To investigate the overall association between co-exposure to metals and phthalates (PAEs) and blood lipid indicators, as well as the role of metabolic disturbances and endogenous metabolites as mediators in this association.

A total of 74 residents from Guangzhou (n=35) and Qingyuan (n=39) were randomly selected, and their urine samples were analyzed for 15 metal elements and 9 PAE metabolites. Generalized linear models and generalized weighted quantile sum (gWQS) regression models were used to assess the association between individual pollutants, combined exposure, and blood lipid levels. Non-targeted metabolomics, meet-in-the-Middle (MITM) approach, and mediation analysis were performed to identify endogenous metabolites and metabolic pathways linking combined exposure with blood lipid changes, and to explore the mediating effects of metabolites.

The concentrations of seven metals, including arsenic and cadmium, and four PAE metabolites, including mono-isobutyl phthalate (MiBP), were significantly positively correlated with increased total cholesterol (TC). The weighted quantile sum (WQS) index, which represented the overall load of metal and PAE combined exposure, showed a dose-dependent relationship with TC increase. For each one-unit increase in the WQS index, TC increased by 0.43 (95% CI: 0.05-0.82) mmol/L. Eight metabolites, including perilla acid, dehydroepiandrosterone, octanoylcarnitine, arachidonic acid, estrone, kynurenine, glucose-6-phosphate, and ferulic acid, were significantly associated with the WQS index and TC levels, and exhibited significant mediating effects, and the corresponding mediation effects were 0.09 (95% CI: 0.02-0.27)，0.18 (95% CI: 0.04-0.35)、0.21 (95% CI: 0.02-0.44)、0.12 (95% CI: 0.02-0.24)、0.08 (95% CI: 0.02-0.21)、0.08 (95% CI: 0.01-0.20) and 0.09 (95% CI: 0.01-0.19), respectively. The biosynthesis pathway of steroid hormones was significantly enriched.

The biosynthesis pathway of steroid hormones and metabolites such as dehydroepiandrosterone and androstenone may mediate the overall association between combined exposure to metals and PAEs and the increase in TC levels, providing the metabolic perspective for the overall effect on blood lipids of co-exposure to metals and PAEs.

To explore the metabolic characteristics and potential biomarkers of vitamin D deficiency in children and adolescents, and to provide a basis for early identification and prevention of vitamin D deficiency.

Sixty pairs of children and adolescents with vitamin D deficiency and normal levels (matched by age and gender) from the nutrition and health monitoring project of rural school-age children in Guangzhou from March to May 2023 were selected as the research subjects. Based on the determination of serum 25(OH)D and serum untargeted metabolomics, differentially expressed metabolites (set threshold: FC value >1.25 or <0.8, VIP value >1) were screened, and metabolic pathways were analyzed. Logistic regression was applied to screen potential biomarkers, and ROC curves were drawn to evaluate their accuracy.

56 differentially expressed metabolites (38 up-regulated and 18 down-regulated) were identified. The analysis of metabolic pathways showed that the steroid hormone biosynthesis pathway was statistically significant(P=0.001, Q_FDR=0.0982). Logistic regression analysis results showed that 12 potential biomarkers such as 7,8-epoxy-4Z,10Z,13Z,16Z,19Z-(OR=1.95, 95% CI: 1.20-3.17) had statistical significance in the association with vitamin D deficiency, and the AUC in the training set was 0.922(95% CI: 0.865-0.978), and in the test set was 0.910 (95% CI: 0.809-1), with high accuracy.

This study revealed the metabolic pathways related to vitamin D deficiency in children and adolescents and identified 12 potential biomarkers, providing a basis for clarifying the metabolic characteristics and carrying out early identification of vitamin D deficiency.

To analyzing the relationship between dietary quality and depression.

Data from seven consecutive cycles of NHANES dietary data from 2007-2020. Using HEI-2015, AEHI, MDS, PDI, hPDI, uPDI and CDAI to evaluate dietary quality; analyzing the relationship between various dietary indices and depression through multivariate weighted logistic regression, and through Restricted Cubic Spline (RCS) analyzes the nonlinear relationship between dietary indices and depression, and conducts sensitivity analysis to ensure the stability of the results.

A total of 18 490 study participants were included, with a weighted mean age of 46.39±16.38 years. logistic regression results showed that the risk of depression was reduced in the HEI Q4 group compared with the HEI Q1 group (OR=0.786; 95% CI: 0.664-0.929), and in the PDI Q2 group compared with the PDI Q1 group (OR=0.847; 95% CI: 0.750-0.955). no nonlinear relationship was found between HEI, AHEI, MDS, PDI, hPDI and depression, and a nonlinear relationship was shown between uPDI, CDAI and depression.

