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 analyze the the current status and deficiencies of the county medical community construction policy and proposes policy recommendations to optimize the construction of the county medical community. Methods Based on the perspective of policy tools, a three-dimensional analysis framework was constructed combining policy evolution and stakeholder dimensions, and content analysis was used to quantitatively analyze the policy text in three dimensions. Results A total of 29 policy documents were included after screening. The overall utilization of policy tools showed an imbalance, with the utilization of capacity-type policy tools as high as 35.38%, but sub-tools such as financial investment (3.07%) and technical support(2.83%) were less used. Incentive-type policy tools were the least used, accounting for only 8.96%, with sub-tools such as price adjustment and promotion further education accounting for only 0.71% and 0.47%, respectively. The distribution of stakeholders was uneven, with primary medical and health institutions and county hospitals being the main targets, accounting for 27.77% and 25.52%, respectively. With the evolution of policies, the number and variety of policy tools used showed a rapid increase, but capacity-type policy tools still dominated, and there was an imbalance in the internal structure of policy tools. Additionally, the involvement of two key stakeholders including medical personnel and the public, was relatively low. Conclusion There is significant differentiation in the utilization of policy tools, with insufficient use of symbolic, incentive-type policy tools.It is suggested to improve the internal structure of policy elements, enhance the balance of policy tool utilization, continuously optimize policy tools, increase the use of incentive-type and symbolic policy tools, and strengthen the participation of two key stakeholders: medical personnel and the public.

Objective To investigate the toxic effect of nano-copper oxide on copper death in mouse alveolar macrophages. Methods MTT assay was used to detect the survival rate of mouse alveolar macrophages (MH-S) treated with nano-copper oxide, transmission electron microscope to observe the morphology of MH-S cells, Western Blot to detect the expression of copper death protein FDX1 and DLAT, transcriptional group sequencing to explore the changes of cell gene expression and key signal pathways in the process of copper death induced by nano-copper oxide, and one-way ANOVA to analyze the difference. Results Copper oxide nanoparticles with 40nm size could enter MH-S cells, decrease the dose-response survival rate of MH-S cells (P < 0.001), increase the concentration of Cu²⁺ in MH-S cells, and induce the expression of FDX1 (P=0.004) and DLAT protein (P < 0.001). However, the administration of copper death inhibitor tetra thiomolybdate (TTM) reduced the cytotoxicity, decreased the level of intracellular Cu²⁺ (P=0.0038), and decreased the expression of FDX1 (P=0.012) and DLAT (P < 0.05).The sequencing results showed that nano-copper oxide could activate IL-17 inflammatory pathway, while TTM could inhibit IL-17 signal pathway. Conclusion Nano-copper oxide can induce the death of copper in mouse MH-S cells, which provides a new clue for the study of the toxic mechanism of nano-copper oxide.

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 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 investigate the prevalence and influencing factors of mild cognitive impairment (MCI) in the elderly in China, so as to provide scientific basis for slowing down the decline of cognitive function and improving their quality of life. Methods Based on the theory of health ecology, people aged 65 and above were selected from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). The research subjects with dementia and missing key variables were excluded, and finally 11 157 elderly people were included. Multivariate unconditional Logistic regression was used to analyze the influencing factors of MCI in Chinese elderly. Results In this study, 1 526 people ≥ 65 years old had MCI, and the prevalence rate of MCI was 13.7%. The results of multivariate unconditional Logistic regression showed that female (OR=1.242, 95%CI: 1.061-1.455) and advanced age (80 to 94 years old: OR=1.744, 95%CI: 1.359-2.239; ≥ 95 years old: OR=3.014, 95%CI: 2.272-3.998), self-rated worse health status (OR=2.308, 95%CI: 1.202-4.433), hearing impairment (OR=4.760, 95%CI: 4.129-5.487), no exercise(OR=1.204, 95%CI: 1.006-1.441), low score of healthy diet (1-2) (OR=1.562, 95%CI: 1.288-1.894), no social participation activities (housework, social activities, recreational activities, social activities), long sleep time (> 8 hours) (OR=1.347, 95%CI:1.156-1.569), disability (OR=2.987, 95%CI: 2.246-3.974), instrumental activity of daily living (IADL) impairment (OR=3.347,95%CI: 2.510-4.462), living in elderly care institutions (OR=1.569, 95%CI: 1.136-2.166), and poor economic accessibility of medical services (OR=1.155, 95%CI: 1.005-1.328) were risk factors for MCI among the elderly in China. Conclusion The prevalence of MCI in the elderly in China is grim. Gender, age, self-rated health status, hearing function, exercise, healthy diet score, social participation, sleep duration, ADL, IADL, living style, and accessibility of medical services are the main influencing factors of the disease in Chinese elderly. Multi-dimensional and systematic intervention measures are needed to slow down the cognitive decline of the elderly in China.

