To alleviate the contradiction in healthcare resources, the Chinese government formally established the framework of a hierarchical medical system in 2015, which contains the following brief generalities: " separate treatment of emergencies and slows, first-contact care at the primary, two-way referral, and upper and lower linkage, ". This study systematically summarizes and models the connotations of China's hierarchical medical system and a sample of 11,200 chronic disease patients in Tianjin, the largest port city in northern China, was selected for the empirical study to investigate the relationship between chronic disease patients' policy perceptions of the hierarchical medical system and their preference for healthcare. We found that under the strategy of separate treatment, improving the healthcare accessibility, drug supply, and lowering the cost of medical care would have a positive impact on increasing the preference of patients with chronic diseases to go to the primary hospitals. Under the two-way triage strategy, improving the level of physician services, referral convenience and treatment Standards have a positive impact on chronic disease patients' preference for primary care; The impact of the hierarchical medical system on the preference for healthcare differed between groups, focusing on differences in health literacy level, age and household type; The role of " upper and lower linkage " is crucial in the hierarchical medical system and it plays a part in mediating the influence of the " separate treatment of emergencies and slows" design and the "two-way referral " order on the treatment preferences of chronic disease patients. The results of the study provide a reference for the further development of a scientific and rational hierarchical medical system in the future.

Objective: Physical examination services play a crucial role in the early detection of diseases, improving the effectiveness of treatment. However, the current physical examination services provided by community health service centers are limited. The objective of this study was to investigate the aspects of physical examination services that are most valued by residents. Methods: Identify and develop attributes and levels through literature research and expert group interviews. A discrete choice experiment was designed. The main effects design gives rise to 16 choice sets. The 16 choice sets were grouped into 2 blocks, and respondents were randomly assigned to one of the blocks. In each choice set, respondents were asked to choose from two alternatives with an opt-out option. In 2023, the discrete choice experiment was administered in several community health service centers within a China population sample. A mixed logit and a latent class analysis were conducted. Results: Participants (n = 399) preferred to receive health advice service. The services provided by the basic team with clinical experts are preferred over those provided solely by the basic team. The results indicated a preference for a participant to be serviced by face-to-face or telephone compared with WeChat. Low cost is also preferred. As participants grow older, their preference for face-to-face or telephone-based services increased. As participants' service demand increase, participants more preferred to receive interpretation of physical examination report and follow-up of important abnormal results, participants more preferred to be serviced by basic team with clinical experts or basic team Conclusion: We should improve the construction of the service team, optimize the service mode, expand the scope of examination services, reduce the cost of examination services, and meet the needs of residents for physical examination services. More attention should be paid to the needs of elderly and rural residents.

BackgroundIn recent years, the development of global public health has become a matter of great concern and importance for governments worldwide. China, as the largest developing country, plays a crucial role in shaping the development of the public health and its ability to respond to sudden public health emergencies through the fairness of its human resource allocation in center for disease control and prevention (CDC).ObjectiveThis study aims to analyze the situation of health human resource allocation in the China Centers for Disease Control and Prevention (China CDCs), assess the fairness of the allocation, and provide reference for the rational allocation of human resources.MethodsWe selected data from the China Health Statistics Yearbook on healthcare technical personnel, other technical personnel, managerial personnel, and workforce technical personnel of China CDCs for the period of 2016–2020. We utilized the Health Resource Density Index to evaluate the level of human resource allocation in China CDCs. Additionally, we used the Gini coefficient and Theil index to assess the fairness of human resource allocation in China CDCs from both a population and geographical perspective.ResultsFirstly, the educational qualifications and professional titles of CDC staff have improved, but the workforce is aging. Secondly, HRDI development trends vary among different personnel types and regions with varying levels of economic development. Finally, the results of the Gini coefficient and Theil index indicate that population distribution fairness is better than geographical distribution fairness. Overall, the unfair population distribution is primarily due to regional disparities.ConclusionThe China CDCs should tailor different standards for the allocation of health human resources based on regional characteristics, aiming to enhance the accessibility of health human resources in various regions and achieve equitable allocation.

