Objective To investigate the effect of daily mean temperature on the daily incidence of hand, foot, and mouth disease (HFMD) in the north-central region of Shenzhen and to analyze the differential effects among various age groups. Methods Data on HFMD incidence and meteorological records from 2010 to 2023 were collected for the north-central districts of Shenzhen (Longgang and Longhua). A Distributed Lag Non-linear Model (DLNM) was employed to analyze the impact of temperature and lag days on HFMD incidence, using 24.6 ℃ (P₅₀) as the reference. The single-day and cumulative lag effects of low temperature (P₅=13.5 ℃) and high temperature (P₉₅=30.0 ℃) were subsequently explored. Results A total of 250 138 HFMD cases were reported in north-central Shenzhen between 2010 and 2023, corresponding to an average annual incidence rate of 336.98 per 100 000 population. The overall temperature-HFMD association, cumulative over a 21-day lag, exhibited an inverted "V" shape, with the peak relative risk (RR) of 3.567 (95% CI: 3.279-3.880) occurring at 28.7 °C. Low temperatures were associated with an increased risk of incidence at lags of 1-3 days, whereas high temperatures demonstrated an increased risk across lags of 1-21 days (RR>1). The cumulative lag effect of low temperature was found to be protective (RR<1), while that of high temperature was detrimental (RR>1). The effects of both low and high temperatures were more pronounced in children under the age of five. Conclusions The relationship between daily mean temperature and the daily incidence of HFMD in north-central Shenzhen is non-linear and subject to a lag effect. Enhanced prevention and control measures are warranted during periods of high temperature, with a specific focus on children under five years of age. Conversely, during periods of low temperature, attention should be directed towards the population aged five years and older.

Objective To explore the environmental factors affecting the incidence of pulmonary tuberculosis (PTB) in the Hotan region based on MaxEnt model, and to predict areas of elevated risk, thereby providing a scientific basis for precise prevention and control of PTB in Hotan. Methods The incidence of PTB reported in Hotan from 2015 to 2021, the geographic coordinates of newly diagnosed cases, and relevant environmental variables in Hotan were collected. The risk prediction model for PTB transmission was constructed based on the MaxEnt modeling framework and maximum entropy algorithms. The relative importance of environmental variables was assessed to identify high-risk areas for PTB transmission within the region. Results From 2015 to 2021, a total of 47 291 new PTB were reported in Hotan. Incidence rates peaked slightly in 2018 before exhibiting a sustained annual decline. Spatially, Moyu County (8 906 cases, 18.8%) and Yutian County (8 274 cases, 17.4%) reported the highest case counts. According to the MaxEnt model output, the three environmental variables contributing most significantly to the spatial distribution of PTB were fractional vegetation cover (FVC, 73.9%), annual average temperature (TEM, 13.0%), and normalized difference vegetation index (NDVI, 6.9%). Hotan City, Moyu County, Luopu County, Yutian County, and Cele County were identified as high-risk areas, with mean risk values of 0.604 302, 0.033 288, 0.031 097, 0.027 203, and 0.025 629, respectively. Conclusions The PTB epidemic in Hotan is multifactorially determined, with economic and climatic factors—specifically, low income and high temperature and humidity—constituting key risk factors for disease incidence. High-risk zones are primarily concentrated in the central and western subregions of Hotan.

Objective To investigate the association between residential environmental factors and the prevalence of respiratory diseases among middle school students in the Bao'an District of Shenzhen. Methods A stratified random cluster sampling method was employed to select middle school students aged 13-17 years in the Bao'an District, Shenzhen. A structured questionnaire was administered to collect data on demographic characteristics and various residential environmental factors. The primary outcome, the prevalence of common respiratory diseases within the past year-including recurrent respiratory tract infections, pneumonia, tracheitis/bronchitis, and allergic rhinitis-was determined based on self-report. Multivariable logistic regression analysis was utilized to examine the associations between specific residential environmental factors and the different respiratory diseases. Results A total of 960 students were included in the final analysis, with a mean age of (14.8±1.79) years; 554 (57.7%) were male. The overall self-reported prevalence of any respiratory disease in the past year was 26.04% (n=250). The multivariable logistic regression analysis indicated that the use of household mosquito repellents was associated with an increased risk of overall respiratory diseases (OR=1.59, 95% CI: 1.09-2.30). Furthermore, the recent acquisition of large furniture (OR=2.41, 95% CI: 1.24-4.60) and the use of mosquito repellents (OR=2.05, 95% CI: 1.01-4.11) were positively correlated with the prevalence of recurrent respiratory tract infections. The use of mosquito repellents was also found to increase the likelihood of tracheitis (OR=1.95, 95% CI: 1.01-3.66, P<0.05). Conclusions The prevalence of respiratory diseases among adolescents appears to be associated with exposure to pollutants within the residential environment. These findings suggest that targeted improvements to the quality of the living environment are of significant importance for the prevention and control of common respiratory diseases in this population.

