To analyze the comprehensive efficiency and total factor productivity changes of county-level medical and health sub-centers (referred to as “sub-centers”) in Sichuan Province, providing valuable references for the continuous advancement of sub-center construction and the healthy development of grassroots medical and health systems nationwide.

A total of 302 sub-centers in Sichuan Province were selected as the research subjects, and the DEA-Malmquist index model was employed to measure and evaluate their static and dynamic efficiencies.

Using 21 cities and prefectures as decision-making units, the comprehensive efficiency of the sub-centers was 0.884, with 12 cities and prefectures experiencing increasing returns to scale and 9 achieving optimal operational efficiency. Analyzing the time series of the 302 sub-centers as decision-making units, the total factor productivity of the sub-centers increased by 1.4%; regionally, total factor productivity rose in 16 cities and prefectures.

The construction of sub-centers in Sichuan Province has been a successful pilot project, with overall operational efficiency being relatively good. However, significant regional development disparities and insufficient technological advancement persist. The government and relevant departments should continue to strengthen policy guidance, develop scientific and reasonable planning, focus on solidifying the grassroots talent base, and enhance information technology infrastructure to empower the vitality of sub-center healthcare.

To provide a new perspective for exploring the influencing factors of depression symptoms in individuals aged 45 and older in China, helping reveal the complex relationships among potential influencing factors.

Using data from the China Health and Retirement Longitudinal Study (CHARLS) 2018, independent variables were determined based on the five dimensions of the health ecological model. A total of 8 485 individuals aged 45 and older were included. The LASSO algorithm was employed for variable selection, and the Apriorism algorithm from association rules was utilized to mine the causal association rules of depression symptoms among the elderly in China from multiple dimensions.

The detection rate of depression symptoms among middle-aged and elderly individuals in China was 38.42%. The variables selected by LASSO regression included gender from the personal traits layer, self-rated health, life satisfaction, disability, number of chronic diseases, visual impairment, hearing impairment, and nighttime sleep duration from the behavioral traits layer, as well as household registration type and education level from the living and working conditions layer. The Apriorism algorithm identified 21 strong association rules, with the highest support of 20.71%, maximum confidence of 68.40%, and the highest lift of 1.78. Key association factors for depression symptoms among the elderly included living in rural areas, having two or more chronic diseases, nighttime sleep duration of less than 6 hours, being female, having a disability, poor self-rated health, and being relatively satisfied with life, with primary school education. Compared to those with excessive nighttime sleep duration, individuals with insufficient nighttime sleep duration exhibited a higher risk of depression symptoms. The factor of rural residence was highly correlated with nighttime sleep duration of less than 6 hours and having two or more chronic diseases.

This study suggests considering depression issues from three dimensions: personal traits, behavioral traits, and living and working conditions, emphasizing the need to pay special attention to rural populations and patients with comorbid chronic diseases during depression symptom screening.

To explore the relationship between depression and angina pectoris, as well as the mortality risk associated with their comorbidity, providing references for the treatment and prognostic management of angina pectoris patients.

Based on the National Health and Nutrition Examination Survey (NHANES) database from 2009 to 2018, data from 11 232 individuals aged 40 and older were analyzed using logistic regression and restricted cubic spline models to investigate the relationship between depression and angina pectoris. Survival curves (Kaplan-Meier) and Cox regression models were employed to examine the differences in mortality risk among four groups.

Logistic regression analysis revealed statistically significant risks of angina pectoris across various depression groups (mild depression group OR=1.78, 95%CI: 1.48-2.20; moderate depression group OR=3.40, 95%CI: 2.62-4.42; severe depression group OR=5.16, 95%CI: 3.94-6.77), indicating that higher levels of depression correlate with greater risk of angina pectoris (W=151.93, P<0.001), suggesting that depression was a risk factor for angina pectoris. In the overall population, the dose-response relationship between the two exhibited a gradually decreasing slope, indicating an increasing trend in angina pectoris risk with worsening depression. The Kaplan-Meier curves and Cox regression models demonstrated that the mortality risk in the comorbid depression and angina pectoris group was higher than that in the depression-only and angina pectoris-only groups, even after adjusting for all potential confounding factors (HR=2.35, 95%CI: 1.77-3.12).

There is a significant correlation between depression and angina pectoris, with the mortality risk in the comorbid depression and angina pectoris group being higher than in either the depression-only or angina pectoris-only groups. Future treatment of angina pectoris should also emphasize the assessment, prevention, and treatment of depression to improve long-term patient outcomes.

