Objective To describe the epidemiological characteristics of hand, foot, and mouth disease (HFMD) among children under seven years of age in Haining from 2009 to 2024 and to forecast the incidence trend for 2025, thereby providing a scientific basis for the formulation of prevention and control strategies. Methods Data on HFMD cases in children under seven in Haining from 2009 to 2024 were collected from the Information Management System for Infectious Disease Reporting of the Chinese Center for Disease Control and Prevention. Descriptive statistical methods and a Joinpoint regression model were employed to analyze the epidemiological characteristics of the disease. A Seasonal Autoregressive Integrated Moving Average (SARIMA) model was developed to model and forecast the incidence rate. Results A cumulative total of 20 847 HFMD cases were reported in Haining from 2009 to 2024 among children under seven, with an average annual incidence rate of 2 507.04 per 100 000 population. Regarding temporal distribution, the incidence exhibited a bimodal pattern with peaks occurring from May to July and from September to November. A statistically significant difference was observed in the average daily incidence across the week (χ²=60.786, P<0.05), with the highest incidence on Mondays, followed by a decreasing trend (χ² for trend=36.522, P<0.05). The annual incidence demonstrated an alternating pattern, with even-numbered years showing higher incidence from 2009 to 2018, whereas odd-numbered years exhibited higher incidence from 2019 to 2024. Cases were predominantly concentrated in infants and toddlers aged 1 to <4 years, accounting for 62.54% (13 037 cases) of the total. The 1 to <2 years age group had the highest incidence rate at 4 327.60 per 100,000, which subsequently decreased with advancing age (χ² for trend=3 143.740, P<0.05). The incidence rate in boys (2 865.06 per 100 000) was significantly higher than that in girls (2 124.34 per 100,000) (χ²=466.132, P<0.05). Enterovirus A71 (EV-A71) was identified as the predominant pathogen (38.38%). The SARIMA(2,0,0)(0,1,1)₁₂ model was determined to be the optimal fit, forecasting that the incidence in 2025 will exceed that of 2024 and will likewise display a bimodal distribution. Conclusion The incidence of HFMD in children under seven years of age in Haining demonstrates clear periodicity. Dispersed children aged 1 to <2 years constitute the highest-risk population, and EV-A71 is the dominant etiological agent. The SARIMA model proves effective for short-term forecasting of incidence trends. It is recommended that public health campaigns for the EV-A71 vaccine be intensified and that surveillance, prevention, and control interventions be enhanced for key populations and regions.

Objective To investigate the effect of a methionine-restricted diet on the progression of atherosclerosis (AS) in ApoE-/- mice and to elucidate the underlying molecular mechanisms. Methods A total of twenty-four 8-week-old male ApoE-/- mice were randomly allocated into three groups (n=8 per group): a control group receiving a standard chow diet (0.86% methionine), a high-fat diet (HFD) group (0.86% methionine), and a methionine-restricted (MR) group receiving an HFD with 0.12% methionine. Following an 8-week dietary intervention, the atherosclerotic plaque area in the aortic sinus was quantified using Oil Red O staining. The expression levels of markers associated with inflammation and oxidative stress were evaluated by immunohistochemistry, quantitative real-time PCR (RT-qPCR), and Western blotting. Furthermore, transcriptome sequencing (RNA-seq) was employed to identify differentially expressed genes (DEGs) and their enriched signaling pathways. Results Compared to the HFD group, dietary methionine restriction significantly attenuated the atherosclerotic plaque burden in the aortic sinus (P<0.05). Histological analyses revealed that methionine restriction markedly reduced macrophage infiltration (CD68), reactive oxygen species (ROS) levels (DHE), and the expression of adhesion molecules (Icam1, Vcam1) and cell proliferation markers (Pcna, Ki67) within the plaques (all P<0.05). These findings were corroborated by RT-qPCR and Western blot analyses, which demonstrated that the MR diet downregulated the mRNA and protein expression of genes associated with inflammation, adhesion, and proliferation in aortic tissues. Transcriptome profiling identified 5 425 DEGs regulated by methionine restriction. Gene enrichment analysis indicated that these DEGs were predominantly involved in signaling pathways related to cell adhesion, NF-κB, and PPAR. Notably, this was characterized by a downregulation of pro-inflammatory genes and an upregulation of antioxidant genes, such as Sod2. Conclusion Dietary methionine restriction mitigates the progression of atherosclerosis in ApoE-/- mice by concurrently inhibiting key pathological processes, including vascular inflammation, oxidative stress, and cellular proliferation, via multi-target mechanisms.

