To explore the relationship between body mass index (BMI) trajectories and cognitive impairment and cognitive function in the elderly in China.

Based on data from the China Health and Retirement Longitudinal Study (CHARLS) from 2005 to 2018, a sample of 6 423 elderly individuals was selected. Group-based trajectory modeling was employed to construct BMI trajectories, and Cox proportional hazards regression models were used to analyze the relationship between BMI trajectories and the risk of cognitive impairment. Generalized linear models were applied to examine the relationship between BMI trajectories and cognitive function.

Three BMI trajectory groups were identified among males: “Normal-Stable Group (57.59%)”, “Normal-Overweight Group (36.27%)”, and “Overweight-Stable Group (6.13%)”. Among females, three BMI trajectory groups were identified:“Normal-Stable Group (68.14%)”, “Normal-Overweight Group (26.70%)”, and “Overweight-Obese Group (5.16%)”. Using the Normal-Stable Group as reference, after adjusting for confounding factors, the risk of cognitive impairment for males in the Normal-Overweight Group and Overweight-Stable Group was [HR (95%CI)] 0.76 (0.64-0.91), P<0.01 and 0.65 (0.43-0.99), P<0.05,respectively. For females, the risk of cognitive impairment in the Normal-Overweight Group and Overweight-Obese Group was [HR(95%CI)] 0.74 (0.63-0.87), P<0.001 and 0.70 (0.50-0.99), P<0.05, respectively. Cognitive function scores for males in the Normal-Overweight Group and Overweight-Stable Group increased by 0.66 (0.42-0.89) points, P<0.001 and 0.78 (0.32-1.24) points, P<0.01,respectively. For females, cognitive function scores in the Normal-Overweight Group and Overweight-Obese Group increased by 1.19(0.91-1.46) points, P<0.001 and 1.44 (0.91-1.96) points, P<0.001, respectively.

There is heterogeneity in the BMI trajectories of the elderly in China, and the classification of BMI trajectories is significantly associated with cognitive impairment and cognitive function. Trajectories of increasing BMI are associated with a reduced risk of cognitive impairment, and cognitive function is generally higher in populations where BMI remains at normal levels.

To analyze the status of antiretroviral therapy (ART), survival outcomes, and influencing factors among HIV-infected children in Guangxi.

A retrospective cohort study was conducted, incorporating data from HIV-infected children aged ≤14 years in Guangxi, including treatment status, survival time, and influencing factors. Logistic regression and Cox proportional hazards regression models were employed for statistical analysis.

A total of 472 HIV-infected children were included, with 27 deaths reported. All children received ART. Factors such as age and clinical stage at diagnosis influenced the risk of delayed initiation of treatment. Survival analysis revealed that baseline CD4+ T-cell levels, clinical stage, and treatment regimen were key determinants of survival time. Children with baseline CD4+ T-cell counts >350 cells/μL had longer survival time compared to those with counts <200 cells/μL (aHR=0.31, 95%CI: 0.13-0.74). Children in WHO clinical stage IV had shorter survival times than those in stage I (aHR=3.22, 95%CI: 1.24-12.2). Additionally, children treated with the 3TC+ABC+LPV/r regimen had shorter survival time than those treated with the 3TC+AZT+EFV regimen (aHR=4.26, 95%CI: 1.16-15.61).

The coverage of ART among HIV-infected children in Guangxi is high, with relatively favorable survival rates. However, efforts should be intensified to educate caregivers and initiate treatment early, optimize treatment regimens, and improve quality of life.

To understand the influencing factors of lumbar disc herniation (LDH) among adult residents of different ethnic groups in Gansu Province, providing foundational data for targeted prevention and control measures.

From May to July 2022,a stratified cluster sampling method was employed based on the altitude of residence (≤1 500 meters, 1 500 to 3 500 meters, >3 500 meters) in Gansu Province. All participants underwent questionnaire surveys, physical examinations, and assessments of blood glucose and lipid levels. A non-conditional binary logistic regression model was used to analyze the influencing factors of LDH prevalence among different ethnic groups.

