This study aims to investigate the mortality among HIV/AIDS patients receiving antiretroviral therapy (ART) in Fangchenggang City, Guangxi Province, and to identify associated factors with AIDS-related and non-AIDS-related deaths, providing scientific evidence for reducing AIDS mortality.

We collected data from the National Comprehensive AIDS Prevention and Control Information System. These data included socio-demographic and follow-up records of 2 728 HIV-1 infected individuals receiving Antiretroviral Therapy (ART) treatment in Fangchenggang City from January 1, 2005 to July 5, 2022. This dataset included socio-demographic and follow-up records during the specified period, providing a comprehensive insight into the therapeutic responses, survival rates, and potential associated complications among ART-treated HIV/AIDS patients within Fangchenggang City. Socio-demographic and follow-up data were analyzed using the cumulative incidence function (CIF) under a competing risk framework and the Fine-Gray subdistribution hazard regression model to assess the associated factors with both AIDS-related and non-AIDS-related deaths.

With an average follow-up period of 6.7 person-years, 295 cases experienced AIDS-related death with a mortality rate of 1.06/100 person-years, while 227 cases died from non-AIDS-related causes, with a mortality rate of 1.2/100 person-years. Under consideration of competing risks, the cumulative incidence of AIDS-related death at 1 year, 5 years, and 13 years post-diagnosis was 2.5%, 8.5%, and 15.0%, respectively. The factors associated with a higher risk of AIDS-related death included: age 60 years or older (aHR=1.5, 95%CI: 1.05~2.15), current spouse’s infection status unknown/not investigated (aHR=1.39, 95%CI:1.03~1.90), history of prophylactic treatment for opportunistic infections (aHR=1.4, 95%CI:1.06~1.84), and occurrence of opportunistic infections or tumors (aHR=1.65, 95%CI: 1.12~2.45). On the contrary, factors associated with a lower risk of AIDS-related death included: being female (aHR=0.67, 95%CI: 0.49~0.90), initial treatment regimen containing EFV (aHR=0.41, 95%CI: 0.25~0.68), having changed the treatment regimen (aHR=0.19, 95%CI: 0.12~0.29), first CD₄ cell count ≥ 200 cells/μL (aHR=0.30, 95%CI: 0.20~0.45), initial viral load (VL) between 50 to 1000 copies/ml (aHR=0.31, 95%CI: 0.18~0.54), and VL < 50 copies/ml (aHR=0.61, 95%CI: 0.44~0.84). Regarding non-AIDS related deaths, passive detection (aHR=1.41, 95%CI: 1.0~1.98), uninvestigated/unknown spouse’s infection status (aHR=1.40, 95%CI: 1.01~1.95), and first CD₄ cell count ≥200 cells/μL (aHR=1.68, 95%CI:1.27~2.22) were found to be associated with increased risk. In contrast, lower risk factors included being female (aHR=0.55, 95%CI: 0.37~0.81), having experienced a change in antiviral treatment regimen post-initiation (aHR=0.33, 95%CI:0.21~0.50), initial treatment regimens containing EFV (aHR=0.55, 95%CI: 0.34~0.88), and NVP (aHR=0.50, 95%CI: 0.3~0.83).

The mortality rate among HIV/AIDS patients receiving ART in Fangchenggang City is relatively low. This study underscores the importance of preventing and treating opportunistic infections or tumors for improving the survival of HIV/AIDS patients. HIV/AIDS care clinics should particularly focus on monitoring and following up on female patients, older patients, and those detected passively, enhancing medication adherence, expanding HIV testing among key populations, and thereby striving to reduce the mortality rate among AIDS patients.

To investigate the relationship between folic acid supplementation behavior and the risk of gestational diabetes mellitus (GDM) in peri-pregnant women, so as to provide evidence for health care of perinatal women.

Based on the monitoring data of pregnancy health care system in Tongzhou district of Beijing from January 2016 to December 2021, multivariate stepwise Logistic regression model and interaction model were used to investigate the effect of folic acid supplementation behavior on the risk of GDM in perinatal women.

