To explore the compliance of telemedicine services on third-party platforms since the release of the“Telemedicine Supervision Rules (Trial)” in 2022.

An anonymous standardized patient method was employed to assess the compliance of diagnostic behaviors on eight well-known, large-scale third-party internet healthcare platforms in China.Diagnostic scenarios were designed around five representative clinical cases. Based on the Telemedicine Supervision Rules (Trial),20 regulatory indicators were extracted across five key dimensions—clinical practice supervision, pharmaceutical services, prescription and medical record standards, identity verification, and quality and safety oversight.

The platforms generally deviated from policy requirements in areas such as online first diagnosis, medication prescribed before diagnosis and prescription authenticity, with average compliance rates of 29%, 25%, and 10%, respectively. Some platforms were suspected of using artificial intelligence to replace doctors in consultations. Compliance was better in areas such as physician qualification certification and real-name authentication, patient real-name authentication, termination of online medical services, and prohibiting patients from being directed to other medical providers, with only a few cases of violations. The causes of compliance issues included the policy’s failure to adapt to industry development, low government regulatory willingness, weak regulatory effectiveness, and the profit-driven behavior of platforms and healthcare providers.

Third-party platforms still face varying degrees of compliance issues in medical practices, pharmaceutical services, prescription regulation, and personnel identity management. It is recommended to strengthen government regulatory functions, enforce platform accountability, improve the dynamic adjustment mechanism of policies, and enhance social supervision and industry self-regulation.

To analyze the death status and life loss of patients with severe mental disorders in Wuhan during the period from 2018 to 2022, in order to provide references for formulating bailout management policy for patients with severe mental disorders.

The death data on gender, age, diagnosis, cause of death, and other related information were obtained from the National Information System for Severe Mental Disorders during 2018—2022. Excel 2022 and SPSS 21.0 software were applied to analyze the death characteristics, death cause distribution and mortality. Years of life lost (YLL) and related indicators were used to analyze the life expectancy reduction due to severe mental disorders.

From 2018 to 2022, a total of 3 557 patients with severe mental disorders died in Wuhan, most of them had schizophrenia (2 541 cases, 71.44%). There were more male patients (2 019 cases, 56.76%) than female patients (1 538 cases, 43.24%). The average age of death was 58.06±15.21 years, mainly concentrated in the elderly population over 60 years old (1 719 cases, 48.33%). Significant differences in mortality rates were observed between 2018 and 2022(χ²=58.678, P<0.001), with statistically significant differences found only among patients with schizophrenia (χ²=45.600, P<0.001) and those with mental retardation accompanied by mental disorders (χ²=16.120, P=0.003). Physical diseases were the leading cause of death (2 193 cases, 61.65%). For patients aged 1-69 years, all causes of death resulted in 83 380.75 person-years of potential years of life lost (PYLL), an average years of life lost (AYLL) of 30.71 years, and a potential years of life lost rate (PYLLR) of 173.89%. The greatest total loss of life was caused by schizophrenia, while the highest AYLL was observed for epilepsy with mental disorders (34.08 years).

Severe mental disorders are important diseases that cause life loss, and combined physical diseases are the main cause of death for patients in Wuhan from 2018 to 2022. It is suggested that we should pay more attention to chronic disease management of patients with severe mental disorders, strengthen bailout, and take multiple measures to reduce the risk of death of patients.

To investigate the relationships between different dimensions of biological rhythm disorders, depression and anxiety symptoms among adolescents, and to identify the key dimensions that have a greater impact on mental health, providing a basis for developing targeted interventions.

Conducted from September to November 2023 in Tianjin, this study recruited middle school students from urban and suburban areas using convenience and stratified cluster sampling methods, yielding 3 787 valid questionnaires. The Self-rating Questionnaire of Biological Rhythm Disorders for Adolescents (SQBRDA), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) were employed to assess biological rhythm disorders, depression, and anxiety symptoms, respectively. Network analysis was utilized to examine the association strengths between dimensions and to calculate centrality indices to pinpoint key nodes.

