Introduction Oral diseases affect nearly half of the global population and impose substantial health and economic burdens, particularly in China. However, evidence on the cost-effectiveness of preventive oral health interventions remains limited. This study aims to evaluate the long-term cost-effectiveness of promoting population-based oral self-care behaviours across China.Methods We developed the China Oral Health Model, a prevention-oriented population policy simulation that projects annual transitions across major oral health states (dental caries, periodontitis, tooth loss and edentulism) among individuals aged ≥12 years. Preventive self-care strategies were modelled as relative reductions in the probabilities of disease onset and progression, implemented through changes in intermediate clinical states. The model was parameterised using nationally representative data from the Fourth National Oral Health Survey of China, 2015 to 2017, supplemented by age-specific prevalence estimates from the literature. We evaluated three key oral self-care behaviours: brushing teeth twice daily, using dental floss and using mouthwash. Intervention effect parameters for brushing, flossing and mouthwash were obtained from published clinical and epidemiological studies, with uncertainty assessed in sensitivity analyses. We conducted a societal-perspective cost-effectiveness analysis, stratified by rural and urban populations, including intervention costs estimated from market price data. Outcomes included lifetime reductions in tooth loss, total costs, quality-adjusted life years (QALYs) gained and incremental cost-effectiveness ratios (ICERs) compared with current practice. Cost-effectiveness was assessed against a willingness-to-pay threshold of $12,720.20 per QALY (one time GDP per capita), with threshold sensitivity analyses using one to three times GDP per capita.Results Brushing teeth twice daily was the only cost-saving intervention, reducing periodontitis by 50.2% relative to status quo, dental caries by 6.5% and tooth loss by 24.8%, while generating $718.82 billion in medical cost savings. The intervention yielded 148.27 million QALYs nationally (98.10 million in urban areas and 50.17 million in rural areas), with a greater reduction in periodontitis observed in rural regions (1.38 percentage points higher than urban). In contrast, dental flossing and mouthwash use increased costs and were not cost-effective at the one time GDP-per-capita threshold (ICERs of $49,677.58/QALY and $84,283.51/QALY, respectively). Findings were robust in threshold sensitivity analyses using one to three times GDP per capita.Conclusion Promoting twice-daily toothbrushing is cost-saving and improves oral health outcomes in China, particularly by reducing periodontitis and tooth loss, with larger periodontitis reductions in rural areas. These findings support the integration of basic oral hygiene practices into national health promotion and disease prevention strategies.

BACKGROUND:Despite the increasing adoption of dispatcher-assisted Cardiopulmonary Resuscitation (DA-CPR), evidence on its efficacy remains relatively scarce in developing countries. This interrupted time-series study assessed the impact of the DA-CPR policy on Out-of-hospital cardiac arrest (OHCA) outcomes in Shanghai, with the aim of informing evidence-based improvements in emergency care systems. METHODS:This study analyzed OHCA data reported by the Shanghai Medical Emergency Center from January 2019 to July 2024. Joinpoint regression analysis was used to identify and adjust for the impact of COVID-19 on OHCA outcomes. A modified autoregressive integrated moving average (ARIMA) model was used to quantify changes in outcomes before and after the implementation of the DA-CPR policy. Counterfactual analysis simulated OHCA outcomes trajectories without the policy, providing visual demonstration of the policy's effects. RESULTS:Among 75,628 OHCA cases (median age 85), annual OHCA incidence ranged from 144 to 287 per 100,000 population, with age-standardized rates of 60 to 105. The average bystander CPR rate was 4.643% (age-standardized: 10.554%), the average ROSC rate was 2.914% (age-standardized: 4.799%), and the 30-day survival rate was 0.376% (age-standardized: 1.379%). Time-series analysis showed a significant post-policy level increase of 3.553 percentage point in bystander CPR (95% CI 1.227-5.879, P < 0.05), 2.215 percentage point in ROSC (95% CI 1.052-3.380, P < 0.001) and 0.461 percentage point in 30-day survival (95% CI 0.025-0.898, P < 0.05). CONCLUSIONS:DA-CPR implementation substantially improved OHCA outcomes in Shanghai, supporting its adoption in developing countries to optimize emergency care outcomes.