The quality of meals has a significant impact on the occurrence of depression. Promote high-quality meals and increase the antioxidant capacity of food, which helps to prevent and slow down the occurrence and development of depression.

To analyze the effects of nighttime sleep duration on postpartum depressive symptoms of couples in Anhui Province on both partners based on the actor-partner interdependence model.

Depression screening using the Edinburgh Postnatal Depression Scale (EPDS) was performed on couples who brought their babies for child health checkups at 42 days, 3 months, 6 months, and 12 months postpartum to maternal and child healthcare facilities in Huaibei City, Jieshou City, Ma'anshan City, and Huangshan City, Anhui Province, from November 2023-October 2024, using the Edinburgh Postnatal Depression Scale (EPDS).To describe the general condition and detection of depressive symptoms in couples, and to analyze the association between the length of nighttime sleep and postpartum depressive symptoms in couples through the actor-partner interdependence model.

A total of 2 424 couples were included in the analysis, and the overall detection rates of depressive symptoms at the four postpartum time points were 18.7% and 19.7% for husbands and wives, respectively. The detection rates of depressive symptoms at the 4 postpartum time points were 17.0%, 20.4%, 19.7%, and 17.8% for husbands and 19.7%, 19.6%, 21.1%, and 18.3% for wives. Spearman's correlation analysis showed that the wife's nighttime sleep duration was negatively correlated with both her own and her husband's depression scores, and positively correlated with the husband's nighttime sleep duration, and the husband's nighttime sleep duration was negatively correlated with his own and his wife's depression scores.Furthermore, the wife's depression scores were positively correlated with her husband's depression scores. The actor-partner interdependence model showed that both wives' and husbands' nocturnal sleep duration were able to predict their own depressive symptoms(β=-0.890, 95% CI=-1.016--0.763, β=-0.417, 95% CI=-0.550--0.284, all P<0.001), the actor effect was significant; in terms of the partner effect, nighttime sleep duration of both wives and husbands predicts each other’s depressive symptoms(β=-0.200, 95% CI=-0.292--0.108, P<0.001).

Postpartum depression is more prevalent among couples in four sites in Anhui Province, and nighttime sleep duration is negatively associated with postpartum depression, with both couples interacting with each other, suggesting that psychological interventions need to be carried out jointly by both couples.

To explore the relationship between screen time and mental health problems of adolescents using restricted cubic spline model.

A questionnaire survey was conducted among 3 960 junior and senior high school students in Jinan, Weifang and Qingdao cities of Shandong Province from February to March 2023. Logistic regression model and restricted cubic spline model were used to analyze the correlation strength and dose-response relationship between screen time and psychological problems. Result 46.41% of adolescents in middle and high school had mental problems, and 29.70% reported that screen time(ST)>2 h/d. There was a nonlinear dose-response relationship between mild psychological problems and ST on rest day (P_nonlinear＝0.003, P_overall＝0.003), and the curve was approximately "J" shaped, and the risk increased beyond 1.5 h/d. ST>2 h/d on rest days was associated with mild psychological problems (OR=1.300, 95% CI;1.085-1.558). Stratified analysis showed that there was a nonlinear correlation between ST on rest day and mild mental problems (P_nonlinear<0.001), and a linear correlation between ST and moderate mental problems (P_nonlinear>0.05)(P_overall<0.001). Only smartphones and tablets were linearly associated with mild mental health problems (P_overall＝0.004), with increased risk beyond 2.0 h/d.

The average screen time over 1.5 h/d increases the risk of psychological problems. It is suggested to lighten students'study burden after class and reduce the use of electronic devices on rest days.

To analyze the prevalence of three cardiovascular diseases categories (hypertension, coronary heart disease and stroke), and their impact on activity of daily living (ADL) among the elderly in rural Dayao County of Yunnan Province.

A multi-stage stratified random sampling method was employed in selecting 1 382 rural residents≥60 years from Dayao County for questionnaire survey and physical examination.Multivariate logistic regression models were applied to analyze the association between the prevalence of hypertension, coronary heart disease (CHD), stroke and ADL.