Background: The physical abilities of older adults decline with age, making them more susceptible to micronutrient deficiency, which may affect their sleep quality. Objectives: This study aimed to construct a risk correlative model for sleep disorders in Chinese older adults based on blood micronutrient levels. Methods: In this matched case-control study, we recruited 124 participants with sleep disorders and 124 matched controls from the Tianjin Elderly Nutrition and Cognition cohort in China. Micronutrient levels in whole blood were measured using the dried blood spot technique. We compared the differences in micronutrient levels between the two groups and also constructed a receiver operating characteristic (ROC) model and nomogram for sleep disorders. Results: In comparison to the control group, the sleep disorders group showed lower levels of blood vitamin A, vitamin E (VE), folate, magnesium, copper, iron, and selenium (Se) in the univariate analysis (p < 0.05). The ROC curve analysis indicated that the combination of VE + folate + Se may have an excellent diagnostic effect on sleep disorders, with an area under the curve of 0.964. This VE + folate + Se was integrated into a nomogram model to demonstrate their relationship with sleep disorders. The consistency index of the model was 0.88, suggesting that the model assessed sleep disorders well. Conclusions: The sleep disorders risk correlative model constructed by the levels of VE, folate, and Se in whole blood might show good performance in assessing the risk of sleep disorders in older adults.

背景　中医药的传承、创新及发展得到了国家的高度重视，然而目前我国基层中医诊疗发展尚不均衡，不同机构的中医诊疗服务运营效率差距较大。目的　通过分析 2021 年天津市基层医疗机构的中医诊疗服务运营情况，为基层医疗机构的中医药发展提供参考依据。方法　于 2021 年，采用全面调查方法收集天津市 16 个行政区域（Dis1~6为市内六区，Dis7~10 为环城四区，Dis11 为滨海新区，Dis12~16 为远郊五区）共计 270 家基层医疗机构的相关数据，并综合运用数据包络分析（DEA）中的 BCC、CCR 模型和随机前沿分析（SFA）两种方法，从不同角度分析机构的中医诊疗服务运营效率。通过文献研究将 DEA 模型的投入指标设为中医类执业医师数、中医科床位、中医诊疗设备台数；产出指标设为中医医疗收入、中医诊疗人次数、以中医为主的出院人次数、上门中医药服务人次数。SFA 模型除产出指标增添总收入一项外，余与 DEA 所设指标一致。结果　各区中有 7 个区的基层医疗卫生机构的中医诊疗服务运营情况有效，Dis9 DEA 弱有效，8 个区 DEA 为无效。有 8 个区规模报酬呈递增状态，7 个区规模报酬不变，Dis3 呈递减状态。8 个非 DEA 有效的区，各区 3 项投入指标均存在冗余情况，产出指标中各区中医医疗收入项不足现象较为严重。SFA 结果中 Dis1~6 技术效率（0.733~0.838），均为高效区；Dis7~10 技术效率（0.691~0.912），3 个高效区 1 个中效区；Dis11 技术效率 0.885 为高效区；Dis12~16（0.399~0.849）3 个高效区 2 个中效区。DEA 结果与 SFA 结果基本一致，中医类执业医师数对运营效率有正影响。结论　天津市各区基层医疗机构中医诊疗服务运营效率总体偏低，但整体发展趋势向好，且有区域特点，整体来看 Dis1~6 优于 Dis7~10，Dis7~10 优于 Dis11~16，各区应根据实际合理规划，避免资源投入过剩以及产出不足情况，尤其要加大对滨海新区及远郊五区的扶持。

China National Health Commission issued an implementation plan for budget performance management in health projects in April 2021, which emphasizes all health projects must be evaluated in advance prior to implementation. The study aims to develop an ex-ante performance evaluation framework for health projects and formulate a self-assessment report template. The study also attempts to gain insights into the ex-ante performance of health projects in China, identify issues and explore the factors that influence the ex-ante performance of health projects and make suggestions about improvement strategies. The framework was established by using a framework development methodology. To develop the framework, the findings from existing research were pooled and organized to create indicators and key points. The preliminary ex-ante performance evaluation framework was refined, validated and tested by the experts. Weight analysis was conducted by using the Analytic Hierarchy Process. Then the indicator system has been transformed into a project ex-ante performance self-assessment report template. Samples of 698 municipal health projects in China from 2021 to 2022 were analyzed. We invited experts to complete the scoring task by using our ex-ante performance evaluation framework. The ex-ante performance evaluation framework primarily examines five aspects, the necessity of the project, economy of input, rationality of performance indicators, feasibility of implementation plans, and compliance of financing. The overall ex-ante performance evaluation score for the sample projects was (91.19 ± 8.02). The sub-scores for necessity of project were (14.74 ± 1.85), economy of input was (34.45 ± 2.43), reasonableness of performance indicators was (8.27 ± 2.28), feasibility of implementation plan was (23.99 ± 3.84), and compliance of financing was (9.75 ± 1.47). Factors such as whether it was an epidemic prevention and control project, the project budget, project content, project objective, and project implementation organization were all influencing the ex-ante performance of health projects (P < 0.05). We have developed a ex-ante performance evaluation framework for health projects and established a project ex-ante performance self-assessment report template. They can offer a sufficient reference for project process management. Project implementation organization should elevate the awareness and proficiency of project managers regarding budget performance management. Government should improve the ability of ex-ante performance evaluation, and eliminate ineffective projects through ex-ante performance evaluation.

