1.Qualitative study on the process evaluation of tobacco control intervention in junior high school
LIU Wanqi, CAO Yuan, SU Qi, LUO Chuning, ZENG Xinying, LIU Ying, LIU Fen, LIU Shiwei
Chinese Journal of School Health 2026;47(2):183-188
Objective:
To evaluate the implementation process of a school-family collaborative "online+offline" tobacco control intervention program in junior high school in Beijing and to explore the execution status, influencing factors and sustainability potential of the intervention, so as to provide evidence for optimizing youth tobacco control strategies.
Methods:
In November 2024, using the random number table method, four first year junior high school classes were selected from three schools each in Fengtai District, Tongzhou District, and Fangshan District of Beijing. One class served as the control group, while the other three classes were designated as intervention groups (one each for online intervention, offline intervention, and combined online offline intervention). The control group received only conventional education.The online intervention group was engaged in WeChat push interventions, including watching micro videos, viewing promotional materials, participating in online quizzes and mini games; the offline intervention group attended knowledge lectures, played peer games, and participated in offline knowledge competitions; the combined online offline intervention group integrated all the aforementioned online and offline intervention measures. The intervention period was from November 2024 to June 2025, spanning a total of 7 months. Based on the Practical, Robust Implementation and Sustainability Model(PRISM) framework, a qualitative research design was employed to conduct semi structured interviews with 48 participants (12 in each of the intervention groups and 12 organizational staff members) from the Centers for Disease Control and Prevention (CDC) in 3 districts and 3 sampled schools. The interview outlines were designed according to the intervention plan. Data was managed using Nvivo 12.0 software and analyzed following Colaizzi s seven step phenomenological analysis method. Theoretical saturation was assessed using a reserved subset of transcripts.
Results:
Four core themes were identified in the tobacco control intervention process. Overall fidelity of intervention implementation was largely consistent with the original plan, and students showed strong willingness and positive evaluations toward interactive formats such as knowledge contests and peer games, though occasional breakdowns in school-family communication and blurred boundaries between online and offline components were observed; the participants showed a polarized response in terms of satisfaction and participation, most students and parents recognized the significance of the activity, and some parents observed a reduction in smoking behavior; the implementation of internal tobacco control policies in the school was strict, and the atmosphere was favorable, but there was still room for improvement, such as the scarcity of community tobacco control activities and the difficulty in implementing smoke free units; implementation and sustainability infrastructure were preliminarily established, such as through homeroom teacher supervision and training student assistants to assisted in activities, while the sustainability support system required further refinement.
Conclusion
The school-family collaborative "online+offline" tobacco control intervention has demonstrated significant positive effects, but further optimization of activity design, enhancement of community reward mechanisms, and standardized training are required to improve the efficacy and sustainability of the intervention.
2.Causal Inference on Association Between Metabolic Syndrome and Breast Cancer: A Bidirectional Two-Sample Mendelian Randomization Study
Yi DU ; Mengyao XUE ; Huiying CHEN ; Ying SUN ; Tianyu LUO ; Haidong SUN
Cancer Research on Prevention and Treatment 2026;53(4):267-273
Objective To investigate the causal relationship between metabolic syndrome and breast cancer by using a bidirectional two-sample Mendelian randomization (MR) approach. Methods Genome-wide association study (GWAS) summary statistics for metabolic syndrome and breast cancer were acquired from the Integrative Epidemiology Unit GWAS database and the GWAS Catalog, with populations encompassing the United States and East Asia. A bidirectional causal design was employed: a forward analysis with metabolic syndrome as the exposure and breast cancer as the outcome, followed by a reverse analysis wherein their roles were interchanged. The inverse-variance weighting (IVW) method was primarily used for effect estimation, supplemented by MR-Egger regression, the weighted median method, the simple mode method, and the weighted mode method. Instrument variable strength was screened using the F-statistic (F>10). Robustness of the results was assessed through heterogeneity tests, horizontal pleiotropy tests, forest plots, and leave-one-out sensitivity analyses. Results The IVW analysis indicated no significant causal relationship between metabolic syndrome and breast cancer (OR=1.00, 95%CI: 0.97-1.03), P>0.05). Sensitivity analyses yielded consistent results, suggesting the good robustness of the study findings. Conclusion This study found no evidence to support a causal relationship, either positive or negative, between metabolic syndrome and breast cancer.
