To explore the time-varying association between adverse childhood experiences and social isolation in middle-aged and older adults and provide a scientific evidence for the early identification of people at risk of social isolation and the development of appropriate interventions.

Data were used from respondents who participated in the life history survey of the China Health and Retirement Longitudinal Study (CHARLS) and at least one of the surveysconducted between 2011 and 2020. Adverse childhood experienceswere collected through self-reporting and divided into four groups based on the number of adverse childhood experiences, which were categorized into the group that had not experienced adverse childhood experiences, the group that had experienced one type of adverse childhood experience, the group that had experienced two types of adverse childhood experiences, and the group that had experienced three or more types of adverse childhood experiences. A time-varying effect model was used to explore the age-varying association between adverse childhood experiences and social isolation among middle-aged and older adults, using age as the time variable.

A total of 14 397 middle-aged and older adults were included in the study. Compared with those who had not experienced adverse childhood experiences, those who had experienced one adverse childhood experience had a higher risk of social isolation between the ages of 61 and 70(OR=1.22, 95% CI:1.06-1.41); those who had experienced two adverse childhood experiences had a higher risk of social isolation between the ages of 50 and 65(OR=1.33, 95% CI: 1.13-1.57); and those who had experienced three or more adverse childhood experiences had a higher risk of social isolation between the ages of 45 and 58(OR=1.86, 95% CI:1.16-2.99).

There is aage-varyingassociation between adverse childhood experiences and social isolation among middle-aged and elderly people, with the more childhood adversities experienced, the younger the age at which social isolation occurs.

To investigate the current situation of resource allocation for early diagnosis and treatment of upper gastrointestinal cancers in public hospitals at different levels in Sichuan Province, and to provide suggestions for further promoting the early diagnosis and treatment projects of upper gastrointestinal cancers and improving the screening quality.

A questionnaire survey was conducted on public hospitals in Sichuan Province that undertook opportunistic screening for upper gastrointestinal cancers in 2023, and the diagnosis and treatment capabilities, hardware capabilities and staffing situations of upper gastrointestinal cancer early diagnosis and treatment in hospitals at different levels were compared and analyzed.

The average annual total number of gastroscopy diagnosis and treatment in 78 hospitals was 8 400.82 person-times. In total 96.15% of the hospitals had an independent endoscopy department, and 87.18% of the hospitals had an independent pathology department. On average, there were 3.29 endoscopy hosts, 10.19 gastroscopes, with an average of 6.97 endoscopy physicians, 4.14 pathologists and 5.41 endoscopy nurses. The higher the hospital level, the higher the relevant indicators of diagnosis and treatment capabilities, hardware capabilities and staffing.

The overall situation of resource allocation for early diagnosis and treatment in public hospitals in Sichuan Province is good, but it is necessary to strengthen the construction of pathology departments and focus on optimizing the resource allocation for early diagnosis and treatment of upper gastrointestinal cancers in secondary hospitals.

To analyze the relationship between residual cholesterol (RC) and metabolically associated fatty liver disease (MAFLD) in the elderly population of Zhongshan, and to explore the potential application value of RC in the diagnosis of MAFLD in older adults.

A cluster sampling method was employed to select elderly individuals aged 60 and above who underwent health check-ups at two community hospitals in Zhongshan, Guangdong Province. Baseline data were collected through questionnaire surveys, physical examinations, and laboratory tests. Multivariable logistic regression analysis was used to assess the association between RC and MAFLD, and a restricted cubic spline model was utilized to further analyze the dose-response relationship between RC and MAFLD.

A total of 6 756 elderly individuals were recruited, with an overall prevalence of MAFLD at 31.0%, higher in females (35.0%) than in males (24.7%). After adjusting for confounding factors, logistic regression analysis indicated that RC, treated as a continuous variable (OR: 1.70, 95%CI: 1.47-1.97), was positively associated with the risk of MAFLD. As a categorical variable, the highest RC group (OR: 2.13, 95%CI: 1.72-2.63) also showed a positive correlation with MAFLD risk. A non-linear relationship was observed between RC levels and MAFLD (P _overalltrend <0.001, P _{non-linearity} < 0.05), with a more pronounced risk increase in males (male OR: 1.83, 95%CI: 1.42-2.38 vs. female OR: 1.64,95%CI: 1.36-1.96).

RC is an independent risk factor for MAFLD in the elderly, and there exists a non-linear dose-response relationship between the two. The impact of RC levels on MAFLD risk is particularly significant in elderly males. Monitoring and managing RC is of great clinical significance in the prevention and treatment of MAFLD in older adults.

To conduct genetic typing of Mycobacterium tuberculosis (MTB) in Guizhou Province using the MLVA technique based on 24 VNTR loci, to identify VNTR typing loci suitable for Guizhou MTB strains, and to establish a high-resolution, user-friendly MLVA typing model for MTB. This model will provide technical means for tracing the sources, transmission, and prevention and control of tuberculosis in Guizhou Province.

