Cardiometabolic multimorbidity (CMM), defined as the coexistence of two or more cardiometabolic diseases, poses a growing global health burden. However, few studies have jointly evaluated the risk of CMM using indicators of both insulin resistance and frailty. Using data from the China Health and Retirement Longitudinal Study (CHARLS), we constructed a composite index integrating the metabolic score for insulin resistance (METS-IR) and the frailty index (FI) and investigated its association with incident CMM among 2,968 middle-aged and older Chinese adults. During the follow-up period, 230 participants (7.75%) developed CMM. In fully adjusted Cox regression models, each 1-SD increase in baseline and cumulative METSIR-FI was associated with a 35% (HR = 1.35, 95%CI: 1.22-1.49) and 45% (HR = 1.45, 95%CI: 1.31-1.61) higher risk of CMM, respectively. Participants in the highest tertile of baseline METSIR-FI had a significantly higher risk of CMM (HR = 2.78, 95%CI: 1.79-4.30), with even stronger associations observed for cumulative METSIR-FI (HR = 4.29, 95%CI: 2.63-6.98) and the highest-risk cluster (HR = 3.69, 95%CI: 2.46-5.55). Restricted cubic spline analyses revealed significant nonlinear dose-response relationships with threshold effects. Incorporating METSIR-FI into conventional risk models improved the C-statistic from 71.32% to 77.47%, with significant net reclassification improvement and integrated discrimination improvement. These findings suggest that a joint metabolic-frailty burden indicator provides incremental prognostic value beyond conventional risk factors and may serve as a practical composite indicator for CMM risk stratification among middle-aged and older adults.

Background: Sleep pattern (sleep duration, trouble sleeping, sleep disorder) is associated with both energy density dietary inflammatory index (EDII) and depression. However, whether depression mediates the EDII-sleep pattern relationship is unclear. Methods: 14,305 participants from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2014 were included in this study. Weighted multivariable logistic regression and mediated effect analysis were conducted to analyze the associations between EDII, depression and sleep pattern. Results: In the regression model with full confounding variables adjusted, the OR (95 % CI) for the association between EDII and sleep pattern was 2.11 (1.44, 3.08). Similarly, comparing the highest to the lowest EDII scores, the association with depression yielded an identical OR of 2.62 (1.89, 3.64). Mediation models showed depressive symptoms mediated 24.06 % of the EDII-sleep pattern link. Analysis by sleep pattern subtypes found depressive symptoms mediated 18.22 % for sleep duration, 30.53 % for sleep disorder (both with substantial direct EDII effects), and 93.73 % for trouble sleeping, where EDII's direct impact was not considerable. Conclusion: Positive association of EDII with unhealthy sleep pattern is partly mediated by depression, and anti-inflammatory diet could be beneficial.

Background:Metabolic syndrome (MetS) and elevated high-sensitivity C-reactive protein (hs-CRP) have been identified as risk factors for heart failure (HF) in some studies. However, little was known about the co-exposure of MetS and inflammation to HF. We aimed to investigate the combined effect of MetS and high hs-CRP levels on the risk of incident HF. Methods:The study included 94,841 participants without HF selected from the Kailuan cohort in 2006 (the baseline) and then followed up until 31 December 2020. Participants were divided into four groups based on the presence of MetS and high hs-CRP levels (>3mg/L) at baseline: MetS-CRP- (n=53,937), MetS-CRP+ (n=10,338), MetS+CRP- (n=23,521), MetS+CRP+ (n=7,045). Cox regression models were used to analyze the association of MetS and inflammation with the risk of HF. Statistical significance was defined as a two-tailed P value < 0.05. Results:The mean age of the participants was 51.5 ± 12.5 years, and 75,976 (80.0%) were male. During 13.1 years of follow-up, 3,058 participants were diagnosed with HF. The HF incidence rate of four groups were 1.69/1000pys, 2.95/1000pys, 3.27/1000pys, 5.33/1000pys. The HR for MetS-CRP+, MetS+CRP-, and MetS+CRP+ were 1.29 (95% CI, 1.15-1.45), 1.40 (95% CI, 1.29-1.53), and 1.85 (95% CI, 1.65-2.06), respectively, compared with MetS-CRP-. After stratification by age (p for interaction < 0.01), compared with the MetS-CRP- group, the HR of the MetS+CRP+ group was 2.17 (95% CI, 1.83-2.57) in participants with < 60 years and 1.53 (95% CI, 1.32-1.78) in participants with ≥ 60 years. There was an interaction between groups and ues of antihypertension medication (p for interaction <0.01). Compared with MetS-CRP-, the risk of HF in the MetS+CRP+ group was increased 1.38-fold (95% CI, 1.12-1.70) in participants with antihypertension medication use and 2.00-fold (95% CI, 1.75-2.27) in participants without antihypertension medication use. Conclusions:The combination of MetS and elevated hs-CRP was associated with increased risk of HF in the Chinese population. Clinical trial registration:https://www.chictr.org.cn, identifier ChiCTR-TNRC-11001489.