BACKGROUND:The global prevalence of eating disorders has been rising, contributing to premature mortality and substantial health burdens among adolescents and young adults. However, long-term trends and future projections remain understudied in this population. METHODS:Using data from the Global Burden of Disease 2021, with eating disorder diagnoses according to ICD-10 criteria, we estimated age-standardized prevalence, incidence, and disability-adjusted life years (DALYs) rates with 95 % uncertainty intervals (UIs). Temporal trends were evaluated using average annual percent change (AAPC) and joinpoint regression. Decomposition analysis evaluated contributions of population growth, aging, and epidemiological changes to DALY trends. Future burden until 2040 was projected using Bayesian age-period-cohort models and Poisson regression. RESULTS:From 1990 to 2021, global age-standardized rates for prevalence, incidence, and DALYs of eating disorders among individuals aged 10-24 years all increased significantly (AAPC for each = 0.53). In 2021, the global prevalence rate was 357.10 per 100,000 population, incidence was 380.96 per 100,000 person-years, and DALYs reached 76.51 per 100,000 population. Females had notably higher prevalence (466.37 [300.21-701.00]) than males. High socio-demographic index (SDI) regions had the highest prevalence (786.08 [516.77-1186.58]), while middle SDI regions experienced the fastest increase (AAPC 1.18 [1.15-1.21]). By 2040, the global prevalence is projected to reach 373.48 per 100,000. CONCLUSIONS:Eating disorders among adolescents and young adults are growing global health challenges, with rising trends expected through 2040. Economic development and cultural changes are key drivers. These findings highlight urgent needs for early detection, accessible treatment, and culturally tailored public health interventions.

ObjectiveThis study aims to investigate the prevalence of smartphone addiction, physical activity levels, and depressive symptoms among secondary school students, and to analyze the combined impact of smartphone addiction and physical activity on depressive symptoms.MethodsA cluster sampling method was employed in two secondary schools in the Jing’an District of Shanghai, China. Univariate analysis was used to compare the prevalence of depressive symptoms across different demographic characteristics. Logistic regression was utilized to examine the associations between smartphone addiction, physical activity, and their combined effect on depressive symptoms.ResultsA total of 1,316 respondents participated in the study, with reported prevalence rates of depressive symptoms (36.2%), smartphone addiction (19.2%), and insufficient physical activity (23.3%). Risk factors for depressive symptoms included being a non-only child (OR=1.421, 95% CI: 1.090-1.853, P=0.009), inadequate sleep duration (OR=2.722, 95% CI: 2.070-3.578, P<0.001) and smartphone addiction (OR=2.173, 95% CI: 1.621-2.913, P < 0.001). Adolescents with smartphone addiction were significantly more likely to report depressive symptoms compared to those without (OR=2.173, 95% CI: 1.621-2.913, P < 0.001). Joint analysis indicated that combined smartphone addiction and insufficient physical activity significantly increased the risk of depressive symptoms (OR=2.781, 95% CI: 1.627-4.753, P < 0.001).ConclusionThe study identified a high prevalence of severe smartphone addiction, insufficient physical activity, and elevated rates of depressive symptoms among secondary school students. Smartphone addiction and inadequate physical activity were associated with increased likelihood of depressive symptoms. Moreover, higher levels of physical activity appeared to mitigate the adverse impact of smartphone addiction on depressive symptoms.

The prevalence of mental health problems among adolescents is on the rise globally, and is a pressing public health concern in many developing countries, including China. While a growing body of epidemiological research has identified potential factors affecting adolescent mental health, few have considered both risk and protective factors across multiple domains or utilized machine learning approaches to identify and rank these factors. This is a cross-sectional study based on data from 3,526 adolescent participants aged 11–15 years in the Qu County Study in China, and aims to identify and rank factors across five domains—including sociodemographic factors, academic functioning, extracurricular activities, life experiences, and resilience factors—in predicting adolescent mental health outcomes. A Bayesian machine learning approach is used to identify and rank important factors in predicting adolescent mental health outcomes, including depressive symptoms, anxiety symptoms, and sleep quality. The machine learning models showed satisfactory predictive performance across outcomes (pseudo-R² = 0.24–0.61; RMSE = 0.65–3.60). Experiences of life stress, benevolent events, environmental sensitivity, and shift-and-persist coping strategies were common top predictors in predicting depressive symptoms, anxiety symptoms, and sleep quality. Stress mindset and expressive suppression strategies were unique predictors of sleep quality and depressive symptoms, respectively. Our results revealed the importance of life experience and resilience factors in predicting adolescent mental health. Future studies should investigate the causal relationship between these understudied factors and adolescent mental health.