3.Varicella vaccination status in Changsha City: a study of birth cohort
Meiling LUO ; Ying ZHAGN ; Li LI ; Haobing YANG ; Haoyue QIU
Journal of Public Health and Preventive Medicine 2026;37(3):48-51
Objective To analyze the varicella vaccination rate in the 2012-2023 birth cohort in Changsha. Methods The varicella vaccination information of all children born in Changsha from 2012 to 2023 was collected through the Hunan Provincial Immunization Planning Information System. The varicella epidemic information from 2012 to 2023 was collected through the China Information System for Disease Control and Prevention. The varicella vaccination rate and its characteristics of children in the birth cohort were descriptively analyzed. Results The first dose vaccination rate of varicella vaccine for children born from 2012 to 2023 was 64.82 %, and the full vaccination rate was 40.87 %. The full vaccination rate of the birth cohort in each year ranged from 18.11 % (2020 birth cohort) -73.07 % (2017 birth cohort), showing an overall increasing trend year by year. Conclusion The varicella vaccination rate has increased among children born between 2012 and 2023 in Changsha, but overall coverage is low. It is necessary to strengthen the publicity of varicella vaccine knowledge and promote timely vaccination of school-age children.
4.Application value of simplified diagnosis and treatment strategies for chronic hepatitis C in human immunodeficiency virus/hepatitis C virus co-infection
Ying CAI ; Zhibin YANG ; Yang LUO ; Cong WANG ; Yongfen ZHU ; Ze LI ; Rusong YANG ; Qiang WU ; Wenbin DONG ; Shifu LI
Journal of Clinical Hepatology 2026;42(6):1287-1293
ObjectiveTo investigate the efficacy and safety of simplified diagnosis and treatment strategies and regimens in the treatment of patients with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infection. MethodsThis multicenter prospective real-world study was conducted among 198 patients with HIV/HCV co-infection who received hepatitis C treatment in 10 designated primary hospitals for hepatitis C in Yuxi, China from July 2023 to June 2024, and according to whether genotype detection was performed, they were divided into genotype detection group with 122 patients and non-genotype detection group with 76 patients. The patients were observed in terms of sustained virologic response at 12 weeks (SVR12), safety, and liver biochemical parameters. Propensity score matching was used to match the two cohorts, using caliper matching (caliper value = 0.02) at a ratio of 1∶1. The independent-samples t test or the Wilcoxon signed-rank test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between groups. ResultsAmong the 122 patients in the genotype detection group, 63.11% (77/122) had genotype 3, while the non-genotype detection group had 76 patients; both groups achieved an SVR12 rate of 100%. From baseline to 12 weeks after treatment, both groups had a significant increase in the serum level of albumin, significant reductions in the serum levels of total bilirubin, alanine aminotransferase, aspartate aminotransferase, and alpha-fetoprotein, and a significant reduction in FibroScan value (all P<0.05). A total of 54 patients (27.27%) experienced at least one adverse reaction, and anemia was the most common adverse reaction (38 patients, 19.19%), with an incidence rate of 50.00% (33/66) in patients with liver cirrhosis. HIV viral load remained <50 IU/mL before and after treatment, and there was no significant change in CD4+ T lymphocyte count after treatment (Z=-0.969, P=0.202). Compared with the genotype detection group, the non-genotype detection group had a significantly shorter time from positive HCV RNA testing to treatment initiation (4±2 days vs 19±4 days, t=5.321, P<0.05) and significantly lower testing costs (618±97 yuan vs 789±129 yuan, t=3.661, P<0.05). ConclusionFor patients with HIV/HCV co-infection, the simplified diagnosis and treatment strategies can achieve a relatively high SVR12 rate, improve biochemical indicators, and effectively reduce time cost and economic burden, with a favorable safety profile.
