Objective To understand the incidence and mortality trends of uterine cancer in tumor registration areas of Shandong Province from 2013 to 2021, and to provide a basis for the prevention and control of uterine cancer. Methods Data were obtained from the Shandong Cancer Surveillance Database. Crude incidence (mortality) rates and age-standardized rates were calculated using Excel 2010 and R 4.4.2. Joinpoint regression was used to calculate the average annual percentage change (AAPC). Results From 2013 to 2021, the crude incidence rate and the Chinese age-standardized incidence rate of uterine cancer among women in tumor registration areas of Shandong Province increased by 4.08% and 2.85% per year, respectively (crude incidence rate AAPC=4.08%, 95% CI: 2.25%-5.95%, P<0.001; Chinese age-standardized incidence rate AAPC=2.85%, 95% CI: 1.02%-4.72%; All P=0.002). Although there was a decrease in crude mortality rate and Chinese age-standardized mortality rate, the difference was not statistically significant (crude mortality rate AAPC=-1.33%, 95% CI: -4.28%-1.71%, P=0.389; Chinese age-standardized mortality rate AAPC=-2.53%, 95% CI: -5.86%-0.91%, P=0.165). The urban incidence rate and mortality were higher than those in rural areas(χ²=513.53, χ²=64.27, both P<0.01). Both the Chinese age-standardized incidence rate in urban areas and the crude incidence rate in rural areas showed upward trends, with annual increases of 3.05% and 3.90%, respectively. Conclusion From 2013 to 2021, uterine cancer among female residents in Shandong Province has shown an upward trend and is a malignant tumor that women should focus on preventing. Early diagnosis and treatment of high-risk groups for uterine cancer should be emphasized, and etiological exploration and research should be strengthened to provide reference for the prevention and treatment of uterine cancer.

Objective To analyze the awareness of nutritional health knowledge among school-age children in Sichuan Province, identify shortcomings and related issues of nutritional health knowledge, and provide a scientific basis for nutritional intervention policies. Methods From October 2023 to May 2024, a multi-stage sampling method was used to collect nutritional health knowledge questionnaires from 12 674 school-age children in 21 districts and counties of Sichuan Province through a questionnaire survey. Descriptive statistical analysis and multivariable analysis were conducted based on survey content. Results The nutritional health knowledge scores [median (interquartile range)] of school-age children in Sichuan Province (including lower elementary school students) in 2023—2024 were 73.00 (63.00-84.00). Scores for lower elementary, upper elementary, middle school, and high school groups were 90.00 (80.00-95.00), 72.00 (62.00-82.00), 69.00 (58.00-77.00), and 66.00 (57.00-74.00), respectively. The higher the grade level, the lower the score, and this was statistically significant. The score rate ranges for the five knowledge dimensions of dietary recommendations, food classification and characteristics, food and growth development and health, food selection, and food safety were 54.82%-81.66%, 60.31%-91.40%, 69.85%-89.50%,71.65%-86.20%, and 69.38%-84.07%, respectively. The lower elementary school grade group had the highest score in each knowledge dimension, and the senior high school group had the lowest score rate. The awareness rate (excluding lower elementary grades) was 32.98%, and the awareness rates for upper elementary school grades, middle school, and high school were 41.91%, 31.12%, and 23.34%, respectively. The higher the grade level, the lower the awareness rate, and this was statistically significant (χ²=249.432, P<0.001). Univariate analysis results showed that gender, grade level, region, whether living on campus, the educational level and occupation of the parents of school-age children had statistically significant differences in the awareness rate of nutritional health knowledge (P<0.05). Logistic regression analysis results showed that the grade level, region (urban or rural), whether living on campus, father’s education and occupation were important factors affecting the awareness level of nutritional health knowledge among school-age children in Sichuan Province. Conclusion There is significant room for improvement in the awareness rate of nutritional health knowledge among school-age children in Sichuan Province. To improve the nutritional health literacy of school-age children, it is necessary to further strengthen the publicity and education of nutritional health knowledge.