Objective To analyze the temporal trends in the disease burden of falls among the Chinese population aged 55 years and older from 1990 to 2021 and to forecast the burden from 2022 to 2030, providing a reference for public health strategy formulation and medical resource allocation. Methods Leveraging the Global Burden of Disease Study 2021 database, data on the burden of falls in the Chinese population aged ≥55 years were extracted. Joinpoint regression analysis was employed to examine temporal trends and identify inflection points in the disease burden. A decomposition analysis was conducted to assess the respective contributions of population aging, population growth, and epidemiological changes. Furthermore, an Autoregressive Integrated Moving Average (ARIMA) model was utilized to project the disease burden for the period of 2022-2030. Results Between 1990 and 2021, the absolute number of fall incidents in the Chinese population aged ≥55 years increased from 3.03 million to 13.45 million, fatalities rose from 31 000 to 107 500, and Disability-Adjusted Life Years (DALYs) increased from 1.46 million to 4.43 million person-years. In both 1990 and 2021, age-standardized incidence rates, age-standardized mortality rates, and age-standardized DALY rates were higher in males than in females. The Joinpoint regression analysis indicated a significant upward trend in the age-standardized incidence rate of falls from 1990 to 2021 (AAPC=0.96%, P<0.05). Conversely, a significant downward trend was observed for both the age-standardized mortality rate (AAPC=-0.47%, P<0.05) and the age-standardized DALY rate (AAPC=-0.52%, P<0.05). The overall trends in the disease burden of falls for both males and females were consistent with those of the total population. Decomposition analysis revealed that epidemiological changes were the primary driver of the increase in fall incidents, contributing 57.03%. Population aging was the core factor in the growth of fall-related fatalities, with a contribution of 86.41%. The ARIMA model forecasts a continued increase in the number of fall incidents, deaths, and DALYs in this demographic through 2030. Conclusion From 1990 to 2021, the absolute burden of falls among the population aged ≥55 years in China demonstrated an increasing trend with notable sex-based disparities. Epidemiological shifts were the central impetus for the rise in fall incidents, whereas population aging predominantly drove the increase in fall-related mortality. It is anticipated that the absolute burden of falls among middle-aged and older adults in China may continue to intensify in the future.

Objective To investigate the 10-year risk of ischemic cardiovascular disease (ICVD) and its associated factors among individuals aged 35 years and older in Huai'an City. Methods A multi-stage cluster random sampling method was employed to select participants aged ≥35 years in Huai'an. The "10-Year ICVD Risk Assessment Chart for Chinese Populations" was utilized to evaluate the 10-year ICVD incidence risk for each participant. Multinomial logistic regression analysis was conducted to identify the factors influencing this risk. Results A total of 10 744 individuals were included in the study, comprising 5 980 males and 4 764 females, with a mean age of 64.68±10.31 years. The average 10-year ICVD risk score was 8.63±3.48. The mean score for males was significantly higher than for females (9.26±3.45 vs. 7.84±3.36; P<0.01). The proportions of the population at low, medium, and high risk were 60.23%, 20.30%, and 19.47%, respectively. With the low-risk group as the reference, multinomial logistic regression analysis revealed that alcohol consumption (Medium-risk group: OR=1.158; High-risk group: OR=1.240), being a farmer (Medium-risk group: OR=1.206; High-risk group: OR=1.120), education level of primary school or below (Medium-risk group: OR=2.438; High-risk group: OR=3.380), abnormal triglyceride (TG) levels (Medium-risk group: OR=1.241; High-risk group: OR=1.288), and abnormal low-density lipoprotein cholesterol (LDL-C) levels (Medium-risk group: OR=1.681; High-risk group: OR=2.428) were associated with a higher likelihood of being in the medium- and high-risk categories for 10-year ICVD incidence. A junior high school education was associated with a greater risk of being in the high-risk category (OR=1.542). Conversely, being male (Medium-risk group: OR=0.827; High-risk group: OR=0.692), residing in an urban area (Medium-risk group: OR=0.795; High-risk group: OR=0.725), and having abnormal high-density lipoprotein cholesterol (HDL-C) levels (Medium-risk group: OR=0.754; High-risk group: OR=0.722) were associated with a lower risk of being in the medium- and high-risk groups (all P<0.05). Conclusion The 10-year risk of ICVD is relatively high among the population aged ≥35 years in Huai'an. Particular attention should be directed towards females, farmers, rural residents, individuals who consume alcohol, and those with abnormal TG and LDL-C levels.

