Objective To investigate the status and related factors of sleep disturbances and mental health among university students in the post-COVID-19 epidemic era. Methods During September and October 2023, a convenience sampling method was used to survey students at a university in Guangdong Province. Non-parametric rank sum test, Spearman correlation analysis, and multiple linear stepwise regression analysis were employed to investigate the relationship between sleep disturbances and mental health among the students. Results A total of 1 488 valid questionnaires were collected in this study, with male students comprising 41.5% and female students comprising 58.5%. Among them, 74.9% reported a history of COVID-19 infection, and 34.2%, 42.8%, 31.9%, and 48.2% reported experiencing insomnia, nightmare distress, anxiety, and depression, respectively. Significant positive correlations were observed between anxiety and insomnia, nightmare distress, and depression （r=0.39, 0.52, and 0.52, all P<0.01）. Insomnia, nightmare distress, and depression positively predicted anxiety （adjusted R²=0.51, β=0.32, 0.30, and 0.50, all P<0.001）. Conclusions In the post- COVID-19 epidemic era, a heightened incidence of sleep disturbances and mental health problems has been observed among university students. Insomnia, nightmare distress, and depression exacerbate the severity of anxiety. It is imperative for universities and relevant authorities to prioritize the sleep and mental health status of university students, along with the associated influencing factors, to enhance sleep quality and promote mental health.

Objective To analyze the survival time of HIV-infected/AIDS patients and its influencing factors in Jinjiang City from 2018 to 2022. Methods The case data of HIV-infected/AIDS patients in Jinjiang City from 2018 to 2022 were derived from the “AIDS Comprehensive Prevention and Control Data Information Management System” of China Disease Prevention and Control Information System, and the influencing factors of the survival time of HIV-infected/AIDS patients were analyzed using univariate and multivariate Cox proportional risk regression models. Results From 2018 to 2022, a total of 937 HIV-infected/AIDS patients with current addresses in Jinjiang City were registered, including 774 males and 163 females. At the end of observation, 151 of the 937 reported cases were AIDS-related deaths, the AIDS-related fatality rate was 16.12%, and the mean survival time was 154.55 months (95% CI: 138.20-170.90). Multivariate Cox proportional risk model results showed that baseline CD4+T lymphocytes were 200 - < 350/μL (HR=0.21, 95% CI: 0.10-0.43), ≥350 /μL (HR=0.18, 95% CI: 0.09 - 0.37), and antiviral therapy (ART) (HR=0.07, 95% CI: 0.04 - 0.13) had a lower risk of death. Conclusion Baseline CD4+T lymphocyte levels and ART are factors influencing survival in HIV-infected/AIDS patients.

Objective To explore the pollution levels of polycyclic aromatic hydrocarbons （PAHs） in atmospheric PM_2.5 in Zhuhai City, and to assess the health risks to the population via inhalation exposure. Methods In 2022, from the 10th to the 16th of each month, PM_2.5 samples were collected in three districts of Zhuhai City. The mass concentration of PM_2.5 was measured using the gravimetric method, while the concentrations of 16 types of PAHs were detected using liquid chromatography. Additionally, the carcinogenic and non-carcinogenic health risks resulting from inhaling PAHs were evaluated. Results In 2022, the concentration of atmospheric PM_2.5 in Zhuhai City was 7.00-80.00 μg/m³, with a median of 19.00 μg/m³ and an annual average of 23.85 μg/m³. The overall concentration of 16 PAHs ranged from 0.43 to 17.99 ng/m³, with a median of 0.68 ng/m³. The median HQ of naphthalene was 4.33×10^-5 and P₉₅ was 1.20×10^-4. The median HQ for benzo [a]pyrene （BaP） was 0.01 and P₉₅ was 0.24. The carcinogenic equivalent concentration of 16 PAHs were calculated using BaP as the reference toxic equivalent factor, the total lifetime excess carcinogen risk （ECR） calculated by P₉₅ was 6.64×10^-7, which was lower than the acceptable level of 1×10^-6. Conclusions The overall concentration of PAHs in atmospheric PM_2.5 in Zhuhai City is relatively low. Besides, both the non-carcinogenic and carcinogenic risks posed to the population by exposure to atmospheric PAHs are within acceptable risk thresholds.

