To explore the differences in the status of co-morbid combinations and health-related quality of life between urban and rural middle-aged and elderly people, and to provide a reference for improving the health of middle-aged and elderly people with co-morbid combinations of chronic diseases.

A total of 6 481 middle-aged and elderly people aged ≥50 years with at least two chronic diseases in China Healthy Aging and Reproductive Lifestyle Survey (CHARLS) 2020 were selected. The basic characteristics of urban and rural chronic disease co-morbid middle-aged and elderly people were described, the health-related quality of life was evaluated using the health utility value of EQ-5D-3L, and the combination of urban and rural chronic disease co-morbid combinations was analyzed using the association network diagram and Apriori association rule.

The health utility value of the elderly in urban chronic disease co-morbidities was 0.8532±0.2400, which was higher than that of the elderly in rural chronic disease co-morbidities (0.8409±0.1952). The top five urban strong link chronic disease co-morbidity combination weights were: hypertension+dyslipidemia; hypertension+heart disease; hypertension+arthritis; gastric disease+arthritis; dyslipidemia+heart disease. In rural areas, there were: gastric disease+arthritis; hypertension+arthritis; hypertension+dyslipidemia; and hypertension+gastric disease. Chronic disease co-morbidities in rural middle-aged and elderly people produced 105 association rules and 86 association rules in urban. Among the top 10 association rules in terms of strength of association rules, there were 9 association rules for hypertension and 1 association rule for chronic lung disease in the rural posterior, while there were 6 association rules for hypertension, 3 association rules for dyslipidemia and 1 association rule for chronic lung disease in the urban posterior.

Health related quality of life of elderly people with chronic disease co-morbidities was higher in urban than in rural areas, with emphasis on pain management and depression and anxiety management in elderly people with chronic disease co-morbidities. There are differences in the combination of chronic disease co-morbidities in urban and rural areas, and the binary, ternary, and quaternary co-morbidity associations between common chronic disease illnesses are high, and hypertension and other chronic diseases and co-morbidities are the highest, and attention should be paid to preventive treatment of hypertension.

To understand the status of alexithymia in people living with HIV aged 50 years and over, and to analyze its influencing factors.

From November 2023 to March 2024, HIV-infected people aged 50 and over in Luzhou City, Ziyang City and Zigong City of Sichuan Province were selected by convenience sampling method. The 20-item Toronto Alexithymia Scale(TAS-20), Loneliness Scale(UCAL) and Montreal Cognitive Assessment Scale(MoCA) were used to conduct a questionnaire survey on people living with HIV aged 50 and over. T-test and ANOVA were used to compare the scores of alexithymia in HIV-infected people aged 50 years and above with different characteristics. Multiple linear regression analysis was used to explore the influencing factors of alexithymia in HIV-infected people aged 50 years and above.

The average scores of TAS-20, UCAL and MoCA were (61.93±10.99) points, (44.91±9.87) points and (18.56±4.86) points, respectively, in 207 HIV-infected patients aged 50 years and above. The detection rate of Alexithymia was 52.2%. The results of multivariate analysis showed that non-marriage (β=0.13,95%CI: 0.03-0.53), loneliness (β=0.44, 95%CI: 0.32-0.55), poor cognitive function (β=-0.25, 95%CI: -0.37-0.14) may be the influencing factor of alexithymia in HIV-infected persons aged 50 years and above.

Compared with other age groups, HIV-infected people aged 50 and above have a higher prevalence of alexithymia, and AIDS prevention and control managers should focus on unmarried, lonely and poor cognitive performance of infected people, to develop personalized interventions for them to alleviate alexithymia.

To analyze the trend of acute myocardial infarction mortality and potential life loss among residents in Nanning City from 2015 to 2023, and provide a basis for formulating chronic disease prevention and control policies.

To collate the death cause monitoring data of the whole population in Nanning City. Crude mortality, standardized mortality, age-specific mortality, composition ratio, potential years of life lost ( PYLL%), standardized years of life lost (SPYLL%) and average years of life lost (AYLL) were calculated.Joinpointlog-linear regression model was used for trend analysis.

