To systematically assess the service capacity of provincial occupational disease prevention and control institutions in China using SWOT analysis and explore pathways for high-quality development.

Employing stratified sampling based on the economic zone classification by the National Bureau of Statistics and distribution characteristics of high-risk industries, we selected 15 provincial occupational disease prevention and treatment institutions from 12 provinces across eastern, central, and western China. Data were collected through institutional questionnaires, expert questionnaires, and semi-structured in-depth interviews）, followed by systematic SWOT analysis of internal and external environmental factors.

Key strengths included comprehensive clinical service capabilities（100% providing health surveillance, 93.3% covering pneumoconiosis diagnosis and treatment）, concentrated resources, and professional authority in occupational health. Weaknesses encompassed talent shortages（reported by 86.7% of institutions）, inadequate preventive services（only 53.3% conducting hazard assessments）, and lagging informatization. Primary opportunities stemmed from national policies supporting medical-preventive integration（endorsed by 91.2% of institutions）and digital technology applications. Main threats included intensified market competition and insufficient public awareness of occupational health.

Provincial occupational disease prevention institutions should adopt a tripartite development strategy focusing on “standardization, technological empowerment, and mechanism innovation”: establish national-level medical centers to develop a comprehensive “prevention-diagnosis-rehabilitation-management” service system; develop regional medical-preventive integration to enhance coordinate occupational health monitoring with clinical services; and promote digital transformation through “Smart Occupational Health” initiatives to overcome data silos. Emphasis should be placed on recruiting and training high-caliber professionals and establishing standardized informatization frameworks to support the high-quality development of occupational disease prevention systems under the Healthy China Initiative.

To explore the influencing factors of payment differences in patients undergoing spine-related surgeries under the Diagnosis-Related Groups（DRG）payment system, and to provide evidencefor improving hospital medical insurance fund surplus and promoting high-quality hospital development.

We collected data from 1 798 inpatients undergoing spine-related surgeries and grouped under the DRG system, along with their medical insurance settlement cost information, at a large Grade-A tertiary hospital in Guangxi from January 1,2022 to December 31,2024. Descriptive statistics, univariate analysis, and multivariate regression models were employed to analyze factors influencing medical insurance payment differences. Structural equation modeling was further applied to validate correlations among variables.

Univariate analysis revealed that age, average length of stay, ADRG group, insurance fund type, case type, presence of complications, primary diagnosis group, and VBP participation status were significant factors influencing medical insurance payment differences in spine-related surgical patients（P<0.05）. The results of multiple linear regression analysis indicated that the top three factors influencing payment differences were ADRG group（β=-1.704,t=-29.369,P<0.001）, centralized procurement status（β=-1.244,t=-17.705,P<0.001）, and case type（β=-1.085,t=-11.257,P<0.001）. Structural equation modeling showed ADRG group as the most influential factor with a path coefficient of 0.55, followed by procurement policy（0.36）and case type（0.21）.

ADRG grouping is the primary determinant of payment differences. Under DRG payment systems, healthcare authorities should optimize disease group weights to reflect actual medical resource consumption and technical complexity. They should actively promote centralized volume procurement of high-value consumables while strengthening synergies between DRG payment and procurement policies. Hospitals need to optimize clinical pathways, control medical costs through rational diagnosis and treatment, thereby improving DRG payment difference levels.

To analyze the pathway through which social capital influences anxiety symptoms in patients with type 2 diabetes mellitus（T2DM）and to explore the mediating effect of sleep quality between these variables, thereby providing evidence for intervention strategies.

A total of 1 726 T2DM patients from 10 hospitals in Ningxia, China, were enrolled. Data were collected via face-to-face interviews using the Self-Rating Anxiety（SAS）and the Chinese version of the Social Capital Scale. The Bootstrap procedure was employed to test the mediating effects.

After adjusting for confounders, social capital exhibited a negative correlation with the prevalence of anxiety symptoms（r=-0.12, P<0.001）, sleep quality was negatively correlated with SAS scores（r=-0.32, P<0.001）, while social capital was positively correlated with sleep quality（r=0.07, P<0.05）. Sleep quality exhibited a partial mediating effect between social capital and anxiety symptoms（β=-0.025, 95% CI: -0.042- -0.009）. Age-stratified analysis revealed that in the elderly group, sleep quality demonstrated a significant mediating effect accounting for 29.2% of the total effect（β=-0.049, 95% CI: -0.079- -0.025）, whereas no statistically significant mediation was observed in the non-elderly group（P>0.05）.

Social capital may indirectly alleviate anxiety symptoms in T2DM patients through improving sleep quality, with this mediating pathway being particularly significant in the elderly population. In clinical practice, it is crucial to emphasize the integration of interventions targeting social capital reconstruction（e.g., community mutual-aid network development）and sleep management（e.g., cognitive behavioral therapy）. Particularly for elderly patients, this combined approach may enhance mental health outcomes through synergistic socio-physio-psychological mechanisms.