Objective To understand the medication adherence of pulmonary tuberculosis patients in Huizhou City,and explore its influencing factors. Methods A survey questionnaire was developed based on the Information-Motivation-Behavioral skills model （IMB）. Convenience sampling was utilized to recruit participants from Huizhou Tuberculosis Prevention and Control Research Institute from March to April 2022 to examine their medication adherence during treatment. A logistic regression model was employed to analyze the factors influencing medication adherence. Results Among the 269 participants,the mean age was （46.64±16.47） years old,with 171 males （63.6%） and 98 females （36.4%）. The medication adherence rate was 83.6% （225/269）. The results of the multivariate logistic regression analysis revealed that a higher level of knowledge regarding treatment information （OR = 1.19） and self-efficacy （OR = 2.91） were associated with improved medication adherence among patients. Conversely,a higher level of perceived barriers （OR = 0.76） was linked to poorer medication adherence in patients. Conclusions The medication adherence of pulmonary tuberculosis patients in Huizhou City is good overall,and the main influencing factors are the level of knowledge regarding treatment information,self-efficacy,and perceived barriers. In the future,interventions such as health education and doctor-patient communication can be strengthened to improve patients' medication adherence.

Objective To analyze the epidemiological and etiological characteristics, as well as the spatiotemporal clustering of hand, foot and mouth disease (HFMD) in Shenzhen from 2017 to 2022, to inform the policy-making for HFMD prevention and control strategies in the region. Methods Comprehensive data from individual HFMD cases and sentinel hospital surveillance in Shenzhen between 2017 to 2022 were systematically gathered. The epidemic features were analyzed using descriptive epidemiological methods. ArcMap 10.8 software was used for global spatial autocorrelation analysis and local spatial autocorrelation analysis. SaTScan 9.0 software was used for spatiotemporal clustering analysis based on discrete Poisson distribution. Results Over the six-year period, Shenzhen reported a total of 267 124 cases of HFMD, with an average annual reporting rate of 291.60 per 100 000. The average annual reporting rate before the COVID-19 pandemic (2017-2019) was 519.57 per 100 000, which was significantly higher than the rate during the COVID-19 period (2020-2022) at 124.33 per 100 000 (P<0.01). HFMD cases were reported throughout the year, with higher incidence observed from May to July and September to November. Most cases occurred in children aged three years and below (207 854 cases, 77.81%), particularly among scattered children (194 214 cases, 72.71%) and those in early childhood care (58 641 cases, 21.95%). HFMD cases were reported across all ten districts of Shenzhen, with Futian District having the highest annual reporting rate at 774.47 per 100 000, followed by Guangming District at 410.97 per 100 000 and Longgang District at 266.23 per 100 000. The predominant strains of HFMD pathogens were Cox A6 and Cox A16. In 2022 there was statistically significant global spatial autocorrelation coefficient Moran's I (Z=2.688, P<0.05) and spatial aggregation. From 2017 to 2022, HFMD in Shenzhen showed obvious clustering in time and space. The first type of clustering area was mainly centered in the streets of Buji and Fuyong in Bao'an District and Longgang District, and the clustering time was mainly concentrated from May to November. Conclusions The prevalence of HFMD in Shenzhen from 2017 to 2022 showed obvious seasonal, regional, and population distribution characteristics. The average annual reporting rate of HFMD during the COVID-19 epidemic period is lower than that before the epidemic, and there is an obvious spatial and temporal clustering of cases.