5.Study of Single-cell Adhesion Kinetics by Fluidic Force Microscopy
Si-Ying QIN ; Tian-Qi YOU ; Tao XU ; Yan LUO ; Xi HU
Progress in Biochemistry and Biophysics 2026;53(7):2000-2014
ObjectiveCell adhesion is a critical process that regulates cellular physiological functions. Quantitative characterization of adhesion dynamics is essential for elucidating the intrinsic mechanical mechanisms underlying cellular activities. Although atomic force microscopy-based single-cell force spectroscopy is widely used for single-cell adhesion measurements, it requires complex chemical modifications for preparation of live-cell probes, leading to limitations such as cumbersome operation, low throughput, and potential impacts on cell viability. Fluidic force microscopy, which combines atomic force microscopy with microfluidic probes, is a technique allowing the operation of force-controlled nanopipettes in aqueous environments. By applying negative or positive pressure via a pressure controller, a single living cell can be captured onto or released from the cantilever under physiological conditions. This procedure offers a simple workflow and high assay throughput for single-cell adhesion measurements without the need for chemical functionalization. In this study, fluidic force microscopy-based single-cell force spectroscopy was adopted to achieve long-term quantitative characterization of single-cell adhesion dynamics in a simpler and more efficient manner, comparing the dynamic differences in adhesion establishment between two cell lines with different differentiation levels. MethodsHEK 293T and hTERT RPE-1 cells were non-invasively captured on the cantilever of a fluidic force microscope via its integrated microfluidic system during 40 h of adhesion culture. Cell-substrate detachment assays were performed, and force-distance curves were recorded to extract key mechanical adhesion parameters, including adhesion force, adhesion energy, and maximum detachment distance. These measurements were combined with real-time monitoring of cell spreading area to systematically characterize the dynamic evolution of single-cell adhesion. ResultshTERT RPE-1 cells rapidly entered a stable adhesion phase within 1 h after seeding, with both area-normalized adhesion force and area-normalized adhesion energy reaching peak values. In contrast, HEK 293T cells required 4 h to achieve stable adhesion. Subsequently, the adhesion force, adhesion energy and maximum detachment distance of hTERT RPE-1 and HEK 293T cells stabilized at approximately 240 nN vs. 30 nN, 2.2 pJ vs. 0.12 pJ and 6 μm vs. 4 μm, respectively. hTERT RPE-1 cells reached the peak of area-normalized adhesion parameters earlier than HEK 293T cells, with their peak area-normalized adhesion force and area-normalized adhesion energy being substantially elevated relative to HEK 293T cells. HEK 293T cells presented stronger linear correlations among adhesion energy, maximum detachment distance and adhesion force compared with hTERT RPE-1 cells. For both cell lines, cell spreading area exhibited a weak correlation with adhesion force. Whereas the area-normalized adhesion parameters of HEK 293T cells remained relatively constant throughout the adhesion process, hTERT RPE-1 cells exhibited elevated values in the early phase, followed by a gradual decline. These results indicated distinct dynamic adhesion patterns between the two cell types, with hTERT RPE-1 cells exhibiting stronger adhesion strength and higher adhesion efficiency. ConclusionIn this study, fluidic force microscopy-based single-cell force spectroscopy was successfully applied to perform long-term in situ quantitative measurement of the adhesion dynamics in single adherent cells. The approach revealed divergent adhesion patterns between HEK 293T and hTERT RPE-1 cells, suggesting a close association between cell differentiation and adhesion behaviors. These findings provide quantitative mechanical evidence for further understanding the underlying mechanisms of cell adhesion.
