To analyze the trends in disease burden of HIV/AIDS in China from 1990 to 2023 and conduct a death attribution analysis, providing evidence for refining national HIV prevention and control strategies.

Utilizing data from the Global Burden of Disease Study 2023, the age-standardized incidence rate, mortality rate and disability-adjusted life years (DALYs) rate were applied to assess the disease burden of HIV/AIDS in China. The Joinpoint regression model was used to calculate the annual percent change (APC) and average annual percent change (AAPC). The age-period-cohortmodel was applied to examine the effects of age, period, and birth cohort in disease burden. Death attribution analyses were performed for comorbidities such as tuberculosis (TB).

The age-standardized incidence rate of HIV/AIDS in China increased from 0.69 per 100 000 in 1990 to 2.36 per 100 000 in 2023, with an AAPC of 3.78%. The age-standardized mortality rate rose from 0.14 per 100 000 in 1990 to 1.65 per 100 000 in 2023, with an AAPC of 7.71%. The age-standardized DALYs rate increased from 6.81 per 100 000 in 1990 to 78.21 per 100 000 in 2023, with an AAPC of 7.70%. Age-period-cohort model analysis revealed a “bimodal” age distribution in incidence, with peaks among the 20-34 and over-70 age groups. Compared with the period 2004-2008, the risk of incidence showed a declining trend after 2008, while the risk of mortality and DALYs increased. All indicators showed higher risks in males than in females. Compared with 1955-1959 birth cohort, the highest incidence risk was observed in the 1930-1934 birth cohort, while individuals born after 1960 showed increasing risks of death and DALYs. In terms of death attribution, deaths due to other diseases caused by HIV increased from 55.38% in 1990 to 93.33% in 2023. TB-related deaths continued to decline, predominantly involving HIV-drug-susceptible tuberculosis (HIV-DS-TB), with a higher proportion among males.

From 1990 to 2023, the disease burden of HIV/AIDS in China showed an upward trend. Young adults aged 20-34 yearsandthe elderly are key priority populations. Non-tuberculosis-related-diseases have become the leading cause of death. Future prevention and control strategies in China should focus on interventions targeting sexual transmission, early detection and treatment for young adults, the elderly, and male populations, as well as enhanced surveillance and management of non-tuberculosis-related-diseases.

To investigate the prognostic value of different deep learning models constructed using integrated multi-omics data for patients with cervical squamous cell carcinoma and to compare their predictive performance.

Using preprocessed multi-omics data from the The Cancer Genome Atlas (TCGA) database for cervical squamous cell carcinoma (CESC), three prognostic prediction models—AutoSurv, DeepSurv, and Cox-nnet—were constructed. The predictive performance of the models was evaluated using the C-index, time-dependent area under the receiver operating characteristic curve (AUC), and the P-value of the log-rank test. The AutoSurv model, which demonstrated superior predictive capability, was selected for interpretability analysis using DeepSHAP to identify mRNAs and miRNAs that help distinguish high-risk from low-risk patients.

The C-index, 1-year AUC, 3-year AUC, and 5-year AUC values for the different model test sets showed that the AutoSurv model had the best predictive performance (C-index: 0.78 (95%CI: 0.75-0.81), AUC (1-year): 0.84 (95%CI: 0.81-0.87), AUC (3-year): 0.78 (95%CI: 0.76-0.85), AUC (5-year): 0.77 (95%CI: 0.75-0.81). The Log-rank test of the Kaplan-Meier survival curves indicated that the survival difference between the high- and low-risk groups classified by the AutoSurv model was statistically significant (P=0.013). The AutoSurv model outperformed the DeepSurv and Cox-nnet models in predicting the prognosis of patients with cervical squamous cell carcinoma. After quantifying the mRNAs and miRNAs that significantly influence the prediction results using DeepSHAP, multiple variables associated with the prognosis of cervical squamous cell carcinoma were identified, including POLR2H, FN1, FYN, UBA52, and RPS27A, among others, which were enriched in molecular signaling pathways such as DNA damage repair and NF-κB.

The AutoSurv model can accurately predict survival risk in CESC patients (C-index: 0.78 (95%CI: 0.75-0.81)). Combined with the DeepSHAP method, it provides valuable interpretability analysis, identifies key predictive variables influencing the prognosis of cervical squamous cell carcinoma, and reveals underlying biological mechanisms. This provides a scientific basis for clinicians to develop personalized treatment strategies and offers a research direction for targeted cancer therapy.

To investigate the efficacy of role-playing in enhancing students’ practical capabilities for responding to public health emergencies, grounded in situated learning theory.