INTRODUCTION:Excessive salt intake is a major risk factor for cardiovascular disease and premature mortality in China and globally. A recent cluster RCT demonstrated the effectiveness of home cook interventions in reducing salt intake and blood pressure among participants from 6 provinces in China. Yet, it remains unclear whether expanding these interventions across China would be cost-effective. METHODS:The China Cardiovascular Disease Prevention Model, a validated microsimulation model that captures the development and consequences of cardiovascular disease among adults aged ≥35 years in China, was used to estimate lifetime averted cardiovascular disease events and deaths, direct medical costs (2022 international dollar), quality-adjusted life years gained, and the incremental cost-effectiveness ratio of home cook interventions versus the status quo. Costs and quality-adjusted life years were discounted at 3%. RESULTS:Compared with the status quo, home cook interventions were projected to avert 1.97 million coronary heart disease events, 3.69 million stroke events, 0.77 million deaths due to coronary heart disease, and 1.29 million deaths due to stroke in women. The interventions would also avert 1.62 million coronary heart disease events, 3.8 million stroke events, 0.6 million deaths due to coronary heart disease, and 1.15 million deaths due to stroke in men. The interventions resulted in an incremental cost-effectiveness ratio of 3,552 international dollar per quality-adjusted life year in women and 5,445 international dollar per quality-adjusted life year in men and, thus, were cost-effective considering a willingness-to-pay threshold of 21,318 international dollar (1-time gross domestic product per capita). CONCLUSIONS:Public health policymakers in China should consider widely adopting home cook interventions to better prevent cardiovascular disease and reduce healthcare costs.

BackgroundPrimary health institutions, as the “first on-site responders,” play a crucial role in responding to health emergencies. However, there are few studies on the systematic assessment of their emergency response capabilities. We aimed to develop a health emergency response capability evaluation framework for primary health institutions to assess the resuscitation capacity in metropolis.MethodsIn the first stage, we collected preliminary indicators through literature and government documents concerning the primary health evaluation. Afterward, we utilized the Delphi method to consult 15 frontline health emergency response practitioners, health management officials, and research experts. After two rounds of questionnaire consultations, participants scored the importance and feasibility of all indicators. Subsequently, we employed the analytic hierarchy process (AHP) to determine the weights assigned to each indicator and construct the framework of health emergency response capability evaluation for primary health institutions.ResultsWe developed a framework for evaluating the health emergency response capabilities of primary health institutions in metropolis, comprising 3 first-level indicators, 11 s-level indicators, and 37 third-level indicators. In both rounds of consultation, experts provided a unanimous positive consensus, with a 100% agreement rate. The authority coefficient was 0.92 for both rounds, and the p-value of Kendall’s W was statistically significant (<0.001). Furthermore, compared to the first round, the level of coordination among experts improved in the second round. In the process of judging matrices, the consistency ratios (CRs) of indicators at all levels were less than 0.1. For first-level indicators, including “prevention and monitoring,” “resource reserve and system construction,” and “emergency response and summarization,” the respective weight values were 0.286, 0.335, and 0.379, respectively.ConclusionThis study developed a framework for evaluating the health emergency response capabilities of primary health institutions in metropolis. This framework can help improve the evaluation systems for emergency response capacity in primary health institutions in China’s metropolis.

ObjectiveTo identify and clarify the key issues faced by tertiary hospitals in responding to public health emergencies.MethodsA literature review index system was constructed, and key issues were identified using hierarchical analysis.ResultsAfter a systematic literature review, 20 types of problems faced by tertiary hospitals in responding to public health emergencies were identified. Three key issues were ultimately identified by prioritizing the issues that needed to be addressed.ConclusionThe key issues of tertiary hospitals in responding to public health emergencies are concentrated in the areas of emergency response capabilities and competencies of medical staff, the number of emergency response personnel, and the standardization and specificity of training and drills. Tertiary hospitals should focus on these issues in developing public health emergency response systems to improve the effectiveness of their emergency response.