6.Effects of music assisted drug treatment on behavioral and psychological symptoms and cognitive function in the elderly with moderate to severe dementia
Cairun LUO ; Hongyan MI ; Ying YANG ; Jiaqi LI ; Xiaobin YANG
Sichuan Mental Health 2025;38(3):235-240
BackgroundWith the acceleration of population aging in China, studies have documented an increased prevalence of dementia in the elderly. Behavioral and psychological symptoms and impaired cognitive function are important problems affecting the quality of life in the elderly with dementia. It has been noted that there are certain limitations on the management of problems mentioned above by drug treatment alone, while its combination with music intervention is emerging as an effective approach. However, the application of this approach in the elderly with moderate to severe dementia is still in its relative infancy. ObjectiveTo investigate the effect of music assisted drug treatment on behavioral and psychological symptoms and cognitive function in the elderly with moderate to severe dementia, so as to provide insights for the development of effective intervention. MethodsA randomized controlled study was utilized to enroll a coherent of 43 elderly patients with moderate to severe dementia who were hospitalized in Geriatric Psychiatry of Deyang Mental Health Center from January to July 2023 and met the International Classification of Diseases, tenth edition (ICD-10) diagnostic criteria for dementia. Eligible subjects were divided into study group (n=22) and control group (n=21) based on random allocation using SPSS 26.0. Both groups received routine drug treatment and nursing care, while the study group added music intervention, which consisted of two 30-minute sessions per week for 8 weeks. Neuro Psychiatric Inventory (NPI) and Mini-Mental State Examination (MMSE) were administered to all patients before and after intervention. ResultsA total of 36 patients completed the study, including 20 case in study group and 16 case in control group. No statistical difference was noted in baseline NPI score and MMSE score between two groups (P>0.05). After intervention, study group reported a statistical reduction in NPI total score [58.00 (49.00, 79.25) vs. 78.50 (55.00, 95.50), Z=-3.902, P<0.01)] along with a clinically unremarkable increase in MMSE score (P>0.05) compared with baseline data. After intervention, NPI total score and scores on sub-domains including agitation/aggression, depression/dysphoria, anxiety and aberrant motor behavior were all significantly lower in study group than those in control group (Z=-2.183, -2.438, -2.691, -3.716, -2.250, P<0.05 or 0.01), while there was no significant difference in MMSE score between two groups (P>0.05). ConclusionMusic assisted drugintervention may ameliorate behavioral and psychological symptoms in the elderly with moderate to severe dementia, while no significant improvement is documented on cognitive function. [Fund by the "14th Five Year Plan" for Philosophy and Social Sciences Research in Deyang (number, DY232C002)]
7.Optimization of Processing Technology of Honey Bran-fried Rosae Laevigatae Fructus and Analysis of Its Mechanism in Treatment of Ulcerative Colitis
Bin LIU ; Lingyun ZHONG ; Hongbing LUO ; Qi DENG ; Fuyu XU ; Simin ZHONG ; Ying ZHOU ; Xide YE ; Feipeng GONG ; Yuncheng GU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(16):216-224
