Objective To investigate the prevalence of the total burden of cerebral small vessel disease (CSVD) and its associated factors in a community-dwelling, middle-aged and elderly population through a cross-sectional study, aiming to elucidate patterns of risk factors and provide evidence for prevention and control strategies. Methods A cross-sectional study was conducted from January to April 2025. Participants were recruited from community residents through random sampling based on health records, supplemented by voluntary participation following health awareness campaigns. Data on demographics and medical history were collected using a standardized questionnaire. Physical activity and dietary metrics were obtained through guided self-administered questionnaires. All participants underwent laboratory examinations and magnetic resonance imaging (MRI). The prevalence of the total CSVD burden was described, and univariate and multivariate analyses were performed to identify associated factors. Results A total of 451 middle-aged and elderly individuals were included in the final analysis. Regarding the total CSVD burden score, 248 participants (54.99%) had a score of 0, 112 (24.83%) had a score of 1, 65 (14.41%) had a score of 2, 24 (5.32%) had a score of 3, and 2 (0.44%) had a score of 4. The overall prevalence of CSVD (total burden score ≥1) was 45.01% (n=203). Among the specific CSVD markers, white matter hyperintensities were present in 142 individuals (31.49%), at least one lacunar infarct was observed in 96 (21.29%), at least one cerebral microbleed was detected in 70 (15.52%), and significant enlargement of perivascular spaces in the basal ganglia was found in 108 (23.95%). Multivariate logistic regression analysis revealed that age (≥60 years, OR=1.933), a history of hypertension (OR=1.617), a history of diabetes mellitus (OR=1.811), a history of migraine (OR=1.994), BMI (24 to <28 kg/m², OR=2.586; ≥28 kg/m², OR=3.127), fasting blood glucose (>6.1 mmol/L, OR=1.887), HbA1c (≥5.7%, OR=1.704), Hcy (>15 μmol/L, OR=1.768), low physical activity level based on the IPAQ (OR=1.887), and a higher Mediterranean Diet (MED) score (OR=0.548) were significantly associated with the prevalence of the total CSVD burden in this community-based population (all P<0.05). Conclusions The findings of this study indicate a substantial prevalence of CSVD in the community-dwelling, middle-aged and elderly population. Multiple common health issues were identified as significant risk factors. Adherence to a Mediterranean dietary pattern may be associated with a reduced risk. These results highlight potential directions for the formulation of targeted prevention and control strategies.

Objective This study aimed to investigate the multisystem health effects of occupational noise exposure on industrial workers and to evaluate the extent of these impacts across different exposure levels, thereby providing a scientific basis for the formulation of targeted occupational health protection strategies. Methods A cross-sectional study was conducted among industrial workers exposed to steady-state or non-steady-state impulse noise who underwent occupational health examinations at Wuxi Eighth People's Hospital between January 2024 and March 2025. Participants were categorized into a control group (no exposure), a low-exposure group, a medium-exposure group, and a high-exposure group based on their occupational noise exposure levels. The incidences of high-frequency hearing loss, hypertension, and electrocardiogram (ECG) abnormalities were compared among these groups. A logistic regression model was employed to analyze the effects of occupational noise exposure on the risks of these health outcomes. Results A total of 5 119 workers were included in this study, comprising 807 in the control group, 1 541 in the low-exposure group, 2 011 in the medium-exposure group, and 760 in the high-exposure group. The overall incidence of high-frequency hearing loss was 6.43% (n=329), hypertension was 24.67% (n=1 263), and ECG abnormalities was 41.84% (n=2 142). After adjusting for confounding variables, logistic regression analysis revealed that occupational noise exposure significantly influenced the risk of high-frequency hearing loss, hypertension, and ECG abnormalities. Compared to the non-exposed control group, the risk of high-frequency hearing loss was elevated by 216.7% in the low-exposure group (OR=3.167, 95% CI: 1.811-5.536), 365.0% in the medium-exposure group (OR=4.650, 95% CI: 2.716-7.960), and 421.8% in the high-exposure group (OR=5.218, 95% CI: 2.950-9.229). The risk of hypertension was increased by 48.2% (OR=1.482, 95%CI: 1.185-1.854), 94.9% (OR=1.949, 95% CI: 1.576-2.410), and 159.2% (OR=2.592, 95% CI: 2.036-3.300) in the low-, medium-, and high-exposure groups, respectively. Similarly, the risk of ECG abnormalities was augmented by 298.4% (OR=3.984, 95% CI: 3.203-4.956), 390.7% (OR=4.907, 95% CI: 3.969-6.067), and 732.0% (OR=8.320, 95% CI: 6.535-10.593) across the respective exposure levels. Conclusions Occupational noise exposure poses a significant hazard to the multisystem health of workers, substantially increasing the risks of high-frequency hearing loss, hypertension, and electrocardiogram abnormalities in a dose-response manner. This study provides evidence to support the development of precise occupational health protection strategies. Enhanced preventative measures are warranted, with particular attention to populations with low-level exposure, to mitigate the adverse health effects of noise.

