Depression is an increasingly serious public health problem worldwide, and the relationship between depression diagnosed using structured clinical interview for DSM-Ⅳ personality disorders according to the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) and lifestyle factors is currently unclear.

To explore the relationship between lifestyle factors and depression in community populations.

A survey was conducted in Majiagou Community, Kailuan, Tangshan City from September 2022 to November 2023, and relevant information was collected through questionnaire surveys and physical examinations. Adopted a single factor, stratified adjusted Logistic regression model to analyze the relationship between using mobile phones, insomnia, physical exercise, drinking alcohol, whether or not pets are kept lifestyle factors and depression, using the XGBoost model and SHapley additive interpretation to analyze the contribution values of variables, and further analyzing the relationship between lifestyle factors and depression through subgroup analysis.

A total of 2 189 people were included in this study, including 312 people (14.25%) with depression and 1 877 people (85.75%) without depression. After adjusting for potential confounding factors, it was found that severe using mobile phones for≥12 hours a day (OR=9.279, 95%CI=6.182-13.929), insomnia (OR=10.516, 95%CI=6.385-17.320), drinking alcohol at least once a week (OR=2.100, 95%CI=1.292-3.412) were associated with an increased risk of depression (P<0.05). Exercising almost every day (OR=0.257, 95%CI=0.162-0.407) and keeping pets (OR=0.632, 95%CI=0.475-0.842) were associated with a reduced risk of depression (P<0.05), and consistent conclusions were drawn in subgroup analysis. The XGBoost model and SHapley additive explanatory analysis obtained the contribution values of each variable as insomnia (SHAP value=0.051), physical exercise (SHAP value=0.034), alcohol consumption (SHAP value=0.024), daily mobile phone usage duration (SHAP value=0.018), and whether or not pets are kept (SHAP value=0.013) .

Insomnia is the most important variable affecting depression among lifestyle factors, followed by physical exercise, alcohol consumption, daily mobile phone usage, and whether or not pets are kept.

Cancer related fatigue (CRF) represents one of the most prevalent symptoms among cancer survivors, significantly impacting their quality of life. Current CRF management in China faces substantial challenges, including insufficient awareness, non-standardized screening protocols, and limited implementation of intervention strategies. To develop a standardized community-based CRF management framework suitable for China's healthcare context, the Community Rehabilitation Working Committee of Chinese Rehabilitation Medicine Association assembled an expert panel to conduct a systematic review of domestic and international CRF management practices, culminating in the Chinese Expert Consensus on Community-based Cancer-related Fatigue Management (2025 Edition). Following evidence-based medicine principles, the consensus panel systematically searched domestic and international databases, screening and evaluating high-quality clinical practice guidelines and expert consensus documents. The expert group addressed critical questions regarding CRF screening, non-pharmacological interventions, pharmacological treatments, exercise protocols, and management considerations for special populations. This consensus aims to provide community healthcare professionals with standardized CRF management recommendations, enhance the capacity of primary healthcare institutions to identify and intervene in CRF cases, empower patients and caregivers, alleviate fatigue symptoms, and ultimately improve quality of life.

With the aging of the population and the increase of the proportion of patients with chronic diseases, the people's demand for primary medical resources is diversified and complicated. There are differences in the demand for primary medical resources among different regions and different groups of people. Some areas are facing the problem of lack of primary medical resources, which seriously restricts the coverage and quality of primary medical and health services, and greatly affects the medical experience and health status of residents.

In order to promote the high-quality development of the primary medical and health service system, the health distance model is introduced to analyze the spatial and temporal evolution process of the allocation mismatch of primary medical resources in China from 2011 to 2021, so as to provide reference for rationally formulating regional health plans, optimizing the allocation of medical resources, improving the capacity of primary medical and health services, and promoting the high-quality development of medical and health services.

An evaluation index system for the mismatch of primary medical resources was established from the three levels of health material resources, human resources and security resources. Data were obtained from the China Statistical Yearbook and China Health Statistics Yearbook. The bi-level programming model and the health distance model were used to measure the mismatch of primary medical resources allocation from 2011 to 2021.

From 2011 to 2021, the overall mismatch degree of primary medical resources allocation in China has a significant downward trend, but the mismatch degree differences between regions and provinces continue to expand. The average values of mismatch in the eastern, central and western regions in 2011 were 0.633, 0.624 and 0.754, respectively, which were moderate mismatch, mild mismatch and severe mismatch. In 2021, the average values of mismatch in the eastern, central and western regions are 0.479, 0.522 and 0.639, respectively, which were moderate matching, mild matching and moderate mismatch.

Promoting the expansion of high-quality medical resources and promoting the balanced layout of regional medical resources are the premise of building a high-quality and efficient medical and health service system. In order to further optimize the allocation of primary medical resources and improve China's medical and health service system, we should formulate reasonable macro policies in combination with the characteristics of each region, improve the level of economic development, optimize the structure of fiscal expenditure, improve the administrative capacity of local governments, reduce the mismatch of primary medical resources allocation, and realize the high-quality development of primary medical and health service system.

The primary entities in community medical activities are the community health service centers. Amidst the backdrop of new medical reforms, the community health service centers have continuously sought appropriate development strategies. The Fenglin Street Community Health Service Center in Xuhui District, Shanghai, has pioneered the "combination of general and specialized disciplines" model, merging general medicine with specialized disease management, which has significantly contributed to the advancement of core disciplinary areas and the enhancement of medical service standards. This paper provides a comprehensive summary of the "combination of general and specialized disciplines" practice in Fenglin, with the aim of offering insights and guidance to related grassroots medical institutions based on the findings.

Single-pill combination (SPC) for hypertension is an intensive treatment that can improve a patient's adherence to medication and antihypertensive efficiency. However, few studies have been conducted on the present status and factors that affect adherence to medication and blood pressure control rate in hypertensive patients in the community, who are taking SPC therapy in China.

