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 establish a screening model for patients with chronic obstructive pulmonary disease (COPD).

By using the method of multi-stage stratified random sampling, 4 587 permanent residents ≥ 40 years old in Guizhou Province were investigated by questionnaire, physical examination, and pulmonary function examination. Variables to be included into the model were screened by univariate analysis and then further screened by multivariate Logistic regression. Logistic regression (LR), random forest (RF) and support vector machine (SVM) were used to construct the screening model of COPD patients, and the area under the curve (AUC) was used to evaluate the effect of the model. Delong method was used to test the difference of AUC between models.

According to the results of multivariate Logistic regression analysis, age, frequent cough before 14 years old, asthma, daily smoking, cooking fuel and exhaust, and harmful gas exposure were included in LR, RF and SVM models. The AUC of the three model training sets were 73.64%, 87.14%, and 73.30%, respectively, and the AUC of the test set were 76.10%, 70.96%, and 76.08%, respectively, all of which had good screening results. The results of Delong method showed that the screening effects of the three models were different between the training set and the test set.

This study established an economical, rapid, and effective screening model for COPD patients through six simple variables such as age and asthma.

To explore the chain-mediated relationship between worker occupation fit (WOF) and occupational stress between occupational fatigue and depressive symptoms.

The method of stratified cluster sampling was used to study the medical staff in Sichuan Province. Pearson correlation analysis, stepwise regression model, and bootstrap method were used to analyze the relationship and chain mediating effect among WOF, occupational stress, occupational fatigue, and depression.

In total 1 988 subjects were enrolled in this study, of which 43.5% (864/1 988) had depressive symptoms, and 6.5%(130/1 988) had severe depressive symptoms; 31.1% (618/1 988) had occupational fatigue symptoms, and the WOF level was 31.6±7.1. Stepwise regression analysis showed that with WOF, WOF type and occupational stress added to the model, the explanation of depressive symptoms in the model increased by 37.3% and 41.4%, respectively. Intermediary effect analysis showed that WOF and occupational stress had chain mediating effect between occupational fatigue and depressive symptoms, and the proportion of chain mediating effect was 1.80% (β = 0.020, bias corrected and accelerated 95%CI: 0.016-0.039).

The occurrence of depressive symptoms in medical staff is not only affected by occupational fatigue but also mediated by WOF and occupational stress.

To understand the attitude of public health physicians towards prescription rights, and to provide support and reference for further exploring the policy formulation and promotion of public health physicians’ prescription rights.

By using the key person method and snowball method, an online cross-sectional questionnaire survey was conducted among public health doctors in all levels of disease prevention and control centers, hospitals, maternal and child health hospitals, grass-roots medical institutions, professional public health and other institutions in Sichuan Province. A total of 246 questionnaires about the current situation, cognition, influence, attitude, and suggestions of public health doctors on prescription rights were qualitatively and quantitatively analyzed.

About 95% of the participants supported to give public health doctors the right of prescription, which was a sign of the identity of public health “doctors”, which could promote the integration of prevention and treatment, improve the efficiency and quality of the public health system, and improve the medical professional ability of public health doctors, so as to improve the quality and effect of public health. The lack of prescription power would reduce the medical professional recognition of public health physicians and the effectiveness of public health doctors in undertaking public health work. Most participants expressed their willingness to accept different forms of prescription rights.

The community of public health doctors has a high demand for prescription rights, and it is considered that the implementation of prescription rights of public health doctors is an important measure to improve the current situation of the separation of medical treatment and prevention of public health doctors and promote the high-quality development of public health doctors.

To investigate the changes in health risk behaviors among high-risk groups in the lung cancer screening cohort in Ma’anshan City, and to explore the association between lung cancer screening and health risk behavior changes.

Follow-up survey was conducted among the high-risk population participating in screening.Basic data and health risk behavior information were collected at baseline and during follow-up. Univariate analysis and multivariate logistic regression analysis were used to explore the association between lung cancer screening and changes in three kinds of health risk behaviors.