Objective To identify the key factors associated with the postoperative recurrence of nephrolithiasis in patients from the Linfen region and to construct a nomogram for predicting recurrence risk, thereby providing a basis for regionalized prevention and treatment strategies. Methods A cohort of patients with nephrolithiasis who underwent minimally invasive surgery at Linfen People's Hospital between January 2022 and October 2023 was prospectively studied. All participants were followed for one year postoperatively to monitor for disease recurrence. Data including general patient characteristics, preoperative laboratory results, and surgical variables were collected. Lasso and Cox regression analyses were employed to screen for significant risk factors for nephrolithiasis recurrence. Subsequently, a nomogram was developed using R software based on the identified factors. The predictive performance and clinical utility of the model were evaluated using the concordance index (C-index), calibration curves, and decision curve analysis. Results This study initially enrolled 480 patients with nephrolithiasis, of whom 469 completed the one-year follow-up. During the follow-up period, 91 patients experienced recurrence, yielding a recurrence rate of 19.40%. Lasso and Cox regression analyses identified the following independent risk factors for recurrence: comorbid diabetes mellitus (HR=1.769), comorbid hypercalciuria (HR=2.456), frequency of noodles consumption (HR=1.933), daily water intake (HR=1.611), primary type of drinking water (HR=2.667), postoperative urinary tract infection (HR=2.231), preoperative osteopontin levels (HR=1.972), and preoperative prognostic nutritional index (HR=2.849). The nomogram, based on the Cox regression model, demonstrated good discrimination with a C-index of 0.824. The calibration curve indicated no statistically significant deviation between the predicted probabilities and actual observations (c²=11.826, P=0.159), suggesting excellent model fit. Decision curve analysis revealed that the model offered a positive net benefit within the risk threshold probability ranges of 0.01-0.65 and 0.78-0.99, with a maximum net benefit of 0.186. Conclusions This study successfully identified key risk factors for the postoperative recurrence of nephrolithiasis in the Linfen population. The constructed nomogram demonstrated robust discrimination and calibration. The positive net benefit within specific risk thresholds indicates its clinical utility, providing a precise and practical tool for guiding regionalized strategies for the prevention and management of nephrolithiasis recurrence.

Objective To investigate the epidemiological characteristics of varicella breakthrough cases among children under 14 years of age in Guangyuan City from 2017 to 2022, with the aim of providing a scientific foundation for the prevention and control of varicella. Methods Data on varicella breakthrough cases in children under 14 were collected for the period 2017-2022 in Guangyuan City. Descriptive epidemiological methods were employed to analyze the characteristics of these cases. Pearson correlation analysis was utilized to assess the relationship between the age at initial vaccination and the interval from vaccination to disease onset. Results From 2017 to 2022, a total of 957 breakthrough cases were reported in Guangyuan City among children under 14, constituting 25.30% of all reported varicella cases. The proportion of breakthrough cases demonstrated a significant increase (c²_{for trend}=130.283, P<0.01). Statistically significant variations in the proportion of breakthrough cases were identified across different months, districts, occupations, and age cohorts (all P<0.01). The incidence exhibited a bimodal distribution with peaks from May to July and from October to December. The majority of cases were reported in Lizhou District (53.29%) and among students (82.76%), with a male-to-female ratio of 1.10: 1. A total of 852 and 105 breakthrough cases were reported in recipients of one and two vaccine doses, respectively. The median interval from vaccination to onset was 8.00 (IQR: 5.84, 9.85) years for single-dose recipients and 4.15 (IQR: 2.30, 6.06) years for two-dose recipients. The difference in the temporal distribution of onset post-vaccination between the one-dose and two-dose groups was statistically significant (c²=14.737, P<0.01). A significant negative correlation was observed between the age at first-dose vaccination and the interval to disease onset (r=-0.236, P<0.01). The incidence rate among unvaccinated individuals was 963.29 per 100 000, whereas the breakthrough infection rate among vaccinated individuals was 316.74 per 100 000. The overall vaccine effectiveness (VE) was calculated to be 69.01%. The VE for the one-dose and two-dose schedules was 63.96% and 85.51%, respectively. Conclusions The proportion of varicella breakthrough cases relative to total varicella incidence among children under 14 in Guangyuan City is on an upward trend. Varicella vaccination is effective in reducing disease incidence, with a two-dose vaccination schedule affording substantially greater protection against varicella than a single-dose regimen.