From 2015 to 2023, a total of 38 870 deaths from acute myocardial infarction were reported in 12 counties (cities, districts) of Nanning City, including 22 566 males and 16 304 females. The crude mortality rate was 59.84/100 000, and the standardized mortality rate was 53.70/100 000. The crude mortality rate and standardized mortality rate both showed a stable trend, with AAPC values of -1.408 and -2.892, and P values of 0.443 and 0.054, respectively. The mortality rate increases with age and shows a linear increase after the age of 40. The proportion of pre hospital mortality in acute myocardial infarction ranged from 81.53% to 87.29%, which was at a high level, but showed an overall downward trend (AAPC=-0.552%, P=0.007). The potential life loss rate ranged from 0.33% to 0.42%, with an average life loss of 6.02 years to 7.03 years, and the trend of change was not statistically significant. However, the potential life loss rate and average life loss of women showed a downward trend, with AAPC values of -5.941% and -3.475%, respectively, and P values of 0.01.

The mortality rate of acute myocardial infarction in Nanning City is relatively high, and the potential loss of life is severe. Pre hospital emergency treatment and health education for acute myocardial infarction should be strengthened, and the elderly and men are the key population for prevention and con.

To analyze the trends in incidence of acutemyocardialinfarction(AMI)in Wuhan from 2016 to 2023, and to provide scientific basisfor prevention and control of AMI in Wuhan.

The incidence data during 2016—2023 from the Surveillance System of cardiovascular diseases in Wuhan were collected to compute the incidence, age-standardized rate by China population 2010 (ASR-C) and by Segi’s world standard population(ASR-W).Theannual percent change (APC) and average annual percent change (AAPC) of incidence of AMI were evaluated using Joinpoint regression model,to analyzethe incidence trends of AMI.

The incidence of AMI in Wuhan increased from 56.67/10⁵ in 2016 to 115.29/10⁵ in 2023(APC=10.24%,P<0.05);andASR-C of AMI increased from 40.45/10⁵ in 2016 to 79.57/10⁵ in 2023(APC=9.75%,P<0.05).The AMI incidence of males(83.65/10⁵) was significantly higherthanthat of females(34.99/10⁵) from 2016 to 2023 (P<0.05).The AMI incidenceofurban area(62.59/10⁵) was significantly higher than that of rural area(55.35/10⁵)(P<0.05).The regression model showed that the incidence and ASR-C of AMI in male and female all showed a significant upward trend (all P<0.05);the incidence and ASR-C of AMI of urban residents all showed a significant upward trend (all P<0.05), while the trends of rural residents from 2016 to 2020 were not statistically significant, but they all showed a significantupward trend from 2020 to 2023 (all P<0.05).The incidence of AMI in age groups<30,30-<40,40-<50, 50-<60, 60-<70 years and≥70 years in Wuhan increased at different rates from 2016 to 2023(P<0.05).Incidence in agegroups 30-<40,40-<50 years increased rapidly,with the AAPCs of 16.73% and 13.87%, respectively.

The incidence of AMI in Wuhan showedan upward trend from2016 to 2023,young adult males are the crucial population for prevention andcontrol.

To analyze the monitoring data of rural drinking water quality and water supply project information in Gansu Province, and to provide a basis for the guarantee of rural drinking water health security.

Based on the water quality monitoring data of rural centralized water supply project in Gansu Province from 2018 to 2023, the water quality index evaluation method was used to compare the differences in water quality, and the chi-square test was used to compare the status of water supply projects in each year.

The results showed that the automatic monitoring system, the proportion of purification and disinfection facilities, and the comprehensive index of water quality in rural centralized water supply project in Gansu Province were improved, and the differences between each year were statistically significant (P<0.05). In the single monitoring index, the total standard rate of total coliforms in microbial index increased from 68.66% to 90.95% from 2018 to 2023, and the turbidity qualified rate in sensory index increased from 92.26% to 98.65%.

The rural drinking water supply situation in Gansu from 2018 to 2023 was improved, and the water quality was on the rise. It is necessary to continue to promote the scale and standardization construction of water supply project to ensure the health safety of drinking water.

To explore the influence of family environment on depression in middle school students, and explore the role of coping styles in this process.