Introduction: The relationship between sleep duration and metabolic syndrome (MetS) remains debatable. In the present study, we analysed the link between total sleep duration (including nighttime sleep and nap duration) and MetS as well as its components among the Chinese population. Material and methods: This was a cross-sectional study from a prospective population cohort including 8616 participants over 40 years in Guangxi, China, evaluated from April 2011 to January 2012. MetS was diagnosed using modified criteria from the National Cholesterol Education Program's Adult Treatment Panel III. Sleep information was obtained through a standard self-report-based questionnaire. The connection between sleep duration and MetS prevalence as well as its components was evaluated using a logistic regression model. Results: After adjusting for potential confoundings, the longer daily sleep duration (>= 10 hours) group was observed to have the higher odds of having MetS than the reference group with >= 7 and < 8 hours of sleep [odds ratio (OR): 1.25, 95% confidence interval (CI): 1.03-1.52, p = 0.023], as well as the highest odds of having elevated triglycerides (OR: 1.25, 95% CI: 1.03-1.52) and fasting blood glucose (OR: 1.21, 95% CI: 1.01-1.45). Further analysis demonstrated that sleeping > 9 hours per night was correlated to MetS in females (OR: 1.27, 95% CI: 1.02-1.58), while napping >= 90 minutes was correlated to MetS (OR: 1.44, 95% CI: 1.11-1.87) in males. Conclusion: Both longer nighttime sleep duration and longer naps may be associated with the development of MetS.

目的 分析贵港市手足口病的空间分布特征,探讨气象因素对手足口病发病的影响及滞后效应.方法 通过Arc-GIS10.8软件分析贵港市手足口病空间分布规律,利用核密度分析方法研究高发病地区,采用R 4.2.0软件对气象因素和手足口病日发病人数进行Spearman秩相关分析以及分布滞后非线性模型研究.结果 2015—2019年贵港市手足口病累积报告40814例.贵港市手足口病存在空间聚集性,核密度分析显示高发病聚集区主要为贵城街道和江南办事处.手足口病发病与日平均气温、日降雨量和日照时数呈正相关,与日平均气压呈负相关.气温为30.4℃(P95)时,滞后21 d有最高累积滞后风险,RR为1.49(95％CI:1.23,1.80);气压为995.3 hPa(P5)时,滞后21 d有最高累积滞后风险,RR为1.56(95％CI:1.29,1.88);日降雨量为25.06 mm(P95)时,滞后21 d有最高累积滞后风险,RR为1.43(95％CI:1.16,1.77);日照时数为10.3 h(P95)时,滞后21 d有最低累积滞后风险,RR为0.48(95％CI:0.38,0.59).结论 高气温、低气压、较高的降雨量都会使手足口病的发病风险增加,而长日照会使发病风险降低,并且都具有一定的滞后效应,本研究可为手足口病的预警预测提供理论依据.

