To analyze theassociation and interactionof night shift work and unhealthy lifestyle on hyperhomocysteinemia(HHcy), and to provide basis for theHHcy preventionamong railway workers.

Total of 6 926 railway workers who received physical examination in a hospital in Guangzhou from September to December 2021 were selected as study objects. Binary logistic was performed to analyze correlation, the restricted cubic spline (RCS) model was used to assess the dose-response relationship, and the interaction of night shift work and unhealthy lifestyle with HHcy were analyzed.

The prevalence rate of HHcy among railway workers was 23.3%. Logistic regression showed that night shift work lasted 0-2.9 years (OR=1.340, 95% CI:1.120-1.603), night shift work frequency ≤ 1 d/w (OR=1.302, 95% CI:1.029-1.646) or ≥ 4 d/w (OR=1.516, 95% CI:1.248-1.841), smoking (OR=1.516, 95% CI:1.248-1.841), overweight (OR=1.173, 95% CI: 1.030-1.335) were positively correlated with HHcy. Sleep duration > 7 h/d and exercise were negatively correlated with HHcy (P<0.05). RCS model found a nonlinear relationship of night shift work with HHcy (P_total <0.001,P_non-linear=0.001). No multiplicative and additive interaction of night shift work and any unhealthylifestyle with HHcy were found(P> 0.05). Among different night shift conditions, smoking, almost inactive, overweight/obesity, and ≤ 7 h/d sleep had a higher risk of HHcy (P<0.05).

Night shift work and unhealthy lifestyle are risk factors for HHcy. In different night shift work conditions, smoking, almost inactive, overweight/obesity, sleep duration ≤ 7 h/d can increase HHcy risk.

To explore the relationship between dietary fiber intake and cognitive function, providing insights for nutritional interventions to prevent cognitive impairment.

Adults over 50 years old from the 2022 Southwest Population Cohort were selected as study subjects. Multiple linear regression and multivariable logistic regression models were used to analyze the relationship between dietary fiber intake and cognitive impairment. Subgroup analysis was performed to explore the association between dietary fiber intake and cognitive impairment across different age and gender groups.

A total of 1 267 participants were included,the median dietary fiber intake of the participants was 13.3 g/d. The dietary fiber intake of individuals with cognitive dysfunction, specifically those with mild cognitive impairment (11.6 g/d), was significantly lower than that of the normal group (13.7 g/d), and the difference was statistically significant (Z=3.93, P<0.001). After adjusting for age, gender, body mass index, education, smoking, per capita monthly household income, hypertension, diabetes, and daily energy intake, dietary fiber intake was positively correlated with cognitive function scores. The logistic regression analysis showed that, compared to the lowest dietary fiber intake group (Q1), the highest dietary fiber intake group (Q4) had a reduced risk of cognitive dysfunction, with statistically significant OR values of 0.29 (95% CI: 0.16–0.53), 0.27 (95% CI: 0.14–0.49), and 0.39 (95% CI: 0.18–0.84). The impact of dietary fiber intake was more pronounced in males and in individuals aged 63 and above.

There is a negative association between dietary fiber intake and cognitive dysfunction, suggesting that dietary fiber may be a protective factor against cognitive dysfunction, with this association being particularly significant in males and individuals aged 63 years and older.

To explore the potential relationship between dietary carotenoid intake and neurodegenerative diseases based on NHANES data.

A multifactorial logistic regression model was used to analyze the relationship between dietary carotenoid intake and neurodegenerative diseases and to explore the association between dietary carotenoid intake and neurodegenerative diseases in different gender and age subgroups, using the NHANES database of people aged 40 years and older from 2003-2018 as the study population.

