To explore the association ofbody mass index (BMI), body roundness index (BRI), waist circumference (WC), and waist hip ratio (WHR) with the risk of all-cause mortality in a community-based cohort.

This study was based on a prospective cohort study conducted in Pudong New Area. Obesity-related indicators were obtained at the baseline survey, mortality data was collectedduring the follow-up period.The associations between BMI, BRI, WC, WHR and the risk of all-cause mortality were assessed using cox proportional hazard model, restricted cubic spline (RCS) regression model, and receiver operator characteristic (ROC) curve.

A total of 9 448 participants was included in the analysis. The median follow-up time was 10.77 years, during which 987 deaths occurred,the all-cause mortality was 10.08/1 000 person-years.After multi-variable adjustment,the HR(95% CI) of elevated BRI, WC, and WHR were 1.07(1.01-1.14), 1.12(1.05-1.20), and 1.14(1.07-1.21), respectively.There were U-shaped dose-response relationship betweenBMI, BRI, WC and all-cause mortality; and alinear dose-response relationshipbetween WHR and all-cause mortality. BRI had the highest accuracy in predicting all-cause mortality, with the AUC of 0.62(95% CI=0.60-0.64).

Obesity is a significant risk factor for all-cause mortality, proper control of obesity and fat distribution can help reduce the risk of all-cause mortality.

To analyze the impact of the outpatient mutual assistance reform of employee medical insurance on outpatient costs in medical and pharmaceutical institutions, offering valuable insights for deepening outpatient medical system reforms and optimizing chronic disease management.

Outpatient cost indicators for hypertensive patients in City L from January 2022 to December 2023 were collected. Univariate analysis and a two-group interrupted time-series model were employed to compare changes in cost indicators before and after the reform.

A total of 688 510 valid cases were included, with 158 474 (23.02%) from pharmacies, and 530 036 (76.98%) from hospitals. The overall outpatient costs in medical and pharmaceutical institutions showed statistically significant differences before and after the reform (Z/t= -3.486/6.972, P<0.05), with post-reform data showing reduced total expenditures. However, the reform also led to a decline in the average reimbursement rate per visit, with a more pronounced effect observed in retail pharmacies than in medical institutions. Furthermore, the reform was associated with increased utilization of Chinese herbal medicines, accompanied by a significant rise in related expenditures (Z/t= -4.229/-4.285, P<0.05).

The outpatient mutual assistance reform of employee medical insurance has alleviated the financial burden of hypertension patients in medical and pharmaceutical institutions, though the payment capacity of health insurance slightly declined in the early stages of reform. It is essential to coordinate the outpatient mutual assistance reform with other policies, establish a comprehensive tripartite linkage system involving medical management, insurance payment, and drug supply, and optimize outpatient management strategies for chronic diseases.

To explore the mediating role of emotional exhaustion in the relationship between workload and turnover intention among grassroots disease control and prevention staff, and the regulatory effect of policy perception.

A total of 1 108 District CDC staffs in Wuhan were selected by general survey in January 2024, and descriptive statistical analyses, regression analyses, and moderated mediated effects analyses were conducted.

(1) Workload could not directly affect the turnover intention in grassroots CDC staff (β= -0.031, P>0.05). (2) Emotional exhaustion played complete mediating roles between workload and turnover intention (95% CI: 0.269-0.371), with mediating effect size of 0.318. (3) Policy perception played a moderating role in the former half of the pathway of the aforementioned mediation model (β= -0.085, 95% CI: -0.170--0.002).

There is a moderated mediating effect between workload and turnover intention in grassroots CDC staffs, and emotional exhaustion is the mediating variable between them. Policy perception buffered the influence of workload on emotional exhaustion. Therefore, reasonably controlling working hours and task volumes, guiding grassroots disease control personnel to alleviate negative emotions, and enhancing their positive perception of the reform known as “public welfare first-class security, public welfare second-class management” can help reduce the level of intention to leave.

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 explore the equity of health supervisor allocation in health supervision agencies in Yunnan Province from 2019 to 2023, and to provide a basis for further optimizing the reform of health supervision in Yunnan Province.

Using the National Health Supervision Information Reporting System and Yunnan Statistical Yearbook data, the configuration of health supervisors in agencies in Yunnan Province was described, and the equity was analyzed by using the agglomeration degree and the Theil Index.

The number of health supervisors in Yunnan Province from 2019 to 2023 was 1 795, 1 762, 1 824, 1 796 and 1763, respectively;The numbers of health supervisors per 10 000 population was 0.37, 0.36, 0.39, 0.38, and 0.38, respectively.The health supervisor’s agglomeration degree in the four regions of Yunnan Province from 2019 to 2023 was different, with that in Central and Northeast regions were always greater than 1, and Northwest region was always the lowest and less than 1 (0.61-0.67). The difference between the health supervisor agglomeration degree and population agglomeration degreeranged from -0.68 to 0.74, with the difference fluctuating around 0 for Northwest and Central regions, also the difference for Northeast Yunnan was always less than 0. There was no significant change in the Theil Index of health supervisors in Yunnan Province from 2019 to 2023, and the Theil Index by geographical distribution (0.073-0.078) was always higher than that calculated by population distribution (0.030-0.032), and the contribution rate between regions was greater than that with regions.

The provision of health supervisors in Yunnan Province has improved, but it is still lower than the national standard.The geographic equity of the allocation is not as fair as the demographic equity. The distribution of resources for health supervisors should be conducted with comprehensive consideration of the population density and the radius of the medical services.