Objective To explore the effects of polycyclic aromatic hydrocarbons（PAHs） exposure and its interaction with alcohol consumption on the mental health of non-smokers. Methods A questionnaire survey and mental health assessment were conducted among 513 non-active smokers in a large enterprise in Guangxi. The general mental health questionnaire was used to evaluate the mental health status of the subjects. Urinary hydroxypolycyclic aromatic hydrocarbons（OH-PAHs） levels were employed as an indicator of internal exposure to PAHs. Logistic regression model and generalized linear model were employed to analyze effects of PAHs exposure and its interaction with alcohol consumption on mental health status. Results The average age of the subjects in this study was（39.60±6.60） years old. 44.2% of the subjects were drinkers, with most being unmarried, male, and exposed to secondhand smoke（P＜0.05）. Logistic regression analysis showed that the increase of urine concentration of 1-hydroxynaphthalene（1-OHNAP） and total hydroxynaphthalene（∑OHNAPs） was associated with the risk of poor mental health（OR=1.23, 95% CI: 1.01-1.49; OR=1.10, 95% CI: 1.00-1.21; all P＜0.05）. Interaction analysis showed that compared with non-drinking and low level OH-PAHs group, the concentration of 1-OHNAP, 2-hydroxynaphthalene（2-OHNAP）, ∑OHNAPs and total hydroxypolycyclic aromatic hydrocarbons（∑OHPAHs） in urine and alcohol consumption increased the risk of poor meatal health in middle-aged and older adults(OR=3.91, 95% CI:1.01-15.11; OR=3.69, 95% CI: 1.05-12.98; OR=1.96, 95% CI: 1.01-3.80; OR=1.73, 95% CI: 1.06-2.93; all P int ＜0.05). Conclusions PAHs exposure is a risk factor for poor mental health in non-smoking populations, and alcohol consumption can exacerbate the risk of poor mental health in middle-aged and elderly non-smokers exposed to PAHs.

Abstract Background The aim of this study is to explore the relationship between reproductive variables and the prevalence of metabolic syndrome (MetS) and its components among Chinese women aged 40 years and older. Methods A cross‐sectional study was conducted among 4453 women aged 40 years and older in Guangxi, China. The associations between women's reproductive factors and MetS were analyzed using a logistic regression model. Results The prevalence of MetS was 23.9% in this population. Women with MetS were mostly older, more likely to be postmenopausal, and had higher parity. Compared to women with one prior live birth, those with three or more live births had the highest odds of having MetS (odds ratio [OR] = 1.56; 95% CI, 1.23–1.99). Similarly, compared to premenopausal women, postmenopausal participants had higher odds of having MetS (OR = 1.86; 95% CI, 1.49–2.31). No associations were observed between MetS and abortion or with age at menarche. Conclusions Our study suggests that multiparity and menopausal status may be associated with the development of MetS. The inconsistency seen in epidemiological research to date calls for further investigation.

It has been recognized for some time that a number of different neuropeptides exert powerful effects on food intake. During the last few years, the neurocircuitry within which these peptides operate has also begun to be elucidated. Peptidergic feeding-regulatory neurones are found both in the hypothalamus and the brainstem, where they act as input stations for hormonal and gastrointestinal information, respectively. These cell populations both project to several other brain regions and interconnect extensively. The present review summarizes the neuroanatomy and connectivity of some prominent peptides involved in food intake control, including neuropeptide Y, melanocortin peptides, agouti gene-related protein, cocaine- and amphetamine-regulated transcript, orexin/hypocretin, melanin-concentrating hormone and cholecystokinin. Disturbances in the hypothalamic neuropeptide systems have been implicated in the phenotype of a genetic model of fatal hypophagia, the mouse anorexia (anx) mutation, which is also discussed.

目的 研究老年男性尿中金属浓度与高尿酸血症的相关性.方法 采用横断面设计,于2016年8月—2017年7月在广西某地区抽取老年男性进行健康体检、尿样采集和问卷调查,采用电感耦合等离子体质谱检测晨尿中锰、钛、钒、铁、钴、镍、铜、锌、砷、钼、镉、铅、硒、铷、锶、钡和铊17种金属元素的浓度.采用Wilcoxon秩和检验、多因素Logistic回归和限制性立方样条(RCS)函数等方法探究老年男性尿中金属浓度与高尿酸血症的相关性.结果 研究最终纳入375名老年男性,共有高尿酸血症患者86名(占22.9％).高尿酸症患者尿中钒、铁、砷、铅、铷、锶和铊浓度均低于非高尿酸血症人群,而锌浓度高于非高尿酸血症人群,差异均有统计学意义(P<0.05).RCS分析结果显示尿铜和尿锌与血尿酸关系曲线分别呈"U"型和"倒U"型,尿铁、钴、铷和锶与血尿酸均呈负相关(P<0.05),且尿铷与血尿酸的关系曲线呈现先快速降低后缓慢降低的下降趋势(P非线性<0.05).根据尿中金属元素浓度三分位数对应的低、中、高水平将研究对象分为T1、T2和T3三组,多因素Logistic回归单金属模型结果显示,尿锌、锶和铷T3浓度组研究对象高尿酸血症的患病风险分别是T1浓度组的3.74(95％CI:1.64～8.50)、0.42(95％CI:0.16～0.93)和0.35(95％CI:0.13～0.99)倍;多金属联合作用模型显示,尿锌T3浓度组研究对象高尿酸血症的患病风险是T1浓度组的4.96(95％CI:2.09～11.81)倍.RCS函数显示校正混杂因素后尿铷和锶与高尿酸血症患病风险呈负向剂量-反应关系(P<0.05,P非线性>0.05).结论 尿中锌、铷和锶水平可能与广西某地区老年男性高尿酸血症有关,其中尿锌与高尿酸血症发生风险呈正相关,而尿铷和锶与其呈负相关.