A total of 4 545 participants were included, with an overall LDH prevalence of 22.8%. The prevalence was highest among the Tibetan population at 30.6%, with significant differences observed among ethnic groups (P<0.05). For the Han ethnic group, a residence duration of less than 36 months, non-drinking, or residing at altitudes of 1 500-3 500 meters were associated with an increased risk of LDH. Conversely, being younger than 30 years, holding a position as a cadre, or residing at altitudes below 1 500 meters were associated with a reduced risk. Among the Tibetan population, low physical activity intensity, an education level of primary school or below, and a residence duration of 24-36 months were linked to an increased risk of LDH, while being male, engaging in low-intensity activities, and being unmarried were associated with a decreased risk. For the Hui ethnic group, a residence duration of 6-23 months or an age range of 30-59 years were related to an increased risk of LDH.

The prevalence of LDH varies among different ethnic groups in Gansu Province, and the influencing factors also differ.

To evaluate the effectiveness of an all-English small class inquiry-based teaching model for basic theories and practices in epidemiology, providing a reference for further improving the quality of all-English instruction in preventive medicine courses.

Based on the undergraduate course “Basic Theory and Case Study of Epidemiology” at Sichuan University, surveys were conducted before and after the course for students in both small and large all-English classes.A comparative analysis was performed between the two class sizes and within the same class before and after the intervention to explore whether the small class inquiry-based teaching model is more advantageous than traditional large class teaching in enhancing students’ all-English professional competence.

Prior to the all-English instruction, there were significant differences in English reading and writing abilities, as well as listening and speaking skills, between students in large and small classes, with small class students demonstrating superior skills (reading and writing: small class 57.1% vs. large class 26.8%;listening and speaking: small class 50.0% vs. large class 20.5%) (P<0.05). Most students in both class sizes lacked experience in delivering presentations and writing research papers in English before the instruction; however, small class students were more willing to attempt all-English oral presentations in class compared to their large class counterparts (small class 92.9% vs.large class 60.7%) (P<0.05). Following the all-English instruction, a significant improvement was observed in English reading and writing abilities, professional knowledge, mastery of English terminology, and participation in group discussions or projects for students in both classes. Overall, small class students exhibited better listening and speaking skills than those in large classes post-instruction, with 50.0% of small class students demonstrating good English listening and speaking skills compared to 14.1% in large classes, reflecting an overall improvement from pre-instruction levels. Small class students reported increased confidence in writing English research papers and more experiences with all-English presentations compared to large class students. Moreover, over 60% of students from both classes expressed a willingness to participate in international conferences and deliver all-English presentations, showing an increase from pre-instruction levels.

The all-English small class inquiry-based teaching model demonstrates greater advantages over large class teaching in enhancing students’ all-English professional competence, contributing to improved international competitiveness for employment and further studies.Implementing this model for undergraduate students in preventive medicine is both feasible and effective.

To investigate the association between blood ethylene oxide exposure levels and sleep disorders.

Utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2015-2018, this study selected adults aged 18 and older. The relationship between blood ethylene oxide exposure levels and sleep disorders was analyzed using multivariable logistic regression, subgroup analysis, interaction analysis, and restricted cubic spline analysis.

A total of 2 579 participants were included, with a median blood ethylene oxide exposure concentration of 21.76 pmol/g Hb, and 753 (29.2%) individuals reported sleep disorders. Multivariable logistic regression indicated that compared to the lowest quartile, the risk of sleep disorders increased by 94% in the highest quartile of blood ethylene oxide exposure (OR=1.94, 95%CI: 1.27-2.95, P=0.012). Subgroup analysis revealed a significant association between ethylene oxide exposure and sleep disorders among women, individuals aged 40 to 59, those of other races, individuals with a poverty ratio of 1.3 to 3.5, those with an education level of high school or below or possessing a college degree, individuals engaging in moderate physical activity, and the unmarried population.Interaction analysis showed that these factors did not exhibit interaction effects on sleep. Restricted cubic spline analysis indicated no nonlinear association between ethylene oxide exposure levels and the occurrence of sleep disorders (P_non-linear=0.09).