Employing the Delphi expert consultation method (n=12), the practical course content was systematically developed. A role-playing teaching approach based on the five-act scenario play Campus Defence was implemented with 120 students from the School of Public Health at a medical university.

Experts reached high consensus on core modules such as “contingency planning” and “case reporting,” providing scientific rationale for scenario development. Quantitative analysis revealed that post-intervention scores (70.94±18.83) significantly exceeded pre-intervention scores (54.43±19.11) (t=12.52, P<0.001), with a substantial effect size (Cohen’s d=1.16). Senior students, female cohorts, and those of intermediate academic standing demonstrated particularly marked improvements.

By establishing a “community of practice,” role-playing effectively facilitated students’ construction of practical knowledge within authentic scenarios. This approach provides theoretical support and a replicable pathway for bridging the knowledge-practice gap in public health education.

To explore the association between visceral fat accumulation indicators and gallstone risk in the Dong population of Guizhou.

A total of 6 375 permanent residents aged 30-79 years were enrolled from the Southwest China Natural Population Cohort of Minority Communities. Logistic regression, subgroup analysis and restricted cubic spline analysis were used to examine the associations of metabolic score for visceral fat (METS-VF), lipid accumulation product(LAP), visceral adiposity index (VAI), and waist circumference (WC) with gallstones.

The gallstone detection rate was 10.9% in the Dong population of Guizhou, higher in females (12.2%) than in males (8.4%). Gallstone patients had higher METS-VF, LAP, VAI, and WC. Compared with Q1, Q4 levels of METS-VF (OR=2.206, 95% CI:1.704-2.856), LAP (OR=2.280, 95% CI:1.789-2.905), VAI (OR=1.674, 95% CI:1.323-2.118) and WC (OR=2.046, 95% CI:1.608-2.603) were all positively associated with gallstone risk. Subgroup analyses showed significant associations only in females (P<0.05), with an interaction between gender and METS-VF (P for interaction =0.007). In the age subgroups, VAI was significant only in participants aged <60 years, while the other indicators were significant in both age groups (P<0.05). Medium-to-high levels of all indicators were positively associated with gallstone risk in those consuming glutinous rice or oil tea (P<0.05). Dose-response analyses showed linear associations of METS-VF and WC with gallstone risk, and nonlinear associations of LAP and VAI with gallstone risk.

Visceral fat accumulation indicators are positively associated with gallstone risk in the Dong ethnic population of Guizhou Province. This association exhibits female specificity and is more pronounced among individuals who consume glutinous rice or oil tea. Public health strategies should prioritize visceral fat management in Dong women, utilize these indicators as supplementary tools for early screening, and develop targeted intervention strategies for high-risk populations to reduce the disease burden of gallstones.

The study aims to investigate the association between hair copper (Cu) levels and fasting blood glucose(FBG) in permanent residents of the Xizang Plateau region, thereby establishing a scientific basis for developing early prevention and control strategies against diabetes mellitus in high-altitude populations.

This cross-sectional study was conducted among permanent residents of Nyingchi City, Xizang Autonomous Region. Data were collected through standardized questionnaires, physical examinations, and biochemical assessments, with hair copper concentrations quantified using inductively coupled plasma mass spectrometry (ICP-MS). Logistic regression models were constructed to determine the independent associations between copper levels and both elevated FBG and hyperglycemia status. Furthermore, restricted cubic spline (RCS) modeling was implemented to explore potential nonlinear dose-response relationships between hair copper concentrations and glycemic indices.

A total of 456 participants were enrolled, stratified into three groups: 261 individuals with normal FBG, 137 with elevated FBG, and 58 with hyperglycemia. Logistic regression analysis revealed that, compared with the low copper level group (Q1), participants in the moderate copper level groups (Q2 and Q3) had a significantly reduced risk of elevated fasting blood glucose (Model 3: Q2: OR=0.50, 95% CI=0.25-0.98; Q3: OR=0.48, 95% CI=0.24-0.95). Regarding the risk of hyperglycemia, compared with the low copper level group (Q1), participants in the Q2 group had a significantly reduced risk of hyperglycemia (Model 2: Q2: OR=0.39, 95% CI=0.16-0.95), while no significant effects were observed for the Q3 and Q4 groups. RCS model further indicated a nonlinear association between hair copper concentration and the risk of elevated FBG (P for nonlinearity =0.010), whereas the nonlinear trend with hyperglycemia risk was not significant (P for nonlinearity =0.387). After combining participants with elevated FBG and hyperglycemia, the risk of abnormal fasting blood glucose showed a nonlinear trend with increasing hair copper concentration (P for nonlinearity =0.008).