The present study aims to determine the medication adherence and blood pressure control rate of community hypertension patients using SPC drugs in Huai'an, Jiangsu Province.

The present cross-sectional study was conducted by performing a questionnaire survey to investigate 387 hypertensive patients who took SPC antihypertensive drugs in Huai'an, Jiangsu Province, from June 2022 to December 2022. Multivariate Logistic regression was performed to analyze the factors for blood pressure control, and Pearson's correlation analysis was conducted to determine the relationship among medication adherence, self-efficacy, and medication satisfaction. A structural equation model was established for medication adherence and blood pressure control rate, with self-efficacy and medication satisfaction, in this population (SEM), in order to determine the path relationships among variables.

The blood pressure control rate for the 387 hypertensive patients who took SPC drugs was 32.30%. Furthermore, the proportion of patients who were unmarried/divorced/widowed, and overweight or obese was significantly lower in the blood pressure controlled group, when compared to the blood pressure uncontrolled group (P<0.05). The questionnaire survey results revealed that the medication compliance, self-efficacy, and medication satisfaction scores were significantly higher for patients in the blood pressure controlled group, when compared to those in the blood pressure uncontrolled group [ (6.45±1.10) vs. (6.00±1.50), (32.10±6.65 ) vs. (30.65±6.66), and (52.45±8.83) vs. (48.27±11.85), respectively; P<0.001]. Furthermore, the multivariate Logistic regression analysis results indicated that overweight or obese (OR=1.717, 95%CI=1.058-2.787, P=0.029), medication adherence (OR=1.461, 95%CI=1.202-1.775, P<0.001), self-efficacy (OR=1.052, 95%CI=1.011-1.095, P=0.013), and medication satisfaction (OR=1.025, 95%CI=1.000-1.051, P=0.048) were the factors that affected the blood pressure control rate. The Pearson's correlation analysis results revealed a linear positive correlation among treatment adherence, self-efficacy, and medication satisfaction (r=0.294, 0.226 and 0.280, respectively; P<0.05). The SEM results revealed that both self-efficacy and medication satisfaction were positively correlated to adherence (path coefficient=0.29 and 0.13; P<0.05), and that adherence was positively correlated to the blood pressure control rate (path coefficient=0.15, P<0.05) .

The blood pressure control rate for community hypertensive patients who take SPC drugs remains low. Factors, such as overweight or obese, medication adherence, self-efficacy and medication satisfaction, can influence the blood pressure control rate. Improving the self-efficacy and medication satisfaction of community hypertensive patients who take SPC drugs can effectively improve the medication adherence of patients, and in turn, improve the blood pressure control rate.

The imbalance and uneven distribution of resources among primary healthcare institutions constitute the primary issues between urban and rural ones. To enhance the quality of primary medical services in urban and rural areas and promote standardized construction, it is of vital significance to accurately grasp the disparities in the quality of primary medical services between them.

To evaluate and compare the service quality of urban and rural primary medical institutions in Chengdu, and to analyze the impact of different patient characteristics on the quality and experience of medical services.

A survey was carried out from November 2019 to January 2020 covering all primary healthcare institutions in 22 districts (counties) of Chengdu City. In this study, all registered general practitioners' patients who had received treatment at these institutions were selected as the research subjects through a convenient sampling method. A Questionnaire on the Quality of primary healthcare services and costs (QUALICOPC) was utilized, and a questionnaire on the quality of primary healthcare services in Chengdu was compiled by integrating it with the actual situation in Chengdu. It encompasses four dimensions: accessibility, continuity, coordination, and comprehensiveness of medical services, and multiple stepwise linear regression analysis was employed to analyze the influencing factors of the quality of primary healthcare services.

A total of 2 153 patients were included, with the scores of the accessibility, continuity, coordination, and comprehensiveness dimensions of rural health clinics being (0.45±0.26) points, (0.68±0.41) points, (0.48±0.41) points, and (0.37±0.40) points, respectively. The scores of the dimensions of community health service centers were (0.45±0.27) points, (0.69±0.39) points, (0.46±0.42) points, and (0.29±0.38) points, respectively. The comprehensiveness dimension score of rural health clinics was higher than that of community health service centers, with a statistically significant difference (P<0.05). The current working conditions (rural health clinics: β=-0.031, P=0.006; community health service centers: β=-0.028, P=0.003) and whether there was a contracted doctor (rural health clinics: β=0.128, P<0.001; community health service centers: β=0.169, P<0.001) are influencing factors of the comprehensiveness of primary healthcare services.

The level of accessibility, coordination, and continuity of PHC quality in urban and rural primary medical and healthcare institutions in Chengdu is relatively high; the comprehensive score of township healthcare centers is higher than that of community healthcare service centers. The current working status has a negative prediction effect on the comprehensive service experience of primary medical and health institutions, and some contracted doctors have a positive prediction effect on the comprehensive service of primary medical and health institutions.

As the cornerstone of primary healthcare services, the quality of general practice directly impacts the effectiveness of the hierarchical medical system and the health rights of the people, and is pivotal to the success of China's healthcare reform. To comprehensively implement the general practice quality management system, strengthen standardized clinical protocols, enhance the evaluation, assessment, and improvement of clinical quality in general practice, and elevate the medical quality of primary healthcare institutions, the General Practice Branch of the Chinese Medical Doctor Association has formulated the Implementation Recommendations for Quality Management and Control in General Practice at Primary Healthcare Institutions (2025 Edition) based on domestic practices. These recommendations elaborate on the core elements and principles of medical quality control, outline the objectives and implementation principles for conducting quality management in general practice at primary healthcare institutions, define the responsibilities of quality control bodies, and provide detailed methodologies for executing general practice quality control. They aim to offer guidance and reference for advancing quality management in general practice at primary healthcare institutions across China.

