Objective To analyze the epidemiological characteristics, changing trends, and spatial-temporal aggregation of hand-foot-mouth disease (HFMD) in Wenzhou from 2013 to 2022, so as to scientifically guide the decision-making of prevention and control. Methods The infectious disease report data for HFMD in Wenzhou city were collected from the China Disease Prevention and Control Information System for the period 2013—2022. Spatial-temporal scanning analysis was conducted using StatsCan software, and spatial autocorrelation analysis was performed using ArcMap 10.2 software to identify spatial-temporal aggregation patterns. Results A total of 260 401 cases of HFMD were reported in Wenzhou from 2013 to 2022, with an average annual incidence of 276.93 per 100 000 and a severe disease rate of 13.82 per 100 000. The incidence exhibited a decreasing trend (χ²_trend=26 402.606, P < 0.05). The incidence rate among individuals over 6 years old increased (χ²_trend=1 814.455, P < 0.05), as did the rates among nursery children, students, and teachers (χ²_trend=5 493.085, P < 0.05; χ²_trend=1 752.584, P < 0.05; χ²_trend=9.424, P < 0.05). Spatial analysis revealed aggregation of HFMD cases in 2017, with a Moran I value of 0.433 514 (Z=2.42 775 and P=0.015 193), indicating positive spatial correlation and hot spots concentrated in Wencheng county and Pingyang county. Spatial-temporal scanning identified a primary aggregation covering Rui’an city, Cangnan county,Pingyang county, and Wencheng county, from January 1, 2014, to December 31, 2018, with a radiation radius of 44.67km (LLR=12 534.45, RR=1.98, P < 0.01). The proportion of enterovirus type 71 (EV-A71) in group A showed a downward trend (χ²_trend=171.245, P < 0.05), while the proportion of other enteroviruses, including coxsackievirus group A 16 (CV-A16), increased(χ²_trend=93.481, P < 0.05). Conclusion The incidence of HFMD in Wenzhou remains high, although both the incidence and severity rates have decreased. Other enteroviruses, including coxsackievirus group A 6 (CV-A6), have become the dominant pathogens, and there has been an increase in incidence among teachers and individuals over 6 years old. The main aggregation areas were identified as Rui’an city, Cangnan county, Pingyang county, and Wencheng county.

Objective To investigate the current status and influencing factors of the utilization of medical assistance policy resources by difficult groups with chronic diseases and economic difficulties in urban villages, analyze the existing problems, and propose corresponding strategies to promote precision management of diseases for vulnerable groups and facilitate health poverty alleviation in the new era. Methods Firstly, using a questionnaire survey, two out of four urban village streets in a certain district of Chengdu were randomly selected to investigate the existing problems in the utilization of medical assistance by difficult groups. Secondly, telephone interviews were conducted to analyze the reasons for not utilizing medical assistance even though meeting the conditions, and countermeasures were proposed. Results Difficult groups utilized the policy of subsidizing and participating in insurance the best, while the utilization of outpatient, inpatient, and supplementary medical assistance policies was the worst. The results of multivariate Logistic regression analysis showed that having more than three comorbidities (OR=0.134) was a risk factor for assistance utilization. Having disabilities (OR=2.625), higher educational level (OR=3.500), and higher average monthly medical expenses (OR=4.148) were protective factors for utilization of assistance. The follow-up results indicated that factors such as patients’ lack of policy awareness, misunderstandings about policies, not seeking treatment at designated hospitals, some Chinese medicine not being reimbursed, and complex application procedures were the main causes leading to their non-utilization of policies. Conclusion Difficult groups with diseases utilize well the government assistance policies obtained through direct help, but the utilization of policies requiring proactive application is poor. The characteristics of patients’ own diseases, inadequate explanation of policies, high reimbursement thresholds, and limited reimbursement scope are the main reasons for difficult groups not applying for medical assistance.

