To analyze the trends in the burden of stroke and its risk factors among Chinese residents from 1990 to 2019, and to provide a scientific basis for formulating targeted stroke prevention and control strategies.

Data on the burden of stroke among Chinese residents in 1990, 2000, 2010, and 2019 were collected from the 2019 Global Burden of Disease Study (GBD 2019). Indicators such as disability-adjusted life years (DALYs), DALY rates, and population attributable fractions (PAFs) were used to analyze the trends in the burden of stroke and its risk factors among Chinese residents from 1990 to 2019.

In 2019, the DALY rates of stroke, ischemic stroke, and hemorrhagic stroke among Chinese residents increased with age, with the highest rates observed in the ≥70 age group (21 061.26/100 000, 11 858.11/100 000, and 8 505.17/100 000, respectively). The DALY rates of stroke, ischemic stroke, and hemorrhagic stroke were higher in men (3 739.30/100 000, 1 627.23/100 000, and 1 924.07/100 000, respectively) than in women (2 701.81/100 000, 1 376.19/100 000, and 1 184.82/100 000, respectively). From 1990 to 2019, the DALY rates of stroke and ischemic stroke increased (with average annual growth rates of 0.44% and 2.39%, respectively), while the DALY rate of hemorrhagic stroke decreased (with an average annual growth rate of –0.08%). In 2019, the top three risk factors for stroke in terms of DALYs, PAFs, and DALY rates were high systolic blood pressure (251763 million person-years, 54.80%, and 1 770.05/100 000, respectively), ambient air pollution (128473 million person-years, 27.95%, and 903.24/100 000, respectively), and smoking (10.099 3 million person-years, 21.96%, and 710.04/100 000, respectively). The top three risk factors for ischemic stroke were high systolic blood pressure (10.896 8 million person-years, 50.94%, and 766.11/100 000, respectively), ambient air pollution (5.737 8 million person-years, 26.81%, and 403.40/100 000, respectively), and high LDL cholesterol (4.427 7 million person-years, 20.69%, and 311.29/100 000, respectively). The top three risk factors for hemorrhagic stroke were high systolic blood pressure (12.919 0 million person-years, 58.18%, and 908.28/100 000, respectively), ambient air pollution (6.403 9 million person-years, 28.82%, and 450.23/100 000, respectively), and high-sodium diet (5.421 3 million person-years, 24.40%, and 381.15/100 000, respectively). From 1990 to 2019, the PAFs of eight risk factors for stroke increased and two decreased, six risk factors for ischemic stroke increased and four decreased, and eight risk factors for hemorrhagic stroke increased and two decreased. Among these, the PAF of ambient air pollution showed the largest increase (with average annual growth rates of 2.83%, 2.65%, and 2.90%, respectively), while the PAF of high-sodium diet showed the largest decrease (with average annual growth rates of –0.36%, –0.43%, and –0.16%, respectively).

The burden of stroke among Chinese residents remained high from 1990 to 2019, with an increasing trend in DALY rates. High systolic blood pressure remained the leading risk factor for stroke and its subtypes.

To understand the incidence trends of intestinal obstruction in Chinese residents from 1992 to 2021 and to provide a scientific basis for formulating precise prevention and control measures for intestinal obstruction.

Data on the number of cases, incidence rate, and age-standardized incidence rate (ASIR) of intestinal obstruction in Chinese residents from 1992 to 2021 were extracted from the Global Burden of Disease Study 2021 (GBD 2021) database. Descriptive analysis and Joinpoint regression models were used to evaluate the trends in the incidence of intestinal obstruction in Chinese residents and calculate the average annual percentage change (AAPC). The age-period-cohort (APC) model was used to assess the age, period, and cohort effects on the risk of intestinal obstruction in Chinese residents.

The incidence rates of intestinal obstruction in the total population, male residents, and female residents of China increased from 204.411/100 000, 227.272/100 000, and 179.973/100 000 in 1992 to 231.393/100 000, 259.508/100 000, and 201.923/100 000 in 2021, respectively. The ASIR decreased from 220.367/100 000, 247.453/100 000, and 192.676/100 000 in 1992 to 198.500/100 000, 226.548/100 000, and 170.553/100 000 in 2021, respectively. The AAPC values of ASIR were –0.355%, –0.302%, and –0.410% (all P<0.01), respectively. The APC model analysis showed that the age effect of the incidence of intestinal obstruction in the total population, male residents, and female residents of China showed an overall upward trend with increasing age. The age effect coefficients increased from 0.126, 0.103, and 0.183 for ages 0–4 years to 0.413, 0.725, and 0.453 for ages ≥95 years, respectively. The period effect of the incidence of intestinal obstruction in the total population, male residents, and female residents of China showed an overall downward trend over time. The period effect coefficients decreased from 1.000, 1.008, and 0.993 for the period 1992–1996 to 0.942, 0.958, and 0.920 for the period 2017–2021, respectively. The cohort effect of the incidence of intestinal obstruction in the total population, male residents, and female residents of China showed a trend of first increasing and then decreasing. The cohort effect coefficients for the total population increased from 0.591 for the 1897–1901 cohort to 1.079 for the 1942–1946 cohort and then decreased to 0.718 for the 2017–2021 cohort. The cohort effect coefficients for male residents increased from 0.640 for the 1897–1901 cohort to 1.076 for the 1947–1951 cohort and then decreased to 0.716 for the 2017–2021 cohort. The cohort effect coefficients for female residents increased from 0.638 for the 1897–1901 cohort to 1.142 for the 1927–1931 cohort and then decreased to 0.706 for the 2017–2021 cohort.