A total of 92 708 subjects were included in this study, including 9 926 patients with GDM, with a prevalence rate of 10.71%. The results of Logistic regression analysis showed that folic acid supplementation during perinatal period (OR=0.627, 95%CI: 0.421-0.933), regular folic acid supplementation (OR=0.927,95%CI: 0.887-0.968), simple folic acid supplementation (OR=0.815, 95%CI: 0.778-0.853), and folic acid supplementation before pregnancy (OR=0.921, 95%CI: 0.882-0.963) were associated with the reduced risk of GDM (P<0.05). The results of interaction analysis showed that there was significant interaction between folic acid supplementation type (OR=0.761, 95%CI:0.726-0.798) and folic acid supplementation time (OR=0.721, 95%CI: 0.658-0.791) and whether folic acid supplementation was regular or not (P<0.05).

Folic acid supplementation before pregnancy and folic acid alone can effectively reduce the incidence of GDM. Nutrition and health education before pregnancy should be strengthened and the importance of regular folic acid supplementation before pregnancy should be emphasized in order to reduce the risk of GDM and protect maternal and infant health.

To investigate the potential relationship between dietary flavanone intake and asthma so as to provide reference for the prevention and control of asthma.

Adults over 20 years old in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2008 were selected as research subjects. Multivariate logistic regression model was used to analyze the relationship between flavanone intake and asthma. Finally, subgroup analysis was used to explore the relationship between flavanone intake and asthma in different sex and age groups.

A total of 5 415 subjects were included, of whom 710 (13.11%) had asthma. The median intake of flavanone was 0.27 mg/d. The intake of flavanone in patients with asthma was significantly lower than that in normal people, and the difference was statistically significant (Z=10.207, P < 0.001). After adjusting for age, sex, body mass index, race, education, drinking, smoking, monthly family poverty, hypertension, and diabetes, the incidence of asthma in the highest quantile was significantly lower than that in the lowest quantile (OR=0.781, 95%CI:0.615-0.991), and the risk of asthma decreased with the increase of flavanone intake (P _trend = 0.015).

There is a negative correlation between flavanone intake and asthma. Flavanone may be a protective factor for asthma, and the correlation may be more obvious in women and young and middle-aged people under 50 years old.

To understand the risk factors of two common chronic diseases in order to provide evidence for the prevention of common chronic diseases and government investment in disease management.

Four waves follow-up data of China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018 were used. In total 2 992 and 1 952 patients with hypertension and rheumatism or arthritis, stomach diseases and rheumatism or arthritis were included. Cox proportional hazard model and shared vulnerability model were used to analyze the influencing factors of multimorbidity.

For people with hypertension and rheumatism or arthritis, living in rural areas (HR=1.367, 95%CI: 1.096-1.705), advanced age group (HR=1.342, 95%CI: 1.013-1.778), obesity (HR=2.424, 95%CI: 1.790-3.283), rheumatism or arthritis as first onset disease (HR=3.797, 95%CI: 3.059-4.713) and other chronic diseases more than 1 (HR=2.694, 95%CI: 2.042-3.555) were associated with a higher possibility of multimorbidity, while people with high education level (HR=0.766, 95%CI: 0.594-0.988) had a lower possibility of multimorbidity, and the shared vulnerability model outperformed Cox model. For people with stomach disease and rheumatism or hypertension: advanced age (HR=0.392, 95%CI: 0.240-0.640), highly educated (HR=0.667, 95%CI: 0.461-0.964),and overweight (HR=0.720, 95%CI: 0.540-0.96)) were associated with lower possibility to have multimorbidity, negative health self-assessment (HR=1.409, 95%CI: 1.038-1.912), being lean (HR=1.935, 95%CI: 1.198-3.126), and having more than 1 chronic diseases (HR=2.339, 95%CI: 1.644-3.328) were associated with higher possibility to have multimorbidity, and there was no significant difference between the two models in this population.

In the hierarchical survival data, the fitting effect of the shared fragile model is better than that of the traditional model. In the group of patients with hypertension and rheumatism or arthritis, there is an increased risk of rheumatism or arthritis in the older age group, obesity and the first onset of rheumatism or arthritis, and the incidence of stomach disease and rheumatism or arthritis is lower in the higher age group and overweight group. Therefore, the prevention measures of chronic multimorbidity should be taken based on different combinations of common diseases to identify high-risk groups respectively, carry out different intervention behaviors, accurately invest medical resources, and reduce the disease burden of the government.

To describe the distribution characteristics of the duration of respiratory events in patients with obstructive sleep apnea (OSA) and analyze the predictive factors of nocturnal minimum blood oxygen saturation.

