To analyze the influencing factors of drug relapse among patients undergoing methadone maintenance treatment (MMT) in Fujian province and construct a risk prediction model.

A retrospective cohort study was conducted. Data were sourced from the Data Information Management System of Drug Maintenance Treatment. Patients who underwent MMT for 180 days or relapsed in Fujian from 2006 to 2023 were included. Lasso-logistic regression was employed to screen the influencing factors, and a risk prediction model was constructed.

The relapse rate of patients undergoing MMT was 75.58% (5 745/7 601). Female gender (OR = 0.801, 95%CI: 0.695–0.923), longer drug use duration (OR = 0.985, 95%CI: 0.974–0.996), and older enrollment age (OR = 0.988, 95%CI: 0.981–0.997) were protective factors for drug relapse. The risk factors for drug relapse were injection drug use in the month before enrollment (OR = 1.156, 95%CI: 1.034–1.293), being employed (OR = 1.184, 95%CI: 1.059–1.326), being referred to MMT by drug-using friends (OR = 1.273, 95%CI: 1.026–1.582), more frequent daily drug use in the month before enrollment (OR = 1.018, 95%CI: 1.005–1.033), longer travel time to the clinic (OR = 1.004, 95%CI: 1.002–1.008), previous participation in MMT (OR = 1.217, 95%CI: 1.095–1.355), coming to MMT by bus (OR = 1.429, 95%CI: 1.193–1.712), and using other means of transportation to MMT (OR = 2.890, 95%CI: 2.033–4.106). The area under curve (AUC) of the constructed risk prediction model was 0.602 (95%CI: 0.588–0.617).

The drug relapse rate of patients undergoing MMT is high in Fujian, and the constructed risk prediction model can be used to identify high-risk populations of drug relapse.

To understand the utilization of community health services and its influencing factors among young and middle-aged working populations in a district of Shanghai city, and to provide a reference for improving the utilization rate of local community health services.

From July to August 2023, a stratified convenience sampling method was used to select 17 000 residents aged 18 years and the above from 10 communities in a district of Shanghai city for a questionnaire survey. Among them, 2 103 young and middle-aged working individuals aged 18–59 who had been ill in the past two weeks and sought medical treatment at medical institutions were included in the analysis of community health service utilization and its influencing factors.

Among the 2 103 young and middle-aged working individuals aged 18–59 who had been ill in the past two weeks and sought medical treatment at medical institutions in a district of Shanghai city, 934 visited community health service centers, with a community health service utilization rate of 44.41%. Multivariable unconditional logistic regression analysis showed that young and middle-aged working individuals aged 30 years and the above and those with respiratory and digestive system diseases had a higher utilization rate of community health services. Those who had purchased commercial health insurance and whose distance to the nearest community health service center was 3 to < 4 and ≥5 km had a lower utilization rate of community health services.

The utilization rate of community health services among young and middle-aged working populations in this district of Shanghai city is relatively low. Age, disease type, purchase of commercial health insurance, and distance to the nearest community health service center are the main factors influencing the utilization rate of community health service centers among the local young and middle-aged working population.

To analyze the composition and influencing factors of hospitalization costs for stroke patients, providing data support for rational control of medical expenses and alleviating the economic burden on patients.

The data of 66 524 stroke patients discharged from January 1, 2020 to December 31, 2022 were collected from the medical expense accounting management reporting system of a province in central China. The grey relational analysis and degree of structural variation analysis were performed to analyze the hospitalization cost composition for stroke and its subtypes. A Generalized Linear Model (GLM) and an eXtreme Gradient Boosting (XGBoost) model were constructed to explore the key influencing factors.

