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.

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 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 evaluate the effect of EV71 inactivated vaccine on the epidemiological characteristics and reported incidence of hand, foot, and mouth disease (HFMD) in Quzhou city.

The surveillance data of HFMD cases in Quzhou city from 2009 to 2022 were collected by China Infectious Disease Reporting Information Management system, and the epidemiological characteristics were descriptively analyzed. The change trend of reported incidence of HFMD in Quzhou before and after the application of EV71 inactivated vaccine was analyzed by interruption time series design.

The average reported incidence of HFMD in Quzhou from 2009 to 2022 was 200.02/100 000. After the application of EV71 inactivated vaccine in Quzhou, the instantaneous change of HFMD reported incidence was -30.296/100 000 (t=0.30, P=0.773), the slope changes was-75.694/100 000 (t=5.43, P < 0.001), and the slope was -33.923 (β₁+β₃=33.923). The proportion of reported cases aged 0 to 4 years in all age groups decreased from 97.72% in 2009—2015 to 90.93% in 2016—2022.

The EV71 vaccine has achieved good prevention and control effect in a short time after coming into the market in Quzhou city, but the incidence rate is still high. It is necessary to strengthen the vaccination of children of school age, especially those less than 12 months old.

To explore the causal relationship between lipoprotein (a) [Lp (a)] and cerebral small vascular disease (CSVD) by Mendelian randomization (MR) analysis.

Using genome-wide association study (GWAS) public database, the single nucleotide polymorphisms independently associated with Lp (a) (P < 5 × 10^-8) were selected as instrumental variables (IVs). The main outcomes of this study were white matter hyperintensity (WMH), cerebral microhemorrhage, and lacunar infarction. Inverse variance weighted (IVW) mothod was used to evaluate the causal relationship between Lp (a) and CSVD. Sensitivity analysis was carried out by MR-Egger and MR-PRESSO to evaluate the pleiotropy of IVs. Furthermore, weighted median method, simple median method, and maximum likelihood ratio method were used to test the reliability of the results.

IVW results showed that there was a positive risk relationship between Lp (a) and WMH (OR=1.083, 95%CI: 1.035-1.134, P <0.001), but Lp (a) was not correlated with cerebral microhemorrhage (P=0.568) and lacunar infarction (P=0.651). MR-Egger analysis showed that the MR analysis of Lp (a) and WMH was not affected by horizontal pleiotropy (P=0.721).

MR analysis shows that Lp (a) is related to the increased risk of WMH.

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 systematically analyze the incidence of nutritional risk in patients with Alzheimer’s disease.

Chinese database (WIP, National Knowledge Infrastructure, Wan fang database, Sino Med) and English database (Cochrane library, PubMed, Embase, Web of Science) were searched, and the related studies on the influencing factors of malnutrition in patients with Alzheimer’s disease were collected. After screening and evaluating the literatures according to the criteria, Stata16.0 and Revman5.4 were used to analyze the prevalence of nutritional risk of Alzheimer’s disease and its influencing factors by meta-analysis.

A total of 25 articles were included, the number of patients with Alzheimer’s disease was 3 372, and the number of patients with nutritional risk was 2 038, involving 12 influencing factors. Meta-analysis showed that the prevalence rate of nutritional risk of AD was 62.5% (95%CI: 56.1%-68.9%). Marital status (OR=0.5, 95%CI: 0.34-0.73), course of disease (MD=0.36, 95%CI: 0.05-0.66) and swallowing function (OR=4.86, 95%CI: 1.74-13.61) were the influencing factors of nutritional risk of AD. Albumin (MD=-7.50, 95%CI: -9.25 to -5.75), cholesterol (MD=-0.87, 95%CI: -1.31 to -0.43), and hemoglobin (MD=-2.71, 95%CI: -3.96 to -1.46) were negatively correlated with nutritional risk in Chinese patients with Alzheimer’s disease.

