Objective: To analyze the mediating effect of self-efficacy on the relationship between social support and depression symptoms among elderly patients with type 2 diabetes mellitus (T2DM), so as to provide the evidence for improving mental health intervention strategies in this population. Methods: From June to July 2024, elderly patients aged ≥60 years with T2DM receiving basic public health management services were recruited from four community health service centers in Nanjing City using convenience sampling. Demographic and disease-related information were collected through questionnaire surveys. Depression symptoms, self-efficacy, and social support were assessed using the 9-item Patient Health Questionnaire, the Diabetes Self-Efficacy Scale, and the Social Support Rating Scale, respectively. A structural equation model was constructed using Mplus 8.3 to examine the mediating effect of self-efficacy on social support and depression symptoms. The significance of the mediating effect was tested using the Bootstrap method. Results: A total of 604 elderly patients with T2DM were surveyed. The median age was 72.00 (interquartile range, 9.00) years. There were 292 males (48.34%) and 312 females (51.66%). The median score of depression symptoms was 2.00 (interquartile range, 5.00) points. A total of 176 participants were identified as having depressive symptoms, with a detection rate of 29.10%. The median scores of self-efficacy and social support were 4.11 (interquartile range, 0.78) and 39.00 (interquartile range, 11.00) points, respectively. The mediation analysis showed that social support had a direct negative effect on depression symptoms among elderly patients with T2DM, with an effect value of -0.137 (95%CI: -0.226 to -0.043). Social support also indirectly affected depression symptoms through self-efficacy, with an effect value of -0.066 (95%CI: -0.099 to -0.037). The mediating effect accounted for 32.51% of the total effect. Conclusions Self-efficacy plays a partial mediating role between social support and depressive symptoms among elderly patients with T2DM. It is recommended to reduce the risk of depression symptoms in this population by improving social support levels and enhancing self-efficacy.

Objective:To analyze the intention to receive influenza vaccination and its associated factors among urban and rural residents aged≥50 in Zhejiang Province, China, in 2024.Methods:This cross-sectional study was conducted between March and May 2024 through a multi-stage intercept survey in 35 counties (cities, districts) selected from a total of 90 in Zhejiang Province, involving 175 communities/villages. The survey targeted residents visiting local hospitals and community health service centers/community health clinics. The questionnaire included basic demographic information, knowledge related to influenza prevention and treatment, chronic disease status, history of influenza vaccination, and intention to vaccinate. Urban and rural residents were classified based on their registered residence, according to the "Rules for Compilation of Statistical Regional Code and Urban-Rural Division Code" issued by the National Bureau of Statistics. Chi-square tests, ANOVA, and multivariate logistic regression models were used to analyze the factors influencing the intention to receive the influenza vaccine.Results:A total of 10 500 participants were surveyed, comprising 4 885 rural residents (46.52%) and 5 615 urban residents (53.48%). Of these, 3 430 rural residents (70.21%) and 3 718 urban residents (66.22%) expressed intention to receive the influenza vaccine. Multivariate logistic regression analysis revealed that for rural residents aged≥50, younger age groups (50-59 years: OR=1.747, 95% CI: 1.290-2.366; 60-69 years: OR=1.838, 95% CI: 1.401-2.411), history of influenza vaccination ( OR=6.721, 95% CI: 5.152-8.767), doctor′s recommendation for vaccination ( OR=3.788, 95% CI: 3.078-4.662), and higher scores on knowledge related to influenza prevention and treatment ( OR=1.090, 95% CI: 1.054-1.128) were significant promoting factors for vaccination intent. For urban residents aged≥50, belonging to the 60-69 age group ( OR=1.264, 95% CI: 1.023-1.563), history of influenza vaccination ( OR=5.392, 95% CI: 4.309-6.748), doctor′s recommendation for vaccination ( OR=5.307, 95% CI: 4.420-6.371), and higher scores on knowledge related to influenza prevention and treatment ( OR=1.051, 95% CI: 1.021-1.082) were significant promoting factors for vaccination intent. Conclusions:The intention to receive the influenza vaccination is notably high among residents aged≥50 in both urban and rural areas of Zhejiang Province, yet there remains potential for improvement. Age, history of influenza vaccination, doctor recommendation, and knowledge related to influenza prevention and treatment are significant factors influencing the intention to receive the influenza vaccination.