To investigate the levels of formaldehyde, benzene, toluene, xylene, and ammonia in the air of hotels, barbershops, beauty salons, and gyms in Shijiazhuang city, and to assess the carcinogenic and chronic non-carcinogenic risks associated with these chemical pollutants in the air of the four types of public venues.

From 2019 to 2023, air samples were collected from operational barbershops, beauty salons, hotels, and gyms in Shijiazhuang to monitor the levels of formaldehyde, benzene, and ammonia. The assessment of inhalation exposure to chemical pollutants was conducted using the health risk assessment methods established by the U.S. Environmental Protection Agency (EPA) to evaluate the carcinogenic and chronic non-carcinogenic risks for workers.

The exceedance rates of formaldehyde in the air of the four public venues were 10.49%, 4.65%, 8%, and 3.13%, respectively, while the exceedance rates of ammonia in beauty salons and barbershops were 5.81% and 2%, respectively. The carcinogenic risk of formaldehyde in all four types of public venues exceeded 10^-6, with the 75^th percentile carcinogenic risk value for formaldehyde in beauty salons exceeding 10^-4. For benzene, half of the carcinogenic risk values in hotels, barbershops, and gyms fell within the range of 10^-6 to 10^-4, with a higher proportion of benzene carcinogenic risks in beauty salons also within this range. The hazard quotients for formaldehyde in all four public venues were greater than 1, with the 25^th percentile hazard quotient for formaldehyde in beauty salons exceeding

There are significant carcinogenic and chronic non-carcinogenic risks associated with formaldehyde in the air of the four types of public venues in Shijiazhuang city, with beauty salons exhibiting higher risks. The elevated carcinogenic risk of benzene in beauty salons warrants attention.

To investigate the correlation between the comorbidity of chronic diseases and concurrent depression symptoms with increased disability risk among older adults in China.

Utilizing data from the 2020 China Health and Retirement Longitudinal Study (CHARLS), we analyzed health-related data, including basic information, chronic diseases, depression symptoms, and disability among individuals aged 60 and above. A chi-square test χ² was employed for preliminary analysis of the association between various factors and disability risk, followed by calibration of a binary logistic regression model. The odds ratios (OR) were estimated to reflect the increased disability risk of respondents with comorbidity and depression symptoms compared to other respondents.

A total of 8 762 respondents were included, with a balanced gender distribution and an average age of 68.10 years. Among the respondents, 41.35% exhibited depression symptoms, and 15.10% had comorbid conditions, with a comorbidity and depression symptom co-occurrence rate of 8.38%. The results indicated that respondents with comorbidity and depression symptoms had a 550% (OR=6.50, 95%CI: 4.98-8.47) increased risk of impairment in Basic Activities of Daily Living (BADL) and a 389% (OR=4.89, 95%CI: 4.07-5.87) increased risk of impairment in Instrumental Activities of Daily Living (IADL), along with a significant increase in the risk of impairment in Activities of Daily Living(ADL) (OR=4.98, 95%CI: 4.16-5.96).

There is a significant correlation between the comorbidity of chronic diseases and concurrent depression symptoms with increased disability risk among older adults in China. This poses a serious threat to the health and quality of life of the elderly, highlighting the need for early screening and intervention, as well as enhanced health education and psychological support to effectively reduce disability risk.

To understand the epidemiological characteristics and pathogen spectrum changes of severe hand, foot, and mouth disease (HFMD) in Jiangxi Province, and to grasp the trend changes in different time periods and populations, providing a scientific basis for the formulation and optimization of HFMD epidemic prevention and control strategies.

A descriptive analysis of the monitoring data of severe HFMD in Jiangxi Province from 2008 to 2023 was conducted, and the Join point regression model was used to analyze the characteristics and trend changes in incidence by year and gender.

From 2008 to 2023, a total of 2 281 severe cases were reported in Jiangxi Province, with laboratory-confirmed cases accounting for 73.26%. The proportion of severe cases decreased from 17.12‰ in 2010 to 0.15‰ in 2023 (APC = -34.74%). The peak incidence occurred from April to July, with a male-to-female ratio of 2.13:1, primarily affecting children under three years old(86.45%). The overall trend in the proportion of severe cases among males and females was consistent, with both showing a year-on-year decline from 2010 to 2023; however, the average annual reduction was greater in females (37.86%) than in males(32.84%). EV-A71 was the dominant strain among laboratory-confirmed cases (79.89%), but the proportion of other enteroviruses significantly increased.

