To classify the general self-efficacy of patients with chronic comorbidities by using latent class analysis, thereby to analyze the influencing factors which affect the general self-efficacy of middle-aged and elderly patients with chronic disease comorbidities based on the results of category analysis, and to provide references for improving the mental health in the multi-dimensional health of the elderly in China and realizing “healthy aging”.

Based on the Ningxia Natural Science Foundation project in 2023, a multi-level stratified random sampling method was adopted to screen out 967 comorbidity patients. Latent class analysis and logistic regression analysis were used to explore the current situation and influencing factors of the general self-efficacy of patients with chronic comorbidities in Ningxia.

Among the 967 study subjects, the diseases with the highest prevalence rates among patients with comorbidities were hypertension, musculoskeletal disorders, and diabetes. The latent class analysis revealed that 402 individuals had low general self-efficacy, 161 had high general self-efficacy, and 403 had moderate general self-efficacy.The C2 “High Self-Efficacy Group” consisted of individuals aged 45 to 59 years (with OR values and 95% CI intervals being 0.374, 0.188; 0.208-0.671; 0.085-0.418), had lower educational levels (with OR values and 95% CI intervals being 0.192, 0.157; 0.041-0.893; 0.011-0.297), and those who received some financial support from their children (with OR values and 95% CI intervals being 0.491, 0.340; 0.328-0.736; 0.209-0.553) generally had lower general self-efficacy (all OR values <1). Among the middle-aged and elderly with two chronic diseases in their comorbidity status, those from C2 “High Self-Efficacy Group” had higher general self-efficacy (with OR values being 6.709, 3.303, both >1, and 95% CI intervals being 4.397-10.138; 2.468-4.421). In addition to the above factors, middle-aged and elderly living in rural areas (with an OR value of 0.616 and a 95% CI range of 0.402-0.944) in C1 “Moderate Self-Efficacy Group” generally had lower general self-efficacy, while those who occasionally Participated in activities from C2 “High Self-Efficacy Group” generally had lower general self-efficacy (with an OR value of 0.377 and a 95% CI range of 0.191-0.744).

In Ningxia, there are more middle-aged and elderly with moderate to low general self-efficacy. Age, educational level, residence,Participation in activities, financial support from children, and comorbidity status all affect the general self-efficacy of middle-aged and elderly in Ningxia. It is recommended to improve the elderly health service system in rural areas, establish elderly activity centers, encourage older people to Participate in more activities, form good exercise habits, and focus on rural Patients with lower educational levels. A series of health activities should be carried out in combination with the characteristics of comorbidities such as hypertension, arthritis, diabetes, etc., to helppatients manage with a positive attitude.

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.

To analyse the association between high blood pressure and dietary behaviors among children and adolescents aged 9 to 17 years in Inner Mongolia, and to develop targeted preventive measures for high blood pressure among children and adolescents in Inner Mongolia.

The data were obtained from the National Monitoring and Intervention Work Program for Common Diseases and Health Influencing Factors in Students, and a total of 129 821 primary and secondary school students were included in the stratified random cluster sampling method in September each year. The χ² test was used for the analysis of single factors, and binary logistic regression was used for multifactorial analyses, and risk prediction of high blood pressure was performed by column-line plots.

In Inner Mongolia, the overall high blood pressure of children and adolescents aged 9-17 years was 16.23%, with simple systolic blood pressure increase as the main cause. By gender, the overall high blood pressure rates of boys and girls were 15.42% and 17.05%, respectively, and the difference was statistically significant (χ²=63.38, P<0.001); the overall high blood pressure rates of primary schools, junior high school, and high school were 14.95%, 16.89%, and 17.77%, respectively, according to the school segments. The difference was statistically significant (χ²=124.95, P<0.001). Logistic regression model analysis showed that the risk of high blood pressure was higher in female students than in male students (OR=1.13, 95% CI:1.10-1.17), and the risk of high blood pressure was higher in junior high school and high school students than in primary school students [OR=1.14(95% CI:1.10-1.18), 1.18(95% CI:1.13-1.23), respectively], the risk of high blood pressure was lower for students in flag counties than for students in urban areas (OR=0.89,95% CI:0.86-0.92), and the rate of high blood pressure was lower for Mongolian and other students than for Han Chinese students [OR=0.96(95% CI:0.92-0.99), and 0.93(95% CI:0.87-0.99)], the risk of high BP was lower for those who ate fried food ≤1 time per week than for those who ate it ≥2 times per week (OR=0.86,95% CI:0.77-0.97), the risk of high BP was lower for those who ate chocolate ≤1 time per week than for those who ate it ≥2 times per week (OR=0.94,95% CI:0.91-0.97), and the risk of high BP was lower for those who ate butter ≤1 time per week had a lower risk of high blood pressure than students who ate it ≥2 times per week (OR=0.95,95% CI:0.92-0.98), ate pastry ≤1 time per week had a lower risk of high blood pressure than students who ate it ≥2 times per week (OR=0.93,95% CI:0.90-0.96), and drank soya milk ≤1 time per week had a higher risk of high blood pressure than students who drank it ≥2 times per week (OR=1.13,95% CI:1.03-1.24), and students who ate breakfast every day had a higher risk of high blood pressure than those who ate it sometimes or never [OR=1.15(95% CI:1.11-1.19),1.23(95% CI:1.15-1.31), respectively].