Activity rhythms showed higher centrality in the network (0.436), the edge weight between decreased interest and low mood was the largest in the depression symptom subnetwork (0.319), and the edge weight between persistent worry and excessive worry was the largest in the anxiety symptom subnetwork (0.446). In the biological rhythm subnetwork, the edge weight between activity rhythms and electronic product use rhythms was the largest (0.566). Females had stronger associations in the depression symptom network and the biological rhythm disorder network (0.194).

The study demonstrates a complex correlation network between adolescent biological rhythm disorders, depression and anxiety symptoms, especially activity rhythm and electronic product use rhythm.

To analyze the epidemiological characteristics of non-melanoma skin cancer (NMSC) in China from 2005 to 2018 and to predict future incidence trends, thereby providing a scientific basis for the prevention and control of NMSC.

Incidence data for NMSC from 2005 to 2018 were obtained from the Chinese Cancer Registry Annual Reports. Joinpoint regression was used to estimate the average annual percentage change (AAPC) and annual percentage change (APC) to reflect time trends. An age-period-cohort model based on the intrinsic estimator algorithm was employed to assess the effects of age, period, and birth cohort. A Bayesian age-period-cohort (BAPC) model using integrated nested Laplace approximation was applied to predict future trends.

From 2005 to 2018, the age-standardized incidence rate (ASIR) of NMSC in China was 1.33 per 100 000, showing an upward trend, with an AAPC of 3.7% (95% CI: 2.5%-4.9%). The ASIR was higher in males (1.46/100 000) than in females (1.21/100 000), although the increase was faster in females (AAPC = 8.8%). The incidence rate in urban areas (1.44/100 000) was higher than in rural areas (1.15/100 000). The risk of NMSC incidence increased with age. The cohort effect showed a downward trend in ASIR. Predictions suggested that the ASIR of NMSC in China will continue to rise, reaching 2.52/100 000 by 2030 (95%CI: 0.22/100 000-4.83/100 000), though future trends remain uncertain.

From 2005 to 2018, the ASIR of NMSC in China showed a rising trend, with significant differences across age, sex, and regions. It is recommended to strengthen targeted prevention and health education efforts in different areas to enhance public awareness of NMSC.

To investigate the correlation and dose-response relationship of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with type 2 diabetes mellitus (T2DM) in the elderly aged over 65 years.

The participants were from the medical examination of the elderly aged 65 years and over in Wujin district, Changzhou city in 2022. The survey contents included questionnaire survey, physical examination and laboratory examination. Logistic regression and restricted cubic spline were used to analyze the correlation and dose-response relationship of NLR and PLR with T2DM.

A total of 112 073 individuals were included in this study, with an average age of 72.66±5.62 years. Among them, 53 557 (47.79%) were male, and 16 935 (15.11%) were T2DM patients. After adjusting for relevant confounding factors, compared with the Q1 group of PLR, the ORs (95% CI) for T2DM in the Q2, Q3, and Q4 groups were 0.93 (0.88-0.97), 0.83 (0.79-0.87), and 0.73 (0.70-0.77).respectively (P _fortrend <0.001). Compared with the Q1 group of NLR, the ORs (95% CI) for T2DM in the Q2, Q3, and Q4 groups were 1.12 (1.06-1.18), 1.19 (1.13-1.25), and 1.35 (1.28-1.42), respectively (P _fortrend <0.001). Subgroup analysis results showed that the established in this study demonstrates notable advantages, including simple operation, rapid reaction, high specificity, superior sensitivity, and low cost, and does not rely on specialized nucleic acid detection equipment, but only requires a thermostatic heating instrument to complete the detection. The method is suitable for the immediate detection of arthropod-borne viruses, offering a novel technical platform for arbovirus identification.correlation between PLR and NLR and T2DM remained statistically significant across subgroups stratified by sex, age, hypertension, BMI, and abdominal obesity (all P-values < 0.05). Hypertension status and gender had significant interactions with the association between PLR, NLR and T2DM (P _{forinteraction} < 0.05). The results of the restricted cubic spline showed that PLR had a negative nonlinear relationship with the prevalence of T2DM (P=0.008), and NLR had a positive nonlinear relationship with the prevalence of T2DM (P<0.001). The threshold effect inflection points of PLR and NLR on T2DM were 158.0 and 2.47 respectively (log-likelihood ratio test P<0.05).