To explore the latent classes of social participation among older adults and their impact on cognitive function, providing a reference for improving cognitive function in the elderly.

Using 2018 CHARLS data, this study analyzed 3 577 adults aged ≥60. Cognitive function was assessed with MMSE. Latent class analysis was conducted in Mplus 8.3, and the BCH method was used to examine the effect of social participation patterns on cognition. Multivariate linear regression analyzed the association between participation categories and cognitive function.

Older adults’ social participation was classified into four latent classes: work-oriented [1 507（42.13%）], comprehensively active [176（4.92%）], volunteer-oriented [334（9.34%）], and low-level-social/family [1 560（43.61%）]. These classes differed significantly in age, education, etc.（P<0.05）. Cognitive function differed significantly across classes（χ²=158.689, P<0.05）. Multivariate linear regression showed the comprehensively active type had a protective effect on cognition（P<0.05）.

This study finds older adults’ social participation types are closely linked to cognitive function, with the comprehensively active group showing the highest levels. Types differ in demographic characteristics and significantly affect cognition. Policymakers and community workers should design and promote diverse, personalized activities based on older adults’ needs and conditions.

To explore the impact of college students’ perceived social support on their well-being, and investigate the moderating effects of gender and educational level on this relationship.

An investigation was conducted on 10 726 college students from eight ordinary institutions of higher education in Shandong Province, using the method of stratified cluster random sampling. Descriptive statistics, one-way ANOVA, and multiple linear regression models were used to analyze the impact of perceived social support on college students’ well-being.

Statistically significant differences were observed in college students’ subjective well-being across variables including education level, academic year, major, and whether they came from single-parent families（P<0.05）. Perceived social support exerted a positive influence on the level of college students’ subjective well-being（P<0.05）. Furthermore, the moderating effects of gender（β=0.045, 95% CI [0.021, 0.069], P<0.01）and education level（β=-0.050, 95% CI [-0.070, -0.030], P<0.01）on the relationship between perceived social support and college students’ subjective well-being were found to be statistically significant.

It is recommended to establish a comprehensive network of perceived social support and propose targeted measures for different gender and educational level groups to enhance college students’ well-being.

To investigate the association between loneliness and the risk of arthritis incidence among middle-aged and older adults in China.

Based on data from the China Health and Retirement Longitudinal Study（CHARLS）2011—2020, this study included 9 086 middle-aged and older adults who were free of arthritis at baseline. Participants were categorized into loneliness and non-loneliness groups according to Item 9 of the Center for Epidemiologic Studies Depression Scale（CES-D）. The Kaplan-Meier method was used to plot cumulative incidence curves, and Cox proportional hazards regression models were employed to assess the association between loneliness and incident arthritis risk.

By December 1, 2020, the mean follow-up time was 8.1 years, a total of 1 808 incident arthritis cases were recorded during follow-up. The loneliness group exhibited an arthritis incidence density of 29.36 per 1 000 person-years, compared with 23.05 per 1 000 person-years in the non-loneliness group. The cumulative incidence rate of arthritis was significantly higher in the loneliness group compared to the non-loneliness group（χ²=31.849, P<0.001）. After adjusting for multiple confounders, participants in the loneliness group demonstrated a 26% increased risk of arthritis development compared with the non-loneliness group（HR=1.26, 95% CI: 1.14-1.40）. Subgroup analyses stratified by age, sex, residence, educational level, health insurance status, smoking status, alcohol consumption, BMI, physical activity level, and other chronic diseases revealed largely consistent findings.

In the middle-aged and older adult population in China, loneliness is significantly associated with an elevated risk of incident arthritis. Promoting social connectivity and implementing targeted interventions to mitigate loneliness may serve as effective strategies for arthritis prevention in this population.

To explore the predictive relationships among depressive symptoms over time and identify core symptoms within the depressive symptom network in empty-nest older adults in China.

Data were obtained from 1 462 eligible empty-nest older adults in the 2018 and 2020 waves of the China Health and Retirement Longitudinal Study（CHARLS）. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale（CESD-10）. A cross-lagged panel network（CLPN）model was fitted and analyzed using R version 4.3.3.

Feeling afraid, loneliness, and effortful behavior were the symptoms with the strongest outgoing predictive effects, significantly predicting changes in other symptoms at the next time point. Additionally, gender differences were observed: depressive symptoms in men were more likely to originate from loneliness, whereas in women, they were more associated with fear.

Intervention strategies should consider gender differences and focus on core symptoms to prevent the progression to high-risk depression among empty-nest older adults with depressive tendencies.