ObjectiveTo optimize the processing technology of honey bran-fried Rosae Laevigatae Fructus(h-RLF), formulate relevant quality standards, and explore its improving effect and mechanism on mice with ulcerative colitis(UC) induced by dextran sodium sulfate(DSS). MethodsTaking the content of polysaccharides and water-soluble extract as the indexes, L9(34) orthogonal test was used to optimize parameters of the amount of honey bran, frying time and frying temperature. The quality of 15 batches of h-RLF decoction pieces was evaluated according to the optimized process, and the inspection limit standard was preliminarily drawn up. Eighty SPF male Kunming mice were randomly divided into 8 groups, including the blank group, model group, mesalazine group(0.13 g·kg-1), RLF group(3.77 g·kg-1), bran-fried RLF group(3.77 g·kg-1), h-RLF low, medium and high dose groups(1.89, 3.77, 7.54 g·kg-1), with 10 mice in each group. The mice in the blank group were free to drink pure water, and the other groups were free to drink 3% DSS solution for 7 days to prepare UC mouse model. Each treatment group was given corresponding drugs by intragastric administration, and the blank and model groups were given equal volume of normal saline. The body weight of mice was recorded daily and the disease activity index(DAI) was calculated. After the administration, the colon tissues of mice were collected to observe the pathological changes by hematoxylin-eosin(HE) staining. The levels of tumor necrosis factor(TNF)-α, interleukin(IL)-1β, IL-6 and IL-10 in the colon of mice were detected by enzyme-linked immunosorbent assay(ELISA). Western blot was used to detect the expression levels of phosphorylation nuclear transcription factor-κB p65(p-NF-κB p65), Toll-like receptor 4(TLR4), p-p38 mitogen-activated protein kinase(p-p38 MAPK), p-extracellular signal-regulated kinase(p-ERK) and p-c-Jun N-terminal kinase(p-JNK) proteins in colon tissues. ResultsThe optimum processing technology of h-RLF was 20 g honey bran per 100 g RLF, and stir-frying at 200 ℃ for 8 min. The limit standard under the examination of h-RLF was preliminarily formulated as follows:the polysaccharide content should not be less than 25% based on anhydrous glucose(C6H12O6), the content of water-soluble extract should not be less than 38%, the moisture content should not be more than 12.0%, the total ash content should not be more than 5.0%, and the acid-insoluble ash content should not be more than 1.0%. The cluster heat map analysis showed that the quality of RLF from Huanggang, Hubei province was better. Animal experiments showed that compared with the blank group, the DAI score of the model group was significantly increased, the levels of TNF-α, IL-1β and IL-6 in the colon tissue were significantly increased, the IL-10 level was significantly decreased, the colonic mucosa was seriously damaged, accompanied by a large number of inflammatory cell infiltration, tissue congestion and a significant reduction in glands, and the expression levels of p-NF-κB p65, TLR4, p-p38 MAPK, p-ERK and p-JNK proteins were significantly increased(P<0.01). Compared with the model group, each administration group could alleviate the symptoms of colonic ulcer, the structure of colonic crypt was basically intact, and the glands were arranged in an orderly manner. Among them, the high-dose group of h-RLF had a better effect, which could significantly reduce the DAI score and the levels of TNF-α, IL-1β and IL-6 in colon tissue(P<0.01), and significantly increase the level of IL-10(P<0.01), alleviate the colonic mucosal injury, and effectively inhibit the expression levels of p-NF-κB p65, TLR4, p-p38 MAPK, p-ERK and p-JNK proteins(P<0.01). ConclusionThe key parameters of the processing technology of h-RLF are determined, and the optimized technology is stable and feasible. The established quality standard is simple and reliable, and can be used for the quality control. h-RLF can effectively alleviate DSS-induced UC, and its mechanism may be related to inhibiting the activation of NF-κB/TLR4/MAPK pathway.
