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 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 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 understand the correlation between food cooking methods, dietary preferences of residents in southwest China, and their body mass index (BMI), providing references for local residents’ nutritional health education and scientific dietary choices. Methods A convenient sampling method was used to survey 7 948 residents in Southwest China, and an unordered multinomial logistic regression model was employed to analyze the influencing factors of BMI. Results The majority of residents in Southwest China preferred slightly spicy and light flavors, each accounting for 41.1%. The fried, sautéed, and stir-fried foods (59.2%) and steamed, boiled, blanched, stewed foods (51.8%) were most frequently consumed by residents. In Southwest China, lower frequency of consuming fried, sautéed, and stir-fried foods was associated with a decreased risk of overweight and obesity (OR=0.658, 95%CI: 0.559-0.775), similar results were found in Sichuan, Chongqing, and Guizhou. In Guizhou, lower frequency of consuming steamed, boiled, blanched, stewed foods was associated with an increased risk of overweight and obesity (OR=1.411, 95%CI: 1.025-1.943). In Guizhou and Yunnan, preference for sour flavors was associated with a reduced risk of overweight and obesity (Guizhou: OR=0.512, 95%CI: 0.271-0.965; Yunnan: OR=0.475, 95%CI: 0.246-0.915). Conclusion Dietary preferences and food cooking methods vary among residents in Southwest China and are correlated with BMI. Sour flavors and high frequency of consuming steamed, boiled, blanched, stewed foods are protective factors against overweight and obesity, while frequent consumption of fried, sautéed, and stir-fried foods is a risk factor. It is recommended to strengthen nutritional education and promote residents to make informed choices in dietary preferences and cooking methods to improve public nutrition and health.

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.

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 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 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.