ObjectiveTo identify the key issues in emergency response to public health emergencies in the Yangtze River Delta region, and to provide a basis for the formulation of relevant policies.MethodLiterature on emergency response to public health emergencies in the Yangtze River Delta region was systematically reviewed and collected, and 18 main problems were identified after collecting and organizing the problems. A questionnaire survey and cluster analysis were used to identify the key issues.ResultsThe study of 18 major problems revealed that "insufficient reserve of emergency medical supplies", "insufficient financial investment to meet the needs of emergency response", "lack of a sound mechanism for the deployment of supplies, resulting in the untimely deployment of materials", were the key issues of emergency response to public health emergencies in the Yangtze River Delta region.ConclusionFuture development of the emergency response system in the Yangtze River Delta region should focus on accelerating the integration process of the Yangtze River Delta, establishing and improving information systems, optimizing the material storage and deployment network, prioritizing the fund investment and utilization mechanism, and improving the effectiveness of public health emergency response.

Background The existing family doctor team performance appraisal system is lack of incentive effect,which has hindered the quality development of contracted family doctor services.However,the performance appraisal system based on family doctor teams includes two processes of"primary distribution"and"secondary distribution",which is more capable of mobilizing the work motivation of the family doctor team members.At present,there is a lack of performance evaluation indicator systems for family doctor assistants and public health physicians,although these two groups of people play an important role in the family doctor team.Objective To construct"secondary distribution"indicator system of family doctor team performance based on contracted service fee,with regard to the roles of family doctor assistants and public health physicians.Methods The draft of the"secondary distribution"indicator system of family doctor team performance was preliminarily formulated through literature analysis and semi-structured interview.On the basis of the draft,an expert consultation questionnaire was designed,and two rounds of expert consultation were implemented and completed from October 2021 to April 2022 to develop the"secondary distribution"indicator system of family doctor team performance based on contracted service fee was established.Results The recovery rates of the two rounds of expert consultation questionnaires was 100.0%.For the secondary distribution system of family doctor assistants and public health physicians,the authority coefficient for the first round of correspondence was 0.742 2 and 0.742 0,respectively.Finally,the"secondary distribution"indicator system of family physician assistants,including 3 first-level and 10 second-level indicators,and the"secondary distribution"indicator system of public health physicians,including 3 first-level and 13 second-level indicators,were constructed.Conclusion The final"secondary distribution"indicator system of family physician assistants with 3 primary indicators and 10 secondary indicators and"secondary distribution"indicator system of public health physicians with 3 primary indicators and 13 secondary indicators is logical and scientific to a certain extent,reflecting the labor value of family doctor assistants and public health doctors in the family doctor team in providing contracted services,which is conducive to the special incentive function of contracted service fee and needs to be optimized and improved in the actual assessment in the future.

BackgroundThe global COVID-19 pandemic has highlighted critical concerns surrounding mental health. Social isolation measures, such as the quarantine of incoming travelers, are essential public health strategies for the prevention and control of infectious diseases. However, quarantine can lead to adverse psychological outcomes, including feelings of confinement, boredom, perceived scarcity of supplies and information, financial hardship, and social stigma. This study aims to assess the mental states of quarantined individuals, investigate the factors affecting their mental well-being, and examine their coping mechanisms, with the objective of providing recommendations to enhance mental health in anticipation of future outbreaks, such as Disease X.MethodsWe surveyed 327 individuals in quarantine from September 22, 2020 to January 9, 2021, collecting general demographic data and information related to COVID-19. Depression and anxiety were assessed using the PHQ-9 and GAD-7 scales, respectively, while stress coping was evaluated with a simplified version of the Cope scale. We analyzed the relationships between independent variables and mental health outcomes.ResultsAmong the individuals undergoing entry quarantine, 27.8% reported symptoms of depression, and 20.5% reported symptoms of anxiety. Students were more likely to experience depression compared to those with permanent jobs or no occupation. Significant risk factors for both depression and anxiety included pre-existing health conditions, lack of medical insurance, concerns about shortages of daily necessities during quarantine, and high scores for “guilt and self-blame.” Additionally, participants who worried about the impact of the epidemic on their studies or work, and those with high scores for “denial,” were more likely to exhibit depressive symptoms. On the other hand, participants who were concerned about potential rejection or discrimination from the outside world after quarantine were more prone to anxiety symptoms.ConclusionAttention should be paid to the negative psychological reactions of the entry quarantined personnel, especially those with pre-existing health conditions, those without medical insurance, and students studying abroad. Accurate and effective epidemic dynamic information and preventive and control measures can be provided to the public to prevent fear and stigma against quarantined personnel.