Objective To explore the status and indication changes for cesarean section in medical institutions in Huainan region,in order to provide empirical evidence for the formulation of scientific intervention measures and management strategies. Methods Women who gave birth in Huainan Maternal and Child Health Hospital,Huainan First People's Hospital,and Huainan Dongfang Hospital from January 2019 to December 2022 were selected as the survey objects. General demographic information and pregnancy-related information were collected. Indicators for cesarean section were evaluated according to Expert Consensus on Cesarean Section Operation （2014）. Descriptive analysis was used to analyze the status of cesarean section and the change of indications,and univariate and multivariate analyses were used to analyze the related factors of cesarean section without medical indications. Results A total of 10 878 cases of maternal data were collected,including 3 750 cases of cesarean section,accounting for 34.47%. The cesarean section rates from 2019 to 2022 showed a gradually decreasing trend （trend χ²=160.049,P<0.01）,and were 45.63%,39.31%,31.85%,and 23.63%,respectively. There was significant difference in the distribution of indications of cesarean section from 2019 to 2022 （χ²=340.037,P<0.01）,among which scar uterus accounted for the highest proportion. From 2019 to 2022,the proportion of scar uterus and fetal distress in the indications of cesarean section showed a gradually increasing trend,while the proportion of placental abruption and placenta previa showed a gradually decreasing trend. Among the 3 750 women who gave cesarean section,166 had cesarean section without medical indications,accounting for 4.43%. The main reason for cesarean section without medical indications was the fear of not being able to deliver naturally,and after the trial delivery,a cesarean section must be changed （32.53%）. The results of multivariate Logistic regression analysis showed that the rate of cesarean section without medical indications was higher in women aged 30-35 （OR=1.093） and 35-40 （OR=1.097）,with a pre pregnancy BMI of≥28.0 kg/m² （OR=2.933）,multiparous women （OR=1.664）,those who were unaware of pregnancy and childbirth related knowledge （OR=1.670）,and those who had prenatal anxiety （OR=4.865）. Conclusions From 2019 to 2022,the cesarean section rate in medical institutions in Huainan region shows a decreasing trend. The highest proportion of cesarean section indications is scar uterus,and there are still a certain proportion of cesarean section without indications.

Objective To investigate the prevalence of cognitive impairment in the elderly aged≥60 years in Guangzhou,and analyze the related influencing factors. Methods From January to December 2023,3 districts of Guangzhou were selected by multi-stage cluster random sampling method,and 8 community health service centers in each district were selected as survey sites. The elderly people aged ≥60 years old were selected from the survey sites to conduct cognitive function assessment and questionnaire survey. The descriptive epidemiological analysis was used to analyze the prevalence of cognitive impairment in the elderly,and univariate and multivariate logistic analyses were used to analyze the influencing factors. Results A total of 2 420 elderly residents in Guangzhou were surveyed using an effective questionnaire,with males accounting for 43.35% and females accounting for 56.65%. The age range was mainly from 60 to 79 years old,accounting for 87.02%. The education level was mainly below high school,accounting for 85.62%. There were 292 elderly people assessed as cognitive impairment,accounting for 12.07%. Multivariate logistic regression analysis showed that ≥70 years old （OR =1.665,3.471）,per capita monthly family income < 3 000 yuan （OR =1.859）,drinking （OR =1.690）,combined use of different types of drugs （OR =2.661） were risk factors affecting cognitive impairment in elderly aged ≥60 years. Education level of junior high school or above（OR=0.268,0.372） and high socio-economic status（OR=0.324） was a protective factor. Conclusions The prevalence of cognitive impairment in the elderly aged ≥60 years in Guangzhou was high. Advanced age,drinking,low and education level socio-economic status,and combined use of different types of drugs are risk factors affecting cognitive impairment.

Objective To understand the epidemic characteristics and long-term trends of other infectious diarrhea in Qiannan Prefecture, Guizhou Province from 2012 to 2022, and provide a reference for local disease prevention and control. Methods Data on other infectious diarrhea cases in Qiannan Prefecture from 2012 to 2022 were collected through the China Disease Control and Prevention Information System. Descriptive epidemiological method and Joinpoint regression model were used to analyze the epidemic characteristics and long-term trends. Results From 2012 to 2022, a total of 11 486 cases of other infectious diarrhea were reported. The average annual reported incidence rate was 31.6 per 100 000 population, and the overall reported incidence rate exhibited an upward trend (trend χ² =663.085, P<0.01). The incidence rate peaked from October to January of the following year. The disease primarily affected scattered children (7 618 cases, 66.3%). Rotavirus was identified as the predominant pathogen (3 312 cases, 95.8%). Joinpoint regression analysis revealed two turning points in the annual reporting rate from 2012 to 2022, with a significant increase observed from 2015 to 2020 (APC=24.023, P<0.05). Conclusions From 2012 to 2022, there has been an upward trend in the overall incidence of other infectious diarrhea in Qiannan Prefecture. The high incidence is observed during the winter and spring seasons, with rotavirus being identified as the dominant pathogen. It is recommended to implement effective comprehensive intervention measures targeting focus groups and areas during the peak incidence season in order to effectively prevent and control the disease within the local community.

