Objective: To explore the spatial distribution of low birth weight (LBW) and the potential environmental risk factors and provide the evidence for the prevention and intervention of LBW. Methods: Data were from a surveillance system for newly born population and adverse pregnancy outcome between 2007 and 2012 in Pingding county, Shanxi province. The data from 313 villages were analyzed. Spatial hierarchical Bayesian model was used to adjust the risk of LBW at village level, Moran’s I and Getis-Ord Gi* were used to analyze the difference in distribution of LBW risk area. Spatial negative binomial model was used to evaluate the association between the risk of LBW and chemical fertilizer application. Results: A total of 18 749 new births were recorded between 2007 and 2012, including 911 LBW cases, the total incidence of LBW was 4.86%. The result of the spatial hierarchical Bayesian model showed that high-risk area of LBW was in the southeast of Pingding and low-risk area was in the middle west of Pingding. The result of Moran’s I showed that there was a clustering pattern of LBW risk, and Getis-Ord Gi* found a high risk (hot spot) area in the south area. Moreover, the findings of association analysis showed that the risk of LBW increased with the increased chemical fertilizer application at village level. Conclusions There were area specific differences in the risk of LBW, and dose-response relationship between chemical fertilizer application and the risk of LBW. Our findings suggest that maternal exposure to chemical fertilizer during pregnancy might be a potential risk factor for LBW in rural area.

Objective:To analyze the trend of dementia mortality rate among individuals aged 60 to 94 years in China from 1982 to 2021.Methods:Utilizing data from the Global Burden of Disease Study 2021, the Joinpoint regression model was employed to analyze the trend in the dementia mortality rate among Chinese older adults from 1982 to 2021. The age-period-cohort analysis method was used to decompose the age effect, period effect and cohort effect of dementia mortality data in Chinese elderly people.Results:From 1982 to 2021, the crude mortality rate of dementia in elderly women aged 60-94 in China (133.67/100 000-214.02/100 000) was higher than that in men (70.92/100 000-119.70/100 000), and the age-standardized mortality rate of dementia in women (230.74/100 000-246.87/100 000) was also higher than that in men (132.88/100 000-140.19/100 000). The age-standardized mortality rate of dementia in both genders showed an N-shaped fluctuation trend. The average annual percent change (AAPC) of dementia mortality rate in elderly males aged 60-94 was 0.07% (95% CI: 0.01%-0.13%), and the AAPC of dementia mortality rate in elderly females was -0.01% (95% CI:-0.08%-0.07%). Age effect analysis showed that from the age of 60, the risk of dementia death in males and females increased with age, especially among elderly people aged 75-94 who experienced a rapid increase in dementia mortality rate. The period effect analysis showed that the overall risk of dementia death in elderly men and women aged 60-94 was decreasing, but it had increased from 2017 to 2021. The cohort effect analysis showed that the risk of dementia death was lower in later birth cohorts. Conclusion:From 1982 to 2021, the dementia mortality rate among Chinese older adults aged 60 to 94 years exhibited fluctuations. Particularly, there has been a notable rebound in recent years. Special attention should be directed towards female seniors and those aged 75 to 94 years.

Objective To observe the effect of flurbiprofen axetil on lung oxygenation function,re-spiratory mechanics and pulmonary complications in patients undergoing thoracoscopic right lung lobectomy with endobronchial blockers during one-lung ventilation(OLV).Methods Sixty patients scheduled for elective thoracoscopic right lung lobectomy with endobronchial blockers for OLV,25 males and 35 females,aged 35-64 years,BMI 18-28 kg/m2,ASA physical status Ⅰ or Ⅱ,were randomly allocated into two groups:the flurbiprofen axetil group(group F)and the control group(group C),30 patients in each group.In group F,flurbiprofen axeil 1.0 mg/kg was injected intravenously 15 minutes before anesthesia induction,while group C was not treated.Blood gas analysis was performed in 2 ml of radial artery 20 minutes before anesthesia induction(T0),30 minutes(T1)and 60 minutes(T2)after OLV,and 15 minutes(T3)after two lung ventilation,then oxygenation index(OI)was calculated respectively and SpO2 was recorded.Pa-rameters of lung mechanics were monitored at T1 and T2 including peak airway pressure(Ppeak),airway platform pressure(Pplat),dynamic lung compliance(Cdyn),and ratio of null lumen volume to tidal vol-ume(VD/VT).The incidence of hypoxemia and the number of remedial cases during OLV were recorded.The postoperative transfer to ICU and complications such as atelectasis,acute lung injury and pneumonia within 72 hours after surgery were recorded.Results Compared with group C,SpO2 at T1,PaO2 and OI at T1—T3,and Cdyn at T1 and T2 were significantly increased in group F(P＜0.05),Ppeak and VD/VT at T1 and T2,Pplat at T2 were significantly decreased in group F(P＜0.05).There were no hypoxemia and remedies occurred during OLV and no patients were transferred to ICU after surgery,no atelectasis,acute lung injury,and pneumonia occurred within 72 hours after surgery between the two groups.Conclusion For patients undergoing OLV with endobronchial blockers undergoing thoracoscopic right lung lobectomy,in-travenous flurbiprofen axetil before induction of anesthesia can help improve lung oxygenation and optimize respiratory parameters during one lung ventilation.

