Objective To analyze the correlation of obesity and physical activity with serum liver function indicators in the middle-aged and elderly population in Guangzhou. Methods Based on the data of Guangzhou Biobank Cohort Study,multiple linear regression model was used to analyze the correlation of central obesity,systemic obesity,and physical activity with various serum liver function indicators. The effects of the interaction between obesity and physical activity on liver function indicators were evaluated by adding interaction terms. Results A total of 8 714 participants with a mean age of （64.65±6.05）years were included. There were 6 251 females （71.74%）and 2 463 males （28.26%）. Compared with the non-central obesity group,the central obesity group had higher alanine aminotransferase （ALT）and aspartate aminotransferase （AST）levels,and lower albumin （ALB）levels,and the regression coefficients β were 4.74,0.66,and -0.27 IU/L,respectively （all P < 0.01）. Compared with the non-systemic obesity group,the systemic obesity group had higher ALT and AST levels and lower ALB levels,and the regression coefficients β were 5.72,1.23,and -0.36 IU/L,respectively （all P < 0.01）. AST levels in inactive group were higher than those in active group,and the regression coefficient β was 0.53 IU/L （P < 0.01）. Conclusion Central obesity,systemic obesity,and low physical activity level were significantly correlated with abnormal serum liver function indicators,suggesting the importance of obesity management and increasing physical activity in maintaining liver function.

Objective To analyze spatial differences and dynamic evolution of allocation of healthcare resources in China. Methods The Dagum Gini coefficient and kernel density estimation methods were used to explore the spatial differences and dynamic evolution of allocation of China's healthcare resources based on the data of 31 provinces,municipalities as well as autonomous regions from 2012 to 2021. Four indicators representing medical and health financial,material,human,and service resources were selected：health expenditure per capita,number of medical institutions per 1 000,number of health technicians per 1 000,and average patient load per physician per day. The global entropy method was used to calculate the resource allocation level index of provinces over the years. Results The Dagum Gini coefficient showed that from 2012 to 2021,the Gini coefficient of China's healthcare resources allocation increased from 0.180 5 to 0.197 2,and then decreased to 0.118 7. The kernel density estimation results showed that the center position of the kernel density curve gradually shifted to the right from about 0.2 with the increase of years,and stabilized at about 0.3. Conclusions The level of healthcare resources allocation is increasing year by year in China,and the overall gap in healthcare resource allocation space is narrowing year by year. There are still unbalanced development status and differentiated resource allocation level in each region,and the main factor affecting the overall regional gap is the gap between regions.

Objective To understand the cognition and needs of health management among rural elderly in Sichuan Province. Method A questionnaire survey was conducted among 744 rural elderly people in Sichuan Province with multi-stage sampling method,and the influencing factors of cognition and needs of health management among elderly people were analyzed with multivariate logistic regression model. Results There were 416 （55.9%） who knew about health management and 604 （81.1%） who needed health management services. The elderly with non-agricultural occupation before 60 years old （OR=1.895）,had higher education level （OR=1.320）,more annual medical expenditure （OR=1.362）,and paid more attention to daily diet control （OR=1.264） had better knowledge of health management,and those without spouse/partner had worse knowledge of health management （OR=0.680）. The elderly with chronic diseases （OR=1.519）,with non-agricultural occupation before 60 years old （OR=1.953）,and paid more attention to daily diet control （OR=1.810） needed health management services more,and those with high satisfaction with their own health （OR=0.576） needed health management services less. Conclusions The rural elderly in Sichuan Province have poor cognition of health management but high needs. Health management in the region should be further improved,especially to improve the health management cognition of the elderly with low education level,no spouse/partner,and farming before the age of 60.