Among 66 524 stroke patients, 85.80%, 10.84%, and 3.36% had ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH), respectively. The M (P₂₅, P₇₅) of the hospitalization cost for stroke patients was 6 992.32 (3 997.76, 13 475.91) CNY. The hospitalization cost for SAH patients was the highest, reaching 88 389.28 (12 494.50, 151 711.34) CNY. The top three categories of hospitalization expenses for stroke patients were drug costs, other costs, and treatment costs, with the average proportions of 29.29%, 24.61%, and 19.43%, respectively. The hospitalization costs of IS and ICH patients were mainly attributed to drug costs. For SAH patients, other costs accounted for the largest proportion of hospitalization expenses. The grey relational analysis results showed that the top three factors correlated with total hospitalization costs were Western medicine costs, other costs, and treatment costs, with correlation coefficients of 0.951 8, 0.936 2, and 0.900 4, respectively. The degree of structural variation analysis showed that the contribution rates of structure variation (CSV) for medication costs, examination costs, and other costs were 24.34%, 19.50%, and 27.74%. The GLM results indicated that longer hospital stays (≥ 7 days), emergency admission, surgery, intensive care, ICH, SAH, and for-profit medical institutions were associated with higher hospitalization costs. The XGBoost model analysis revealed that the top five factors influencing hospitalization costs for stroke patients were the type of medical institution, length of stay, whether surgery was performed, the level of medical institution, and the subtype of stroke.

IS is the most common stroke subtype, and hospitalization costs for stroke patients are primarily driven by drug expenses. SAH patients have higher hospitalization costs, mainly due to other expenses. By implementing appropriate admission assessments, improving medical efficiency, shortening hospital stays, and optimizing treatment plans, the economic burden on stroke patients can be reduced.

To explore the application of the prevention, preparation, response, and recovery (PPRR) theory in the cross-departmental collaboration in the prevention and control of infectious diseases in the China International Import Expos (CIIEs) held in every November in Shanghai from 2018 to 2024, thus providing an empirical basis and theoretical reference for optimizing the cross-departmental collaboration mechanism under regular prevention and control.

We collected the epidemic prevention and control work plans, emergency response plans, technical guidelines, summary reports, and relevant epidemic cases handled by Shanghai Center for Disease Control and Prevention during the CIIEs from 2018 to 2024. The case analysis method was used to analyze the practices and achievements of cross-departmental collaboration in the prevention, preparation, response, and recovery phases based on the PPRR model.

An efficient information collaboration mechanism was established based on an innovative "1+6+N" cross-departmental command architecture. The work in the prevention phase encompassed establishing a cross-departmental and multi-dimensional risk assessment model, adopting a layered monitoring strategy, and strengthening health monitoring. In the preparation phase, a modular prevention and control plan library was established, consisting of work plans, emergency plans, and technical guidance or operation manuals. In addition, cross-departmental joint training and exercises were conducted, and emergency material reserves were reasonably allocated to improve the response speed. In the response phase, a "4 h plus 12 h" disposal requirement was strictly implemented. Public health, security and CIIE bureau teams were mixed as an emergency response group and divided into several units. The interval between risk identification and risk confirmation as well as between risk confirmation and risk management was strictly controlled through risk hierarchical management. During the recovery phase, full-process post evaluation was conducted to solidify experience and promote optimization of resource allocation and disposal processes while assessing the effectiveness of the response. Upon evaluation, the above measures are expected to be effective to increase the risk warning time to within 30 minutes and reduce the overall emergency decision-making and response time to 10% of that under the conventional model. Therefore, Shanghai achieved "zero infection" of epidemics and "zero transmission" of imported diseases.

The collaborative mechanism architecture constructed based on the PPRR model can be used for the research of cross-departmental collaborative mechanisms in mass gatherings. In the future, cross-departmental collaboration on infectious disease prevention and control in mass gatherings can be further promoted in three dimensions: mechanism innovation, technological empowerment, and collaborative governance.

To explore the relationship between hypertension prevalence and sleep among adult residents in Guangdong province, providing scientific evidence for the control and prevention of hypertension.

Data were collected from 4 982 adult residents aged ≥18 years in 11 monitoring sites of Guangdong province in the 2022 Chinese Nutrition and Health Surveillance. The unconditional multivariate logistic regression model was employed to analyze the relationships of sleep problems and sleep duration with hypertension prevalence among adult residents in Guangdong province.