ObjectivesThis research aims to assess the effectiveness and cost-effectiveness of pre-pregnancy deafness screening policies.MethodsMarried couples from Shanghai, Beijing, and Suzhou in China were enrolled. We conducted high-throughput, pre-pregnancy genetic screenings for deafness in women and their partners. We compared the cost-effectiveness of deafness genetic screening with the status quo. The two-step screening (wife then partner) and following treatments and interventions were included in the decision tree model. We conducted a cost-effectiveness analysis based on the decrease in deaf newborns, healthy newborn births, and cost-utility analysis of pre-pregnancy deafness genetic screening separately. Cost, utility, and probability data used in the three models were collected from a survey combined with literature and expert consultants. A 5% discount rate and a series of one-way sensitivity analyses along with a Monte Carlo simulation were used to test the reliability of this research.ResultsBetween Jan 1, 2019, and Dec 31, 2021, we recruited 6,200 females and 540 male spouses from community health service centers in Shanghai, Beijing, and Suzhou. The incremental cost-effectiveness ratio (ICER) for reducing deaf newborn births was USD 32,656 per case and USD 1,203,926 per case for increasing one healthy newborn birth. This gap exists because of the overall decrease of newborn births. From the perspective of the whole society, deafness genetic screening is not cost-effective for reducing the overall quality-adjusted life years (QALY) in the population.DiscussionPre-pregnancy genetic testing is effective in decreasing the occurrence of congenital deafness. It is a cost-saving measure when compared with the costs of future medical expenditure and income loss for the affected families. However, such screening and preventive avoidance of pregnancy will decrease the population size and QALY. Only post-screening ART with PGT was shown to increase the birth of healthy newborns. Focusing on key groups such as premature births or consanguineous couples may improve the societal effects of screening.

The number of Chinese oldest-old (aged 80+) is growing rapidly and some studies have shown that the health status is unequal among older persons in different regions. However, to the best of our knowledge, no study to date has analyzed health inequalities among the oldest-old in urban and rural areas in China. This study therefore aimed to examine the correlation between health inequalities among the oldest-old in urban and rural areas of China. From the 8th wave of the Chinese Longitudinal Health Longevity Survey (CLHLS), we selected 8124 oldest-old participants who met the requirements of the study. Chi-square tests were used to analyze the distribution characteristics of indicators and a logistic model was performed to determine the factors associated with different self-rated health (SRH). The Fairlie model was adopted to decompose the causes and related contributions to health inequality. Our results found that of the Chinese oldest-old, 46.57% were in good health. Urban residents reported significantly better SRH than rural residents (50.17% vs. 45.13%). Variables associated with good and poor SRH had different distribution characteristics. The logistic model suggested that marital status, alcohol consumption, and annual income were important factors underlying the SRH differences. Our decomposition analysis indicated that 76.64% of the SRH differences were caused by observational factors, and validated that the difference in SRH between urban and rural areas was significantly (P<0.05) associated with exercise status (45.44%), annual income (37.64%), social activity status (3.75%), age (-5.27%), and alcohol consumption (-2.66%). Therefore, socioeconomic status and individual lifestyle status were the main factors underlying the health inequality between urban and rural Chinese oldest-old.

Retirement has a heterogeneous impact depending on gender and occupation. This study aimed to analyze and evaluate the heterogeneity and potential mechanism of retirement on the biomedical risk factors for cardiovascular and metabolic diseases. Physical examination data from 2017 to 2020 were extracted from a hospital database in Shanghai. The fluctuation tendency of biomedical risk factor indicators for cardiovascular and metabolic diseases was evaluated by gender and occupation shortly after retirement using fuzzy regression discontinuity design and was analyzed for internal mechanism. Retirement had a significantly negative influence on body weight (& beta; = -3.943), body mass index (& beta; = -2.152), and diastolic blood pressure (& beta; = -5.180) in women working in public institutions or state-owned enterprises, but a positive influence on their blood glucose level (& beta; = 0.696). Retirement had a significantly positive effect on high-density lipoprotein in men (& beta; = 0.138), particularly those employed in private enterprises (& beta; = 0.339). The internal influencing mechanism of retirement showed that the health attention effect after retirement among women in government or public institutions on diastolic blood pressure reduction was better than that before retirement. The body weight, body mass index, and diastolic blood pressure of women in public institutions or state-owned enterprises were reduced at retirement; however, they were exposed to higher risks of elevated blood glucose level. Conversely, high-density lipoprotein level, which is protective against cardiovascular disease, was increased in men at retirement. Retirement has a heterogeneous effect on cardiovascular and metabolic health among people of different genders or occupational experiences. Retirees with low health awareness should be targeted for behavioral interventions and monitored conscientiously by health providers during retirement adaptation.