Objective To investigate the contamination status of aflatoxin B₁ in foodstuffs in Yunfu City,and preliminarily assess the dietary exposure and health risk. Methods Based on the determination results of random sampling foodstuffs in Yunfu City from 2019 to 2022,the Monte Carlo probability model was used to assess the dietary exposure of aflatoxin B₁ in different population groups by region,gender,and age. The risk of liver cancer was described by using the point estimation method and the margin of exposure method. Results The mean content of aflatoxin B₁ in 1 239 samples of 10 types of foodstuffs was 3.98 µg/kg,with peanut oil （5.89 µg/kg）,brewed sauce （1.75 µg/kg）,and corn oil （1.10 µg/kg） ranking among the top three. The overall detection rate was 31.9%,with the top three being brewed sauce,peanut oil,and corn oil,which were 60.0%,44.4%,and 29.4%,respectively. The overall exceeding rate was 3.8%,and all unqualified products were peanut oil. At the 50 and 95 percentiles （representing mean and high exposure levels respectively）,for urban and rural populations,the aflatoxin B₁ exposure were 1.41 and 18.33 ng/（kg·d）,respectively; the MOE values both were much lower than 10 000.The incidence risk of liver cancer was 0.039 and 0.513 cases per 100 000 individuals per year,respectively. The main sources of aflatoxin B₁ were vegetable oils,rice,and wheat flours,accounting for 82.3%,9.2%,and 6.4% of dietary exposure,respectively. The exposure and health risks in rural areas were higher than those in urban areas. There was a trend that the younger the age,the higher the exposure and health risk,with the 3-5-year-old group being the highest. Conclusions Foodstuff in Yunfu City is contaminated with aflatoxin B₁ to a certain extent,and the health risk of dietary exposure should be paid attention to and priority should be paid to rural areas and young people. It is suggested to strengthen the supervision of foodstuffs with high detection rate.

Objective To investigate the delayed recovery and its risk factors in patients with general anesthesia. Methods Patients who underwent general anesthesia in the Second Affiliated Hospital of Army Military Medical University,Ninth People's Hospital of Chongqing,and Chongqing West Hospital from June 2018 to June 2023 were selected by random number table method. The incidence of delayed recovery after general anesthesia was analyzed by descriptive analysis method,and its risk factors were analyzed by logistic regression. Results A total of 1 056 patients under general anesthesia were included in this study. The duration of stay in the post anesthesia care unit （PACU） after surgery was 30-98 minutes. Among them,196 cases （18.56%） had delayed recovery. Logistic regression analysis revealed that delayed recovery after general anesthesia was more likely to occur in patients aged 36-65 years （OR=4.541） and 66-78years （OR=6.413）,with cardiac function grade of Ⅱ （OR=3.685） and Ⅲ （OR=5.493）,higher BMI values （OR=3.466）,hypothermia （OR=3.173）,intraoperative additional anesthetic medication （OR=3.840）,increased intraoperative fluid volume administered （OR=3.419）,complicated with underlying diseases （OR=3.120）,longer anesthesia duration （OR=2.628）,emergency surgeries （OR=3.104）,central nervous system injuries （OR=3.426 ）,metabolic diseases （OR=3.769）,respiratory dysfunction （OR =3.276）,drinking habits （OR=2.878）,abnormal kidney function （OR=3.256）,abnormal blood perfusion of tissues and organs （OR=3.432）,and absolute or relative overdose of anesthetic drugs （OR=3.180）. Conclusions There is a high incidence of delayed recovery in patients with general anesthesia. Age,high BMI,hypothermia,excessive intraoperative fluid volume administered,intraoperative additional anesthetic medication,duration of anesthesia,emergency surgery,central nervous system injury,metabolic diseases,complicated with underlying diseases,cardiac function grade,respiratory dysfunction,drinking habits,abnormal kidney function,abnormal blood perfusion of tissues and organs,and absolute or relative overdose of anesthetic drugs are risk factors for delayed recovery after general anesthesia.

