To investigate the relationship between social alienation and health promotion behaviors in community chronic co-morbid older adults, and explore the mediating role of self-perceived aging.

Using the convenience sampling method, A questionnaire survey was conducted using the General Information Questionnaire, the General Alienation Scale, the Simplified Self-perceived Aging Scale, and the Health Promoting Lifestyle Scale on 611 community-based older adults with chronic co-morbidities in Hangzhou, and structural equation modeling was constructed using AMOS.

The total score of chronic co-morbid social alienation in the community was (36.38±10.41) points, the total score of self-perceived aging was (50.10±14.68) points, and the score of health promotion behavior was (93.79±15.56) points. The results of the mediation effect test showed that the effect value between social alienation and health promotion behavior was -0.205 (95%CI: -0.285 to -0.121), accounting for 45.86% of the total effect; the effect value of self-perceived aging in the mediation effect between social isolation and health promotion behavior was -0.242 (95%CI: -0.299 to -0.191); the total effect value was -0.447 (95%CI: -0.508 to -0.383), and the mediation effect accounted for 54.14% of the total effect.

Social alienation and self-perceived aging of chronic co-morbid older adults directly affect health promotion behaviors, while social alienation can indirectly affect health promotion behaviors through self-perceived aging.

To explore the potential categories of health literacy of the elderly with chronic disease comorbid disability and their relationship with family nursing quality.

713 comorbid disabled elderly in Urumqi, Xinjiang were investigated by general data, function of daily living index, health literacy scale for chronic disease patients and Family Care Quality Scale for disabled elderly (FCCI). Mplus 8.3 was used to make potential profile analysis of their health literacy, and SPSS 26.0 software was applied. To compare the quality of family care for the elderly with comorbidity and disability in different categories of health literacy.

The health literacy of the elderly with concomitant disabilities can be divided into three categories:high health literacy - high willingness (35.5%), medium health literacy - good acceptance (47.7%), and low health literacy - low access to information (16.8%). There were significant differences in the total score of family care quality and the scores of each dimension among the 3 different health literacy groups (P<0.001). The total score of family care quality in the group with high health literacy and high willingness was the highest (47.47±0.128), and the total score of family care quality in the group with low health literacy and low information access was the lowest (40.28±0.315). The scores of family care quality in the group with high health literacy and high willingness were higher than those in the other two groups, including scores of disabled elderly (28.03±0.053), caregiver (11.02±0.054) and family members (8.42±0.062). The scores of family care quality in the group with low health literacy and low access to information were lower than those in the other two groups, including scores of disabled elderly (24.78±0.176), caregiver (8.97±0.116) and family members (6.53±0.101).

There are three potential categories of health literacy for the elderly with comorbid disabilities, and the quality of family care for the elderly with comorbid disabilities is different in different potential categories. It is suggested that targeted personalized intervention programs should be developed based on the groups with the same health literacy of the elderly with comorbid disabilities, so as to improve the quality of their family care.

To establish a method for the determination of 18 phthalates (PAEs) metabolites in urine by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) based on solid-phase support liquid-liquid extraction (SLE) technology.

Urine sample spiked with internal standards was first hydrolyzed by enzyme, then purified on a SLE column. The separation was performed on a BEH C18 column. The detection was performed in multi-reaction monitoring scan under negative mode. Internal standard method was applied for quantitative analysis.

The 18 PAEs metabolites showed good linear relationships in the range of 0.10-80 ng/ml (r>0.999). The average recoveries of 18 PAEs metabolites ranged from 84.0%-113.0% with relative standard deviations between 1.1% and 9.5%. The limits of detection and quantitation of the method were 0.001-0.07ng/ml and 0.002-0.2 ng/ml, respectively. The intra-day and the inter-day precisions were 1.3%-7.0% and 1.0%-8.1%, respectively. 160 urine samples were analyzed with this method. Except for 3 PAEs metabolites that were not detected, the detection rates of the remaining 15 PAEs metabolites ranged from 1.9% to 100%, and the detection rates of 8 PAEs metabolites were 100%. Among them, mono-n-butyl phthalate had the highest concentrations with a median concentration of 126 ng/ml.

