To understand the cognitive situation of health emergency response capabilities among emergency response personnel in urban and district-level disease control institutions in Tianjin, identify the training needs of the personnel, and provide countermeasures and suggestions for enhancing the emergency response capabilities of urban and district-level disease control institutions in Tianjin.

Using a cross-sectional survey, an online questionnaire survey was conducted in 2024 to assess the emergency response capabilities and training needs of district-level emergency responders across the city. A total of 946 valid questionnaires were included, and multiple linear regression analysis was used to analyze the influencing factors of the self-assessment scores for health emergency response capabilities.

The score of health emergency response capabilities among urban and district-level disease control institutions in Tianjin was (59.55±6.641) out of the total possible score，with an average score of (2.38±0.27) per item. The results of multiple linear regression analysis showed that the number of participations in health emergency response events (β=0.982) and professional technical titles (β=0.817) were the main influencing factors of the emergency response capability score. There was a significant demand for training in public health response to infectious diseases (47.99%), basic knowledge and skills related to infectious diseases (46.19%), and on-site handling procedures for public health emergencies (40.80%).

The reasonable and balanced composition of education and professional titles is an important link to improve the emergency response capability of district-level CDC in Tianjin. Participating in on-site disposal is an important way to enhance emergency capabilities. It is necessary to improve the normalized emergency drill mechanism, and carry out systematic, cutting-edge and targeted training based on needs, so as to continuously improve the emergency response capability of district-level CDCs.

To analyze the spatial distribution of women of childbearing age and the allocation of resources for maternal and neonatal care, and to assess the spatial accessibility of critical maternal care resources, providing a scientific basis for optimizing resource allocation.

Taking the critical maternal care centers in Jiangsu Province in 2024 as the supply side and the population of women of childbearing age in Jiangsu Province as the demand side, the comprehensive service capacity index was constructed using the entropy weight method. The spatial accessibility of resources was evaluated using the shortest distance method and the Gaussian two-step floating catchment area method.

The distribution of women of childbearing age was mainly concentrated in the urban areas of Nanjing, Suzhou, and Wuxi. 92.91% of the critical maternal care centers were located in the top 20% of areas with the highest population density of women of childbearing age. The proportions of provincial, municipal, and county-level critical maternal care centers were 19.69%, 21.26%, and 59.06%, respectively. They were allocated 35.08%, 21.41%, and 43.51% of the bed resources and 37.03%, 21.60%, and 41.36% of the physician resources, respectively. The average annual delivery volume was 4 874.32 cases, 2 472.48 cases, and 1 628.47 cases, respectively. In terms of time cost, the average time for women of childbearing age in the province to reach the nearest critical maternal care center was 18.74 minutes. 69.81% of women of childbearing age could obtain care services within 15 minutes, 27.40% of the population needed 15-30 minutes, and 2.79% of the population needed more than 30 minutes. From the perspective of supply and demand, when the time thresholds were 15 minutes, 30 minutes, and 45 minutes, the proportions of the population with good or better accessibility were 16.69%, 24.42%, and 29.03%, respectively.

The spatial accessibility of critical maternal care resources in Jiangsu Province is generally good, but the distribution of obstetrician resources does not fully match the population distribution. The accessibility level of resource allocation in some areas such as Dongtai City and Xiangshui County in Yancheng City still needs to be improved. The "abundance and high quality" in resource-intensive areas has not been fully transformed into fairness and accessibility. It is recommended to enhance the fairness and efficiency of resource allocation through measures such as balancing supply and demand and improving management and service capabilities.

To analyze the evolution characteristics and influencing factors of total health expenditure structure in Qinghai Province from 2009 to 2021, and to provide reference for regional health policy optimization.

The data of total health expenditure and influencing factors of total health expenditure in Qinghai Province from 2009 to 2021 were selected. Based on the financing source method, the structural change degree analysis method was used to explore the dynamic changes of health financing structure, and the principal component regression model was used to identify the key influencing factors.

