Objective To understand the epidemic characteristics of diabetic nephropathy in China and to provide scientific basis for the prevention and treatment of diabetic nephropathy. Methods Data from the Global Burden of Disease (GBD) database in 2019 was selected to collect data on the incidence of diabetic nephropathy in China from 1990 to 2019. The characteristics and trends of standardized incidence rates and age-specific incidence rates in each year were described, and the Joinpoint regression model was used to analyze the temporal trend of the incidence rate of diabetic nephropathy in China. Results There was no turning point in the trend of age-standardized prevalence of type 1 diabetic nephropathy in the whole population and women in China, and the annual percent change (APC) equaled the average annual percent change (AAPC), showing an upward trend. The average annual growth rate of the whole population was 1.02% (95%CI: 0.87%-1.17%), and that of women as a whole was 1.21% (95%CI: 1.08%-1.35%). The turning point of male trend was in 1994, 2011, and 2017, with an overall average annual growth of 0.56% (95%CI: 0.20%-0.92%). The incidence rates for age groups under 20 years old showed a decreasing trend (AAPC=-0.71% to -0.12%), while those aged 20 and above showed an increasing trend (AAPC=1.06% to 3.99%), all with statistical significance (P<0.05). The standardized incidence rates of type 2 diabetic nephropathy for the whole population, males, and females in China had turning points in 1995, 2000, 2005, 2010, and 2015, with an overall annual decrease of 0.15%(95%CI: -0.17% to -0.12%) for the whole population, 0.12% for males (95%CI: -0.16% to -0.09%), and 0.18% for females(95%CI: -0.22% to -0.15%). Conclusion The epidemic trend of diabetic nephropathy in China from 1990 to 2019 is still grim, and more attention should be paid to diabetes and its complications. In particular, the prevalence rate of women has been higher than that of men, and the prevalence rate of type 2 diabetic nephropathy in the age group of 15-39 years old, 55-59 years old, and ≥ 75 years old, as well as the age group of ≥ 20 years old with the increasing prevalence of type 1 diabetic nephropathy.Strategies and measures should be promptly implemented to address these issues.

Objective To investigate the high-risk factors for preeclampsia in Urumqi, establish a risk prediction model, and validate its effectiveness. Methods A total of 6 138 pregnant women undergoing antenatal examination from February 2021 to February 2023 were collected through the integrated platform of clinical research in Urumqi Maternal and Child Health Hospital. General data, pregnancy history, and pregnancy complications were recorded. The patients were randomly divided into a modeling group (n=4 308) and a validation group (n=1 830) in a 7:3 ratio. The logistic regression model analysis method was used to construct a Nomogram prediction model. The receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were employed to assess the discrimination, calibration, and clinical applicability of the prediction model. Results The advanced age (OR=1.887, 95%CI: 1.535-2.319), overweight (OR=3.221, 95%CI: 2.699-3.844), family history (OR=1.575, 95%CI: 1.254-1.979), hypertension history (OR=17.552, 95%CI: 7.021-43.882), hypertension complicating pregnancy (OR=1.827, 95%CI: 1.388-2.405), preeclampsia history (OR=6.216, 95%CI: 3.578-10.770), and primiparity (OR=2.384, 95%CI:1.777-3.200) were identified as independent risk factors of preeclampsia in Urumqi. The results of ROC curve test showed that the area under the curve and 95%CI of the model group were 0.762 (0.742-0.782), and for the validation group were 0.765 (0.734-0.796). The calibration curve and DCA curve demonstrated that the Nomogram had good accuracy and clinical applicability. Conclusion The established nomogram prediction model exhibited good predictive ability and provides an important reference for clinical practitioners to identify high-risk patients. Early intervention measures should be implemented to prevent further progression and improve maternal and infant outcomes.

Objective To review and analyze the literature related to public health events in China from 2003 to 2023, so as to provide reference for predicting, preventing, and responding to future public health events, and to enhance China’s capacity to deal with sudden public health emergencies. Methods A total of 2 717 articles related to public health field published between 2003 and 2023 and indexed in databases including SCI, CSSCI, CSCD, and PKU core in China National Knowledge Infrastructure (CNKI) were selected as data sources. The CiteSpace software was utilized to explore research hotspots and trends in the evolution of pathways in the field of public health events. Results The study revealed fluctuations in the number of publications on public health events. Author collaboration was relatively stable, while institutional collaboration intensity was low and interdisciplinary collaboration was limited. Research hotspots included emergency management, sudden events, epidemic prevention and control, infectious diseases, and online public opinion. Research content encompassed the epidemic characteristics, influencing factors, emergency response capabilities, and governance responses to public health events.Research topics went through three stages: exploration of public health theories, system construction, and social governance. Conclusion Future research directions will focus mainly on risk communication, public opinion management, and collaborative governance in public health events.