Objective To explore the effects of overweight/obesity and dyslipidemia and their interaction on blood pressure control in community hypertensive patients. Methods A total of 11 254 hypertensive patients with follow-up management in the medical community of Linping District Integrated Traditional Chinese and Western Medicine Hospital were selected for the study. The blood pressure control situation was analyzed by using the data of their health examination in 2021,and the influence of overweight/obesity and dyslipidemia on blood pressure control was analyzed by logistic regression model. The interaction between overweight/obesity and dyslipidemia on blood pressure control was analyzed using a multiplicative and additive model. Results The blood pressure control rate of hypertensive patients was 39.63%,and the proportion of patients with overweight/obesity and dyslipidemia were 60.41% and 58.00% respectively. Multivariate unconditional logistic regression analysis showed that overweight/obesity （OR=0.694） and dyslipidemia （OR=0.900） were both influential factors for blood pressure control （both P<0.01）. Interaction analysis showed that the blood pressure control of overweight/obesity with dyslipidemia was only 0.664 times that of non-overweight/obesity with normal blood lipids （95% CI：0.596-0.738）. The excess relative risk,interaction attribution ratio,and interaction index of overweight/obesity and dyslipidemia were -0.228 （95% CI：-0.289- -0.167）,-0.500 （95% CI：-0.626- -0.374）,and 1.721 （95% CI：1.244-2.381）,respectively. Overweight/obesity and dyslipidemia had additive interaction on blood pressure control. The multiplicative interaction between overweight/obesity and dyslipidemia on blood pressure control was not statistically significant （OR=0.987,95% CI：0.950-1.024）. Conclusion Overweight/obesity and dyslipidemia are important risk factors for blood pressure control in community hypertensive patients,and their additive interaction increases the risk of uncontrolled blood pressure in community hypertensive patients.

Objective To understand the characteristics of cardiovascular and cerebrovascular events in Wuhan and provide the reference for related prevention and control work. Methods The data of cardiovascular and cerebrovascular events in Wuhan from 2014 to 2020 were retrospectively analyzed by descriptive epidemiological methods. Results From 2014 to 2020,the standardized morbidity of cardiovascular and cerebrovascular events in Wuhan was 298.39/100 000,and the standardized morbidity decreased year by year （P<0.05）. There was no significant change in the morbidity of cardiovascular and cerebrovascular events from 2014 to 2018 （APC= -0.14%,P>0.05）,the morbidity of cardiovascular and cerebrovascular events showed a downward trend from 2018 to 2020 （APC= -6.92%,P<0.05）. The morbidity and standardized morbidity of cardiovascular and cerebrovascular events in males were higher than those in females （P<0.01）,and the morbidity and standardized morbidity of APC in females showed a downward trend （P<0.05）. The onset age of cardiovascular and cerebrovascular events in males （median age 67.0 years） was younger than that in females （median age 72.0 years） （P<0.01）. The morbidity of cardiovascular and cerebrovascular events increased with age,and was at a low level before 40 years old,and gradually increased after 40 years old,reaching a peak after 85 years old （3 436.63 per 100 000）. The standardized morbidity in central urban area was lower than that in remote urban area （P<0.01）,and the APC of the morbidity and standardized morbidity in central urban area showed a decreasing trend （both P<0.05）,while in remote urban area showed no obvious decreasing trend （P>0.05）. Conclusions The morbidity of cardiovascular and cerebrovascular events in Wuhan showed a stable trend from 2014 to 2018,and a decreasing trend from 2018 to 2020. The population in the remote urban area,males,and the elderly should be the key groups of attention.

Objective To investigate the negative emotions and influencing factors of adolescent patients in fever clinics during the epidemic,and provide the reference for health education departments to formulate targeted intervention measures. Methods Adolescent patients who visited fever clinic in a hospital in Shanghai from February 2021 to December 2022 were selected for this study. The negative emotion related scale was used to evaluate the occurrence of negative emotions and a questionnaire survey was conducted on related factors. Descriptive analysis was used to analyze the occurrence of negative emotions in this population,and univariate and multivariate analysis methods were used to analyze the influencing factors of negative emotions in adolescent patients. Results In this study,a total of 1 608 adolescents in fever clinic were effectively investigated,and 294 cases of negative emotions were detected,the detection rate was 18.28%. Multivariate logistic regression analysis showed that the frequency of parental conflict （OR=3.020）,interpersonal sensitivity （OR=4.567）,history of COVID-19 infection （OR=4.078）,history of centralized isolation of COVID-19 （OR=3.893）,sequelae of COVID-19 （OR=2.362）,and social support （OR=3.044） were all independent risk factors that led to negative emotions of adolescent patients in fever clinics during the epidemic. Conclusions During the epidemic,the detection rate of negative emotions in adolescent patients in fever clinics is high. The frequency of parental conflict,interpersonal sensitivity,history of COVID-19 infection,history of centralized isolation of COVID-19,sequelae of COVID-19,and social support are all important factors that induce negative emotions in adolescent patients in fever clinics. It is necessary to increase health education and psychological counseling,and pay attention to the mental health problems of adolescents,actively engage in psychological regulation to prevent adolescent depression.