How to allocate the existing medical resources reasonably, alleviate hospital congestion and improve the patient experience are problems faced by all hospitals. At present, the combination of artificial intelligence and the medical field is mainly in the field of disease diagnosis, but lacks successful application in medical management. We distinguish each area of the emergency department by the division of medical links. In the spatial dimension, in this study, the waitlist number in real-time is got by processing videos using image recognition via a convolutional neural network. The congestion rate based on psychology and architecture is defined for measuring crowdedness. In the time dimension, diagnosis time and time-consuming after diagnosis are calculated from visit records. Factors related to congestion are analyzed. A total of 4717 visit records from the emergency department and 1130 videos from five areas are collected in the study. Of these, the waiting list of the pediatric waiting area is the largest, including 10,436 (person-time) people, and its average congestion rate is 2.75, which is the highest in all areas. The utilization rate of pharmacy is low, with an average of only 3.8 people using it at the one time. Its average congestion rate is only 0.16, and there is obvious space waste. It has been found that the length of diagnosis time and the length of time after diagnosis are related to age, the number of diagnoses and disease type. The most common disease type comes from respiratory problems, accounting for 54.3%. This emergency department has congestion and waste of medical resources. People can use artificial intelligence to investigate the congestion in hospitals effectively. Using artificial intelligence methods and traditional statistics methods can lead to better research on healthcare resource allocation issues in hospitals.

Abstract Background To investigate the mental health status and stress coping of quarantined personnel entering Shanghai from abroad, identify the key influencing factors, and provide suggestions for improving the mental health of COVID-19 quarantined personnel. Methods We surveyed quarantined individuals to collect general demographic data and COVID-19-related information of 327 entry personnel at the quarantine medical observation point. PHQ-9, GAD-7, and Cope scale (simplified version) were used to assess depression, anxiety, and individual stress coping. We analyzed the independent individual variables for their relationship with mental health outcomes. Results Among the entry quarantined personnel, we found that 27.8% scored positively for depression and 20.5% for anxiety. Depressive symptoms were more likely in individuals with pre-existing health conditions (p = 0.003), lack of medical insurance (p = 0.012), worry about the impact of the epidemic on their studies / work (p = 0.020), worry about the lack of daily necessities during quarantine (p = 0.005), and worry about being rejected or discriminated against by the outside world after quarantine (p = 0.002). Anxiety symptoms were more likely in those without medical insurance (p = 0.008) and those worried about being rejected or discriminated against by the outside world after quarantine (p = 0.010). In terms of stress coping, those with higher scores in "denial (disapproval of events) (p = 0.025, P = 0.041), guilt and self-blame (p = 0.001, p = 0.009)" were more likely to score higher for depression and anxiety. Conclusion Attention should be paid to the negative psychological reactions of the entry quarantined personnel, especially those with pre-existing health conditions, those without medical insurance, and students studying abroad who are at high risk of negative emotions. Timely mental health support should be provided. Accurate and effective epidemic dynamic information and preventive and control measures can be provided to the public through media publicity to prevent fear and stigma against quarantined personnel.

OBJECTIVE:To conduct a literature survey of COVID-19-related chronic diseases to inform future research.METHODS:Publications on COVID-19 and chronic disease were retrieved from PubMed using MeSH Major Topic, including the terms COVID-19, SARS-CoV-2, Chronic Disease and Noncommunicable Diseases. Bibliometric features, journals, research areas, countries, funding agencies and citation reports, were extracted from Web of Science and highly cited papers identified and summarized. Fisher's exact probability test was used to associate highly cited papers with countries.RESULTS:A total of 1034 English-language publications were included. Urology/nephrology was the most active research area (n=230), PLOS ONE the most frequently involved journal (n=29) and the United States of America (USA) had the greatest research output (n=223). A medium number of publications were in the areas of hematology and immunology and these papers had a high citation rate. No statistically significant difference was found in the ratio of highly cited papers: total papers across high-output countries (P=0.668). The USA, Europe and China were the sources of the most highly cited articles and productive funding agencies.CONCLUSIONS:The influence of COVID-19 on chronic disease has received considerable attention. Hematology and immunology may continue to be productive research fields. Much research remains to be done to characterize the emerging chronic effects of COVID-19 on human health.

