To explore the relationship between female reproductive history and cognitive dysfunction in old age.

Based on the survey data of the Chinese Longitudinal Healthy Longevity Survey database in 2018, binary logistic regression and R4.3.3 software were used to construct a restricted cubic spline model to analyze the dose-response relationship between the number of births, gestational age and cognitive dysfunction in women.

7508 elderly women were included, of whom 764 (10.17%) had cognitive dysfunction. After adjusting for confounding factors, the first gestational age (OR=1.025, 95%CI:1.007-1.044), the last gestational age (OR=1.071, 95%CI:1.056-1.086), and the number of pregnancies (OR=1.085, 95%CI:1.044-1.127) had an impact on the cognitive function of elderly women. The results of the restricted cubic spline model showed that there was a linear dose-response relationship between the number of pregnancies and the risk of cognitive dysfunction in women (P_overall<0.05, P_{non-linearity}=0.67), and the cognitive function was not adversely affected when the number of pregnancies was ≤4 (OR<1, 95%CI:0.45-1). When she had only one child, there was a nonlinear dose-response relationship between the gestational age and the risk of cognitive impairment (P_overall<0.05, P_{non-linearity}<0.05), suggesting that the best childbearing age was 27 to 30 years old (OR<1, 95%CI:0.89-1). When she had more than one child, there was a nonlinear dose-response relationship between the first and last gestational age and the risk of cognitive impairment (P_overall<0.05, P_{non-linearity}<0.05), suggesting that the best childbearing age was 22 to 35 years old (OR<1, 95%CI: 0.99-1).

There is a correlation between female reproductive history and cognitive function in old age. Limiting the number of childbearing and encouraging age-appropriate childbearing can improve cognitive function in old age.

To investigate the relationship between stress-induced hyperglycemia in acute pancreatitis (AP) patients and the risk of developing new-onset diabetes after pancreatitis.

This study selected patients with acute pancreatitis (AP) who had no prior history of diabetes and were hospitalized in the Department of Gastroenterology at Nanjing Drum Tower Hospital, affiliated with Nanjing University, 2015-2019. New-onset diabetes after pancreatitis was diagnosed based on established criteria. The relationship between stress-induced hyperglycemia upon admission and the risk of developing new-onset diabetes was assessed using the COX proportional hazards model. Stratified analyses were conducted based on gender, age, education level, place of residence, marital status, smoking history, admission diagnosis, Body Mass Index (BMI), history of pancreatic necrosis/abscess, and severity of the condition.

This study included a total of 1258 participants. The follow-up incidence of diabetes was 28.3%. Patients who experienced stress-induced hyperglycemia upon admission had a higher risk of developing new-onset diabetes compared to those with normal blood glucose levels (HR=1.40, 95%CI:1.06-1.85). Subgroup analysis indicated that patients who were elderly(HR=2.01, 95%CI:1.19-2.12), male(HR=1.17, 95%CI:1.03-2.35), from rural areas(HR=1.37, 95%CI:1.24-1.53),had a history of smoking(HR=1.25, 95%CI:1.14-1.38), had a history of pancreatic necrosis/abscess(HR=1.34，95%CI:1.07-1.98), BMI≥28 kg/m ? (HR=2.33, 95%CI:1.57-4.553), or had moderate to severe pancreatitis(HR=1.45, 95%CI:1.27-2.58; HR=1.23, 95%CI:1.06-1.93), had a greater risk of developing new-onset diabetes if they experienced stress-induced hyperglycemia.

Stress hyperglycemia at admission is associated with an increased risk of new-onset diabetes after pancreatitis. Effective glucose management in high-risk AP patients with stress hyperglycemia may help reduce the risk of developing new-onset diabetes.

To explore the influence of social networks on health-related behaviors in stroke patients.