IntroductionEmergency medical rescue plays a vital role in alleviating the harm of all kinds of emergencies to people's physical and mental health and life safety. The current emergency medical teams (EMTs) formation model is not unified. We focused on the disadvantages of the bricolage mode of China EMTs and put forward empirical-based countermeasures to improve the emergency management ability of EMTs.MethodsFrom March to September 2022, 23 leaders of EMTs in North China (Tianjin) were selected by objective sampling method to conduct one-to-half structured in-depth interviews. Nvivo12.0 software was used for three-level coding. The disadvantages of the bricolage model of EMT were analyzed.ResultsBased on the three-level coding, 150 initial concepts, 36 sub-coding, 17 main coding, six categories, and two core categories were sorted out. Management structure, internal stability, and support are recognized as the crucial elements armed with the EMTs.DiscussionThe bricolage EMTs have disadvantages such as a chaotic management structure, weak internal stability, and inadequate support. It is necessary to construct full-time EMTs that incorporate a standardized personnel admission mechanism, full-time training and exercise mechanism, diversified incentive mechanism, and multi-agent cooperation mechanism, etc.

The current research on ST elevation myocardial infarction (STEMI) patients has been mostly limited to Door-to-Balloon (D-to-B) time. This study aimed to compare the effects of different hospital admission modes to on the time metrics of patients undergoing primary percutaneous coronary intervention (PPCI). It also examined the effects of these modes on in-hospital mortality and other influencing factors. The goal was to prompt healthcare facilities at all levels, including chest hospitals, the Centers for Disease Control and Prevention (CDC), and communities to take measures to enhance the treatment outcomes for patients with STEMI. A total of 1053 cases of STEMI patients admitted to Tianjin Chest Hospital from December 2016 to December 2023 and successfully underwent PPCI were selected for this study. They were divided into three groups based on the admission modes: the ambulances group (363 cases), the self-presentation group (305 cases), and the transferred group (385 cases). Multivariate logistic regression was used to explore the impact of different modes of hospital admission on the standard-reaching rate of key treatment time metrics. The results showed that the S-to-FMC time of transferred patients (OR = 0.434, 95% CI 0.316–0.596, P < 0.001) and self-presentation patients (OR = 0.489, 95% CI 0.363–0.659, P < 0.001) were more likely to exceed the standard than that of ambulance patients; The cath lab pre-activation time of self-presented patients was also less likely to meet the standard than that of ambulance patients (OR = 0.695, 95% CI 0.499–0.967, P = 0.031); D-to-W time of self-presentation patients was less likely to reach the standard than that of ambulance patients (OR = 0.323, 95% CI 0.234–0.446, P < 0.001);However, the FMC-to-ECG time of self-presentation patients was more likely to reach the standard than that of ambulance patients (OR = 2.601, 95% CI 1.326–5.100, P = 0.005). The Cox proportional hazards model analysis revealed that for ambulance patients, the time spent at each key treatment time point is shorter, leading to lower in-hospital mortality rate (HR0.512, 95% CI 0.302–0.868, P = 0.013) compared to patients admitted by other means. We found that direct arrival of STEMI patients to the PCI hospital via ambulance at the onset of the disease significantly reduces the S-to-FMC time, FMC-to-ECG time, D-to-W time, and catheterization room activation time compared to patients who self-present. This admission mode enhances the likelihood of meeting the benchmark standards for each time metric, consequently enhancing patient outcomes.