Depression is an increasingly serious public health problem worldwide, and the relationship between depression diagnosed using personality disorder formulaic interviews (SCID) and social support according to the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) is currently unclear.

To explore the relationship and improvement strategies between social support and depression in community populations.

From September 2022 to November 2023, a total of 2 549 people from Majiagou Community in Kailuan, Tangshan City, Hebei Province were collected for health examinations, the collection of social support is conducted by using Social Support Rating Scale (SSRS), and the diagnosis of depression is carried out through SCID in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). Logistic regression model was used to analyze the correlation between social support and depression, Lasso regression analysis was used to obtain variable importance, and further analyzed the relationship between social support and depression using subgroup analysis.

This study included a total of 2 189 individuals who met the inclusion and exclusion criteria, including 312 individuals (14.25%) with depression and 1 877 individuals (85.75%) without depression. The prevalence of depression in high-level social support was 12.07% (225/1 864), in moderate level social support it was 19.84% (51/257), and in low-level social support it was 52.94% (36/68). In Lasso regression analysis, social support (coefficient=1.082) was the most important variable affecting depression. Through multiple Logistic regression, it was found that a decrease in social support level was associated with an increased risk of depression. Compared with high-level social support, the OR (95%CI) of moderate level social support and low-level social support were 1.535 (1.072-2.198) and 4.993 (2.823-8.830), respectively, and this relationship existed in different age, gender, and well-being subgroups.

The improvement of social support level among the community population is related to the reduction of the risk of depression, and relevant measures should be taken to enhance the level of social support among the community population.

Poor sleep quality in older adults is closely associated with a range of adverse health outcomes. Strengthening sleep health and rehabilitation management within existing primary healthcare for older adults can help prevent or slow the onset and progression of many chronic diseases, thereby saving substantial medical resources. However, a comprehensive sleep-rehabilitation management system has yet to be established at the primary healthcare level. To address this gap, the Community Rehabilitation Working Committee of Chinese Rehabilitation Medical Association, has developed the Chinese Expert Consensus on Sleep Health and Rehabilitation Management for Community-dwelling Older Adults (2025 Edition), in collaboration with experts from multiple domestic institutions. Grounded in evidence-based research on sleep rehabilitation and informed by multidisciplinary clinical experience, the consensus considers the current availability of community-level rehabilitation resources and future trends in primary healthcare. It offers consensus-based recommendations on age-related changes in sleep physiology, goals and requirements for sleep management, rehabilitation screening and assessment, management content, and procedural workflows. The publication of this consensus is expected to play a pivotal role in guiding primary healthcare institutions to implement standardized and evidence-based management of sleep rehabilitation in older adults.

The incidence of cognitive impairment is rising year by year among middle-aged and elderly individuals, yet its pathogenesis remains unclear and effective treatments are lacking. Integrating multidimensional factors to construct a predictive model can enhance the early identification and intervention of high-risk populations for cognitive impairment.

To explore and construct a risk prediction model for cognitive impairment in community-dwelling middle-aged and elderly adults based on a biomarkers-genetic-environment multidimensional perspective.

A total of 2 243 middle-aged and elderly people in the community who underwent health examinations at Songjiang District Sijing Community Health Center of Shanghai from April to September 2021 were included as the research subjects. Their sociodemographic data, lifestyle, personal disease history and physical examination indicators were collected. The homocysteine (Hcy) concentration was measured by fully automatic biochemical analyzer to determine whether it was hyperhomocysteinemia (HHcy), and single nucleotide polymorphism (SNP) gene sites rs429358 and rs7412 were detected by ligase detection reaction technology to determine the Apolipoprotein E (APOE) genotype. Cognitive function was assessed using Two-tiered Cognitive Self-Assessment (TCSA), and the subjects were divided into normal cognitive group and cognitive impairment risk group according to the assessment results. The general data and physical examination indicators of the two groups were compared. The multivariate logistic stepwise regression method was used to screen independent predictors, and a nomogram prediction model for the risk of cognitive impairment in middle-aged and elderly people was constructed. The Bootstrap self-sampling method was used for internal validation to determine the accuracy of the prediction model.

The incidence rate of cognitive impairment risk in the community-dwelling middle-aged and elderly people was 16.72%. Multivariate Logistic regression analysis revealed that advanced age (OR=1.064, 95%CI=1.040-1.088, P<0.001), smoking (OR=1.746, 95%CI=1.277-2.386, P<0.001), hypertension (OR=2.584, 95%CI=1.761-3.793, P<0.001), stroke (OR=1.451, 95%CI=1.048-2.008, P=0.025), HHcy (OR=2.421, 95%CI=1.827-3.207, P<0.001) and E4 carrier (OR=2.034, 95%CI=1.473-2.808, P<0.001) were risk factors for cognitive impairment in middle-aged and elderly people in the community, while long years of education (OR=0.922, 95%CI=0.893-0.952, P<0.001) and appropriate sleep duration (OR=0.614, 95%CI=0.470-0.802, P<0.001) were protective factors for cognitive impairment. The nomogram prediction model was constructed based on the influencing factors in the multivariate Logistic regression analysis. The consistency index of the model was 0.743 (95%CI=0.712-0.771) .

Years of education, smoking, adequate sleep, history of hypertension and stroke, hyperhomocysteinemia (HHcy), and E4 carrier are influencing factors for cognitive impairment in middle-aged and elderly people. A risk prediction model based on multi-dimensional prediction of "biomarkers-genetics-environment" can provide guidance for screening the risk of cognitive impairment in community-dwelling middle-aged and elderly people.

Currently, there is a growing global demand for healthcare professionals, but the attrition rate of medical personnel is continuously increasing. This makes the retention of medical staff a pressing public health issue.