Objective To examine the concentration of trihalomethanes （THMs） in drinking water in Longgang District,Shenzhen,and to evaluate the potential risk of THMs to human health. Methods The concentration of THMs in the municipal water supply of Longgang District,Shenzhen was monitored from 2019 to 2023. An evaluation of the health risk associated with THMs exposure through drinking water and bathing in Longgang District,Shenzhen was conducted using a health risk assessment model. Results The detection rates of trichloromethane （TCM） were all 100.00%. The detection rates of bromo-dichloromethane （DCBM） were over 97.00%,and the detection rates of dibromo-chloromethane （DBCM） ranged from 76.34% to 95.83%. The lowest detection rate was found for tribromomethane （TBM）. The carcinogenic risk of THMs through drinking water exceeded that through skin exposure,while the carcinogenic risk of THMs through skin exposure was below 1.0×10^-6. Additionally,the carcinogenic risk of THMs exposed to peripheral water through drinking water was greater than 1.0×10^-6 but less than 1.0×10^-4. Furthermore,the non-carcinogenic risks of THMs in different exposure paths,various water sample types,and diverse water collection periods were found to be <1. Conclusions The carcinogenic risk values of TCM,DCBM,and DBCM in drinking water exceed the recommended levels set by USEPA,indicating a certain level of health risk within an acceptable range. The carcinogenic risk of exposure through drinking water is higher than that through bathing skin.

Objective To analyze the incidence trend of hepatitis A in China from 2005 to 2021,and provide the scientific reference for the prevention and treatment of hepatitis A. Methods Disease data and population data were obtained from the Public Health Science Data Center of the Chinese Center for Disease Control and Prevention and the work dynamics of the Bureau of Disease Control and Prevention of the National Health Commission,as well as the population data of the National Bureau of Statistics. Joinpoint regression model was used to analyze the reported incidence trend of hepatitis A in China. Results A total of 582 531 cases of hepatitis A were reported in China from 2005 to 2021,with an average annual reported incidence of 2.5343/100 000 and an average annual percent change （AAPC） of -10.00% （P<0.001）,showing a downward trend. From 2005 to 2018,the reported incidence of hepatitis A showed a decreasing trend in 26 provincial administrative regions （P<0.05 or P<0.01）,and a stable trend in 5 provincial administrative regions （all P>0.05）. There was no statistical significance in the 1-year-old group and the ≥85 year-old group （both P>0.05）,and the other age groups showed a downward trend （all P<0.01）. Conclusion The overall reported incidence of hepatitis A in China from 2005 to 2021 is in a downward trend,but it is still necessary to implement health education and strengthen the disease prevention awareness and self-protection ability of the population.

Objective To analyze the epidemiological characteristics of the incidence and death of digestive system malignancies in Weihai residents,and provide a reference for evaluating and improving the interventional measurements. Methods Based on the surveillance data of digestive system malignancy of residents in Weihai from 2015 to 2022 and the population data of the same period,the annual percentage change （APC） of the morbidity and mortality of esophageal cancer,gastric cancer,colorectal cancer,liver cancer,gallbladder cancer,and pancreatic cancer were calculated,and their time variation trends were analyzed. Results From 2015 to 2022,the standardized morbidity of digestive system malignancies in Weihai ranged from 58.82 to 72.88 per 100 000 population,while the standardized mortality ranged from 38.72 to 47.40 per 100 000 population. Colorectal cancer,gastric cancer,and liver cancer were responsible for the majority of the morbidity and mortality among the digestive system malignancies. For both males and females,the morbidity of colorectal cancer showed a statistically significant increasing trend （P<0.05 or P<0.01）;in contrast,the morbidity of liver cancer exhibited a statistically significant decreasing trend （P<0.05 or P<0.01）. The mortality of colorectal cancer also displayed a statistically significant upward trend for both genders （P<0.05 or P<0.01）,whereas the mortality for gastric cancer and liver cancer demonstrated a statistically significant downward trend （all P<0.01）. The morbidity and mortality of digestive system malignancies were higher in males than in females,with differences in the peak age of onset for the major types of malignancies. Conclusions The morbidity and mortality of digestive system malignancies in Weihai have remained stable from 2015 to 2022,with gastric cancer,liver cancer,and colorectal cancer accounting for a significant proportion of both. It is important to note that the trends in morbidity and mortality vary among different types of cancers,thus requiring specific measures to be implemented for precise prevention and control strategies.

