Artificial intelligence (AI) is increasingly entering medicine and nursing education, raising concerns about how healthcare students respond to AI-related occupational uncertainty. AI replacement anxiety (ARA) may become more or less salient across academic days, but little is known about its short-term within-person temporal associations with state anxiety and day-level academic burnout indicators. This 10-day weekday diary study included 751 medicine and nursing students who provided 4,625 observed diary records after quality screening. Daily surveys assessed ARA and three academic burnout constructs using single day-adapted proxy indicators, together with a two-item state-anxiety measure. Two-level Bayesian dynamic structural equation modeling tested six primary dimension-specific models in the ARA-to-state-anxiety and state-anxiety-to-ARA directions. Supplementary joint multivariate models, a stricter 695-participant sensitivity sample, and a targeted calendar-spacing sensitivity analysis examined unique effects, posterior contrasts, and robustness. In the ARA-to-state-anxiety direction, higher daily ARA was associated with higher subsequent cynicism, and higher cynicism was associated with later state anxiety. This M2 component pattern remained supported when the weekend interval was represented using calendar-day spacing. In the reverse direction, higher state anxiety was consistently associated with a higher subsequent score on the academic-inefficacy proxy indicator, but the subsequent association of this indicator with ARA was less robust across model specifications and was attenuated in the weekend-spacing sensitivity analysis. The model-based indirect effects remained uncertain, with 95

Late-life depressive symptoms remain a pressing global health issue, particularly among older adults with persistent socioeconomic disadvantages. While previous studies have linked socioeconomic status (SES) to mental health, few have integrated dynamic SES trajectories, psychosocial mechanisms and cultural contexts in a unified life course framework. Drawing on harmonized longitudinal data from 6 global aging cohorts (Health and Retirement Study (HRS), China Health and Retirement Longitudinal Study (CHARLS), Survey of Health, Ageing and Retirement in Europe (SHARE), English Longitudinal Study of Ageing (ELSA), Mexican Health and Aging Study (MHAS) and Korean Longitudinal Study of Aging (KLoSA); n = 64,479), this study examined how childhood SES, adult SES and SES mobility predicted incident depressive symptoms. A moderated chain mediation model tested the indirect effects of frailty and social activity, and the buffering role of family support. Cross-lagged panel network analysis was used to explore symptom-level directional associations. The results showed that higher childhood and adult SES, and stable high and upward SES trajectories, were consistently associated with lower risk of late-life depressive symptoms. Frailty and reduced social activity partially mediated these associations, while family support moderated the frailty–depressive symptoms pathway. Network analysis revealed temporal, symptom-level effects of adult SES on depressive symptoms, particularly in low- and middle-income countries. Subgroup analysis indicated stronger SES protection among men, with stable middle SES benefiting women more. Socioeconomic advantage across the lifespan protected against late-life depressive symptoms via social pathways, with culturally embedded family support acting as a key buffer. These findings highlight the importance of integrated, equity-focused and culturally sensitive strategies to sustain mental health in aging populations. Xu et al. analyzed longitudinal data from six global aging cohort studies to examine how socioeconomic status across the lifespan relates to depressive symptoms in later life.

Objective:This study aimed to review the rates of physical frailty and sarcopenia, as well as associated risk factors, among adults aged 60 and older living in the community. Methods:A systematic literature search was conducted in PubMed, Wiley Library, Embase, Web of Science, and Cochrane Library for articles published from January 2000 to December 2024. The review followed PRISMA guidelines for meta-analysis. Results:Sixteen studies with 41,765 participants were included in the meta-analysis. The pooled prevalence of frailty/sarcopenia was 27% (95% CI: 19-35%). Specifically, the pooled prevalence of frailty was 25% (95% CI: 16-38%) and that of sarcopenia was 23% (95% CI: 13-37%). Age, malnutrition, depression, falls, and hypertension were identified as significant risk factors for frailty/sarcopenia. Conclusion:Nearly 30% of older adults in the community are affected by frailty/sarcopenia. Early identification of these risk factors is crucial for the prevention and management of frailty/sarcopenia. Further research is needed to determine effective interventions and strategies to reduce the incidence of frailty/sarcopenia.