From July to September 2023, participants living in Guangdong were selected as the survey respondents using convenient sampling method. The general information questionnaire, stroke health-related behavior questionnaire and social network questionnaire were used to collect data. Social network analysis was used to explore network characteristics and draw social network diagrams. Latent class analysis was used to explore health-related behavior patterns of stroke. Kruskal-Wallis H test and Bonferroni test were used to compare the differences in social networks of different health-related behavior patterns.

Stroke health-related behaviors can be divided into three categories, namely "good health behavior group" (C1, 58.15%), "smoking and drinking group" (C2, 24.60%), and "sedentary lifestyle and imbalanced diet and sleep group" (C3, 17.25%). The network effective size, efficiency, and betweenness centrality of the "smoking and drinking group" and the "sedentary lifestyle and imbalanced diet and sleep group” were lower than that of the "good health behavior group" (P<0.05/3). In contrast, the density, network hierarchy, network constraint, percentage of individuals who smoked and drank, and percentage of individuals who did not exercise and ate healthily of the two groups were higher than that of the "good health behavior group" (P<0.05/3).

Social network characteristics with high betweenness centrality, low hierarchy, low constraint and high network efficiency can promote health-related behaviors of stroke. Building a social network with equality, low constraint and positive healthy interaction is helpful for community stroke prevention and treatment.

To investigate the relationship between total cholesterol (TC) levels, snoring condition with Metabolic Syndrome (MetS) in a population of 30-79 years old from the Dong ethnic minority in Guizhou Province, and to further analysethe interaction between the two on MetS.

The data of this study came from the database of the “Natural Population Cohort Study in the Gathering Places of Ethnic Minorities in Southwest China”, and a total of 5 815 people of Dong ethnic group aged 30-79 years in Guizhou Province were included, and used binary logistic regression to analyse the associations of TC level and snoring condition with MetS, respectively. A multiplicative model and an additive model were constructed for assessing the association of the interaction between TC level and snoring condition with MetS.

The detection rate of metabolic syndrome was 22.08% in the population of the hereditary Dong ethnic group aged 30-79 years in Guizhou Province. In the total population, TC levels ≥5.20 mmol/L were found to be positively associated with MetS compared to participants with TC levels <5.20 mmol/L (OR=2.19, 95%CI: 1.93-2.49). In addition, snoring was positively associated with the MetS prevalence (OR:2.17, 95% CI:1.19-2.47). There was no multiplicative but additive interaction between TC level and snoring condition on MetS in the total population (the relative excess risk due to interaction=1.10, 95% CI: 0.41-1.79; the attributable proportion due to interaction=0.25, 95% CI: 0.12-0.39; the synergy index=1.49, 95% CI: 1.15-1.92).

In the prevention and control of MetS, attention should be paid not only to biochemical indicators such as TC levels, but also to the effect of snoring on the disease. By cultivating a healthy lifestyle, TC levels can be reduced and snoring can be improved with a view to playing a positive role in the management and control of MetS.

To analyze the training content needs and preferences of administrative personnel in a tertiary public hospital under the backdrop of high-quality hospital development, aiming to enhance their overall performance and effectiveness in supporting hospital growth.

This study utilized a questionnaire survey and employed chi-square goodness-of-fit test for statistical analysis.

A total of 70 questionnaires were collected. 84.29% of the respondents believed that the relevance of training content, 74.29% thought time conflicts, and 70.00% considered leadership attention, training participation awareness, and the competence of training instructors as the main factors affecting training quality. 65.71% of the respondents identified holistic thinking ability, 62.86% noted innovation capability, and 44.29% pointed out decision-making skills as the most needed training content.

The main factors affecting the quality of management ability training for hospital administrative staff are the relevance of training content and employees’ willingness to participate in training. The ability that needs the most training is communication skills, while the greatest demand is for knowledge about the hospital’s development history and culture. The optimal format is monthly offline lectures lasting 1-2 hours.

To analyze the late diagnosis of newly reported HIV/AIDS in Hebei province from 2016 to 2022, and to understand the proportion of late diagnosis of HIV/AIDS and its influencing factors.

