To understand children’s parents’ cognition and behavior of antibacterial drugs, so as to provide reference for promoting rational use of antibacterial drugs in children, reducing bacterial drug resistance and adverse drug reactions.

From April 2022 to April 2023, 517 parents of pediatric inpatients at Pingshan District People’s Hospital in Shenzhen were surveyed on the cognition and behavior of antibacterial drug use. Descriptive analysis, univariate analysis and multiple linear regression analysis were used to explore the possible factors affecting parents’ cognition and behavior of rational use of antibiotics.

A total of 517 questionnaires were collected, of which 482 were valid, with an effective recovery rate of 93.23%. The scores of parents’ knowledge and practice on antibacterial drugs were (7.06±3.91) and (28.02±4.32), and the scoring rates were (44.11±24.46)% and (80.06±12.34)%, respectively. The cognitive score was positively correlated with senior high school or technical secondary school (β=0.180, 95% CI: 0.677-2.569), junior college (β=0.244,95% CI: 1.177-3.125), undergraduate degree or above (β=0.353, 95% CI: 2.035-4.333), and was negatively correlated with parents’ with medical background (β=-0.109, 95% CI: -2.800--0.371). The behavioral score was positively correlated with the mother (β=0.123, 95% CI: 0.358-2.198) and parents’ with medical background (β=0.090, 95% CI: -0.006-2.874).

The overall awareness of antimicrobial drugs among parents of children in this urban area is relatively low, and the score rate for rational use of antibiotics is relatively high. However, there are still some misconceptions. It is recommended that relevant departments should strengthen the education of antimicrobial knowledge to the public, strengthen the management of grassroots medical institutions and retail pharmacies, strictly regulate access channels, standardize medication behavior, and try to eliminate the hidden dangers of unreasonable use of antibiotics.

To analyze the effects of diabetes distress (DD) and depressive symptoms (DS) on self-efficacy in community patients with type 2 diabetes mellitus (T2DM), and to explore the mediating effect of DD on DS and self-efficacy.

A total of 648 community patients with T2DM in Nanjing were selected by convenience sampling method and investigated with the general information questionnaire, Diabetes Distress Scale, 9-item Patient Health Questionnaire and Diabetes self-efficacy Scale. A multiple linear regression model was used to analyze the influencing factors of self-efficacy, and mediating effect analysis was used to explore the mediating role of DD.

The prevalence of DD and DS was 27.5% and 40.4%, respectively, and the self-efficacy score was 3.82±0.60. DD and DS were significantly positively correlated (r=0.56, P<0.01), and both were negatively correlated with self-efficacy. DD (β=-0.34, P<0.01) and DS (β=-0.16, P<0.01) were the influencing factors of self-efficacy, and DD had a partial mediating effect between DS and self-efficacy, Bootstrap 95%confidence interval was -0.28--0.16 (P<0.01).

Community health workers need to conduct early screening and treatment of DD and DS in T2DM patients, which can help improve patients’ self-efficacy inmanaging the disease.

This study applied the ecology of the medical care model to describe healthcare-seeking behaviors among community-based individuals and to examine the association between multimorbidity and various types of healthcare-seeking behaviors.

A cross-sectional survey was conducted in Fangshan District, Beijing and Wuyuan County, Jiangxi Province from July to September 2023. Community residents aged 20 years old and above were sampled by using a multistage stratified sampling approach and recruited to participate in the study. The number of individuals who had symptoms or had relevant healthcare-seeking behaviors was calculated per thousand people per month and relevant indicators were demonstrated by using the ecology of the healthcare model. Multivariate logistic regression analyses were applied to explore the association between self-reported multimorbidity and each level of healthcare-seeking behaviors, with key socio-demographic characteristics adjusted in the model.