Dietary behaviour is closely associated with high blood pressure in children and adolescents, and this aspect should be actively addressed in future preventive measures.

To analyze the changing trends of urolithiasis burden among Chinese young and middle-aged adults from 1990 to 2021 and predict disease burden from 2022 to 2030, providing evidence for public health strategies and healthcare resource allocation.

Utilizing the Global Burden of Disease 2021 database, we calculated incidence and disability-adjusted life years (DALYs) for urolithiasis in Chinese adults aged 20-54. Joinpoint regression identified temporal trends and turning points. Age-period-cohort modeling decomposed age, period, and cohort effects on incidence. Autoregressive integrated moving average (ARIMA) models projected future disease burden.

From 1990 to 2021, urolithiasis cases increased from 9.566 million to 10.197 million (EAPC=0.20%), while age-standardized incidence declined (EAPC= -0.39%). DALYs decreased from 58 700 to 42 200 person-years (EAPC= -1.06%), with DALY rate declining (EAPC= -1.67%). Males consistently exhibited higher standardized incidence and DALY rates. Age-period-cohort analysis showed a linear rise in incidence risk with age, with relative risks (RR) from 0.279 to 2.331. The period effect had a “rising-declining” fluctuation (RR 0.937-1.080). The cohort effect decreased steadily as birth year advanced, with RR values from 0.835 to 1.607. Projections suggest cases will reach 10.396 4 million by 2030, yet standardized incidence and DALY metrics will maintain downward trajectories.

Despite decreasing standardized disease burden and persistent gender disparities since 1990, urolithiasis demonstrates age-progressive risks, period-specific fluctuations, and cohort-driven mitigation. Predicted high absolute burden underscores the urgency for targeted prevention strategies to address this persistent public health challenge.

To analyze and compare the characteristics of comorbidity patterns in skeletal fluorosis patients across different endemic regions, laying the foundation for further research on influencing factors, while providing references for healthcare systems to develop more targeted, effective, and cost-efficient chronic disease management plans for this special population.

This study adopted a cross-sectional design, selecting patients over 40 years old with skeletal fluorosis from Nayong County, Guizhou Province (a coal-burning fluorosis endemic area), Jishan County, Shanxi Province (a water-drinking fluorosis endemic area), and Ruoergai County, Sichuan Province (a tea-drinking fluorosis endemic area) as research subjects. The Apriori algorithm was used to analyze the dataset, and indicators such as the minimum conditional support were set to derive disease association rules. Additionally, Yule’s Q method was applied for systematic cluster analysis, and a dendrogram was drawn to explore the comorbidity patterns of chronic diseases in the elderly.

In the coal-burning type disease area, patients aged over 70 accounted for the highest proportion (43.55%), and the prevalence rates of chronic kidney disease (12.61%), hypertension (33.24%), and cholelithiasis/cholecystosis (11.89%) were higher than those in the drinking-water type and tea-drinking type disease areas. The tea-drinking type disease area was dominated by individuals aged 50-60 years (38.57%), with the highest prevalence of other bone diseases (68.93%). The drinking-water type disease area had the largest proportion of patients aged 60-70 years (43.04%).Comorbidity analysis showed that the coal-burning type disease area had the highest comorbidity rate (43.98%). In terms of comorbidity patterns, the most typical combination of two concurrent diseases was diabetes-coronary heart disease, while the combination of three concurrent diseases was mainly diabetes-coronary heart disease-hypertension. The tea-drinking type disease area had a comorbidity rate of 34.29%, with the main two-disease comorbidity pattern being coronary heart disease-cholelithiasis/cholecystosis, and the three-disease comorbidity pattern adding other bone diseases to the above combination. The drinking-water type disease area had the lowest comorbidity rate (21.43%), with the main two-disease comorbidity being cholelithiasis/cholecystosis-stroke, and the three-disease comorbidity pattern being stroke combined with diabetes and hypertension.Cluster analysis independently showed that the coal-burning type disease area could be clustered into 6 categories (dominated by metabolic cardiovascular diseases), the tea-drinking type disease area into 4 categories (highlighting metabolic skeletal diseases), and the drinking-water type disease area into 5 categories (characterized by multi-system metabolic inflammatory diseases).

There are significant differences in the comorbidity patterns of skeletal fluorosis patients among coal-burning, tea-drinking, and water-drinking fluorosis endemic areas. The coal-burning endemic area is dominated by metabolic and cardiovascular diseases such as diabetes, coronary heart disease, and hypertension. In the tea-drinking endemic area, there is a significant association between coronary heart disease and gallstones/gallbladder cysts, as well as a comorbidity pattern of diabetes and pulmonary tuberculosis. The water-drinking endemic area is characterized by the association between gallstones/gallbladder cysts and stroke; meanwhile, the combination of kidney disease and metabolic diseases highlights multisystem damage.