Objective To identify the risk factors for hyperuricemia and construct a risk prediction model for patients with Type 2 Diabetes Mellitus (T2DM), thereby enabling the identification of high-risk individuals within this patient population. Methods This study was based on retrospective data from 2 329 patients with T2DM admitted to the Chinese PLA General Hospital between December 5, 2016, and December 13, 2021. Univariate analysis was initially employed to describe and explore factors associated with hyperuricemia. Subsequently, a random forest algorithm was utilized for preliminary variable screening, followed by logistic regression analysis to determine statistically significant independent predictors. These predictors were then used to construct the risk prediction model. The predictive efficacy of the model was evaluated using the Receiver Operating Characteristic (ROC) curve. Results The prevalence of hyperuricemia among the cohort of patients with T2DM was 20.35%. Following the initial screening with the random forest algorithm, 20 variables were selected from the initial dataset. Logistic regression analysis further identified five key independent variables: Blood Urea (BU), Triglycerides (TG), Body Mass Index (BMI), Glycated Hemoglobin (HbA1c), and Total Protein (TP). A logistic regression model was subsequently constructed, yielding the following risk prediction formula for hyperuricemia in patients with T2DM: logit(P)=-4.936-0.159×HbA1c(%)+0.062×BMI+0.196×TG(mmol/L)+0.155×BU(mmol/L)+0.023×TP(g/L). The Area Under the ROC Curve (AUC) was 0.765 (95% CI: 0.739-0.791) in the training set and 0.699 (95% CI: 0.632-0.766) in the testing set. Conclusion Lower levels of HbA1c and elevated levels of BMI, TG, BU, and TP are significant risk factors for the development of hyperuricemia in patients with T2DM. The prediction model, developed based on these five variables, demonstrates a competent capacity for accurately identifying individuals at high risk for hyperuricemia within the T2DM patient population.

Objective To investigate the effects of exposure to shift work and long working hours on the risk of Metabolic Syndrome (MS) among medical personnel and to explore the interaction between these two occupational factors. Methods Taking medical personnel from a comprehensive tertiary hospital for a study involving questionnaires, physical examinations, and biochemical analyses. Restricted Cubic Spline (RCS) models were utilized to analyze the dose-response relationships between the duration of shift work (in years), weekly working hours, and MS. Multivariable logistic regression models were applied to assess the association of shift work and long working hours with MS. Furthermore, both multiplicative and additive models were established to evaluate the interaction effect between shift work and long working hours on MS. Results A total of 689 medical personnel participated, with a mean age of (34.7±8.7) years and a median work tenure of 10.0 (5.0, 17.0) years; 509 (73.90%) participants were female. Among the participants, 509 (73.9%) engaged in shift work, 535 (77.6%) worked long hours, and 400 (58.1%) were exposed to both conditions. MS was detected in 132 participants, yielding a prevalence rate of 19.2%. The RCS models indicated significant non-linear relationships between both the duration of shift work and weekly working hours and the risk of MS after adjusting for covariates (both P<0.05). The risk of MS was positively associated with the duration of shift work up to 12.5 years, after which the association became negative. The risk of MS increased significantly for weekly work durations of 41-54 hours, with the rate of increase slowing after 55 hours. Binary logistic regression results showed a significantly elevated risk of MS in the groups with 0.1-<12.0 years (OR=5.263, 95% CI: 2.458-11.268) and ≥12.0 years of shift work (OR=3.515, 95% CI: 1.796-6.879). Similarly, an increased risk was observed for those working 41-54 hours/week (OR=2.014, 95% CI: 1.057-3.837) and ≥55 hours/week (OR=4.634, 95% CI: 2.360-9.098). In the interaction models, both a significant multiplicative interaction (OR=1.885, 95% CI: 1.387-2.561) and a significant additive interaction (OR=1.316, 95%CI: 1.158-1.496) were observed between shift work and long working hours on the risk of MS. Conclusion Both shift work and long working hours are associated with an increased risk of Metabolic Syndrome in medical personnel. Moreover, a significant interaction effect exists between these two occupational exposures on the risk of developing MS.