The ASIR of intestinal obstruction in Chinese residents showed an overall downward trend from 1992 to 2021, but it is still necessary to strengthen the prevention and control of intestinal obstruction in male and elderly populations.

To understand the trends in meningitis incidence and mortality among Chinese residents from 1990 to 2021, and to provide a reference for the development of relevant prevention and control policies and measures for meningitis in China.

Data on meningitis incidence and mortality among Chinese residents from 1990 to 2021 were collected from the Global Burden of Disease Study 2021 (GBD 2021) database. Descriptive analyses were conducted using indicators such as the number of cases, incidence rate, age-standardized incidence rate (ASIR), number of deaths, mortality rate, and age-standardized mortality rate (ASDR). Joinpoint regression models were used to analyze the trends in incidence and mortality rates of meningitis among Chinese residents and to calculate the average annual percentage change (AAPC). Age-period-cohort (APC) models were used to fit and estimate the age, period, and cohort effects on the risk of meningitis incidence and mortality among Chinese residents.

The incidence rate of meningitis among the total population, male residents, and female residents in China decreased from 28.34/100 000, 31.66/100 000, and 24.81/100 000 in 1990 to 4.82/100 000, 5.84/100 000, and 3.75/100 000 in 2021,respectively. The ASIR decreased from 30.83/100 000, 34.48/100 000, and 27.20/100 000 in 1990 to 5.79/100 000, 7.16/100 000, and 4.42/100 000 in 2021, respectively. The AAPC values for ASIR were –5.30%, –4.96%, and –5.71% (all P<0.001), respectively. The mortality rate of meningitis among the total population, male residents, and female residents in China decreased from 3.17/100 000, 3.60/100 000, and 2.71/100 000 in 1990 to 0.43/100 000, 0.50/100 000, and 0.36/100 000 in 2021, respectively. The ASDR decreased from 3.54/100 000, 4.02/100 000, and 3.06/100 000 in 1990 to 0.48/100 000, 0.58/100 000, and 0.38/100 000 in 2021, respectively. The AAPC values for ASDR were –6.31%, –6.11%, and –6.56% (all P<0.001), respectively. The APC model analysis showed that the age effects of both meningitis incidence and mortality initially decreased and then increased with age. The age effect coefficients for meningitis incidence among the total population, male residents, and female residents in China decreased from 1.945, 1.857, and 2.065 for ages 0–4 to –1.194, –1.112, and –1.381 for ages 45–49, and then increased to 1.874, 2.087, and 1.905 for ages 90–94, respectively. The age effect coefficients for meningitis mortality among the total population and male residents decreased from 2.425 and 2.386 for ages 0–4 to –1.279 and –1.381 for ages 25–29, and then increased to 2.116 and 2.371 for ages 90–94, respectively. The age effect coefficients for meningitis mortality among female residents decreased from 2.466 for ages 0–4 to –1.329 for ages 30–34, and then increased to 2.086 for ages 90–94. Both the period effects of meningitis incidence and mortality showed a decreasing trend. The period effect coefficients for meningitis incidence and mortality among the total population, male residents, and female residents in China decreased from 0.583 and 0.671, 0.555 and 0.652, and 0.612 and 0.686 for the period 1992–1996 to –0.362 and –0.368, –0.291 and –0.339, and –0.463 and –0.404 for the period 2017–2021, respectively. Both the cohort effects of meningitis incidence and mortality showed a fluctuating downward trend. The cohort effect coefficients for meningitis incidence and mortality among the total population, male residents, and female residents in China decreased from 0.094 and 0.150, 0.207 and 0.214, and –0.025 and 0.115 for the cohort 1902–1906 to –1.037 and –1.461, –1.097 and –1.537, and –1.002 and –1.401 for the cohort 2017–2021, respectively.

The incidence and mortality rates of meningitis among Chinese residents showed an overall downward trend from 1990 to 2021. However, it is still necessary to strengthen the prevention and control of meningitis among residents in younger and older age groups.

To understand the incidence trends of chronic obstructive pulmonary disease (COPD) among elderly adults in China and to provide a reference for optimizing COPD prevention and control strategies in China.

Data related to the incidence of COPD among Chinese residents aged ≥60 years from 1992 to 2021 were collected from the Global Burden of Disease Study 2021 (GBD 2021) database. Descriptive analyses were conducted using indicators such as the number of incident cases, incidence rate, and age-standardized incidence rate. Joinpoint regression models were used to analyze the trends in COPD incidence among elderly adults in China and to calculate the annual percentage change (APC) and average annual percentage change (AAPC). Age-period-cohort (APC) models were applied to fit and estimate the age, period, and cohort effects on the risk of COPD incidence among elderly adults in China.