The information of newly reported HIV/AIDS cases in Hebei province from 2016 to 2022 was collected through the national basic information system of HIV/AIDS, and identified relevant cases by definition of late diagnosis. Trend Chi-square test was used to analyze the changing trend of late diagnosis proportion, the influencing factors of late diagnosis were analyzed by Chi-square test and Logistic regression model.

From 2016 to 2022, 14 689 HIV/AIDS cases were newly reported in Hebei province, and the proportion of late diagnosis was 33.1%. The proportion of late diagnosis showed an upward trend in each year (χ²=69.826, P<0.001). The results of Logistic regression showed that the proportion of late diagnosis was higher in the farmers, the source of testing consulting and medical institutions and other, and the higher age group. The OR (95%CI) of farmers was 1.154 (1.021-1.303) compared with the household workers, and the unemployed. Compared with the custodial population, the OR (95%CI) of testing counseling and medical institutional and other sources were 1.909 (1.236-2.949), 3.205 (2.08-4.938) and 1.808 (1.136-2.875). The OR (95%CI) of each age group was 1.945 (1.469-2.577), 3.279 (2.458-4.375), 3.996 (2.97-5.377), 5.223 (3.87-7.05) and 5.202 (3.814-7.095), respectively. The proportion of late diagnosis varies greatly in different cities, City 5, City 11 and City 1 was higher than the average of the whole province.

From 2016 to 2022, the proportion of late diagnosis HIV/AIDS cases in Hebei province is increased in each year, and there are big regional differences. Occupation, sample source and age are the influential factors of late diagnosis, targeted measures should be taken to prevent and improve the ability of early detection.

To understand the intake of added sugars among primary school students, to analyze the sources and influencing factors of intake, and to propose improvement measures.

A stratified cluster sampling method was used to select 12,603 primary school students in Lianyungang as the research subjects. A food atlas-based questionnaire was used to investigate the intake of foods with added sugars and calculate daily intake of added sugars.

The median added sugar intake of primary school students was 22.1 g/day, 45.7% of students consumed more than 25 g/day, and 21.7% of students consumed more than 50 g/day. Sugar-sweetened beverages, flavored yogurt, pastries and sweets were the four main sources of added sugar intake among primary school students (accounting for 38.3%, 24.0%, 14.1% and 12.1% respectively). Multiple linear regression analysis showed that boys, higher grade, higher BMI, and less sleep were associated with increased intake of added sugars.

The excessive intake of added sugar by primary school students in Lianyungang was quite prominent. On the one hand, nutrition education should be carried out to publicize the harm of excessive intake of added sugar.On the other hand, it isrecommended to include the added sugar content in the nutrition label to guide teenagers to choose healthy food.

To analyze whether there is a threshold effect between thyroid hormone sensitivity indexes and breast cancer, and to analyze the subgroup analysis and interaction test of age.

2 892 adults from NHANES were collected between 2007 and 2012, including 83 breast cancer patients. Central thyroid hormone sensitivity indices were calculated, including Thyroid Feedback Quantile Index for T4(TFQI_FT4) and T3(TFQI_FT3), Thyroid Stimulating Hormone T4 Resistance Index(TT4RI), Thyroid Stimulating Hormone T3 Resistance Index(TT3RI), and TSH Index(TSHI), as well as peripheral thyroid hormone sensitivity index FT3/FT4. The association between breast cancer and the thyroid system was investigated using a multivariable logistic regression model. Smooth curve fitting and stratified analysis were used too, and subgroup analysis and interaction tests were performed based on age.