A total of 124 MTB strains were collected from Guizhou Province. PCR amplification was performed using 24 internationally recognized VNTR loci for MTB, followed by analysis of the amplification products using capillary electrophoresis. The number of repeats at each locus was counted, and allele polymorphism and the discriminatory index for each locus were calculated. Clustering analysis of the tested strains was conducted using BIONUMERICS 8.0 to explore the typing characteristics of MTB in Guizhou Province based on 24-VNTR, 15-VNTR, 12-VNTR, and 8-VNTR.

The allele polymorphism and discriminatory index of the 24 VNTR loci indicated that seven loci, including QUB-11b, had high discriminatory power, eleven loci, including MIRU-10, had moderate power, and six loci, including MIRU-20, had low power. Furthermore, clustering analysis revealed that the 24-VNTR typing exhibited the highest discriminatory ability at 95.16% (118/124), approaching the level of single strain identification, followed by 15-VNTR at 91.13% (113/124), 12-VNTR at 90.32% (112/124), and 8-VNTR at 83.06% (103/124). All four VNTR typing models successfully categorized the 124 MTB strains into four clusters.

This study identified six high-resolution loci, including QUB-11b, as the preferred VNTR loci for MLVA typing of MTB strains in Guizhou Province, with other loci ranked according to their discriminatory power as supplementary typing methods. The 24-VNTR, 15-VNTR, and 12-VNTR methods demonstrated high typing capabilities, providing technical support for molecular tracing of tuberculosis in Guizhou Province.

To investigate the longitudinal association between glycemic profile and the incidence of chronic kidney disease (CKD), as well as the impact of genetic susceptibility on this association.

Utilizing baseline survey and genetic data from the UK Biobank, Cox proportional hazards models were employed to assess the correlation between baseline hemoglobin A1c (HbA1c) levels and glycemic status with the onset of CKD, along with the role of genetic susceptibility in this relationship.

A total of 81 059 participants were included in this study, with 15.2% classified as prediabetic and 6.9%as diabetic. During a median follow-up period of 13.5 years, 3 637 new cases of CKD were observed. Multivariable-adjusted models indicated that both type 2 diabetes (T2D) and prediabetes significantly increased the risk of developing CKD compared to participants with normal blood glucose levels, with hazard ratios (HRs) and 95% confidence intervals (CIs) of 2.04 (95%CI:1.85-2.25) and 1.09 (95%CI: 1.00-1.18), respectively. A clear risk gradient was observed when HbA1c was below the diabetes threshold; participants with HbA1c ≥6.6% had approximately double the risk of CKD compared to those with HbA1c <5.0%. A significant multiplicative interaction between glycemic status and genetic risk was found (P _interaction <0.001). In all genetic risk groups, hyperglycemia significantly increased the risk of CKD. Among participants with high genetic risk, those with both T2D and high genetic risk exhibited the highest CKD risk (HR=6.67, 95%CI: 5.75-7.74) compared to those with low genetic risk and normal blood glucose.

Glycemic status is associated with the risk of CKD across all genetic risk groups.

To explore the effects of self-rated health and self-care ability, as well as their interaction, on depression symptoms in the elderly.

Based on data from the 2020 China Health and Retirement Longitudinal Study, relevant data from 8 948 individuals aged 65 and above were collected. Statistical analyses were conducted using chi-square tests and multivariate logistic regression, followed by interaction analysis using an additive model.

Among the elderly, 3 616 (40.41%) exhibited depression symptoms. After adjusting for gender, age, education level, marital status, living area, exercise habits, and sleep conditions, the regression model indicated that self-rated health (OR=2.60, 95%CI: 2.34-2.89) and self-care ability (OR=2.32, 95%CI: 2.10-2.56) were independent risk factors for depression symptoms in the elderly (P<0.001). The interaction analysis revealed a synergistic additive interaction between self-rated health and self-care ability (OR=5.98, 95%CI: 5.27-6.79),with the excess relative risk, attributable proportion of interaction, and interaction index being 1.92 (95%CI: 1.65-2.71), 0.32(95%CI: 0.21-0.41), and 1.63 (95%CI: 1.34-1.97), respectively.

Poor self-rated health and impaired self-care ability both increase the risk of depression in the elderly, and there is a synergistic additive interaction between the two. Efforts to prevent and treat depression in the elderly should focus on improving their self-rated health and self-care ability.

To clarify the current status of diabetes management and services in primary healthcare institutions, explore the factors influencing their diabetes service capacity, and provide theoretical references for enhancing this capacity.