8.Analysis of human parvovirus B19 nucleic acid detection in blood products in China
Yue WANG ; Xiaobei ZHENG ; Qin GONG ; Ying ZHAO ; Yuanxiu LUO ; Dandan YANG ; Linlin ZHANG ; Zheng JIANG ; Gan PENG ; Jin ZHANG ; Bingbing KE
Chinese Journal of Blood Transfusion 2025;38(7):950-957
Objective: To analyze the nucleic acid load of human parvovirus B19 in major commercially available blood products in China, including human albumin, human intravenous immunoglobulin, human rabies immunoglobulin and various coagulation factor products, aiming to provide evidence for improving blood product manufacturing processes and quality control of source plasma. Methods: A total of 98 batches of coagulation factor products were tested for human parvovirus B19 nucleic acid using real-time fluorescent quantitative PCR, including 42 batches of human prothrombin complex, 35 batches of human coagulation factor Ⅷ, and 21 batches of human fibrinogen. Additionally, 6 batches of human albumin, 6 batches of human intravenous immunoglobulin, and 38 batches of human rabies immunoglobulin were tested for human parvovirus B19 nucleic acid. Results: Human parvovirus B19 nucleic acid were undetectable in human albumin, human intravenous immunoglobulin and human rabies immunoglobulin. Among the 98 batches of coagulation factor products tested for human parvovirus B19 nucleic acid, B19 nucleic acid reactivity rate was 69.0% (29/42) for human prothrombin complex batches, but nucleic acid concentration were all significantly lower than 10
IU/mL. The reactivity rate of B19 nucleic acid in 35 batches of human coagulation factor Ⅷ was 48.6% (17/35), with nucleic acid concentration all below 10
IU/mL. The reactivity rate of B19 nucleic acid in 21 batches of human fibrinogen was 61.9% (13/21), with nucleic acid concentration all below 10
IU/mL. Conclusion: No human parvovirus B19 has been detected in human albumin, human intravenous immunoglobulin, or human rabies immunoglobulin. Human parvovirus B19 nucleic acid may exist in commercially available coagulation factor products, highlighting the need for enhanced screening of human parvovirus B19 nucleic acid in these products. It is also recommended that B19 viral nucleic acid testing be conducted on source plasma, particularly for coagulation factor products.
9.Analysis of human parvovirus B19 nucleic acid detection in blood products in China
Yue WANG ; Xiaobei ZHENG ; Qin GONG ; Ying ZHAO ; Yuanxiu LUO ; Dandan YANG ; Linlin ZHANG ; Zheng JIANG ; Gan PENG ; Jin ZHANG ; Bingbing KE
Chinese Journal of Blood Transfusion 2025;38(7):950-957
Objective: To analyze the nucleic acid load of human parvovirus B19 in major commercially available blood products in China, including human albumin, human intravenous immunoglobulin, human rabies immunoglobulin and various coagulation factor products, aiming to provide evidence for improving blood product manufacturing processes and quality control of source plasma. Methods: A total of 98 batches of coagulation factor products were tested for human parvovirus B19 nucleic acid using real-time fluorescent quantitative PCR, including 42 batches of human prothrombin complex, 35 batches of human coagulation factor Ⅷ, and 21 batches of human fibrinogen. Additionally, 6 batches of human albumin, 6 batches of human intravenous immunoglobulin, and 38 batches of human rabies immunoglobulin were tested for human parvovirus B19 nucleic acid. Results: Human parvovirus B19 nucleic acid were undetectable in human albumin, human intravenous immunoglobulin and human rabies immunoglobulin. Among the 98 batches of coagulation factor products tested for human parvovirus B19 nucleic acid, B19 nucleic acid reactivity rate was 69.0% (29/42) for human prothrombin complex batches, but nucleic acid concentration were all significantly lower than 10
IU/mL. The reactivity rate of B19 nucleic acid in 35 batches of human coagulation factor Ⅷ was 48.6% (17/35), with nucleic acid concentration all below 10
IU/mL. The reactivity rate of B19 nucleic acid in 21 batches of human fibrinogen was 61.9% (13/21), with nucleic acid concentration all below 10
IU/mL. Conclusion: No human parvovirus B19 has been detected in human albumin, human intravenous immunoglobulin, or human rabies immunoglobulin. Human parvovirus B19 nucleic acid may exist in commercially available coagulation factor products, highlighting the need for enhanced screening of human parvovirus B19 nucleic acid in these products. It is also recommended that B19 viral nucleic acid testing be conducted on source plasma, particularly for coagulation factor products.
