Objective To analyze the correlation between body mass index （BMI） or waist circumference （WC） and the risk of positive thyroid autoantibody among physical examinees in Shanghai. Methods A total of 3 840 physical examinees in Shanghai were randomly selected by multi-stage cluster sampling method in the health examination center of Huadong Sanatorium from January to September 2019. Demographic data, physical examination, and laboratory indicators were collected. Multivariate Logistic regression and restricted cubic spline （RCS） were used to explore the correlation between BMI or WC and the risk of positive thyroid autoantibody. Results The incidence rate of positive thyroid autoantibody was 23.2% （892/3 840）. The result of RCS showed that there was linear dose-response relationship between continuous changes of BMI or WC and positive thyroid autoantibody （P_{for non-linearity} > 0.05）. Multivariate Logistic regression showed that obese people defined by BMI and WC had 1.82 and 2.20 times of the risk of positive thyroid autoantibody, respectively, compared with non-obese people. Simple abdominal obesity （OR=2.06） and compound obesity （OR=2.79） were independent risk factors for positive thyroid autoantibody. Conclusions The increase of BMI and WC in the physical examinees in Shanghai significantly increases the risk of positive thyroid autoantibody. Attention should be paid to the population with compound obesity and simple abdominal obesity, and a reasonable obesity management program should be developed to reduce visceral fat content.

Objective To analyze the change trend and influencing factors of the incidence of very low and low birth weight infants in Xi'an, and to provide theoretical basis for the prevention and treatment of very low and low birth weight infants. Methods Data of infants registered in Xi'an and born in Northwest Women's and Children's Hospital and their mothers from 2014 to 2019 were collected from the maternal and infant management system in the region. The incidence of very low and low birth weight infants was retrospectively analyzed, and the influencing factors of very low and low birth weight infants were analyzed. Results From 2014 to 2019, 41 683 newborns were born live in Xi'an, of which 387 were born with very low birth weight, accounting for 0.93%, with an average birth weight of （1 190.8±232.1） g. There were 1 182 low birth weight infants, accounting for 2.84%, with an average birth weight of （2 195.4±240.1） g. The incidence of very low birth weight and low birth weight was significantly decreased from 2014 to 2019 （P<0.01）. Multivariate Logistic regression analysis showed that pre-pregnancy body mass index ≤ 18.5 kg/m² （OR=4.104）, placenta abruption （OR=2.732）, placenta previa （OR=3.093）, premature rupture of membranes （OR=3.557）, complicated with gestational hypertension （OR=2.519）, multiparous （OR=4.586）, multiple births （OR=3.056）, and premature delivery （OR=3.823） were the risk factors for very low and low birth weight infants. Conclusions The incidence of very low and low birth weight infants in Xi'an is decreasing year by year, but the current situation is not optimistic due to the influence of many factors. Comprehensive preventive measures should be taken for pregnant women with risk factors to reduce the incidence of very low and low birth weight infants.

Objective To investigate the compliance of prevention and treatment and blood pressure control in patients with essential hypertension, to provide a reference for controlling the development of essential hypertension. Methods A total of 696 patients with essential hypertension who received medical treatment in Lujiang County Hospital of Traditional Chinese Medicine from May to December 2019 were selected for a questionnaire survey and physical examination to further analyze the influence of different population characteristics and different prevention and treatment items on blood pressure control. Results Among the 696 patients with essential hypertension, 16.24% （113/696） met the blood pressure control standard. The compliance with smoking cessation, limiting alcohol consumption, reducing sodium intake, weight control, moderate exercise, and taking medication as prescribed by the doctor were 24.86%,28.45%, 64.51%, 58.05%, 66.38%, and 83.05%, respectively. Multivariate Logistic regression analysis showed that patients with essential hypertension aged 55-69 （OR=1.567）, with an education level of senior high school/technical secondary school or above （OR=2.849）, course of disease ≤ 10 years （OR=1.431）, good compliance with smoking cessation （OR=1.852）, good compliance with limiting alcohol consumption （OR=2.083）, good compliance with reducing sodium intake （OR=3.511）, good compliance with weight control （OR=1.145）, good compliance with moderate exercise （OR=1.670）, and good compliance with medication as prescribed by the doctor （OR=1.399） had a higher possibility of reaching the standard of blood pressure control. Conclusions The achievement of blood pressure control in patients with essential hypertension needs to be improved, and is closely related to the characteristics of the population and the compliance with prevention and treatment items. Comprehensive prevention and treatment of hypertension should be carried out for key populations and risk factors to improve patients' prevention and treatment compliance and promote blood pressure control.