The incidence rates of COPD among elderly adults in China overall, males, and females decreased from 1 374.91/1 000 001 359.40/100 000, and 1 389.29/100 000 in 1992 to 1 252.95/100 000, 1 207.43/100 000, and 1 179.24/100 000 in 2021, respectively. The age-standardized incidence rates decreased from 1 548.64/100 000, 1 590.77/100 000, and 1 515.03/100 000 in 1992 to 1 252.95/100 000, 1 331.37/100 000, and 1 190.16/100 000 in 2021, respectively. The AAPCs of the age-standardized incidence rates were –0.73%, –0.61%, and –0.83%, respectively (all P<0.05). The APC model analysis showed that the age effects on COPD incidence among elderly adults in China overall, males, and females all showed an increasing trend with age, with the age effect coefficients increasing from –0.817, –0.791, and –0.861 for ages 60-64 to 0.521, 0.611, and 0.504 for ages 90-94, respectively. The period effects on COPD incidence among elderly adults in China overall and females showed a trend of first decreasing and then increasing over time, with the period effect coefficients decreasing from 0.013 and 0.033 for the period 1992–1996 to –0.028 and –0.059 for the period 2007-2011, and then increasing to 0.013 and 0.024 for the period 2017–2021, respectively. The period effects on COPD incidence among elderly male adults showed an overall increasing trend over time, with the period effect coefficients increasing from –0.017 for the period 1992–1996 to 0.014 for the period 2017–2021. The birth cohort effects on COPD incidence among elderly adults in China overall, males, and females all showed a decreasing trend with birth year, decreasing from 0.255, 0.194, and 0.283 for the birth cohort 1902–1906 to –0.279, –0.307, and –0.258 for the birth cohort 1957–1961, respectively.

The age-standardized incidence rate of COPD among elderly adults in China showed an overall decreasing trend from 1992 to 2021, but the disease burden of COPD among males and elderly adults at advanced ages continues to increase.

To investigate the prevalence, awareness, and treatment rates of diabetic retinopathy (DR) among individuals aged 18–75 years with diabetes mellitus in Hubei province, and to provide scientific evidence for DR prevention and control.

In 2019, a multi-stage stratified cluster random sampling method was used to select 1 708 individuals aged 18–75 years with diabetes mellitus from four survey sites in Hubei province. Questionnaires, physical measurements, laboratory tests, and fundus examinations were conducted. The prevalence, awareness, and treatment rates of DR among individuals with diabetes with different characteristics were analyzed. Multivariable logistic regression analysis was used to analyze the influencing factors of DR.

After excluding individuals without fundus photographs or with unqualified photographs, a total of 1 489 participants were included in this study. The prevalence of DR was 12.6%, the awareness rate among individuals with DR was 13.3%, and the treatment rate was 18.5%. The awareness rate (χ²=4.207) and treatment rate (χ²=7.243) were significantly higher in urban residents than in rural residents (all P<0.05). With increasing education level, the awareness rate of DR showed a significant upward trend (χ²=3.045, P<0.05); the treatment rate of DR showed a marginally significant upward trend (χ²=2.616, P=0.053). With increasing annual household income, both the awareness rate (χ²=7.148) and treatment rate (χ²=3.228) of DR showed a significant upward trend. Individuals with diabetes who had urban employee medical insurance had higher DR awareness (χ²=11.503) and treatment rates (χ²=10.800) (all P<0.05). Multivariable logistic regression analysis showed that poor fasting blood glucose control (>7 mmol/L, Wald χ²=6.563), longer diabetes duration (≥5 years, Wald χ²=22.171), and having hypertension (Wald χ²=5.760) were associated with a higher risk of DR, while having urban employee medical insurance (Wald χ²=4.612) was associated with a lower risk of DR (all P<0.05).

The prevalence of DR among individuals aged 18–75 years with diabetes mellitus in Hubei province is not high, but the awareness and treatment rates are low. Prevention and control education and screening efforts should be strengthened for high-risk populations with DR, with a focus on improving the awareness and treatment rates of DR among individuals in rural areas, those with low education and income levels, and those with low medical insurance coverage.

To investigate the salt intake status and its influencing factors among adult residents in rural areas of Hebei province, and to provide a reference for developing salt reduction interventions for residents in this area.

In August 2022, 600 adult residents aged ≥18 years were selected from 11 prefecture-level cities in Hebei province (Shijiazhuang, Handan, Xingtai, Baoding, Zhangjiakou, Chengde, Tangshan, Qinhuangdao, Cangzhou, Hengshui, and Langfang) using a convenience sampling method. Questionnaires, physical examinations, and 24-hour urine collection and testing were conducted. The daily salt intake of the subjects was calculated using the 24-hour urinary sodium method, and a multifactorial unconditional logistic regression model was used to analyze the influencing factors of salt intake among adult residents in rural areas of Hebei province.

The daily salt intake of the 597 rural adult residents finally included in the analysis ranged from 1.05 g to 35.54 g, with a mean daily salt intake of [9.66 (6.67, 13.41) g]. The low-salt group (daily salt intake < 9.66 g) and high-salt group (daily salt intake ≥9.66 g) consisted of 298 and 299 individuals, accounting for 49.92% and 50.08%, respectively. Multifactorial unconditional logistic regression analysis showed that frequent consumption of broad bean paste (OR=1.642, 95%CI: 1.152–2.340) was a risk factor for salt intake among adult residents in rural areas of Hebei province, while age ≥60 years (OR=0.628, 95%CI: 0.430–0.916) and the use of low-sodium salt (OR=0.544, 95%CI: 0.308–0.962) were protective factors.