Objective To investigate the pathogen pollution in the poultry and environment in Changsha live poultry wholesale market. Methods In total 817 live poultry and environment samples from Changsha county wholesale poultry market were collected from 2022 to 2023. AIV, NDV, C. psittaci, Brucella, and S. suis nucleic acids were detected by real-time fluorescence PCR, and the results were statistically analyzed. Results The overall positive rates of AIV, NDV, C. psittaci, Brucella, and S.suis in market poultry and environment were 64.01%, 32.19%, 6.36%, 0.24%, and 17.75%, respectively. The positive rates of NDV and S. suis in 2023 were higher than those in 2022, and the positive rates of five pathogens were the highest in October or December. There were significant differences in the positive rates of NDV (χ²=6.23, P=0.01) and S. suis (χ²=45.40, P<0.01) in different years and in AIV (χ²=50.50, P<0.01), NDV (χ²=41.28, P<0.01), C. psittaci (χ²=32.83, P<0.01), and S. suis (χ²=59.43,P<0.01) in different months. The sampling sites with the highest positive rates of AIV, NDV, C. psittaci, Brucella, and S. suis were poultry stores (67.53%), market public areas (44.00%), market public areas (8.00%), sheep/dog stores (3.57%), and poultry stores (19.02%). The samples with the highest positive rates of AIV, NDV, C. psittaci, Brucella, and S. suis were poultry drinking water (90.91%), air (61.11%), poultry cages (9.59%), sheep/dogs and other cages (3.77%), and air (31.25%). The positive rates of AIV (χ²=69.06, P<0.01), NDV (χ²=20.98, P<0.01), Brucella (χ²=27.25, P<0.01), S. suis (χ²=8.37, P=0.02) in different sampling sites and AIV (χ²=155.80 , P<0.0l), NDV (χ²=132.59, P<0.01), Brucella (χ²=10.10, P<0.0l) and S. suis (χ²=49.92,P<0.01) in different samples were significantly different. Conclusion The AIV, NDV, C. psittaci, Brucella, and S. suis nucleic acid pollution are common in poultry and environment in Changsha live poultry wholesale market, which indicates that the live poultry wholesale market needs to strengthen the prevention and control measures of zoonosis, such as place disinfection, health education and epidemic surveillance.

Objective To investigate the impact of social and family elderly care on the social participation (labor participation, social recreational activities) of the elderly. Methods A multi-stage stratified random sampling method was employed to conduct a questionnaire survey on the elderly in five urban districts of Xuzhou city. Totally 1 000 elderly individuals aged 60 and above were selected as the study subjects. Descriptive analysis and χ² test were performed using Stata 18.0. A binary logistic regression model was utilized to explore the influence of social and family elderly care on the social participation of the elderly. A significance level of α=0.05 was set for the tests. Results Among the 1 000 elderly individuals, 217 were engaged in labor, and 623 participated in recreational activities, with participation rates of 21.7% and 62.3%, respectively, indicating relatively low participation rates. A higher level of elderly care was associated with a lower probability of labor participation among the elderly. Elderly individuals with higher economic support from their children had a higher probability of labor participation. Moreover, compared to elderly individuals without material support from their children, those receiving such support had a higher probability of participating in recreational activities. Conclusion Family and social elderly care are important influencing factors for the social participation of the elderly. It is essential to further improve the elderly care system, enhance the level of social participation among the elderly, to achieve the goal of active aging.