Objective To investigate the status and influencing factors of screening compliance in high-risk populations of lung cancer in Guangzhou, and to analyze the results of lung cancer screening. Methods Permanent residents in Guangzhou from January 2020 to December 2021 were selected to conduct a questionnaire survey, collect their social demographic data and lung cancer risk factors, and screen out high-risk populations of lung cancer. The high-risk population of lung cancer was scanned with low-dose spiral CT （LDCT） by professional radiologists and diagnosed according to the diagnostic criteria. The descriptive analysis method was used to analyze the screening compliance and screening results of high-risk populations, and univariate and multivariate analysis methods were used to analyze the influencing factors of screening compliance of high-risk populations of lung cancer. Results Among 17 980 residents, the high-risk rate of lung cancer was 19.96% （3 589/17 980）, and the compliance rate of LDCT screening was 34.99% （1 256/3 589）. The diagnostic rate of lung cancer in 3 589 high-risk persons was 2.17% （78/3 589）, of which 61.54% （48/78） were male, 38.46% （30/78） were female, 17.95% （14/78） were 40 to 50 years old, 33.33% （26/78） were 51 to 60 years old, and 48.72% （38/78） were 61 to 74 years old. Logistic regression analysis showed that the high-risk populations of lung cancer with female （OR=2.130）, older （OR=1.408）, body mass index ≥ 24.0 kg/m² （OR=2.349, 2.375）, technical secondary school education or above （OR=2.008, 3.251）, alcohol consumption （OR=1.498）, smoking （OR=2.239）, passive smoking （OR=2.428）, family history of lung cancer （OR=2.081）, history of chronic respiratory diseases （OR=2.006）, and infrequent exercise （OR=2.130） had higher screening compliance. Conclusions The screening compliance of high-risk populations of lung cancer in Guangzhou is generally low. Age, education level, and family history are all related to screening compliance. High-risk screening of lung cancer is helpful for early diagnosis of lung cancer and related diseases, and improves the quality of life of people.

Objective To investigate and analyze the compliance of healthy dietary behavior and its influencing factors in patients with coronary heart disease （CHD） in Shangqiu City. Methods Patients diagnosed with CHD in Shangqiu City from June 2019 to May 2022 were selected for a face-to-face questionnaire survey on compliance of healthy dietary behavior and its influencing factors. The descriptive epidemiological analysis method was used to analyze the results, and univariate and multivariate analysis methods were used to analyze the influencing factors of healthy dietary behavior compliance. Results A total of 1 384 CHD patients were enrolled, and the score of healthy dietary behavior compliance was （55.95 ± 11.82）, among which the scoring rate of cooking and eating habits was the highest, and the scoring rate of fruit and vegetable eating behavior was the lowest. The results of multiple linear regression analysis showed that gender （β'=0.122）, age （β'=0.131）, BMI （β'=-0.215）, education level （β'=0.073）, occupation （β'=0.081）, household disposable income （β'=0.072）, the severity of disease （β'=0.055）, and underlying diseases （β'=0.128） were influencing factors of healthy dietary behavior compliance of CHD patients in Shangqiu City. Conclusions The compliance of healthy dietary behavior of CHD patients in Shangqiu City is low, which is affected by many factors such as gender, age, BMI, etc. CHD patients should be fully aware of the impact of a healthy diet on their diseases, consciously learn the dietary knowledge and adjust the dietary structure, change bad dietary habits, and improve compliance of healthy dietary behavior.