BACKGROUND:Rapid urbanization in China has raised significant public health concerns, particularly regarding residents' physical and mental well-being. Effective interventions are urgently needed to address these issues. OBJECTIVE:This study evaluates the impact of China's Healthy City Pilot Policy (HCPP), introduced in 2016, on improving residents' health outcomes and examines demographic differences and mechanisms driving these effects. METHODS:Using data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, a difference-in-differences (DID) approach was employed, along with propensity score matching (PSM-DID), placebo tests, and sensitivity analyses for robust results. RESULTS:The HCPP significantly enhanced residents' health in pilot cities, leading to better self-rated health, lower medical expenses, higher life satisfaction, and reduced depression. These benefits were most pronounced among the elderly, women, less-educated individuals, and residents of rural and central-western regions. Key mechanisms included increased physical exercise, social activities, and improved air quality. CONCLUSION:The HCPP positively impacts urban health, especially for vulnerable groups, highlighting the urgent need to integrate health considerations into urban planning and providing valuable insights for future policy development.

The purpose of this study was to explore the metabolomic differences between Major depressive disorder (MDD) and healthy individuals among adolescents and the association between childhood maltreatment (CM) and differentially abundant metabolites. The exploratory study included 40 first-episode drug-naïve adolescents with MDD and 20 healthy volunteers. We used the Beck Depression Inventory (BDI-13) to assess the severity of depression and the Childhood Trauma Questionnaire (CTQ) to assess the presence of childhood maltreatment. The plasma samples from all participants were collected for targeted metabolomics analysis using ultra-performance liquid chromatography coupled with tandem mass spectrometry (UPLC‒MS/MS) methods. Spearman correlation was applied to analyse the correlations between clinical variables and metabolites. We found 11 increased metabolites and 37 decreased metabolites that differed between adolescents with MDD and healthy individuals. Pathway enrichment analysis of differentially abundant metabolites showed abnormalities in energy metabolism and oxidative stress in MDD. Importantly, we found that creatine, valine, isoleucine, glutamic acid and pyroglutamic acid were negatively correlated with the BDI-13, while isocitric acid, fatty acid and acylcarnitine were negatively associated with CTQ, and 4-hydroxyproline was positively related to CTQ in adolescents with MDD. These studies provide new ideas for the pathogenesis and potential treatment of adolescents with MDD.

Background and aimsSalt substitute is considered an effective strategy to reduce sodium and increase potassium intake and thereby lower blood pressure in China, but its benefits and risks are uncertain in real-world data. This study is designed to compare the difference in the 1-year efficacy of salt substitute and salt restriction on urinary electrolytes and blood pressure.Methods and resultsA total of 2,929 and 2,071 participants with the 24-h estimated urinary sodium excretion (eUNaE) above 2.36 g/d using salt substitute (SS) and salt restriction (SR) strategies, respectively, were followed for 1 year. Salt substitute users were further divided by potassium chloride (KCl) content (13% vs 25%) and duration (9–11 vs 12 months). The 24-h eUNaE and estimated urinary potassium excretion (eUKE) levels were calculated using the Kawasaki formula from spot urine sample. The SS group (n = 1,897) had lower eUNaE (3.82 ± 1.03 vs 4.05 ± 1.01 g/day, p < 0.01) than the SR group (n = 1,897) after 1 year. Both 13 and 25% KCl substitutes reduced eUNaE versus restriction (p < 0.05). The SS group had a higher eUKE than the SR group (2.09 ± 0.43 vs 1.71 ± 0.62 g/day, p < 0.01). The eUKE was higher with 25% versus 13% KCl substitutes, while the Na/K was lower with 25% versus 13% KCl substitutes (p < 0.05). No significant blood pressure differences occurred between the SS and SR groups (p > 0.05), whereas 25% KCl exposure was related to a lower level of SBP, regardless of whether it was compared with SR or 13% KCl.ConclusionCompared with salt restriction, salt substitute results in more sodium reduction and greater potassium increase. In spite of this, it does not result in better control of blood pressure, especially for the group receiving 13% KCl.