Objective To explore the pollution level and spatiotemporal characteristics of indoor dust di (2-ethylhexyl) phthalate(DEHP) in daily life and the influencing factors of potential family environment and personal living habits, providing scientific basis for the prevention and control of DEHP pollution in indoor dust. Methods Considering the factors of climate, economy and pollution level, household dust samples were collected and investigated in 9 typical cities of Lanzhou, Luoyang, Panjin,Mianyang, Qingdao, Shenzhen, Shijiazhuang, Wuxi, and Xi’an. DEHP content in the treated dust samples was measured using gas chromatography-mass spectrometry (GC-MS). The Wilcoxon rank sum test was employed to examine differences in DEHP levels across various seasons, dominant wind directions, types of home decoration, and living habits. Multiple linear regression was used to identify factors influencing DEHP content in indoor dust. Results DEHP levels in indoor dust varied significantly with season and dominant wind direction in some cities (P<0.05). Specifically, Luoyang and Mianyang exhibited higher DEHP levels during the heating season compared to other periods, while Shenzhen and Shijiazhuang showed lower levels during the heating season (P<0.05). In Mianyang, the upwind areas had significantly higher DEHP levels than the downwind areas (P<0.05). Factors influencing household dust DEHP levels included PM_2.5 (β=0.003, 95%CI: 0.001-0.005), PM₁₀ (β=-0.003,95%CI: -0.005 to -0. 001), formaldehyde (β=3.626, 95%CI: 0.195-7.057), and per capita GDP (β=-0.072, 95%CI: 0.050-0.095). Conclusion DEHP is commonly found in indoor dust in daily life. Seasonal variations and wind direction affect its levels in different cities, though no consistent pattern of pollution characteristics is observed across the cities. Additionally,DEHP content in indoor dust may be influenced by temperature, PM₁₀, xylene, computer use, carpet use, and indoor plant cultivation..

Objective To analyze the direct disease economic burden of inpatients with endocrine diseases during pregnancy, to provide a strong basis for optimizing the allocation of health resources and disease cost control in public hospitals, and to strengthen the theory of prevention and treatment of endocrine-related diseases during pregnancy. Methods CRITIC-VIKOR model was used to evaluate the direct disease economic burden of inpatients with endocrine diseases during pregnancy. Results The four endocrine diseases during pregnancy were toxic diffuse goiter, polycystic ovary syndrome, postpartum hypopituitarism, and gestational diabetes. Among them, the economic burden of toxic diffuse goiter was heavy, wih the benefit ratio of 0, and the disease burden of polycystic ovary syndrome was relatively light, with the benefit ratio of 1. The benefit ratios of the remaining two diseases were 0.761 and 0.756, respectively. Conclusion CRITIC-VIKOR model can be used to evaluate the direct economic burden of inpatients with endocrine diseases during pregnancy. We should strengthen the hierarchical management and classification of endocrine diseases during pregnancy, improve early screening and intervention, and further optimize the cost structure of endocrine diseases during pregnancy to reduce economic burden.

Objective To investigate whether the amino acid variation in the nonstructural protein of Severe Acute Respiratory Syndrome Coronavirus2 (SARS-CoV-2) is related to the severity of Corona Virus Disease 2019 (COVID-19). Methods The data obtained from the Global Shared Influenza Data Initiative (GISAID) database were analyzed, and the nonstructural protein amino acid mutations with high mutation rate in SARS-CoV-2 sequences were screened. The outcomes were divided into mild and severe diseases, and the chi-square test was used to compare the basic characteristics between the groups. The relationship between the mutations selected and the prognosis of the patients was analyzed. Results A total of 23 498 cases were included, including 11 444 males (48.70%) and 12 054 females (51.30%). The median age ［M（P₂₅，P₇₅）］ was 38 (26-53) years old. The severe infection rate of novel coronavirus in male was higher than that in female (χ²=226.564, P < 0.001). The severe infection rate of novel coronavirus increased with the increase of age (χ²=6 088.032, P < 0.001). The year of onset (χ²=1 604.070, P <0.001) and continent (χ²=4 520.240, P < 0.001) were significantly correlated with the severity of novel corona virus infection.Several amino acid variations in the SARS-CoV-2 gene group associated with the severity of novel corona virus’s sensitive dyeing were determined. NSP4_T492I (aOR=0.574, 95%CI: 0.487-0.676), NSP12_G671S (aOR=0.657, 95%CI: 0.458-0.941),NSP6_T77A (aOR=0.422, 95%CI: 0.235-0.759), and NSP3_P1228L (aOR=0.124, 95%CI: 0.080-0.190) were negatively correlated with novel coronavirus’s severe infection. NSP12_P323L (aOR=2.126, 95%CI: 1.531-2.953), NSP13_P77L (aOR=1.923, 95%CI: 1.115-2.369), and NSP14_A394V (aOR=20.486, 95%CI: 9.649-43.495) were positively correlated with novel coronavirus’s severe infection. Conclusion The amino acid variation of SARS-CoV-2 nonstructural protein may be related to the severity of COVID-19 virus infection, and it is necessary to screen several nonstructural protein amino acid variants which can be related to the severity of novel coronavirus infection.