The results of multivariate logistic regression analysis showed that women(OR=4.24, 95% CI: 1.80-9.96,P=0.001), those with positive pulmonary nodules(OR=1.98, 95% CI: 1.23-3.20, P=0.005) and those who consulted the doctor after screening(OR=1.65, 95% CI: 1.08-2.52, P=0.020) were more likely to quit smoking. Persistent smokers who were 60 to 69 years old(OR=1.60, 95% CI: 1.14-2.24, P=0.007), had a history of lung-related diseases(OR=1.95, 95% CI: 1.13-3.39, P=0.017), and discussed their medical condition with relatives and friends after screening(OR=1.65，95% CI: 1.16-2.33，P=0.005) were more likely to smoke less. Women(OR=2.19, 95% CI: 1.20-4.02,P=0.011), patients with a history of lung related diseases(OR=1.91,95% CI: 1.13-3.22,P=0.015), patients with a history of malignant tumors(OR=3.07,95% CI: 1.18-8.01,P=0.022), and patients receiving medical advice(OR=1.69, 95% CI: 1.04-2.75, P=0.035) were more likely to abstain from alcohol. Women(OR=1.41, 95% CI: 1.02-1.94, P=0.037), older than 70 years(OR=1.70, 95% CI: 1.07-2.68, P=0.024) and those who had annual physical examination(OR=2.03, 95% CI: 1.44-2.86, P<0.001) were more likely to start physical exercise.

Lung cancer screening is closely related to changes in health risk behaviors of screening population such as smoking, drinking, physical exercise, etc. Health education should be strengthened to guide high-risk population to make changes in health risk behaviors.

To analyze the mortality trend of lung cancer in Sichuan Province from 2007 to 2021, and provide evidence for formulating lung cancer prevention and control policies in the new period.

Lung cancer mortality was obtained from Health Statistics Yearbook of Sichuan Province. A cohort age-period model was used to estimate the effect of age, period and birth cohort on lung cancer mortality in residents aged 20-84.

The mortality rates of lung cancer in male and female increased from 59.68/100 000 and 16.48/100 000 in 2007 to 75.14/100 000 and 30.49/100 000 in 2021 respectively. Compared with residents aged 20-24, male and female residents aged 75-79 were 101 times and 121 times higher than those aged 20-24 respectively; male and female lung cancer mortality risks from 2017 to 2021 were 1.29 times and 1.31 times higher than those from 2012 to 2016 respectively; male and female lung cancer mortality risks born in 1927—1931 were 73.42 times and 38.49 times higher than those born in 1992—1996 respectively.

Lung cancer mortality in Sichuan Province fluctuates from 2007 to 2021, and male mortality is higher. There were differences in lung cancer mortality risk by age, period, and birth cohort.

To analyze the epidemiological characteristics and spatiotemporal clustering of hepatitis B virus (HBV)infection in China from 2011 to 2021, to provide a foundation for future HBV prevention and control initiatives.

Data on HBV incidence from 2011 to 2021 across different regions of China were gathered from the "China Health Statistical Yearbook" and the Chinese Center for Disease Control and Prevention. A descriptive analysis was performed to investigate the trends of HBV. Spatial autocorrelation analysis was utilized to explore both global and local spatial clustering of HBV incidence, while spatiotemporal scan analysis was employed to investigate the spatiotemporal clustering of HBV incidence.

Between 2011 and 2021, a total of 10 838 518 cases of HBV were reported in China, with an annual average incidence rate of 71.78 per 100,000 population. There was no statistically significant difference in the decreasing trend of hepatitis B incidence during this period (Z=-1.557, P=0.120). Spatial autocorrelation results identified 7 high-high clustering areas of HBV incidence, primarily in Guangdong, and 3 low-low clustering areas, mainly in Shanghai and Jiangsu. Spatiotemporal scan results revealed 2 high-incidence clusters in the northwest region from 2011 to 2015, shifting to 6 clusters in the south and its northern areas from 2017 to 2021. There were 14 low-incidence clusters from 2016 to 2021, mainly in the east and northeast regions.

From 2011 to 2021, HBV incidence in China displays spatial and spatiotemporal clustering, with a nonsignificant decreasing trend. Future efforts should enhance HBV monitoring and resource allocation for prevention and control in high-prevalence areas.