Model3 showed that Thyroid Stimulating Hormone (TSH) (OR=1.33, 95%CI:1.08-1.63), TFQI_FT4(OR=2.61, 95%CI:1.25-5.45), TFQI_FT3(OR=3.15, 95%CI:1.18-8.44), TT4RI(OR=1.03, 95%CI:1.01-1.05), TT3RI(OR=1.10, 95%CI:1.03-1.18), and TSHI(OR=1.68, 95%CI:1.14-2.50) were significantly positively associated with the risk of breast cancer. A linear relationship with breast cancer was observed when TFQI_FT3≥0.7, TSHI≥2.4, and TT4RI<50(P<0.05). TFQI_FT4 showed a threshold effect(likelihood ratio test=0.040) when TFQI_FT4<0.25. The relationship between TFQI_FT4 and breast cancer was not significant(OR=1.07, 95%CI:0.36-3.15), but when TFQI_FT4≥0.25, it was significantly associated with an increased risk of breast cancer(OR=12.79, 95%CI:2.50-65.40). Subgroup analysis further revealed that in women over 55 years old, increased central thyroid hormone sensitivity indices were associated with breast cancer risk(P<0.05).

Increased central thyroid hormone sensitivity indices are significantly associated with the risk of breast cancer, which may be a potential indicator for breast cancer detection in the future.

To analyze herpes zoster vaccine (HZV) vaccination intention and influencing factors among people aged 40 years and above.

A stratified sampling method was used to select people aged ≥40 years from 6 streets of 3 districts in Nanjing for a questionnaire survey. Multivariate Logistic regression model was used to analyze the influencing factors of HZV vaccination intention.

Among those who had not been vaccinated with HZV, 27.00% (385/1 426) were willing to receive HZV vaccination. High income region (OR=1.53,95%CI:1.05-2.21), employee basic medical insurance (OR=1.52,95%CI:1.02-2.27), per capita monthly household income >10 000 yuan (OR=2.15,95%CI:1.26-3.67), currently or before retirement engaged in health care (OR=1.86,95%CI:1.05-3.30), self-assessed good or very good health status (OR=3.27,95%CI:1.50-7.09), family history of HZ (OR=1.93,95%CI:1.37-2.71), influenza vaccine immunization history (OR=2.53,95%CI:1.66-3.84), HZV willingness to pay >1 000 yuan (OR=2.49,95%CI:1.44-4.30), perceived susceptibility (OR=1.17,95%CI:1.02-1.34), and self-efficacy (OR=1.59,95%CI:1.28-1.96) were the influencing factors to promote the HZV vaccination intention.

The willingness rate of HZV vaccination in people ≥40 years old in Nanjing is low. Health education about Herpes zoster (HZ) and HZV should be strengthened, especially the susceptibility of HZ and the safety of HZV. According to the characteristics of HZV vaccination recipients, vaccination agencies can take various ways to publicize vaccination service information and optimize the vaccination process such as appointment and payment. Relevant departments should explore HZV immunization strategies to reduce the economic burden of HZV vaccination.

To explore the causal relationship between testosterone and endometriosis, andto identify and quantify the role of gut microbiota as a potential mediator through Mendelian randomization analysis.

Utilizing the summary data from the IEU GWAS database for testosterone (n=199 569) and endometriosis (8 288 cases and 68 969 controls) as the exposure and outcome variables, and the aggregated gut microbiota data from the MiBioGen Consortium (n=18 340) as the mediator, a bidirectional, two-step Mendelian randomization analysis was conducted. Causal relationships were assessed using inverse varianceweighted, MR-Egger, weighted median, weighted model, and simple modelto assess causality, while sensitivity analysis was conducted to ensure the robustness of the findings.

Impact of testosterone on endometriosis:Inverse variance weighted estimates suggested that testosterone had negative causal effects on endometriosis (OR=0.804, 95%CI:0.670-0.964, P=0.018).Impact of endometriosis on testosterone:Reverse Mendelian randomization showed that endometriosis did not present a causal effect on testosterone (OR=0.991, 95%CI:0.958-1.026, P=0.616).The class Melainabacteria, one of the gut microbiotas, accounted for a 17.21% reduction in the risk of endometriosis associated with testosterone (mediation proportion: 17.21%, 95%CI:0.090-0.264, P=0.035).

Testosterone is one of the protective factors of endometriosis.Low testosterone levels increase the risk of endometriosis.Gut microbiota may be a mediator of the causal effect of testosterone on endometriosis.