A total of 6 004 records with completed surveys were included in the analysis (56.4% of participants were females, mean age: 50.4±14.7). On a thousand-person per month basis, about 382 participants self-report having symptoms, 162 had visited to healthcare facilities (including 61 visited to primary healthcare facilities, 47 visited to tertiary hospitals), 62 were self-medicated, 10 were hospitalized, 5 visited to emergency department, 4 had operations and 1 received tele-medicine. A higher proportion of healthcare seeking behaviors were observed among individuals with multimorbidity than those self-reported with no or one chronic condition. The results of multivariate logistic regression analyses showed that compared with individuals without chronic condition, individuals with one chronic condition or multimorbidity had higher likelihood of healthcare facility visits [(OR:1.67, 95% CI:1.38-2.02) and (OR:3.40, 95% CI:2.83-4.08)], and hospitalization [(OR:2.60, 95% CI:2.04-3.32) and (OR:5.17, 95% CI:4.10-6.51)].

Among all individuals with potential healthcare needs, less than half had healthcare seeking behaviors, and the proportion is higher among individuals with multimorbidity. Future research should further investigate the implication of findings on population medicine from the ecology of medical care model. Actions are also needed to further strengthen the healthcare system and optimize its integration and effectiveness in addressing the emerging challenge of multimorbidity and to reduce the unmet health needs.

Toanalyze the application of CNN-BiLSTM combination model and intelligent algorithm optimization in the prediction and early warning of HFMD incidence and to discussthe optimization model for predicting the incidence of HFMD, so as to provide reference for relevant departments to formulate prevention and control measures.

The monthly incidence data of hand, foot and mouth disease in Shanxi Province from January 2009 to December 2019 and the year-end resident population data released by the Shanxi Statistical Yearbook 2008-2020 were collected from January 2009 to December 2019.The monthly incidence data of hand, foot and mouth disease in Shanxi Province from January 2009 to December 2019 were used as sample modeling data to construct the corresponding models in MATLAB 7.6 software, and the prediction effect of each model was compared, and the optimal model was selected according to the principle that the smaller the error value and the higher the accuracy.

By comparing the root mean square error and mean absolute error obtained by predicting the monthly incidence of foot and mouth disease of hand with different models, it can be seen that the CNN-BiLSTM model optimized based on intelligent algorithm is significantly better than the unoptimized CNN-BiLSTM combination model, that is, the values of RMSE and MAE of CNN-BiLSTM-PSO/GAPSO/SSA (1.943 3,1.309 7; 1.879 2, 1.240 2; 1.419 5, 1.169 1) is smaller than the corresponding CNN-BiLSTM model (2.066 3, 1.390 8), among which the CNN-BiLSTM-SSA combination model performs best.

The CNN-LSTM-SSA model has good predictive performance and accuracy in predicting the monthly incidence trend of HFMD, which can be used to predict the future incidence of HFMD in Shanxi Province.

To evaluate the relationship between dietary diversity and hypertension among residents aged 35-74 in the Guangxi Province, to analyze the association between dietary diversity and hypertension by assessing the Dietary Diversity Score (DDS), and to provide reference for improving dietary diversity and controlling hypertension in the local population.

This cross-sectional study included participants from the Prospective Cohort Study on Chronic Diseases in Guangxi Ethnic Minority Population. Baseline surveys and physical measurements were conducted on residents aged 35-74. A dietary diversity score (DDS) was calculated based on a food frequency questionnaire. Binary logistic regression models were used to explore the relationship between DDS and hypertension, and restricted cubic spline models were used to examine the dose-response relationship between DDS and hypertension.

A total of 12 896 participants were included, among whom 4541 (35.21%) were diagnosed with hypertension. The mean DDS of residents aged 35-74 in Guangxi was (5.45±1.39). The consumption frequency of cereals and tubers was high, while the intake of dairy products was relatively low. The binary logistic regression analysis showed that after adjusting for confounding factors, DDS was a protective factor for hypertension (OR=0.95, 95% CI: 0.92-0.98, P=0.001). The restricted cubic spline model demonstrated a linear dose-response relationship between DDS and hypertension (P_{overall trend}<0.05, P_{non-linearity}=0.787). As DDS increased, the risk of hypertension linearly decreased.