Objective To evaluate the health risk of heavy metal concentration, source analysis and inhalation pathway of PM_2.5 in ambient air of Huai’an city. Methods The ambient air PM_2.5 samples were collected regularly at a monitoring site in Huai’an city from 2020 to 2022. The contents of 10 heavy metals in PM_2.5 were determined by ICP-MS, and the traceability analysis of heavy metals was carried out by enrichment factor method and principal component analysis. According to the national“Technical Standard for Assessing Population Health Risk”, the health risk of heavy metals to the population was evaluated. Results The annual average values of Al, Mn, Pb, Cr, Ni, As, Se, Sb, Cd and Tl in PM_2.5 of Huai’an city from 2020 to 2022 were 131.11, 28.52, 20.61, 8.09, 5.95, 4.11, 2.62, 1.84, 0.76, and 0.18 ng/m³, respectively. The concentration levels of these metals in winter and spring were higher than those in summer and spring (Z=2.390-7.182, P < 0.05). The results of enrichment factor analysis showed that the elements EF of Se, Cd, Sb, As, Pb, and Tl 6 were more than 100. The principal component analysis showed that the heavy metals in PM_2.5 in Huai’an city mainly came from mixed pollution of traffic, industrial production, coal combustion, and natural emission. For non-carcinogenic effects, Sb, Al, As, Cd, Cr, Mn, Ni, and Se 8 were lower than the screening concentration, and the risk of non-carcinogenic effects (HQ) was less than 1. For carcinogenic effects, the excess carcinogenic risks of As, Cd, and Cr were 1.77 × 10^-5,1.37 × 10^-6, and 9.70 × 10^-5, respectively. Conclusion The sources of heavy metals in PM_2.5 in Huai’an city are multiple compound pollution. The non-carcinogenic effects of Sb, Al, As, Cd, Cr, Mn,Ni, and Se 8 are acceptable, but As, Cd and Cr have potential carcinogenic risk.

Objective To systematically understand the cognitive status of immunization professionals in Jinan on the relevant vaccination guidance in the “National Immunization Program Vaccine Child Immunization Program and Instructions (2021 Edition)”, in order to provide more targeted technical guidance and better improve the immunization program and guidance principles for children. Methods In September 2022, a questionnaire survey was conducted on 15 immunization technical backbones in the district and county CDCs of Jinan, as well as 423 vaccination units (including maternity vaccination rooms)engaged in pre-check and vaccination. The survey data was descriptively analyzed, and χ² tests and multivariate logistic regression analysis were conducted using Excel 2010 and SPSS 18.0 software. The awareness rate of the corresponding knowledge of the survey subjects was calculated based on the accuracy of the answers given by the 15 CDC personnel to the overall knowledge of the immunization program, the knowledge of immunization of children with special health conditions, and the knowledge of simultaneous vaccination. Results The awareness rates of the survey subjects for the overall knowledge of the immunization program, the knowledge of immunization of children with special health conditions, and the knowledge of simultaneous vaccination were 29.91%, 23.29%, and 48.63%, respectively. The results of the multiple-factor logistic regression analysis showed that educational level (OR=1.88, 95%CI: 1.13-3.12), years of preventive vaccination work (OR=1.49, 95%CI:1.01-2.22), and professional qualification category (OR=0.25, 95%CI: 0.068-0.88) were influencing factors of the awareness rate of the immunization program for the survey subjects. Educational level (OR=3.01, 95%CI: 1.63-5.57) and profession (OR=0.24, 95%CI: 0.075-0.78) were influencing factors of the awareness rate of immunization for children with special health conditions. Only gender (OR=0.37, 95%CI: 0.16-0.86) was an influencing factor of the awareness rate of simultaneous vaccination for the survey subjects. Conclusion The cognitive level of immunization clinic staff in Jinan regarding the immunization program, including the vaccination of children with special health conditions and simultaneous vaccination, still needs to be further improved. It is recommended to reasonably increase professional technical training focused on relevant knowledge of immunization. It is also recommended to further improve and refine the guidelines or instructive documents related to the immunization of children with special health conditions and simultaneous vaccination.