Objective To understand the prevalence of ground glass nodules （GGN） in health examination population in Shanghai and explore its correlation with metabolic diseases. Methods A total of 10 403 health examinees were selected for the survey,and the prevalence of GGN and metabolic indicators in this population were analyzed. Univariate and multivariate analyses were used to examine the impact of metabolic diseases on GGN. Results The prevalence of GGN in health examination population of the region was approximately 35.90% （3 735/10 403）,with females accounting for 38.87% （1 703/4 381） and males accounting for 33.74% （2 032/6 022）,with a statistically significant difference （P<0.05）. There was a statistically significant difference in the prevalence of GGN among patients with different metabolic diseases （P<0.05 or P<0.01）. Hypertension （OR=1.168） was a risk factor for GGN in the population. In addition to hypertension,high levels of low-density lipoprotein cholesterol （LDL-C） （OR=1.287） was a risk factor for GGN in females. For males,diabetes （OR=1.234）,impaired glucose regulation （OR=1.342）,and low levels of high-density lipoprotein cholesterol （HDL-C） （OR=1.315） were risk factors for GGN,while fatty liver （OR=0.858） was found to be a protective factor. Conclusions The prevalence of GGN is relatively high in health examination population in Shanghai. The prevalence of GGN in females is affected by hypertension and high levels of LDL-C,while the prevalence of GGN in males is related to hypertension,diabetes,impaired glucose regulation,low levels of HDL-C,and fatty liver.

Objective To explore the relationship between Chinese visceral adiposity index （CVAI） and new-onset stroke in a large sample cohort of middle-aged and elderly individuals. Methods A Cox regression model was established using data from the China Health and Retirement Longitudinal Study （CHARLS） conducted between 2011 and 2018,to investigate the relationship between CVAI and new-onset stroke. Restricted cubic spline model was used to examine potential non-linear relationships,while subgroup analyses explored the moderating effects of social,demographic,and economic factors. Results A total of 6 902 participants were included in this study,among whom 398 （5.76%） experienced new-onset stroke. The median CVAI at baseline was 93.26 （63.21,123.96）,and the CVAI in new-onset stroke patients was higher than that in non- new-onset stroke patients （P<0.01）. Cox regression model results showed that after adjusting covariates,the risk of new-onset stroke increased by 67.2% for every one quartile increase of CVAI （60.75） （P<0.01）. Compared with CVAI Q₁ group （< 63.21）,CVAI Q₂,Q₃,and Q₄ groups （63.21 - <93.26,93.26- <123.96,and ≥123.96） had an increased risk of new-onset stroke by 78.5%,96.7%,and 184.2%,respectively （all P < 0.01）. The risk of new-onset stroke increased with increasing CVAI （P_trend < 0.001）. Restricted cubic spline regression analysis showed that there was a dose-response relationship between CVAI and new-onset stroke （P<0.01）,and the relationship was linear （P_nonliner =0.53）. Subgroup analysis showed that age may have a moderating effect on the relationship between the two groups （P_interaction <0.05）,and the lower age group was more affected. Conclusions The CVAI is closely associated with new-onset stroke,showing a dose-response relationship. Younger individuals with high CVAI should be particularly vigilant about their risk for developing strokes.