Objective To understand the prevalence and influencing factors of screening myopia combined with overweight/obesity in children and adolescents from 2019 to 2021 in Xi'an City,and to provide a reference for the co-prevention of myopia and overweight/obesity. Methods Students from 12 schools monitored for common diseases in Xi'an from 2019 to 2021 were selected for this study,and stratified cluster sampling was carried out in grades 4 to 6 of primary school,junior high school,and senior high school. To describe the status quo of screening myopia combined with overweight/obesity,χ² test and multiple logistic regression were used to analyze the influencing factors of comorbidity. Results From 2019 to 2021,a total of 5 768 children and adolescents were included,including 1 877 （32.54%） in grades 4 to 6 of primary school,1 928 （33.43%） in junior high school,and 1 963 （34.03%） in senior high school. The co-incidence rates of screening myopia and overweight/obesity from 2019 to 2021 were 27.4% （985/3 601）,16.1% （168/1 041）,and 27.4% （308/1 126）,respectively,with a J-shaped curve. The 3-year total co-incidence rate was 25.3% （1 461/5 768）. The co-incidence rate was higher in urban area than in suburban county,higher in boys than in girls,and increased with phase of studying （all P<0.01）. Video time ≥2 h/d was a risk factor for screening myopia combined with overweight/obesity in grades 4 to 6 of primary school students （OR=2.111）. Outdoor activity time ≥2 h/d was a protective factor for screening myopia combined with overweight/obesity in grades 4 to 6 of primary school students and junior high school students （OR=0.531,0.544）. Conclusions Reducing video time and increasing outdoor time can reduce the incidence of screening myopia combined with overweight/obesity in children and adolescents.

Objective To analyze the changes in the prevalence of abnormal glucose and lipid metabolism among newly treated HIV-infected patients in Guangzhou from 2010 to 2021,and explore the influence of gender,age,period,and cohort factors. Methods Based on the treatment data of 16 454 newly treated HIV-infected patients at Guangzhou Eighth People's Hospital from 2010 to 2021,the trends in the prevalence of abnormal glucose,triglyceride,and cholesterol metabolism were analyzed by using Joinpoint regression,and the influencing factors of prevalence change were analyzed by using age-period-cohort model. Results Among the 16 454 newly treated HIV-infected patients,the mean age was （36.78±12.07） years old,and 13 783 （83.8%） were males. From 2010 to 2021,the prevalence of abnormal glucose metabolism （AAPC=-2.4%,95% CI：-5.31% - 0.50%,P=0.103）,abnormal triglyceride metabolism （APC=AAPC=-4.13%,95% CI：-7.59% - -0.54%,P=0.029）,and abnormal cholesterol metabolism （APC=AAPC= -13.47%,95% CI：-16.03% - -10.84%,P < 0.001） showed a downward trend. The prevalence of abnormal lipid metabolism in females was higher than that in males. The results of the age-period-cohort model showed that the prevalence of abnormal glucose metabolism and triglyceride metabolism was highest in the age of 40-50 years,the prevalence of abnormal cholesterol metabolism gradually declined with age; the prevalence of abnormal glucose and lipid metabolism showed an overall decreasing trend with the period; and the prevalence of abnormal glucose and lipid metabolism was higher in the population of the earlier birth cohort. Conclusions The overall burden of abnormal glucose and lipid metabolism among newly treated HIV-infected patients has decreased in recent years. However,there is a need to enhance the prevention and control measures for abnormal glucose metabolism. Females,middle-aged and older groups,and earlier infected individuals are at high risk for abnormal glucose and lipid metabolism.