Objective To einvestigate the association between elevated relative fat mass （RFM） and metabolic diseases in individuals with normal weight, and to characterize the distribution of this phenotype within the South China population. Methods The analysis utilized baseline data from the South China Cohort （SCC）, a prospective study on chronic diseases in a natural population, collected between 2018 and 2020. Participants aged 25-89 years were included. This study examined the distribution of the normal-weight high RFM phenotype across various subgroups and its association with the prevalence of diabetes, hypertension, and dyslipidemia. Results Among normal-weight individuals, the proportion of high RFM was significantly greater in females （25.34%） than in males （18.03%）, a disparity that widened with increasing age. A higher prevalence of elevated RFM was observed in subgroups characterized by low income （23.86%）, lower educational attainment （32.69%）, ethnic minority status （28.15%）, alcohol consumption （22.99%）, and non-smoking status （23.68%）. Within the normal-weight cohort, individuals with high RFM exhibited an increased risk for diabetes （OR=1.58）, hypertension （OR=1.67）, and dyslipidemia （OR=1.68） compared to their low RFM counterparts. Conclusion RFM effectively identifies metabolically at-risk individuals with normal body weight, thereby facilitating early intervention strategies to promote health outcomes.

Objective To investigate the interaction between the stress hyperglycemia ratio (SHR) and hypertension among a community population in Chun'an County, and to inform the development of targeted comprehensive community intervention strategies based on the findings. Methods Between January and February 2024, a stratified random sampling method was employed to select 1 022 permanent residents from the health records of community health service centers in Chun'an County as study participants. Sociodemographic data were collected via a questionnaire, and levels of SHR, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were recorded. Participants were stratified based on the presence or absence of hypertension to compare SHR levels and other baseline characteristics. A logistic regression model was constructed using key variables to analyze the association between SHR levels and the risk of hypertension. Furthermore, participants were categorized into quartiles based on their SHR levels to compare differences in blood pressure (SBP and DBP) across these groups. Spearman correlation analysis was utilized to assess the correlation between SHR and both SBP and DBP. Results Among the 1 022 participants, 340 were diagnosed with hypertension, corresponding to a prevalence rate of 33.27% (340/1 022). The prevalence was higher in males at 35.23% (210/596) compared to females at 30.52% (130/426). The blood pressure control rate (blood pressure maintained below the target value) among residents aged 18 years and older was 39.12% (133/340). Unadjusted logistic regression analysis revealed a significant association between SHR levels and the risk of hypertension (OR=8.958, 95% CI: 5.178-15.498). This association remained significant after adjusting for confounding factors, including age, BMI, history of alcohol consumption, history of smoking, frequency of physical exercise, and average daily sleep duration (OR=9.616, 95% CI: 5.115-18.080). Statistically significant differences in both SBP and DBP levels were observed across the SHR quartiles (all P<0.01). Spearman correlation analysis demonstrated a significant positive correlation between SHR and both SBP (r=0.587, P<0.05) and DBP (r=0.580, P<0.05). Conclusions SHR is an independent risk factor for hypertension in this community-dwelling population. A significant positive correlation and a synergistic mechanism exist between SHR and hypertension. The development of community-based comprehensive intervention strategies predicated on SHR levels may facilitate the early prevention and control of hypertension.

Objective To investigate the current status of diagnostic and treatment delays among lung cancer patients utilizing a fine-grained segmentation approach and to analyze the multidimensional factors influencing these delays. Methods A retrospective study was conducted on the clinical data of lung cancer patients admitted to the First Hospital of Handan City from January 2024 to December 2024. Data on patient-related delay, diagnostic delay, treatment initiation delay, and total delay were collected. Linear regression analysis was employed to identify the determinants of each delay interval. Results Among the 366 lung cancer patients included, the median patient-related delay was 60.00 (44.00, 74.00) days;the median diagnostic delay was 34.00 (24.00, 46.25) days;the median treatment initiation delay was 20.00 (14.00, 26.00) days;and the median total delay was 114.00 (93.75, 133.25) days. Linear regression analysis revealed that age (≥60 years, β′=0.145), health insurance type (urban employee-based, β′=-0.236), and clinical stage at diagnosis (Stage I-II, β′=0.136) were significant factors influencing patient-related delay (P<0.05). Determinants of diagnostic delay included health insurance type (urban employee-based, β′=-0.348;self-funded, β′=-0.292), clinical stage at diagnosis (Stage I-II, β′=0.136), level of the initial consultation hospital (tertiary hospital, β′=-2.267), and experiencing inter-hospital transfers to obtain a definitive diagnosis (β′=0.157) (P<0.05). Factors associated with treatment initiation delay were clinical stage at diagnosis (Stage I-II, β′=1.137), experiencing inter-hospital transfers for diagnosis (β′=0.151), and awaiting genetic testing results (β′=0.158). The significant predictors for total delay were age (≥60 years, β′=0.143), health insurance type (urban employee-based, β′=-0.229;self-funded, β′=0.123), clinical stage at diagnosis (Stage I-II, β′=0.136), level of the initial consultation hospital (secondary hospital, β′=-0.234;tertiary hospital, β′=-0.329), experiencing inter-hospital transfers for diagnosis (β′=0.146), and awaiting genetic testing results (β′=0.136). Conclusions The delays in the diagnosis and treatment of lung cancer, in descending order of duration, were patient-related delay, diagnostic delay, and treatment initiation delay. Targeted interventions based on the influencing factors identified at each stage may be implemented to shorten the overall diagnostic and treatment timeline for lung cancer.