Salt intake among adult residents in rural areas of Hebei province is high. Age, frequent consumption of broad bean paste, and current use of low-sodium salt are the main influencing factors of salt intake among rural adult residents in the area.

To analyze the current status of body composition, sedentary time, and physical activity levels in overweight and obese pregnant women during early pregnancy, and to explore the influencing factors of visceral fat area (VFA), so as to provide a scientific basis for preventing excessive weight gain and improving health status in this population.

This cross-sectional study recruited 154 overweight and obese women in early pregnancy (gestational age ≤14 weeks) from the nutrition clinic of Haidian Maternal and Child Health Hospital in Beijing city from November 2023 to May 2024. Demographic characteristic, physical activity, and dietary information were collected through a basic health status questionnaire, the International Physical Activity Questionnaire (IPAQ), and a Food Frequency Questionnaire (FFQ). Body composition was measured based on bioelectrical impedance analysis. Spearman correlation analysis was used to analyze the correlation between body composition-related indicators and VFA. Multiple logistic regression and generalized additive models were used to analyze the influencing factors of VFA.

A total of 131 valid questionnaires and 154 body composition reports were collected, with effective rates of 85% and 100%, respectively. 45.04%of the pregnant women had low physical activity levels, and 54.96%had moderate or higher levels. The median (interquartile range) of body composition-related indicators were as follows: VFA, 136 (116–157) cm²; waist-to-hip ratio, 0.93 (0.90–0.96); body weight, 72 (67–76) kg; body fat, 27 (25–31) kg; basal metabolic rate (BMR), 5 522 880 (5 284 392–5 799 024) J; body mass index (BMI), 27 (26–29); muscle mass, 41 (36–41) kg; and body fat percentage, 38 (36–41)%. Sedentary time was 400 (240–480) min/d. Multiple logistic regression analysis showed that after adjusting for confounding factors such as age, dairy, refined grains, and fruit and vegetable intake, excessive BMI was a risk factor for higher VFA (OR=2.7, 95%CI: 1.602–2.951). Generalized additive models showed that sedentary time and physical activity level had statistically significant effects on VFA (P<0.05).

Insufficient physical activity levels and prolonged sedentary time in some overweight and obese pregnant women during early pregnancy should be addressed. Excessive BMI is a major risk factor for visceral fat accumulation. Overweight and obese pregnant women should arrange sedentary and exercise time appropriately according to their own circumstances, regularly monitor their body composition, and effectively prevent excessive weight gain during pregnancy and improve their overall health.

To analyze the influence of primary care physicians′ professional identity and job resilience on the construction of learning organizations, and to provide a reference for the reform of primary healthcare supply-side capacity.

From August to October 2022, 400 primary care physicians were selected from Yichang in Hubei province, Zhongmu in Henan province, Neijiang in Sichuan province, and Jinan in Shandong province using purposive sampling. Structural equation modeling was constructed using AMOS 28 software to analyze the influencing factors of learning organization construction among primary care physicians.

A total of 387 valid questionnaires were collected from primary care physicians, of which 27.65% (107 individuals) were classified as high-learning primary care physicians. Primary care physicians with senior professional titles (36 individuals), bachelor′s degree or above (212 individuals), monthly income >5 000 yuan (97 individuals), and more than 10 years of working experience (105 individuals) had a higher proportion of high-learning individuals within their respective groups compared to other types, at 36.11%, 29.72%, 31.56%, and 30.48%, respectively, demonstrating stronger active learning awareness and active service behavior. Structural equation analysis showed that primary care physicians′ professional identity and job resilience had direct effects on the construction of learning organizations, with effect values of 0.255 and 0.273, respectively (both P<0.01). Simultaneously, professional identity positively influenced job resilience, with an effect value of 0.637 (P<0.001). Effect decomposition showed that professional identity could partially and positively affect the construction of learning organizations among primary care physicians through the mediating role of job resilience, with an indirect effect value of 0.174 (P<0.001).

Currently, the construction of learning organizations among primary care physicians needs to be further strengthened. Comprehensively cultivating and shaping primary care physicians′ professional identity and job resilience can effectively enhance their active learning awareness and active service behavior, thereby contributing to the overall framework of supply-side structural reform in the primary healthcare system.

To understand the utilization of oral health services and the cost of oral disease treatment among residents in Shenzhen city, Guangdong province, and to provide a reference for monitoring and evaluating oral health care work in Shenzhen city.

From July to November 2018, a multi-stage stratified cluster sampling method was adopted. Based on the per capita gross domestic product (GDP) of each district in Shenzhen city in 2016, 8 880 residents were randomly selected from high-GDP districts (Nanshan district and Luohu district) and low-GDP districts (Longgang district and Longhua district) in Shenzhen city for questionnaire surveys and oral examinations to analyze the utilization of oral health services and the cost of oral disease treatment among local residents.