Objective:To analyze the pneumococcal vaccination rate and the influencing factors among residents aged≥50 in Zhejiang Province.Methods:This cross-sectional study was conducted between March and May 2024. A multi-stage intercept survey was used to intercept and survey 10 500 residents who visited or underwent physical examinations at 175 community health service centers/clinics in 35 counties (cities, districts) of Zhejiang Province. The questionnaire included basic demographic characteristics, history of pneumonia, chronic disease conditions, pneumococcal vaccination status, doctor recommendation, reasons for vaccination/non-vaccination, and channels for obtaining pneumococcal vaccine information. Participants were grouped based on demographic characteristics, chronic diseases conditions, history of pneumonia and doctor recommendations. The chi-square test was used to assess differences in vaccination rates among demographic groups while binary logistic regression models were used to identify factors affecting the vaccination rate.Results:Among the 10 500 surveyed participants, 1 724 (16.42%) had received pneumococcal vaccination. Binary logistic regression analysis revealed significantly higher vaccination rates among those who received a doctor recommendation compared to those without (26.25% vs 7.59%; OR=4.414, 95% CI: 3.851-5.059). Participants benefiting from the free vaccination policy showed higher vaccination rates than those who didn′t (47.59% vs 5.18%; OR=12.527, 95% CI: 10.723-14.634). The top three reasons for getting vaccinated against pneumonia were the free vaccination policy (65.43%), community promotion (52.15%), and family recommendations (42.34%). The top three sources through which respondents learned about the pneumococcal vaccine were television (64.64%), doctors (59.81%) and family members (50.92%). Conclusion:The pneumococcal vaccination rate among residents aged≥50 years in Zhejiang Province is relatively high but still needs further improvement, with vaccination rates closely associated with factors such as free vaccination policy and doctor recommendation.

Metabolic dysfunction-associated steatotic liver disease (MASLD) comprises a spectrum of liver injuries, including steatosis to steatohepatitis (MASH), liver fibrosis, cirrhosis, and relevant complications. The liver mainly comprises hepatocytes, liver sinusoidal endothelial cells (LSECs), Kupffer cells (KCs), immune cells (T cells, B cells), and hepatic stellate cells (HSCs). Crosstalk among these different liver cells, endogenous aberrant glycolipid metabolism, and altered gut dysbiosis are involved in the pathophysiology of MASLD. This review systematically examines advances in understanding the molecular pathogenesis of MASLD, with a focus on emerging therapeutic targets and translational clinical trials. We first delineate the crucial regulatory mechanisms involving diverse liver cells and the gut-liver axis in MASLD development. These cell-specific pathogenic insights offer valuable perspectives for advancing precision medicine approaches in MASLD treatment. Furthermore, we evaluate potential therapeutic targets and summarize clinical trials currently underway. By comprehensively updating the MASLD pathophysiology and identifying promising strategies, this review aims to facilitate the development of novel pharmacotherapies for this increasingly prevalent condition.
Humans ; Fatty Liver/therapy* ; Animals ; Liver/pathology* ; Kupffer Cells/metabolism* ; Hepatocytes/metabolism* ; Hepatic Stellate Cells/metabolism*