Objective To analyze the differences in chronic disease multimorbidity trajectories and influencing factors between middle-aged and elderly agricultural and non-agricultural production operators. Methods Data from five waves of the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020 were used. Group-based trajectory modeling (GBTM) was applied to fit multimorbidity trajectories for both groups, and multivariable logistic regression analysis was conducted to identify factors influencing the trajectory groups. Results A total of 9 937 participants were included, with 5 010 in the agricultural group and 4 927 in the non-agricultural group. In the agricultural group, the multimorbidity trajectories were classified into three patterns: no-multimorbidity (19.22%, 963 cases), new-onset multimorbidity (56.45%,2 828 cases), and progressive multimorbidity (24.33%, 1 219 cases). In the non-agricultural group, four patterns were identified: no-multimorbidity (18.06%, 890 cases), new-onset multimorbidity (41.10%, 2 025 cases), progressive multimorbidity (33.65%, 1 658 cases), and high-growth multimorbidity (7.18%, 354 cases). Increasing age, obesity, sleep duration ≤6 hours, and poor psychological status significantly increased the risk of multimorbidity in both groups (P<0.05). Among agricultural group, overweight (OR=1.37, 95% CI: 1.14-1.65; OR=2.49, 95% CI: 2.01-3.08) and obesity(OR=2.21, 95%CI: 1.59-3.06; OR=5.58, 95% CI: 3.93-7.92) significantly increased the risks of multimorbidity. In the non-agricultural group, higher education levels reduced the risk of new-onset multimorbidity(OR=0.75, 95% CI: 0.60-0.95), and moderate physical activity decreased the risk of high-growth multimorbidity(OR=0.68, 95% CI: 0.52-0.90). Smoking cessation was significantly associated with increased risks of multimorbidity (OR=1.55, 95% CI: 1.04-2.32; OR=2.37, 95% CI: 1.57-3.57; OR=4.02, 95%CI: 2.31-7.00). Conclusion In agricultural populations, the new-onset multimorbidity type is dominant, driven by obesity and insufficient sleep. In non-agricultural populations, the high-growth multimorbidity type is associated with poor psychological status and health deterioration after smoking cessation. It is necessary to strengthen weight and sleep management for agricultural populations and focus on mental health as well as post-cessation monitoring for non-agricultural populations to reduce the risk of multimorbidity.

Objective The aim is to explore the influence of age-friendly community environments on social adaptation of urban older adults, and to test the mediating role of social participation between the two, so as to provide a theoretical basis for optimizing age-friendly community environments and promoting healthy aging. Methods Based on CLASS 2020, 5 726 urban older adults aged 60 and above were selected as the study population, with age-friendly community environments as the explanatory variable, social adaptation as the outcome variable, and social participation as the mediating variable. The relationship between the variables was explored through Pearson correlation analysis, and the mediating effect was tested using Hayes’ Process plug-in. Results The mediating effect analysis showed that the age-friendly community environments had a direct effect (β=0.036, 95% CI: 0.005-0.068) on the social adaptation of urban older adults, accounting for 90.00% of the total effect. Social participation (β=0.004, 95% CI: 0.001-0.007), which accounted for 10.00% of the total effect, played a mediating role between the two. Conclusion Age-friendly community environments can improve the social adaptation of older adults through the path of social participation, suggesting that policymaking needs to focus on optimizing community environments and stimulating social participation of older adults in order to achieve the goals of healthy ageing and active ageing.

Objective To understand the economic burden of hospitalized cases of mycoplasma p neumonia (MPP) in Wuhan in 2023, and to provide a scientific basis for the formulation and improvement of public health prevention and control policies. Methods A questionnaire survey was conducted on the hospitalized cases of MPP in Wuhan from January to October 2023. Non-parametric tests were used to analyze the differences in direct, indirect, and total economic burden among different groups of patients due to MPP. Multivariable Logistic regression was used to analyze the related factors affecting economic burden. Results A total of 342 cases of hospitalized MPP were investigated. The total economic burden was higher in severe cases and those with symptoms of fever, cough, and headache (P<0.001). Seeking medical treatment at a tertiary general hospital in a remote urban area (OR=0.156, 95% CI: 0.032-0.764), being aged 19-59 years (OR=13.706, 95% CI: 4.697-39.999), being aged ≥60 years (OR=57.661, 95% CI: 13.283-250.315), hospitalization lasting more than 7 days (OR=3.244, 95% CI: 1.624-6.479), and caregivers missing work for more than 7 days (OR=8.323, 95% CI: 4.108-16.862) were identified as factors associated with the total economic burden (P<0.05). Conclusion Visiting a children’s specialized hospital, severe cases, having symptoms of fever, cough, and headache, increasing age, length of hospital stay, and days of caregiver’s lost work all bring heavier economic burdens to patients. Public health policy interventions such as strengthening clinical diagnosis and treatment, and improving the medical security system should be strengthened to reduce the economic burden on patients.