Objective:To analyze the trend of dementia mortality rate among individuals aged 60 to 94 years in China from 1982 to 2021.Methods:Utilizing data from the Global Burden of Disease Study 2021, the Joinpoint regression model was employed to analyze the trend in the dementia mortality rate among Chinese older adults from 1982 to 2021. The age-period-cohort analysis method was used to decompose the age effect, period effect and cohort effect of dementia mortality data in Chinese elderly people.Results:From 1982 to 2021, the crude mortality rate of dementia in elderly women aged 60-94 in China (133.67/100 000-214.02/100 000) was higher than that in men (70.92/100 000-119.70/100 000), and the age-standardized mortality rate of dementia in women (230.74/100 000-246.87/100 000) was also higher than that in men (132.88/100 000-140.19/100 000). The age-standardized mortality rate of dementia in both genders showed an N-shaped fluctuation trend. The average annual percent change (AAPC) of dementia mortality rate in elderly males aged 60-94 was 0.07% (95% CI: 0.01%-0.13%), and the AAPC of dementia mortality rate in elderly females was -0.01% (95% CI:-0.08%-0.07%). Age effect analysis showed that from the age of 60, the risk of dementia death in males and females increased with age, especially among elderly people aged 75-94 who experienced a rapid increase in dementia mortality rate. The period effect analysis showed that the overall risk of dementia death in elderly men and women aged 60-94 was decreasing, but it had increased from 2017 to 2021. The cohort effect analysis showed that the risk of dementia death was lower in later birth cohorts. Conclusion:From 1982 to 2021, the dementia mortality rate among Chinese older adults aged 60 to 94 years exhibited fluctuations. Particularly, there has been a notable rebound in recent years. Special attention should be directed towards female seniors and those aged 75 to 94 years.

Objective:To construct a diagnostic model for fatty liver using body composition analysis and further evaluate the diagnostic effect of the model on fatty liver.Methods:726 cases with chronic liver disease who visited Tianjin Second People's Hospital from April 2019 to June 2022 and had body composition analysis tests were retrospectively enrolled and were divided into a fatty liver group (551 cases with fatty liver) and a control group (175 cases without fatty liver) according to the measured values of abdominal ultrasound and controlled attenuation parameter. An independent sample t-test and a non-parametric rank sum test were used for statistical processing. Logistic regression was used to construct a diagnostic model. Hosmer-Lemeshow was used to validate the fit of model. Receiver operating characteristic curve was used to confirm the diagnostic efficiency of the model. In addition, 341 cases of chronic liver disease who visited Tianjin Second People's Hospital were included to further verify the application effect of the model between July 2022 and February 2023.Results:Compared with the control group, the differences in various indicators of body composition analysis in the fatty liver group were statistically significant ( P < 0.05). Basal metabolic rate (X1), visceral fat area (X2), and body fat (X3) were eventually included in the diagnostic model for BCA-FL (body composition analysis-fatty liver)= -7.771+0.002X1-0.035X2+0.456X3 with the Hosmer-Lemeshow test (P=0.059). The measured area under the receiver operating characteristic curve, the sensitivity, and the specificity were 0.888, 0.889, and 0.726, respectively, when the diagnostic threshold value was 0.615 with the Youden index and the receiver operating characteristic curve. In the validated model group, the area under the receiver operating characteristic curve, Youden index, sensitivity, and specificity were 0.875, 0.624, 0.799, and 0.825, respectively. Conclusion:The diagnostic model BCA-FL for fatty liver constructed using human body composition analysis has good diagnostic efficacy and is suitable for screening fatty liver in different basic liver disease populations.