目的 从评价主客体、评价方法、评价指标、评价应用4方面对中国评价体系现况进行系统综述,总结卫生应急能力评价体系的建设优缺点,为下一步丰富和完善卫生应急体系建设提供参考.方法 运用文献研究法,对评价体系的主客体、评价方法、评价指标内容和评价指标应用4方面进行系统研究和概括讨论.结果 在评价主客体方面,我国现行的卫生应急评价体系由中国疾病预防控制中心制定,评价全国范围内省、市、县各级卫生系统内相关单位的卫生应急能力.在评价方法方面,我国采取自下而上的方式,各级卫生系统行政部门自评普查,并由中国疾病预防控制中心汇总分析评价.在评价指标方面,按照事件发展可分为准备阶段、应对阶段和事后阶段3大类指标,可细分为11类一级指标.在评价指标应用方面,按照评价客体分为个人层面评估、机构组织层面评估和区域卫生系统层面评估.不同层面需根据不同评价客体选择不同侧重的指标用于评价.结论 我国未来卫生应急能力评价体系还需加快标准化和个性化融合,适当引入第三方评价,丰富评价主客体,改善指标体系重主观、轻客观现状,推动理论研究向实际应用发展,定期开展评估工作.

Objective:To investigate the effects of anxiety and depressive symptoms in mediation of pain catastrophizing on disability in patients with low back pain.Methods:A cross-sectional survey was conducted among 97 patients with low back pain in the Changjiang Subdistrict community health center from July to October 2021. Oswestry Disability Index, pain catastrophic subscale in Coping Strategies Questionnaire-24, Generalized Anxiety Disorder Scale-short version, Patient Health Depression Questionnaire-short version were used to evaluate the activity dysfunction, pain catastrophic cognition and anxiety and depression levels of patients,respectively. Path analysis was implemented to test the mediation model, and the indirect effects were assessed using the bootstrap procedure with bias-corrected 95 %CI. Results:Results suggested significant positive correlations among pain catastrophizing, anxiety, depressive symptoms and disability of patients. In addition, both anxiety and depressive symptoms significantly mediated the impact of pain catastrophizing on disability (standardized indirect effects were 0.183 and 0.197, P<0.05). Patients with higher levels of pain catastrophic cognition showed higher levels of anxiety and depressive symptoms (β=0.757, 0.720; P<0.01), and reported more severe motor dysfunction (β=0.241, 0.274; P<0.05). Conclusions:Our findings suggest that anxiety and depression may be the psychological pathways through which pain catastrophizing predicts disability in patients with low back pain. Effective psychological interventions, such as emotion regulation and stress reduction strategies should be considered in treatment and supportive care for patients with low back pain.

目的 探索中国老年人健康状况的影响因素,为卫生管理部门制定老年人健康相关政策提供参考和理论依据.方法 基于第8轮中国老年健康影响因素跟踪调查(CLHLS)数据,纳入12164名65岁及以上老年人的应答资料.根据Grossman健康需求模型,从人口学特征、社会支持、生活方式和经济状况4个维度,选取年龄、性别、BMI、婚姻状况、居住状态、吸烟情况、饮酒情况、锻炼情况、社交活动、年收入、居住地等指标进行研究.采用χ2检验和logistic回归方法分析中国老年人健康状况的影响因素.结果 47.79％(5813/12164)的老年人健康状况好,男性老年人中健康状况好的比例(50.09％,2821/5632)高于女性老年人(45.81％,2992/6532;χ2=22.240,P<0.001).健康状况好和健康状况差的老年人年龄、性别、BMI、吸烟情况、饮酒情况、规律锻炼情况、社交活动、年收入、居住地9个因素的分布特征均不同(P均<0.01).logistic回归分析结果显示,年龄、性别、BMI、婚姻状况、吸烟情况、饮酒情况、规律锻炼情况、社交活动及年收入是老年人健康的重要影响因素(P均<0.05),其中年龄≥100岁、男性、BMI正常或偏高、丧偶、规律锻炼、参与社交活动、年收入较高是老年人健康的保护因素(OR=1.141～1.580),曾经吸烟、曾经饮酒、从未饮酒是其危险因素(OR=0.491～0.828).结论 在面临人口严重老龄化的现况下,我国相关部门应高度重视老年人特别是女性和低收入群体的健康,加大对老年人群体的健康教育与宣传,引导老年人形成良好的生活习惯,并鼓励社会提供更多的养老服务.