Of the 23 108 study participants included in this study, 216 had Parkinson’s disease dementia (PD) and 183 had Alzheimer’s disease (AD). The carotenoid intake of PD patients (7,597.9 mcg/d) was significantly lower than that of the normal population (8,719.8 mcg/d) and the difference was statistically significant, while that of AD patients (7 189.8 mcg/d) was significantly lower than that of the normal population (8,721.4 mcg/d) and the difference was statistically significant. After adjusting for age, sex, body mass index, race, education, alcohol consumption, smoking, household poverty-to-income ratio, hypertension, diabetes mellitus, Cardiovascular disease and the NHANES cycle, the prevalence of PD was significantly lower in the highest tertile group compared with the lowest tertile group (OR=0.65, 95% CI: 0.44-0.98), and the risk of AD was significantly lower in the Q2 group (OR=0.65, 95% CI: 0.43-0.99). In subgroup analyses, a lower risk of PD was observed in the group with the highest dietary carotenoid intake in those aged 70 years or older (OR=0.52, 95% CI: 0.30-0.96); the protective effect of dietary carotenoid intake on AD was demonstrated in the Q4 group of women (OR=0.49, 95% CI: 0.26-0.93).

There is a negative association between carotenoid intake and the risk of developing neurodegenerative diseases, and carotenoids may be a protective factor against neurodegenerative diseases, a relationship that varies by age, sex, and whether or not the individual has hypertension or diabetes.

To investigate the differences in gut microbiota and energy metabolism among individuals with varying body mass index (BMI) levels, and to provide insights for the prevention and treatment of overweight and obesity.

A total of 98 healthy adults were recruited from Chengdu, categorized into four groups based on BMI: overweight (n=16), obesity (n=15), underweight (n=16), and normal weight (n=51). Participants underwent questionnaire surveys, physical examinations, body composition analysis, biochemical tests, and energy expenditure measurements. Fecal samples were collected for 16S rDNA sequencing and gas chromatography-mass spectrometry (GC-MS) metabolomics analysis. Univariate analysis of variance and chi-square tests were performed to compare differences in gut microbiota structure and energy metabolism among the four groups.

Gut microbiota structure analysis: Significant differences were observed in the gut microbiota structure among the four groups, with statistical significance in ACE and Chao1 indices (P=0.003, P=0.003). The normal weight group exhibited higher ACE and Chao1 indices compared to other groups, indicating a higher species richness. The relative abundance of different bacteria varied across groups. Compared to the normal weight group, the overweight, obese, and underweight groups showed reduced species richness and lower relative abundance of beneficial bacteria such as Bifidobacterium. Functional metabolic pathways of the gut microbiota were altered in these groups, with significant differences in the synthesis and metabolism of various amino acids, including glycine, in the overweight and obese groups (P=0.009, P=0.032).Correlation with BMI and energy expenditure indicators: The gut microbiota structure was associated with different levels of energy metabolism indicators. Bifidobacterium was positively correlated with cold-induced thermogenesis (CIT) (P=0.011), while Bifidobacterium animalis was negatively correlated with BMI and basal energy expenditure (BEE) (P<0.001), and positively correlated with CIT (P=0.029).

There are differences in gut microbiota structure and functional metabolic pathways among individuals with different BMI levels. The gut microbiota structure is associated with various energy metabolism indicators at different levels. These findings suggest that gut microbiota may play a role in energy metabolism and could be a potential target for interventions aimed at preventing and treating overweight and obesity.

Toinvestigate whether maternal vitamin D deficiency (VDD) prevents normal placental development through the Wnt/β-catenin signalling pathway during preconception and pregnancy, which in turn triggers adverse pregnancy outcomes.

Four-week-old female SD rats were randomly divided into two groups according to body mass, Ctrl group fed with standard rat chow and VDD group fed with vitamin D deficiency chow. After eight weeks of feed intervention and successful construction of the VDD rat model, blood was taken from the orbits, male and female were co-caged. The females were executed at 18 days of gestation (GD18).Tissue samples were collectedfor later experiment.