The risk of T2DM increased with the increase of NLR and decreased with the increase of PLR. This study also found nonlinear dose-response relationships between NLR, PLR and T2DM.

To explore the association between serum uric acid (SUA), the uric acid to high-density lipoprotein cholesterol ratio (UHR), and liver function among Zhuang minority male residents aged 35-74 years in Guangxi, and to provide scientific evidence for developing strategies to regulate SUA levels and preserve hepatic health.

A cross-sectional study was conducted based on the Guangxi Ethnic Minorities Cohort, using structured questionnaires, physical examinations, and blood and urine sample collection. Logistic regression analysis was used to identify factors associated with liver dysfunction, while restricted cubic spline was performed to evaluate dose-response relationships of SUA and UHR with liver dysfunction.

This study included 4 977 Zhuang minority male adults, with a mean age of 54.8 years. Among them,38.4% of participants had middle school education, 53.9% were farmers, and 47.1% with household income over 30 000 Yuan in the past year, 30.9% with SUA levels >420 μmol/L, and 10.4% had liver dysfunction. After adjusting for confounders, compared to the normal SUA group, the adjusted OR(95% CI) for liver dysfunction in the 421-479 μmol/L and ≥480 μmol/L groups were 1.30 (1.01-1.67) and 1.69 (1.32-2.15), respectively. Compared with the lowest UHR quartile (≤22.25%), the adjusted OR (95% CI) for the 22.26-28.96%, 28.97-38.26%, and ≥38.27% quartiles were 1.23 (0.89-1.71), 1.76(1.24-2.50), and 2.08 (1.39-3.11), respectively. The risk of liver dysfunction increased non-linearly with the increase of SUA and UHR levels (P_nonlinearity <0.001).

SUA and UHR demonstrated significant associations with the risk of liver dysfunction among Zhuang minority male residents aged 35-74 years in Guangxi. Targeted health education efforts should be strengthened to control SUA levels and reduce UHR, thereby helping to preserve liver function in middle-aged and older individuals of the Zhuang minority.

To analyze the risk factors for renal failure in patients with chronic kidney disease (CKD) complicated by hypertension.

A total of 230 CKD patients with hypertension admitted to Chaohu Hospital Affiliated to Anhui Medical University from April 2023 to April 2024 were enrolled. According to the occurrence of renal failure, the patients were divided into the renal failure group (n=47) and the non-renal failure group (n=183). Baseline characteristics were compared between the two groups. Lasso regression and multivariate logistic regression were used to screen for risk factors of renal failure.

Among the 230 patients, 47 (20.43%) developed renal failure. Logistic regression analysis revealed that hyperuricemia (OR=3.104, 95% CI: 1.661-5.800), anemia (OR=3.413, 95% CI: 1.706-6.828), hyponatremia (OR=2.852, 95% CI: 1.383-5.882),proteinuria (OR=2.858, 95% CI: 1.318-6.198), advanced age (OR=2.579, 95% CI: 1.396-4.765), and uncontrolled blood pressure (OR=2.211, 95% CI: 1.193-4.096) were independent risk factors for renal failure in CKD patients with hypertension.

CKD patients with hypertension have a high risk of renal failure. Advanced age, uncontrolled blood pressure, hyperuricemia, anemia, hyponatremia, and proteinuria are significant risk factors for renal failure in this population.

To explore the relationship between subjective cognitive decline and frailty in community-dwelling older adults with comorbidities, and analyze the mediating effects of self-perceptions of aging and cognitive reserve.

From June to October 2023, 505 community-dwelling older adults aged 65 and above in Xinxiang City with comorbidities were selected to conduct a questionnaire survey. Descriptive statistics, ANOVA and correlation analysis were performed on the data, and AMOS 27.0 was used to construct a chain mediation model.