Objective:To analyze the intention to receive influenza vaccination and its associated factors among urban and rural residents aged≥50 in Zhejiang Province, China, in 2024.Methods:This cross-sectional study was conducted between March and May 2024 through a multi-stage intercept survey in 35 counties (cities, districts) selected from a total of 90 in Zhejiang Province, involving 175 communities/villages. The survey targeted residents visiting local hospitals and community health service centers/community health clinics. The questionnaire included basic demographic information, knowledge related to influenza prevention and treatment, chronic disease status, history of influenza vaccination, and intention to vaccinate. Urban and rural residents were classified based on their registered residence, according to the "Rules for Compilation of Statistical Regional Code and Urban-Rural Division Code" issued by the National Bureau of Statistics. Chi-square tests, ANOVA, and multivariate logistic regression models were used to analyze the factors influencing the intention to receive the influenza vaccine.Results:A total of 10 500 participants were surveyed, comprising 4 885 rural residents (46.52%) and 5 615 urban residents (53.48%). Of these, 3 430 rural residents (70.21%) and 3 718 urban residents (66.22%) expressed intention to receive the influenza vaccine. Multivariate logistic regression analysis revealed that for rural residents aged≥50, younger age groups (50-59 years: OR=1.747, 95% CI: 1.290-2.366; 60-69 years: OR=1.838, 95% CI: 1.401-2.411), history of influenza vaccination ( OR=6.721, 95% CI: 5.152-8.767), doctor′s recommendation for vaccination ( OR=3.788, 95% CI: 3.078-4.662), and higher scores on knowledge related to influenza prevention and treatment ( OR=1.090, 95% CI: 1.054-1.128) were significant promoting factors for vaccination intent. For urban residents aged≥50, belonging to the 60-69 age group ( OR=1.264, 95% CI: 1.023-1.563), history of influenza vaccination ( OR=5.392, 95% CI: 4.309-6.748), doctor′s recommendation for vaccination ( OR=5.307, 95% CI: 4.420-6.371), and higher scores on knowledge related to influenza prevention and treatment ( OR=1.051, 95% CI: 1.021-1.082) were significant promoting factors for vaccination intent. Conclusions:The intention to receive the influenza vaccination is notably high among residents aged≥50 in both urban and rural areas of Zhejiang Province, yet there remains potential for improvement. Age, history of influenza vaccination, doctor recommendation, and knowledge related to influenza prevention and treatment are significant factors influencing the intention to receive the influenza vaccination.

Objective:To analyze the pneumococcal vaccination rate and the influencing factors among residents aged≥50 in Zhejiang Province.Methods:This cross-sectional study was conducted between March and May 2024. A multi-stage intercept survey was used to intercept and survey 10 500 residents who visited or underwent physical examinations at 175 community health service centers/clinics in 35 counties (cities, districts) of Zhejiang Province. The questionnaire included basic demographic characteristics, history of pneumonia, chronic disease conditions, pneumococcal vaccination status, doctor recommendation, reasons for vaccination/non-vaccination, and channels for obtaining pneumococcal vaccine information. Participants were grouped based on demographic characteristics, chronic diseases conditions, history of pneumonia and doctor recommendations. The chi-square test was used to assess differences in vaccination rates among demographic groups while binary logistic regression models were used to identify factors affecting the vaccination rate.Results:Among the 10 500 surveyed participants, 1 724 (16.42%) had received pneumococcal vaccination. Binary logistic regression analysis revealed significantly higher vaccination rates among those who received a doctor recommendation compared to those without (26.25% vs 7.59%; OR=4.414, 95% CI: 3.851-5.059). Participants benefiting from the free vaccination policy showed higher vaccination rates than those who didn′t (47.59% vs 5.18%; OR=12.527, 95% CI: 10.723-14.634). The top three reasons for getting vaccinated against pneumonia were the free vaccination policy (65.43%), community promotion (52.15%), and family recommendations (42.34%). The top three sources through which respondents learned about the pneumococcal vaccine were television (64.64%), doctors (59.81%) and family members (50.92%). Conclusion:The pneumococcal vaccination rate among residents aged≥50 years in Zhejiang Province is relatively high but still needs further improvement, with vaccination rates closely associated with factors such as free vaccination policy and doctor recommendation.