To investigate the association between the cardiometabolic index (CMI) and diabetes risk among hypertensive patients.

Utilizing health examination data from the National Basic Public Health Service Project in Jianye District, Nanjing (2019—2023), CMI was calculated basing on triglycerides, high-density lipoprotein cholesterol, waist circumference, and height. Diabetes was diagnosed according to the National Basic Diabetes Prevention and Management Guidelines (2022). Multivariable logistic regression models were applied to evaluate the association between CMI and diabetes risk, with odds ratios(ORs) and 95% confidence intervals(CIs) calculated. Restricted cubic spline analysis was used to explore the dose-response relationship. Subgroup analyses were performed to assess effect modifications.

This study included 56 760 hypertensive patients, with a final effective sample of 28 665 after excluding those with missing CMI-related indicators, of whom 7 535 had diabetes. Compared to those with lower CMI, hypertensive patients with higher CMI had significantly increased diabetes risk (P<0.001). Logistic analysis showed the highest CMI group (Q4) had a 40% higher diabetes risk than the lowest group (Q1) (OR=1.40, 95% CI: 1.30-1.52). Dose-response analysis revealed a nonlinear relationship (nonlinear P<0.001), indicating extreme CMI values might signal higher metabolic risks. Stratified analysis found a stronger association between CMI and diabetes risk in female hypertensive patients (OR=1.21, 95% CI: 1.16-1.27).

In Nanjing Jianye District residents, there is a significant positive correlation between CMI and diabetes risk in hypertensive patients, more pronounced in women. It is recommended to include CMI in metabolic risk assessment for community hypertensive patients, with a focus on personalized intervention for abdominal obesity and dyslipidemia in women.

To evaluate the spatial accessibility of various types of healthcare institutions in an urban district of a prefecture-level city in the Yangtze River Delta, in order to provide a basis for optimizing healthcare service allocation.

This study obtained 2024 healthcare facility data and population data for each subdistrict (town) through secondary data collection, and gathered population spatial distribution data and road traffic data from public service platforms. The Two-Step Floating Catchment Area (2SFCA) method based on a Gaussian decay function was used to assess the accessibility levels of different healthcare institutions within the district.

Within a 15-minute drive, 42.5% of demand points cannot access primary healthcare institutions and are classified as inaccessible areas. Comprehensive specialty healthcare institutions exhibit a clustered distribution in the southeastern region, indicating significant regional disparities in development. Dental service institutions demonstrate overall good accessibility; however, resource levels remain notably insufficient in the northwestern region. Accessibility to rehabilitation service institutions is relatively balanced overall, though areas requiring improvement still exist in the northwest.

The distribution pattern of medical institutions in city districts is “dense in urban areas and sparse in suburbs”, and the results of the accessibility of various types of medical institutions are different, so the results of this study can provide a reference for other cities to evaluate the spatial allocation of medical resources.

To investigate the association between the metabolic syndrome-insulin resistance index (METS-IR) and the risk of kidney stones, as well as its potential threshold effect.

Data were obtained from individuals undergoing health screening at the Affiliated Hospital of Yangzhou University in 2022. This cross-sectional study included 80 046 eligible participants. Participants were divided into three tertile groups based on METS-IR levels. Multivariate logistic regression was used to analyze the association between METS-IR and kidney stone risk. Piecewise linear regression was applied to evaluate the threshold effect, with sex-stratified and multiple subgroup analyses conducted.

The prevalence of kidney stones increased with higher METS-IR tertiles (low: 3.83%, medium: 6.47%, high: 9.91%). After multivariate adjustment, each standard deviation increase in METS-IR was associated with a 20% higher risk of kidney stones in women (OR=1.20, 95% CI: 1.08-1.33) and a 24% higher risk in men (OR=1.24, 95% CI: 1.18-1.31). Compared with the low METS-IR group, the high METS-IR group had a 41% higher risk in women (OR=1.41, 95% CI: 1.13-1.74) and a 56% higher risk in men (OR=1.56, 95% CI: 1.37-1.78), both showing significant dose-response relationships. A clear threshold effect was observed in men (inflection point=43.72, P<0.001), where each 1-unit increase in METS-IR below the inflection point was associated with a 5% higher risk (OR=1.05, 95% CI: 1.04-1.06), while the association weakened above the inflection point (OR=1.01, 95% CI: 1.00-1.02).