Introduction Cardiometabolic disease (CMD) is the leading cause of mortality in China. A healthy diet plays an essential role in the occurrence and development of CMD. Although the Chinese heart-healthy diet is the first diet with cardiovascular benefits, a healthy dietary pattern that fits Chinese food culture that can effectively reduce the risk of CMD has not been found.Methods/design The study is a single-centre, open-label, randomised controlled trial aimed at evaluating the effect of the Reducing Cardiometabolic Diseases Risk (RCMDR) dietary pattern in reducing the risk of CMDs in people with dyslipidaemia and providing a reference basis for constructing a dietary pattern suitable for the prevention of CMDs in the Chinese population. Participants are men and women aged 35–45 years with dyslipidaemia in Tianjin. The target sample size is 100. After the run-in period, the participants will be randomised to the RCMDR dietary pattern intervention group or the general health education control group with a 1:1 ratio. The intervention phases will last 12 weeks, with a dietary intervention of 5 working days per week for participants in the intervention group. The primary outcome variable is the cardiometabolic risk score. The secondary outcome variables are blood lipid, blood pressure, blood glucose, body composition indices, insulin resistance and 10-year risk of cardiovascular diseases.Ethics and dissemination The study complies with the Measures for Ethical Review of Life Sciences and Medical Research Involving Human Beings and the Declaration of Helsinki. Signed informed consent will be obtained from all participants. The study has been approved by the Medical Ethics Committee of the Second Hospital of Tianjin Medical University (approval number: KY2023020). The results from the study will be disseminated through publications in a peer-reviewed journal.Trial registration number Chinese Clinical Trial Registry (ChiCTR2300072472).

Background: Gestational diabetes mellitus (GDM) is one of the most prevalent pregnancy problems, and there is still debate over the relationship between vitamin D and GDM. Objectives: Our objective is to investigate the correlation between vitamin D and GDM by employing Mendelian randomization (MR) with summary data obtained from genome-wide association studies (GWAS). Methods: Data on exposures and outcomes, namely vitamin D, vitamin D insufficiency, and GDM, were acquired from the IEU OpenGWAS Project. Bidirectional MR analysis was performed utilizing the inverse variance weighted (IVW) method as the principal analytical approach. The complementary approaches employed in this study encompassed weighted median, simple mode, weighted mode, and MR-Egger regression. A series of sensitivity analysis were conducted in order to assess the reliability of the obtained results. Results: The data were acquired from the IEU OpenGWAS Project. Following the application of the three assumptions of MR, 13 single nucleotide polymorphisms (SNPs) were included in the MR analysis for vitamin D levels and vitamin D deficiency on GDM, and 10 and 26 SNPs were included for GDM on vitamin D levels and deficiency, respectively. The findings from the IVW analysis revealed a significant positive correlation between vitamin D levels and GDM (OR = 1.057, 95% CI: 1.011–1.104, p = 0.015). Conversely, a negative correlation was seen between vitamin D deficiency and GDM (OR = 0.979, 95% CI: 0.959–0.999, p = 0.039). The results of the reverse MR study revealed no evidence of reverse causation between GDM and vitamin D. The findings from multiple MR approaches were in line with the direction of IVW analysis. Sensitivity analysis revealed no evidence of heterogeneity, pleiotropy, or outliers, suggesting the robustness of the results. Conclusions: There exists a causal association between vitamin D and GDM, whereby vitamin D levels serve as a risk factor for GDM.

BackgroundMedium-chain fatty acids (MCFAs) and docosahexaenoic acid (DHA) could affect the occurrence of mild cognitive impairment (MCI). beta-hydroxybutyrate (BHB), mitochondrial DNA copy number (mtDNAcn) and mitochondrial DNA (mtDNA) deletions might be their potential mechanisms. This study aimed to explore the relationship between MCFAs, DHA and MCI, and potential mechanisms.MethodsThis study used data from Tianjin Elderly Nutrition and Cognition (TENC) cohort study, 120 individuals were identified with new onset MCI during follow-up, 120 individuals without MCI were selected by 1:1 matching sex, age, and education levels as the control group from TENC. Conditional logistic regression analysis and mediation effect analysis were used to explore their relationship.ResultsHigher serum octanoic acid levels (OR: 0.633, 95% CI: 0.520, 0.769), higher serum DHA levels (OR: 0.962, 95% CI: 0.942, 0.981), and more mtDNAcn (OR: 0.436, 95% CI: 0.240, 0.794) were associated with lower MCI risk, while more mtDNA deletions was associated with higher MCI risk (OR: 8.833, 95% CI: 3.909, 19.960). Mediation analysis suggested that BHB and mtDNAcn, in series, have mediation roles in the association between octanoic acid and MCI risk, and mtDNA deletions have mediation roles in the association between DHA and MCI risk.ConclusionHigher serum octanoic acid and DHA levels were associated with lower MCI risk. Octanoic acid could affect the incidence of MCI through BHB, then mitochondria function, or through mitochondria function, or directly. Serum DHA level could affect the incidence of MCI through mitochondria function, or directly.