This study demonstrates that appropriate hair copper levels are significantly associated with a reduced risk of abnormal fasting blood glucose. However, this inverse association is abolished with copper excess, revealing a significant nonlinear relationship between hair copper concentration and the risk of abnormal fasting blood glucose.

To analyze the trends and projections of the burden of depressive disorders in China, Japan, the United States, and globally from 1990 to 2050, and to explore epidemiological characteristics in the context of population aging.

Age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized disability-adjusted life year rate (ASDR), and age-standardized lived years with disability rate (ASYR) for depressive disorders during 1990—2021 were obtained from the Global Burden of Disease (GBD) 2021 database. Trends were stratified by age and sex. The Nordpred model was used for projections to 2050. Differences were examined in relation to the socio-demographic index (SDI).

Global ASIR increased from 1990 to 2021. China showed a slight decline in ASIR but incident cases grew from 30.5 to 42.4 million. The United States had the highest burden, with a 56% increase in ASDR and an accelerated rise after 2010, while Japan remained relatively stable. The projections showed that ASIR and ASDR in the United States would continue to increase by 2050, and aging-driven case expansion in China and Japan. Global ASIR increased from 3 305.96 per 100 000 in 1990 to 4 212.34 per 100 000 in 2021. China showed slight declines in ASIR and ASPR, with ASPR decreasing from 3 071.84 per 100 000 to 2 875.68 per 100 000, but the number of incident cases increased to 42.36 million due to population size. The United States had the highest disease burden, with ASIR increasing to 6 782.80 per 100 000 and ASDR increasing to 1 010.70 per 100 000. Japan’s ASIR increased to 2 992.26 per 100 000. SDI was positively correlated with ASIR (r=0.367, P<0.001). Females consistently exhibited a higher burden, with the largest sex differences in the United States. Age-specific burden was concentrated among those aged 15-49 years in the United States and among those aged ≥70 years in China. In Japan, the burden was characterized by a dual-peak distribution among both young and older populations.

The burden of depressive disorders in China, Japan, and the United States is expected to increase under population aging, with distinct national patterns: rapid escalation in the United States, heavy absolute burden in China, and a dual-risk expansion toward both younger and older generations in Japan. Strengthening primary and community mental health services targeting females, older adults, and young populations is warranted.

To investigate the association between changes in intrinsic capacity (IC) and the risk of cardiovascular disease (CVD) among middle-aged and older adults.

A total of 2 858 participants from the China Health and Retirement Longitudinal Study (CHARLS) 2011—2018 were included. IC impairment groups were constructed based on changes in five IC domains (locomotion, vitality, cognition, psychological, and sensory) between 2011 and 2013. Cox proportional hazards regression was employed to assess the association between IC changes and CVD. Subgroup and sensitivity analyses were also conducted.

During the 7-year follow-up, 526 (18.4%) incident CVD events were recorded. Compared with the intact group, the hazard ratios (HRs) for incident CVD were 1.47 (95% CI: 1.09-1.99) for the improved group, 1.43 (95% CI: 1.09-1.86) for the persistently mildly impaired group, and 1.74 (95% CI: 1.28-2.37) for the persistently severely impaired group. Compared with the persistently impaired group, the risk of CVD was lower in the improved group (HR=0.58, 95% CI: 0.45-0.76). Subgroup analysis showed an interaction between IC changes and age (P for interaction <0.05).

Persistent IC impairment significantly increases the risk of cardiovascular disease, with risk rising progressively according to the severity of impairment, whereas improvements in intrinsic capacity are associated with a reduced risk.

To characterize the serum metabolomic profile of hyperuricemia (HUA) in a natural population from Chongqing, identify gut microbiota-related metabolites among the differential metabolites, and explore their mediating role in the association between drinking frequency and HUA, so as to provide evidence for intervention.

This cross-sectional study was based on serum samples from 403 participants in Chongqing at the baseline stage of the China Multi-Ethnic Cohort(CMEC) in Southwest China. Untargeted metabolomics was used to identify serum metabolites. Differential metabolites were screened according to fold change and variable importance in projection (VIP), and pathway enrichment analysis was performed based on the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Gut microbiota-related metabolites were identified among the differential metabolites according to the literature and compound annotation, and were further screened using multiple linear regression. Correlation analyses were then conducted between these metabolites, clinical phenotypes, and drinking frequency. Logistic regression and mediation analysis were used to investigate the role of metabolites in the association between drinking frequency and HUA.