To investigate the relationship between Dietary Inflammatory Index (DII) and sarcopenia in older adults and to provide a scientific basis for the prevention and treatment of sarcopenia.

From January 2022 to January 2023, 253 older adults over 60 years old were recruited in Chengdu. DII were calculated according to the semi-quantitative food frequency questionnaire, and the groups were divided into Q1-Q4 according to the DII from low to high, sarcopenia was diagnosed according to Asian Working Group for sarcopenia 2019. The relationship between DII and sarcopenia was estimated by logistic regression analysis.

After controlling confounding factors, compared with the Q1 group, the risk of sarcopenia in the Q3 group and Q4 group was 3.94 times and 7.02 times higher than that in the Q1 group (P<0.05), and the risk of sarcopenia increases in older adults with higher DII.

Higher DII increases the risk of sarcopenia, and it is recommended to provide dietary guidance for older adults to reduce the risk of sarcopenia affected by DII.

To analyze the change of disease burden of injury in China from 1990 to 2019, and to predict the change trend from 2020 to 2034, so as to provide basis for the formulation of injury prevention and control strategies.

Using the global disease burden research database in 2019, the change trends of age-standardized incidence, prevalence, mortality and disability-adjusted life expectancy rate of injuries in China were analyzed, and the average annual change percentage was calculated.The grey prediction model GM (1) was used to predict the annual DALY change trend from 2020 to 2034.

From 1990 to 2019, the incidence, prevalence, mortality and Daly rate of self-injury and interpersonal violence showed a downward trend, with the largest decrease among people aged 0-9 (AAPC=-2.27%,-0.26%,-4.72%,-6.00%). The incidence and prevalence of traffic injuries showed an upward trend, while mortality and DALY rates generally showed a downward trend, but those over 70 years old showed an upward trend (AAPC=0.26%, 0.88%). The incidence of accidental injuries showed an overall downward trend (AAPC=-0.08%), but showed an upward trend in 2006—2019 (AAPC=2.69%), and the mortality and DALY rates showed an overall downward trend, among which the morbidity, prevalence, mortality and Daly rates of people ≥ 70 years old showed an upward trend (AAPC=1.84%, 1.15%, 0.66%, 0.51%). The grey prediction model showed that the DALY of the three kinds of injuries will show a downward trend from 2020 to 2034. It is estimated that by 2035, the Daly rate will decrease to 166.304 / 100 000, 862.338 / 100 000 and 715.27 / 100 000 respectively.

The mortality rate and DALY rate of three kinds of injuries in China show a general downward trend from 1990 to 2019, but the incidence rate of traffic injuries and accidental injuries are still rising, and the disease burden of the elderly is still increasing.

To measure China’s medical resources mismatch index, to analyze the differences in the spatial distribution of medical resources mismatch, and to clarify the specific path to improve the mismatch of medical resources.

Based on the 2009-2021 data, China’s medical capital and labor mismatch indices were measured, the spatial and temporal evolution characteristics and sources of differences were analyzed using Dagum’s Gini coefficient and its decomposition method, and the fsQCA method was used to analyze the conditional groupings of high or low medical resource mismatches.

There were different degrees of capital mismatch or labor mismatch in each region. The overall Gini coefficient showed an "inverted V" evolution trend, the overall Gini coefficient within the region showed a fluctuating downward trend, and the overall Gini coefficient between regions was more complicated. Inter-region differences were the most important factor in the differences in the spatial allocation of medical resources. There were two types of pathways that lead to a high medical resource mismatch, i.e., labor-labor mismatch index and labor-labor mismatch index. There were 2 types of paths, i.e., labor force-hospital structure dual-driven (H1) and service level auxiliary-driven (H2), and 2 types of paths leading to low medical resource mismatch, i.e., urbanization-hospital structure-service level linkage-restricted (L1, L2) and internal and external linkage-restricted (L3, L4).

It’s supposed to play themacro-controlrole for the government to promote the rational allocation of regional medical resources, take the medical association as an important hand to play the leading role of tertiary hospitals, and fully implement the development strategy of new type of urbanization and lower the threshold of population settlement.