Among the 4 982 adult residents in Guangdong province, there were 2 393 (49.41%) residents without sleep problems and 2 589 (50.59%) residents with sleep problems. Among them, 1 084 (19.65%), 3 168 (66.54%), and 730 (13.81%) residents had insufficient sleep, adequate sleep, and excessive sleep, respectively. There were 1 611 residents with hypertension, and the complex weighted prevalence of hypertension was 30.04%. After adjusting confounding factors such as gender, age, educational background, marital status, place of residence, current smoking, frequency of alcohol consumption, physical activity, family history of hypertension, body mass index, and central obesity, the results of the unconditional multivariate logistic regression analysis showed that the risk of hypertension among adult residents with sleep problems in Guangdong province was 1.237 times (95%CI: 1.122–1.364) that of adults without sleep problems. The risk of hypertension among adult residents aged ≥ 60 years and with sleep problems in this province was 1.468 times (95%CI: 1.183–1.823) that of those without sleep problems. The risk of hypertension among adult residents with excessive sleep was 1.228 times (95%CI: 1.046–1.442) that of those with adequate sleep. For female adult residents with excessive sleep, the risk of hypertension was 1.340 times (95%CI: 1.006–1.786) that of those with adequate sleep. For female adult residents aged ≥ 60 years and with excessive sleep, the risk of hypertension was 1.446 times (95%CI: 1.001–2.088) that of those with adequate sleep.

The risk of hypertension increased in adults with sleep problems in Guangdong province, especially in those aged ≥ 60 years. Excessive sleep duration was also associated with increased risk of hypertension, especially in females and the adults aged ≥ 60 years.

To analyze the opportunistic screening results for upper gastrointestinal cancer in Sichuan province from 2019 to 2023, thus providing a reference for promoting opportunistic screening for upper gastrointestinal cancer in this region.

Data were collected from the Early Diagnosis and Treatment Management Platform of the Sichuan Cancer Prevention and Control Center. The study included 844 844 high-risk individuals aged ≥ 40 years who underwent gastroscopy at 88 secondary or higher-level hospitals across 18 cities (prefectures) in five major economic regions (Chengdu Plain Economic Zone, Southern Sichuan Economic Zone, Northeastern Sichuan Economic Zone, Panxi Economic Zone, and Northwestern Sichuan Ecological Demonstration Area) of Sichuan province from July 2019 to May 2023. The biopsy rate, lesion detection rate, and early diagnosis rate of upper gastrointestinal cancer in Sichuan province were analyzed.

Among the 844 844 high-risk individuals who underwent opportunistic screening for upper gastrointestinal cancer from 2019 to 2023, 182 133 individuals underwent biopsies, with a total of 190 852 biopsy sites, yielding a biopsy rate of 22.59%. A total of 20 647 cases of lesions were detected, with a lesion detection rate of 2.44%. Among the detected cases, 5 258 were early-stage lesions, resulting in an early diagnosis rate of 25.47%. The esophagus, cardia, and stomach showed the bioscopy rates of 3.80%, 1.09%, and 17.71%, lesion detection rates of 1.37%, 0.29%, and 0.78%, and early diagnosis rates of 28.29%, 20.44%, and 22.37%, respectively. Comparative analysis by demographic characteristics revealed that males had higher biopsy rate and lesion detection rate but lower early diagnosis rate than females (all P < 0.001). Both the biopsy rate and lesion detection rate increased with age, while the early diagnosis rate decreased with age (all P < 0.001). Differences were observed in biopsy rate, lesion detection rate, and early diagnosis rate across different regions (all P < 0.001). Individuals who underwent painless gastroscopy had higher biopsy rate, lesion detection rate, and early diagnosis rate than those who underwent conventional gastroscopy (all P < 0.05). The examination with the use of chemical staining methods resulted in higher biopsy rate, lesion detection rate, and early diagnosis rate than the examination without the use of chemical staining (all P < 0.001). In addition, differences were also observed in biopsy rate, lesion detection rate, and early diagnosis rate among individuals with different Helicobacter pylori test results (all P < 0.05).