Objective:To investigate the adverse childhood experience (ACE) effects on the risk of chronic diseases among middle-aged and elderly.Methods:A retrospective cohort study was conducted using the China Health and Retirement Longitudinal Study data. We used life history study data in 2014 as baseline data and data of chronic diseases of middle-aged and elderly in 2015 as outcomes. A zero-inflated negative-binominal model was used to estimate the incidence rate ratio ( IRR) for the association between ACE and chronic diseases. Results:Compared with the less than 4 points of ACE exposure in childhood, individuals with ACE exposure 4-, 6- and ≥9 were associated an increased risk of chronic disease, adjusted IRR (95% CI), 1.10(1.04-1.16), 1.18 (1.13-1.25), 1.34 (1.27-1.42), respectively, with a significant dose-response relationship that chronic diseases risks increase parallel with the increase of ACE exposure. Conclusions:ACE might serve as one of the critical risk factors of chronic diseases in middle-aged elderly. It's of public health significance for early screening and intervention of ACE, reducing the incidence of chronic diseases, and improving middle-aged and older adults' quality of life and health.

Objective:To depict the long-term trends of prevalence and disease burden of preterm birth from 1990 to 2019.Methods:Data was from the 2019 Global Burden of Disease study. The prevalence rate (%) and disability adjusted life years (DALYs) rate of preterm birth were adopted and were further stratified by sex. China's prevalence rate and DALYs rate were compared with those of high-income, middle and high-income, middle and low-income, and low-income countries, defined by the World Bank. Joinpoint log-linear regression model was used to analyze the trend.Results:In 2019, the prevalence of preterm birth in China was 6.34% [95% uncertainty interval ( UI): 6.23%-6.44%], lower than the global average level (11.24%,95% UI: 11.16%-11.32%) or the average level of low-income (13.15%, 95% UI: 12.97%-13.33%), lower-middle income (12.53%, 95% UI: 12.39%-12.68%), upper-middle income (8.22%, 95% UI: 8.15%-8.29%) and high-income (8.75%, 95% UI: 8.67%-8.84%) countries. The DALYs rate (person-year /100 000) of preterm birth in China was 217.12 (95% UI: 191.30-246.69), lower than the average level of the world (886.81, 95% UI: 762.12-1 034.49), low-income (1 905.24, 95% UI: 1 542.35-2 377.54), lower-middle-income (1 349.98, 95% UI: 1 154.04-1 583.81) and upper-middle-income (366.56, 95% UI: 321.51-416.88) countries, but higher than the average level of high-income countries (206.21,95% UI: 179.96-234.90). From 1990 to 2019, the prevalence and DALYs rate of preterm birth in China showed a downward trend, with an average annual decline of 0.56% (95% CI:0.54%-0.58%) and 5.87% (95% CI:5.54%-6.19%), respectively. In general, the prevalence rate of preterm birth in men declined faster than that in women (men:0.64%, 95% CI: 0.62%-0.66%; women: 0.46%, 95% CI: 0.44%-0.48%), so as the DALYs rate (men:5.90%, 95% CI: 5.56%-6.24%; women:5.81%,95% CI: 5.50%-6.13%). Conclusions:From 1990 to 2019, the prevalence and DALYs rate of preterm birth in China showed an overall downward trend, and the decline rate was higher in men than in women. The etiological research on the risk factors of preterm birth, especially spontaneous preterm birth, should be further pursued, and a more comprehensive and precise monitoring, prevention, and health care system for preterm birth needs to be formulated.