The prevalence of hypertension is high among residents aged 35-74 in the Guangxi Province, while the level of dietary diversity is relatively low. Increasing dietary diversity may help reduce the incidence of hypertension.

This study aimed to analyze the prevalence of three types of cardiovascular diseases (hypertension, coronary heart disease, and stroke) and their relationships with depression symptoms among rural residents of Yiliang County, Yunnan Province.

A health interview and examination survey was conducted on 2 506 rural residents aged ≥35 years in Yiliang County, Yunnan province by utilizing a multistage stratified random sampling method. A binary logistic regression model was employed to analyze the relationships between depression symptoms and three types of cardiovascular diseases (CVDs): hypertension, coronary heart disease(CHD), and stroke.

The prevalence of hypertension, CHD, stroke, and depression symptoms in the surveyed population was 64.2%, 4.3%, 3.3%, and 5%, respectively. Prevalence of hypertension, CHD, stroke, and depression symptoms increased with age (χ²=106.237,χ²=21.084,χ²=27.135,χ²=43.556,P<0.001). Females exhibited a higher prevalence of both hypertension (67.6% vs. 60.8%,χ²=12.677,P<0.001) and depression symptoms (6.3% vs. 3.8%,χ²=8.080,P<0.05) compared to males. Individuals with lower educational levels and household per capita income had a higher prevalence of hypertension (χ²=23.362,χ²=9.249,P<0.05)and depression symptoms (χ²=16.191,χ²=6.665,P<0.05). The prevalence of depression symptoms were higher in the Han majority than in ethnic minority groups (χ²=14.231, P<0.001). Individuals with good access to medical services had a higher prevalence of depression symptoms than their counterparts (χ²=5.220, P<0.05). The results of logistic regression analysis revealed that individuals with CHD (OR=3.462, 95% CI:1.962-6.108), and stroke (OR=3.683, 95% CI:2.001-6.781) had a higher risk of developing depression symptoms.

The Prevalence of three types of CVDs higher among rural residents in Yiliang County of Yunnan Province compared to other regions. Targeted prevention and intervention efforts are warranted, particularly among females, individuals with lower educational levels, and those with lower incomes. Implementing effective strategies to mitigate the prevalence of CVDs will contribute to improverural residents’ mental health.

To explore the clustering of drug-resistant Mycobacterium tuberculosis (MTB) in Zigong from 2018 to 2020, analyze the genetic relationship between strains, and speculate whether there is a potential correlation between drug-resistant strains isolated from different patients, so as to provide a reference for the prevention and treatment of drug-resistant tuberculosis in Zigong.

The drug-resistant MTB strains isolated from Zigong from 2018 to 2020 were used as the research objects and the standard MIRU-VNTR 12-loci method was used for typing study. The band sizes of the amplified products were analyzed by PCR and agarose gel electrophoresis to obtain the number of replicates of different loci of the strains. The data were imported into the MIRU-VNTRplus database and the SITVIT2 website to construct the phylogenetic tree diagrams and the minimum spanning trees, and the global source analysis of the isolated strains was performed. The discriminatory ability of the 12-locus method was evaluated by locus polymorphism analysis, and the local prevalence and transmission of drug-resistant TB were analyzed by calculating the cluster formation rate and recent transmission rate.

The overall resolution HGI index of MIRU-VNTR standard 12-loci typing was 0.974. MIRU26 and MIRU31 showed high polymorphism; MIRU10, MIRU16, MIRU39, and MIRU40 showed moderate polymorphism, and the remaining loci showed low polymorphism. The most concentrated locus was MIRU2, and the most dispersed locus was MIRU26. The 120 drug-resistant strains contained 77 genotypes, with a clustering rate of 46.67 % and a recent transmission rate of 34.17 %. The minimum spanning tree showed that 120 drug-resistant strains could be divided into three clonal complexes, CC1, CC2, and CC3, according to the VNTR typing results. Among the 120 valid strains, 12 genotypes of 32 strains could be found on the SITVIT2 website, and the corresponding 12 MIT numbers were distributed in 14 countries on five continents worldwide.