METS-IR is significantly associated with kidney stone risk, with a threshold effect observed in men. METS-IR may serve as a potential marker for assessing kidney stone risk, providing a new perspective for early screening and intervention, particularly in high-risk populations at the early stage of metabolic abnormalities.

To investigate the associations between blood benzene levels and the prevalence of heart diseases, as well as myocardial injury biomarkers, using data from the National Health and Nutrition Examination Survey (NHANES).

A total of 3 546 participants with available blood benzene measurements and heart disease questionnaire data were included in the study. Weighted logistic regression and weighted generalized linear models were used to perform multivariable-adjusted analyses. Restricted cubic spline (RCS) models were constructed to explore potential nonlinear relationships.

After natural logarithmic transformation, each one-unit increase in blood benzene was significantly associated with a higher odds of congestive heart failure (OR=1.59, 95% CI: 1.03-2.44, P=0.037), coronary heart disease (OR=1.59, 95% CI: 1.08-2.34, P=0.020), and myocardial infarction (OR=1.39, 95% CI:1.07-1.81, P=0.013). Meanwhile, serum lactate dehydrogenase levels increased by an average of 4.78 U/L (95% CI: 2.61-6.96, P<0.001), and high-sensitivity cardiac troponin I levels increased by an average of 1.10 ng/L (95% CI: 0.00-2.20, P=0.050). Although RCS analyses did not reveal significant non-linear associations, they supported a positive dose-response and dose-effect relationship between blood benzene levels and these adverse cardiac outcomes.

Blood benzene levels are significantly positively associated with the odds of heart disease and cardiac injury biomarkers, providing important clues for further investigation into the potential impact of low-level benzene exposure on cardiovascular health.

To analyze the exposure levels and health risks of nine pollutants in urban and rural drinking water of Liaoning Province, and to provide a reference for ensuring drinking water safety.

Water samples from 28 large-scale water supply units were monitored in 2024. The indicators included bisphenol A (BPA), nitrosodimethylamine (NDMA), di(2-ethylhexyl) adipate (DEHA), diethyl phthalate (DEP), dibutyl phthalate (DBP), perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), vanadium (V), and chlorinated paraffins (CPs). The results were evaluated according to the standards for drinking water quality (GB 5749-2022), except for CPs. The comparison of concentration differences between the two groups was performed using the Mann-Whitney U test, while the Kruskal-Wallis rank-sum test was employed for comparisons among multiple groups. The χ² test was used for the comparison of rates. Using the health risk assessment methods of the U.S. Environmental Protection Agency and the technical guide for environmental health risk assessment of chemical exposure (WS/T 777-2021), the health risks to people through oral of drinking water were assessed.

A total of 112 water samples were collected and tested. The detection rates of the indicators, in descending order, were PFOA (36.61%)> NDMA (25.89%)> PFOS (16.07%)> DBP (15.18%)> BPA (4.46%)>CPs (2.67%). DEHA, DEP, and V were not detected. Except for CPs, the compliance rate for DBP was 99.96%, while all other indicators reached 100%. BPA and NDMA concentrations in wet season were higher than that in dry season, and the detection rate of NDMA was also higher in the wet season compared to the dry season; the NDMA concentration in the finished water was higher than that in the tap water, and all these differences were statistically significant (P<0.05). In surface water sources for drinking water, the concentrations of NDMA and DBP were higher than those in groundwater (P<0.05); the detection rates of DBP and PFOA in surface water were higher than those in groundwater (P<0.05). The hazard quotient (HQ) for PFOA is greater than 1, indicating a high non-carcinogenic risk; the carcinogenic risk values (CR) of NDMA, PFOA of male and female, and PFOS are all between 1.0×10^-6 to 1.0×10^-4, indicating a certain risk.

In Liaoning Province, there is exposure to BPA, NDMA, DBP, PFOA, PFOS and CPs in drinking water samples. NDMA, PFOA and PFOS carry a certain level of potential carcinogenic risks, but all are within the acceptable range. PFOA presents a certain non-carcinogenic risk and requires attention.