This study was to investigate the differences between young older adults with and without vision impairment on neuropsychological and psychiatric outcomes following falls during the past year and to identify predictors of cognitive decline or mental distress. A secondary analysis of 668 young older Chinese adults aged 65 ∼ 79 years old with a history of falls was conducted from the cross-sectional survey data in the 2018 wave of the Chinese Longitudinal Health Longevity Survey (CLHLS). Participants with vision impairment scored significantly higher on anxiety and depression and lower on cognitive function and SWB than those without vision impairment. And vision impairment was a significant predictor of adverse outcomes for all four neuropsychological and psychiatric measures. Neurocognitive deficits, psychological problems, and decreased self-sufficiency are quite common among community-dwelling older adults with visual impairment who have a history of falls within a year.

Accumulating evidence indicates that plasma metal levels may be associated with Type 2 diabetes mellitus (T2DM) incident risk. Mitochondrial function such as mitochondrial DNA copy number (mtDNA-CN) might be linked to metal exposure and physiological metabolism. Mediation analysis was conducted to determine the mediating roles of mtDNA-CN in the association between plasma metals and diabetes risk. In the present study, we investigated associations between plasma metals levels, mtDNA-CN, and T2DM incident in the elderly population with a 6-year follow-up (two times) study. Ten plasma metals [i.e. manganese, aluminum, calcium, iron, barium (Ba), arsenic, copper, selenium, titanium, and strontium] were measured using inductively coupled plasma mass spectrometry. mtDNA-CN was measured by real-time polymerase chain reaction. Multivariable linear regression and logistic regression analyses were carried out to estimate the relationship between plasma metal concentrations, mtDNA-CN, and T2DM incident risk in the current work. Plasma Ba deficiency and mtDNA-CN decline were associated with T2DM incident risk during the aging process. Meanwhile, plasma Ba was found to be positively associated with mtDNA-CN. Mitochondrial function mtDNA-CN demonstrated mediating effects in the association between plasma Ba deficiency and T2DM incident risk, and 49.8% of the association was mediated by mtDNA-CN. These findings extend the knowledge of T2DM incident risk factors and highlight the point that mtDNA-CN may be linked to plasma metal elements and T2DM incident risk.

Background: Mold exposure is a common environmental issue that can adversely affect health, particularly among older adults. The impact of mold exposure on anxiety symptoms in this population has not been extensively studied. Objective: This study aims to examine the relationship between mold exposure and anxiety symptoms in older adults, considering the mediating role of cognitive function and the moderating effects of open window ventilation and multivitamin supplementation. Methods: Data from the eighth wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) was utilized, including 11,021 participants aged 65 and older. Logistic regression models and moderated mediation analysis were employed to explore these relationships. Results: Mold exposure was significantly associated with increased anxiety symptoms (OR=1.831, 95 % CI=1.588-2.110). Cognitive impairment partially mediated this relationship. Open window ventilation (B=-0.040, P<0.001) and multivitamin supplementation (B=-0.197, P<0.001) served as protective factors. Subgroup analysis indicated higher vulnerability among females (OR=1.72, P<0.001), those aged 65-79 (OR=1.86, P<0.001), urban residents (OR=2.50, P<0.001), individuals not living with family members (OR=1.89, P<0.001), those with higher education (OR=2.01, P<0.001), married individuals (OR=1.80, P<0.001), and those in very good health (OR=2.11, P=0.026). Conclusion: Mold exposure contributes to anxiety symptoms in older adults, with cognitive decline playing a mediating role. Effective interventions, including improved ventilation and multivitamin supplementation, can mitigate these effects. These findings highlight the need for targeted public health strategies to enhance the well-being of older adults.

The concept of intrinsic capacity (IC) was introduced to define healthy aging and active aging based on functional capacity, yet there is limited understanding of the risk of IC decline at a population level. To consolidate existing evidence for rates of IC decline and risk factors among community-dwelling adults 60 years or older. According to the PRISMA guidelines, the literature search was independently conducted by two researchers in 8 databases from inception to January 2024 without language restrictions using combinations of free words and subject words. Qualities of included studies were assessed using Joanna Briggs Institute’s (JBI’s) critical appraisal checklist for prevalence studies. To pool the data, a random-effect meta-analysis was performed, followed by subgroup analysis and sensitivity analysis. All analyses were performed by Stata14.0. From 1594 records, 15 studies were extracted with 33,070 participants for meta-analysis. The pooled prevalence of IC decline in community settings was 67.8