Objective To investigate the prevalence of osteoporosis among the rural elderly population in southern Sichuan and to analyze its potential influencing factors, thereby providing an evidentiary basis for the prevention and management of osteoporosis in this demographic. Methods A multi-stage stratified sampling method was employed from January to December 2023 to recruit elderly individuals from rural areas in southern Sichuan region as study participants. Health literacy regarding osteoporosis was assessed using the osteoporosis knowledge assessment questionnaire (OKAQ) and the osteoporosis knowledge test (OKT). Bone mineral density was measured using a radial ultrasonic bone densitometer. Serum 25-hydroxyvitamin D[25(OH)D]concentrations were determined via chemiluminescence immunoassay. Multivariate logistic regression analysis was conducted to analyze the potential influencing factors for osteoporosis among the rural elderly. Results A total of 582 individuals were enrolled, comprising 259 males and 323 females, with a mean age of (68.6±5.8) years. The prevalence of osteoporosis in this cohort was 25.60% (149/582). The mean scores for osteoporosis-related knowledge, attitude, and practice were (12.36±3.33), (24.08±5.45), and (28.15±6.19), respectively. The mean serum 25(OH)D concentration was (33.87 ± 14.49) ng/mL;335 participants (57.56%) exhibited normal vitamin D levels, while 247 (42.44%) were deficient. The multivariate logistic regression analysis identified several risk factors for osteoporosis: age ≥70 years (OR=16.793), a history of fractures (OR=5.308), lack of regular outdoor activity (OR=2.540), serum vitamin D deficiency (OR=24.674), absence of regular calcium supplementation (OR=3.360), low osteoporosis-related knowledge scores (OR=6.473), and low osteoporosis prevention and management practice scores (OR=2.448). Conversely, a BMI<18.5 kg/m² (OR=0.015) and a BMI of 18.5 to<24.0 kg/m² (OR=0.214) were identified as protective factors (all P<0.05). Conclusion The prevalence of osteoporosis is high among the elderly population in rural southern Sichuan. The prevention of osteoporosis may be enhanced by improving health literacy, maintaining an optimal body mass index (BMI), increasing outdoor physical activity, and ensuring adequate calcium supplementation.

Objective To investigate the risk factors for fragility fractures in patients with osteoporosis and to construct a nomogram prediction model, thereby providing a reference for preventative and interventional strategies. Methods Patients diagnosed with osteoporosis at the Jiangbei Campus of Zhongda Hospital Affiliated with Southeast University between January 2022 and June 2024 were selected for this study. Relevant patient data were collected, and baseline characteristics were balanced using propensity score matching. Univariate and multivariate logistic regression analyses were employed to identify the factors influencing the occurrence of fragility fractures, and a nomogram prediction model was subsequently constructed. Results Following propensity score matching, baseline characteristics were well-balanced between the case group (n=73) and the control group (n=292). Multivariate logistic analysis identified several significant risk factors associated with fragility fractures in patients with osteoporosis (all P<0.05): monthly household income per capita <1 000 RMB (OR=3.160), excessive alcohol consumption (OR=2.264), a history of falls within the last year (OR=2.749), a history of previous fractures (OR=5.458), use of glucocorticoids for ≥3 months (OR=3.103), low level of physical activity (OR=3.165), poor balance (OR=2.844), frequency of nocturia (once/night, OR=2.124; ≥twice/night, OR=3.498), serum procollagen type I N-terminal propeptide (P1NP) levels (OR=1.451), daily calcium intake ≥600 mg (OR=0.260), and serum 25-hydroxyvitamin D [25(OH)D] levels (OR=0.644). A nomogram prediction model was developed based on these factors. The results demonstrated that the model possessed good discrimination and calibration. Furthermore, decision curve analysis indicated that the model yielded a favorable net benefit across a threshold probability range of 0 to 1. Conclusions Multiple factors, including monthly household income per capita, alcohol consumption, and a history of falls, are significantly associated with the incidence of fragility fractures in patients with osteoporosis. The nomogram prediction model constructed based on these factors demonstrates good discrimination and calibration, as well as a significant net benefit within a specific threshold range. This model provides a robust tool for the early clinical identification of high-risk populations and facilitates the development of personalized prevention and intervention strategies, ultimately contributing to a reduction in fracture risk.