Objective To analyze the correlations of D-dimer and the Global Registry of Acute Coronary Events(GRACE)score with long-term heart failure(HF)in patients with acute myocardial infarction(AMI).Methods A total of 398 patients with AMI were selected as research objects and divided into normal D-dimer group(n=309)and elevated D-dimer group(n=89)based on the D-dimer level.Cox proportional hazard model was used to analyze the risk factors for long-term HF in both groups.Time-dependent receiver operating characteristic(ROC)curve was used to analyze the values of D-dimer,GRACE score and their combination in predicting long-term HF.According to the GRACE score and D-dimer level,398 patients were divided into low-value group(181 patients with normal D-dimerand low GRACE score),high-value group(70 patients with elevated D-dimer and high GRACE score),and middle-value group(147 patients did not meet the conditions of the low-value and high-value groups).Kaplan-Meier method was used to analyze the occurrence of long-term HF in the three groups.Point-biserial analysis was used to analyze the correlation between elevated D-dimer and the occurrence of long-term HF.Results The number of patients with long-term HF in the elevated D-dimer group was 2.3 times of the normal group.D-dimer and GRACE score were independent risk factors for long-term HF in patients with AMI(P＜0.05).Both D-dimer and GRACE score had certain predictive values for the occurrence of HF at 5 years after AMI,but the predictive efficiency of GRACE score was better.The incidence of long-term HF in the high-value group was significantly higher than that in the low-value group and the middle-value group(P＜0.01).D-dimer was signif-icantly positively correlated with the occurrence of long-term HF after AMI(P＜0.001).Conclu-sion Both D-dimer and GRACE score are independent risk factors for long-term HF in patients with AMI,and the two indexes have certain predictive value for the occurrence of long-term HF.Patients with both elevated indicators are high-risk groups for long-term HF.

Objective To analyze the correlations of D-dimer and the Global Registry of Acute Coronary Events(GRACE)score with long-term heart failure(HF)in patients with acute myocardial infarction(AMI).Methods A total of 398 patients with AMI were selected as research objects and divided into normal D-dimer group(n=309)and elevated D-dimer group(n=89)based on the D-dimer level.Cox proportional hazard model was used to analyze the risk factors for long-term HF in both groups.Time-dependent receiver operating characteristic(ROC)curve was used to analyze the values of D-dimer,GRACE score and their combination in predicting long-term HF.According to the GRACE score and D-dimer level,398 patients were divided into low-value group(181 patients with normal D-dimerand low GRACE score),high-value group(70 patients with elevated D-dimer and high GRACE score),and middle-value group(147 patients did not meet the conditions of the low-value and high-value groups).Kaplan-Meier method was used to analyze the occurrence of long-term HF in the three groups.Point-biserial analysis was used to analyze the correlation between elevated D-dimer and the occurrence of long-term HF.Results The number of patients with long-term HF in the elevated D-dimer group was 2.3 times of the normal group.D-dimer and GRACE score were independent risk factors for long-term HF in patients with AMI(P＜0.05).Both D-dimer and GRACE score had certain predictive values for the occurrence of HF at 5 years after AMI,but the predictive efficiency of GRACE score was better.The incidence of long-term HF in the high-value group was significantly higher than that in the low-value group and the middle-value group(P＜0.01).D-dimer was signif-icantly positively correlated with the occurrence of long-term HF after AMI(P＜0.001).Conclu-sion Both D-dimer and GRACE score are independent risk factors for long-term HF in patients with AMI,and the two indexes have certain predictive value for the occurrence of long-term HF.Patients with both elevated indicators are high-risk groups for long-term HF.

AIM: To investigate the changes of retinal nerve fiber layer(RNFL)thickness, retinal thickness and blood flow density in different stages of diabetic retinopathy(DR)patients based on optical coherence tomography angiography(OCTA).METHODS: A retrospective analysis was conducted on 382 patients(382 eyes)diagnosed with DR in our hospital from February 2023 to February 2024. According to the staging criteria, the patients were divided into mild group(n=121), moderate group(n=133), severe group(n=72), and proliferative group(n=56). The general clinical data of the four groups of patients was compared; OCTA was used to scan and collect data from all patients, and the RNFL thickness, retinal thickness, and blood flow density were compared among the four groups of patients.RESULTS: There was no statistically significant difference in age, gender, hypertension, chronic kidney disease, and random blood glucose among patients in the mild, moderate, severe, and proliferative groups(all P>0.05). As the stage of DR worsened, the duration of the disease gradually prolonged(P<0.05). The thickness of the RNFL(superior, inferior, temporal, nasal, and average thickness)and retinal thickness significantly increased with the severity of DR(all P<0.001); however, there was no statistically significant difference in inferior RNFL thickness between the moderate and mild groups(P>0.05). The blood flow density in the superficial and deep retinal layers, as well as in the choroidal capillary layer, significantly decreased with the progression of DR(all P<0.05). Nevertheless, there was no statistically significant difference in superficial retinal blood flow density between the moderate and severe groups(P>0.05).CONCLUSION: OCTA can accurately observe the changes in RNFL thickness, retinal thickness, and blood flow density in patients with DR at different stages, which can serve as sensitive indicators for monitoring DR progression.