Among the interviewed respondents, the prevalence of hypertension, CHD, stroke, and the impaired rate of physical activity of daily life (PADL), instrumental activity of daily life (IADL) and ADL was 66.2%, 14.6%, 5.9%, 6.6%, 36.5%, and 37.2%, respectively. The prevalence of hypertension, CHD, and stroke and impaired rate of PADL, IADL, and ADL increased with age (, P<0.05). Females had higher prevalence of hypertension, impaired rate of IADL and ADL than males (χ²=7.319, χ²=56.112, χ²=52.510, P<0.05). Older adults with lower level of education had lower prevalence of CHD (χ²=3.930, P<0.05) while they had higher impaired rate of PADL, IADL, and ADL than their counterparts (χ²=7.438, χ²=99.487, χ²=101.057, P<0.001). Similarly, older adults with lower household incomes had lower prevalence of CHD and stroke (χ²=6.442,χ²=4.250, P<0.05) while they had higher impaired rate of IADL and ADL (χ²=6.517, χ²=4.934, P<0.05) than their counterparts. The outcomes of the analysis utilizing multivariate logistic regression suggested that hypertensive older adults (OR=1.760, 95% CI: 1.037-2.985) and older adults who suffered from stroke (OR=3.692, 95% CI:1.989-6.856) were more likely to have higher impaired rate of PADL than their counterparts.

There is a relatively high prevalence of three types of cardiovascular diseases while low level of daily living activity among older adults in Dayao County. Reducing the prevalence of hypertension and stroke would be helpful to alleviate the impaired rate of activity of daily living.

To explore the pathways through which social support influences value co-creation behaviors in older adults, clarify the mediating role of service co-creation literacy, and examine the moderating effect of sense of community.

A random sampling method was employed to select elderly individuals from communities in Changzhi City as research subjects from September to November 2024. Data from 424 community-dwelling elderly individuals were included in the analysis. The data were analyzed using SPSS 24.0, and the PROCESS macro with the bootstrap method was utilized to test mediating and moderating effects.

(1) Social support has a significant direct effect on value co-creation behavior (β=0.114, 95% CI: 0.029-0.199, P=0.009); (2) Service co-creation literacy has a significant partial mediating effect between social support and value co-creation behavior, with a mediating effect size of 0.125(95% CI:0.060-0.189,P<0.001), accounting for 52.3% of the total effect; (3) Sense of community has a moderating effect on the impact of service co-creation literacy on value co-creation behavior (β=0.147,P<0.001).

This study reveals that by constructing a mechanism that emphasizes strengthening the social support system within community health services, cultivating service co-creation literacy among the elderly, and enhancing the sense of community, it is possible to effectively stimulate the elderly population’s participation in value co-creation behaviors in health services.

To comprehensively evaluate the medical quality level of tertiary general hospitals in Guangxi and propose targeted quality improvement strategies.

Through the fuzzy union of entropy-weighted TOPSIS method and RSR method, we evaluated the medical quality of general hospitals in Guangxi cities and towns from 2019 to 2022, and utilized the obstacle degree model for the diagnosis of obstacle factors of medical quality development.

The top three weights of medical quality evaluation indexes were the percentage of special medical service volume (0.334), the number of patients referred downstream (0.216), and the percentage of commented prescriptions (0.107); the medical quality levels of Nanning City, Liuzhou City, and Guilin City were in the forefront, and that of Fangchenggang City, Laibin City, and Hechi City were in the back; the barrier factor diagnosis showed that the medical quality was greatly affected by functional positioning and rational drug use, with the barrier degree of 73.77% and 17.70% respectively, but the barrier degree of functional positioning showed a decreasing trend year by year, and the barrier degree of rational drug use showed a rising trend year by year, in which the barrier degree of rational drug use in Nanning City and Guilin City in 2022 had exceeded that of functional positioning.

The development of healthcare quality is not balanced between cities in Guangxi and the focus of development is different, tertiary general hospitals should clarify their own functional positioning and strengthen the guarantee of rational medication use.

To understand the public’s intention on the scope of granting prescribing rights to public health physicians, to provide reference opinions on the pilot work in progress in China, and to provide scientific basis and support for further exploring the policy formulation and promotion of granting prescribing rights to public health physicians in the province.

Using snowball method to conduct this survey, combined with personal interview method to collect the suggestions of different occupational groups in Sichuan province on the different scope of practice of public health doctors.

A total of 1 706 valid questionnaires were collected in this study. The results showed that 89.45% of the respondents supported giving public health doctors the right to prescribe, 76.85%-83.06% of the respondents suggested that public health doctors’ right to prescribe diseases such as infectious diseases, chronic diseases, occupational diseases, parasites and endemic diseases be completely lifted. 90.97% of the respondents believed that public health doctors should be allowed to prescribe non-drug interventions to patients with chronic diseases and people at risk of chronic diseases.

Based on the existing pilot programme, the subsequent scope of practice of public health physicians’ prescriptive authority should be further improved, and consideration should be given to the gradual trial implementation of prescriptive authority for non-pharmacological interventions, so as to give full play to the functional advantages of public health physicians as prevention-oriented physicians, and at the same time the mechanism for the training, development and assessment of public health physicians should be strengthened, in order to provide the grass-roots level with a high-quality team of public health physicians.