To investigate the policy effects and underlying mechanisms of the Beijing Sub-Center construction on the allocation of medical resources.

Panel data from 16 districts in Beijing spanning 2005 to 2022 was analyzed. The entropy weight method was utilized to assess healthcare resource allocation, while the regression control method was applied to estimate policy effects.

The Beijing Sub-Center construction significantly enhanced hospital capacity and staffing in Tongzhou District, yielding average annual treatment effects of 732.168 additional hospital beds and 1 998.943 healthcare personnel. These impacts were statistically significant (P<0.1) across multiple years. However, the policy showed no notable effect on the number of hospital beds per 1 000 people or the total number of healthcare institutions.

The construction of the Beijing Sub-Center has effectively bolstered hospital capacity and increased healthcare personnel in Tongzhou District. Nevertheless, a gap persists between resource availability and the rising demand fueled by population growth. It is recommended to moderately expand medical service facilities, optimize the spatial distribution of resources, and enhance the efficiency and equity of healthcare resource allocation across Beijing.

To estimate the utilization of cancer screening and physical examinations in Beijing and analyses its main influencing factors, and to provide evidence for improving cancer prevention and control strategy.

From November to December 2024, a questionnaire survey was conducted among residents aged 35 to 74 from 10 districts in Beijing using probability proportionate to size (PPS) sampling and random sampling. Multivariable-adjusted logistic regression was employed to explore the potential factors influencing residents’ cancer screening behavior.

A total of 4 452 residents were included in the analysis, with 39.4% having undergone cancer screenings or physical examinations within the past 5 years. Female residents (OR=1.33, 95% CI: 1.16-1.52), those with basic medical insurance (OR=1.63, 95% CI: 1.41-1.89), residents with a family history of cancer (OR=2.11, 95% CI: 1.78-2.50), and those willing to uptake cancer screening and physical examinations (OR =1.71, 95% CI: 1.46-2.01) were more likely to have cancer screening(P<0.05).

The utilization rate of cancer screening and physical examinations among residents in Beijing remains low. To address this issue, measures such as innovating “individual-family” and “extended-family” cancer screening models, promoting the translation of cancer prevention knowledge into actionable behaviors, supporting the adoption of appropriate screening technologies, and establishing and intelligent management system should be implemented. These measures will comprehensively improve the coverage of cancer screening and physical examination services among residents, thereby achieving cancer early diagnosis and treatment, and contributing to the Healthy China initiative.

To investigate the mediating role of life satisfaction in the relationship between different types of leisure activities and cognitive function among rural older adults in Guizhou Province.

In July-August 2022, a face-to-face questionnaire survey was conducted in 12 villages across 2 counties in Guizhou Province, targeting at adults aged 60 and above. Using a self-administered questionnaire, Mini-mental State Examination(MMSE), and Satisfaction With Life Scale(SWLS), data was analyzed via descriptive statistics, partial correlation, and multiple regression. Mediation was assessed using the “mediation” package in R 4.3.1 and validated via the Bootstrap method.

A total of 1 298 adults aged 60 years and above were included in this study. The average score for cognitive function was 20.29±5.96, and the average score for life satisfaction was 26.41±4.61. Leisure activities were categorized into family-oriented and non-family-oriented types, with average scores of 8.64±3.04 and 8.86±2.55, respectively. Both types of leisure activities were positively correlated with life satisfaction and cognitive function (P<0.05). Life satisfaction partially mediates the relationship between family-oriented leisure activities and cognitive function, with an indirect effect of 0.059 (95% CI: 0.032-0.090), accounting for 13.4% of the total effect. This indirect effect is significant in elderly women (0.116, 95% CI: 0.064-0.170), representing 26.3% of the total effect, but not in elderly men.

In Guizhou Province, life satisfaction mediated the link between family-oriented leisure activities and cognitive function among rural older women. Strengthening support for rural older adults’ leisure activities can enhance their life satisfaction and cognitive function.

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 establish a method for the determination of three datura alkaloids including atropine, hyoscine and racanisodamine in poisoned samples by ultra performance liquid chromatography-hybrid triple quadrupole linear ion trap-mass spectrometry(UPLC-QqLIT-MS), and provide scientific basis for the quick handling of food poisoning event and the clinical treatment of patients.

Blood, urine and residual food samples from patients were added with borax-NaOH buffer solution, and the analytes were extracted using ethyl acetate, dried with nitrogen, and dissolved in the initial mobile phase. Separation was achieved on a DikmaLeapsil C18 chromatographic column (2.1 mm×150 mm, 2.7 μm) with gradient elution using a mobile phase consisting of water and acetonitrile (containing 0.1% formic acid and 2 mmol/L ammonium formate). The quantitative determination was carried out by using the multi reaction monitoring mode, and the qualitative analysis of the suspected positive results was carried out by using the enhanced product ion (EPI) scanning mode.

The three alkaloids exhibited good linearity (r ≥ 0.997 1) within the concentration range of 0.5-100 μg/L across different matrices. The detection limits ranged from 0.05 to 0.12μg/L.The average recoveries were 91.9%-110.0%, with relative standard deviations of 1.16%-9.03%. The EPI scanning function can effectively eliminated false positive results by confirming suspicious positives.

This method is simple, rapid, and accurate for qualitative and quantitative determination of atropine, hyoscine, and racanisodamine in poisoned samples. It effectively reduces false positives and is suitable for screening and confirmation of datura alkaloid poisoning.