目的 了解天津市基层医疗卫生机构护士工作压力现状,并分析压力影响因素,为基层医疗卫生机构管理者有效降低护士工作压力提供参考.方法 采用便利抽样于2022年6-7月应用中国护士工作压力源量表对天津市99家基层医疗卫生机构923名护士进行横断面调查研究,并对数据进行分析.结果 923名护士工作压力得分为(80.30±23.49)分,每个条目均分为(2.29±0.92)分,其中工作量及时间分配、护理专业工作和病人护理3个维度的护士工作压力得分最高.年龄、每月夜班数和用工形式均是基层医疗卫生机构护士工作压力的影响因素(均P＜0.05).结论 天津市基层医疗卫生机构护士工作压力处于中等以上程度,护理管理者要建立长效激励机制、弹性化排班与岗位调动机制,通过宣传引导机制等方式增强护士职业荣誉感,以降低护士工作压力.

Background Currently, scholars in China are exploring chronic disease management models based on treatment-prevention integration, however, the quantitative evaluation researches are scarce and in the initial stage, lacking in relevance and timeliness. Objective To construct the on-site evaluation index system for integration of medical and preventive services for chronic diseases in primary health care institutions and provide a reference for the quality improvement of integration of medical and preventive services. Methods The on-site evaluation index system for integration of medical and preventive services for chronic diseases in primary health care institutions was initially constructed by literature review, policy induction and expert interview. From June to August 2022, two rounds of expert consultation with 17 experts were conducted using the Delphi method, the index system was determined according to the results of expert consultation, and the weight of each index was calculated by using the analytic hierarchy process. Results The on-site evaluation index system for integration of medical and preventive services for chronic diseases in primary health care institutions was initially constructed consisting of 5 primary indexes, 12 secondary indexes and 37 tertiary indexes. The effective questionnaire recovery rate of the two rounds of expert consultation was 100.0% with the expert authority coefficient of 0.81; the Kendall coordination coefficients of the importance of the three levels of indexes were 0.239 (χ2=8.76, P<0.05) and 0.275 (χ2=4.15, P<0.05) , the Kendall coordination coefficients of the feasibility of the three levels of indexes were 0.234 (χ2=19.63, P<0.05) and 0.248 (χ2=12.43, P<0.05) . The on-site evaluation index system for integration of medical and preventive services for chronic diseases in primary health care institutions was finally constructed consisting of 5 primary indexes, 12 secondary indexes and 40 tertiary indexes, the weight of the five primary indicators was 0.200 0. Conclusion The evaluation index system has a certain practical guidance for the improvement of the capacity of integration of medical and preventive services for chronic diseases in urban and rural community health service institutions. However, the evaluation index system should also be dynamically adjusted according to the specific situation to effectively reflect the quality of integration of medical and preventive services for chronic diseases in primary health care institutions.

"我愿做一枚白昼的月亮,不求炫目的荣华,不淆世俗的浪潮".繁华人世,芸芸众生,我们皆不过为浩瀚宇宙中的沧海一粟.尽管渺小却也尝试绽放,哪怕星星点点的光芒,都会成为黑暗中的闪耀.纵然世间的纷纷扰扰难以平息,尽管很多事情都不会如意,但我们也要有勇气踏过泥泞曲折,仰望漫天星辰.学医是缥缈却又真实,是苦涩却又甘甜,是难以到达却又振奋人心的.我深知学医的不易,身边也不乏劝我放弃的亲人朋友,但我觉得那是一种信仰、是一种追求,是如星辰一般闪耀的光.苦与难都是众说纷纭,总要自己亲自走一遭才不枉此生.