Objective: The concept of intrinsic capacity (IC) revolves around healthy aging and active aging. Since the Introduction of the concept by the World Health Organization in 2015, a series of studies have been conducted by scholars from multiple fields. However, no bibliometric analysis has systematically investigated this issue. We aim to identify the current landscape and frontier trends of scientific achievements on IC in older adults through bibliometric approaches. Methods: Quantitative analysis of publications relating to IC in older adults from 2015 to 2023 was interpreted and graphed through the Web of Science Core Collection database on December 5, 2023. A variety of quantitative variables was analyzed, including publication and citation counts, H-index, and journal citation reports. Co-authorship, citation, co-citation, and co-occurrence analyses were performed for countries/regions, institutions, authors, and keywords using the VOSviewer and CiteSpace. Results: A total of 952 original and review articles in English were identified. The European countries possessed an absolute advantage in this field. The most contributive institution was the University of S & atilde;o Paulo. The most productive author is Cesari Matteo from France, followed by Qaisar Rizwan from the United Arab Emirates. However, a relatively low level of research cooperation existed between institutions and authors. Important topics mainly include the connotations, theoretical framework models, evaluation, screening tools, and application scenarios of IC. Among the promising hotspots, "biological aging", "ICOPE", "Covid-19", "prevention", "inflammation", "caf22", "prevalence", and "randomized controlled trial" displayed relatively latest average appearing year. Conclusion: Global trends indicate a growing scientific output on IC in older adults, and developed countries are leading the way. There is still room for improvement in research team collaboration. The focus gradually shifts from theoretical research to empirical research. It is recommended to pay attention to the latest hot spots, such as "biological aging", "ICOPE implementation", "postCOVID-19 syndrome", and "biomarkers".

Aromatherapy is a natural treatment method that uses essential oils (EOs) extracted from aromatic plants; EOs and their components exhibit a wide range of pharmacological activities, with a special focus on their implementation toward mental disorders, such as anxiety and depression. This study aimed to identify the scientific output and activity related to aromatherapy in anxiety, depression, and insomnia through bibliometric approaches. In this bibliometric study, we utilized CiteSpace and VOSviewer to evaluate the Web of Science Core Collection publications and to build visualizing maps to analyze the research progress on this topic between 2001 and 2021. A total of 1159 original and review articles in English, published in 578 different peer-reviewed journals by 260 authors, were identified. In the recent two decades, there was a steady increase in the number of published articles, especially in the following five years. All publications were distributed among 88 countries/regions. The United States had the most publications, with 188 (16.22%) articles, followed by China [131 (11.30%)], Brazil [110 (9.49%)], and Japan [85 (7.33%)]. Most studies were published in the Journal of Ethnopharmacology, and Physiology & Behavior was the most cited journal. Hritcu L was the top published scientist and Gupta SC was the most frequently co-cited. The knowledge base of this field research mainly included the related efficacy of aromatherapy/EOs, application status, and biochemical mechanism. And the keyword co-occurrence analysis revealed that the topics "oxidative stress," "chemical composition," "systematic review," and "sleep quality" were research frontiers. In conclusion, this comprehensive bibliometric study provides an updated perspective on research hotspots of aromatherapy in anxiety or depression and developmental tendencies of natural remedies for mental health. In addition, this study could also provide valuable information for research teams, practitioners, and decision-makers when designing and implementing natural treatment methods for mental health-promoting interventions for individuals with mood disorders.