The biopsy rate, lesion detection rate, and early diagnosis rate in opportunistic screening for upper gastrointestinal cancer in Sichuan province were low from 2019 to 2023. Efforts are still required, with particular attention needed for male and elderly populations.

To analyze the cause ranking and trends of injury-related deaths among residents in Shaanxi province from 2015 to 2023, providing a reference for formulating injury prevention and control strategies.

The injury-related death data were sourced from the Population Death Information Registration Management System of Shaanxi Province from January 1, 2015 to December 31, 2023. The Joinpoint regression model was adopted to analyze the trends in mortality rates of all injuries and the top four death causes, and the average annual percentage change (AAPC) was calculated.

From 2015 to 2023, the top four causes of injury-related deaths among residents in Shaanxi province were road traffic injuries, falls, suicide, and poisoning. During this period, the mortality rates from overall injuries, road traffic injuries, and suicide showed a downward trend (all P < 0.05), while the mortality rate from falls presented an upward trend (AAPC = 3.32%, P = 0.014). Among male residents, the mortality rates from overall injuries and road traffic injuries showed a downward trend (both P < 0.05). Among female residents, the mortality rate from suicide showed a downward trend (P < 0.05), whereas that from falls showed an upward trend (AAPC = 6.34%, P = 0.001). The mortality rates from overall injuries and road traffic injuries among the residents aged < 15 years and 15–44 years showed a downward trend (all P < 0.01), and that from suicide among residents aged < 15 years showed an upward trend (AAPC = 14.76%, P = 0.039). The mortality rates from road traffic injuries and suicide among residents aged 45–64 years and those from suicide and poisoning among residents ≥ 65 years showed a downward trend (all P < 0.01). Among urban residents, the mortality rates from overall injuries and road traffic injuries showed a downward trend (both P < 0.01). Among rural residents, the mortality rates from road traffic injuries and suicide showed a downward trend (both P < 0.01), while that from falls showed an upward trend (AAPC = 5.35%, P = 0.001).

From 2015 to 2023, the mortality rates from overall injuries, road traffic injuries, and suicide among residents in Shaanxi showed a downward trend, while that from falls showed an upward trend. The mortality rate trends varied across different injury types among residents of different genders, ages, and residential areas.

To analyze the cost-effectiveness per case of different screening methods for latent infection of mycobacterium tuberculosis (MTB) in the student population in Chongqing, thus providing a scientific basis for optimizing large-scale tuberculosis screening among students.

The tuberculin skin test (TST) and recombinant MTB fusion protein skin test (EC-ST) were adopted to conduct tuberculosis examination and close contact screening among 46 531 students in grades one and two of 46 senior high schools in Chongqing from January to December 2024. The positive detection and cost-effectiveness of TST and EC-ST in tuberculosis examination and close contact screening were compared.

The infection rates of MTB detected by TST and EC-ST were 35.74% (8 132/22 751) and 5.73% (1 304/22 748), respectively. The average detection cost per case of MTB infection was 83.93 CNY for TST and 872.24 CNY for EC-ST. In the close contact screening, the infection rates of MTB detected by TST and EC-ST were 46.36% (210/453) and 6.74% (39/579), respectively. The average detection cost per case of MTB infection was 64.71 CNY for TST and 742.31 CNY for EC-ST. Among the 39 MTB-infected patients detected by EC-ST, 8 tuberculosis patients were detected, and the average detection cost was 7 237.50 CNY. Among the 210 MTB-infected patients detected by TST, no tuberculosis patient was detected.

EC-ST is suitable for accurate screening of high-risk close contacts, and TST with a low cost is still a reasonable choice for large-scale tuberculosis examination in the general student population.