Objective To analyze the impact of ambient temperature on influenza incidence in Dongguan City, providing a basis for future influenza prevention and control. Methods Data on reported influenza cases and meteorological factors in Dongguan City from 2017 to 2024 were collected. A Distributed Lag Non-linear Model (DLNM) was constructed to analyze the effect of temperature on influenza incidence. Results From 2017 to 2024, the average annual reported incidence of influenza in Dongguan City was 182.01 per 100 000 population, and the median daily average temperature was 24.7 ℃. The overall cumulative effect of temperature on influenza demonstrated a unimodal distribution, with RR peaking at 3.11 (95% CI: 2.30-4.22) when the temperature reached 15.9 ℃. The relationship between single-day exposure within a 14-day lag period to extreme high temperature (P_97.5) and influenza incidence exhibited an inverted "J" shape, while the relationship with extreme low temperature (P_2.5) showed an inverted "V" shape. The detrimental effect of extreme high temperatures was significant for the total population and for males at a cumulative lag of 1-2 days, with the maximum RR observed at a 2-day cumulative lag (RR=1.36, 95% CI: 1.02-1.82 and RR=1.39, 95% CI: 1.03-1.86, respectively). For the female population, the effect was significant at a 1-day cumulative lag (RR=1.27, 95% CI: 1.00-1.61). The cumulative effect for children aged 0-<7 years was significant only on the day of exposure (RR=1.15, 95% CI: 1.01-1.32). The adverse effect of extreme low temperatures was significant for the total population, for both sexes, and for children aged 0-<7 years at a cumulative lag of 5-14 days. The greatest impact was observed in males at a cumulative lag of 11 days (RR=2.27, 95% CI: 1.64-3.15), and in females and children aged 0-<7 years at a cumulative lag of 12 days (RR=2.44, 95% CI: 1.76-3.39; and RR=2.39, 95% CI: 1.67-3.43, respectively). For individuals aged 7-<19 and ≥19 years, the cumulative effects were not statistically significant throughout the entire lag period. Conclusion Ambient temperature is a significant factor influencing influenza incidence. The risk of influenza associated with extreme low temperatures is greater than that associated with extreme high temperatures, and the effect of extreme low temperatures has a longer lag period. Children aged 0-<7 are a particularly susceptible population. It is recommended that relevant authorities strengthen influenza prevention and control measures for high-risk groups during periods of low temperature.

Objective To investigate the prevalence and associated factors of comorbidity among hypertension, diabetes, and dyslipidemia in adults in Fukang City, and to analyze the relationship with health-related behaviors, so as to provide an evidence base for the development and optimization of integrated management policies for these conditions. Methods A cross-sectional study was conducted utilizing data from the 2023 Adult Chronic Disease and Risk Factor Survey in Fukang City. Association rule mining was employed to analyze the influential factors of comorbidity among hypertension, diabetes, and dyslipidemia. Results The study included 2 941 adults. The standardized prevalence rates for hypertension, diabetes, and dyslipidemia were 13.86%, 7.24%, and 26.78%, respectively, with males exhibiting significantly higher rates than females (all P<0.01). The standardized prevalence of comorbidity involving these three conditions was 9.14%. Specifically, the standardized rates for comorbidities were 3.98% for hypertension with dyslipidemia, 1.68% for diabetes with dyslipidemia, 1.18% for diabetes with hypertension, and 0.77% for the coexistence of all three conditions. With a minimum support threshold of 3% and a confidence threshold of 10%, association rule analysis revealed the following high-lift rules: for males, a strong association existed with {excessive red meat consumption, sedentary behavior} (Confidence = 20.34%);for females, the strongest association was with {inadequate or excessive sleep duration} (Confidence = 11.36%). Among different age cohorts, the 45 to <60 age group was associated with {current smoking} (Confidence = 23.04%), whereas the ≥60 age group was linked to {excessive red meat consumption, insufficient physical activity} (Confidence = 23.96%). Conclusion The comorbidity of hypertension, diabetes, and dyslipidemia is prevalent among adults in Fukang City. Excessive red meat consumption, sedentary behavior, and insufficient physical activity were identified as common risk factors. These factors warrant significant attention in the implementation of integrated management strategies for these cardiometabolic conditions.