To investigate the retention intention of primary healthcare workers in urban and rural areas of China and its influencing factors.

This cross-sectional study, conducted from May to October 2022, involved online questionnaires administered to 44 community health centers and 18 township hospitals across 27 provinces and 4 municipalities in China&apos;s mainland. The survey covered demographics, work-related factors, COVID-19 impacts, psychological responses, and retention intention. Multivariate linear regression was used to analyze determinants.

A total of 3 769 questionnaires were collected. The survey results showed that the lowest score for intention to stay was (19.8±3.7) in Jiangxi Province, while the highest score was (23.9±3.8) in the Xizang Autonomous Region. Significant positive predictors included advanced age, female gender, marital status, higher monthly income (>5 000 CNY) , <20 years of service, strong institutional support, urban practice location, high job satisfaction, and high personal achievement scores (all P<0.001) . Negative predictors included managerial roles, elevated Patient Health Questionnaire (PHQ) scores, emotional exhaustion, and depersonalization (all P<0.001) . Urban-rural comparisons revealed urban workers prioritized career development pathways and job benefits, whereas rural workers emphasized job security and employment stability (all P<0.001) .

The overall retention intention of primary healthcare workers in urban and rural areas of China is at a moderate level. The factors influencing the retention intention of primary healthcare workers in urban and rural areas differ. Corresponding measures can be proposed to improve their retention intention based on these differences.

In recent years, the prevalence of diabetes among adults in China has continued to rise, reaching as high as 11.9%, with with type 2 diabetes mellitus (T2DM) being the main type, accounting for more than 90% of the diabetic population, and the onset of the disease is becoming increasingly younger. China has now entered the stage of comprehensively building a Healthy China, and exploring the construction of a chronic disease management path with the integration of healthcare and prevention as the core has become an important trend. This specification, based on the existing content and process of the integration of healthcare and prevention services for T2DM, formulates standardized diagnostic and treatment specifications for the integration of healthcare and prevention services for T2DM. The content of the specification mainly includes basic requirements for service provision, content of services, and service processes, aiming to optimize the primary diagnosis and treatment and health management process of T2DM, control the incidence and mortality rate of T2DM through early detection and comprehensive management, and reduce and delay the occurrence of complications, thereby effectively building a primary prevention and treatment line for chronic diseases.

Hypertension is one of the most prevalent chronic diseases in China. As of 2021, there are over 270 million people suffering from hypertension in our country, which is the most significant risk factor for the death of urban and rural residents due to cardiovascular and cerebrovascular diseases. China has now entered the stage of comprehensively building a Healthy China, and exploring the construction of a chronic disease management path with the integration of healthcare and prevention as the core has become an important trend. This specification is based on the existing content and process of hypertension integration of healthcare and prevention services, and formulates standardized service diagnostic and treatment norms for the integration of hypertension healthcare and prevention. The content of the specification mainly includes basic requirements for service provision, service content, service process, etc., aiming to optimize the primary diagnosis and treatment and health management process of hypertension, control the incidence and mortality of hypertension, and reduce and delay the occurrence of complications, thereby effectively building a primary prevention and treatment line for chronic diseases.

Early diagnosis and treatment of herpes zoster (HZ) are crucial in reducing post-herpetic neuralgia complications. However, research on prevention and treatment at the primary healthcare level remains insufficient.

Based on the hierarchical diagnosis and treatment system between community health service centers and general hospitals, this study aims to establish a comprehensive community-based clinical pathway for HZ, providing guidelines for standardized management in community settings.

Through a systematic review spanning from 2003 to 2023, international and domestic literature on HZ prevention, diagnosis, pain assessment tools, and treatment measures were collated. Utilizing focus group discussions, 12 experts engaged in HZ-related work or research from Shanghai, Beijing, including representatives from disease control centers, health commissions, comprehensive hospitals, and community health centers, refined and constructed the clinical pathway and operational protocols for community HZ diagnosis and treatment.

Within the hierarchical medical system, the community-based pathway for HZ diagnosis and treatment encompasses stages of prevention, diagnosis and differential diagnosis, treatment, and follow-up. The established pathway assigns initial HZ diagnosis, graded treatment, and follow-up responsibilities to community health service centers while general hospitals handle specialized differential diagnoses and non-basic services. This pathway is anchored by community general practitioners as its central axis.

The community-based pathway for diagnosing and treating HZ developed in this study, within the framework of a hierarchical medical system, can effectively enhance the standardization of HZ diagnosis and treatment in primary healthcare institutions. Moreover, it establishes a solid clinical and theoretical foundation for promoting a two-way referral model of HZ under nationwide hierarchical diagnosis and treatment.

Chronic diseases have become a significant public health issue in China. Due to the prolonged course and difficulty in achieving a cure, it is essential to promote full-life-cycle integrated medical and preventive care for prevention and treatment of chronic diseases. However, medical services and public health services in China are separatedand there is still a gap in the supply of integrated medical and preventive care. Grassroots doctors are key providers of such services, and their behavior directly impacts the quality of integrated medical and preventive care. Therefore, it is crucial to explore the behavioral intention of grassroots doctors in providing integrated medical and preventive care for chronic diseases.

This study investigates the current status and influencing factors of the behavioral intention of integrated medical and preventive care provided by grassroots doctors for patients with chronic diseases in Shandong Province. The aim of the study was to offer insights and guidance for improving the quality of integrated medical and preventive care at the grassroots level.

A total of 481 grassroots doctors were collected through multi-stage stratified cluster random sampling in Shandong Province. A questionnaire survey was conducted to investigate grassroots doctors&apos; behavioral intention to integrate medical and preventive care, and the influencing factors were analyzed using univariate analysis and binomial logistic regression. The questionnaire of this study was entitled "Questionnaire on the behavioral intention of integrated medical and preventive care provided by grassrootd doctors for patients with chronic diseases" and its content was modified after expert consultation. The questionnaire mainly includes four parts: questionnaire on general situation, questionnaire on the awareness of integrated medical and preventive care, questionnaire on the assessment of the environment of integrated medical and preventive care in grassroots medical institutions, and questionnaire on the behavioral intention of integrated medical and preventive care provided by grassroots doctors.