Objective To explore the correlation between sleep and depression in middle-aged and elderly people in Chinese community, so as to provide references for improving sleep quality, mental health and quality of life of middle-aged and elderly people. Methods The data of this study were collected from the China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2018. After screening the data, 6 312 participants were included in the study, and they were divided into groups according to their nocturnal sleep duration. The multivariate linear regression model and multivariate logistic regression model were constructed, and the covariates were adjusted to analyze the relationship between nocturnal sleep duration and depression. Results There were 76.81% of the patients having too short or too long sleep at night (7 to < 8 hours was the normal sleep time).The scores and detection rates of depression in 2018 were significantly different among different night sleep length groups (F=30.127, χ²=67.928, P<0.001). There was a negative correlation between night sleep time and depression score (β=-0.278, P<0.001). After further consideration of covariates, short sleep duration (≤ 5 h) was a risk factor for depression (OR=1.621, 95%CI:1.371-1.918), and the risk of depression was higher in women than in men (OR=1.673, 95%CI: 1.363-2.054 in women; OR=1.501, 95%CI: 1.120-2.012 in men). Conclusion The nocturnal sleep of the middle-aged and elderly is related to depression and is affected by demographic, socio-economic factors, health behavior factors and other covariables, and middle-aged and elderly women have a higher risk than men and older age. Attention should be paid to sleep health and mental health of the middle-aged and elderly, so as to improve their quality of life.

Objective To study the impact of exposure to green space during pregnancy on low birth weight (LBW) and preterm birth (PTB) in pregnant women, and to explore the susceptible window period of green space exposure, providing data support for related research fields. Methods This study recruited pregnant women and their infants in the Sichuan multi-level infant and early life (SMILE) cohort study as the research subjects, and information on sociodemographic characteristics, lifestyle habits, and birth outcomes were collected. A 250m buffer zone was delineated based on the pregnant women’s residential addresses, and the average normalized difference vegetation index (NDVI) during pregnancy was calculated. Cox proportional hazards regression models were used to analyze the impact of green space exposure during pregnancy on LBW and PTB and to identify the key window period of green space exposure affecting LBW and PTB. Results In total 6 612 pregnant women were included in this study, and the prevalence rates of LBW and PTB were 3.36% and 3.43%, respectively. It was found that the fourth quartile of NDVI was negatively correlated with LBW and PTB (LBW:HR=0.38, 95%CI: 0.24-0.59, P=0.012; PTB: Q4:HR=0.33, 95%CI: 0.21-0.51, P < 0.001). In the third trimester of pregnancy, NDVI had a protective effect on LBW (Q2: HR=0.28, 95%CI: 0.19-0.42, P=0.003; Q3: HR=0.17, 95%CI: 0.11-0.27, P<0.001; Q4: HR=0.07, 95%CI: 0.04-0.12, P<0.001)and PTB (Q2: HR=0.19, 95%CI: 0.13-0.28, P < 0.001; Q3: HR=0.10, 95%CI: 0.07-0.16, P<0.001; Q4: HR=0.03, 95%CI:0.02-0.06, P<0.001), and as the level of NDVI increased, the protective effect became stronger. Conclusion Green space during pregnancy is negatively correlated with LBW and PTB. Late pregnancy may be a key window period of exposure, and higher levels of green space are more beneficial for maternal and child health.

Objective To investigate the internal exposure levels of selenium, arsenic, chromium, and cadmium in blood and urine of general population in Jiangxi Province from 2017 to 2018. Methods A multi-stage complex sampling method was employed to detect the content of selenium, arsenic, chromium, and cadmium in the fasting venous whole blood and urine samples of 720 selected subjects using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The exposure situation of residents in different genders, ages, urban and rural areas, and monitoring sites was analyzed. Spearman correlation was used to evaluate the bivariate correlation between blood metal concentrations and urine metal levels. Results The median levels of blood selenium and urine selenium in the general population of Jiangxi Province from 2017 to 2018 were 90.89 μg/L and 13.67 μg/L, respectively. The median levels of blood arsenic and urine arsenic were 1.26 μg/L and 24.03 μg/L, respectively. The median levels of blood chromium and urine chromium were 0.51 μg/L and 1.84 μg/L, respectively. The median levels of blood cadmium and urine cadmium were 0.85 μg/L and 0.61 μg/L, respectively. There were statistically significant differences in blood selenium (Z=-5.09, P < 0.01) and urine selenium concentrations (Z=-3.94, P < 0.05) between different urban and rural areas, with concentrations higher in urban areas. Except for blood cadmium and urine cadmium, there were statistically significant differences in the concentration levels of other inorganic substances between different monitoring sites (P < 0.05). Differences in blood selenium (H=34.56, P < 0.05), blood cadmium (H=54.14, P < 0.05), and urine cadmium (H=63.447, P < 0.05) among different age groups were statistically significant, with concentrations gradually increasing with age. No statistically significant differences in concentrations of other inorganic substances between different genders were found (P > 0.05) except for urine selenium (Z=-3.77, P < 0.05). The strongest correlation coefficient among the four inorganic substances was 0.419 for blood cadmium and urine cadmium. Conclusion Residents in different regions of Jiangxi Province exhibit varying levels of internal exposure to selenium, arsenic, and chromium. Cadmium showed no regional differences in whole blood and urine load levels within the province, suggesting cadmium accumulation and a positive correlation with age.