Objective The study aims to analyze the types and causes of multiple misalignment between supply and demand of health and wellness services in China, with a view to providing novel and operable theoretical perspectives and practical paths for solving the problem of misalignment between supply and demand and breaking through the bottlenecks of current health and wellness services. Methods A meta-ethnographic approach was adopted to analyse 16 original studies, to scientifically classify the types of multiple misalignment between supply and demand of health and wellness services in China, and to systematically deconstruct their causes with the help of the ROCCIPI technology framework. Results This study summarized the significant misalignment between supply and demand of health and wellness services in China in terms of quantity matching, quality satisfaction, structural rationality and information symmetry. Then, the root causes of the misalignment were analyzed from the seven core dimensions of rule-making and enforcement, opportunity grasping, capacity provision, information exchange, benefit distribution, process optimization, and awareness enhancement. Conclusion It is suggested to focus on five core dimensions, including collaborative participation of multiple stakeholders, dynamic requirements identification, efficient resource integration, integration of digital and intelligent technologies, and cultivation of professional talents, so as to promote the precise matching and sound development of supply and demand in health and wellness services.

Objective To analyze the fairness and impact mechanisms of the allocation of public health physician resources in China. Methods The fairness of public health physician resource allocation in 31 provinces across the country was set as the outcome variable, and 7 indicators were selected from the government, socio-economic and individual levels as conditional variables, and a fuzzy set qualitative comparative analysis (fsQCA) was performed. Results There were large differences in the allocation of public health physician resources in 31 provinces in China. Single factors cannot constitute a necessary condition to affect the fair allocation of public health physician resources. There were 10 paths that affect the fair allocation of public health physician resources, of which 2 paths had high fairness configurations, with an overall consistency of 0.97 and an overall coverage of 0.61. There were 8 paths in low fairness configurations, with an overall consistency of 0.96 and an overall coverage of 0.83. Conclusion Population aggregation is the basic premise for determining the fair allocation of public health physician resources. Financial support and residents’ income are key guarantees to support the fair allocation of public health physician resources. Medical insurance and basic public health service subsidies are complementary support for promoting the fair allocation of public health physician resources. Multi-factor coupling is a systematic mechanism for realizing the fair allocation of public health physician resources.

Objective This study aims to explore the relationship between socioeconomic status (SES) and intrinsic capacity (IC) in older adults, as well as the mediating role of healthy lifestyle. Methods Based on data from the Hubei Memory and Aging Cohort Study (HMACS), SES was assessed based on education, occupation, and income, and then categorized into high, medium, and low groups. Healthy lifestyle score (0-6 points) was constructed based on smoking, drinking, diet, social activities, physical exercise, and intellectual leisure activities. IC was assessed according to the indicators recommended by the WHO (2015). Group differences were compared using χ² tests or variance analysis. We performed a multivariable logistic regression analysis to assess the association between SES and IC impairment, and general linear regression models were used to analyze the association between SES and IC. A mediation model was employed to assess the mediating effect of healthy lifestyles on the association between SES and IC, with comparisons across sex and SES groups. Results A total of 5 628 eligible participants aged ≥60 years were included. Older adults with high SES had significantly higher healthy lifestyle scores than those with low SES (P<0.05). The IC impairment in the middle and low SES groups was 1.507 times (95% CI: 1.289-1.762) and 6.476 times (95% CI: 5.051-8.304) than that of the high SES group, respectively, both with P<0.001. SES and IC were significantly positively correlated (β=0.530, 95% CI: 0.505-0.555, P<0.001), with the strongest association in the low SES group (β=1.004,95% CI: 0.773-1.234, P<0.001). Healthy lifestyle partially mediated the relationship between SES and IC, with a mediation effect of 9.25%. The mediation effects were 8.32% in males and 10.19% in females. The mediation effect was significant only in the medium SES group (15.03%), with no significant mediation observed in the low or high SES groups. Conclusion In older adults, SES and IC are significantly positively correlated. SES is associated with IC both directly and indirectly through a healthy lifestyle, with mediating effects varying by sex and SES. Therefore, health promotion measures for older adults should fully consider sex and SES differences, emphasize the improvement of healthy lifestyles, enhance IC in older adults, and promote healthy aging.