Since 2010, the incidence of severe HFMD in Jiangxi Province has shown a year-on-year declining trend. EV-A71 remains the dominant pathogen, but it has not been detected since 2017; thus, there is a need to strengthen genetic typing of other enteroviruses in severe cases. Children under three years old are the key target for intervention, and targeted measures should be implemented to reduce the risk of infection in this population.

To investigate whether C-reactive protein (CRP) can modulate the relationship between obesity phenotypes and stroke risk in middle-aged and elderly individuals through a cohort study.

Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS), participants from the baseline survey in 2011 and follow-ups in 2013, 2015, and 2018 were selected. Based on the participants’ weight status (overweight/obese) and metabolic abnormalities, they were categorized into four obesity phenotypes: Metabolically Healthy Normal Weight (MHNO), Metabolically Healthy Overweight/Obese (MHO), Metabolically Unhealthy Normal Weight (MANO), and Metabolically Unhealthy Overweight/Obese(MAO). Additionally, participants were grouped into three categories based on CRP quartiles. The Cox proportional hazards regression model was employed to analyze the relationship between obesity phenotypes, CRP, and stroke, incorporating interaction terms between obesity phenotypes and CRP in the regression model. Finally, stratified analyses were conducted to explore whether CRP modulates the relationship between obesity phenotypes and stroke.

Totally 6 868 participants were included in this study, with 421 (6.13%) experiencing a stroke during the 7-year follow-up period. The Cox proportional hazards regression model indicated that, compared to the MHNO group, the risk of stroke increased by 66%, 85%, and 151% for the MHO, MANO, and MAO groups, respectively, with hazard ratios (HR) and 95% confidence intervals (CI) of 1.66 (1.15-2.38), 1.85 (1.39-2.46), and 2.51 (1.92-3.29), respectively. Furthermore, stratified analysis revealed that in the CRP T1 group, the MHO and MANO groups did not show an increased risk of stroke compared to the MHNO group (P > 0.05). In the CRP T2 group, the risk of stroke for the MHO and MANO groups increased by 111% and 127%, with HR and 95%CI of 2.11 (1.11-4.02) and 2.27 (1.29-3.98), respectively. Similarly, in the CRP T3 group, the risks for the MHO and MANO groups increased by 93% and 89%, with HR and 95%CI of 1.93 (1.06-3.50) and 1.89 (1.17-3.05), respectively.

CRP can modulate the relationship between obesity phenotypes and stroke in middle-aged and elderly individuals.

To analyze whether there is a potential causal association between inflammatory cytokines and various tendinopathies, including Achilles tendonitis, bicipital tendinitis, calcific tendinitis of the shoulder, gluteal tendinitis, and patellar tendinitis.

In this study, single nucleotide polymorphisms from the data of a large-scale genome-wide association study were selected as instrumental variables, and bidirectional Mendelian randomization as well as multivariate Mendelian randomization, were used to investigate the causal effects of inflammatory cytokines and the risk of developing Achilles tendonitis, Bicipital tendinitis, Calcific tendinitis of shoulder, Gluteal tendinitis and Patellar tendinitis.

In forward Mendelian analyses, monocyte chemotactic protein-3（OR=0.896,95% CI:0.806-0.995） and vascular endothelial growth factor（OR=0.917,95% CI:0.845-0.995） were potential protective factors for Achilles tendonitis, and monokine induced by interferon-γ（OR=1.158,95% CI:1.029-1.302） was a potential risk factor for Achilles tendonitis. Monocyte chemotactic protein-3（OR=1.214,95% CI:1.034-1.426）was a potential risk factor for Bicipital tendinitis, while hepatocyte growth factor （OR=0.661,95% CI:0.489-0.893） as a potential protective factor for Bicipital tendinitis. Hepatocyte growth factor （OR=0.730,95% CI:0.557-0.957）was a potential protective factor for Calcific tendinitis of shoulder. Interleukin-13 （OR=0.828,95% CI:0.714-0.960） was a potential protective factor for Gluteal tendinitis. Interleukin-8 （OR=0.649,95% CI:0.444-0.949） as a Patellar tendinitis potential protective factor and tumor necrosis factor-α （OR=1.707,95% CI:1.085-2.685）was a potential risk factor for Patellar tendinitis. In multivariate Mendelian analysis, hepatocyte growth factor（OR=0.687,95% CI:0.511-0.924） remained a protective factor for Bicipital tendinitis. Sensitivity analyses showed that the main analyses were robust without outliers, with no significant outliers, heterogeneity, or horizontal pleiotropy.