Objective To explore the status and influencing factors of oral hygiene behavior among urban adult residents in Nanjing City, and to offer references for the prevention and treatment of oral diseases. Methods A stratified random sampling approach was employed to investigate the oral hygiene behavior of urban adult residents in Nanjing City from June to December 2022. The descriptive epidemiological method was utilized to analyze the status of oral hygiene behavior, and the influencing factors were analyzed through univariate and multivariate logistic regression analyses. Results A total of 1 680 urban adult residents in Nanjing City were investigated, and 1 529 effective subjects were obtained, with an effective rate of 91.01%. There were 315 cases with good oral hygiene behavior, accounting for a good rate of 20.60%. There were 1 214 cases of poor oral hygiene behavior, with a poor rate of 79.40%. The top three major poor items were brushing time < 3 min, toothbrush use time ≥ 3 months, and irregular oral examination. Multivariate Logistic regression analysis indicated that gender (female OR=1.869), age (OR=0.183), education level (college degree or above OR=2.331), history of oral diseases (OR=0.674), dental anxiety (OR=0.266), and source of oral hygiene knowledge (medical institution OR=3.251) were the influencing factors of oral hygiene behavior among urban adult residents in Nanjing City (all P<0.05). Conclusions The oral hygiene behavior of urban adult residents in Nanjing City requires improvement, particularly in aspects such as brushing time, toothbrush use time, and regular oral examinations, which are affected by multiple factors. Oral health education and oral disease prevention and intervention measures can be strengthened based on individual conditions, thereby guiding residents to establish good oral hygiene habits and enhance oral health status.

Objective To understand the awareness and attitude of HIV service providers towards pre-exposure prophylaxis (PrEP) and explore its influencing factors which may provide suggestions for next steps. Methods From May to September 2022, HIV service providers in 16 prefectural cities (cities) in Yunnan Province were surveyed with self-administered online questionnaire to collect their demographic characteristics, knowledge related to PrEP, and attitudes towards PrEP. Logistic regression model was used to analyze the relevant factors affecting the survey subjects' attitudes towards PrEP. Results Among 542 HIV service providers, the awareness rate of PrEP knowledge was 91.5% (496/542) and 93.9% (509/542) supported PrEP strategy. Lack of knowledge (42.4%), fear of side effects (33.3%), and difficulty in follow-up (27.3%) were the main reasons for not supporting PrEP. Multivariate Logistic regression analysis showed that knowledge of PrEP (OR=55.38) were the promoting factors supporting PrEP strategy. Further analysis found that knowing the role of PrEP (OR=4.71), the effective protection rate of PrEP (OR=4.22), and the need to use condoms when taking PrEP (OR=14.02) promoted supportive attitudes towards the PrEP strategy. Conclusions Although HIV service providers have a high awareness of PrEP knowledge, they do not fully grasp the relevant knowledge such as effectiveness of PrEP and measures of PrEP. Most HIV service providers support the PrEP strategy, but some barriers remain. Training should continue to be strengthened, emphasizing the role of social organizations, and optimizing the PrEP process to facilitate the implementation of PrEP.

Objective To establish an evaluation index system for insurance compensation for vaccine adverse events in Guangdong Province. Methods The index system was initially formulated by referring to literature review and policy documents of other pilot regions and other similar insurance products, and the indicators were selected by collecting experts' scores through three rounds of questionnaires using the Delphi method, and the weights of each indicator were calculated using the percentage weighting method. Results A total of 24 experts participated in the survey evaluation, including 7 experts from national and provincial CDCs, 5 experts from provincial health administration departments, and 12 experts from higher education institutions; 9 experts with senior titles, 8 experts with associate titles, and 7 others. The areas of expertise involved epidemiology (n=9), health policy (n=7), insurance (n=6), pharmacology (n=1), and health toxicology (n=1). The participation rate of experts in the three rounds was 95.80%, 100.00%, and 95.80%, respectively. The average coefficient of expert authority was 0.79, among which the average coefficient of expert judgment was 0.76 and the average coefficient of familiarity was 0.82. Following three rounds of expert consultations, an evaluation index system for insurance compensation for vaccine adverse events in Guangdong Province was established, which included five primary indicators (pilot results, pre-planning, implementation, post-analysis, and support work), 12 secondary indicators (number of insured, policy formulation, insurance fund raising, etc.), and 34 tertiary indicators (number of insured vaccine companies, number of insured persons vaccinated, policy integrity, etc.). Conclusion The evaluation index system established in this study has a high degree of authority and coordination of expert opinions, and can be used for the specific evaluation of the work on compensation insurance for vaccine adverse events in Guangdong Province.