83.16% (400/481) of grassroots doctors had a high level of behavioral intention to provide integrated medical and preventive care. Grassroots doctors who were female (OR=2.149) , had junior college diploma (OR=2.736) , had a higher level of awareness of integrated medical and preventive care (OR=3.549) , and were employed in the organizations with better environment (OR=8.264) had a stronger behavioral intention to provide integrated medical and preventive care (P<0.05) .

Currently, grassroots doctors show strong behavioral intention to provide integrated medical and preventive care for patients with chronic diseases. However, it is still necessary to establish a sound incentivization mechanism. A variety of promotional strategies should be utilized to further raise awareness among grassroots doctors. Additionally, dedicated funding should be well allocated to optimize the healthcare environment at the grassroots level. It is also essential to develop well-defined policy documents and service guidelines for integrated medical and preventive care. Furthermore, targeted training on integrated medical and preventive care should be implemented for grassroots doctors with specific characteristics.

The accelerated aging process, combined with the increase in widowhood and social isolation, has led to a rise in chronic diseases, further increasing the social burden.

To explore the association between the marital status of older adults and the prevalence of cognitive impairment, as well as the impact of social support and lifestyle on this association.

A total of 9 466 older adults aged 65 years and above from Wuhan and Xiaogan, Hubei Province, were included in this study from 2018 to 2023. Participants were categorized into a married group (n=7 055) and an unmarried group (n=2 411) based on their marital status. Baseline information was collected through structured questionnaires, and cognitive function was assessed using the Mini-mental State Examnation and the Montreal Cognitive Assessment-basic China (MoCA-BC). A multivariable Logistic regression model was employed to analyze the association between marital status and cognitive impairment in the overall population as well as in subgroups stratified by age and sex. Further analyses explored the independent and combined effects of marital status, social support, and lifestyle habits on cognitive impairment risk.

Compared with the elderly with spouses, no spouse was an independent risk factor for cognitive impairment (OR=1.299, 95%CI=1.227-1.376, P<0.001). Further subgroup analysis showed that never married (OR=1.679, 95%CI=1.448-1.947, P<0.001) and widowed (OR=1.282, 95%CI=1.206-1.362, P<0.001) were independent risk factors for cognitive impairment in the elderly. Gender and age stratified analysis showed that never married (OR=2.316, 95%CI=1.680-3.193, P<0.001) and widowed (OR=1.731, 95%CI=1.405-2.131, P<0.001) were independent risk factors for cognitive impairment in elderly men. Widowed was an independent risk factor for cognitive impairment in elderly women (OR=1.163, 95%CI=1.002-1.351, P=0.047). In the 65-74 years old group, never married (OR=1.953, 95%CI=1.390-2.746, P<0.001) and widowed (OR=1.315, 95%CI=1.120-1.545, P=0.001) were independent risk factors for cognitive impairment. In the ≥75 years old group, widowed was an independent risk factor for cognitive impairment (OR=1.470, 95%CI=1.238-1.747, P<0.001). Multivariate Logistic regression analysis on marital status, social support and living habits associated with cognitive impairment showed that compared with the elderly with spouse and social support and healthy living habits, the elderly with spouse and social support but unhealthy living habits (OR=1.262, 95%CI=1.169-1.363, P=0.002), spouse and no social support but healthy lifestyle (OR=1.650, 95%CI=1.479-1.841, P<0.001), spouse and no social support but unhealthy lifestyle (OR=1.777, 95%CI=1.575-2.005, P<0.001), no spouse and social support with healthy lifestyle (OR=1.284, 95%CI=1.189-1.397, P<0.001), no spouse and social support with unhealthy lifestyle (OR=1.999, 95%CI=1.768-2.260, P<0.001), no spouse and social support with unhealthy lifestyle (OR=1.999, 95%CI=1.768-2.260, P<0.001), no spouse and no social support but healthy lifestyle (OR=1.680, 95%CI=1.500-1.882, P<0.001), no spouse and no social support but unhealthy lifestyle (OR=2.422, 95%CI=2.141-2.740, P<0.001), no spouse and no social support but healthy lifestyle (OR=2.422, 95%CI=2.141-2.740, P<0.001) were at increased risk for cognitive impairment.

The prevalence of cognitive impairment, especially among older adults without spouses, notably increases, particularly for those who have never married or are widowed. Regardless of marital status, the lack of social support and unhealthy lifestyle are risk factors for cognitive impairment. This study highlights the importance of paying attention to marital status, social support, and lifestyle in the health management of older adults.

General practice outpatient teaching is one of the commonly-used teaching methods in clinical practice. At this stage, however, the general practice outpatient teaching activities in most clinical training bases in our country are only finished by general practitioners and general practice residents, and the connection with specialists and general practitioners in grassroots practice bases is not close enough. How to optimize outpatient teaching models and methods to further improve the post competence of general practice residents is currently a research hot spot.

To explore the application effect of general practice-specialty-grassroots practice base joints outpatient teaching in the standardized training of general practice residents.

A non-concurrent controlled trial was conducted, 24 general practitioner residents who underwent standardized training for general practitioners in Tongliao People's Hospital, Inner Mongolia Autonomous Region, from October 2019 to October 2021 were selected as the control group, and 23 general practitioner residents who underwent standardized training for general practitioners in Tongliao People's Hospital from November 2021 to October 2023 were selected as the experimental group. In the control group, general practice instructors conducted general practice outpatient teaching training once every 2 weeks, and in the experimental group, on the basis of general practice instructors, specialist and grassroots practice base instructors were added to conduct general practice-specialty-grassroots practice base joint outpatient teaching training, once every 2 weeks, and the training time for the two groups both is 2 years. After the training, the two groups of residents were assessed with the mini clinical exercise evaluation (mini-CEX) assessment scale and the "general practice reception skills evaluation table" to compare the training effects of the two groups.