To analyze the influence of school bullying on the development track of adolescents’ early non-suicidal NSSI, and to provide evidence for the prevention of adolescents’ early NSSI.

A total of 941 first grade students were investigated in March 2023, September 2023 and March 2024 by using the School Bullying Questionnaire and the Adolescents’ Non-Suicidal Self-Injury Behavior Assessment Questionnaire (ANSAQ). The heterogeneity of the developmental trajectory of early non-suicidal NSSI was analyzed by the latent variable growth mixed model (LGMM), and the influence of school bullying on the heterogeneity of NSSI was explored by multiple logistic regression analysis.

The LGMM results showed that class 1 (Class1) was the “low-risk mitigation group” (87.35%) and class 2 (Class2) was the “medium-risk stable group” (7.23%); Category 3 (Class3) was the “high-risk deteriorating group” (5.42%); Male students were the protective factors in the “medium-risk stable group” (OR=0.369, 95% CI=0.216-0.631) and the “high-risk deteriorating group” (OR=0.325, 95% CI=0.121-0.872), and bullying was the protective factor in the “medium-risk stable group” (OR=1.375, 95% CI=1.269-1.490) and “high-risk worsening group” (OR=1.526, 95% CI=1.343-1.734).

The developmental trajectory of non-suicidal NSSI in early adolescents is heterogeneous, and school bullying is a risk factor for NSSI in early adolescents.

To understand the health care providers’ willingness to recommend nasal spray influenza vaccine and the influencing factors, and to provide suggestions for formulating an immunization service strategy for the nasal spray influenza vaccine.

From March to May 2023, a convenience sampling method was used to conduct an online questionnaire survey among 171 health care providers in vaccination clinics in Shanghai, Weifang and Wuhan. We analyzed their willingness to recommend nasal spray influenza, as well as the reasons and influencing factors.

The willingness of Chinese health care providers to recommend the nasal spray influenza vaccine was 83.04%. The more the vaccine and the more they accepted the vaccine, the higher the willingness was (OR=2.71,95% CI:1.50-4.63,P<0.001). The reasons why they were willing to recommend the vaccine were that they believed in its safety, fewer side effects, effectiveness and convenience of vaccination. The main reasons for being unwilling to recommend it were that they lacked the knowledge about the supplier and pricing method of the vaccine, and trust in its safety and effectiveness.

Chinese health care providers have a high willingness to recommend nasal spray influenza vaccine, which is mainly affected by their perception of and acceptance about the vaccine. During the formulation of the vaccine’s immunization service strategy, providing health education and specific training to health care providers may help them understand the market information, safety and effectiveness of the vaccine.

To investigate the impact of social capital on the patient activation of rural empty-nest elderly patients with chronic diseases and the mediating role of self-efficacy.

A questionnaire survey was conducted among 425 rural empty-nest older adults with chronic diseases using multistage stratified random sampling combined with convenience sampling. Pearson correlation analysis was employed to examine the relationships between variables. Independent t-tests and ANOVA were used for group comparisons. Multiple linear regression analysis was conducted to examine the effects of social capital and self-efficacy on patient activation. The mediating role of self-efficacy between social capital and patient activation was analyzed using the PROCESS macro.

Correlation analysis showed that social capital, self-efficacy, and patient activation were positively correlated with each other (r=0.300, 0.224, and 0.312, P<0.001). The mediation effect analysis indicated that social capital (β=0.224, 95% CI:0.116-0.283), social participation (β=0.141, 95% CI:0.035-0.166), social support (β=0.189, 95% CI: 0.075-0.215), and social connections (β=0.180, 95% CI:0.049-0.152) had significant direct predictive effects on patient activation. Additionally, self-efficacy played a partial mediating role, accounting for 12.50% of the total effect.

Primary healthcare teams and government authorities should focus on and strengthen the dual-pathway intervention of social capital development and self-efficacy enhancement for rural empty-nest elderly patients with chronic diseases. This approach can more effectively activate their engagement in autonomous health management.