From 2009 to 2021, the average annual growth rate of total health expenditure in Qinghai Province was 13.86%, the proportion of government health expenditure increased from 39.81% to 49.21%, the proportion of personal expenditure decreased from 30.04% to 22.09%, the overall structural change degree was 18.79%, and the financing balance was significantly improved. Principal component regression showed that population size (β=0.114), economic development (β=0.114), medical resource supply (β=0.113) and urbanization rate (β=0.112) were the main positive driving factors, while the proportion of personal expenditure (β=-0.091) was significantly inhibited.

The scale of health financing in Qinghai Province continues to expand, and the burden of residents is gradually reduced. However, it is necessary to optimize the structure of government investment, improve the efficiency of resource utilization, and optimize the structure of medical insurance payment.

To analyze the differences in inpatient cost structure and variation between patients discharged against medical advice (DAMA) and those discharged per medical advice (DC) under the DRG payment model, aiming to support resource optimization and risk communication strategies.

Front-page medical records of all DAMA and DC inpatients from a tertiary general hospital between 2020 and 2024 were collected. Descriptive statistics and univariate analysis were used to compare cost differences. Cluster analysis and structural variation degree analysis were conducted to examine cost composition and annual variation trends.

Significant differences were found between the two groups in total and itemized inpatient costs. DAMA patients exhibited a “majority low-cost, minority high-expenditure” pattern, dominated by drug expenses and relatively low treatment costs. In contrast, DC patients showed more balanced cost distribution with stable proportions of diagnostic, treatment, and drug costs. Structural variation analysis indicated greater variation among DC patients, driven by changes in treatment and general medical service fees, while DAMA patients were mainly affected by diagnostic cost fluctuations.

Medical institutions should prioritize optimizing the cost structure of DAMA patients to enhance resource allocation and cost control, promoting standardized clinical practice and effective use of medical insurance funds under DRG reform.

This study is based on the log-binomial model, aiming to explore the impact of adverse early childhood experiences on frailty in old age among middle-aged and elderly people in rural areas of Ningxia, and to provide scientific methods and evidence-based references for promoting the health of middle-aged and older adults in China.

Utilizing the health follow-up data collected by the research group during the Extended Consolidation Phase of Health Poverty Alleviation (July-August 2024), middle-aged and elderly people aged 45 and above were selected as the research subjects, and a total of 5 644 valid samples were included. The χ² test was used to analyze the differences in frailty among different characteristic subjects in middle-aged and elderly people, and the log-binomial regression model was used to explore the effect of adverse childhood experiences on frailty in later years in middle-aged and elderly people.

A total of 900 middle-aged and elderly people suffered from frailty in this study, accounting for 15.95% of the total number. The results of the log-binomial regression model showed that two adverse childhood experiences, namely, going hungry during childhood and adolescence (PR=1.587, 95% CI:1.244-2.025), poor physical health during childhood and adolescence (PR=1.492, 95% CI:1.115-1.996), and very poor (PR=1.856, 95% CI:1.351-2.549), were risk factors for frailty in the later years of middle-aged and elderly people in rural Ningxia. The presence of both parents (PR=0.628, 95% CI:0.547-0.720) and the average health of the father (PR=0.644, 95% CI:0.422-0.983) during childhood and adolescence were protective factors for the occurrence of frailty in the later years of middle-aged and elderly people in rural Ningxia.

The incidence of frailty in old age among middle-aged and elderly people in rural Ningxia is relatively high. Among them, the problem of frailty in old age is more severe among middle-aged and elderly people exposed to two kinds of adverse childhood experiences, namely, going hungry during childhood and adolescence, poor physical health during childhood and adolescence, and very poor health. The sensitivity and attention to the public health threat of adverse childhood experiences should be enhanced. The occurrence and development of risk events should be detected and intervened as early as possible to reduce the risk of frailty in the later years of middle-aged and elderly people and improve their physical fitness and health level.

To investigate the influence of childhood adverse experiences on mobile phone dependence of middle school students, and to explore the mediating role of self-efficacy and self-control.

A total of 1 724 college students from three undergraduate colleges in Hunan, Hubei and Guizhou were investigated from April to June 2024 by using the health Hazard Behavior questionnaire, Adverse Childhood Experience Scale (ACEQ), self-efficacy scale (GSES) and Self-control Scale (SCS).

