Objective:To analyze the association between household and leisure-time physical activity (HLPA) and the risk of cardiometabolic multimorbidity (CMM) in the elderly.Methods:This retrospective cohort study utilized three longitudinal datasets from the Chinese Longitudinal Healthy Longevity and Happy Family Study (CLHLS-HF) covering 2008-2018, 2011-2018, and 2014-2018. A total of 10 876 participants aged ≥65 years who completed at least one follow-up were enrolled for cohort analysis. The general data, lifestyle, histories of chronic diseases, and physical examination results were collected. The HLPA score was utilized as an indicator to assess the degree of HLPA participation of the study subjects, the subjects were divided into 4 groups by quartile of HLPA score (Q1, Q2, Q3, and Q4), and were stratified jointly by sex, type of residence and household income; stratified Cox regression was applied to analyze the association between HLPA score and the risk of CMM morbidity, and Cox regression combined with restricted cubic spline (RCS) model was utilized to analyze the dose-response relationship between HLPA score and CMM morbidity.Results:The cohort was observed for a total of 51 630.24 person-years, with a median follow-up time of 3.95 (2.57, 6.04) years, with 576 new cases of CMM and an incidence density of 11.16 per 1 000 person-years. Compared with the HLPA score Q1 group, the risk of CMM morbidity was significantly reduced by 31%, 41%, and 44% in the elderly in the Q2 ( HR=0.69, 95% CI: 0.53-0.90), Q3 ( HR=0.59, 95% CI: 0.45-0.77) and Q4 ( HR=0.56, 95% CI: 0.42-0.74) groups, respectively (all P<0.05). The HLPA score was non-linearly associated with CMM morbidity ( P for nonlinear=0.010), with the risk of CMM morbidity decreasing with the increase of HLPA score, with a significant downward trend up to the median, after which the decline leveled off. There was an interaction between the HLPA score and exercise ( P for interaction=0.016); there was a negative association between the HLPA score and the risk of CMM morbidity in the no-exercise population ( HR=0.65, 95% CI: 0.52-0.80, P<0.001). Conclusion:There is a nonlinear negative association between HLPA and the risk CMM morbidity in elderly in China, and interventions focused on those who do not exercise may yield better results.

Objective:To analyze the co-morbidity patterns of chronic diseases among the elderly in China and provide suggestions for health management strategies.Methods:It was a cross-sectional study. A total of 9 383 respondents aged ≥60 years with complete data of key variables (chronic disease status, age, gender, marital status, etc.) in the 2020 China Health and Aged Care Tracking Survey (CHARLS) dataset were selected as study subjects. Systematic clustering was used to analyze the pattern of multimorbidity among urban and rural elderly, and probit model was used to analyze the relevant factors associated with the risk of multimorbidity in order to provide suggestions for health management strategies.Results:There were similarities in the multimorbidity patterns of chronic diseases among the elderly in both urban and rural areas in China, including emotional and mental problems, Parkinson′s disease and malignant tumors such as cancer as a group of psychosomatic and neurodegenerative disease pattern, and stroke, asthma and liver disease as a group of inflammatory response disease pattern. However, there were differences, with dyslipidemia clustered as a separate group among the urban elderly, and memory-related diseases with diabetes or elevated blood glucose, chronic lung disease and kidney disease clustered as another group; and in rural elderly, gastric or digestive disorders were clustered with memory-related disorders, diabetes or elevated blood glucose, chronic lung disease, and kidney disease. Registered residence in rural areas ( Z=-0.530), and heavy physical activity (Z=-0.024) were negatively with the risk of multimorbidity. Age ( Z=0.037), alcohol consumption ( Z=0.037), smoking ( Z=0.042), depression score ( Z=0.130), and length of sleep ( Z=0.027) were positively correlated with the risk of multimorbidity (all P<0.05), with domicile location being the most strongly associated factor, and depression score being the second one. Conclusion:The pattern of chronic disease co-morbidity among the elderly in China differs between urban and rural areas. It is recommended that targeted chronic disease management strategies should be developed based on the characteristics of chronic disease co-morbidity among the elderly in urban and rural areas in China to improve the effectiveness of chronic disease co-morbidity prevention and management.