To conduct molecular surveillance and evolutionary analysis of avian influenza virus (AIV) in air samples collected from the live poultry wholesale market in Changsha, providing laboratory data for the prevention and control of human AIV infections.

Air samples were collected from poultry stalls in live poultry wholesale market in Changsha. AIV nucleic acid detection and nucleotide sequencing were performed. The sequencing results were analyzed using BLAST, key amino acid (aa) residue alignment, and nucleotide evolutionary analysis.

All 27 air samples from the live poultry wholesale market tested positive for AIV nucleic acid (100% positivity rate). Two AIV nucleotide sequences (CS17 and CS11) were obtained. For CS17, the HA and NA genes exhibited the highest nucleotide similarities to A/duck/Bangladesh/38285/2019(H11N3)(98.47%) and A/mallard/South Korea/JB21-58/2019 (H5N3) (98.94%), respectively. For CS11, the HA and NA genes showed the highest nucleotide similarities to A/environment/Fujian/EV01/2020(H11N3)(95.34%) and A/duck/Wenzhou/771/2013 (H7N3) (95.30%), respectively. Internal gene analysis revealed that CS17 originated from H3N8, H4N6, H3N2, and H6N1 viruses, while CS11 was derived from H7N9, H3N2, and related viruses. Both CS17 and CS11 were identified as H11N3 subtype AIV (abbreviated as H11N3-CS17 and H11N3-CS11, respectively).The H11N3-CS17, H11N3-CS11, and 101 H11N3 strains (retrieved from GISAID) exhibited conserved molecular features in their HA proteins. All strains retained a single basic amino acid (aa) at the HA cleavage site and preserved Q/G residues at the receptor-binding sites. No critical mutations were observed at R293K (NA protein), S31N (M2 protein), E627K, or D701N (PB2 protein), nor deletions in the 69-73 (NA protein) or 218-230 (NS1 protein) regions. Notably, specific mutations were identified: L89V (PB2 protein), and N30D and T215A (M1 protein). Phylogenetic analysis indicated that the HA and NA genes of both strains belonged to the Eurasian lineage. H11N3-CS17 clustered into a subclade with H11N3 viruses from ducks in Bangladesh and Japan, while H11N3-CS11 formed a subclade with H11N3 viruses from domestic ducks and live poultry market environments in China.

Two H11N3 subtype AIV strains were identified in air samples from the live poultry wholesale market in Changsha. These strains exhibited molecular features of low pathogenicity and avian receptor specificity but displayed distinct genetic reassortment and evolutionary subclades, warranting further surveillance.

To systematically assess the trend of high BMI-related gout disease burden in China, Japan and Korea and globally from 1990 to 2021, and to provide a scientific basis for gout prevention and control.

Based on data from the Global Burden of Disease Study (GBD), the disease burden characteristics of high BMI-induced gout were resolved by gender and age group,and trends in the rate of standardized disability-adjusted life years (DALYs) were analyzed by using the Joinpoint regression model,and trends in the burden of disease were predicted for the period of 2022-2035 by the ARIMA model.

From 1990 to 2021,the rates of standardized DALYs among adults in China,Japan,Korea,and the world showed a simultaneous upward trend,with an increase of 114.82% in China,which was significantly higher than that of Japan(38.41%),Korea(62.40%), and the global average(62.01%). Gender analysis showed that the rate of standardized DALYs was higher in males than in females in all regions. The age distribution showed a single-peak pattern of increasing and then decreasing, with peak ages of 55-59 years for males and 65-69 years for females in China and globally, whereas peak ages were reached most recently in Japan for males(70-74 years) and females(75-79 years), and peak ages for males in South Korea(60-64 years) were in the middle of the range between China and Japan, and peak ages for females were in line with the global trend(65-69 years).The results of the Joinpoint regression showed that the peak ages of 1990-2021 DALYs rates of gouty diseases attributable to high BMI in China,Japan,and Korea and globally were on the rise in 2021 (AAPC was 2.50%,1.04%,1.58%,and 1.58%,respectively,all P<0.05).

The burden of gout associated with high BMI continues to increase in China,Japan,Korea,and globally,and it is necessary to strengthen the comprehensive management of BMI in the population and to implement focused interventions for high-risk age and gender groups.