There is a significant positive correlation between high blood ethylene oxide exposure levels and sleep disorders.

To explore the bidirectional relationship between depression symptoms and physical functional impairment trajectories in Chinese elderly individuals.

Utilizing data from four waves of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011, 2013, 2015, and 2018, we employed group-based trajectory modeling to identify distinct trajectory groups for depression symptoms and physical functional impairment among the elderly. A dual trajectory model was then used to assess the degree of association between these trajectory groups.

The group-based trajectory model categorized depression symptoms into four groups: consistently low depression symptoms, decreasing depression symptoms, increasing depression symptoms, and consistently high depression symptoms. Physical functional impairment was classified into four groups: no physical functional impairment, worsening physical functional impairment, improving physical functional impairment, and high physical functional impairment. Dual trajectory analysis revealed that 44.86% of individuals in the decreasing depression symptoms group followed the improving physical functional impairment trajectory; conversely, 37.58% of individuals in the increasing depression symptoms group followed the worsening physical functional impairment trajectory. Among those in the worsening physical functional impairment group, 47.8% followed the increasing depression symptoms trajectory, while 41.9% of individuals in the improving physical functional impairment group followed the decreasing depression symptoms trajectory.

In most cases, there is a positive correlation between the trajectories of depression symptoms and physical functional impairment. A decrease in depression symptoms is typically associated with an improvement in physical functional impairment, while an increase in depression symptoms corresponds with a worsening of physical functional impairment, and vice versa.

To explore the association between blood pressure levels and the risk of stroke-related death in type 2 diabetic population.

A survey was carried out on 9 708 type 2 diabetic patients who participated in the chronic disease patient health management of basic public health services in Huai’an District and Qing jiang pu District (former Qing he District) of Huai’an city. Multivariate proportional-hazards Cox regression analysis was used to analyze the association between blood pressure levels and the risk of stroke-related death in type 2 diabetic patients, and further stratified analysis was carried out according to smoking, body mass index (BMI), central obesity, and dyslipidemia respectively. The follow-up duration was calculated from December 31, 2013 to December 31, 2020, and death from stroke (I60-I69) was defined as the end-point event.

The follow-up duration was 63 833.8 person-years, and the stroke death density was 5.4 per 1 000 person-years. After adjusting for relevant confounding factors, taking the normal blood pressure group as the reference, the HR value of the stroke-related death risk in the grade III hypertension group was 4.45 (95%CI: 2.09-9.48). The stratified analysis results showed that compared with the normal blood pressure group, among smokers, those with BMI ≥ 24.0 kg/m², those with central obesity, and those with dyslipidemia, the stroke-related death risks in the grade III hypertension group increased by 3.12 (HR=4.12, 95%CI:1.16-14.67), 1.97 (HR=2.97, 95%CI: 1.26-7.00), 3.19 (HR=4.19, 95%CI: 1.27-13.86), and 5.49 (HR=6.49, 95%CI: 1.97-21.43) times, respectively. Sensitivity analysis was carried out by excluding the baseline stroke patients, participants who died in the first year of follow-up, and those over 80 years old, and a significant positive relationship between blood pressure levels and the risk of stroke-related death was found.

Elevated blood pressure levels will increase the risk of stroke-related death in type 2 diabetic patients, and there is a positive relationship between blood pressure levels and the risk of death. Among type 2 diabetic patients, those with low BMI have a higher risk of stroke-related death than those with high BMI.

To understand the epidemiological characteristics of cervical cancer mortality among women in Jinan city, providing reference for the prevention and control of cervical cancer.

Data on cervical cancer mortality among women in Jinan from 2011 to 2023 were collected. Using SPSS 20.0 software, mortality rates were calculated for urban and rural areas, age-standardized mortality rates for women aged 35 to 64, cumulative mortality rates for those aged 0 to 74, and years of life lost (YLL) due to premature death. The annual average percentage change (AAPC) was employed to analyze trends in cervical cancer mortality.