Subjective cognitive decline had a positive impact on frailty (β=0.100, 95% CI: 0.006-0.191, P=0.040). Self-perceptions of aging and cognitive reserve played a mediating role between subjective cognitive decline and frailty (β=0.079, 95% CI: 0.042-0.123, P<0.001; β=0.029, 95% CI: 0.011-0.056, P<0.001), accounting for 36.12% and 13.37% of the total effect value, respectively. Moreover, self-perceptions of aging and cognitive reserve jointly played a chain-mediating role between subjective cognitive decline and frailty (β=0.010, 95% CI: 0.004-0.021, P<0.001), accounting for 4.77% of the total effect value.

The findings that self-perceptions of aging and cognitive reserve play independent mediating roles and a chain-mediating role between subjective cognitive decline and frailty suggest that attention should be paid to the subjective feelings of community-dwelling older adults with comorbidities. It is essential to cultivate a positive view of aging among the elderly and enhance their cognitive reserve levels. By doing so, the onset of frailty can be delayed, thus promoting healthy aging.

To analyze the current status and changing trends of ischemic stroke burden attributable to high LDL-C in China from 1990 to 2021. By integrating the prediction results for the next decade, this research offers actionable insights for designing evidence-based interventions targeting ischemic stroke prevention and management in China.

Data were obtained from the Global Burden of Disease Study (GBD) 2021 database and screened for Chinese regions, causes of ischemic stroke deaths, and high LDL-C risk factors. The disease burden was measured using indicators such as mortality and disability-adjusted life year (DALY) rates, and systematically analyzed the trends using the Joinpoint regression model. The autoregressive moving average (ARIMA) model was employed to predict the standardized mortality and standardized DALY rates of ischemic stroke attributable to high LDL-C in China from 2022 to 2031.

The overall trend of ischemic stroke rates attributable to high LDL-C in the Chinese population was declining between 1990 and 2021, with mean annual percentage changes (AAPC) of-0.42% (95% CI: -0.66%~-0.18%, P<0.05) and -0.46% (95% CI: -0.63%~-0.29%, P<0.05), with significant age and sex disparities observed. According to the ARIMA model, China’s standardized mortality and DALY rates linked to elevated LDL-C would decline to 15.01 per 100 000 population and 319.00 per 100 000 population, respectively, by 2031.

The disease burden of ischemic stroke attributable to high LDL-C remains substantial in China, and the interventions on LDL-C levels in the priority populations of men and elderly ischemic stroke patients should be reinforced, and prevention and control strategies as well as institutional support should be improved for the purpose of alleviating the disease burden of ischemic stroke more effectively.

To explore the factors affecting the acceptance of pre-pregnancy eugenic health examination for women of childbearing age and provide evidence for improving pre-pregnancy health care services.

A multi-stage stratified random sampling method was adopted to investigate the pre-pregnancy eugenic health examination of 1 995 women of childbearing age in Mianyang City, Sichuan Province through questionnaires. Based on the Andersen theoretical model, four logistic regression analysis models were established to explore the factors influencing the acceptance of pre-pregnancy eugenic health examination by women of childbearing age.

The rate of pre-pregnancy eugenic health examination was 61.1%, of which 53.1% were free and 46.9% were self-paid. The predisposing characteristics, enabling resource-financing, enabling resource-organization and perceived needs were incorporated into the regression model layer by layer. It was found that enabling resource-organization had the greatest impact. Model 4 had the strongest overall explanatory power. Logistic regression analysis results showed that women of childbearing age without insurance or only with commercial insurance (OR=0.526, 95% CI: 0.278-0.996) and those who purchased the urban-rural resident basic medical insurance (OR=0.757, 95% CI:0.597-0.959) had a lower rate of pre-pregnancy eugenic health examination compared to those who purchased urban employee basic medical insurance (P<0.05). From the organizational perspective, women of childbearing age who knew about the free pre-pregnancy eugenic health examination policy (OR=2.907, 95% CI: 2.267-3.728). From the perceived demand perspective, women who planned to get pregnant (OR=1.811,95% CI: 1.459-2.249) were more inclined to accept the pre-pregnancy eugenic health examination (P<0.05).

It is necessary to further promote the implementation of free pre-pregnancy health care service policy, strengthen health education based on primary medical and health institutions, and promote more women of childbearing age to take the initiative to accept pre-pregnancy eugenic health examination services.