The study suggests a potential causal relationship between inflammatory cytokines and the five tendon diseases investigated.

To understand the molecular epidemiological characteristics of multi-drug-resistant (MDR) Salmonella clinical isolates in Guizhou Province and clarify the carrying of β-lactamase resistance genes to provide a reference basis for the prevention and treatment of MDR Salmonella in Guizhou province.

A total of 70 MDR Salmonella were used for the study, antibiotic susceptibility analyses of Salmonella were carried out using the micro broth dilution method, molecular epidemiological analyses were carried out using the method of multilocus sequence typing (MLST). Polymerase Chain Reaction was used to detect the β-lactamase resistance genes in the MDR Salmonella strains.

The 70 MDR Salmonella strains in Guizhou province were predominantly resistant to antibiotics of 4-5 classes at the same time, accounting for 64.3% of the total, even 4.3% of the strains showed extensive drug-resistance. The 70 MDR Salmonella strains contained 15 sequence types, belonging to 13 eBurst groups, with ST34, ST11, and ST19 being the most common ST types. The most ST type in Tongren City, and unique ST type appeared in some cities, with different dominant ST type with different resistance profiles. The detection of β-lactamase gene showed that 80.0% of the strains carried at least one of β-lactam-resistant genes, with the most common one being bla_TEM (78.6%). The bla_CTX-M gene was detected in 2.9% strains, and the resistant genes subtypes were bla_CTX-M-55 and bla_CTX-M-64. The bla_SHV, bla_OXA-2, and bla_PER genes were not detected.

The MDR Salmonella ST34, ST11 and ST19 as common sequence types in Guizhou province, and there was a certain degree of homology among MDR Salmonella in different regions, and that these strains may have been transmitted in different regions. The β-lactam antibiotics was mainly mediated by bla_TEM.

To grasp the current situation and trends of occupational hazards in workplaces of key industries in Ji’an City, and provide a basis for improving the prevention and control of occupational diseases.

The data of occupational hazards in the workplaces of key industries in Ji’an City from 2021 to 2023 were collected from the Workplace Occupational Hazard Monitoring System, and the monitoring results were summarized and analyzed.

A total of 654 enterprises from key industries were recruited as the monitoring subjects in Ji’an City from 2021 to 2023, which were mainly small and micro-scale(94.34%) and manufacturing (74.92%) industries. The exposure ratio of occupational hazards among employees was 55.35%, and the exposure ratio of noise hazard was the highest(47.44%), the second was dust hazard (44.12%). The rates of occupational health training for enterprise leaders, occupational health management personnel, and workers were 72.78%, 72.78% and 83.74%, respectively, which were all increasing gradually year by year (χ²=15.808, 17.649, 398.746, respectively, all P<0.05). The distribution rates of dust masks, anti-poisoning masks or face masks, and noise prevention earplugs or earmuffs were 90.39%, 61.33% and 66.31%, respectively. The distribution rates of dust masks and noise prevention earplugs or earmuffs showed an increasing trend year by year (χ²=24.010, 21.100, respectively, all P<0.05). The rates of installation of dust prevention facilities, anti-poisoning facilities and noise prevention facilities were 88.99%, 76.00% and 54.67%, respectively, which were all increasing year by year (χ²=14.625, 9.818, 34.993, respectively, all P<0.05). There were 437 enterprises exceeded the standard, with an exceeding rate of 66.82%. From 2021 to 2023, the exceeding standard rates of post testing were 40.92%, 24.41%, 24.17%, respectively, which showed a decrease trend year by year (χ²=78.647, P<0.05), and increased with the decrease of enterprise size (χ²=10.093, P<0.05). Among the different kinds of occupational hazard factors, the exceeding rate of noise posts was the highest, the exceeding rates of dust posts and chemical agents’ posts showed a decrease trend year by year (χ²=72.219, 31.342, respectively, all P<0.05).

In recent years, the status of occupational disease hazards in key industries in Ji’an City has been improved, but the situation is still very serious. It is necessary to further strengthen and improve the prevention and control of occupational diseases to protect the occupational health rights and interests of workers.