Objective To explore the various dietary patterns of permanent residents in Yuncheng City and their impact on high-risk groups for coronary heart disease (CHD), and to provide a scientific basis for reducing the risk of CHD in local residents from the perspective of dietary patterns. Methods Permanent residents of Yuncheng City were selected as study subjects using a phased random sampling method. Relevant data from the participants were collected through questionnaire surveys, physical examinations, and laboratory tests. The food frequency method was employed for dietary assessment, while the Framingham risk score was utilized to estimate the risk of CHD over the next 10 years. Dietary patterns were identified through factor analysis, and the relationship between these dietary patterns and the risk of CHD was examined using both univariate and multivariate analyses. Results A total of 2 037 residents were included in the study, among them 526 were identified as high-risk groups for CHD, accounting for 25.82%. Factor analysis identified four dietary patterns in Yuncheng City: traditional pattern, meat pattern, starch pattern, and dairy-egg-fruit pattern. After adjusting for confounding factors, logistic regression analysis showed that a high score in the meat pattern (Q4, OR=1.835, 95% CI: 1.329-3.224) and a high score in the dairy-egg-fruit pattern (Q4, OR=0.671, 95% CI: 0.329-0.871) were associated with being at high risk for CHD (both P<0.01). Conclusion Dietary patterns are closely related to the risk of CHD in Yuncheng City, and it is necessary to advocate for a reasonable and healthy diet among residents to improve the occurrence and development of CHD.

Objective To investigate the epidemiological status and influencing factors of adult metabolic syndrome （MS） in Shenzhen,and to provide the scientific basis for the prevention and control strategy of MS. Methods A multi-stage stratified random sampling method was adopted to conduct questionnaire survey,physical examination,and laboratory testing among permanent residents aged 18 and above in 10 districts of Shenzhen from April to December 2021. Multivariate logistic regression was used to analyze the influencing factors of MS. Results A total of 6 256 adults were included,with a mean age of （40.28±14.23） years old,and male to female ratio was 0.99∶1. There were 1 107 participants with MS,the prevalence rate was 17.70% （standardized rate was 19.63%）. The most common combination of MS was “abdominal obesity + abnormal blood pressure + high triglycerides”,with a proportion of 28.18% （312 patients）. The results of multivariate analysis showed that female （OR=0.589）,secondary school education （OR=0.720）,college and higher education （OR=0.531）,underweight （OR=0.160） were protective factors for MS,and 35 - 64 years age group （OR=2.379）,65 - 94 years age group （OR=7.242）,overweight （OR=6.292）,obesity （OR=19.355）,smoking （OR=1.316）,and hyper- uricemia （OR=2.040） were the risk factors for MS. Conclusions The prevalence of MS in adults in Shenzhen is relatively high. It is necessary to strengthen the monitoring and intervention of weight,blood pressure,blood glucose,and blood lipid in high-risk groups such as older men,overweight and obesity,smoking,and hyper- uricemia,so as to prevent the occurrence of MS.

Objective To analyze the distribution of height and body mass and the prevalence of short stature among primary and secondary school students in Enshi City. Methods Using stratified cluster sampling method,from January to June 2023,5 primary schools and 5 junior high schools in different districts of Enshi City were selected. Then,students from 4 classes in each grade of each school were randomly selected for height and body mass measurement. Simultaneously,demographic information,lifestyle behaviors,and family conditions of the students were collected through questionnaires. Descriptive analysis was utilized to examine the distribution of height and body mass,while univariate and multivariate analyses were applied to analyze the factors influencing short stature. Results A total of 9 652 primary and secondary school students participated in this study. The average height of boys aged 6-9 years was higher than that of girls,the average height of girls aged 10-12 years was higher than that of boys,and the average height of boys aged 13-16 years was higher than that of girls again. Amongst the participants,7.02% were underweight,66.74% were normal,14.92% were overweight,and 11.31% were obese. There were fewer overweight and obese at the age of 6,and the number of overweight and obese at the age of 12 increased significantly. Short stature was detected in a total number of 251 cases,with a detection rate of 2.60%. Notably,the detection rate of short stature was significantly higher in girls （3.01%） compared to boys （2.20%,P<0.05）. Although the highest detection rate of short stature was observed at 8 years old （3.35%）,no significant difference was found in the detection rate across different ages （P>0.05）. Multivariate logistic regression analysis revealed that primary and secondary school students in Enshi City with short stature had the following influencing factors：parental short stature （OR=5.959）,growth hormone deficiency （OR=8.575）,outdoor activity time （OR=0.828）,sleep time （OR=0.738）,regular meals （OR=0.389）,Western fast food consumption （OR=1.493）,and snack food consumption （OR=2.947）. Conclusions The height and body mass development of primary and secondary school students in Enshi City conforms to the general laws of growth and development,while also exhibiting certain characteristics. For instance,the detection rate of short stature is significantly higher in girls than in boys,and there has been a notable increase in the number of obese 12-year-olds. The incidence of short stature is influenced by various factors such as physical exercise,sleep,and diet. It can be prevented by considering the developmental characteristics of primary and secondary school students in the region,as well as individual differences.