Among the 8 576 residents finally included in the analysis in Shenzhen city, 2 929 used oral health services, with a utilization rate of 34.2%. The utilization rates of oral health services among preschool children (3–5 years old), adolescents (12–15 years old), and adults (35–74 years old) were 28.3% (519/1 833), 37.6% (2 071/5 510), and 27.5% (339/1 233), respectively. The main reason for preschool children to use oral health services was consultation and examination (41.8%), while the main reason for adolescents and adults to use oral health services was treatment (43.1% and 77.5%, respectively). The costs of oral disease treatment for preschool children and adults were (1 025.00±220.63) and (1 832.32±127.36) yuan, respectively. There were no statistically significant differences in the costs of oral disease treatment among preschool children and adults of different genders, educational levels, and districts (all P>0.05).

The utilization rate of oral health services among residents in Shenzhen city is still low, while the cost of oral disease treatment is high.

To investigate and analyze the current status and problems of infant and young child nutrition services in maternal and child health institutions in China.

In 2022, a purposive sampling method was used to select 56 maternal and child health institutions from 16 provinces (municipalities) in China. An online questionnaire survey was conducted to collect information on the implementation of three types of infant and young child nutrition services (feeding guidance, physical growth assessment, and micronutrient deficiency risk screening), reasons for not providing these services, the number of four types of nutrition service personnel (clinical practitioners, public health practitioners, nurses, and technicians), and the availability of two types of nutrition service tools (dietary assessment and anthropometric measurement).

Among the surveyed institutions, provincial, city, and county (district) level institutions accounted for 14.29% (8/56), 39.29% (22/56), and 46.42% (26/56), respectively. The overall implementation rates of feeding guidance and physical growth assessment were both 100.00%, while the overall implementation rate of micronutrient deficiency risk screening was 69.64% (39/56). The implementation rates of each service item for feeding guidance (breastfeeding, complementary feeding, healthy diet, nutrient supplementation, and responsive feeding) and physical growth assessment (age-specific weight, age-specific length/height, age-specific head circumference, length/height-specific weight, and age-specific BMI) were all above 90.00%. The implementation rates of risk screening for iron, vitamin D, and vitamin A deficiency were 69.64% (39/56), 66.07% (37/56), and 55.36% (31/56), respectively. The main reasons for not implementing these services were insufficient technical skills of service personnel (9 institutions), lack of charging standards (8 institutions), and lack of equipment (8 institutions). Nutrition service personnel were mainly clinical practitioners (pediatrics) and nurses, accounting for 45.76% (329/719) and 27.54% (198/719), respectively. The availability rate of dietary assessment tools ranged from 57.14% to 83.93%, and the availability rates of anthropometric measurement tools were all above 90.00%.

Currently, the content of infant and young child nutrition services in maternal and child health institutions in China is not yet comprehensive, the capacity for micronutrient deficiency risk screening is weak, and professional training of nutrition service personnel and the provision of service tools need to be strengthened.

To analyze the influence of Internet use on the physical and mental health of older empty nesters and to provide a reference for improving their health status.

Data on 3 970 empty nesters (living alone or only with spouse/cohabitant for at least 180 days in the past year) aged 60 years and older were extracted from a survey of the China Health and Retirement Longitudinal Study (CHARLS) in 2020. Physical and mental health were assessed in the 2020 survey using the Basic Activities of Daily Living Scale (BADL) and the Center for Epidemiologic Studies Depression Scale (CESD-10), respectively. From all participants, 638 Internet users (observation group) were matched with the same number of non-Internet users (control group) using 1:1 propensity score matching (PSM). Univariate and multiple linear regression analyses were used to examine the influence of Internet use on the physical and mental health of the older empty nesters.

Of the 3 970 participants, 19.75% reported Internet use. Before the PSM, there were statistically significant differences in the covariates between the observation and control groups (P<0.05 for all), but after the PSM, the between-group differences in the covariates were not statistically significant (all P>0.05). Multivariate linear regression analysis showed that Internet use was positively associated with the physical health (β=0.289, P<0.05) and mental health (β=1.024, P<0.05) of older empty nesters. In addition, physical health was also influenced by gender, age, social participation, and nighttime sleep duration (all P<0.05), while mental health was also influenced by gender, household registration type, education, alcohol consumption, and nighttime sleep duration (P<0.05). Among these factors, social participation and nighttime sleep duration had the greatest influence on physical health (β= –0.411, P<0.05) and mental health (β=2.235, P<0.05).

The Internet usage rate among China's elderly empty nesters is relatively low. Internet use can effectively improve the physical and mental health of this population. Social participation and nighttime sleep duration are important factors influencing the physical and mental health of elderly empty nesters.

To analyze the impact of the urban and rural resident basic medical insurance on catastrophic health expenditure in Chinese residents.

Data from the 2020 China Family Panel Studies (CFPS) were used. Probit regression analysis was conducted with urban and rural resident basic medical insurance as the core variable. Propensity score matching (PSM) was taken to test for endogeneity.