In the experimental group mini-CEX, the scores of the seven assessment indicators in the assessment scale, namely medical history, physical examination, humanistic care, clinical judgment, health education and consultation, organizational effectiveness, and overall performance, were all higher than those in the control group, and the differences were statistically significant (P<0.05) . In the experimental group, the scores of the five assessment indicators in the general practice consultation skills evaluation table, including complete medical history collection, medical history inquiry skills, physical examination, health education, and reasonable consultation time, were all higher than those in the control group, and the differences were statistically significant (P<0.05) .

General practice-specialty-grassroots practice base jointed outpatient teaching activities can strengthen the clinical diagnosis and treatment thinking, communication and collaboration ability, and comprehensive service awareness of general practice residents by integrating multidisciplinary teaching resources, and effectively improve the training quality of general practice residents.

Currently, the state attaches great importance to the development of early diagnosis and treatment services for cognitive disorders, and the preliminary community cognitive screening is the underlying foundation of the early diagnosis and treatment service system for cognitive disorders, as well as the primary barrier in the cognitive screening process, and the quality of its screening has a direct impact on the level of brain health of the elderly and the overall efficiency of cognitive screening.

To provide a reference for promoting the high-quality construction of cognitive disorders service centers by analyzing the development of preliminary cognitive screening services in Nanjing.

From December 2023 to August 2024, we visited the cognitive service centers in Nanjing, and 12 sample institutions that provided early screening services for dementia among the surrounding elderly population were taken as the research objects. The questionnaire included the basic characteristics of the organization and the status of the initial cognitive screening service development.

Basic characteristics of the institutions: 75.0% (9/12) of the sample institutions operated on the basis of elderly service organizations; the average number of months of cognitive primary screening services carried out in each sample institution was (16±6) months, and the average annual volume of screening services was (245±235) ; in terms of occupational category, nurses accounted for the highest proportion [36.8% (21/57) ] ; in terms of staffing, only 33.3% (4/12) of the sample institutions were staffed with both physicians and nurses. In terms of service content: 16.7% (2/12) of the sample institutions have adopted diversified screening methods for cognitive screening, and the types of cognitive early intervention services range from 3 to 7. Four (33.3%) institutions have penetrated the network of cognitive cooperative institutions, 5 (41.7%) institutions had plan to penetrate the network of cognitive cooperative institutions, but the service radiation scope of 16.7% (2/12) of the sample institutions is still limited to the community where the institutions are located. Only 66.7% (8/12) of the sample institutions provide cognitive early intervention services, and 75.0% (9/12) provided early follow-up services. In terms of the results of service development: the average annual screening rate of high-risk groups for cognitive disorders of the sample organizations is 28.85%, the average annual rate of early intervention for cognitive disorders is 60.97%, and the average annual rate of early follow-up for cognitive disorders is 70.94%. In terms of the source of funding, the funding for the cognitive screening program of the sample organizations came from the institutions themselves and government program subsidies.

Cognitive initial screening service system of Nanjing community cognitive service centers has begun to take shape, and early prevention and control of cognitive disorders have achieved certain results, but there are problems such as incomplete staffing, non-standardization of cognitive initial screening service, slow progress of cognitive initial screening service, and insufficient financial guarantee, etc. It is still necessary to improve cognitive prevention and control mechanism, strengthen cognitive prevention and control guarantee, and enhance social support to promote cognitive disorders service network construction and standardization management.

With the further aging of the population, the incidence of cognitive impairment is increasing, and there is a lack of effective treatments. The construction of an accurate risk prediction model can be used to help community healthcare workers to identify, warn and intervene with potential patients at an early stage, and to reduce the pressure on social healthcare.

This study aims to construct a prediction model for the risk of cognitive impairment in older adults in the community, analyse the influencing factors of cognitive impairment in older adults, and provide empirical references for the development of targeted interventions.

In April 2024, elderly people aged ≥60 years were selected from the China Health and Retirement Longitudinal Survey (CHARLS) 2020 database (n=7 334) , and their socio-demographic characteristics and data on their health status and behaviours, activities of daily living (ADL) , depression, and cognitive abilities were collected. They were randomly divided into a training set (n=5 133) and a validation set (n=2 201) in a ratio of 7∶3. The best predictor variables were screened using LASSO regression ten-fold cross-validation, the factors influencing cognitive impairment in older adults were analysed using Logistic regression, and nomagram were constructed, and the performance of the predicion model was assessed using the area under the curve of the subject work characteristics (ROC) curves and the analysis of the calibration curves.