Globally, humans are increasingly faced with a wide variety of health risks. It is meaningful that both scholars and practitioners recognize the multifaceted nature of health risk perception and communication (HRPC). Extensive studies related to HRPC have been conducted to date. However, no bibliometric analysis has systematically investigated this issue. The purpose of this study was to identify the current landscape and frontier trends of scientific achievements on HRPC through bibliometric approaches. Quantitative analysis of publications relating to HRPC from 1999 to 2021 was interpreted and graphed through the Web of Science Core Collection database on October 21, 2022. A variety of quantitative variables was analyzed by using Microsoft Excel 2019, including publication and citation counts, H-index, and journal citation reports. Co-authorship, citation, co-citation, and co-occurrence analyses were performed for countries/regions, institutions, authors, and keywords using the VOSviewer and CiteSpace. A total of 1,518 original and review articles in English were identified. The United States has considerable influence in this field, with the majority of publications (772, 50.86%), citations (23,951 times), the highest H-index (453), and close collaborations with the United Kingdom and Australia. The most contributive institution was University of North Carolina. The most productive author is Waters EA, followed by Lemyre L and Renner B. However, the relatively low level of research cooperation existed between institutions and authors. Important topics mainly include the connotations, categories, theoretical framework models, and application scenarios of HRPC. Among the promising hotspots, “Covid-19,” “pandemic,” “vaccine hesitancy,” “social media,” “e-cigarettes,” and “mental health” displayed relatively latest average appearing year. Global trends indicate a growing scientific output on HRPC, and developed countries are leading the way. There is still a need to improve collaboration between research teams. The focus gradually shifts from theoretical research to empirical research. It is recommended to pay attention to the latest hot spots, such as “Covid-19,” “vaccine hesitancy,” “social media,” “e-cigarettes,” and “mental health”.

ObjectiveRelevant research focusing on young adults with Unipolar Depression (UD) and Bipolar Depression (BD) is limited. The current research aims to investigate childhood trauma and personality traits in young adults with UD and BD.MethodsTwo hundred and thirty-five patients in a first depressive episode (diagnosed UD and BD), 16–25 years old, were recruited from Second Xiangya Hospital. And 79 healthy controls (HC) were recruited from the community to form the comparison group. Patients' childhood trauma was measured by the Childhood Trauma Questionnaire (CTQ), and personality was measured by Eysenck Personality Inventory (EPI). The Kruskal-Wallis test was used to compare depression, anxiety, CTQ, and EPI scores between the HC (n = 79), UD (n = 131), and BD (n = 104) groups. Factors independently associated with mood disorders and BD were determined using binary logistic regression analyses.ResultsCompared with HC, mood disorders had more severe anxiety and depression symptoms, and higher CTQ. Emotional abuse (OR = 1.47; 95% CI = 1.08–2.01), emotional neglect (OR = 1.24; 95% CI = 1.05–1.46), and neuroticism (OR = 1.25; 95% CI = 1.16–1.35) were associated with significantly increased odds of mood disorders. Whereas, higher extraversion scores were a protective factor for mood disorders. Compared with UD, BD had more severe anxiety symptoms, and higher CTQ, than extraversion and neuroticism personality scores. Anxiety (OR = 1.06; 95% CI = 1.02–1.08) and extraversion (OR = 1.05; 95% CI = 1.03–1.09) were associated with significantly increased odds of BD.ConclusionInterventions to prevent childhood trauma may improve young adults' mental health. Using childhood trauma and personality to anticipate BD and UD creates more accurate treatment for young adults with first depression.

BackgroundGiven the potentially negative effects of hearing loss on mental health and cognitive function, it is critical to gain a better understanding of the mechanisms underlying the link between hearing loss and cognitive impairment. This study aimed to investigate the moderating effects of social relationships, including their components in the role of depressive symptoms as a mediator between hearing loss and cognitive impairment.MethodsCross-sectional analyses were conducted with 8,094 Chinese older adults (aged ≥65 years) from the Chinese Longitudinal Healthy Longevity Survey in 2018. Simple mediation analysis and moderated mediation analysis were conducted to examine the roles of depressive symptoms and social relationships in the association between hearing loss and cognitive impairment.ResultsThere is a significant correlation between hearing loss, depressive symptoms, social relationships, and cognitive function. Depressive symptoms partially mediated the association between hearing loss and cognitive function [standardized regression B-coefficient (B) = −0.114; 95% confidence interval (CI): (−0.158, −0.076)]. Social relationships moderated the effect of hearing loss on cognitive function through both path b (depressive symptoms - cognitive function) [B = 0.021; 95% CI: (0.008, 0.034)], and path c’ (hearing loss-cognitive function) [B = 0.597; 95% CI: (0.463, 0.730)]. Furthermore, social activities and social networks moderated both the direct and indirect effects of moderated mediation. However, there appeared to be no moderated effect of social support for both the direct and indirect paths.ConclusionSocial relationships moderated both the direct and indirect effects of depressive symptoms on the association between hearing loss and cognitive impairment. These findings shed light on the mechanisms underlying the relationship between hearing loss and cognitive impairment in Chinese older adults. It might be worthwhile to recommend multidimensional health and social interventions aimed at improving mental health and social inclusion among older adults with hearing loss.