Objective To evaluate the current status of anti-osteoporosis treatment among patients with fragility fractures and to explore its multidimensional influencing factors, thereby providing an evidence basis for the formulation of intervention strategies and the optimization of management pathways. Methods A cross-sectional survey was employed. A total of 412 patients with fragility fractures admitted to Beijing Luhe Hospital between June 2023 and June 2024 were included as study subjects. The receipt of anti-osteoporosis treatment was statistically recorded, and patients were subsequently categorized into a treatment group and a non-treatment group. The risk of refracture and the quality of life were assessed for both groups, and multivariate logistic regression analysis was conducted to identify the determinants of receiving anti-osteoporosis treatment. Results A final cohort of 396 patients was enrolled, of whom 138 (34.85%) received anti-osteoporosis therapy post-fracture. The multivariate logistic regression analysis indicated that age (OR=1.914), hip fracture (OR=2.122), bone mineral density (BMD) testing (OR=2.134), health beliefs (high necessity/high concern, OR=2.939; low necessity/high concern, OR=3.850), proportion of out-of-pocket payment (30%-60%, OR=3.905; >60%, OR=5.854), specialist referral (OR=2.193), clarity of discharge instructions (OR=2.527), disease cognition (OR=0.900), and fear of falling (OR=0.945) were significant factors influencing the initiation of anti-osteoporosis treatment following a fragility fracture (all P<0.05). Conclusions The rate of anti-osteoporosis treatment among patients with fragility fractures is suboptimal, constrained by a confluence of medical conditions (e.g., age, BMD testing), patient-related cognitive and belief factors (e.g., health perceptions, risk awareness), and healthcare policy elements (e.g., referral mechanisms, medical insurance coverage). It is recommended that clinical practice establishes an integrated management pathway encompassing screening, referral, and intervention. Furthermore, enhancing stratified patient education based on cognitive levels and optimizing medical insurance coverage to alleviate the economic burden are advised. A multidimensional, synergistic strategy is imperative to improve the standardization of treatment, consequently reducing the risk of subsequent fractures and improving the quality of life for this patient population.

Objective To investigate the recurrence of pulmonary tuberculosis (TB) within a six-year follow-up period among patients who successfully completed treatment in Xishuangbanna in 2017, and to explore the association between various influencing factors and TB recurrence. Methods A cohort of 1 249 patients who successfully completed treatment for pulmonary tuberculosis in Xishuangbanna in 2017 was identified from the Tuberculosis Information Management System. The recurrence density was calculated across different demographic characteristics, and the Log-rank test was employed for statistical analysis. Subsequently, a Cox regression analysis was utilized to identify independent risk factors for recurrence within the six-year period. Propensity score matching (PSM) was performed to adjust for the effect of age, after which the hazard ratios (HR) for the identified independent risk factors were recalculated. Results Among the 1 249 successfully treated patients, 78 experienced recurrence within six years, yielding a recurrence rate of 6.25% and a recurrence density of 0.314 per 100 person-years. The median time to recurrence was 37.28 months. Both the Log-rank test and univariate Cox regression analysis indicated that advanced age, occupation as a farmer, retreatment status, positive etiological classification, and the presence of pulmonary cavities were associated with a higher risk of TB recurrence. Multivariate Cox regression analysis revealed that advanced age and the presence of pulmonary cavities were independent risk factors for recurrence. Following PSM adjustment for age, the HR for the presence of pulmonary cavities was 1.895 (95% CI: 1.589-3.872; P<0.01). Conclusions A notable probability of recurrence exists within six years following successful treatment for pulmonary tuberculosis, with patients presenting with cavitary pulmonary tuberculosis exhibiting a significantly higher risk. The number of recurrence cases in the current study is limited; therefore, the confirmation of additional influencing factors necessitates larger-scale, longer-term follow-up studies.