Objective To analyze the results of genetic metabolic disease screening and gene mutation characteristics in newborns in Haikou, Hainan. Methods A retrospective analysis was conducted on 185 660 newborns born at the Haikou Maternal and Child Health Hospital from March 2017 to March 2021 who underwent genetic metabolic disease screening. All newborns underwent tandem mass spectrometry screening for genetic metabolic diseases within 7 days after birth. The positivity rate of genetic metabolic disease screening in newborns was statistically analyzed, and the specific gene mutation characteristics of the metabolic diseases were investigated. Results Among 185 660 newborns in Haikou, 88 were diagnosed with genetic metabolic diseases, with a total prevalence rate of 1 in 2 110 (47.40 per 100 000). Among the 88 cases, the prevalence rates of organic acidemia, amino acid metabolism disorders, and fatty acid oxidation disorders were 1/3 640, 1/10 921, and 1/9 283, respectively, with methylmalonic acidemia, medium-chain acyl-CoA dehydrogenase deficiency, and citrin deficiency ranking the top three.Genetic testing revealed that in 42 cases of methylmalonic acidemia, MUT and MMACHC mutation genes were detected, with the c.609G>A mutation in the MMACHC gene being the most common（37.97%）. The ACADM mutation genes in 15 cases of medium-chain acyl-CoA dehydrogenase deficiency were mainly detected at c.387+1delG (25.00%), c.449_452delCTGA(16.67%), and c.1076C>T (16.67%). The SLC25A13 mutations in 8 cases of citrin deficiency were mainly detected at c.154C>T(37.50%) and c.1638_1660dup (25.00%). Other detected mutation genes in genetic metabolic diseases mostly had 2 or 1 mutation sites. During treatment and follow-up, 49 children were normal (55.68%), 36 children experienced developmental delays(40.90%), and 3 children died (3.41%). Conclusion Haikou, Hainan has a certain incidence of genetic metabolic diseases in newborns, with medium-chain acyl-CoA dehydrogenase deficiency, methylmalonic acidemia, and citrin deficiency having the highest prevalence. These diseases exhibit specific characteristics in mutation sites.

