The 25(OH)D deficiency is a prevalent issue among patients with chronic kidney disease (CKD). The aim of our study is to investigate whether low levels of 25(OH)D are associated with increased all-cause and cardiovascular mortality in patients with CKD.

This retrospective cohort study utilized the National Health and Nutrition Examination Survey (NHANES) and the National Death Index (NDI) 2007—2018 database to investigate the association between 25(OH)D levels and all-cause mortality as well as cardiovascular mortality. A total of 2 668 eligible subjects were included in this study, with follow-up conducted until December 31, 2019. Cox proportional hazards regression, restricted cubic spline, Kaplan-Meier survival curves, and competing risk survival analysis were performed to evaluate the associations. Furthermore, subgroup and sensitivity analyses were performed.

During a median follow-up of 6 years in a weighted population of 11 715 452 eligible participants, there were 665 deaths from any cause, including 196 cardiovascular-related deaths. After adjusting for covariates, lower levels of 25(OH)D were significantly associated with increased risks for both all-cause (HR=0.85, 95%CI: 0.77-0.94) and cardiovascular mortality (SHR=0.80, 95%CI: 0.67-0.94). Consistent results were also observed when analyzing 25(OH)D as a categorical variable (quartile) (both P<0.05). Weighted restricted cubic splines revealed an inverse J-shaped association between levels of 25 (OH) D and all-cause mortality (P_nonliner> 0.05). Subgroup analysis (P_interaction>0.05) and sensitivity analysis (HR=0.85, 95%CI: 0.77-0.93) yielded similar findings.

Lower 25(OH)D levels, both as a continuous and categorical variable, are significantly associated with an increased risk of all-cause mortality and cardiovascular disease-related mortality.The 25(OH)D has a negative j-shaped association with all-cause and cardiovascular mortality.

According to the theory of life course, family environmental factors in early life have influence on individual health. The objective is to understand the influence and importance of family environmental factors in early life and other factors in adulthood on self-rated health of the middle-aged and elderly, so as to provide reference for active aging and healthy aging.

The demographic data, social support, and early family environmental factors of people over 45 years old from Chinese General Social Survey (CGSS) data in 2021 were collected. Chi-square test, binary Logistic regression, and random forest model were used to analyze the influencing factors and importance of self-rated health of the middle-aged and elderly.

Among the 4 311 subjects, 2 427 were unhealthy and 1 884 were healthy. The regression results showed that the middle-aged and elderly people aged 79 and over, working in agriculture, not working, never engaging in social and recreational activities, middle-and lower-middle-level socioeconomic status, and fathers with college education or above had a higher rate of self-rated unhealth (P < 0.05). The self-rated unhealthy rate of the middle-aged and elderly with normal and overweight, non-depression, average family economic level and higher than the average level of BMI was lower (P < 0.05). The order of influencing factors was depression (73.717), family economic level (55.361), nature of work (47.074), personal socio-economic status (42.177), BMI (38.952), age (28.842), frequency of social and recreational activities (28.270), and father’s education level (22.319).

There are many factors affecting the self-rated health of the middle-aged and elderly in China. Depression, family economic level, and the nature of work are important factors affecting the self-rated health of the middle-aged and elderly in China. Attention should be paid to special groups such as depression, low income, perennial farming, and out of work.

To investigate the relationship between muscle strength and the risk of depression in the middle-aged and elderly, and to provide reference for the prevention and treatment of depression in the middle-aged and elderly in China.

Based on the data of China Health and Retirement Longitudinal Study (CHARLS), the middle-aged and elderly people who participated in the survey in 2015 and 2018 were selected. Firstly, restricted cubic splines (RCS) were used to analyze whether there was a dose-response relationship between upper limb strength (standardized grip strength) and lower limb strength (time to stand up from a chair) and the risk of depression in the middle-aged and elderly. Secondly, the upper and lower limb strength were divided into three groups, and Logistic regression model was used to evaluate the correlation between upper and lower limb strength, overall muscle strength and depression risk in the middle-aged and elderly.

A total of 6 245 subjects were enrolled in this study. During the 3-year follow-up period, a total of 2 095 (33.5%) subjects had depressive symptoms.There was a dose-response relationship between upper and lower limb strength and the risk of depression in the middle-aged and elderly. Logistic regression model showed that after adjusting the confounding factors such as sex, age and marital status, stronger upper and lower limb strength could reduce the risk of depression by 24% and 28%, respectively. Compared with the weakest overall muscle strength group, the strongest muscle strength group had a 48% lower risk of depression (OR=0.52,95%CI: 0.41-0.67).

Strong muscle strength can reduce the risk of depression in the middle-aged and elderly.

To investigate the relationship between hearing loss and the risk of muscular dystrophy in the middle-aged and elderly, so as to provide scientific basis for the prevention and intervention of myogenic in this population.