At a threshold of 40%, the incidence of catastrophic health expenditure among Chinese residents was 13.88%. Probit model analysis showed that urban and rural resident basic medical insurance reduced the incidence of catastrophic health expenditure, with insured individuals having a 5.70% lower probability of experiencing catastrophic health expenditure compared to uninsured individuals. After addressing endogeneity, PSM results showed that urban and rural resident basic medical insurance still had a suppressive effect on the occurrence of catastrophic health expenditure. The impact of urban and rural resident basic medical insurance on reducing the incidence of catastrophic health expenditure differed significantly between western (β= –0.089) and eastern (β= –0.050) regions (both P<0.01). Age (β=0.035), education level (β= –0.011), urban-rural classification (β= –0.035), and regional classification (β=0.015) were also important factors influencing catastrophic health expenditure (all P<0.01).

urban and rural resident basic medical insurance can effectively reduce the probability of catastrophic health expenditure among Chinese residents. Relevant departments can reduce the probability of catastrophic health expenditure by further refining urban and rural resident medical insurance policy design, improving the multi-level medical security system, and flexibly formulating regional medical insurance policies.

To investigate the prevalence of malnutrition among syphilis-exposed uninfected (SEU) infants and young children in Hunan province and explore its related factors.

A total of 5 404 infants and young children born to mothers infected with syphilis, registered in the Hunan Provincial Management Information System for Prevention of Mother-to-Child Transmission of HIV, Syphilis, and Hepatitis B from January 2018 to December 2020, were included in this study. These children were followed up regularly until 18 months of age. Data collected included maternal demographic characteristics, gestational and delivery information, syphilis infection and treatment status, infant birth information, infant prophylactic medication use, syphilis testing results, and length and weight measurements at different follow-up time points (3, 6, 9, 12, and 18 months of age). Malnutrition among SEU infants and young children was assessed based on the WHO 2006 Child Growth Standards. Generalized estimating equations were used to fit logistic regression models to analyze the related factors.

The prevalence of malnutrition among SEU infants and young children at 3, 6, 9, 12, and 18 months of age was 7.5% (403/5 404), 6.1% (309/5 092), 4.2%(193/4 554), 3.8% (148/3 928), and 3.7% (125/3 348), respectively. The prevalence of stunting was 5.2% (280/5 404), 4.7% (241/5 092), 3.3% (149/4 554), 3.0% (116/3 928), and 2.8% (95/3 348), respectively. The prevalence of underweight was 2.5% (135/5 404), 1.2% (62/5 092), 0.9%(40/4 554), 0.4% (15/3 928), and 0.4% (12/3 348), respectively. The prevalence of wasting was 2.0% (107/5 404), 1.2% (62/5 092), 0.9% (42/4 554), 0.8% (32/3 928), and 0.9% (30/3 348), respectively. The prevalence of malnutrition was higher in younger SEU infants and children. Maternal first antenatal care visit at ≥28 weeks of gestation (adjusted odds ratio [OR_adj]=1.63, 95%CI: 1.27–2.09), low birth weight (OR_adj=2.35, 95%CI: 1.77–3.13), and preterm birth (OR_adj=1.83, 95%CI: 1.45–2.31) were risk factors for malnutrition in SEU infants and young children. Maternal standard syphilis treatment during pregnancy (OR_adj0.78, 95%CI: 0.62–0.97) and female sex of the child (OR_adj=0.62, 95%CI: 0.53–0.71) were protective factors against malnutrition.

The prevalence of malnutrition among SEU infants and young children was relatively low. Late first antenatal care visit (≥28 weeks), standard syphilis treatment during pregnancy, low birth weight, preterm birth, and female sex were factors influencing malnutrition in SEU infants and young children.

To analyze the leftover food situation among students in key monitored counties under the Rural Compulsory Education Student Nutrition Improvement Program in Henan province in 2021, and to provide scientific evidence for improving the current situation of food waste and strengthening nutrition and health education.

In 2021, a stratified random cluster sampling method was used to select 4 832 primary and secondary school students from four key monitored counties implementing the Rural Compulsory Education Student Nutrition Improvement Program in Henan province. Their height and weight were measured, and a questionnaire survey was conducted to analyze their usual leftover food situation and the satisfaction of students who ate at school with the school meals.

Among the 4 832 surveyed students, 33.35% reported leftovers during their usual meals. Among those who had leftovers, the frequency of leftovers was mainly 1–4 days per week (46.64%), the amount of leftovers was mainly "only a little left" (74.52%), the types of leftovers were mainly staple foods (54.23%) and vegetables (42.69%), and the main reasons for leftovers were “too much food provided, couldn’t finish it” (38.56%) and “dislike this kind of food” (27.64%). Among the students who ate at school, 12.28% felt that the school meals were too salty, 22.98% felt that the school meals were too greasy, and only 32.49% liked the food provided by the school. Logistic regression analysis showed that township schools (OR=2.055, 95%CI: 1.645–2.567), middle school (OR=1.171, 95%CI: 1.015–1.352), and snacking frequency of 3–4 times/week (OR=1.934, 95%CI: 1.601–2.336) were risk factors for student leftovers, while non–boarding students (OR=0.567, 95%CI;0.477–0.672) and overweight/obesity (OR=0.830, 95%CI:0.717–0.961) were protective factors.

There is a certain degree of leftover food among students in key monitored counties under the Rural Compulsory Education Student Nutrition Improvement Program in Henan province, and student satisfaction with the food provided by schools is low. School location, school level, boarding status, nutritional status, and snacking frequency are influencing factors for leftovers.

To understand the characteristics of air pollution and the associated population health risks during the heating season (October 15 to April 15 of the following year) and the non-heating season (April 16 to October 14 of the following year) in Hohhot city, Inner Mongolia, from 2017 to 2022, and to provide a reference for the development of scientific environmental protection policies in this region.