Objective:To analyze the infection status and influencing factors of Helicobacter pylori ( Hp) in healthy children. Methods:This is a cross-sectional study. The data of 684 children aged 3 to 14 years who underwent the 13C urea breath test in the Health Management Center of Fuwai Central China Cardiovascular Hospital from December 2022 to December 2023 were retrospectively collected, and 652 of them who met the criteria were included in the analysis. According to whether they were infected with Hp, the children were divided into the infected group and the non-infected group, and the differences in age, gender, living habits and other aspects between the two groups were compared. Multivariate logistic regression analysis was used to analyze the factors influencing Hp infection. Results:Among the 652 children, there were 134 cases in the infected group and 518 cases in the non-infected group, with an Hp infection rate of 20.6%. The Hp infection rate showed an upward tendency with age. The Hp infection rates in children aged 3 to 5 years, 6 to 11 years, and 12 to 14 years were 12.6%, 22.0%, and 25.2% respectively ( χ 2=9.862, P=0.007). Univariate analysis showed that the proportions of Hp infection were higher in children who never washed their hands, ate in school cafeterias, did not have separate meals, were fed with chewed food, bit their fingers or toys, lived with relatives who had a history of gastrointestinal diseases, had low family income, had parents with low educational level, and were mixed/artificially fed during infancy, which were 26.1%, 24.1%, 25.4%, 25.7%, 26.0%, 25.8%, 25.1%, 23.7%, and 23.6% respectively (all P<0.05). Multivariate analysis showed that separate meals, good handwashing habits, and high family income were protective factors against Hp infection ( OR=0.689, 0.779, 0.602, P=0.004, 0.013, 0.019), while feeding with chewed food was a risk factor for Hp infection ( OR=1.998, P=0.001). Conclusion:The Hp infection rate of children undergoing health examination in Zhengzhou is at low level, and the main influencing factors are separate meals, handwashing habits, feeding with chewed food, and family income.

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 explore the correlation between triglyceride glucose index (TyGI) and hyperuricemia (HUA) in theindividuals undergoing physical examinations.Methods:It was a cross-sectional study. A total of 21 720 individuals who underwent health examinations at the Health Management Center of Xiangya Hospital, Central South University from October 2020 to March 2021 were selected as the research subjects. Based on whether uric acid levels exceeded the normal range, the participants were divided into a HUA group and a control group (normal uric acid group). The independent correlation between TyGI and HUA was determined with multiple logistic regression analysis, and stratified analysis was conducted to investigate population differences in the correlation. And finally, a further evaluation was conducted to determine whether there was a nonlinear relationship between TyGI and HUA through smooth curve fitting and threshold saturation effect analysis.Results:The TyGI in the HUA group was significantly higher than that in the control group ( t=-41.787, P<0.001). After adjusting for relevant factors, the multiple logistic regression analysis showed that there was a significant positive correlation between TyGI and risk of HUA ( OR=1.755, 95% CI: 1.632-1.887); and as TyGI increased, the risk of HUA gradually increased. Stratified analysis and interaction tests were conducted based on age, gender, body mass index, blood glucose abnormalities, hypertension, and estimated glomerular filtration rate (eGFR), it′s indicated that TyGI was positively correlated with the risk of HUA in various populations except for in the individuals with a eGFR less than 60 ml·min -1·(1.73 m 2) -1 and in females (all P>0.05). The smooth curve fitting between TyGI and HUA suggested that as TyGI increased, the risk of HUA tended to increase. However, when TyGI reached a certain threshold, the risk of HUA no longer increased. Further analysis of threshold saturation effects suggested that the inflection point of TyGI was 9.871. Conclusion:The correlation between TyGI and HUA in the population undergoing health examinations is nonlinear.