The prevalence rate of nutritional risk in Chinese patients with Alzheimer’s disease is high and is related to marital status, course of disease, albumin, cholesterol, hemoglobin and swallowing function. Clinical attention should be paid to related factors and early identification and intervention to reduce the occurrence of nutritional risk and the impact of nutritional risk on the progression of Alzheimer’s disease.

To investigate the causal relationship between tea intake and sex hormone levels by two-sample Mendelian randomization analysis.

Single nucleotide polymorphisms related to tea intake were screened from the genome-wide association study as genetic instrumental variables. Five Mendelian randomized methods including simple model, weighted model, inverse variance weighted (IVW) analysis, weighted median method, and MR-Egger method were used to study the causal association between tea intake and sex hormone levels, which was evaluated by the β value.

A total of 41 SNPs were included in this study. The results of inverse variance weighting method showed that tea intake could increase the level of bioavailable testosterone (β=0.073, P < 0.05) and decrease the level of estradiol (β=-0.023, P < 0.05). The estimated results of MR-Egger effect showed that tea intake could increase the level of bioavailable testosterone (β=0.179, P<0.05) and decrease the level of estradiol (β=-0.049, P<0.05), and the weighted median method also found that tea could increase the level of bioavailable testosterone (β=0.120，P<0.05) and decrease the level of extradiol (β=-0.047, P<0.05), consistent with the results of IVW method. MR-Egger regression method showed that there was no horizontal pleiotropy, leaving one method and Cochran’s Q statistics test showed no heterogeneity, and the direction of single SNP was correct.

Tea intake can up-regulate testosterone level and down-regulate estradiol level. Reasonable tea intake will contribute to the effective intervention of sex hormone-related diseases and provide important reference for the prevention and treatment of clinical diseases.

To construct the trajectories of four kinds of scores in Rey Auditory Verbal Learning Test (RAVLT) and to explore the relationship between each trajectory and the progression of mild cognitive impairment (MCI) to Alzheimer’s disease (AD).

Data were collected from the Alzheimer’s Disease Neuroimaging Program (ADNI). The research subjects were MCI patients who had been followed up for more than 5 years and completed the RAVLT test. Four kinds of trajectories with different scores of RAVLT were constructed based on the group-based trajectory model (GBTM). Cox regression model was used to explore the relationship between four different score trajectories and the progression of MCI patients to AD.

In the analysis of the four types of RAVLT scores, it was found that three trajectories were identified in the verbal learning scores.Compared with the low-stable group, the risk of AD in the moderate-stable group was lower (adjusted HR=0.27, 95%CI: 0.11-0.71). The delayed recall score identified three trajectories. Compared with the low-stable group, the high-rising group had an increased risk of AD (adjusted HR=3.38, 95%CI: 1.41-8.11).

MCI patients with lower verbal learning scores or higher delayed recall scores have a higher risk of developing AD.

To explore the mechanism of online social participation affecting the health of the elderly through online social support and online risk exposure, and to explain the regulatory role of intergenerational cohabitation.

The data of online social participation and health status of people over 60 years old in Henan Province in 2023 were selected, and the moderated mediating effect, moderating effect, and regulated mediating effect were tested with the moderated intermediary effect model in PROCESS4.0 macro program.

Online social participation positively affected online social support (β=1.734, P < 0.001) and online risk exposure (β=1.453, P < 0.001). Online social support positively affected physical health (β=0.183, P < 0.001) and mental health (β=0.398, P < 0.001). Online risk exposure negatively affected physical health (β=-0.490,P < 0.001) and mental health (β=-0.598, P < 0.001). The interaction between online social participation and intergenerational cohabitation negatively affected online risk exposure (β=-0.784, P < 0.001), and the mediating effect differences between intergenerational cohabitation group and non-intergenerational cohabitation group were 0.384 (95%CI: 0.146-0.678) and 0.469(95%CI: 0.205-0.778) respectively on the physical/mental health path of online social participation.

Online social participation has a positive impact on the physical and mental health of the elderly through online social support, and a negative impact on physical and mental health through online risk exposure. Intergenerational cohabitation weakens the positive impact of online social participation on online risk exposure and the intermediary effect of online risk exposure.