The detection rate of cognitive impairment in older adults was 14.48% (1 062/7 334) . LASSO regression screened nine potential predictor variables, which were age, type of residence, marital status, gender, education, exercise, society, activity of daily living, and depression. The results of multifactorial Logistic regression analysis showed that age [OR (95%CI) =1.238 (1.109-1.504) for 70-79 years old and OR (95%CI) =2.231 (1.546-3.222) for ≥80 years old using 60-69 years old as a reference] , type of residence [OR (95%CI) =2.144 (1.617-2.842) for rural using urban as a reference] , marital status [OR (95%CI) =0.691 (0.562-0.851) for no spouse, using spousal as a reference] , education [OR (95%CI) =0.209 (0.173-0.254) for primary school and below, using illiteracy as a reference, and for junior high school OR (95%CI) =0.059 (0.038-0.090) , OR (95%CI) for high school/vocational high school=0.043 (0.021-0.089) , and OR (95%CI) for college and above=0.038 (0.005-0.280) ] , and society [with no society as a reference, and OR (95%CI) with society=0.746 (0.624-0.892) ] , ability to perform ADL [OR (95%CI) =1.529 (1.171-1.997) with no impairment as a reference and OR (95%CI) =1.580 (1.319-1.891) with impairment] , and depression [OR (95%CI) =1.580 (1.319-1.891) with no depression as a reference and OR (95%CI) =1.580 (1.319-1.891) with depression] were the influencing factors of cognitive impairment (P<0.05) . Based on the seven predictor variables screened by multifactor Logistic regression analysis, a prediction model was established. The areas under the ROC curves of the prediction model in the training and validation sets were 0.821 (95%CI=0.805-0.836) and 0.839 (95%CI=0.817-0.861) , respectively; the Hosmer-Lemeshow test χ²=5.022 (P=0.755) and χ²=3.963 (P=0.860) ; calibration curves showed significant agreement between predicted and actual values.

In this study, a prediction model for the risk of cognitive impairment in community-dwelling older adults containing a total of seven indicators, including age, residence, and so on, was established, and the prediction model had good accuracy and differentiation, which can be used to identify the risk of developing cognitive impairment in older adults.

With the increasing degree of aging, the proportion of functional decline in the elderly is increasing year by year. Early identification of functional decline is of great significance for realizing healthy aging. Delphi method has been used to construct and verify the function impairment screening tool (FIST) for the elderly.

To evaluate the feasibility, reliability and validity of the function impairment screening tool among community-dwelling older adults.

From March to August 2022, 145 elderly people aged 60 and above from different communities in Beijing were selected to evaluate the feasibility of the scale using the scale acceptance rate, scale qualification rate, and scale completion time; internal consistence reliability was evaluated using Cronbach's α and split-half reliability coefficients; construct validity was evaluated using exploratory factor analysis; and criterion validity was evaluated using Spearman's correlation analysis.

The FIST scale contains 3 dimensions with 16 items: ability of daily living (6 items), ability of domestic life (5 items), and ability of social activities (5 items). The FIST scale acceptance rate and scale qualification rate were both 100%, and the scale completion time was 1-2 min. The Cronbach's α for the FIST total scale was 0.924, and the Cronbach's α for the three dimensions of ability of daily living, ability of domestic life and ability of social activities were 0.588, 0.817 and 0.892. The corrected item-total correlation for the FIST corrected entries ranged from 0.058 to 0.898, and Cronbach's α after deleting an entry ranged from 0.910 to 0.928. The Spearman-Brown coefficient for the total FIST scale was 0.911 and the Guttman split-half coefficient was 0.709; the Spearman-Brown coefficients for the three dimensions of ability of daily living, ability of domestic life and ability of social activities were 0.703, 0.709 and 0.932, and the Guttman split-half coefficients were 0.646, 0.695 and 0.822. The exploratory factor analysis extracted four initial eigenvalues >1 male factors with a cumulative variance contribution of 78.61%, and the factor loadings for each entry ranged from 0.585 to 0.940. The Spearman rank correlation coefficient between the total score of the FIST scale and the Barthel index was 0.876 (P<0.001) .

FIST has high feasibility, reliability and validity and can be used as an assessment tool for physical function impairment in community-dwelling older adults.

Rural doctors are the most convenient providers of community-based rehabilitative services for chronic disease patients and disabled people in rural areas, with the promotion of graded diagnosis and treatment policies, people began to pay attention to the competence of community-based rehabilitative services among rural doctors.

By investigating the competence of community-based rehabilitative service among rural doctors, analyzing the shortage of competence, and providing references for improving it.

A multi-stage stratified cluster sampling and purposive sampling methods were used to select 3 916 rural doctors from five provinces in east, central, and western China. The survey was conducted from July to August 2020. The questionnaire mainly focused on investigating the possession of rural doctors' competence in rehabilitation function assessment and community rehabilitation guidance, as well as whether the competence could meet their actual work needs.

Of the 3 916 rural doctors surveyed, 2 391 (61.1%), 3 704 (94.6%), 2 365 (60.4%) were found to have competence in rehabilitation function assessment, community rehabilitation guidance, and comprehensive community-based rehabilitative service, respectively. The comparison of the rehabilitation function assessing competence, community rehabilitation guiding competence, and comprehensive community rehabilitation service competence of rural doctors in the eastern, central, and western regions showed statistically significant differences (P<0.001), while the rural doctors in the western region had the lowest proportion of competence; There were statistically significant differences (P<0.05) in the proportion of the rehabilitation function assessing competence and the comprehensive competence of community rehabilitation services among rural doctors with different educational backgrounds and practicing qualifications. Rural doctors with an educational background of technical secondary school/ high school or below had a relatively higher proportion of competence, and general practitioners also had a relatively higher proportion of competence. The proportion of rural doctors who need to provide six services in daily work, including muscle strength grading assessment, motor function assessment, joint activity assessment, rehabilitation guidance for common disease patients, rehabilitation guidance for chronic disease patients, and rehabilitation guidance for disabled patients, was 73.5% (2 880/3 916), 73.8% (2 891/3 916), 74.1% (2 900/3 916), 96.3% (3 773/3 916), 95.9% (3 754/3 916), 89.1% (3 490/3 916), respectively. The proportion of the three classification competencies included in the rehabilitation function assessment competence that meet the work needs does not exceed 75.0%, and the three classification competencies included in the community rehabilitation guidance competence meet the work needs with a rate of 92.4% (3 487/3 916), 91.7% (3 441/3 916), 85.6% (2 987/3 916), respectively.