Objective To investigate the association between diabetes subtypes, classified using a novel typing method, and the risk of cardiovascular disease, in order to promote precision subtype management and optimize primary prevention strategies for cardiovascular diseases. Methods A retrospective cohort study was conducted on 843 patients newly diagnosed with type 2 diabetes mellitus (T2DM) between 2015 and 2022. Baseline clinical data were collected, and patients were categorized into four subtypes using K-means clustering. They were followed up until July 2025 to determine cardiovascular outcomes, and the risk of cardiovascular events among the subtypes was compared. Results Among the 828 T2DM patients, 146 (17.63%) were classified as Severe Insulin-Deficient Diabetes (SIDD), 168 (20.29%) as Severe Insulin-Resistant Diabetes (SIRD), 173 (20.89%) as Mild Obesity-Related Diabetes (MOD), and 341 (41.18%) as Mild Age-Related Diabetes (MARD). Significant differences in age, BMI, and other indicators were observed among the different subtypes (P<0.05). A total of 86 patients (10.39%) developed cardiovascular diseases. The incidence was 15 cases (10.27%) in the SIDD subtype, 30 (17.86%) in the SIRD subtype, 18 (10.40%) in the MOD subtype, and 23 (6.74%) in the MARD subtype. There was a statistically significant difference in the incidence of cardiovascular diseases among the subtypes (Log-rank χ²=17.132, P=0.001). Multivariate Cox analysis revealed that T2DM subtypes (SIDD: HR=3.484, SIRD: HR=4.999, MOD: HR=6.287), age, eGFR, and LDL-C were influencing factors. Both the Fine-Gray competing risk model and the cause-specific Cox model indicated that the SIRD subtype was an independent risk factor (HR=2.710 and 2.855, respectively; P<0.001), while the effects of the SIDD and MOD subtypes were not statistically significant (P>0.05). Conclusion The novel classification method can effectively assess the risk of cardiovascular disease in patients with T2DM. The SIRD subtype represents a high-risk population that should be prioritized for intervention.

Objective To analyze the hospitalization expenses and associated influencing factors for syphilis cases in Yunnan Province, thereby providing a reference for the rational control of inpatient costs. Methods Data were extracted from the front pages of medical records for syphilis inpatients in Yunnan Province between January 2018 and December 2021. Line graphs were employed to illustrate the temporal trends of various hospitalization cost components. An ordered multinomial logistic regression model was utilized to analyze the factors influencing total hospitalization expenses. Results A total of 1 083 syphilis hospitalizations were recorded in Yunnan Province from 2018 to 2021. The total hospitalization costs remained relatively stable during this period. While expenditures on Western and traditional Chinese medicines demonstrated a downward trend, costs associated with diagnostics and medical consumables exhibited a sustained increase. The ordered multinomial logistic regression analysis revealed that, in comparison to cases with unclassified syphilis, the odds of incurring higher hospitalization costs were 4.265 times greater for neurosyphilis (95% CI: 2.622-6.936), 2.983 times greater for congenital syphilis (95% CI: 1.407-6.325), and 1.595 times greater for latent syphilis (95% CI: 1.068-2.382). Relative to a length of stay of ≤5 days, the odds of higher expenses were 5.734 times greater for hospitalizations of 6-13 days (95% CI: 4.024-8.171) and 65.720 times greater for stays exceeding 13 days (95% CI: 42.374-101.930). Furthermore, patients who were divorced, widowed, or of other marital statuses had 2.077 times the odds of higher hospitalization costs compared to unmarried patients (95% CI: 1.049-4.111) (all P<0.05). Conclusion Although the overall hospitalization expenses for syphilis cases in Yunnan Province have remained relatively stable, the control over diagnostic and consumable costs has been inadequate. Syphilis classification, length of hospital stay, and marital status were identified as significant factors associated with hospitalization expenses. It is recommended that the promotion of low-cost diagnostic methods be pursued to reduce inpatient costs. Additionally, enhanced efforts in early screening, diagnosis, and treatment of syphilis are crucial to mitigate disease severity, consequently shortening the length of hospitalization and controlling associated expenditures.