Objective To develop the satisfaction assessment scale for primary vaccination clinic services and to test its reliability and validity. Methods The initial scale for evaluating the satisfaction of primary vaccination clinic service was developed by using literature research, interviews, and expert survey. The formal scale was obtained by field investigation of parents of children aged 0 - 6 years in vaccination clinic after screening items, and the reliability and validity of the scale were evaluated. Results The final scale contained five dimensions and 30 items. Exploratory factor analysis extracted five common factors, which were service standardization, service accessibility and tangibility, humanistic care, responsiveness, and service guarantee, with a cumulative explained variance percentage of 73.64%. Confirmatory factor analysis showed a χ²/df ratio of 2.042, RMSER of 0.067, CFI of 0.942, TLI of 0.933, all indicating a good model fit. The CR values for the five dimensions were 0.943, 0.931, 0.855, 0.943, and 0.861, respectively. Similarly, the AVE values were 0.664, 0.618, 0.665, 0.770, and 0.674, respectively, indicating ideal aggregation validity. However, the square roots of AVE for service standardization and service accessibility and tangibility were smaller than the correlation coefficients among some factors, suggesting slightly poor discriminant validity. The Cronbach's α coefficient of the total scale was 0.977, and the Guttman split-half coefficient was 0.932, both indicating good reliability. Conclusion The reliability and validity of the vaccination satisfaction evaluation scale prepared in this study are acceptable, which can provide a tool for improving the quality of vaccination service.

Objective To investigate and analyze the knowledge,attitude,and practice of occupational exposure among emergency medical staff,to provide a basis for improving their occupational protection level. Methods In April 2023,8 public hospitals in Yuncheng City were randomly selected. A total of 40 emergency medical staff from each hospital participated in a questionnaire survey on knowledge,attitude,and practice of occupational exposure. Descriptive analysis was used to analyze the knowledge,attitude,and practice of occupational exposure among emergency medical staff in this region. Univariate and multivariate analysis methods were employed to analyze the factors affecting these aspects. Results The scores for knowledge,attitude,and practice of occupational exposure among 302 emergency medical staff in Yuncheng City were （6.80±2.23）,（7.21±1.96）,and （6.47±2.11） points respectively. The items with lower average scores for knowledge included standard prevention concepts,occupational exposure medication plans,and standard preventive measures. For attitude scoring items with lower average scores included strengthening immune acceptance to reduce the risk of post-exposure infection,requiring serological monitoring after exposure,and experiencing negative emotions after occupational exposure. Practice scoring items with lower average scores included tracking and monitoring after occupational exposure,correctly handling the scene after occupational exposure,and reporting immediately after an occurrence. Multiple linear regression analysis revealed that educational level （β'=0.353,0.132,0.058）,years of experience in emergency positions （β'=0.247,0.328,0.142）,history of emergency exposure （β'=0.203,0.248,0.215）,perceived level of emergency exposure risk （β'=0.196,0.177,0.314）,and participation in emergency self-protection training courses （β'=0.362,0.638,0.455） were all significant factors associated with the knowledge,attitude,and practice scores of occupational exposure among emergency medical staff. Conclusions The knowledge,attitude,and practice of occupational exposure among emergency medical staff are at a moderate level. Understanding the high and low score items of knowledge,attitude,and practice of occupational exposure,as well as the differences in knowledge,attitude,and practice levels of occupational exposure among emergency medical staff in different situations,can lead to targeted and more effective intervention measures to effectively improve the occupational protection level of emergency medical staff.