From 2011 to 2023, the cervical cancer mortality rate for women was 3.05 per 100 000, with a standardized mortality rate of 1.83 per 100 000 and an average age at death of 61.65 years. The truncated mortality rate was 3.36 per 100 000, and the cumulative mortality rate was 0.20%. The mortality rate, standardized mortality rate, proportion of total malignant tumors, truncated mortality rate, and cumulative mortality rate for cervical cancer all exhibited an upward trend, while the age at death showed a downward trend. Mortality rates gradually increased after the age of 30, peaking in the 75 to 79 age group. The cervical cancer mortality rate and YLL rate among women aged 45 to 59 in urban areas and those over 60 in rural areas also showed increasing trends.

The cervical cancer mortality rate in Jinan city is on the rise, with notable urban-rural disparities. Targeted tertiary prevention measures should be implemented to effectively reduce the incidence and mortality rates of cervical cancer.

To analyze the current status and trends of the burden of respiratory syncytial virus (RSV) lower respiratory tract infections in China from 1992 to 2021, providing a reference for the prevention and control of RSV infections in the country.

The burden of disease was assessed using disability-adjusted life years (DALYs). Data on DALYs for RSV lower respiratory tract infections in China from 1992 to 2021 were extracted from the 2021 Global Burden of Disease Study database. Join point regression analysis was employed to evaluate trends in disease burden, and an age-period-cohort (APC) model was constructed to explore the impacts of age, period, and birth cohort on disease burden.

In 2021, the DALYs rate for RSV lower respiratory tract infections in China was 3.08 per 100 000, with the highest DALYs number (35 400 person-years) and rate (45.63 per 100 000) observed in the 0-4 age group, followed by those aged 65 and older (5 300 person-years, 2.68 per 100 000). From 1992 to 2021, the DALYs rate for RSV lower respiratory tract infections in China showed a declining trend (AAPC=-12.96%, P<0.001), with the DALYs rate remaining relatively stable from 2012 to 2016 (AAPC=-1.61%, P=0.198), while other intervals exhibited a downward trend, particularly from 2019 to 2021, which had the most significant decline (AAPC=-57.90%, P<0.001). Among different age groups, the 0-4 age group experienced the largest decrease in DALYs rate (AAPC=-12.02%, P<0.001), whereas the decline was the smallest in those aged 65 and older (AAPC=-5.19%, P<0.001). The APC model indicated that age, period, and birth cohort effects influenced the changes in DALYs rates for RSV lower respiratory tract infections in China, with DALYs rates initially decreasing and then increasing with age, while declining with advancing periods and shifting birth cohorts.

The burden of RSV lower respiratory tract infections in China showed a downward trend from 1992 to 2021, predominantly affecting children and the elderly.

To analyze the correlation between changes in uric acid trajectories in a male population undergoing health check-ups and the occurrence of hypertension, diabetes, and dyslipidemia.

This study selected 5 316 male subjects who met the inclusion and exclusion criteria from the Health Management Center of The Second Affiliated Hospital of Dalian Medical University over a ten-year period from 2012 to 2022. A group-based trajectory model (GBTM) was constructed based on uric acid levels, and the Cox proportional hazards regression model was utilized to analyze the risks of developing hypertension, diabetes, and dyslipidemia across different uric acid trajectory groups.

The study participants were categorized into low stable, low increasing, moderate increasing, and high increasing groups. The incidence of hypertension in the high increasing group was significantly higher than that in the low stable group. After adjusting for confounding factors, the Cox proportional hazards regression analysis indicated that the risk of developing hypertension in the high increasing group was 1.51 times (95%CI: 1.20-1.91, P<0.001) compared to the low stable group. However, no significant correlation was found between changes in uric acid trajectories and the occurrence of diabetes. A significant correlation was observed between changes in uric acid trajectories and dyslipidemia; as uric acid levels increased, the incidence of dyslipidemia also rose. After adjusting for confounding factors, the Cox proportional hazards regression analysis revealed that the risk of developing dyslipidemia in the high increasing group was 1.75 times (95%CI: 1.44-2.12, P<0.001) compared to the low stable group.

Among male individuals undergoing health check-ups, there is a correlation between uric acid trajectories and hypertension as well as dyslipidemia, yet no significant correlation with the occurrence of diabetes.