Objective To understand the drug resistance of tuberculosis patients in Xi'an, and to analyze the mutation characteristics of drug-resistant genes related to Mycobacterium tuberculosis （MTB） that are resistant to commonly anti-tuberculosis drugs. Methods The sputum samples of tuberculosis patients with positive sputum smears reported by tuberculosis-designated hospitals in Xi'an from January to December 2020 were isolated and cultured, and the samples identified as MTB-positive strains were tested for drug sensitivity, and the mutation characteristics of drug-resistant related genes of drug-resistant strains were analyzed by whole genome sequencing （WGS）. Results A total of 892 MTB-positive patients were identified, including 758 newly treated patients and 134 retreated patients; 209 cases were drug-resistant, and the total drug resistance rate was 23.43%; The rates of monodrug resistant tuberculosis （MR-TB）, poly-drug resistant tuberculosis （PDR-TB）, multidrug-resistant tuberculosis （MDR-TB）, extensive drug-resistant tuberculosis （XDR-TB）, and rifampicin-resistant tuberculosis （RR-TB） were 10.43%, 2.47%, 4.60%, 0.45%, and 6.28%, respectively. The drug resistance rate of retreated patients （31.34%） was significantly higher than that of newly treated patients （22.03%）; The proportion of MR-TB, PDR-TB, MDR-TB, XDR-TB, and RR-TB in drug-resistant patients of the two groups was statistically significant （all P<0.05）. Among 209 MTB-resistant strains, the mutations of resistance-related genes to commonly used anti-tuberculosis drugs were 81 strains of katG （77.14%, isoniazid）, 54 strains of rpoB （96.43%, rifampicin）, 49 strains of rpsL （84.48%, streptomycin）, 24 strains of embB （88.89%, ethambutol）, 17 strains of pncA （89.47%, pyrazinamide）, 10 strains of gyrA （90.91%, ofloxacin）, and 18 strains of rss （94.74%, second-line injection type anti-tuberculosis drugs）. Among them, katG S315T （72 strains）, rpsL K43R （42 strains）, rss A1401G （23 strains）, rpoB S531L （19 strains）, embB M306V （13 strains）, and rpoB H526D （11 strains） had the highest mutation frequency of related drug resistance genes. Conclusions Tuberculosis patients in Xi'an are highly resistant to commonly used anti-tuberculosis drugs. The gene mutations of drug-resistant strains are mainly katG, rpoB, rpsL, embB, and pncA, and mainly occur at high-frequency mutation sites such as katG S315T and rpsL K43R. It is theoretically feasible to develop sensitive and specific rapid molecular detection methods based on the above mutation characteristics.

Objective To investigate the prevalence and influencing factors of stress incontinence in adult women in Weihui City. Methods From April to June 2022, adult women in Weihui City were selected by convenient sampling method, and the adult women who met the research conditions were investigated by questionnaire, routine urine test, and urodynamics test. The descriptive analysis method was used to analyze the prevalence of stress incontinence in adult women, and univariate and multivariate analysis methods were used to analyze the influencing factors of stress incontinence. Results A total of 1 645 effective subjects were obtained, and 308 cases of stress incontinence were detected, with a prevalence rate of 18.72%, including 184 cases of mild incontinence （59.74%）, 97 cases of moderate incontinence （31.49%）, and 27 cases of severe incontinence （8.77%）. Multivariate logistic regression analysis showed that age （OR=1.412）, body mass index ≥ 24.0 kg/m² （OR=2.393）, physical activity （OR=1.213）, menstruation （OR=2.208）, reproductive history （OR=3.086）, pelvic surgery history （OR=1.853）, urinary tract infection history （OR=1.451）, water intake （OR=1.567）, and timely urination （OR=0.692） were the influencing factors of stress incontinence in adult women. Conclusions The prevalence of stress incontinence in adult women in Weihui City is high, and mild stress incontinence is more common, which is affected by many factors. Effective interventions should be taken to address modifiable factors, such as guiding adult women to reduce the prevalence of stress incontinence by controlling body mass index, appropriate physical activity, ensuring water intake, and developing good urination habits.

Objective To investigate the cervical vertebrate sub-health status of medical staff and its influencing factors, and to provide a reference for preventing and improving the cervical vertebrate sub-health of medical staff. Methods The simple sampling method was used to conduct a questionnaire survey on the medical staff of different positions in 2 tertiary hospitals and 2 secondary hospitals from April to June 2022. The basic information, lifestyle, work factors, and cervical vertebrate discomfort were collected. The cervical vertebrate sub-health status of medical staff and its influencing factors were analyzed by univariate and multivariate Logistic regression methods. Results A total of 1 196 medical staff were investigated, and 1 084 effectively responded, with an effective response rate of 90.64%. There were statistically significant differences in the incidence of cervical vertebrate sub-health among medical staff with different ages, body mass index （BMI）, daily screen time, physical exercise, sleep time, job position, working years, average daily working time, night shift frequency, forced posture, and heavy physical work （P<0.05 or P<0.01）. Multivariate Logistic regression analysis showed that age （OR=1.241）, BMI （OR=1.581）, daily screen time （OR=5.825）, physical exercise （OR=0.269）, sleep time （OR=0.620）, job position （physician OR=1.389, nurse OR=1.634）, average daily working time （OR=1.822）, night shift frequency （OR=1.982）, forced posture （OR=2.547）, and heavy physical work （OR=1.673） were influencing factors of cervical vertebrate sub-health of medical staff. Conclusions The incidence of cervical vertebrate sub-health among medical staff is relatively high, which is affected by their basic characteristics, lifestyle, work factors, etc. So it is necessary to pay attention to the high-risk population to adjust their life and work status to prevent cervical spondylosis.