A total of 56 differential metabolites were identified, mainly enriched in primary bile acid biosynthesis, pentose and glucuronate interconversions, and arginine biosynthesis. Multiple linear regression identified 15 gut microbiota-related metabolites with statistical significance, including indole-3-propionic acid and indoleacetylglutamine. Indoleacetylglutamine was positively correlated with uric acid, creatinine, and other clinical indicators, and showed a mediating effect (indirect effect: 0.006, 95% CI: 0.001-0.014; proportion mediated: 7.3%).

Patients with HUA exhibited alterations in their metabolic profile. The screened gut microbiota-related metabolites, such as indoleacetylglutamine, may play a role in the association between drinking frequency and HUA. Interventions targeting the gut microbiota and its related metabolites may help reduce HUA associated with drinking habits and metabolic alterations, and may provide a novel therapeutic strategy for HUA patients with drinking habits.

To explore the relationship between the frailty index (FI) and the incidence of arthritis in middle-aged and elderly populations.

Using data from the China Health and Retirement Longitudinal Study (CHARLS) database, a total of 1 449 middle-aged and elderly individuals aged ≥45 years who were free of arthritis at baseline in 2011 were enrolled and followed up until 2020. The growth mixture model (GMM) was employed to identify the dynamic trajectories of the frailty index (FI) during the period from 2011 to 2015. Multivariable Cox regression analysis was performed to assess the associations of baseline FI, cumulative average FI, and FI trajectories with the incidence of new-onset arthritis. Restricted cubic spline(RCS) was used to examine the dose-response relationship, and Kaplan-Meier survival curves were generated.

During the follow-up period, 259 cases of new-onset arthritis were reported, with a cumulative incidence rate of 17.87%. The total number of follow-up person-years was 12 672.7 person-years. After adjusting for multiple covariates including age, sex, body mass index (BMI), history of chronic diseases, and laboratory test results, compared with the lowest baseline FI quartile, the highest baseline FI quartile was associated with a 185% increased risk of developing arthritis (HR=2.85, 95% CI: 1.85-4.40, P<0.001). In comparison with the lowest cumulative average FI quartile, the highest cumulative average FI quartile was linked to a 150% increased risk of arthritis (HR=2.50, 95% CI: 1.67-3.74, P<0.001). Additionally, relative to the group with stable low FI levels, the high-level increasing FI group showed a 150% higher risk of arthritis onset (HR=2.50, 95% CI: 1.82-3.43, P<0.001). RCS analysis demonstrated a linear positive correlation between baseline FI and arthritis incidence (P-nonlinear=0.071), whereas a nonlinear relationship was found between cumulative average FI and arthritis occurrence (P-nonlinear=0.019). Kaplan-Meier curves confirmed that the cumulative risk differences in arthritis incidence among the three exposure groups were statistically significant (Log-rank test, all P<0.001).

Frailty is an independent risk factor for the development of arthritis in middle-aged and elderly individuals. For middle-aged and elderly individuals with high FI,attention should be paid to the prevention and screening of arthritis.

To analyze the status and related factors of glycemic control among type 2 diabetes patients in Anhui Province, providing a scientific basis for improving diabetes management outcomes.

A face-to-face questionnaire survey and blood glucose test were conducted among type 2 diabetes patients aged 30 and above in Anhui Province using a multi-stage stratified random sampling method. The χ² test was used to compare the differences in glycemic control rates among patients with different characteristics, and an unconditional logistic regression model was applied to analyze the related factors of achieving glycemic control targets.

A total of 806 patients were surveyed, and 805 valid questionnaires were collected. Among the 805 patients, the male-to-female ratio was 1:1, the median age was 62 years, and the glycemic control rate was 49.57%. Living in rural areas (OR=0.679), timely preparation of medications in advance (OR=0.573), and experiencing adverse reactions after medication (OR=0.738) were negatively associated with achieving glycemic control targets among patients. Compared with patients with a disease duration of less than 5 years, those with a disease duration of 10 years or more had greater difficulty achieving glycemic control (OR=0.540). Consciously increasing exercise intensity or frequency was positively associated with achieving glycemic control targets (OR=1.360). The odds of achieving glycemic control targets among patients who had quit drinking were 2.732 times higher than those among current drinkers. (OR=2.732).

The glycemic control level among type 2 diabetes patients aged 30 and above in Anhui Province needs further improvement. Greater attention should be given to diabetes management in rural areas, and comprehensive prevention and control measures, including lifestyle interventions and scientific medication guidance, should be implemented to improve patients’ blood glucose levels.