高校实施本科生导师制是高校教学体制改革的一种新趋势。本研究以广西壮族自治区某医科大学公共卫生学院预防医学专业首批实行本科生导师制的2015级学生以及未实行导师制的2014级学生为研究对象，通过统计学方法分析比较两组学生大一至大三47门必修考试科目成绩。研究结果显示，2015级学生的学业成绩显著优于2014级学生，其中英语以及专业课成绩优势尤为显著。研究表明，本科生导师制的实施有助于提升学生的学习成绩，是值得推广的高校人才培养的有效模式。

MS是一组心血管疾病危险因素,近年来发病率不断升高.睡眠是调节人体新陈代谢的重要生理过程.随着人们生活方式改变,睡眠不足或睡眠质量下降逐渐增加.睡眠时长、午睡与MS患病风险相关.本文对睡眠时长和午睡与MS相关性的研究进展进行综述.

目的:探讨基于网络课程建设的混合式教学模式在《环境卫生学》课程中的应用效果.方法:以广西医科大学2018～2020年参加国家公共卫生执业医师资格考试医学综合笔试的预防医学应届毕业生为研究对象,其中2018年考生采取传统教学,2019年考生采取混合式教学,2020年考生采取基于网络课程建设的混合式教学模式.结果:学生采取基于网络课程建设的混合式教学模式时,平均成绩均高于传统模式和混合式教学模式,也均高于广西区内学校和全国成绩(P＜0.05);随着教学模式的不断改革优化,学生的掌握率逐年上升,也高于广西区内学校和全国平均水平.结论:基于网络课程建设的混合式教学模式能显著提高《环境卫生学》的教学效果,对突破传统课堂教学的局限性和提高学生自主学习能力具有重要意义.

BackgroundThe aim of this study is to explore the relationship between reproductive variables and the prevalence of metabolic syndrome (MetS) and its components among Chinese women aged 40 years and older. MethodsA cross-sectional study was conducted among 4453 women aged 40 years and older in Guangxi, China. The associations between women's reproductive factors and MetS were analyzed using a logistic regression model. ResultsThe prevalence of MetS was 23.9% in this population. Women with MetS were mostly older, more likely to be postmenopausal, and had higher parity. Compared to women with one prior live birth, those with three or more live births had the highest odds of having MetS (odds ratio [OR] = 1.56; 95% CI, 1.23-1.99). Similarly, compared to premenopausal women, postmenopausal participants had higher odds of having MetS (OR = 1.86; 95% CI, 1.49-2.31). No associations were observed between MetS and abortion or with age at menarche. ConclusionsOur study suggests that multiparity and menopausal status may be associated with the development of MetS. The inconsistency seen in epidemiological research to date calls for further investigation.