This method is simple, sensitive, and accurate, and it is suitable for the determination of 18 PAEs metabolites in large batchs of urine samples.

To assess the association between the cardiometabolic index (CMI) and the risk of kidney stone prevalence, and to analyze its role across different population subgroups.

This cross-sectional study included health examination data from 76 624 adults. The association between CMI and the risk of kidney stones was evaluated using multivariable logistic regression models. Stratified analyses were conducted to explore the effect of different population characteristics. A piecewise linear regression model was used to assess the nonlinear relationship between CMI and kidney stone risk.

CMI levels were positively associated with the prevalence of kidney stones, with the prevalence increasing from 4.33% in the lowest tertile to 9.94% in the highest tertile (P<0.001). Even after adjusting for potential confounders, CMI remained significantly associated with an increased risk of kidney stones (OR = 1.15, 95% CI = 1.10-1.20, P<0.001). Stratified analyses showed that the effect of CMI on kidney stone risk was more pronounced in individuals aged ≥60 years (OR = 1.19, 95% CI = 1.08-1.32, P<0.001) and in males (OR = 1.16, 95% CI = 1.10-1.21, P<0.001), while no significant association was found in females (OR = 1.11, 95% CI = 0.96-1.28, P = 0.157). A nonlinear relationship was observed between CMI and kidney stone risk. Risk significantly increased when CMI was <0.73 (OR = 1.15, 95% CI = 1.10-1.20, P<0.001), while the risk plateaued for CMI ≥0.73 (OR = 1.09, 95% CI = 1.03-1.15, P = 0.002).

Elevated CMI is significantly associated with a higher risk of kidney stones, demonstrating a nonlinear threshold effect. As a comprehensive marker reflecting metabolic burden, CMI may be useful for screening and targeting interventions in high-risk populations for kidney stones.

To investigate the mediating effects of daily activity ability and depression on pain status and subjective life expectancy in elderly patients with chronic diseases, and to provide suggestions and references for active aging.

Based on The China Health and Retirement Longitudinal Study (CHARLS) 2020 data, 5 768 patients with chronic diseases aged ≥60 years were selected as the study subjects, and Spearman correlation analysis was used to explore the correlation between pain, ability to perform activities of daily living, depression, and subjective life expectancy, and PROCESS 4.1 program Model 6 was used to construct the chain-mediated model.

Pain was positively correlated with impaired daily activity ability and depression (r=0.399, P<0.001; r=0.370, P<0.001), was negatively correlated with subjective life expectancy (r=-0.221, P<0.001); The mediating effects of daily activity ability and depression on pain and subjective life expectancy were significant, with simple mediating effects of -0.023 (95%CI: -0.031 to -0.016) and -0.042 (95%CI: -0.049 to -0.034), respectively. The chain mediation effect was -0.013(95%CI: -0.016 to -0.010). The total mediating effect of daily activity ability and depression on pain and subjective life expectancy was -0.078, accounting for 57.78%.

There is a chain mediated effect between daily activity ability and depression on pain status and subjective life expectancy in elderly patients with chronic diseases. With the popularization of primary medical and health services, the family doctor service team needs to improve the comprehensive management of elderly patients with chronic diseases, improve the subjective well-being of elderly patients with chronic diseases from pain management, daily activity intervention, depression regulation and other aspects, and prolong the subjective life expectancy.

To understand the utilization and demand status of cancer screening services among residents in Sichuan Province, and provide scientific basis for further promoting cancer screening strategies.

Using multi-stage stratified clustering and probability proportional to size (PPS) sampling, a face-to-face questionnaire survey was conducted among 15-74-year-old permanent residents from 10 cities (prefectures) in Sichuan Province. Using chi-square test for univariate analysis of cancer screening service utilization and demand, and using logistic regression model for multivariate analysis.