Objective To explore the mechanism of Canopy homolog 2 (CNPY2) and aerobic exercise through nuclear factor kappa-B (NF-κB) signal pathway in non-alcoholic fatty liver disease (NAFLD) induced by high fat diet. Methods Male CNPY2 knockout (CNPY2 KO) mice and wild (WT) mice aged (12±1) weeks were randomly divided into control group (CON),hyperlipidemic model group (MOD), and hyperlipidemic model exercise group (MOD+EX) after one week of adaptive feeding.CON group was fed with normal diet, and MOD group and MOD+EX group were fed with high fat diet until the end of 18 weeks.From the 10^th week, the mice in the MOD+EX group received adaptive treadmill training for a week, followed by continuous exercise intervention until the end of the 18-week experiment. The serum levels of TC, TG, LDL-C, HDL-C, ALT, and AST were detected by automatic biochemical analyzer, the pathological morphology of liver was analyzed by HE staining and oil red O staining, the protein expressions of CNPY2, IκB α, p-IκBα, NF-κB, and NF-κB in liver were detected by Western Blot, thelevels of TNF-α and IL6 in liver were detected by ELISA, and the expressions of NF- κB mRNA, TNF- α mRNA, and IL-6 mRNA in liver were detected by q RT-PCR. The data were analyzed by single factor analysis of variance and independent sample t-test. Results The expression of CNPY2 in MOD group was higher than that in CON group (t=-5.730, P=0.001) while the expression of CNPY2 in MOD+EX group was lower than that in MOD group (t=3.714, P=0.010).Compared with CON group, the serum levels of TC, TG, LDL-c, ALT, and AST in MOD group of WT mice and CNPY2 KO mice were higher (WT: t=-13.325, P < 0.001; t=-4.889, P < 0.001; t=-10.442, P < 0.001; t=-3.500, P=0.003; t=-15.122, P <0.001; CNPY2 KO: t=-6.910, P < 0.001; t=-4.962, P < 0.001; t=-7.457, P < 0.001; t=-4.584, P < 0.001; t=-7.336, P <0.001).The levels of TNF-α, IL-6, p-IκBα/IκBα, p-NF-κB/NF-κB, NF-κB mRNA, TNF-α mRNA, and IL-6 mRNA in liver were increased significantly (WT: t=-25.179, P < 0.001; t=-21.043, P < 0.001; t=-9.177, P < 0.001; t=-12.207, P < 0.001; t=-5.205, P=0.002; t=-6.910, P < 0.001; t=-4.802, P=0.003; CNPY2 KO: t=-18.878, P < 0.001; t=-21.840, P < 0.001; t=-14.033, P < 0.001; t=-12.511, P < 0.001; t=-6.870, P < 0.001; t=-9.546, P < 0.001; t=-8.303, P < 0.001), HDL-C level decreased (WT: t=11.695, P < 0.001; CNPY2 KO: t=6.598, P < 0.001), and hepatocyte steatosis with large amount of lipid droplets was observed. Compared with MOD group, the above-mentioned indexes were effectively improved in WT mice and CNPY2 KO mice in MOD+EX group. Compared with WT mice, the above-mentioned indexes of CNPY2 KO mice were improved effectively. Conclusion CNPY2 regulates NF-κB signal pathway and participates in the formation and development of NAFLD. Both CNPY2 gene deletion and aerobic exercise can improve NAFLD, which may be related to the decrease of liver CNPY2 expression, inhibition of NF-κB signal pathway, down-regulation of liver inflammatory cytokines and reduction of liver inflammation.

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.