Amulti-level sampling method was conduct in Qingpu District. A total of 1 902 junior and senior school students from four middle schools were investigated. The questionnaires included self-designed questionnaire which was used for collecting the students’ information of gender, age, family environment and so on,coping style questionnaire for middle school students which was used for evaluating the scores of coping factors, Patient Health Questionnaire (PHQ-9) which was used for evaluating the scores of depression. The t-Test, Mann-Whitney Test, Pearson correlation analysis and Spearman rank correlation analysis were used for difference analysis or correlation analysis, and the SPSS Process was used for Mediation analysis.

ThePHQ-9 scores of junior high school students in the adverse family environment (divorced/single-parent family, unharmonious family atmosphere, and non-wealthy family) were significantly higher than those in favorable family environment (non-divorced/single-parent family, harmonious family atmosphere, and wealthy family). Students in the adverse family environment scored higher in "problem-focused coping" and lower in "emotion-focused coping", while students in adverse family environment scored the opposite. The results of mediation analysis showed that "emotion-focused coping" played a partial mediating role in the relationship between depression and family structure (β=0.212, 95%CI:0.029-0.421) or family atmosphere (β=0.304, 95%CI:0.169-0.461) or family economic status (β=0.261, 95%CI:0.058-0.491) in the middle school students, and the mediation effect accounted for 9.83%, 15.13% and 13.85% of the total effect respectively. "Problem-focused coping" also played a partial mediating role in the relationship between depression and family structure (β=0.316, 95%CI:0.139-0.521) or family atmosphere (β=0.455, 95%CI:0.311-0.626) or family economic status (β=0.505, 95%CI:0.306-0.730) in the middle school students, and the mediation effect accounted for 14.68%, 22.72% and 26.75% of the total effect respectively.

The adverse family environment is a risk factor for depression in middle school students, and coping styles play a partial mediating role in this process.

To understand the HIV infection risk perception bias and its related influencing factors among young men who have sex with men (MSM) in Shandong Province, so as to provide reference for making feasible HIV health education plans.

From April to July, 2022, young MSM were recruited in six cities in Shandong province, and a questionnaire survey was conducted and blood samples were collected to collect demographic characteristics, HIV risk perception and risk behavior of MSM. Logistic regression model was used to analyze the influencing factors of HIV infection risk perception bias among young MSM.

A total of 978 MSM were investigated, of which 85%(831/978) were over 20 years old, 97.6%(955/978) were unmarried/divorced or widowed, 61.1%(598/978) were college educated, 2.6% (25/978) were positive for HIV antibody and 3.6%(35/978) for syphilis antibody. 47.1%(461/978) had HIV infection risk perception bias, of which 54.0%(249/461) underestimate the risk and 46.0%(212/461) overestimate the risk. Logistic regression analysis showed that unmarried/divorced/widowed (OR=11.693,95%CI:1.546-88.407) and having no or low risk of new drugs (OR=2.041,95%CI:1.477-2.825) were the risk factors for underestimating the risk. Household registration in Shandong province (OR=2.618,95%CI:1.397-4.902), college education or above (OR=1.728, 95%CI:1.206-2.475), homosexuality (OR=2.532, 95%CI:1.093-5.845), having general or high risk of new drugs(OR=8.323, 95%CI:4.602-15.052), who had not received AIDS intervention (OR=2.288,95%CI:1.224-4.292) and had not taken preventive drugs before exposure (OR=11.905,95%CI: 3.663-38.462) were the risk factors for overestimating the risk.

HIV infection risk perception bias among young MSM in Shandong Province is high, and HIV risk behaviors are widespread. It is necessary to strengthen the education of MSM who have low self-rated HIV infection risk but have high-risk behaviors, improve risk awareness and reduce the occurrence of dangerous behaviors.

To study the relationship between the education of offspring and the developmental trajectory of cognitive function in the rural elderly, and to explore the mediating effect of intergenerational support.

Based on seven waves of a special longitudinal survey spanning 18 years, a group-based trajectory model was used to identify the heterogeneous developmental trends of cognitive function in the rural elderly population. An unordered polytomous logistic regression was employed to study the association between offspring’s education and the developmental trajectory cognitive function among the rural elderly. The KHB method was utilized to analyze the mediating effect of intergenerational support.