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 current situation of job burnout among family doctors in primary medical and health institutions in Sichuan Province and its influencing factors.

From July to September 2024, through the stratified random cluster sampling method, 588 family doctors from 15 primary medical and health institutions in 5 counties (cities and districts) in Sichuan Province were selected as the survey subjects. The basic information and job burnout of family doctors were investigated by using maslach burnout inventory human service survey.The χ² test or Fisher’s exact probability method was used to analyze the detection rates of job burnout amongfamily doctors with different characteristics, and the influencing factors of job burnout among family doctors were analyzed by using binary logistic regression.

The M-values of the scores of the three dimensions of emotional exhaustion, emotional alienation and personal achievement among family doctors in primary medical and health institutions in Sichuan Province were 25 points, 8 points and 41 points respectively. Job burnout was detected in 430 family doctors, with a detection rate of 73.13%.The detection rates of mild, moderate and severe were 34.69% (204 doctors), 35.88% (211 doctors) and 2.55% (15 doctors), respectively. Binary logistic regression analysis showed that compared with those aged 20-29, family doctors aged 40-49(OR=0.312,95% CI:0.178-0.548) and 50-59(OR=0.473,95% CI:0.242-0.926) had a lower risk of job burnout. Compared with those with contracted service numbers ≤2 000, family doctors with contracted service numbers ≥5 001 had a higher risk of job burnout(OR=2.345, 95% CI: 1.276-4.308). Frequent overtime work was a risk factor for job burnout in family doctors(OR=1.587, 95% CI: 1.042-2.418).Family doctors with an average annual total income of more than 50 001 yuan had a lower probability of being detected job burnout than those with an average annual total income of no more than 50 000 yuan (OR=0.558,95% CI:0.370-0.842).

The current situation of job burnout among family doctors in primary medical and health institutions in Sichuan Province is not optimistic. Effective measures should be taken from multiple dimensions to alleviate the job burnout of family doctors, and continuous dynamic monitoring should be carried out at the same time.

To analyze the contamination status of Listeria monocytogenes in the production and distribution stages of enoki mushrooms in Chengdu.

A total of 180 samples were collected from two major enoki mushroom manufacturers in Chengdu, including enoki mushrooms (30 samples), culture media (14 samples), environmental samples (25 samples), tools and equipment (64 samples), operators (30 samples), and other samples (17 samples). L.monocytogenes was isolated and identified according to the 2024 National Manual for Monitoring Food Contaminants and Harmful Factors. Whole-genome sequencing (WGS) was conducted on the isolates to predict serotypes and analyze lineages, sequence types (ST), clonal complexes (CC), antimicrobial resistance genes, and virulence genes. Homology among strains was determined based on core genome multilocus sequence typing (cgMLST) genetic characteristics.

A total of 69 L.monocytogenes strains were detected from 180 samples, with an overall detection rate of 38.33%. The strains belonged to two lineages (I and II), with lineage II being predominant (97.10%, 67/69). Three serotypes were identified, among which serotype 1/2a,3a was dominant (94.20%, 65/69). Seven CC types were detected, with CC8 (52.17%, 36/69) and CC155 (30.43%, 21/69) being dominant. Eight ST types were identified, among which ST8 (52.17%, 36/69) and ST155 (30.43%, 21/69) were the predominant types. All strains carried only the antimicrobial resistance gene fosX. All 69 strains carried virulence island 1 (LIPI-1), and six virulence genes (prfA, plcA, hly, mpl, actA, and plcB) were all positive. All 69 strains also carried virulence island 2 (LIPI-2); among the nine virulence genes, inlA, inlB, inlC, and inlJ were positive in all strains; inlE, inlG, and inlH were all negative; and the carriage rates of inlF and inlK were both 97.10% (67/69). CgMLST clustering analysis revealed the presence of homologous strains.

L.monocytogenes contamination is present in both the production and distribution stages of enoki mushrooms in Chengdu, with a potential for cross-contamination. Although current antimicrobial resistance is not severe, the strains harbor numerous virulence genes, suggesting potential for acquiring resistance genes and posing a threat to human health.

To investigate and to analyze the residue status of fishery anesthetics in commonly marketed fresh and live freshwater fish and shrimp in Shandong Province.

From 2021 to 2023, a total of 480 freshwater fish and shrimp were collected from 16 prefecture-level cities in Shandong Province, and the four anesthetics of eugenol, MS-222, diazepam, and oxazepam were detected by ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS).

Among the four anesthetics, eugenol had the highest detection rate of 31.9% (153/480), followed by diazepam and oxazepam with detection rates of 6.7% (32/480) and 3.1% (15/480), and MS-222 was not detected. Eugenol had the highest detection rate and level of detection in grass carp, diazepam was detected only in fish and oxazepam was detected only in shrimp.

The primary fishery anesthetic detected in commonly marketed fresh and live freshwater fish and shrimp in Shandong Province is eugenol, with overall low residue levels.

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.