In this study, people aged 45 and above in the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015 were selected as research subjects. Self-reported hearing loss was used to evaluate hearing loss. Based on the consensus of Asian muscular dystrophy working group in 2019, muscular dystrophy was determined. Cox proportional hazard model was used to investigate the relationship between hearing loss and the risk of myasthenia.

Among 11 528 middle-aged and elderly people, the incidence of baseline hearing loss was 12.8%. During the 4-year follow-up, there were 558 new cases of muscular dystrophy, with an incidence of 6.4%. The results of the Cox proportional hazard model showed that subjects with hearing loss had an increased risk of muscular dystrophy by 31.1% (HR=1.311, 95%CI: 1.059-1.625) compared with those without hearing loss. The results of stratified analysis showed that the relationship between hearing loss and muscular dystrophy was more obvious in women, the elderly, rural household registration, married people, those with education level of junior high school or above, and those with high annual family income.

Hearing loss is related to the increased risk of muscular dystrophy in middle-aged and elderly people in China. Early screening and intervention for hearing loss may help reduce the incidence of future muscular dystrophy.

To investigate the related factors of death in patients with drug-resistant tuberculosis in Henan Province.

The data of tuberculosis patients diagnosed in all 18 prefecture-level cities and 2 directly administered counties in Henan Province from 2011 to 2021 were selected. The patients with complete course of treatment and treatment outcome were selected. The cumulative survival rate was calculated by Kaplan-Meier method, and Cox proportional hazard regression was used to identify the factors affecting the survival time of patients.

Among the 1 078 patients with drug-resistant tuberculosis, a total of 66 patients (6.1%) died, and the cumulative survival rate within 30 months was 90.1%. In total 50% of the patients died within 10 months. After controlling other factors, age (HR=1.053, 95%CI: 1.029-1.087), XDR-TB patients (HR=3.032, 95%CI: 1.584-5.767), smoking (HR=1.879, 95%CI: 1.006-3.509) and BMI (HR=0.294, 95%CI: 0.088-0.978) were the main risk factors for death of tuberculosis patients during treatment.

Among drug-resistant tuberculosis patients in Henan Province, elderly patients, XDR-TB patients, smoking patients and patients with BMI less than 18.5 have a relatively higher risk of death. Additional support should be provided for the treatment of these patients to reduce mortality.

To investigate the drug resistance and molecular epidemiological characteristics of clinically isolated Staphylococcus aureus in Huai’an city, so as to provide references for the diagnosis, treatment, prevention and control of infection.

Staphylococcus aureus isolated from clinical samples were collected and methicillin-resistant Staphylococcus aureus（MRSA）was detected by cefoxitin or oxacillin resistance phenotype or mecA gene. The drug sensitivity test was carried out by microbroth dilution method. Based on the whole genome sequencing, the strains were analyzed by single nucleotide polymorphism and multi-locus sequence typing. The virulence and drug resistance genes of the strains were identified by online database.

A total of 83 strains of Staphylococcus aureus were isolated from 7 types of clinical specimens, and MRSA accounted for 59.04%. The isolated strains had the highest resistance to penicillin (97.59%) and were sensitive to Nez Olamide, tigecyclines, vancomycin, teicoplanin, and nitrofurantoin, and multiple drug-resistant strains accounted for 57.83%. There were 20 ST types in 83 strains of Staphylococcus aureus, and ST398 (21.69%) was the main type. There were 187 292 SNP loci in 83 genomes. These strains carried 38 kinds of drug resistance genes, among which tet (38), blaZ, arlR, arlS, mgrA, norA, mepA, ErmC,LmrS, and mepR had higher carrying rates. These strains carried 8 enterotoxin genes including sea, seb, sec, sed, seh, selk, sell,and selq, among which selk and selq (both 32.53%) had the highest carrying rate, and ST1 strain carried the largest number of kinds of enterotoxin genes. The carrying rates of lukF-PV and lukS-PV genes encoded by PVL were 49.40% and 6.02%, respectively. The carrying rate of tsst-1 gene encoded by toxic shock syndrome toxin TSST-1 was 3.61%.

The drug resistance of Staphylococcus aureus isolated from Huai’an area is strong and the detection rate of MRSA is high. The ST types of strains are rich, and there is a certain correlation between ST types and pathogenicity.

To analyze the coupling and coordination relationship of high-quality development of tertiary public general hospitals in Guangxi, and to explore the path of high-quality development of tertiary public general hospitals, so as to provide a basis for related policy formulation.

