged 10-24 in China from 1990 to 2021.

Based on the 2021 global burden of disease (GBD) database, the incidence, prevalence, and disability-adjusted life years (DALYs) rate of anxiety disorders in adolescents aged 10-24, along with their corresponding standardized rates, were extracted as indicators of disease burden. With 1990 as the baseline, the overall and gender- and age-specific changes in these indicators in 2021 were analyzed. Joinpoint regression analysis was used to dynamically analyze the changes in these three disease burden indicators from 1990 to 2021. The grey prediction model GM(1,1) was employed to estimate the disease burden trend of anxiety disorders in adolescents over the next decade.

In 2021, incident case number, prevalent case number, and DALYs of anxiety disorders in adolescents were 1 637 600, 10 267 500, and 12 793 000, respectively, which decreased by 30.51%, 33.91%, and 33.59%, as compared with 1990; however, the standardized incidence, standardized prevalence, and standardized DALYs rate of anxiety disorders in adolescents were 451.49/100 000, 3 481.74/100 000, and 418.95/100 000, respectively, which represented an increase of 2.29%, 2.03%, and 2.37%, as compared to 1990; there are differences in the disease burden for anxiety disorders between genders, which were manifested that girls are more likely to suffer from anxiety disorders than boys; and the standardized incidence of anxiety disorders among adolescents between the ages of 10-14 years was higher, while the standardized prevalence and the standardized DALYs rate among them between the ages of 15-19 years were higher. The Joinpoint regression model showed that the standardized incidence, standardized prevalence, and standardized DALYs rate of anxiety disorders in adolescents aged 10-24 increased from 1990 to 2021, with a larger increase from 2019 to 2021. The grey prediction model indicated that by 2031, the standardized incidence, standardized prevalence, and standardized DALYs rate would reach 559.44/100 000, 3 597.01/100 000, and 430.65/100 000, respectively.

The disease burden of anxiety disorders in adolescents aged 10-24 years is concerning, and interventions for anxiety disorders should be performedinadolescents of different genders and ages.

To investigate the association between long-term exposure to atmospheric pollutants (PM_2.5 and NO₂) and the risk of developing type 2 diabetes, and the mediating role of abnormal lipid metabolism in the association.

Based on a China Multi-Ethnic Cohort and data collected from 2018—2019 on 15 573 participants in Sichuan Province and hospital discharge data in Sichuan Province from 2018—2022. Logistic regression and Cox proportional risk model were used to investigate the two-by-two associations between PM_2.5 and NO₂, dyslipidemia, and type 2 diabetes; regression-based causal mediator model was used to explore the mediating role of dyslipidemia in the association between PM_2.5 and NO₂ and type 2 diabetes.

For each 1 standard deviation (SD) increase in atmospheric PM_2.5 and NO₂ concentrations, the population Odds ratio (OR) (95% CI)for dyslipidemia was 1.042 (1.002-1.084) and 1.047 (1.003-1.093), respectively and the Hazard ratio (HR)(95% CI) for developing type 2 diabetes was 1.159 (1.044-1.288) and 1.330 (1.173-1.509), respectively. Patients with dyslipidemia had a higher risk of developing type 2 diabetes with a HR(95% CI) of 1.777 (1.418-2.227). Dyslipidemia partially mediated the association of chronic exposure to PM_2.5 and NO₂ on developing type 2 diabetes mellitus, with natural indirect effects HR (95% CI) of 1.004 (1.000 - 1.008) and 1.005 (1.000 - 1.010), respectively, corresponding to 3.1% and 2.0% of the total effect, respectively.

Long-term exposure to PM_2.5 and NO₂ was positively associated with dyslipidemia and increased risk of type 2 diabetes, and dyslipidemia partially mediated the association of air pollution on the risk of type 2 diabetes.

To explore the association between depressive symptoms and all-cause mortality and cardiovascular disease mortality in patients with chronic comorbidity.

Single-factor analysis was performed using chi-square test, and the relationship between PHQ-9 scores, depressive symptoms, and all-cause mortality as well as cardiovascular disease mortality in patients of multimorbidity were analyzed using COX proportional hazards regression model.

The results of the multivariable COX regression showed that as compared to those without depressive symptoms, patients of multimorbidity with depressive symptoms had HR=1.665 (95% CI: 1.135-2.444) for all-cause mortality and HR=2.090 (95% CI: 1.216-3.594) for cardiovascular mortality. With an increase in PHQ-9 score, the risks of all-cause mortality (HR=1.060, 95% CI: 1.014-1.107) (P_trend<0.010) and cardiovascular mortality (HR=1.072, 95% CI: 1.005-1.144) (P_trend<0.010) gradually increased. Subgroup analysis by urban and rural areas showed that there was an interaction between different urban and rural depressive symptoms on the risk of all-cause mortality in patients of multimorbidity (P interaction <0.05). In rural areas, patients of multimorbidity with depressive symptoms had 2.637 times (95% CI: 1.639-4.243) higher risk of all-cause mortality and 3.207 times (95% CI: 1.686-6.101) higher risk of cardiovascular mortality compared to those without depressive symptoms. With an increase in PHQ-9 score, the risks of all-cause mortality (P_trend<0.001) and cardiovascular mortality (P_trend<0.001) also increased. However, these associations were not significant in urban areas.