A total of 265 OSA patients who underwent polysomnography (PSG) in the Sleep Medicine Center of the West China Fourth Hospital of Sichuan University from January to December 2022 were divided into mild, moderate, and severe groups according to their Apnea Hyponea Index (AHI) values. The differences of basic information and sleep parameters dominated by respiratory events were described. The correlation factors of nocturnal lowest oxygen saturation were selected, and the factors with r > 0.3 were included in the multiple linear regression model.

With the aggravation of OSA, the proportion of male, smoking and drinking increased, neck circumference, apnea index, longest apnea time, snoring index, and maximum systolic blood pressure increased (P < 0.05). The lowest oxygen saturation at night was correlated with sex, age, BMI, apnea index, longest apnea time, and average apnea time. Multiple linear regression results showed that the longest apnea time, apnea index, BMI, and the highest systolic blood pressure were negatively correlated with the lowest nocturnal oxygen saturation (P < 0.05). The longest apnea time was the strongest predictor of the lowest nocturnal oxygen saturation (standardized β=-0.516, P < 0.05, 95%CI: -0.579 to-0.453).

The longest apnea time plays an important role in evaluating the severity of OSA and predicting the lowest blood oxygen saturation at night.

To understand the current situation of death anxiety of the elderly in rural areas of Sichuan and its influencing factors.

A questionnaire survey was conducted among 702 rural elderly from 6 prefecture-level cities in Sichuan Province. On the basis of describing the current situation of death anxiety, the χ² test and logistic regression analysis were used to explore the influencing factors of death anxiety.

The scores of emotional dimensions of death anxiety, stress and pain, time consciousness, and cognitive dimension of the elderly in rural areas of Sichuan were (1.10 ±1.33), (2.29 ±1.80),(0.76±0.79), and (1.18±0.79), respectively. The total score was (5.33±3.68), and 245 (34.90%) had high death anxiety. Multivariate analysis showed that the number of children (OR=0.742, 95%CI: 0.630-0.875)), subjective well-being (OR=0.453,95%CI: 0.335-0.612)) and physical fitness (OR=0.581, 95%CI: 0.452-0.746) were the protective factors of death anxiety in the elderly, while chronic diseases (OR=1.575, 95%CI: 1.032-2.404)) were the risk factors of death anxiety.

The death anxiety of the elderly in the rural areas of Sichuan is at a medium-low level, and the rural elderly with a small number of children, chronic diseases, poor physical fitness, and low subjective well-being have a higher level of death anxiety, which should be paid more attention to.

To investigate the status and distribution characteristics of microbial pollution on the surface of indoor air and public facilities at a metro station of a city in the central south China.

The total number of bacteria and fungi in the air and those of bacteria, fungi, coliform, and Staphylococcus aureus on the surface of key public facilities were sampled and detected. Multiple linear regression and Logistic regression were used to analyze the influencing factors.

The median of the total number of bacteria and fungi in the indoor air of metro station was 194.35 and 346.29 CFU/m³, respectively, the median of the total number of bacteria and fungi on the surface was 15.00CFU/25cm² and 0.00CFU/50cm², and the positive rates of coliform group and Staphylococcus aureus were 2.22% and 11.11%, respectively. There were differences in the temporal and spatial distribution of microorganisms in the indoor air of the metro: the total number of bacteria in the station hall was the highest and the total number of fungi in the platform was the highest; the total number of bacteria was the highest in the early peak period and the highest in the evening peak period. The total number of bacteria and fungi on the surface of the ticket inspection machine was higher than that of other public facilities, the total number of fungi on the surface of public facilities at noon was lower than that in the evening peak period, and the positive rate of coliform group was lower than that in the morning peak period. The total number of bacteria in the indoor air of subway station was negatively correlated with temperature (β=-0.06,95%CI: -0.11 to -0.01) and wind speed (β=-0.28, 95%CI: -0.55 to -0.01). The total number of air fungi was positively correlated with relative humidity (β=0.01, 95%CI: 0.00 to 0.02) and negatively correlated with PM_2.5 (β=-0.01, 95%CI: -0.02 to-0.01). There was a negative correlation between the total number of bacteria on the surface and PM_2.5 (β=-0.04, 95%CI: -0.07 to -0.02).