Objective:To construct a scoring system for the main examination report of health examination and evaluate its effect.Methods:A historical control study design was used in this study. By sorting out the problems in 321 main examination reports from December 2023 by equal proportion random sampling method, the quality control plan of main examination report of 2024 was formulated and the "Quality Control Rating Table of Checkup Summary Report" was constructed, which included the principle of conclusion words, classification, sorting, dynamic comparison, disease analysis, health guidance, consistency, completeness, language expression, timeliness and physician. Each principle had its corresponding scoring standard, with a total score of 100 points, 91-100 classified as grade A, 61-90 classified as grade B, and≤60 classified as grade C. According to the "Quality Control Rating Table of Checkup Summary Report", 1 691 main examin reports from January to June 2024 were selected for analysis. In addition, the differences of those reports were analyzed according to categories of primary examination physicians in internal medicine and subspecialties.Results:Compared with December 2023, the proportion of grade A report in June 2024 increased by 111.3% ( χ2=133.38, P<0.001), while the proportion of grade B and C reports decreased by 84.7% ( χ2=61.82, P<0.001) and 97.6% ( χ2=42.36, P<0.001), respectively. In terms of scoring principles, compared with December 2023, the error rates of conclusion words, disease analysis, health guidance and consistency in June 2024 were improved by 54.9%, 46.7%, 62.9% and 100.0%, respectively ( χ2=27.68, 13.41, 48.34 and 7.84, all P<0.001). Additionally, compared with 2023, the total scores of the checkup summary reports of internal medicine and subspecialties in 2024 were increased by 6.8% ( t=-6.843, P<0.001) and 12.6% ( t=-5.321, P<0.001), respectively. Conclusion:The scoring system constructed through the"Quality Control Rating Table of Checkup Summary Report"is scientific, reasonable and practical, which can effectively improve the quality of the main examination report and has strong operability.

Objective:To analyze the correlation between mental health status and metabolic syndrome (MetS) in health checkup people.Methods:It was a cross-sectional study, 2 920 participants who received health checkup in the Health Examination Center of Peking University Third Hospital from January 2019 to December 2023 were selected using cluster sampling method. Their general information, physical examination, biochemical indicators, body composition, and self-evaluation scores on the Symptom Checklist-90 (SCL-90) were collected. According to the inclusion and exclusion criteria, a total of 2 813 study subjects were included, and divided into the MetS group and the non-MetS group based on whether they had MetS. The differences in general demographic information, body composition, blood biochemistry, and SCL-90 scores between the two groups were compared. Binary Logistic regression analysis was used to explore the correlation between mental health status and MetS.Results:Of the 2 813 subjects included, 1 576 were males (56.0%) and 1 237 were females (44.0%), with an average age of (41.7±11.0) years, the MetS group had 586 cases (20.8%) and the non-MetS group had 2 227 cases (79.2%). The MetS group had higher levels of age, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, low density lipoprotein cholesterol (LDL-C), fasting blood glucose, glycosylated hemoglobin (HbA 1c), free thyroxine(FT4), total triiodothyronine (TT3), free triiodothyronine (FT3), waist-to-hip ratio, visceral fat area, body fat percentage, uric acid/creatinine, homocysteine (Hcy), aspartate aminotransferases (AST), and alanine transaminase (ALT) levels, as well as higher scores for somatization, hostility, paranoia, and other factor compared to the non-MetS group (all P<0.05), while high density lipoprotein cholesterol (HDL-C) and estimated glomerular filtration rate (eGFR) levels were lower than those in the non-MetS group (all P<0.05). The proportion of male, and the positive rates of SCL-90, somatization, interpersonal sensitivity, hostility, paranoia and other factor in the MetS group were higher than those in the non-MetS group (all P<0.05). Multifactorial analysis showed that individuals with a positive SCL-90 assessment had a 1.34 times higher risk of MetS than those with a negative assessment ( OR=1.34, 95% CI: 1.06-1.68; P=0.014). Among them, individuals with positive somatization ( OR=2.02, 95% CI: 1.25-3.28; P=0.004) and hostility ( OR=1.61, 95% CI: 1.02-2.56; P=0.042) had increased risk of MetS. Conclusion:Poor mental health status increases the risk of MetS.