Objective To investigate the association between sedentary time and the risk of sarcopenia among community-dwelling older adults, with the aim of providing targeted interventions for the prevention of sarcopenia in this population. Methods A cross-sectional study was conducted utilizing a multistage stratified quota sampling method to recruit 480 community-dwelling adults aged 60 years and older who had resided continuously for at least six months in cities such as Shanghai, Wuxi. The International Physical Activity Questionnaire-Short Form (IPAQ-S) was administered to assess sedentary time, and participants were evaluated for the prevalence of sarcopenia. A multivariate logistic regression model was employed to analyze the association between sedentary time and sarcopenia. Furthermore, a restricted cubic spline (RCS) model was used to explore the dose-response relationship between sedentary time and the risk of sarcopenia. Results A total of 496 valid questionnaires were returned, yielding a response rate of 97.25%. Sarcopenia was diagnosed in 91 participants, corresponding to a prevalence of 18.35%. Sedentary time ranged from 2 to 11 hours, with a mean of (6.41±2.37) hours. Multivariate logistic regression analysis indicated that sedentary time ≥8 h/d (OR=4.860) and 6-8 h/d (OR=2.943) were significant risk factors for sarcopenia in community-dwelling older adults (both P<0.01). The RCS analysis revealed a non-linear dose-response relationship between sedentary time and the risk of sarcopenia (P for non-linearity=0.044). Specifically, the risk of sarcopenia increased sharply with sedentary time exceeding 5 hours per day. In subgroup analyses stratified by age, sex, and physical activity level, a significant positive correlation was consistently observed between sedentary time and sarcopenia risk (P<0.05). The association was more pronounced in individuals aged 75-80 years (OR=1.396), females (OR=1.383), and those with no regular physical activity (OR=1.276). Conversely, the association was comparatively weaker in individuals aged 65-<75 years (OR=1.173), males (OR=1.171), and those who engaged in regular physical activity (OR=1.240). Conclusion The prevalence of sarcopenia is elevated among community-dwelling older adults, and prolonged sedentary time constitutes an independent risk factor for its development. The risk of sarcopenia increases significantly when daily sedentary time surpasses 5 hours.

Objective To investigate the temporal evolution of fall risk perception and its determinants in patients with osteoporotic fractures. Methods A prospective study design was employed, enrolling 118 patients with osteoporotic fractures admitted between January 2023 and October 2024. Patients were surveyed using the Fall Risk Perception Scale at five time points: at discharge (T0), and at 1 month (T1), 3 months (T2), 6 months (T3), and 12 months (T4) post-discharge. A latent class growth model (LCGM) was utilized to identify distinct trajectories of fall risk perception scores over time. Subsequently, logistic regression analysis was performed to ascertain the factors influencing these developmental trajectories. Results The mean fall risk perception scores for the 118 patients were (47.66±8.41) at T0, (50.65±8.92 )at T1, (51.50±10.68) at T2, (49.16±12.42) at T3, and (47.33±12.21) at T4. The LCGM analysis identified three distinct trajectories for fall risk perception scores: a "sustained low-risk perception" group (n=34, 28.81%), a "moderate fluctuation" group (n=56, 47.46%), and a "sustained high-risk perception" group (n=28, 23.73%). Ordinal multinomial logistic regression analysis revealed that patients who were younger than 60 years (OR=3.559, 4.311), had an educational attainment of junior high school or higher (OR=3.326, 4.896), reported a history of falls (OR=2.985, 4.180), had no depression (OR=2.888, 2.804), or possessed a good knowledge of osteoporosis (OR=3.286, 4.255) were significantly more likely to belong to the moderate fluctuation or sustained high-risk perception groups (all P<0.05). Conclusion The perception of fall risk among patients with osteoporotic fractures follows distinct temporal trajectories. Age, educational attainment, history of falls, depression, and osteoporosis-related knowledge are significant determinants of these trajectories. Healthcare professionals should consider the specific characteristics of these different trajectory groups to develop tailored, individualized intervention strategies aimed at enhancing patients' perception of fall risk.