Data on monitored pollutants during the heating and non-heating seasons from January 1, 2017, to December 31, 2022, were collected from the Hohhot Ecological Environment Monitoring Station. Time series plots of pollutants were generated, and health risk values were calculated using the model recommended by the United States Environmental Protection Agency (USEPA) to assess the health risks posed by air pollutants to the population.

From 2017 to 2022, there were 1 099 days in the heating season and 1 092 days in the non-heating season in Hohhot city. The exceedance rates of inhalable particulate matter (PM₁₀), fine particulate matter (PM_2.5), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), and 8-hour ozone (O_{3-8 h}) concentrations during the heating and non-heating seasons were 16.7% and 4.0%, 18.4% and 1.1%, 0 and 0, 2.2% and 0.1%, 0.1% and 0, and 0 and 12.5%, respectively. Compared with the non-heating season, the exceedance rates of PM₁₀, PM_2.5, and NO₂ were higher during the heating season, while the exceedance rate of O_{3-8 h} was lower during the heating season (all P<0.001). From 2017 to 2022, the annual average mass concentrations of PM₁₀, PM_2.5, SO₂, NO₂, and CO during both the heating and non-heating seasons showed a downward trend (all P<0.001). The annual average mass concentrations of PM₁₀, PM_2.5, SO₂, NO₂, and CO were higher during the heating season than during the non-heating season for each year, while the annual average mass concentration of O_{3-8 h} was lower during the heating season (all P<0.001). Time series plots showed that the daily average concentrations of PM₁₀, PM_2.5, SO₂, NO₂, and CO in Hohhot city from 2017 to 2022 were higher during the heating season than during the non-heating season, while the daily average concentration of O_{3-8 h} was lower during the heating season. Comparison of the daily average concentrations of air pollutants between the heating and non-heating seasons also showed that the daily average concentrations of PM₁₀, PM_2.5, SO₂, NO₂, and CO were higher during the heating season than during the non-heating season for each year from 2017 to 2022, while the daily average concentration of O_{3-8 h} was lower during the heating season; these differences were all statistically significant (all P<0.001). From 2017 to 2022, the non-carcinogenic risk value of PM₁₀ was > 1×10^–6 during both the heating and non-heating seasons in Hohhot city. The non-carcinogenic risk value of PM_2.5 was > 1×10^–6 during the heating season and <1×10^–6 during the non-heating season. The non-carcinogenic risk values of SO₂ and NO₂ were <1×10^–6 during both the heating and non-heating seasons.

From 2017 to 2022, air pollution in Hohhot city was more severe during the heating season than during the non-heating season. PM₁₀ and PM_2.5 pollution was particularly serious in this region, posing potential risks to human health.

To develop a mask suitability correlation model based on facial features extracted from facial images using facial recognition technology, enabling rapid mask recommendations for users and reducing infection risk.

Frontal facial photographs of volunteers were collected, and mask sealing performance tests were conducted to obtain facial feature dimensions and mask suitability data. Dimensionality reduction and clustering were applied to the facial feature data, and a correlation model was established between facial clusters and mask sealing performance data. This model facilitates rapid mask recommendations based on facial images.

Facial image data from 245 volunteers were collected. Each volunteer randomly selected 2–3 masks from five common types for sealing performance tests, resulting in a total of 589 mask sealing performance data points, with each mask type tested 115–125 times. Statistical analysis revealed that two masks, ENVIP3DF (84.3%) and 801-N95 (68.9%), had higher passing rates, with a statistically significant difference (χ²=127.546, P<0.05). The majority of the data was used for model training, and a small portion was used for validation. Validation results showed that for volunteer 1, the test scores and recommendation degrees for two randomly selected masks were ENVIP3DF (200, 95.0%) and 801-N95 (145, 94.6%), respectively; for volunteer 5, the scores and recommendation degrees were 801-N95 (152, 64.7%) and 9132 (52, 39.4%), respectively. For each volunteer, there was a significant positive correlation between the actual mask sealing performance test score and the proposed mask suitability recommendation correlation model (r=0.642, P<0.05). The proposed method can accurately predict mask sealing test results based on facial image processing data.

This method can rapidly recommend optimal masks based on facial images and is suitable for emergencies or situations where standard mask sealing performance testing is inconvenient.

To investigate the adherence to four healthy lifestyle factors–nonsmoking, no or moderate alcohol consumption, adequate physical activity, and a healthy diet–among residents aged 35–75 years in Gansu province and to identify the influencing factors, providing a reference for promoting healthy lifestyles among residents.

Data were collected from December 2015 to December 2022 as part of the Early Screening and Comprehensive Intervention Program for High-Risk Cardiovascular Disease Populations. The study included 27 436 residents aged 35–75 years from 10 project sites in Gansu province: Baiyin district of Baiyin city, Anding district and Tongwei county of Dingxi city, Huating city of Pingliang city, Qingcheng county of Qingyang city, Qingshui county of Tianshui city, Gaotai county and Shandan county of Zhangye city, Liangzhou district of Wuwei city, and Yongjing county of Linxia Hui autonomous prefecture. The dataset included demographic information, adherence to the four healthy lifestyle factors (nonsmoking, no or moderate alcohol consumption, adequate physical activity, and healthy diet), and was complete with no history of CVD or cancer. Adherence to the four healthy lifestyle factors was analyzed, and a multifactorial unconditional logistic regression model was used to analyze the influencing factors.