Objective:To analyze the predictive effects of the Big Five personality traits and emotions on self-management behaviors in patients with type 2 diabetes mellitus (T2DM).Methods:This study was a cross-sectional research. From 2016 to 2020, community interventions for self-management among patients with chronic diseases were conducted in Hangzhou, targeting patients with type 2 diabetes recruited from 69 community health service centers across the city. The data for this study were derived from the baseline information collected during the community intervention. The Chinese Big Five Personality Inventory (CBF-PI-15), the Type 2 Diabetes Self-Management Scale (2-DSCS), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS) were employed for questionnaire assessments. Biochemical indicators, including postprandial 2-hour blood glucose, glycated hemoglobin (HbA 1c), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured. Spearman correlation analysis was used to examine the relationship between personality traits, relevant biochemical indicators, and self-management behaviors. Hierarchical regression analysis was employed to assess the predictive effects of the Big Five personality traits and emotions on self-management behaviors after controlling for demographic characteristics and factors related to health status. Results:A total of 839 patients were included in this study, comprising 518 females (61.75%) and 321 males (38.25%), with an average age of (66.92±8.67) years and an average disease duration of (8.87±6.91) years. There were significant differences in self-management behavior scores among patients with varying disease durations, educational levels, treatment methods, and levels of anxiety and depression ( t/F=6.172, 3.340, 4.699, 16.007, 27.127, all P<0.05). Neuroticism showed a negative correlation with various dimensions of self-management behaviors ( r=-0.130--0.073), while conscientiousness and agreeableness were positively correlated with various dimensions of self-management behaviors ( r=0.072-0.215). Dietary control score was negatively correlated with HbA 1c and LDL-C ( r=-0.106, -0.077), and regular exercise score was negatively correlated with postprandial 2-hour blood glucose, HbA 1c, TG, TC, HDL-C, and LDL-C ( r=-0.115--0.071). The total score of the 2-DSCS was negatively correlated with HbA 1c, TG, and TC ( r=-0.104--0.071). Patients with a disease duration exceeding 15 years and those receiving insulin injections or a combination of oral medication and insulin injections had higher total 2-DSCS score ( β=0.085, 0.146, 0.118, all P<0.05). Conversely, patients with higher HbA 1c and SDS standard scores had lower total 2-DSCS score ( β=-0.151, -0.328, both P<0.05), while those with higher agreeableness scores had higher total 2-DSCS score ( β=0.143, P<0.05). Conclusion:The traits of neuroticism, conscientiousness, and agreeableness within the Big Five Personality Traits, as well as anxiety and depressive emotions, are correlated with self-management behaviors. Specifically, agreeableness has a positive predictive effect on self-management behaviors, whereas depressive emotions have a negative predictive effect.

Objective:To construct and evaluate a training program for health management specialist nurses.Methods:Mainly qualitative analysis, The training system of health management specialist nurses was preliminarily drawn up based on literature review and semi-structured interview. The Delphi expert consultation method was used to conduct a two-round expert letter inquiry with 17 experts in the professions such as health management medicine, health management nursing, nursing management, and nursing education; and the analytic hierarchy process was applied to determine the weights of the indicators.Results:The effective recall rates of the questionnaires for the 2 rounds of expert consultation was 94.44%(17/18) and 100%(17/17), with expert authority coefficients of 0.90 and 0.92 and Kendall harmony coefficients of 0.207 and 0.249, respectively (all P<0.001). The training system of health management specialist nurses included 4 parts: training objective, training content, training management, training assessment and evaluation. There were 8 indicators in the training objective part. There were 5 first-level indicators, 15 second-level and 67 third-level indicators in the training content part. There were 5 first-level indicators, 12 second-level indicators in the training management part. There were 3 first-level indicators, 10 second-level indicators in the training assessment and evaluation part. Conclusion:The training program for specialized nurses in health management developed in this study demonstrates high levels of expert enthusiasm, authority, and consensus, indicating its feasibility.

Objective:To analyze the scientific research projects of health management disciplines in medical institutions in Beijing.Methods:This study was an observational study, and data was retrieved through computer between 2014 and 2023 from the scientific research data filling system of health management disciplines in medical institutions in Beijing region, which recorded the project name, project category, scientific research funding, institution, discipline, field, etc.. Excel 2016 was used to analyze the scientific research projects of health management disciplines in medical institutions in the Beijing region.Results:From 2014 to 2023, a total of 1 848 scientific research projects of health management disciplines in medical institutions in the Beijing region were initiated, with research funding of 1 204.775 million yuan. In terms of institutional categorization, they were mainly concentrated on central and municipal medical institutions, and in terms of research fields, there were 1 577 projects in Western medicine, with research funding of 1 133.240 million yuan, and 271 projects in Chinese medicine/combination of Chinese and Western medicine, with research funding of 71.535 million yuan. Cardiovascular diseases ranked first in the sub-discipline of Western medicine, and Chinese internal medicine ranked first in the sub-discipline of Chinese medicine.Conclusions:The scientific research projects of health management disciplines in medical institutions in Beijing are characterized by an imbalance in the distribution of institutions and the classification of funded sub-disciplines. The research innovation of health management in medical institutions needs to strengthen multidisciplinary cooperation and talent cultivation.