10.Association between urinary metal mixtures and mild cognitive impairment among elderly residents in Guangdong compounds
Chuijia KONG ; Ying ZHANG ; Zhenkun TAN ; Junjiao PING ; Haibo ZHANG ; Jiali LUO ; Xinxia LIU
Journal of Environmental and Occupational Medicine 2025;42(8):893-899
Background Environmental metal exposure is closely associated with the onset and progression of mild cognitive impairment (MCI) in the elderly. Effectively identifying hazardous metal exposure and assessing their interaction effects have significant public health implications. Objective To explore the relationship between urinary single metal and metal mixture exposure and MCI in elderly compound residents. Methods This study included 391 elderly individuals aged 60 and above from residential compounds in Zhongshan City, Guangdong Province. Concentrations of iron (Fe), copper (Cu), selenium (Se), arsenic (As), cadmium (Cd), manganese (Mn), chromium (Cr), nickel (Ni), vanadium (V), cobalt (Co), antimony (Sb), thallium (Tl), zinc (Zn), calcium (Ca), and magnesium (Mg) in urine were measured using inductively coupled plasma mass spectrometry. Cognitive function in the elderly was assessed using the Chinese version of the Mini-Mental State Examination (MMSE). Logistic regression was used to explore the relationship between single metal exposure level and MCI. LASSO regression and multi-metal logistic regression models were used to identify key metal ions associated with MCI. Bayesian kernel machine regression (BKMR) was employed to analyze the relationship between key metal ion mixtures and MCI, as well as the interactions between metals. Age, gender, education level, occupation, and body mass index were adjusted as covariates. Results A total of 78 among the 391 elderly individuals surveyed (19.94%) were diagnosed with MCI (MCI group), and the other 313 individuals were controls. The levels of Se, Cd, Mn, and As in the urine of the MCI group were significantly higher than those in the control group (P < 0.05). In the single-metal model, after adjusting for covariates and using the first quartile (Q1) of each metal concentration as the reference, the OR for MCI in the elderly in the Q4 group of Se was 2.190 (95%CI: 1.017, 4.716); for Cd, the OR was 2.345 (95%CI: 1.041, 5.283) in the Q3 group and 2.371 (95%CI: 1.043, 5.393) in the Q4 group; for Mn, the OR was 2.355 (95%CI: 1.038, 5.344) in the Q2 group; for As, the OR was 3.377 (95%CI: 1.442, 7.908) in the Q3 group and 2.886 (95%CI: 1.227, 6.788) in the Q4 group; for Sb, the OR was 2.779 (95%CI: 1.234, 6.257) in the Q2 group. When urinary metal concentrations were ln-transformed and included as continuous variables in the single-metal model, Cd concentration was positively correlated with MCI (OR=1.377; 95%CI: 1.008, 1.882; P=0.044). Cd, Se, Mg, Ca, Mn, As, Cr, Co, Tl, and Sb were selected by the LASSO regression model and included in the multi-metal model. In the multi-metal model, compared with Q1, the OR for MCI in the elderly was 0.395 (95%CI: 0.164, 0.953) in the Q2 group of Co and 0.390(95%CI: 0.167,0.911) in the Q3 group of Co; for Mn, the OR in the Q2 group was 2.636 (95%CI: 1.053, 6.596); for Sb, the OR in the Q2 group was 2.640 (95%CI: 1.047, 6.658). As continuous variables, Mg (OR=0.472; 95%CI: 0.248, 0.899; P=0.022) and Co (OR=0.857; 95%CI: 0.737, 0.996; P=0.044) concentrations were negatively correlated with MCI. The BKMR mixture analysis suggested that Mg and Co exhibited a synergistic negative correlation with MCI, while Mn and Sb exhibited a synergistic positive correlation with MCI. Mg and Co attenuated the positive correlation of Mn and Sb with MCI, whereas Mn weakened the protective effects of Mg and Co. Conclusion Elevated levels of Se, Cd, As, Mn, and Sb in urine may increase the risk of MCI in the elderly, while Mg and Co have protective effects. Potential synergistic or antagonistic interactions may be found among Mn, Sb, Mg, and Co, which should not be overlooked in terms of their impact on the cognitive function of the elderly.


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