The evaluation index system of high-quality development of tertiary public general hospitals in Guangxi was constructed from the four dimensions of medical quality, operational efficiency, sustainable development, and satisfaction evaluation. The coefficient of variation method and rank sum ratio method were used to comprehensively evaluate and classify the high-quality development level of the tertiary public general hospitals in 14 prefectures and cities in Guangxi in 2019, and the coupling coordination degree model was used to calculate the coupling and coordinated development level.

Most of the sample hospitals were in the primary coordination stage, and the proportion of other coupling coordination types from high to low were intermediate coordination (22.73%), reluctant coordination (18.18%), on the verge of disorder (13.64%), and good coordination (4.55%). According to the principle of optimal classification, the tertiary public hospitals in Guangxi were divided into high, medium, and low grades. Most of the hospitals were in the middle level and there was much room for development and progress.

The coupling coordination degree of the tertiary public general hospitals in Guangxi is not high, and there are still some problems, such as uneven distribution of medical resources, large differences in medical quality, and lack of motivation for personnel training. It is necessary to improve the medical service system and improve the core competitiveness.

To analyze the time trend and potential influencing factors of hospitalization of children with mental disorders in Beijing.

The information on hospital admissions of children with mental disorders living in Beijing from 2014 to 2018 was collected. Joinpoint regression model and grey correlation analysis were used to explore the changing trend of hospital admissions and the correlation intensity of the influencing factors.

From 2014 to 2018, the number of hospitalized children with mental disorders showed an upward trend with an average annual change rate of 19.33%. In the subgroup, the number of hospitalized children with mood disorders increased most rapidly (average annual percentage rate change (AAPC) =34.39%), followed by female children (AAPC=31.97%). The results of grey correlation analysis showed that per capita disposable income (correlation degree 0.841) and per capita GDP (correlation degree 0.837) had the strongest correlation with the number of hospitalized children with mental disorders.

The number of hospitalized children with mental disorders increased significantly from 2014 to 2018, and the trend of hospitalization of children with mental disorders with different characteristics and the correlation order of influencing factors were different. We should focus on the strongly related factors of different children with mental disorders and strengthen the mental health education and prevention and control of children in Beijing so as to provide reference for the formulation of relevant policies.

To analyze the relationship between obstructive sleep apnea (OSA) and nocturnal blood pressure, and to evaluate the possible effect of obesity in this association, so as to provide reference for further exploring the mechanism of OSA-related hypertension.

A total of 753 adult patients diagnosed with OSA were randomly selected from August 2021 to December 2022 in the Sleep Medicine Center of the Fourth West China Hospital of Sichuan University because of snoring, apnea, and other reasons. After polysomnography (PSG) was completed, 753 adult patients diagnosed with OSA were selected as research subjects. The general data of patients, PSG related data, nocturnal blood pressure and related indicators were collected. Correlation analysis and structural equation model were used to analyze the effects of OSA and obesity on nocturnal blood pressure.

In patients with OSA, Apnea Hyponea Index (AHI) was positively correlated with systolic blood pressure (SBP), diastolic blood pressure (DBP) (r=0.297 and 0.222, P < 0.001), and BMI (r=0.443, P < 0.001), and BMI was positively correlated with SBP and DBP (r=0.313 and 0.260, P < 0.001). The results of structural equation model suggested that obesity played an intermediary role in the effect of OSA on nocturnal SBP and DBP. The standardized intermediary effect values were 0.063 (95%CI: 0.035-0.090) and 0.059 (95%CI: 0.032-0.087), respectively, and the proportion of intermediary effect was 21.72% and 26.22%, respectively.

OSA can directly affect the blood pressure of patients. At the same time, obesity plays an intermediary role in the effect of OSA on SBP and DBP.

To analyze the changing trend of disease burden of senile dementia attributed to high BMI in China from 1990 to 2019, and to provide references for the formulation of prevention and control strategies for senile dementia in China.

The data of death number, mortality rate, disability adjusted life years (DALY) number and DALY rate of senile dementia attributed to high BMI in China from 1990 to 2019 were extracted from the global disease burden database, and the estimated annual percentage of change (EAPC) was used to analyze the change trend in terms of sex, age and exposure rate.

From 1990 to 2019, the disease burden of senile dementia attributed to high BMI in China showed an upward trend. The burden of women was higher than that of men, and the latter had the fatest increase. The mortality rate and DALY rate increased with the increase of age, with the fastest increase in males aged 60 to 70 years and females aged 60 to 75 years, respectively.Males had larger EAPC than females in the same age group. From 1990 to 2019, the DALY loss of senile dementia caused by high BMI had the fatest increase, and the standardized (summary exposure value) SEV rate of high BMI increased rapidly (EAPC=3.67%, P < 0.001).

From 1990 to 2019, the burden of senile dementia attributed to high BMI in China became heavier. With the increase of aging and obesity rate, the burden of senile dementia attributed to high BMI is expected to continue to increase rapidly without no sustained and effective intervention.