Background Adverse childhood experiences (ACEs) have been associated with an increased risk of low back pain (LBP). However, the role of depressive symptoms (DS) in this relationship remains insufficiently explored. This study aims to investigate the mediating effect of DS on the association between ACEs and LBP. Method This retrospective cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS). DS were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Logistic regression analyses evaluated associations between ACEs and both DS and LBP. Mediation analysis further examined the mediating effect of DS on the ACEs-LBP association. Results This study included 8186 participants (3979 males; 4207 females). Logistic regression revealed associations between ACEs and both DS and LBP. Mediation analysis identified DS as a partial mediator in the relationship between LBP and eight ACEs: loneliness, peer bullied, poor self-reported health status, sibling death, parental mental health issues, starvation, and poor childhood neighborhood safety and quality. DS accounted for 18.42 % of the total association between ACE count and LBP. After adjusting for the demographics and DS, marginal analysis confirmed a dose-response relationship, with escalating ACE exposure linked to a higher probability of LBP. Conclusion Our study demonstrates a significant association between ACEs and LBP and DS in middle-aged and older Chinese adults. Critically, DS serves as a mediator in the relationship between ACEs and LBP, underscoring its role as a psychological pathway through which early-life adversity influences LBP.

As the mainstay of healthcare, the job satisfaction of medical staff deserves attention. This study aimed to explore the correlation between the perception of the high-performance work system (P-HPWS) and job satisfaction of medical staff in public hospitals and to further investigate the mediating effect of self-efficacy. From November 2019 to January 2020, a cross-sectional survey on working doctors and nurses was conducted in five tertiary public hospitals in China. A total of 520 participants were surveyed. The P-HPWS, job satisfaction, and self-efficacy were assessed using the 25-item self-administered scale, six-item job satisfaction questionnaire, and the General Self-Efficacy Scale, respectively. Linear regression and mediation effects models were used to identify the associations between primary variables. The results showed a significant positive correlation between P-HPWS and job satisfaction (P < 0.01), while self-efficacy played a mediating role between P-HPWS and job satisfaction. This finding reveals the benefits of improving employees’ P-HPWS and self-efficacy on their job satisfaction, and that hospitals can improve their management systems by implementing and refining HPWS.

Objective: The purpose of this article is to study the diagnostic value of the ultra-high-power microscopy of pharyngeal swabs of patients with respiratory mycoplasma infections and its role in promoting the treatment of respiratory diseases in patients.Methods: The mycoplasma culture medium test and mycoplasma IgM test were compared in terms of their positive rates and their advantages and disadvantages.Results: The results of the study showed that the positive rate for the mycoplasma IgM test was 48.78%. The ultra-high magnification microscope was obviously superior and has the advantage of being fast and low cost while producing accurate results. Its positive rate is as high as 88.09%.Conclusion: Using ultra-high-power microscopy to examine pharyngeal swabs from patients with respiratory mycoplasma infection is of great significance.

The purpose of this study was to explore the correlation between the perception of high performance work system (P-HPWS) and job burnout of nurses, further to detect the mediating effect of regulatory emotional self-efficacy (RES). From November 2019 to January 2020, a cross-sectional survey on working nurses was conducted in 5 hospitals in Lanzhou, China. A total of 1266 nurses were investigated. Demographics and perception of high performance work systems, job burnout, and RES were collected. The data were statistically processed using correlation analysis, multiple linear regression analysis, and a test of mediated moderation. The P-HPWS was significantly negatively correlated with job burnout (P < 0.01). The RES played a mediating effect between the perception of HPWS and job burnout. The results support the important role of P-HPWS in the remission of job burnout, and the hospital can improve its management by implementing and perfecting the HPWS.

Objective: To determine the most effective non-pharmacological interventions to control the blood pressure variation in older hypertensive patients. Methods: Primary endpoints were office systolic blood pressure (SBP) and diastolic blood pressure (DBP). The quality of evidence was assessed using the "risk of bias 2" tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. We performed a Bayesian network meta-analysis using R-4.0.2 software to compare the efficacy of interventions. Results: 36 eligible studies (3,531 patients) with a median follow-up of 12 weeks, assessing 18 non-pharmacological interventions, were included. The percentages of high, moderate, low, and very low certainty evidence were 16.7%, 38.9%, 33.3%, and 11.1%, respectively. Conclusion: High certainty evidence suggests that self-management education is most effective in lowering SBP and DBP in older patients with hypertension, followed by moderate-intensity aerobic exercise. Moderate-intensity resistance training is the most effective exercise for lowering SBP. (C) 2022 Elsevier Inc. All rights reserved.