The standardized path coefficient (β=0.518), self-efficacy and self-control had partial mediating effect and chain mediating effect between adverse childhood experiences and the aggregation of harmful behaviors of college students. The effect sizes of the three mediators were 0.029 (95% CI: 0.016-0.044), 0.132 (95% CI: 0.110-0.156) and 0.034 (95% CI: 0.025-0.045), accounting for 4.07%, 18.51% and 4.77% of the total effect, respectively.

Adverse childhood experiences directly affect the aggregation of harmful behaviors of college students, and self-efficacy and self-control play a chain mediating role in the influence of adverse childhood experiences on the aggregation of harmful behaviors of college students.

To analyze the relationship between dietary patterns and central obesity to provide a theoretical basis for preventing and improving central obesity.

A multi-stage stratified cluster random sampling method was used to select adult residents aged 18 and above in Handan City for the 2022 monitoring of Chinese residents’ nutrition and health status as the survey subjects. Collect basic and dietary information of survey subjects and conduct physical examinations. Calculate the central obesity rate among residents. Exploratory factor analysis was used to extract dietary patterns, and the quartiles of factor scores for each dietary pattern were ranked from low to high as Q1, Q2, Q3, Q4. Apply binary logistic regression to analyze the relationship between dietary patterns and central obesity.

The standardized central obesity rate of adult residents in Handan was 53.3%. Six dietary patterns were extracted, namely the meat-fish-fruit-fungi pattern, snack-beverage-milk pattern, vegetable-staple-low-legume pattern, nut pattern, egg pattern, and alcohol pattern. Binary logistic regression analysis showed that the meat-fish-fruit-fungi pattern was associated with central obesity (Q4: OR=0.422, 95% CI: 0.216-0.822). The vegetable-staple-low-legume pattern was associated with central obesity (Q4: OR=2.138, 95% CI: 1.052-4.343). The alcohol patterns were associated with central obesity (Q4: OR=2.013, 95% CI: 1.085-3.734).

The central obesity rate of adult residents in Handan is relatively high. The meat-fish-fruit-fungi pattern is a protective factor for central obesity, while the vegetable-staple-low-legume pattern and alcohol pattern are risk factors for central obesity. It is recommended to moderately increase the intake of high-quality proteins such as meat, fish, and legume, as well as fruits and fungi, and reduce the intake of staple food, and avoid excessive alcohol consumption.

To analyze the impact of screen exposure and behaviors such as smoking, alcohol consumption, and sugary drink intake on the risk of developing central obesity, and to provide evidence for obesity prevention and control.

This study utilized the Guizhou Adult Chronic Disease Natural Population Cohort. A baseline survey was conducted from 2010 to 2012 among adult residents from 48 townships across 12 counties (districts/cities) in Guizhou Province using multi-stage stratified cluster random sampling. Follow-up was conducted from 2016 to 2020. A total of 2 310 participants with complete baseline and follow-up data were included in the analysis. Participants were divided into four groups based on screen exposure duration: <2 h, 2~<3 h, 3~<4 h, and ≥4 h; and into four groups based on non-screen sedentary duration: <1 h, 1~<2 h, 2~<3 h, and ≥3 h. Cox proportional hazards regression models were used to analyze the impact of screen exposure and non-screen sedentary behavior on central obesity under different behavioral patterns.

The average screen exposure time among the subjects was 3.39±2.33 hours. Among the 2 310 participants, 999 developed new-onset central obesity, with an incidence rate of 43.2%. After adjusting for other factors, multivariate Cox regression analysis showed that as screen exposure duration increased, the risk of central obesity gradually rose. The risks of central obesity in the 2~<3 h, 3~<4 h, and ≥4 h screen exposure groups were 1.391 times (HR=1.391, 95% CI=1.076-1.796, P=0.012), 1.424 times (HR=1.424, 95% CI=1.167-1.737, P=0.001), and 1.795 times (HR=1.795, 95% CI=1.268-2.541, P<0.001) higher than that of the <2 h group, respectively. In contrast, non-screen sedentary behavior showed no statistically significant association with the risk of central obesity. The risks for the 1~<2 h, 2~<3 h, and ≥3 h non-screen sedentary groups were 0.874 (HR=0.874, 95% CI=0.709-1.078, P=0.303), 0.878 (HR=0.878, 95% CI=0.695-1.125, P=0.208), and 0.910 (HR=0.910, 95% CI=0.485-1.510, P=0.717) times that of the <1 h group, respectively. Interaction effects between screen exposure and smoking, alcohol consumption, and sugary drink intake further increased the risk of central obesity.