A total of 7 442 valid questionnaires were collected, with an effective rate of 91.30%. 1 099 residents (14.77%) had undergone cancer screening, aged between 40 and 60 years old (OR=1.62, 95%CI:1.31-2.00), female (OR=1.92, 95%CI:1.65-2.25), married, with a college/undergraduate education or above, civil servants and public institution staff (OR=1.59, 95%CI:1.20-2.09), with a family history of cancer, urban household registration (OR=1.46,95%CI:1.23-1.74), poor self-rated health status, and higher utilization rate of cancer screening services for urban employees with basic medical insurance.5034 residents (67.64%) had a demand for cancer screening services. Married individuals with higher education levels, total household income ≥ 60000 yuan/year (OR=1.20,95%CI:1.07-1.35), family history of cancer, and poor self-rated health status had a higher demand for cancer screening services.

There is a high demand for cancer screening services among residents in Sichuan Province, but the actual utilization is insufficient. It is recommended to improve and promote cancer screening work by strengthening health education and establishing a multi-channel funding mechanism for cancer screening.

To explore the incidence, time of occurrence and influencing factors of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in stable chronic obstructive pulmonary disease (COPD) patients within one year.

Retrospectively collected information on COPD case home page visits in Yunnan Province from 2016 to 2022, establishing a longitudinal observation cohort based on patients’ names and ID numbers. The incidence rate, time of occurrence and average number of AECOPD within one year of COPD were calculated, and the relationship between patients’ exposure factors and the number of AECOPD within one year was analyzed by using multivariate linear regression, and the exposure factors affecting AECOPD within one year of COPD patients were analyzed by using Cox regression.

The mean age of 405 428 COPD patients was（70.75±10.95）years, the mean number of comorbidities was 1.14±1.15, the incidence of AECOPD within one year was 17.55%, the mean duration of occurrence was（4.58±3.64）months, and the mean number of AECOPD per patient was 0.27. The regression results showed that gender (HR=1.473, 95%CI: 1.446-1.500), age (HR=1.011, 95%CI: 1.010-1.012), number of comorbidities (HR=1.083, 95%CI: 1.076-1.090), medical insurance type (HR=1.481, 95%CI: 1.394-1.574), and admission season (HR=1.115, 95%CI: 1.090-1.140) were the influencing factors for acute exacerbation in patients with COPD within one year.

The incidence of AECOPD in COPD patients in Yunnan Province within one year is 17.55%. We should start from various risk factors and focus on male, elderly, patients with multiple comorbidities, those admitted in spring and winter seasons, and non-resident medical insurance patients. Take corresponding preventive measures and strengthen the management of AECOPD.

To study the protective effect of melatonin on PM2.5-induced inflammation and lymphangiogenesis in the lung of ApoE^-/- mice.

Twenty-eight male ApoE^-/- mice were randomized into: control group, PM2.5 group, melatonin group and PM2.5+melatonin group. All mice were fed with western diet for 24 weeks. From the 25th week, mice in the melatonin group and PM2.5+melatonin group were daily orally gavage with melatonin (20 mg/kg·bw) for 8 weeks; mice in the PM2.5 group and PM2.5+melatonin group were exposed to PM2.5 by tracheal instillation (5mg/kg); and mice in the control group and melatonin group were instilled with saline at the same time. After 24 h of PM2.5 exposure, mice were euthanized and weight gain and lung weight/body weight ratio in four groups were analyzed. The concentrations of inflammatory cytokines (TNF-α and IL-6) in the lung tissue of mice were measured. Immunofluorescence staining of lung tissue was visualized the lymphatic marker LYVE1 expression. Western Blot was used to assess the protein expression levels of lymphangiogenesis markers PROX1 and LYVE1, lymphangiogenesis regulatory proteins VEGF-C and VEGFR-3 in lung tissues.

The levels of TNF-α and IL-6 and the protein expressions of PROX1, LYVE1, VEGF-C and VEGFR-3in lung tissues of PM2.5 group were significantly higher than the control group (P<0.05). Moreover, the levels of TNF-α, IL-6 and the protein expressions of PROX1, LYVE1, VEGF-C and VEGFR-3 in lung tissues of the PM2.5+melatonin group were significantly lower than the PM2.5 group (P<0.05).

