Objective To explore the clustering of lifestyle among middle school students in Zhengzhou and its correlation with high blood pressure, in order to provide a scientific basis for the development of effective strategies for preventing and controlling high blood pressure in adolescents. Methods A multi-stage cluster random sampling method was used to select 8 middle schools in Zhengzhou in 2021, with a total of 2 791 students included. A self-made questionnaire was used to investigate their general information and dietary and exercise behaviors, as well as measuring their height, weight, and blood pressure. A latent class clustering analysis was conducted, as well as a binary logistic regression analysis for correlation. Results In total 23.5% of the middle school students were reported to have high blood pressure, with a higher prevalence among junior high school students (26.0%) than high school students (20.2%) (χ²=12.760, P<0.001). A latent class clustering analysis of dietary and exercise behaviors identified two categories: sub-healthy and healthy lifestyles. Logistic regression analysis found that after adjusting for gender, ethnicity, age, grade, and BMI, the risk of high blood pressure in sub-healthy students was 1.357 times that of healthy students (OR=1.357, 95%CI: 1.083-1.701). Conclusion Sub-healthy lifestyles increase the risk of high blood pressure in adolescents, providing new information for exploring the risk factors of cardiovascular and metabolic abnormalities in adolescents as well as the prevention and control of high blood pressure in adolescents.

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 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 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 explore the research hotspots and development trends of health management (physical examination)centers, providing reference and ideas for further research in health management (physical examination) centers in China. Methods A total of 7 516 articles published by health management (physical examination) centers and included in the China National Knowledge Infrastructure (CNKI) and PubMed databases were analyzed using CiteSpace software to analyze and visualize the knowledge map of keywords and publishing institutions. Results Since 1995, the number of research articles from health management (physical examination) centers had been increasing, with the highest numbers of published Chinese and English articles in the journals “Chinese Journal of Health Management” (164 articles) and “Medicine” (112 articles), respectively. The most frequen keywords in Chinese and English articles were influencing factors (242 times) and risk factors (113 times), and the research hotspots of health management (physical examination) centers also focused on cardiovascular metabolic diseases and common malignant tumors. “Elderly people,” “health management,” and “intestinal flora” were emerging persistent keywords until 2023. The density of the network map of collaboration among Chinese research institutions was relatively low, with few connections between institutions. Conclusion The number of research articles from health management (physical examination) centers in China has been increasing year by year, and research on health management, intestinal flora, and related topics is at the forefront of research in health management (physical examination) centers, with elderly people as the main research subjects.These studies will provide epidemiological theory and practical experience for the prevention and control of chronic diseases, but further multi-center and interdisciplinary cooperation and comprehensive implementation of medical service charges for health management are needed to promote the long-term development of health management.

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 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 differences of intestinal flora, metabolic pathways, and functional genes among people at ten-year risk of atherosclerotic cardiovascular disease (ASCVD) in Tibetan population. Methods Based on the follow-up survey data of the natural population cohort in Lhasa in southwest China, a total of 94 people were included in the “China Blood Lipid Management Guide 2023” for follow-up analysis. DNA was extracted from stool samples and analyzed by macro genomic sequencing. The composition of intestinal flora of people at different 10-year risks of ASCVD was compared by bioinformatics method. The metabolic pathway and functional genes were predicted by Kyoto Encyclopedia of Gene and Genome (KEGG) and MetaCye database. Linear discriminant analysis and generalized linear regression were used to screen differential bacteria and explore their relationship with related phenotypes. Results The α diversity of people at risk of ASCVD in the middle and high 10-year risk was significantly decreased (t=-8.213, P=0.032). Strains closely related to butyrate production such as Bacteroides uniforms, (LDA=4.035, P=0.001), Faecalibacterium prausnitzii (LDA=3.876, P=0.003), Bacteroides ovatus (LDA=3.648, P=0.006), Bacteroides fragilis (LDA=3.604, P=0.003), Ruminococcus bicirculans (LDA=3.188, P=0.009), and Roseburia hominis(LDA= 3.169, P=0.004) were enriched in the population with low 10-year risk of ASCVD. The pathways and functional genes related to lipopolysaccharide synthesis (LDA=2.619, P=0.004) and lipid metabolism (LDA=2.694, P=0.001) were significantly up-regulated in the middle and high 10-year ASCVD risk population. Conclusion The intestinal microflora and metabolic function of the people at 10-year risk of ASCVD are significantly changed, and the imbalance of intestinal flora may also be one of the important reasons for changing the 10-year risk of ASCVD.

Objective To understand the clinical features and epidemiological characteristics of monkeypox cases in Shangcheng district, Hangzhou city, providing reference basis for monkeypox epidemic prevention and control work. Methods Data on 35 monkeypox cases detected by medical institutions in Shangcheng district, Hangzhou city from July to December 2023 were collected, including demographic information, clinical manifestations, epidemiological information, laboratory test results, and the clinical features and epidemiological characteristics of the cases were analyzed. Results All 35 monkeypox cases were male sexual contacts, with a median age of 28 years (range: 20 to 37 years). None had a history of smallpox vaccination, and all of them were identified through active medical consultation. Among them, 25 cases (71.43%) admitted to having had male homosexual contact within 21 days before onset, with an interval from last exposure to onset ranging from 1 to 14 days, median (Q1, Q3) of 6 (5, 9) days. Clinical symptoms mainly included fever, rash, inguinal lymph node pain, and muscle soreness; 24 cases (68.57%) presented with fever, all 35 cases had a rash, of which 9 cases (25.71%) had painful rashes, predominantly in the genital or anal region, accounting for 65.71% (23/35). Eleven cases (31.43%) of monkeypox cases were co-infected with Human Immunodeficiency Virus (HIV), with a 48.57% (17/35) prevalence of sexually transmitted diseases. Throat swabs and vesicle swabs were collected from all cases for nucleic acid testing, with a positive detection rate of 62.86% (22/35)in throat swabs, median CT value of 31, and 100% (35/35) in vesicle swabs, median CT value of 22. Conclusion The main clinical feature of monkeypox is rash, and the early recognition of skin rash by clinical doctors is key to early detection of cases.The high positive rate of monkeypox nucleic acid detection in vesicle specimens indicates the need for timely nucleic acid testing in high-risk individuals presenting with rash symptoms for early diagnosis and treatment.