目的 分析甘肃省0～6岁儿童先天性心脏病(congenital heart disease,CHD)的非遗传影响因素,为预防儿童CHD提出建议.方法 采用分层等距抽样方法,在甘肃全省抽取并筛查5个区县0～6岁儿童29566例.将从中筛查出的106名CHD患儿作为病例组并随机抽取同年龄、同性别、相同生活环境下的健康儿童318名,作为对照组进行1:3病例对照匹配;应用Cox比例风险模型拟合Logistic回归分析模型分析儿童CHD的影响因素;应用限制性立方样条模型分析儿童出生体重与CHD患病的剂量反应关系.结果 多因素分析结果表明:儿童出生体重、母亲文化程度、食用腌晒食品、药物流产史、孕前服用排卵药物、孕期食用鱼肉、经常体育锻炼与儿童CHD的患病风险均存在相关性(均有P＜0.05).限制性立方样条反应分析结果显示:儿童出生体重与CHD患病的关联强度呈线性剂量-反应关系(总趋势P＜0.001,非线性P=0.246).结论 建议育龄妇女做好孕前检查,合理使用促排卵药物;孕期妇女要做好孕期保健和筛查,多食用鱼虾等海产品,不食用腌晒食品,适当进行体育锻炼,加强妇幼保健知识的学习降低儿童CHD的患病风险.

目的 分析四川省泸州市HIV/AIDS患者生存情况及其影响因素.方法 选取2010-2019年泸州市报告的≥15岁HIV/AIDS患者,采用寿命表法计算生存率,采用Kaplan-Meier法计算中位生存时间和绘制生存曲线,采用Cox比例风险回归模型分析生存时间的影响因素.结果 共纳入研究对象12274例,中位生存时间为87.35(95％ CI:86.22～88.49)个月,确诊后1、3、5、7和9年累积生存率分别为78％、73％、69％、66％和63％;多因素分析结果显示,在发生AIDS相关死亡风险方面,男性是女性的1.491倍;汉族是其他民族的2.118倍;离异或丧偶是已婚的1.545倍;确诊感染时的年龄≥60岁是15～＜20岁的3.392倍;大专及以上是文盲的0.473倍;注射毒品、采(供)血及输血/血液制品是异性性传播的1.513倍;样本来源于医疗机构是检测咨询的1.131倍;首次检测CD4+T淋巴细胞计数为≥501个/μl是≤200个/μl的0.205倍;首次诊断疾病状态为AIDS是HIV感染的1.166倍;未接受抗病毒治疗是接受抗病毒治疗的3.524倍.结论 性别、婚姻状况、诊断时的年龄、文化程度、感染途径、样本来源、首次检测CD4+T淋巴细胞计数、疾病状态及抗病毒治疗是影响HIV/AIDS患者生存时间的因素,早发现、早诊断、早治疗可降低HIV/AIDS患者的死亡风险.

目的:通过总结甘肃省0～6岁残疾儿童流行病学调查结果,初步制定针对甘肃省残疾儿童早诊断早干预的防控策略.方法:在甘肃省全省范围内,运用多阶段、分层抽样结合概率比例抽样的方式抽取5个目标县,向基层推广残疾适宜筛查技术,以区(县)为单位,通过听力、视力、智力、肢体、孤独症、先心病等基层适宜性筛查技术,调查某类儿童残疾实际筛查人数占同期应筛查儿童人数的百分比,了解甘肃省0～6岁儿童不同残疾类型的疾病现患率.结果:总共诊断出残疾儿童337例,其中有35名儿童合并有2种残疾,10名儿童合并3种残疾,共发生残疾392次,原因不明115例(29.34％),有明确原因的277例(70.66％).结论:大量普及儿童保健工作,重视对儿童发育筛查,加大优生优育宣传力度,早发现、早干预发育偏差的儿童,能够降低残疾儿童的发生率.