Screen exposure significantly contributes to central obesity. It is essential to control screen time and reduce unhealthy behaviors during screen exposure to lower the risk of central obesity.

To understand the detection rate and molecular typing characteristics of human rhinovirus in influenza-like cases among children in Guizhou Province from 2023 to 2024.

Throat swab samples of 4 771 children influenza-like cases in Guizhou Province from 2023 to 2024 were collected. A total of 11 common respiratory pathogens, including rhinovirus (HRV), enterovirus (EV), adenovirus (ADV), Boka virus (HBoV), influenza virus (IFV), parainfluenza virus (HPIV), common coronavirus (HCoV), novel coronavirus (SARS CoV-2), metapneumovirus (HMPV), respiratory syncytial virus (RSV) and mycoplasma pneumoniae (MP), were detected by multiple fluorescent quantitative PCR. Epidemiological data were analyzed by Excel 2021 and SPSS 22 statistical software for HRV; Select qualified HRV positive samples for VP4/VP2 gene sequencing, use MEGA11 for gene typing, and construct a phylogenetic tree using adjacency method.

A total of 371 HRV-positive samples were detected, with a detection rate of 7.78%. No statistically significant difference in HRV detection rates was observed between different gender groups (P=0.669) or age groups (P=0.328). However, a statistically significant difference was found across seasons (P<0.001). The detection rate of HRV co-infection was 3% (143/4 771), with HRV and EV co infection detected the most, accounting for 27.97% (40/143), followed by HRV and HPIV co infection, accounting for 14.69% (21/143), and RSV co-infection, accounting for 12.59% (18/143). A total of 20 HRV VP4/VP2 gene sequences were obtained, including 16 HRV-A strains, 1 HRV-B strain, and 3 HRV-C.

HRV is an important pathogen causing influenza-like cases in children in Guizhou Province from 2023 to 2024. HRV-A is the main popular plant type. There is co-infection with HRV in the case, with co infection of two pathogens being the most common. The main co-infection viruses are EV, HPIV, and RSV.

To analyze the regional differences in the vaccination coverage of China’s National Immunization Program (NIP) between the eastern and western regions (Changxing Town in Shanghai and Gengma Town in Gengma County, Yunnan Province), to identify weak links in implementation, and to provide a basis for optimizing cross-regional public health collaboration.

Based on the National Immunization Program Vaccination Coverage Monitoring Plan (2023 edition), a retrospective cohort study was conducted to systematically analyze the vaccination data of children born between 2017 and 2023 in the two regions (Changxing Town, n=3 749; Gengma Town, n=5 456). Chi-square tests were used to compare differences in vaccination rates, full-course rates, compliance rates, and timeliness rates.

Both regions achieved vaccination and compliance rates exceeding 90%. The full-course vaccination rate in Gengma Town (96.9%) was significantly higher than that in Changxing Town (94.2%, χ²=40.64, P<0.001). The impact of household registration type on full-course vaccination rates showed regional heterogeneity (Gengma Town OR=3.65; Changxing Town OR=1.89). The overall timeliness rate in Changxing Town was higher (92.5%-99.2%), but the timeliness rates for the first doses of measles and Japanese encephalitis vaccines among children born in 2018 and 2021 were significantly lower (P<0.001). In Gengma Town, delays in the primary immunization (DTaP1-3) and booster immunization (DTaP4) for diphtheria, tetanus, and pertussis were prominent among children aged 5-7. The timeliness rates for DTaP1-3 and DTaP4 among children born in 2018 were only 41.1% and 50.2%, respectively.

Significant spatial heterogeneity exists in the implementation of the NIP between the eastern and western regions.