At eight weeks of modelling,the serum 25(OH)D levels of female rats in VDD group were significantly lower compared with those of the Ctrl group(P<0.001). At GD18, measured the placental 25(OH)D, 1,25(OH)₂D, and VDR levels, these indexes in the VDD group were (6.75 ± 1.40) ng/ml, (24.23 ± 8.31) ng/L, (74.46±27.54) nmol/L, which were significantly lower than indexes in the Ctrl group: (16.76±3.12) ng/ml, (36.19±4.27) ng/L, and (137.52±26.25) nmol/L(P<0.01). Placenta diameter, weight, syncytial trophoblast area, and foetal weight were measured at GD18. There was a significant difference between the two groups. At GD18, compared with the Ctrl group, the number of implanted fetuses and live fetuses per litter decreased, but the number of absorbed fetuses increased in the VDD group. The level of β-catenin hosphorylation was significantly increase in the placental tissues of pregnant rats in the VDD group.

Maternal vitamin D deficiency before and during pregnancy is an important cause of placental dysplasia, which in turn can induce adverse pregnancy outcomes, and the mechanism may involve the Wnt/β-catenin signalling pathway.

To examine the frequency and distribution patterns of birth defects in Hainan Province between 2016 and 2021, in order to offer insights for the improvement of maternal and child health services in the region.

Data on perinatal birth defect surveillance were gathered and analyzed from 28 weeks of gestation to 7 days postpartum in all monitored hospitals across Hainan Province between January 1, 2016 to December 31, 2021.

The comprehensive dataset revealed a total of 346 425 births recorded in Hainan Province from 2016 to 2021. Of these, 11 000 cases were identified with birth defects, translating to an average incidence rate of 317.53 per 10 000 births. Notably, the incidence of birth defects varied significantly across different demographics. Rural areas exhibited a lower rate (297.90 per 10 000) compared to urban areas (338.88 per 10 000), with a statistically significant difference (χ²=67.977, P<0.001). Additionally, male neonates showed a higher incidence (346.22 per 10 000) than female neonates (281.32 per 10 000), also with a statistically significant difference (χ²=164.878, P<0.001). Maternal age played a crucial role as well, with the 35-year-old and older age group demonstrating the highest incidence (364.81 per 10 000).The five most prevalent birth defects included congenital heart disease (180.99 per 10 000), polydactyly (20.24 per 10 000), talipes equinovarus (12.04 per 10 000), other external ear malformations (10.74 per 10 000), and syndactyly (5.05 per 10 000).Regarding prenatal diagnosis, only 11.72% of birth defects were confirmed prenatally, with clinical and ultrasonic diagnosis accounting for 98.87% of the total diagnoses. In terms of prognosis, a promising 91.92% of fetuses with congenital disorders were live births.

Suggest an increase in the prevalence of perinatal birth abnormalities in Hainan Province from 2016 to 2021. In response to these findings, it is imperative to strengthen the three-level preventive measures of birth defects, aiming to reduce incidence rates.

To construct the evaluation index system of public hospital operation management to provide a reference tool for administrative departments and public hospitals to grasp the public hospital operation management situation.

Based on the balanced scorecard theory, the evaluation index system of public hospital operation management was initially constructed through literature analysis, the final evaluation index system was determined by Delphi method, and the index weight was calculated by AHP method.

The response rate of expert consultation for the secondround was 100%, the authority coefficient was 0.840 and the coordination coefficients of the importance, feasibility and relevance of the indicators were 0.210, 0.181 and 0.196, respectively (P<0.001). The final evaluation index system consisted of 4 first-level indicators, 16 second-level indicators and 39 third-level indicators. The top 3 indicators of combined weight were inpatient satisfaction(0.0979), outpatient satisfaction(0.0682) and the proportion of medical service income(0.0494).

The public hospital operation management evaluation index system constructed by this research had high scientific, rational and practical guiding significance and was an effective tool to analyze and evaluate the operation management of public hospitals.

To construct an evaluation indicator system for the development of occupational disease clinical specialties, providing a basis for the construction and evaluation of occupational disease clinical specialties.