Objective To analyze the detection rate of esophageal cancer and its precancerous lesions within an asymptomatic health check-up population aged ≥40 years in Qingdao, and to investigate the associated risk factors. Methods This study enrolled individuals aged ≥40 years undergoing health examinations at the Qingdao Municipal Central Hospital of Kangfu University from October 2023 to November 2024. Participants were screened using endoscopy combined with histopathological biopsy and completed a structured questionnaire. Descriptive statistics were employed to analyze the detection rates of esophageal cancer and precancerous lesions. Univariate and multivariate logistic regression analyses were conducted to identify associated risk factors. Results A total of 14 958 individuals were screened. Pathological abnormalities were identified in 536 cases, corresponding to an overall detection rate of 3.58%. Among these, esophageal cancer was diagnosed in 2 cases (0.01%), low-grade intraepithelial neoplasia (LGIN) in 421 cases (2.81%), and high-grade intraepithelial neoplasia (HGIN) in 113 cases (0.76%). Multivariate logistic regression analysis indicated that male gender (OR=2.109), advanced age (OR=1.645), history of alcohol consumption (OR=2.309), frequent consumption of pickled foods (OR=2.315), frequent consumption of excessively hot foods or beverages (OR=3.466), a history of digestive system diseases (OR=2.205), a family history of esophageal cancer (OR=3.564), and occupational exposure (OR=2.868) were significant risk factors for esophageal cancer and precancerous lesions in this population. Conclusions The prevalence of esophageal cancer among the asymptomatic population aged ≥40 years in Qingdao is low. However, the substantial proportion of LGIN and HGIN highlights a significant at-risk population that warrants attention. Male gender, advanced age, alcohol consumption, frequent intake of pickled and excessively hot foods, a history of digestive diseases, a family history of esophageal cancer, and occupational exposure are key determinants for the development of esophageal cancer and its precursor lesions.

Objective To investigate the impact of vulnerable plaque screening using carotid high-resolution magnetic resonance imaging (HR-CMR) on the effectiveness of secondary prevention in patients with transient ischemic attack (TIA)/minor stroke. Methods Patients with TIA/minor stroke admitted to our hospital between February 2021 and February 2024 was enrolled. Based on patient preference, they were allocated to a control group (n=414) or an observation group (n=420). A 1∶1 propensity score matching was performed to balance the baseline characteristics, resulting in 392 matched pairs in each group. The control group received standard secondary prevention therapy and follow-up according to established clinical guidelines. In the observation group, patients were stratified into high-risk and low-risk subgroups based on the findings of vulnerable plaque screening via HR-CMR and received targeted preventive strategies accordingly. The outcomes of interest, including stroke recurrence rates, medication adherence, imaging characteristics, adverse events, and cost-effectiveness, were compared between the two groups. Results In the final analysis, 32 patients from the control group and 14 from the observation group were lost to follow-up. The one-year stroke recurrence rate in the observation group was significantly lower than that in the control group, and the time to recurrence was longer (P<0.05). Post-intervention, both groups exhibited a reduction in plaque thickness, plaque length, intraplaque hemorrhage, and fibrous cap rupture compared to baseline; however, these improvements were significantly more pronounced in the observation group (P<0.05). Medication adherence was significantly higher in the observation group compared to the control group (P<0.05). There was no statistically significant difference in the incidence of various adverse reactions between the two groups (P>0.05). A cost-effectiveness analysis revealed an incremental cost-effectiveness ratio (ICER) of 219.80 RMB/% (ΔC/ΔE), indicating that an additional expenditure of 219.80 RMB was associated with the prevention of one additional case of stroke recurrence. This suggests a superior cost-effectiveness advantage for the intervention strategy employed in the observation group. Conclusions The application of vulnerable plaque screening based on HR-CMR in the secondary prevention of TIA/minor stroke can effectively reduce the rate of stroke recurrence, enhance plaque stability, and improve medication adherence without increasing the incidence of adverse events. Furthermore, this approach demonstrates a notable cost-effectiveness advantage.