Among the 27 436 residents aged 35–75 years included in the analysis, 20 777 (75.7%), 27 183 (99.1%), 5 838 (21.3%), and 3 917 (14.3%) adhered to nonsmoking, no or moderate alcohol consumption, adequate physical activity, and a healthy diet, respectively. Only 713 residents (2.6%) adhered to all four healthy lifestyle factors. Multifactorial unconditional logistic regression analysis showed that being female, aged 65–75 years, and having a college degree or higher were positively associated with nonsmoking. Being aged 45–54 years, having a junior high school education, and having a history of hypertension or diabetes were negatively associated with nonsmoking. Being female, aged 55–75 years, and having a history of myocardial infarction or stroke were positively associated with no or moderate alcohol consumption, while having a junior high school education or higher was negatively associated. Being female, aged 45–75 years, having a junior high school education or higher, and having a history of hypertension, diabetes, myocardial infarction, or stroke were positively associated with adequate physical activity. Being female, having a junior high school education or higher, and having a history of hypertension, diabetes, myocardial infarction, or stroke were positively associated with a healthy diet, while living in rural areas was negatively associated. Being female, aged 55–75 years, having a junior high school education or higher, and having a history of hypertension or diabetes were positively associated with adherence to all four healthy lifestyle factors.

The adherence rate to all four healthy lifestyle factors was low among residents aged 35–75 years in Gansu province. Sex and education level were common influencing factors for adherence to the four healthy lifestyle factors.

To differentiate between "indeterminate" early and late HIV infection samples to ensure timely follow-up.

A retrospective analysis was conducted on all "indeterminate" HIV infection samples from the Pudong New Area confirmatory laboratory between 2014 and 2019. Samples were grouped based on epidemiological data and follow-up results: 58 "early positive-indeterminate"and 31 "late positive-indeterminate"samples. Fourth-generation rapid diagnostic tests (RDTs) and third-generation enzyme-linked immunosorbent assays (ELISAs) were performed on both groups. The characteristics of the screening results and confirmatory bands were analyzed, and the differences in CD4⁺T cell levels before and after 3 years of treatment were compared between the two groups.

Both the fourth-generation RDT and third-generation ELISA antibody tests were 100% positive in both the "early positive-indeterminate" and "late positive-indeterminate" groups. However, the S/CO values from the third-generation ELISA showed a statistically significant difference between the two groups (t=31.65, P<0.001). The proportions of different band patterns in the antibody confirmatory test that transitioned to "early positive" and "late positive" were also statistically significant (χ²=65.10, P<0.001). The overall distribution of changes in CD4⁺T cell counts before and after 3 years of treatment differed significantly between the "early positive-indeterminate" and "late positive-indeterminate"groups (U=415.5, P<0.001).

Combining screening results and confirmatory band characteristics can effectively distinguish different stages of infection in "indeterminate" HIV antibody results and provide corresponding follow-up recommendations. Furthermore, changes in CD4⁺T cell counts before and after treatment can be used to assess immune reconstitution following treatment.

To conduct laboratory detection on a suspected botulism incident and provide experimental evidence for the prevention and rapid identification of botulism.

Sample processing and testing were carried out according to the national standards GB4789.12–2016, GB 15193.2–2014 "National Food Safety Standard - Laboratory Operation Standards for Food Toxicology," and the instructions for botulinum toxin diagnostic serum. Mouse bioassay and diagnostic serum were used for botulinum toxin detection and confirmatory typing tests.

A total of 114 SPF-grade female KM mice were used and divided into groups for detection and confirmatory typing tests. The mice were intoxicated via intraperitoneal injection. The detection test results showed that, except for the control group, animals in all sample groups exhibited typical botulism symptoms. All animals in the marinated raw fish-trypsin group, gastric contents group, and gastric contents-trypsin group died within 1–36 h. No deaths were observed in the marinated raw fish group or the blood group. The confirmatory typing test results showed that all animals in the marinated raw fish-trypsin group injected with type A, B, C, D, E, F, and A–F mixed diagnostic sera died. However, when the marinated raw fish-trypsin solution was diluted with sterile normal saline (NS) at ratios of 1:1, 1:2, and 1:3 and then reacted with type A, B, C, D, E, F, and A–F mixed diagnostic sera, no deaths occurred in the animals. Deaths were observed in all toxin control groups, but no deaths occurred in the toxin inactivation control groups. When the gastric contents-trypsin solution was diluted with NS at a 1:1 ratio and then reacted with type A, B, C, D, E, F, and A–F mixed diagnostic sera, no animal deaths occurred. However, deaths were observed in the toxin control group, while no deaths occurred in the toxin inactivation control group. According to the instructions for the botulinum toxin diagnostic serum, the poisoning was not caused by typical type A, B, C, D, E, or F botulinum toxin. It was preliminarily determined that the marinated raw fish and gastric contents contained other atypical or non-typical botulinum toxins.

This food poisoning incident was caused by non-A, -B, -C, -D, -E, or -F botulinum toxin.