A total of 1 342 elderly individuals, aged 60 to 100 years and having participated in at least two survey waves, were included. Three cognitive function trajectory groups were identified: the low decline group (19.75%), the moderate decline group (44.41%), and the high stability group (35.84%). Compared with subjects in the low decline group, those with higher levels of offspring education were more likely to belong to the moderate decline or high stability groups. Intergenerational support played a significant mediating role in this relationship, exhibiting a characteristic of need dependency. Furthermore, intergenerational economic support contributed the most to the mediating effect in each trajectory group, and robustness checks yielded similar results.

There is heterogeneity in the trajectories of cognitive function among the rural elderly. The educational achievements of offspring are an intrinsic driving force for the positive development of cognitive function in this demographic. At the same time, under the continuous impact of modern ideas and cultural waves, the traditional "filial piety culture" in rural areas of China remains deeply rooted.

To provide a basis for formulating precise prevention and control strategies, the temporal and spatial aggregation characteristics of county road traffic injury mortality were analyzed, Shandong, 2012-2021.

The traffic injury mortality rate was calculated by using the data from the death registration and reporting system of Shandong. Geoda 1.18 and SatScan 9.7 were used for spatial autocorrelation analysis and spatiotemporal scanning analysis to explore the characteristics of spatiotemporal aggregation, and principal component regression analysis was used to explore the influencing factors.

Road traffic injury mortality rate in Shandong from 2012 to 2021 showed an overall decreasing trend and was high in the fall. The spatial correlation existed in each year, and the "high-high" aggregation area was mainly located in the central and northwestern parts of Shandong. The spatial scan revealed the existence of four clusters across the entire population. Cluster 1 existed from March 2012 to February 2015, covering 26 districts and counties, primarily located in south-central Shandong. Similar to the total population, urban and rural areas were mainly located in the central and southern part of Shandong, and the main urban agglomeration area existed from January 2012 to December 2014, covering 19 districts and counties; The main rural agglomeration area existed from January 2012 to December 2014, covering 38 districts and counties. Principal component regression analysis showed that the variables reflecting the economic and transportation conditions had a greater impact. Among them, the number of permanent residents and the volume of passenger and freight transportation were positively correlated with the mortality rate, while others were negatively correlated.

From 2012 to 2021, the mortality rate of road traffic injuries in Shandong showed a decreasing trend. The main agglomeration area exists in the central and southern part of Shandong, and the rural agglomeration is more obvious. According to the characteristics of clustering, attention should be paid to the enforcement of laws and regulations, infrastructure construction, population flow and other factors in high-risk areas, and prevention and control strategies should be adopted or adjusted according to local conditions.

To analyze the changes and influencing factors of female health literacy level in Nanchang, and to provide reference for intervention in female health literacy.

Based on the health literacy monitoring of residents in Nanchang from 2018 to 2023, analyze the data of 10 034 women in the effective sample. Conduct inter-group difference comparisons and influencing factor analyses on the health literacy levels of women with different characteristics by using the χ² test and Logistic regression model. And analyze the changes in the health literacy of women in Nanchang City using the χ² trend test.

From 2018 to 2023, the level of female health literacy in Nanchang showed rising year by year, increased from 17.87% to 30.80%. Health knowledge and concept as well as safety and first aid ranked first in three aspects and six dimensions of health literacy. The factors affecting female health literacy in Nanchang included regions, age, education, occupation and marriage. The health literacy level of urban women was 1.249 times higher than that of rural women (OR=1.249, 95%CI: 0.934-1.669; The health literacy level of women aged 35-44 was 93.5% higher than that of women aged 15-24; The health literacy level of women with junior college and above (OR=15.851, 95% CI: 12.525-20.060) was 15.851 times higher than that of women with primary school and below; The health literacy level of female civil servants/teachers and other employees of public institutions (OR=0.373, 95%CI: 0.252-0.553) and female farmers (OR=0.368, 95%CI: 0.231-0.585) were significantly lower than female medical staff; Unmarried women had a higher level of health literacy than married women by 45.5% (OR=0.545, 95%CI: 0.332-0.896).

The level of female health literacy in Nanchang has been improved. In the future, infectious and chronic disease prevention and basic medical literacy should be the key content. Focusing on key population such as women of farmers, the elderly, lower education level and low-income, targeted health education and promotion activities will be innovatively carried out to popularize healthy lifestyles and skills.