Objective To study symptom clusters and their influence on the quality of life in elderly patients with coronary heart disease complicated with heart failure. Methods Elderly patients with coronary heart disease complicated with heart failure who were admitted to the hospital from January 2021 to June 2022 were selected. The basic data including gender, age, education level, course of coronary heart disease, and cardiac function grading were obtained. The Chinese version of the Memorial Symptom Assessment Scale-Heart Failure （MSAS-HF） was used to investigate the occurrence and severity of symptoms. The exploratory factor analysis method was used to explore the types and composition of symptom clusters. The Minnesota Living with Heart Failure Questionnaire based on Chinese culture（C-MLHF） was used to evaluate the quality of life. The symptom clusters of elderly patients with coronary heart disease complicated with heart failure and their influence on the quality of life were analyzed. Results There were 1 228 effective subjects, with an effective rate of 96.01%. The high incidence of symptoms was short-winded （71.99%）, dyspnea when lying flat （66.69%）, fatigue （64.50%）, palpitation （61.89%）, etc. The high severity of symptoms was dyspnea when lying flat （2.95±0.63）, short-winded （2.92±0.59）, sleep difficulty （2.90±0.65）, fatigue （2.89±0.52）, etc. Five symptom clusters were obtained by exploratory factor analysis, which was fatigue symptoms （fatigue, sweating, and drowsiness）, dyspnea symptoms （dyspnea, oppressive wake, and dyspnea when lying flat）, ischemic symptoms （palpitation, dizziness, chest pain, and numbness of hands and feet）, congestion symptoms （short-winded, edema, and cough）, and psychological symptoms （anxiety, sadness, feeling nervous, and difficulty in concentrating）. The total score of C-MLHF was （62.87±11.05）, and the scores of the physical field, emotional field, and other fields were （42.36±8.90）, （11.54±5.16）, and （13.92±6.73）, respectively. The symptom clusters of elderly patients with coronary heart disease complicated with heart failure were positively correlated with quality of life （all P<0.05）. Fatigue symptoms （β'=0.267）, dyspnea symptoms （β'=0.173）, ischemic symptoms （β'=0.312）, congestion symptoms （β'=0.265）, and psychological symptoms （β'=0.277） were all influencing factors of quality of life in elderly patients with coronary heart disease complicated with heart failure. Conclusions Elderly patients with coronary heart disease complicated with heart failure have fatigue symptoms, dyspnea symptoms, ischemic symptoms, congestion symptoms, and psychological symptoms, which seriously affect the quality of life of patients. It is necessary to carry out targeted symptom management to reduce physical and mental discomfort and improve the quality of life of patients.

Objective To explore the difference of neurobehavioral development among children of different birth and gestational ages. Methods Neonates born in Northwest Women's and Children's Hospital from January 1, 2019 to June 30, 2020 were selected by random sampling method, and were divided into premature infants group （gestational age 28-36 weeks）, early infants group （gestational age 37-38 weeks）, and term infants group （gestational age ≥ 39 weeks） according to gestational age. Neonatal Behavioral Neurological Assessment （NBNA） was performed in premature and early infants at 40 weeks of corrected gestational age and in term infants at 24 hours after birth. At 6 months, 12 months, and 24 months after birth, premature infants, early infants, and term infants were followed up to evaluate their neuropsychological development level using the Neuropsychological Development Scale for Children Aged 0-6 from Beijing Capital Children's Research Institute. Results There were 986 newborns in this study. There were 122 premature infants, including 54 males and 68 females, with an average gestational age of （32.42 ± 1.54） weeks; 275 early infants, including 122 males and 153 females, with an average gestational age of （37.54 ± 1.21） weeks; 589 term infants, including 245 males and 344 females, with an average gestational age of （39.89 ± 0.52） weeks. At the age of 6 months, the scores of total development quotient, gross motor, fine motor, cognition, language, and social interaction in premature infants and early infants were significantly lower than those in term infants （all P<0.01）. At the age of 12 months and 24 months, the scores of total development quotient, gross motor, fine motor, cognition, language, and social interaction in premature infants were significantly lower than those in term infants （all P<0.01）. The gestational age was positively correlated with the scores of gross motor, fine motor, cognition, language, and social interaction （all P<0.05）. The older the gestational age was, the higher the scores of gross motor, fine motor, cognition, language, and social interaction were （r=0.992, 0.968, 0.955, 0.933, 0.990）. Conclusions The neurobehavioral development levels of postnatal premature infants and early infants are significantly lower than that of term infants. The neuropsychological development levels of 6-month-old premature infants and early infants are significantly lower than that of term infants. The neuropsychological development levels of 12-month-old and 24-month-old premature infants are still significantly lower than that of term infants, but the early infants are equivalent to that of term infants.