Objective To analyze the epidemiological characteristics and treatment-related deaths within 12 months of HIV/AIDS patients aged 50 and above reported in a province, providing a basis for targeted prevention and control measures. Methods Data on HIV/AIDS cases aged 50 and above reported in a province from 2010 to 2019 were collected from the China CDC Information System for Comprehensive Prevention and Control of AIDS, and the epidemiological characteristics and treatment-related deaths within 12 months were analyzed. The comparison of rates was performed using the χ² test, trend changes were analyzed using the trend χ² test, and the comparison of CD4⁺ T lymphocyte detection results between groups was performed using non-parametric tests. Results From 2010 to 2019, a total of 2 875 cases of HIV/AIDS aged 50 and above were reported in the province, accounting for 19.4% of the total cases (14 819 cases). The proportion of new cases increased from 10.3% in 2010 to 24.6% in 2019, with a statistically significant difference (χ²_trend =126.741, P < 0.001), and the annual reported incidence showed an increasing trend (χ²_trend=936.208, P < 0.001). The male-to-female ratio was 5.3:1, with an average age of (58.40±7.50) years. The majority were farmers, accounting for 49.0% (1 408/2 875). The primary education level accounted for 42.0%(1 208/2 875). The majority were identified by medical institutions, accounting for 64.5% (1 854/2 875); sexual transmission was the primary route, accounting for 96.8% (2 784/2 875). Among male cases, same-sex transmission accounted for 49.5% (1 423/2 416). Among female cases, non-marital heterosexual transmission and spousal transmission accounted for 49.0% (212/433) and 51.0% (221/433), respectively. The median CD4⁺ T lymphocyte count at the initial test was 266 cells/mm³. There was a statistically significant difference in CD4⁺ T lymphocyte counts between males and females (Z=-5.395, P < 0.001). The treatment rate within 12 months of diagnosis was 56.7% (1 632/2 875), showing an increasing trend each year (χ²_trend=115.054, P < 0.001). The mortality rate within 12 months of diagnosis was 15.2% (433/2,875), showing a decreasing trend each year (χ²_trend=61.654, P < 0.001). Conclusion The number and proportion of HIV/AIDS cases aged 50 and above in the province have been increasing annually. It is necessary to strengthen targeted health education and interventions for this population as well as expand testing to achieve early detection and treatment.

Objective To explore the influencing factors of falls in the elderly and to provide evidence for the prevention of falls. Methods The study was based on a large sample of 179 141 individuals in Shanghai, with a final inclusion of 40 244 participants. Firstly, independent variables including basic demographics, living environment, health status, and lifestyle habits were selected, with falls as the dependent variable, and univariate and multivariate logistic regression analyses were conducted. Secondly, negative emotions were considered as independent variables, and multivariate logistic regression analysis was performed. Results The fall incidence rate in the elderly within 90 days was 19.55%. Living alone (fall within 30 days: OR=1.161, 95%CI:1.051-1.282; fall between 31-90 days: OR=1.173, 95%CI: 1.070-1.287), unclean living environment (OR=1.775, 95%CI:1.331-2.367; OR=1.117, 95%CI: 1.037-1.203), having ≥3 chronic diseases (OR=2.024, 95%CI: 1.763-2.322; OR=2.089,95%CI: 1.835-2.379), using urine or stool pads (OR=1.581, 95%CI: 1.351-1.850; OR=1.445, 95%CI: 1.239-1.685), and low frequency of outdoor activities (occasional outdoor activitie: OR=1.458, 95%CI: 1.171-1.816; OR=1.359, 95%CI: 1.114-1.658;rarely going out: OR=2.084, 95%CI: 1.673-2.596; OR=2.053, 95%CI: 1.682-2.506) were identified as risk factors for falls within 30 days and 31 to 90 days. Advanced age (70-79 years: OR=1.179, 95%CI: 1.063-1.308; 80 years and above: OR=1.159, 95%CI: 1.040-1.292), abnormal vision (OR=1.235, 95%CI: 1.079-1.414), and needing assistance with household chores (partially completed by others: OR=1.572, 95%CI: 1.139-2.169; fully completed by others: OR=1.649, 95%CI: 1.269-2.143)were risk factors for falls within 30 days. There was no collinearity between the independent variables. Compared with those who did not feel negative emotions, the elderly who frequently felt fatigued had a lower risk of falling (fall within 30 days: OR=0.886, 95%CI: 0.811-0.968; fall between 31-90 days: OR=0.900, 95%CI: 0.828-0.977), while the elderly who frequently felt angry had a higher risk of falling (fall within 30 days: OR=1.491, 95%CI: 1.248-1.782; fall between 31-90 days: OR=1.270,95%CI: 1.067-1.513). Conclusion Elderly individuals living with others, maintaining a clean and tidy indoor environment, having a flat and clutter-free floor, and maintaining a good emotional state have a reduced risk of falling. For elderly individuals with relatively good activities of daily living (ADL) and cognitive function, it is advisable to encourage appropriate outdoor activities and engage in moderate-intensity and frequency physical activities to prevent falls.