The level of microorganisms in indoor environment of three metro stations in a city in the central south China is low, and the surface of public facilities is contaminated by pathogenic bacteria. The distribution of bacterial and fungal concentrations in metro stations vary among regions and time periods, which is related to temperature, humidity, wind speed, and PM_2.5.

To understand the current situation of nosocomial infection management in primary medical institutions in Guizhou Province, and to provide reference for standardizing the professional development of nosocomial infection management in primary medical institutions.

By using the method of electronic questionnaire survey, the management of nosocomial infection in primary medical institutions in Guizhou Province from April 1 to 30, 2022 was investigated, and 611 valid questionnaires were retrieved.

Among the 611 primary health care institutions, 401 medical institutions set up nosocomial infection committees, 149 medical institutions set up independent nosocomial infection management departments, 321 medical institutions were equipped with full-time staff for nosocomial infection management, and 573 medical institutions were equipped with part-time staff for nosocomial infection management. In total, 321 primary health care institutions were equipped with 334 full-time staff for nosocomial infection management. The average age was (35.19±8.57) years old, the gender was mainly female, the major was nursing, and the degree was bachelor degree or below. The management of nosocomial infection in different types of primary health care institutions was compared and analyzed, and there were differences in age, professional background, educational background, and working years of nosocomial infection department (P < 0.05). The focus of the full-time staff of nosocomial infection management was the issue of salary.

The construction of the organizational structure of nosocomial infection management in private grass-roots medical institutions in Guizhou Province needs to be strengthened, and some full-time staff are engaged in nosocomial infection management for a short time, so they need to strengthen their ability and training.

To evaluate the service effect of health education institutions in China, identify the existing problems, and put forward feasible solutions.

The Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) and Rank-sum ratio (RSR) were used to evaluate the service effect of health education institutions in 31 provinces (autonomous regions and municipalities directly under the central government).

In total 14 indicators for evaluating the service effectiveness of health education institutions were selected in the study. Among them, the top two index with the largest weight were the number of people covered by short messages and the number of audio and video products, while the last two were the number of host websites and the number of programs by co-operating with TV stations. The evaluation of entropy weight TOPSIS method showed that the Ci value of each region was between 0.022 and 0.665. The evaluation results of RSR method showed that the number of areas where the service effect of health education institutions was poor, average, good, and excellent were 2,13, 13, and 3, respectively. The general trend of the two results was basically consistent with that of the fuzzy joint model.

The fuzzy combination of entropy weight TOPSIS method and RSR method can better evaluate the service effect of health education institutions in China. There is an imbalance between the content and the region in the service of health education institutions. We should increase the total investment in health education publicity and human resources, and put forward measures according to the differences of different regions, so as to improve the service effect of health education institutions and enhance residents’ well-being and satisfaction.

To investigate the causal relationship between 211 intestinal microorganisms and anxiety by Mendelian randomization analysis.

Based on the genome-wide association study data of MiBioGen Alliance and Finnish database, the qualified instrumental variables were extracted, and the inverse variance weighting method was used as the main Mendelian randomized analysis method, combined with MR-Egger and Weighted median methods. Finally, the results were verified by Cochran’s Q statistics, intercept terms of MR-Egger regression, MR-PRESSO, and leave-one-out methods.

Cyanobacteria (OR=1.103, 95%CI: 1.001-1.215, P=0.048), Shigella (OR=1.159, 95%CI: 1.027-1.309, P=0.017), and Slackia (OR=1.170, 95%CI: 1.047-1.307, P=0.017) were positively correlated with the risk of anxiety. Firmicutes (OR=0.857, 95%CI:0.754-0.974, P=0.018), Clostridium (OR=0.817, 95%CI: 0.701-0.951, P=0.009), Clostridium (OR=0.849, 95%CI: 0.736-0.980, P=0.025), Eubacterium_rectale_group (OR=0.861, 95%CI: 0.748-0.993, P=0.039), Ruminococcaceae_UCG004(OR=0.886, 95%CI: 0.789-0.994, P=0.039), and Ruminococcaceae_UCG011(OR=0.919, 95%CI: 0.854-0.989, P=0.025) were negatively correlated with anxiety risk. The results were verified and no heterogeneity and horizontal pleiotropy were found.

This study evaluates the potential causal relationship between intestinal microorganisms and anxiety, providing reference for the diagnosis, prevention and treatment of anxiety in the future.