Ambient PM2.5 exposure obviously increases lung inflammation of ApoE^-/- mice, and may increase lymphangiogenesis in lung through regulating the VEGF-C/VEGFR-3 signaling pathway in the lung tissues; melatonin markedly improves PM2.5-induced lung inflammation and reduces lymphangiogenesis in lung.

To comprehensively understand the incidence of metabolic syndrome (MS) and its potential risk elements in middle-aged and elderly people in Tibet, and to provide a scientific and reliable reference for the development and implementation of precise prevention and control strategies for MS in Tibet.

Between June 2021 and December 2022, 6 286 middle-aged and elderly people were strictly screened in Tibet by multi-stage stratified cluster random sampling. The data were organized and analyzed by using SPSS27.0 software, and the differences in MS prevalence among different groups were compared by using the chi-square test and the trend chi-square test, and further analyses of the factors affecting the prevalence of MS were conducted using logistics regression.

Among 6 286 middle-aged and elderly participants, a total of 1 409 patients were screened, with an overall prevalence of metabolic syndrome of 22.41%, the older the age, the higher the prevalence of MS (χ² = 49.694, P < 0.001); the prevalence of MS in men was 27.8%, higher than that in women, which was 18.21%, with a statistically significant difference (P < 0.001). Multifactorial unconditional logistic regression analysis revealed that the main risk factors for the prevalence of MS were advanced age (OR=2.053, 95% CI: 1.545-2.728) for those aged 70 years and above, a family history of hypertension (OR=2.691, 95% CI: 2.293-3.158), a family history of diabetes (OR=4.480, 95% CI: 2.066-9.716) and a body mass index (BMI)≥24.0 kg/m² (OR=14.148, 95%CI: 11.778-16.995), however, female (OR=0.508, 95%CI: 0.443-0.584) and alcohol consumption (OR=0.628, 95%CI: 0.487-0.812) were protective factors for the development of MS. In addition, among the various combinations of abnormal components of MS, the aggregation pattern of “abnormal glucose + abnormal blood pressure +central obesity” was the most prevalent, involving a total of 340 cases, with a prevalence rate of 5.41%.

The prevalence of MS in middle-aged and elderly people in Tibet is at a high level, in which males, elderly people, people with a family history of hypertension or diabetes, and overweight or obese people should be regarded as the priority targets for MS prevention and control. This study provides a basic reference for the prevention and control of MS in Tibet, so that precise prevention and control measures can be taken according to the high-risk groups.

To explore the impact of social participation on cognitive decline in middle-aged and elderly people, and to provide a reference for improving or maintaining the cognitive health of middle-aged and elderly people.

A total of 6 645 middle-aged and elderly people over 50 years old in the 2018 China Longitudinal Survey on Influencing Factors of Elderly Health (CLHLS) were selected as the research subjects, and cognitive frailty was evaluated by the Mini-Mental State Evaluation Scale (MMSE) and Frailty Index (FI). A multivariate logistic regression model was used to analyze the effects of social participation type and intensity on cognitive weakness.

The higher the participation of middle-aged and elderly people in family activities, individual activities, and group activities, the lower the incidence of cognitive weakness. High participation in family activities had the highest effect on mild (OR=0.271, 95%CI:0.228-0.321), moderate (OR=0.463, 95%CI:0.361-0.592) and severe (OR=0.079, 95%CI:0.043-0.146) cognitive frailty. The incidence of cognitive frailty was negatively moderated by high participation in family activities (OR=2.263, 95%CI:1.579-3.244), and the incidence of cognitive frailty was negatively moderated by urban middle-aged and elderly people in group activities (OR=0.459, 95%CI:0.289-0.727) and high participation (OR=0.490, 95%CI:0.331-0.725).

It is of great significance to increase the enthusiasm of middle-aged and elderly people for social participation, especially family activities, to delay the decline of cognitive frailty.