Objective To evaluate the pilot hospitals of modern hospital management system in Sichuan Province, so as to provide reference for strengthening the construction of modern hospital management system. Methods The index weight, comprehensive evaluation, ranking and grading of the pilot hospitals were carried out by criteria importance through inter-criteria correlation (CRITIC), technique for order preference by similarity to ideal solution (TOPSIS), and rank-sum ratio (RSR). Results The range of RSR (Ci) of pilot hospitals in 2021 was 0.409 to 0.611, and 3, 14, 14, and 2 hospitals were graded as good, relatively good, average, and poor. The grading results were statistically significant, and the proportion of medical service income was the main influencing factor of the evaluation results. Conclusion The pilot project of modern hospital management system in Sichuan Province has achieved initial results, and the level of rational drug use in each pilot hospital has been improved, but there is still a gap in operation quality and safety, medical service price adjustment, and outpatient service management.

Objective To analyze the effects of air pollutants on male semen quality and different stages of sperm development in Taiyuan. Methods Totally 7 614 men who were admitted to the Reproductive Department of the First Hospital of Shanxi Medical University from January 1 to December 31, 2019 were enrolled. Their age, semen collection season, and semen parameters were recorded. At the same time, the monitoring data of six air pollutants (SO₂, NO₂, CO, O₃, PM_2.5, and PM₁₀) were collected, and the exposure of air pollutants in the whole developmental period (0 to 90 days before semen collection) and three critical developmental periods (0-9 days, 10-14 days, and 70-90 days) were calculated. Nonparametric Mann-Whitney U test was used to compare the data difference between qualified and unqualified semen parameters. The generalized estimation equation was used to explore the effects of six kinds of air pollutants on the quality parameters of each sperm at different stages of sperm development. Results During the whole period of sperm development, the exposure concentrations of SO₂, NO₂, O₃, and PM_2.5 were different between the qualified and unqualified groups of normal sperm morphology. The exposure to PM₁₀ at 10 and 14 days before semen collection was positively correlated with semen volume (OR=1.245, 95%CI: 1.057-1.467), sperm concentration (OR=1.247, 95%CI: 1.027-1.514), total sperm count (OR=1.385, 95%CI: 1.167-1.643), total motility (OR=1.236,95%CI: 1.085-1.409), and forward movement (OR=1.207, 95%CI: 1.059-1.376). The O₃ exposure was positively correlated with sperm concentration (OR=1.250, 95%CI: 1.002-1.558; OR=1.173, 95%CI: 1.025-1.343), total sperm count (OR=1.255,95%CI: 1.026-1.537; OR=1.218, 95%CI: 1.074-1.380), and normal sperm morphology (OR=1.295, 95%CI: 1.047-1.602; OR=1.229, 95%CI: 1.076-1.404). Conclusion Exposure to air pollutants increases the risk of unqualified semen parameters at all stages of sperm development, and the critical window period focuses on 10-14 days before semen collection, which is the developmental stage of sperm motility. PM₁₀ and O₃ are the main reproductive toxins affecting the decline of male sperm quality in Taiyuan, which need to be paid attention to.

Objective To investigate whether there is a mediating effect of cognitive function between social participation and frailty. Methods Using the China Health and Retirement Longitudinal Survey (CHARLS) database, three rounds of survey data in 2011, 2013, and 2015 were selected for the study. The data in 2011 were the baseline data, and the ID number was used to match the participants in the follow-up in 2013 and 2015. A total of 3 139 people were enrolled in this cohort study. Cox regression model and simple mediating effect model were used to analyze the relationship among social participation, cognitive function, and frailty. Results A total of 259 patients had frailty during the follow-up period. The results of multivariate Cox regression model adjusting social demography and lifestyle showed that social participation (HR=0.641, 95%CI: 0.496-0.829)and cognitive function (HR=0.952, 95%CI: 0.928-0.977) were associated with frailty. The results of the intermediary model with relevant covariates showed that cognitive function has a significant mediating effect between social participation and frailty. Conclusion Social participation and cognitive function are associated with frailty, and cognitive function has some mediating effect between social participation and frailty.

Objective To explore the construction of technical evaluation index system of primary children’s health management services, and to provide reference basis for improving the technical aspects of health management services for children at the grassroots level. Methods By means of literature analysis, policy induction and expert discussion, a preliminary framework and content pool for the evaluation index system of technical assessment for primary children’s health management services were established. The Delphi expert consultation method was then used to determine the content of each index. Results After two rounds of expert consultations, a two-level index system with 2 primary indicators and 5 secondary indicators, two of which had 2 tertiary indicators under each, was constructed. Specific content was assigned to this index system, and corresponding scores were allocated on a percentage basis. The positive coefficient of the experts in the two rounds of consultations were 92% and 100% respectively, and their authority coefficients were both 0.88. The coordination coefficients for the rationality assessment of the index in the two rounds of expert consultation were all between 0 and 1 (P < 0.05). Conclusion The constructed evaluation index system for technical assessment of primary children’s health management services using the improved Delphi method is reasonably effective, and this evaluation index system can provide a reference for the technical assessment of health management services for children at the grassroots level..