The standard VNTR-12 locus method resolves drug-resistant tuberculosis strains well. There is a certain range of transmission of drug-resistant TB in Zigong, and the recent transmission rate is high, targeted surveillance is helpful in the prevention and control of tuberculosis.

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 explore the effect of arsenic on cell proliferation, the antagonism of PC against arsenic and the relationship associated to wnt/β-catenin signaling pathway by using Proanthocyanidins (PC) and sodium arsenite (NaAsO₂) to intervene human hepatocyte L-02.

We treated cells with different doses of PC alone or in combination with NaAsO₂. The cell activities were detected by Cell Counting Kit-8 (CCK-8) method. Cell scratch experiment and Transwell experiment were used to detect the ability of cell migration and invasion. Real-time Polymerase Chain Reaction (Real-time PCR) method and western blotting (WB) method were used to detect the expression levels of message RNA (mRNA) and protein.

NaAsO₂ increased the activity of cell proliferation (1.740±0.105), enhanced the ability of migration (556.000±3.606) and invasion (439.667±8.622). NaAsO₂ up-regulated the protein expression of proto-oncogene c-myc (0.739±0.012), cyclinD1 (0.943±0.002), Vascular Endothelial Growth Factor (VEGF) (1.020±0.019), apoptosis inhibitor gene survivin (0.571±0.033)and Matrix Metalloproteinase-7 (MMP-7) (0.695±0.059). NaAsO₂could also up-regulate the protein and mRNA levels of pathway core moleculars wnt3a (protein: 1.044±0.010, mRNA: 1.789±0.165) and β-catenin (protein: 0.958±0.037, mRNA: 1.596±0.217). Compared with NaAsO₂ group, when PC intervention was introduced, the levels of proliferation related proteins such as c-myc (0.438±0.046) decreased. The levels of mRNA and protein of wnt3a (mRNA: 1.181±0.018, protein: 0.822±0.015) and β-catenin (mRNA: 0.965±0.078, protein: 0.832±0.064) decreased. The expression of pathway inhibitors Glycogen synthase kinase-3β (GSK-3β) (0.885±0.058) and Axin (0.749±0.016) increased.

NaAsO₂ induce L-02 cell proliferation, which may be due to its activation of wnt/β-catenin signaling pathway. PC can down-regulate wnt/β-catenin pathway, thereby antagonizing the cell proliferation induced by NaAsO₂.

To explore the mediating effect of pain condition between the number of chronic diseases and handgrip strength and the moderating role of sleep quality among middle-aged and elderly people over 45 years old in China.

Based on the data from the 2015 China Health and Elderly Tracking Survey, model 4 and model 59 in the Process 4.1 program were used to analyze and construct the mediator model and the mediator model with moderation.

A total of 13 930 Chinese middle-aged and older adults were included after screening, with handgrip strength values of (30.81 ± 10.03), number of chronic diseases (1.33 ± 1.44), number of pain sites (1.60 ± 3.23), and sleep quality (2.98 ± 1.21). Chronic conditions inversely predicted handgrip strength (B=-0.212, P<0.001). Number of pain sites partially mediated the relationship between chronic conditions and handgrip strength (B=-0.177, P<0.001). Sleep quality moderated the first half of the mediating pathway (chronic diseases → pain conditions), and simple slope plots showed that the number of chronic diseases had a more significant effect on pain conditions in middle-aged and older adults with low sleep quality than in middle-aged and older adults with high sleep quality.

Chronic diseases can affect grip strength directly or indirectly through pain conditions, and sleep quality moderates the mediating effect of pain conditions. Reduced grip strength due to chronic diseases in middle-aged and older adults can be mitigated by reducing pain conditions and improving sleep quality.