目的 了解甘肃省0～6岁儿童在视力、听力、肢体、智力、孤独症以及多重残疾等6类残疾的患病情况,并分析母亲孕前及孕期健康状况等相关因素与儿童残疾的相关性.方法 从甘肃省0～6岁儿童残疾筛查项目数据库中提取2017年1月1日-2017年12月31日数据并进行整理,采用Logistic回归分析模型对数据进行分析.结果 203名(6.64％0)儿童被确诊为残疾,其中男童128名,现患率为7.2‰,女童75名,现患率为5.86‰.Logistic回归分析模型分析结果 显示与儿童残疾相关的因素有12个,其中最主要的因素有早产自娩、既往分娩缺陷、孕前6个月服用过促进排卵药物、孕期疾病史有慢性呼吸系统疾病、居住地周围有排放环境污染物的化工厂及矿场、食用腌晒食品＞350 g/周、室内经常有人吸烟(均为P＜0.05).结论 肢体残疾、智力残疾和视力残疾为重点预防残疾种类;母亲孕前、孕期的健康状况和生活习惯与儿童残疾的发生有关,提示女性应当注重孕期健康和饮食习惯,预防儿童残疾的发生.

目的 通过分析2010-2016年甘肃省围生儿死亡数据资料,了解甘肃省围生儿死亡现状,为卫生行政部门制定降低围生儿死亡的干预措施提供理论依据.方法 回顾性分析2010-2016年甘肃省各地区上报的围生儿死亡报告卡与围生儿死亡监测报表.采用年估计变化百分比法(EAPC)来评价围生儿死亡率的时间变化趋势;应用x2检验比较各地区的围生儿死亡率.结果 2010-2016年甘肃省围生儿死亡率总体呈下降趋势,平均死亡率为8.08‰;2016年甘肃省围生儿死亡率为6.63‰;围生儿死亡主要发生在孕28周～、以死胎为主,低出生体质量儿居多;围生儿死亡中,尸检率低,死亡地点多在医院,占比达78.88％;家长认为病情不重是未治疗或未就医的主要原因;围生儿死亡前7位死因顺位依次是早产儿或低出生体质量、先天畸形、出生窒息、胎儿窘迫、新生儿疾病、肺透膜病、脐带异常.结论 甘肃省围生儿死亡率呈下降趋势;为进一步降低甘肃省围生儿死亡率,应加强孕期保健,完善围生保健系统,预防早产及出生缺陷三级预防依旧是降低围生儿死亡率的重要措施.

Objective To understand the HIV/AIDS knowledge level among middle school students in ethnic minority areas,and to provide evidence-based solution for HIV/AIDS Health Education and Health Promotion.Methods Questionnaire survey was carried out in 1 793 middle school students from 14 schools in Hui,Yi and Hani regions.Results The HIV/ AIDS knowledge level among junior middle school students in Hui,Yi and Hani regions was 7.5%,40.4%and 5.9%,respectively.In senior middle school students,the rates were 31.2%,48.7%and 70.6%,respectively.The HIV/ AIDS knowledge level and the risk perception of HIV/ AIDS infection rates among junior middle school students and senior school students were of significant difference in Hui and Hani regions.The HIV/AIDS knowledge level among middle school students in ethnic minority areas was low.Conclusion Improving their HIV/AIDS knowledge level through appropriate methods of health education and health promotion.

Objective:To evaluate the nutritional status of children under 5 years in poor rural area of Linxia county,provide a basis for improving the nutritional status of the children. Methods:Cluster sampling method was used to survey the families with children under 5 years from 10 administrative villages of 5 towns in rural area of Linxia county by a questionnaire,the body height and body weight of children were used as the evaluation indicators of nutritional status in children. Results:The incidences of emaciation,growth retardation and low body weight of children under 5 years in the area were 2.3%,21.4% and 8.1%,respectively.The incidence of growth retardation in boys(24.0%) was significantly higher than that in girls(18.1%)(P<0.05);the feeding rate of colostrum in children under 2 years was 63.1%. Conclusion:The nutritional status of children under 5 years in poor rural area of Linxia county is lower than WHO child growth standards.The feeding method should be improved,colostrum feeding should be promoted,it is recommended to continue pure breastfeeding until 6 months after birth,continue breastfeeding until 2 years or more,the complementary feed should be added reasonably.