Objective To explore the characteristics of intestinal flora in obese preschoolers, and to analyze the intake of different kinds of food in preschoolers. Methods Obese children were selected as the study group by convenient sampling method, and non-obese children of the same gender and age ± 0.5 years were selected as the control group. Fresh feces of two groups of children were collected in the morning, and fecal DNA samples were extracted with fecal DNA genomic extraction kit. Polymeric chain reaction （PCR） was used to detect intestinal flora. The 24-hour dietary review method was used to investigate the food intake of children on the first day by their parents, and the daily food intake of children was evaluated according to the relevant standards of Practical Child Nutrition. The descriptive analysis method was used to compare the characteristics of intestinal flora and food intake of the two groups. Results A total of 790 obese children （study group） were included in this study, including 458 boys and 332 girls, with an average age of （4.15±0.54） years. There were 784 non-obese children （control group）, including 447 boys and 337 girls, with an average age of （4.16±0.61） years. There were no significant differences in gender distribution and an average age between the two groups （all P > 0.05）. The Proteobacteria content of the study group appeared significantly higher than that of the control group, and the differences between the groups were statistically significant （P<0.01）, whereas the rest of the two groups, such as Firmicutes, Bacteroidetes, Actinobacteria, and other genera, showed no significant differences （all P > 0.05）. The children in the study group had significantly higher intakes of oils and fats than the children in the control group, with statistically significant differences （P<0.01）, and the compliance rate of vegetable, grain, and dairy intake was significantly lower than that in the control group, while the compliance rate of egg products intake was higher than that in the control group, and the differences between groups were statistically significant （all P<0.01）. The rate of excessive intake of meat and egg products in the study group was significantly higher than that in the control group （all P<0.01）. Conclusions Most obese preschoolers have an imbalance of intestinal flora, mainly with the increase of Proteobacteria. At the same time, compared with healthy children, obese preschoolers have a higher intake of fat, a higher rate of excessive intake of meat and egg products, and an insufficient intake of vegetables, grains, and dairy products. It is suggested that obese preschoolers should take lifestyle intervention by adjusting their diet structure or taking probiotics, to improve their obesity status.

Objective To investigate the high-risk factors and adverse pregnancy outcomes of registered pregnant women in Xi‘an City, and analyze the related factors affecting the adverse pregnancy outcomes. Methods The pregnant women who were registered in the obstetrics department of a hospital in Xi'an City from January 2020 to January 2022 were selected. The risk assessment of high-risk pregnancy was carried out according to the high-risk pregnancy situation, and the pregnancy outcome was tracked to analyze the basic situation and the influence of high-risk factors on the adverse pregnancy outcomes. Results A total of 6 332 registered pregnant women were included in the study, including 1 508 high-risk pregnancies, accounting for 29.97%. The high-risk factors were abnormal pregnancy history （43.63%）, gestational hypertension （33.69%）, age ≥35 years old （26.86%）, gestational diabetes （19.83%）, cicatricial uterus （13.59%）, prenatal hemorrhage （12.86%）, and placenta previa （8.55%）. Adverse pregnancy outcomes occurred in 452 of 6 332 pregnant women, accounting for 7.14%. Multivariate Logistic regression analysis showed that age ≥35 years old （OR=1.581）, pre-pregnancy body mass index ≥28.0 kg/m² （OR=1.432）, abnormal pregnancy history （OR=2.121）, prenatal hemorrhage （OR=1.464）, placenta previa （OR=1.766）, number of high-risk pregnancy factors （OR=2.667）, and pregnancy risk grade （OR=3.367） were independent influencing factors for adverse pregnancy outcomes among registered pregnant women. Conclusions The factors related to high-risk pregnancy are the main risk factors affecting the adverse pregnancy outcome of registered pregnant women. Health management for high-risk pregnant women should be emphasized and appropriate intervention measures should be taken in time to improve the pregnancy outcome.