Objective To investigate the correlation between the ratio of fasting blood glucose to high density lipoprotein cholesterol (GHR) and metabolically associated fatty liver disease (MAFLD). Methods A retrospective study was conducted on individuals who underwent physical examinations at our hospital from January 2021 to December 2023. Multivariate logistic regression was used to analyze the association between GHR and MAFLD. The restricted cubic spline (RCS) was employed to explore the non-linear relationship, and the predictive efficacy of GHR was evaluated through the receiver operating characteristic curve (ROC). Results A total of 17 472 subjects were included, among which 6 403 had MAFLD and 11 069 did not. After stepwise adjustment for various confounding factors, GHR was still significantly positively correlated with MAFLD (P<0.001); for each unit increase in GHR, the risk of MAFLD increased by 14.9%. Compared with the lowest GHR quartile Q1 group, the risks of MAFLD in Q2, Q3, and Q4 groups were 1.507, 2.045, and 2.721 times that of the Q1 group, respectively; the risk of MAFLD increased with the increase in GHR quartiles (P_trend<0.001). RCS analysis indicated a nonlinear association between GHR and MAFLD (P<0.001), with an inverted L-shaped curve and a turning point at 5.739. ROC curve analysis showed that GHR was significantly better than HDL-C or FBG alone in predicting MAFLD, with an area under the curve (AUC) of 0.769. Conclusion GHR is an independent risk factor for MAFLD and may serve as a promising biomarker for predicting MAFLD.

Objective To investigate the incidence of post-traumatic stress disorder (PTSD) among patients with traumatic fractures and to analyze its associated risk factors. Methods A convenience sampling method was employed to recruit patients with traumatic fractures admitted to the orthopedic department of The Second People's Hospital of Taizhou between July 2021 and June 2024. A questionnaire-based survey was administered. The incidence of PTSD was analyzed using descriptive epidemiological methods, while univariate and multivariate analyses were utilized to identify its determinants. Results A total of 1 040 patients with traumatic fractures were included in the investigation. The incidence of PTSD was 11.15% (116 cases) at 1 month post-injury, decreasing to 6.63% (69 cases) at 3 months, and further to 2.12% (22 cases) at 6 months. Multivariate logistic regression analysis revealed that at 1 month post-injury, the significant risk factors for PTSD were female gender (OR=1.648), average monthly household income <2 000 RMB (OR=2.128), traffic accident as the cause of injury (OR=3.294), severe injury (OR=2.159), critical injury (OR=2.715), poor sleep quality (OR=1.532), severely deficient family support (OR=2.723), and an expected rehabilitation outcome of disability (OR=3.234) (all P<0.05). At 3 months post-injury, significant predictors included female gender (OR=2.602), severe injury (OR=2.316), critical injury (OR=4.552), poor sleep quality (OR=2.645), and an expected rehabilitation outcome of disability (OR=6.194) (all P<0.05). At 6 months post-injury, poor sleep quality (OR=4.267) and an expected rehabilitation outcome of disability (OR=4.745) remained significant risk factors (all P<0.01). Conclusions The incidence of PTSD in patients with traumatic fractures demonstrates a dynamic temporal pattern, with the highest prevalence observed in the initial post-traumatic period. The factors influencing PTSD onset vary at different time points post-injury. Notably, poor sleep quality and an anticipated outcome of disability are primary, persistent risk factors for the long-term development of PTSD.

Objective To investigate the trend of morbidity and mortality of thyroid cancer in Wuhan from 2010 to 2019, so as to provide a scientific basis for prevention and control. Methods Based on the incidence and mortality data of thyroid cancer between 2010 and 2019 in Wuhan mortality and chronic surveillance system. We analyzed the change trend of thyroid cancer in incidence, mortality, standardized mortality and standardized mortality among different gender and age-groups. A Joinpoint regression model was used to examine secular trends. Results From 2010 to 2019, the incidence of thyroid cancer in Wuhan was 33.75/10⁵. The incidence of thyroid cancer was 52.38/10⁵ in females which was much higher than that in males 15.66/10⁵, with statistical significance (P<0.05). The mortality rate of thyroid cancer was 0.4/10⁵ from 2010 to 2019. The mortality rate of thyroid cancer was 0.51/10⁵ in females which was much higher than that in males 0.29/10⁵, with statistical significance (P<0.05). Increasing trend were shown in incidence (AAPC was 21.674%, P<0.05) and standardized incidence (AAPC was 21.720%, P<0.05) of thyroid cancer in Wuhan from 2010 to 2019. There was no statistical significance in the trend of thyroid cancer mortality (AAPC was 4.891%, P>0.05) and standardized mortality (AAPC was 2.479%, P>0.05). The age curve of thyroid cancer incidence showed an unimodal distribution, and the peak of male incidence was 40-<45 years old, the incidence peaks in the 50-<55 age group in females. Conclusions From 2010 to 2019, the incidence and mortality of thyroid cancer in females in Wuhan was significantly higher than that in males, and the incidence increased with age increased, while the death rate did not increase significantly. Therefore, early screening of thyroid cancer should be actively carried out for menopausal women.