Depressive symptoms is a risk factor for all-cause mortality and cardiovascular disease mortality in patients of multimorbidity, and more attention should be paid to psychological interventions for patients of multimorbidity in rural areas to reduce the risk of mortality in patients of multimorbidity.

To assess the impact of the utilization of basic public health services on residents’ willingness to the first choice of medical institutions for treatment.

This study utilized information from a resident survey conducted by the Provincial Natural Science Foundation Project. The project adopted a multi-stage sampling method and utilized the resident household survey questionnaire, which was conducted from January 2020 to October 2021 in Shandong Province. A total of 2 917 valid questionnaires were obtained, and the survey respondents were residents aged 15 and above. Binary logistic regression model and propensity score matching (PSM) method were used for analysis.

The proportion of residents who have established health records was 63.9%, and the utilization rate of health education was 49.6%.83.8% respondents preferred to choose primary healthinstitutions for treatment. The results of propensity score matching showed that under the three methods of kernel matching, radius matching, and nearest neighbor matching, the average treatment effect on the treated (ATT) for the utilization of health education in residents’ willingness to the first choice of healthcare institutions were 0.084 3, 0.088 9, and 0.090 3, respectively.

The consultation rate of primary health institutions is performing well. Essential public Health services usage had a positive effect on residents’ willingness to choose primary health institutions for medical treatment. It is recommended to increase constructive investment in primary health institutions, enhance the service supply capacity of providers and strengthen the relevanceof basic public health services for demanders.

This study aimed to explore the causal relationship between Hashimoto's thyroiditis (HT) and ischemic stroke (IS) through Mendelian randomization (MR) and to identify key interacting genes using bioinformatics methods.

Single nucleotide polymorphisms (SNPs) significantly associated with exposure factors were selected as instrumental variables. The random-effects inverse-variance weighted method (IVW) was used as the main analysis method of MR analysis, and the odds ratio (OR) evaluated the causal association of HT and IS. The HT and IS datasets were downloaded from the GEO database. HT data were subjected to Weighted gene co-expression network analysis (WGCNA) and differential analysis and screened for overlapping genes between the two diseases by intersection of differential genes in IS. Hub genes were obtained by intersecting the top 20 genes in the five algorithms of the Cytoscape software cytoHubba package. LASSO regression was applied to identify key comorbidity genes.

IVW results showed that HT was a risk factor for the development of IS (OR=1.087, 95% CI: 1.001-1.181, P=0.048) while IS did not increase the risk of HT (OR=1.159, 95% CI: 0.899-1.494, P=0.256). Integration analysis of HT and IS data identified 102 overlapping genes. A total of 11 Hub genes were identified by the five algorithms. LASSO regression ultimately identified SERBP1 and WDR75 as key comorbidity genes.

This study demonstrates that HT may be a risk factor for the development of IS through MR analysis and identified SERBP1 and WDR75 as key comorbidity genes for HT with IS using bioinformatics methods, which may be the potential therapeutic target for HT patients with IS.

To analyze the survival time of HIV/AIDS patients in Hebei province, and to explore the influencing factors, so as to provide basis for improving the quality of life of patients.

Retrospective cohort study was used to collect information of HIV/AIDS in Hebei province from 1989 to 2022. Life table was used to describe the survival status. Log-rank test and Cox regression were used to analysis the influencing factors of survival time.

There were 22 563 cases of HIV/AIDS, with males accounting for 88.7% and homosexual transmission accounting for 62.1%. The average age at the time of discovery was 38.1±13.9. The 1-year,3-year,5-year and 10-year cumulative survival rates of HIV/AIDS patients were 91.46%,88.03%, 85.56% and 79.34%. The risk of death in female was lower than that in male (HR=0.824, 95% CI: 0.713-0.953). The risk of death in patients receiving antiviral treatment was lower than in those who have not received treatment (HR=0.079, 95% CI:0.069-0.091). Baseline CD4 cell counts ranging from 200 to 349 cells/μl (HR=0.451, 95% CI: 0.222-0.914), 350 to 499 cells/μl (HR=0.354, 95% CI: 0.175-0.719), and above 500 cells/μl (HR=0.342, 95% CI: 0.168-0.693) have a lower risk of death. People over 50 years old have a higher risk of death (HR=2.585, 95% CI: 2.143-3.117). Among the sources of case samples, the case death risk of those from HIV testing and counseling was lower than the cases from medical institutions(HR=0.444,95% CI: 0.387-0.510). And the case death risk of those from detainees was lower than the cases from medical institutions(HR=0.417,95% CI: 0.297-0.584).

Gender, educational level, baseline CD4 cell count, sample source, age at discovery, and antiviral treatment were influencing factors on survival time. Early detection, early treatment, strengthening the publicity and education of key groups, paying attention to the elderly cases over 50 years old, and strengthening medical personnel to actively carry out AIDS testing and consulting services have a positive effect on prolonging the survival time of HIV/AIDS cases.