Background: Sleep problems are common among older adults worldwide. The present study aims to determine the prevalence of poor sleep quality and its independent factors among retired people in health check-ups population in China.Method: In this multicenter, cross-sectional survey in 2017, a group of retired people was invited to participate in an online survey of health status, and their data, including socio-demographic information, lifestyle, and medical characteristics, were recorded. Binary logistic regression was used to analyze the independent factors responsible for poor sleep quality.Results: Data from 17,408 responders who met the inclusion criteria were analyzed; among them, 53.04 % (95 % CI = 52 %-54 %) reported poor sleep quality. Binary logistic regression showed that poor sleep quality was associated with a number of factors, including being female (OR = 1.42, 95 % CI = 1.32-1.53), being single (OR = 1.35, 95 % CI = 1.18-1.54), non-smoker (OR = 1.12, 95 % CI = 1.03-1.22), physical inactivity (OR = 1.14, 95 % CI = 1.05-1.23), poor self-rated health status (OR = 1.69, 95 % CI = 1.43-2.00), long-term medication use (OR = 1.05, 95 % CI = 1.07-1.23), chronic pain (OR = 1.33, 95 % CI = 1.22-1.45), comorbidity (OR = 1.16, 95 % CI = 1.07-1.25), and depressive symptoms (mild depression: OR = 2.14, 95 % CI = 1.96-2.34; moderate depression: OR = 4.00, 95 % CI = 3.49-4.58, moderately severe depression: OR = 4.15, 95 % CI = 3.47-4.97, severe depression: OR = 4.27, 95 % CI = 2.93-6.22); while age (OR = 0.99, 95 % CI = 0.99-1.00) was negatively related to poor sleep quality.Conclusion: The prevalence of poor sleep quality in the studied population is relatively high (53.04 %). Sleep problems are common among Chinese retirees, especially older females, and have a great impact on their quality of life. People living with depression, chronic diseases, and chronic pain were at a higher risk of developing sleep disorders. Therefore, it is critical to formulate effective management strategies for Chinese retirees with poor sleep quality in the context of healthy aging.

ObjectiveThe purpose of this study was to explore the relationship between academic stress, school bullying and self-harm behaviors among Chinese middle school students and to further explore the impact of anxiety and depression on this relationship.MethodsThe students (aged 12–16 years) in a middle school in Changsha city were invited to respond to a questionnaire through an online platform. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess the severity of anxiety and depressive symptoms, respectively. The experience of being bullied, academic stress, and self-harm behaviors were assessed using several questions on the basis of previous studies.ResultsA total of 1,313 middle school students completed the study, and 3.40% and 4.10% of them reported suicide attempts (SAs) and non-suicidal self-injury (NSSI), respectively. Univariate logistic regression analysis revealed that anxiety symptoms (OR = 1.23, 95% CI: 1.18–1.28; OR = 1.25, 95% CI: 1.19–1.31), depressive symptoms (OR = 1.20, 95% CI: 1.16–1.25; OR = 1.26, 95% CI: 1.20–1.31), school bullying (OR = 3.8, 95% CI: 2.11–6.89; OR = 2.76, 95% CI: 1.39–5.47), and academic stress (OR = 2.20, 95% CI: 1.27–3.80; OR = 3.80, 95% CI: 1.20–7.25) were common factors of NSSI and SAs. In addition, depressive symptoms showed a mediating effect on the association of school bullying and academic stress with SAs or NSSI, and anxiety symptoms showed a mediating effect on the association of school bullying and academic stress with NSSI only.ConclusionAppropriate strategies are needed to reduce academic pressure and prevent school bullying. Meanwhile, negative emotions such as depression and anxiety should be evaluated and intervened in to prevent self-harm behaviors among middle school students.