In-depth interviews were conducted involving 28 participants, including administrators, medical staff, and diabetic patients from four primary healthcare institutions in a district of Chengdu. Grounded theory was employed to summarize and refine the factors affecting diabetes service capacity in these institutions.

Through three-level coding, 24 initial categories, 7 main categories, and 3 core categories were identified, leading to the construction of a theoretical framework for the"Influencing Factors Model of Diabetes Service Capacity in Primary Healthcare Institutions." The current status of the sample institutions was analyzed across three dimensions: resource allocation, policy support, and daily operations.

The diabetes service capacity of primary healthcare institutions in the studied district of Chengdu is influenced by resource allocation, policy support, and daily operations. To enhance this capacity, measures such as strengthening daily operations, improving policy support mechanisms, and optimizing the allocation of human and material resources should be implemented.

To investigate the impact of serum free fatty acids (FFA) on serum uric acid (SUA) levels in young and middleaged hyperuricemia (HUA) patients with different body mass indexes (BMI).

A total of 144 young and middle-aged male patients first diagnosed with HUA at Zhu Xianyi Memorial Hospital of Tianjin Medical University from March 2018 to May 2020 were selected. They were divided into three groups based on BMI: normal group (18.5 kg/m² ≤ BMI < 24.0 kg/m², n=42), overweight group (24.0 kg/m² ≤ BMI < 28.0 kg/m², n=58), and obese group (BMI ≥ 28 kg/m², n=44). Additionally, they were categorized into tertiles based on FFA levels: low tertile group (FFA ≤ 0.37 mmol/L, n=48), middle tertile group (0.37 mmol/L < FFA < 0.7 mmol/L, n=48),and high tertile group (FFA ≥ 0.7 mmol/L, n=48). General information and laboratory data, including FFA and SUA levels, were collected and statistically analyzed.

As BMI increased, FFA levels in the normal, overweight, and obese groups showed a significant upward trend (P < 0.05). SUA levels also increased, with statistically significant differences between the normal and obese groups and between the overweight and obese groups (P < 0.05), but no significant difference was observed between the normal and overweight groups (P > 0.05). With increasing FFA levels, BMI and SUA levels in the low, middle, and high FFA tertile groups also increased. Significant differences were observed between the low and high tertile groups and between the middle and high tertile groups (P < 0.05), but no significant difference was found between the low and middle tertile groups (P > 0.05). Two-way ANOVA revealed an interaction between FFA and obesity on the SUA levels (F=2.701, P=0.033), indicating that their combined effect further elevated SUA levels. Spearman correlation analysis showed a positive correlation between FFA and SUA levels in the obese group (r=0.428, P=0.004). However, no such correlation was observed in the normal and overweight groups (P > 0.05).

In young and middle-aged HUA patients, those with obesity and high FFA levels exhibit higher SUA levels. The effects of FFA and obesity on SUA levels are both additive and interactive.

To analyze and assess the characteristics of the infected population and the disease burden of clonorchiosis in a city of the Pearl River Delta, providing a scientific basis for future prevention and control strategies.

Based on population monitoring and medical institution data from 2019 to 2023 regarding clonorchiosis in the city, infection rates and prevalence proportions were calculated for different genders and age groups. The characteristics of patients seeking medical attention were described, and the disease burden was evaluated using Disability-adjusted Life Years (DALYs).

The overall infection rate for clonorchiosis in the surveyed population from 2019 to 2023 was 8.32%, with a male infection rate of 12.50% and a female infection rate of 4.84%, showing a statistically significant difference (χ²=98.54, P<0.001). The weighted infection rate was 7.87% [95% Confidence Interval (CI): 5.67%-10.06%]. The weighted infection rates across various age groups ranged from 0.09% to 16.18%, with higher rates observed in individuals over 40 years of age. The majority of infections were mild (97.00%), while moderate and severe infections were less common. The annual DALYs lost due to clonorchiosis were 14 399.10 for males and 4 606.71 for females, totaling 19 005.81, equating to a loss of 4.76 DALYs per 1 000 people per year.From 2019 to 2023, a total of 3 193 cases of clonorchiosis sought medical attention, primarily through outpatient services (95.49%). The proportions of complications such as cholelithiasis, cholecystitis, cholangitis, liver cysts, gallbladder polyps, cholecystectomy, gallbladder hypertrophy, and cholangiocarcinoma were 1.16%, 0.60%, 0.53%, 0.22%, 0.06%, 0.06%, 0.00%,and 0.00%, respectively. The average outpatient medical cost was 155.62 yuan, while the average inpatient medical cost was 6 545.97 yuan.

The burden of clonorchiosis in the city of the Pearl River Delta is significant, characterized by a high population infection rate, primarily among males, middle-aged and elderly individuals, and mild infections. Future efforts should focus on public education, screening, and treatment for at-risk populations.