[背景]被动吸烟是非吸烟人群睡眠质量的危险因素.研究发现不良的厨房烹饪条件、烹饪行为及通风状况也与人群睡眠质量相关.但不良厨房烹饪条件、烹饪行为和通风状况单独作用及与被动吸烟交互作用对非吸烟人群睡眠质量影响鲜有报道.[目的]探讨厨房烹饪条件、烹饪行为和通风状况单独作用及与被动吸烟交互作用对非吸烟人群睡眠质量的影响.[方法]采用整群抽样的方法,于2017年9月对广西某企业514名非吸烟员工进行问卷调查和健康体检.通过问卷收集研究对象的人口学特征、被动吸烟、厨房烹饪条件(如厨房面积)、烹饪行为(如是否加热食用油至冒烟后才炒菜)及通风状况(如通风设备使用情况及通风效果)等.采用匹兹堡睡眠质量指数量表(PSQI)评估研究对象的睡眠质量情况.根据研究目的,进一步排除既往已确诊或自述患有某些慢性疾病、焦虑症和抑郁症者,以及少部分主要信息缺失者,最终本研究共纳入426名研究对象.采用logistic回归模型分析被动吸烟和厨房烹饪条件、烹饪行为、通风状况单独作用及两两交互作用对非吸烟人群睡眠质量的影响.[结果]研究对象PSQI总分为(5.50±0.14)分,被动吸烟组PSQI总分较无被动吸烟组高(P=0.002).被动吸烟(OR=2.06,95％CI:1.34～3.16)和厨房通风效果不良(OR=2.00,95％CI:1.32～3.04)是非吸烟者总体睡眠质量的危险因素.交互分析显示,与无被动吸烟+良好厨房烹饪条件/烹饪行为/通风状况相比,被动吸烟+厨房面积≤5m2(OR入睡 =2.47,OR总体=2.35,P＜0.05)、被动吸烟+加热食用油至冒烟后才炒菜(OR总体=2.59,P＜0.05)、被动吸烟+厨房不采用机械通风设备(OR日间=1.97,OR总体=2.13,P＜0.05)或厨房通风效果不良(OR睡眠时间=2.13,OR日间=2.58,OR总体= 3.86,P＜0.05)的非吸烟者发生睡眠质量不好的风险更高.[结论]被动吸烟和厨房通风不良均是非吸烟者总体睡眠质量的危险因素,并且被动吸烟分别与厨房面积≤5 m2、加热食用油至冒烟后才炒菜、厨房不采用机械通风设备或通风效果不良两两同时存在时对非吸烟人群睡眠质量的危害更大.

Metabolic syndrome is a clinical syndrome characterized by the co-existence of obesity, hyperglycemia, hypertension, dyslipidemia and other metabolic disorders.At present, the incidence of metabolic syndrome is increasing year by year.Metabolic syndrome is more common among the elderly, seriously threatening the quality of life in the elderly.Tea, as one of the most popular beverages in the world, has been found to have effects on lowering the levels of blood pressure, blood glucose and lipid and so on.This review summarizes the effects and possible mechanisms of tea drinking on metabolic syndrome and its components in the elderly.

[背景]已有研究表明,钒、钴、锶、钼等微量元素稳态失衡可能会导致人体的生理异常甚至引发疾病,但目前关于其对老年人认知功能影响的研究还鲜有报道.[目的]探讨广西某地区老年男性尿液中钒、钴、铜、锶、钼5种微量元素水平与认知功能的相关性.[方法]于2016年8月—2017年7月在广西某地区共招募了375名符合标准的60岁及以上老年男性,通过问卷调查收集基本信息,采用中文版简易精神状态检查量表(MMSE)评估研究对象的认知功能;同时收集尿液,采用电感耦合等离子体质谱检测5种微量元素浓度.采用Wilcoxon秩和检验比较不同认知功能水平研究对象尿中微量元素浓度差异;使用一般线性模型探索尿液微量元素与MMSE分值的关系;根据各微量元素浓度的三分位数,将研究对象分为T1～T33组,采用二元logistic回归模型分析微量元素水平与认知功能受损的关系.[结果]在本研究调查的375名老年男性中,共有109名(29.1％)存在认知功能受损.认知功能受损者和认知功能正常者尿钒、钴、铜、锶和钼的中位数浓度(肌酐校正)分别为1.31、0.15、8.96、62.15、73.75μg·g-1和1.04、0.12、7.68、49.32、62.60μg·g-1,认知功能受损者尿钒、钻、铜和锶的浓度均高于认知功能正常者(均P＜1.05).一般线性模型结果显示:校正混杂因素后,Ig铜和Ig锶每增加一个单位,MMSE分值分别变化-0.91 (95％CI:-1.76～-0.07)、-1.56(95％CI:-2.92～-0.20).logistic回归模型结果显示:在校正混杂因素前,5种微量元素均为认知功能受损的危险因素(均P趋势＜0.05);校正混杂因素后,钒、铜和锶仍为认知功能受损的危险因素(均P趋势＜0.05),与T1浓度组的老年人相比,钒、铜和锶的T3浓度组老年人认知功能受损的风险OR (95％CI)值分别为2.08 (1.15～3.76)、2.04 (1.15～3.63)和1.94 (1.10～3.43).5种微量元素同时纳入logistic回归模型结果显示:与铜的T1浓度组相比,T3浓度组老年人认知功能受损的风险增加(0R=1.96;95％CI:1.07～3.58).[结论]尿中钒、铜和锶水平较高可能与广西某地区老年男性认知功能受损相关.