目的 评估2018年—2020年天津市结对县医院健康帮扶效果,总结经验与问题,为卫生健康精准扶贫的高效开展提供参考依据.方法 针对结对县医院构建3个一级指标、6个二级指标、22个三级指标的评价指标体系,选取20所县医院进行调研,采用秩和比法、数据包络分析法描述健康帮扶效果并评价其运行效率.结果 经帮扶后,结对县医院诊断符合率、抢救成功率、科研项目数等指标有所提升,但部分医院存在投入过剩或产出不足的问题.结论 天津市结对县医院卫生服务能力明显增强,深化健康扶贫应注重长期规划,合理配置健康帮扶资源,提高帮扶效益.

Objective:Construct the performance evaluation index system of standardized training programs for resident doctors,and provide a reference for the improvement of standardized training standards for residents in Tianjin.Methods:Two rounds of expert correspondence using the Delphi method were conducted to determine an indicator system containing four primary indicators(budget indicators,output indicators,benefit indicators,satisfaction indicators),eight secondary indicators and 31 tertiary indicators,and the weights were calculated using hierarchical analysis.Results:Both rounds of questionnaires achieved a valid return rate of 100.0％,and the authority coefficient of experts was 0.81,which was higher than 0.7.The experts answered the questionnaires positively,and the research results were more credible.The experts reached a consensus after two rounds of questionnaire consultation and finally formed a performance evaluation index system for the residency standardized training program that included 31 three-level indicators in four dimensions.Conclusion:The evaluation index system has certain practical guiding significance for the adjustment and improvement of standardized training for resident doctors,but it is also necessary to dynamically adjust the evaluation index system according to the specific situation to effectively reflect the effect of standardized training for resident doctors.

目的:调查天津市老年护理服务需求现状并分析其影响因素,为满足多样化老年护理服务需求提供参考依据.方法:采用分层抽样法,使用Barthel指数评定表及自制问卷,在天津市医疗机构中调查 5?280 例老年人对老年护理服务的需求情况,采用Logistic回归模型,分析老年护理服务需求的影响因素.结果:老年人对健康监测(68.82％)、精神与心理支持(52.19％)等老年护理服务项目需求较高.患有疾病、存在健康危险因素、存在不良用药会增加老年护理服务需求,一年内住院次数越多、自理能力越差的老年人对老年护理服务需求程度越高.结论:老年护理服务需求受生理、心理和社会层面因素影响呈现差异化;精准对接老年人特别是失能老年人护理服务需求,创新老年护理服务模式是完善老年健康服务体系的重要策略.

脑机接口（BCI）是脑部与外部设备互联的渠道，其经过发展已经成为了一个较为成熟的技术体系。现阶段BCI已经发展成为了3大模式：侵入式、半侵入式和非侵入式。而根据现阶段不同的测量脑功能技术，形成了基于不同神经影像学技术的各有优缺点的BCI，如：基于脑电图、皮层脑电图、功能性核磁共振或功能性近红外光谱等的BCI，而其中基于脑电图的BCI根据电位类型又可以细分为：基于事件相关电位-P300、运动想象、稳态视觉诱发电位、慢皮层电位的BCI。通过对现有不同BCI范式进行分析介绍，此后又分别探讨了BCI在信号融合、新型信号、采集方式和采集设备的研发与在脑功能改变和新兴技术结合应用等领域未来的发展方向。

ABSTRACT Background There are minimal data on the relationship between DII and MCI in an elderly Chinese population and no research has assessed the potential effect of LTL. Objective We investigated the association between DII and MCI while taking into account the potential effect of LTL. Methods This cross-sectional study included 3,386 participants aged ≥ 60 years of age from the Tianjin Elderly Nutrition and Cognition Cohort study. DII score was constructed based on a validated self-administered food frequency questionnaire was calculated based on the method developed by Shivappa et al. LTL was measured by quantitative real-time polymerase chain reaction. Multivariable logistic regression analysis was used to analyze the association between DII, LTL and MCI. Moreover, mediation analysis was employed to test the mediation effect of LTL on the total effect of DII on MCI. Results Compared with the participants in the lowest tertiles of LTL and DII score, the odds ratios (ORs) of MCI in the highest tertiles were 0.386(95% CI: 0.281-0.529) and 1.650 (95% CI: 1.232-2.209), respectively. The significant association between DII score and MCI persisted after further adjusting for LTL (OR: 1.595; 95% CI: 1.189-2.140). The link between DII score and MCI was mediated partially by LTL (βindirect effect= -0.008, P<0.05). Conclusion High DII score was positively associated with MCI prevalence in an elderly Chinese population and the link between DII scores and MCI seemed to be mediated partially by LTL.