OBJECTIVES:Exercise is a key way to control the blood glucose, which can improve blood lipids and blood pressure, reduce glycated hemoglobin levels, and increase insulin sensitivity. It is of great significance for maintaining blood glucose homeostasis. This study aims to explore the optimal exercise combinations suitable for diabetic patients, and to provide scientific and effective personalized exercise guidance for diabetic patients.METHODS:The physical examination data and questionnaire results of were collected from the Third Xiangya Hospital of Central South University. The study was involved in 3 867 diabetes from January, 2020 to December, 2021. The basic information and living habits were obtained through questionnaires. The fasting blood samples were collected to measure the levels of total cholesterol (TCh), triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and fasting blood glucose. Physical measurements included height, weight, waistline, hipline, and blood pressure. Categorical variables were tested using chi-square tests, and continuous variables were tested using non-parametric Kruskal-Wallis test. Multiple linear regression model was used to analyze the relationship between exercise behaviors (frequency, duration, and intensity), years of exercise, diet habits, medicine, and fasting blood glucose. The relationship between different exercise behaviors and various indexes (BMI, blood pressure, blood lipids, blood glucose) was analyzed by multiple rising sun rose plots. The polar thermal diagram showed the relationship of exercise behaviors with the best expected effect.RESULTS:Non-parametric Kruskal-Wallis test showed that there were significant differences in other indexes except LDL-C (P=0.681) among groups with different exercise behaviors (all P<0.01). The multiple rising sun rose plots showed that diabetic patients who did moderate to high intensity exercise more than 5 times a week for more than 30 min each time had a healthier BMI, blood lipid levels, blood glucose levels, and blood pressure. Polar thermal diagram showed that low-intensity exercise once or twice a week requires 30 to 60 min or more of exercise to achieve the desired results. Multiple linear regression analysis showed that frequency (β=-0.208, 95% CI -0.356 to -0.059, P=0.006), duration (β=-0.227, 95% CI -0.387 to -0.066, P=0.006), intensity of exercise (β=-0.110, 95% CI -0.218 to -0.002, P=0.046), diet habits (β=0.462, 95% CI 0.295 to 0.556, P<0.001) and medicine (β=-0.520, 95% CI -0.720 to -0.312, P<0.001) were correlated with fasting blood glucose.CONCLUSIONS:Moderate to high intensity exercise for more than 30 min and 5 times a week is the most beneficial combination for diabetes. Low exercise intensity should be combined with higher exercise frequency and longer exercise time to achieve the desired effect. With the increase of exercise intensity, the relationship between low exercise frequency and long exercise time is weakened.

近年来，为探索健康体检的价值，国内外开展了大量研究。基于研究结果，国外医学协会及权威杂志认为健康体检不能降低总死亡率和心血管事件，因此不推荐对无症状的成年人进行年度健康体检。为客观评价这一结论，本文通过检索4个文献数据库2000至2022年关于健康体检价值的英文文章，从研究目的、研究设计及方案、可能影响结果的主要问题等方面进行解读和分析。由于不同国家对健康体检的付费机制不同，且健康管理服务内涵及实施方案差别巨大，研究结果存在较大的异质性。因此，不能依据现有临床研究结果得出健康体检“有用”或“无用”的结论。尽管如此，这些研究对于合理设置健康体检项目、规范主检报告以及加强检后健康管理有一定的启示作用。未来，以健康体检为基础的健康管理对于提高慢性病防控水平，降低死亡率的价值仍需进一步研究及评价。

OBJECTIVESTo examine the relationship between hearing loss and subjective well-being (SWB) and to investigate the mediating roles of social activity and cognitive function in the link between hearing loss and SWB.METHODSAn analysis of 11,949 older Chinese adults was conducted from the 2018 wave of the Chinese Longitudinal Health Longevity Survey. Multiple linear regression and mediation analysis were conducted.RESULTSHearing loss had a significant negative association with SWB (B = -0.787; 95% CI: -0.961, -0.613). Hearing loss influenced older adults' SWB in the following three ways: first, via the partial mediating effect of social activity (B = -0.021, 95% CI: -0.036, -0.009); second, via the partial mediating effect of cognitive function (B = -0.275, 95% CI: -0.347, -0.252); and third, via the serial mediating effects of social activity and cognitive function (-0.016, 95% CI: -0.021, -0.011).CONCLUSIONSSocial activity and cognitive function play a serial intermediary role in the relationship between hearing loss and SWB among older Chinese adults.CLINICAL IMPLICATIONSMultidimensional health and social interventions aimed at improving mental health and social inclusion among adults with hearing loss should be recommended.