An initial expert consultation questionnaire was developed through literature research and group discussions. The Delphi method was applied to conduct two rounds of expert consultations with 34 experts in the field of occupational diseases from 13 provinces (autonomous regions and municipalities) including Beijing, Sichuan, and Henan. The final evaluation indicator system for occupational disease clinical specialties was formed, and the hierarchical weights of each index were determined using the priority diagram method.

The response rates for the two rounds of expert consultations were 97.14% and 94.12%. The expert authority coefficients were 0.856 and 0.860, and the Kendall’s concordance coefficients of the experts were 0.18 and 0.12 (P<0.01). The final occupational disease clinical specialty evaluation indicator system consisted of 5 first-level indicators, 17 second-level indicators, and 67 third-level indicators.

The enthusiasm, authority, and consistency of the two rounds of expert consultations were high. This evaluation indicator system is scientifically sound and reliable, providing a reference for the construction and high-quality development of occupational disease clinical specialties.

To understand the current situation of the construction of the integration mechanism of medical treatment and prevention in infectious disease hospitals in China, and to provide data support for the promotion of related work and policy formulation.

Based on the survey data of the construction of the integration mechanism of medical treatment and prevention in infectious disease hospitals in China, a quantitative analysis was conducted on the current situation of the related work of the integration of medical treatment and prevention in 97 secondary and tertiary infectious disease hospitals. A difference analysis was carried out on the current situation of the integration of medical treatment and prevention in different regions. Moreover, the t-SNE algorithm and data visualization were used to cluster the sample institutions for a comparative study at the hospital level.

Among the sample institutions in the eastern region, 46.51% had policy support related to the integration of medical treatment and prevention at the provincial (municipal) level, with an obvious advantage compared to other regions (P=0.001). The proportions of sample institutions in the eastern and central regions that established internal systems for the integration of medical treatment and prevention were higher (P=0.015), accounting for 27.91% and 28.57% respectively. In terms of the proportion of infectious disease hospitals that independently set up public health departments: the eastern region had the highest proportion, accounting for 72.09%; the northeastern region had the lowest proportion, accounting for 20.00%; and there were significant statistical differences among different regions (P=0.001). The t-SNE algorithm grouped the sample institutions into three categories: head tertiary hospitals, typical secondary hospitals and medium-sized hospitals. The construction of the integration mechanism of medical treatment and prevention in the three hospitals in head tertiary hospitals was significantly better than that in the other two categories.

The work on the integration of medical treatment and prevention for infectious diseases in China is still in the stage of exploration and breakthrough. All regions should explore the models and paths for the integration of medical treatment and prevention for infectious diseases in combination with local actual situations. The pilot construction of the integration of medical treatment and prevention of infectious diseases at both the "regional" and "hospital" levels should be coordinated，in order to promote infectious disease hospitals to better fulfill their public health functions, and take this as a breakthrough to open up the effective integration and interconnection of personnel, information and resources between medical institutions and disease control institutions.

To analyze the impact of DIP payment reform on total hospitalization costs, drug costs, and treatment costs of hospitalized patients with chronic lung disease, and to provide a decision-making reference for the deepening reform of DIP.

Using the first national DIP pilot cities as a sample area, case data of 10 058 chronic lung patients hospitalized in provincial hospitals in the area were extracted for the study, and the causal effects of DIP on total patient costs, drug costs and treatment costs were estimated by the PSM-DID model.

After the DIP payment reform, the total cost for patients with chronic obstructive pulmonary disease decreased by 5.9% (P=0.001), were 1 162.92 yuan; the cost of medication decreased by 8.83% (P=0.003), were 477.21 yuan; and the cost of treatment decreased by 27.3% (P=0.001), were 152.54 yuan.

The DIP payment reform has achieved short-term reform effects on reducing total hospitalization costs, drug costs, and treatment costs for patients hospitalized with chronic obstructive pulmonary disease. In order to guarantee the continuous implementation of DIP, the medical insurance department should also continue to strengthen the supervision of the diagnosis and treatment process of medical institutions to maintain the long-term continuation of the effect of fee-control; medical institutions should further promote the refinement of management.