To establish a simultaneous determination method by inductively coupled plasma mass spectrometry（ICP-MS）for 32 elements and 15 rare-earth elements in whole blood including Ni, Sb, Li, Be, Mn, Co, Ge, Cd, Sn, Te, W, Tl, Bi, Ga, Cs, Mo, Cr, U, V, Ba, Sr, As, Al, Ti, Pb, Cu, Se, Rb, Zn, Fe, Ca, Mg, La, Ce, Pr, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, Yb, Lu and Y.

Blood samples were diluted 20-fold with a 0.05% Triton X-100-0.5% HNO₃ and then the analytes were determined by ICP-MS. Sc, Rh, Os, and Ir were selected as internal standards. The helium collision mode（KED）was used to eliminate interferences for some elements.

The 47 elements showed good linearities with correlation coefficients greater than 0.999. The method detection limits were 0.001-1.55 μg/L（Fe, Ca, and Mg were 0.01-0.06 μg/mL）. The within-batch RSDs were less than 10%, and the between-batch RSDs were less than 15%. The average recovery rates ranged from 75.6% to 120.9%. The average determination results of 22 elements in the whole-blood reference material were within the uncertainty range of the certified values.

This method is simple and fast, with high sensitivity, good stability, low detection limits, and it is suitable for the determination of 47 elements in blood samples.

To evaluate the safety and efficacy of two doses of recombinant zoster vaccine（RZV）in normal immune population over 50 years of age in Nanchang.

1 802 people over 50 years old who received two doses of RZV were selected as the observation group, and 2 132 people were simultaneously inoculated with Pneumococcal Vaccine Polyvalent（PPV23）and Quadrivalent influenza vaccines（QIV）in subjects over 50 years of age served as a control group. The incidence of adverse reactions and the incidence of Herpes zoster（HZ）within 1 year after vaccination were analyzed and compared between the observation group and the control group after vaccination.

In the observation group, the incidence of adverse reactions was 23.89%, the incidence of adverse reactions at inoculation site, abnormal vital signs and non-inoculation site were 16.79%, 9.05% and 7.69%, and the incidence of grade 1 and grade 2 adverse reactions were 22.42% and 1.47%. The incidence of adverse reactions in control group was 8.72%, the incidence of adverse reactions at inoculation site, abnormal vital signs and non-inoculation site were 7.38%, 2.06% and 1.17%, and the incidence of grade 1 and grade 2 adverse reactions were 7.60% and 1.13%. There were statistically significant differences in the incidence of adverse reactions between the observation group and the control group（χ²=187.817-339.938, P<0.05）, but there was no significant difference in the incidence of grade 2 adverse reactions（χ²=0.109-1.833, P>0.05）. Within one year after vaccination, the incidence of HZ was 0.33% in the observation group and 1.45% in the control group. The estimated vaccine effectiveness（VE）after two doses of RZV vaccine was 77.82%（95% CI:47.07%-90.70%）.

Two doses of RZV were highly effective. Although the incidence of adverse reactions is high but the degree is mild, it has a good safety.

To analyze the trends in incidence and disability-adjusted life years（DALYs）of neonatal tuberculosis in China from 1990 to 2021.

Based on the 2021 global burden of disease（GBD）study data, extracted incidence and DALYs of neonatal tuberculosis（infants aged <28 days）in China from 1990 to 2021. Using Joinpoint log-linear regression models, calculated the estimated annual percentage change（EAPC）, average annual percent change（APC）and annual percentage change（APC）by period to analyze trend variations across different drug-resistant tuberculosis types（drug-susceptible tuberculosis（DS-TB）, multidrug-resistant TB without extensive drug resistance（MDR-TB non-XDR）, and extensively drug-resistant tuberculosis（XDR-TB））.

China’s exhibited a pronounced downward trend in both incidence and DALYs of neonatal tuberculosis（incidence EAPC: -5.88%, AAPC: -4.74%; DALYs EAPC: -6.36%, AAPC: -5.23%）from 1990 to 2021. The most substantial decline occurred during 2000-2010（DALYs 2000-2003 APC: -17.65%）, but significantly slowed after 2015（DALYs 2015-2021 APC: -1.96%, P=0.229）. DS-TB incidence（AAPC: -4.72%）and DALYs（AAPC: -2.60%）similarly declined, mirroring overall epidemic patterns. A precipitous decline was observed in MDR-TB non-XDR（DALYs EAPC: -8.51%）.

Significant achievements have been made in neonatal tuberculosis control in China over the past three decades, with particularly notable reductions in the burden of DS-TB. However, the pace of tuberculosis control progress has slowed since 2013 amid escalating threats drug-resistant tuberculosis. Critical next steps include: intensified perinatal TB screening, advanced drug-resistance surveillance, molecular diagnostics deployment, and precision interventions for sustained neonatal TB burden reduction.