Objective To investigate the effect of aerobic exercise on blood pressure in patients with resistant hypertension through meta-analysis, aiming to identify more effective intervention strategies and provide reference for the control and treatment of resistant hypertension. Methods A systematic search was performed in CBM, CNKI, WANFANG, VIP, PubMed, OVID,Embase, and Web of Science for randomized controlled trials (RCTs) published in Chinese or English from inception to March 25, 2025. Two researchers independently conducted study selection and data extraction. Risk of bias was assessed using RoB 2,and statistical analyses were performed with RevMan 5.4. Results A total of 10 studies were included, comprising 532 cases.Meta-analysis showed that aerobic exercise significantly reduced systolic blood pressure (SBP) (SMD=0.77, 95% CI: 0.57-0.96, P<0.000 01), diastolic blood pressure (DBP) (SMD=0.83, 95% CI: 0.63-1.02, P<0.000 01), 24-hour SBP (SMD=0.48,95% CI: 0.23-0.73, P=0.000 2), and 24-hour DBP (SMD=0.43, 95% CI: 0.17-0.68, P=0.000 9). Subgroup analyses indicated greater SBP reductions among participants aged≤60 years, with BMI≤28 kg/m², exercise intensity >60% VO_2max, and intervention>12 weeks. DBP improvements were more evident in subgroups with age≤60 years, BMI≤28 kg/m², intensity ≤60% VO_2max, and duration >12 weeks. For 24-hour SBP, larger effects were found in subgroups with age>60 years, BMI≤28 kg/m², intensity≤60%VO_2max, and duration >12 weeks. In contrast, greater 24-hour DBP reductions occurred in participants aged≤60 years, with BMI≤28 kg/m², intensity >60% VO_2max, and duration≤12 weeks. Conclusion Aerobic exercise has a positive effect on reducing blood pressure in patients with resistant hypertension. Differences in participant characteristics and intervention protocols may affect the extent of this effect. The current relevant studies are limited in number and most have some risk of bias. However, the limited quantity and quality of existing studies highlight the need for further high-quality research to confirm and extend these findings.

Objective To accurately evaluate the influencing factors and urban-rural differences in the well-being among the elderly in Guizhou Province, so as to provide scientific basis and practical strategies for enhancing the well-being of the elderly. Methods Using stratified and convenience sampling methods, 1 500 elderly aged 60 and above who met the survey requirements were selected from six prefectures in Guizhou Province. The well-being of Older People Scale (WOOP) was applied for questionnaire surveys. Combined with the random forest model and the ordered logistic regression analysis, the importance evaluation and the urban-rural differences of the influencing factors on the well-being of the elderly in Guizhou Province were analyzed. Results The overall well-being level of the elderly in Guizhou Province was relatively high, and that in urban areas was slightly higher than that in rural areas. The mean value of subjective well-being among urban elderly was 4.21±0.65, while that of rural elderly was 4.11±0.75. The results of the random forest model and the ordered logistic regression analysis showed that physical health, mental health, social life, receiving support, acceptance and resilience, feeling useful, independence, and making ends meet were important influencing factors for the well-being of the elderly. The regression coefficient values of these factors all showed significance at the 0.001 level. Among them, the making ends meet (with a weight value of 0.231) was the core driving factor for the well-being of rural elderly. Meanwhile, mental health (with a weight value of 0.136) and physical health (with a weight value of 0.122) were the core driving factors for the well-being of urban elderly.Living situation (β=0.880, z=6.751, P<0.001) had a significant impact on the well-being of urban elderly but has no significant impact on that of rural elderly. Conclusion There are significant urban-rural differences in the influencing factors of the well-being of elderly in Guizhou Province. To enhance the well-being of elderly, it is necessary to start from multiple dimensions and implement precise policies. In rural areas, priority should be given to increasing the income of rural elderly. While in urban areas, efforts should be focused on optimizing the living situation of the elderly and building a comprehensive and multi-level medical and elderly care service support system.