Overall, the community-based rehabilitation service competence of rural doctors in China is in relatively good condition. However, there are deficiencies in the competence of rural doctors in western China. The community-based rehabilitation service competence of rural doctors could meet the needs of rural residents, and with the gradual formation of the continuous rehabilitation service mode of staying in the hospital during the acute period and returning to the community during the recovery period, rural residents will have a higher demand for the community-based rehabilitation service of rural doctors. Therefore, positive measures should be taken to enhance the rehabilitation service competence of rural doctors, and practical exercises are the more effective measures we have found.

The development of the clinical diagnosis and treatment technology combined with general practice and specialist in the community is an important measure to improve the comprehensive service level of community health centers (CHCs), promote the more reasonable medical order, and implement hierarchical medical system. In this article, we find that most of CHCs in the city have carried out the clinical diagnosis and treatment technology combined with general practice and specialty, by analyze the documents related to the development of community health in Shanghai and published literature, and combine the survey results of these technologies carried out by Shanghai community health centers. It has become an important strategy for CHCs to improve their clinical capacity, the development of these technologies, by focusing on common and frequently-occurring diseases in the community, and combining its own medical advantages, to select appropriate disease types. However, during the development of the clinical diagnosis and treatment technology combined with general practice and specialist, there are some difficulties, such as the lack of relevant talents in the community and awareness of some experts on community specialized services, the difficulty of in-service education of general practitioners, besides, specialized drugs in the community and brand publicity on community characteristic technologies are also indispensible. The development of the clinical diagnosis and treatment technology combined with general practice and specialist in the community needs the policy support of the health administrative department. We suggest that CHCs should carry out the training of the combination of general practice and specialist in combination with the professional development of general practitioners, increase the drugs for specialty and special disease diagnosis and treatment, propagate the community characteristic technology in multiple ways, and explore the general practice and specialist combined diagnosis and treatment mode innovatively.

Health informatisation is an effective means to enhance the service capacity of primary healthcare institutions. Since the 12th Five-Year Plan, Sichuan Province has attached great importance to the construction of primary health informatisation, with a view to realising the enhancement of the management level and service capacity of primary healthcare institutions empowered by health information. However, there is a lack of research on the current status of health informatisation construction and application in the province.

Summarise the current situation and effectiveness of information technology construction in primary healthcare institutions in Sichuan Province.

From May to June 2023, a questionnaire survey was conducted on 143 district and county health administrative departments and 1 028 primary healthcare organisations in 21 cities and states in Sichuan Province using stratified random sampling method. The questionnaires were developed in terms of information personnel, information infrastructure, information systems, and IT applications. The questionnaires were deployed in the unified primary healthcare platform at the provincial level and were filled in by personnel familiar with information technology construction in each primary healthcare institution.

In terms of personnel, 40.95 per cent (421/1 028) of the institutions had information staff, with an average of (0.48±1.12) part-time staff and (0.25±1.08) full-time staff per institution. Information standardisation has been completed in primary healthcare institutions, forming a pattern of coordinated construction at the provincial level. In terms of system construction, 98.83 per cent (1 016/1 028), 99.61 per cent (1 024/1 028) and 99.32 percent (1 021/1 028) were equipped with the HIS, the basic public health service system, and the contracted management system for family doctors, respectively, an average of (2.28±2.63) clinical service systems, (2.56±1.97) medical management systems, and (10.00±20.81) out-of-hospital/supervisory bar systems were used. In terms of technology application, the rate of electronic health records reached 94.93% (2 021/2 129), the total use of electronic medical records reached 77.43% (796/1 028), and 32.60% (1 091/3 347) of the institutions' TCM centres were connected to the Sichuan Provincial TCM Center Health Information Platform, which realized health record access, consultation contracting, consultation follow-up, and configuration of terminals for basic public health services accounted for 83.46% (858/1 028), 56.91% (585/1 028), 68.77% (707/1 028), and 81.91% (842/1 028), respectively, and 74.12% (762/1 028) of the institutions at the upper and lower levels of the healthcare consortium carried out business synergies.

Since the 'Twelfth Five-Year Plan', the overall construction of information technology in primary healthcare institutions in Sichuan Province has been better, showing the development trend of comprehensive consolidation of infrastructure, diversified development of basic medical service functions, integrated integration of basic public health service functions, gradual adaptation of information technology to the development of integrated healthcare service system, and continued expansion of the application of new technologies. Eco-application scenarios of primary healthcare informatisation.

In the context of an aging society, the incidence of chronic degenerative bone and joint diseases has been increasing year by year, and the serious lack of capacity of primary bone health services has become a key constraint to the efficiency of disease prevention and treatment, and there is an urgent need to identify its weak points for accurate optimization and effective enhancement.

This study aims to construct an evaluation index system of bone health service capacity of primary healthcare institutions to cope with the increasing burden of chronic musculoskeletal diseases and the insufficient capacity of primary bone health services in an aging society.

From September 2024 to January 2025, Chinese journal databases such as CNKI, Wanfang Data Knowledge Service Platform, Wipu Chinese Science and Technology Journal Database, China Biomedical Literature Database, and English databases such as Web of Science, PubMed, Embase, etc. were used to search for information on the evaluation of the capacity of the primary osteopathic health care service related literature on the indicator system. We checked and sorted out the relevant policies and regulations and guidance outlines on the official websites of the Chinese Government Website, the National Health and Health Commission, and the State Administration of Traditional Chinese Medicine, etc., so as to get a preliminary understanding of the current research status of the evaluation of the capacity of bone health services, and to summarise and analyse the latitudinal framework that affects the evaluation results. Literature research method was used to sort out related literature and policies, semi-structured interviews and brainstorming method were used to construct a preliminary pool of index system entries. Delphi method was used to carry out two rounds of expert consultation to screen and optimize the indexes, and Hierarchical Analysis Method was used to determine the weights of the indexes.

The study invited 24 experts from 21 regions and different professional fields in China. The positive coefficient of the experts reached 100.0%, and the authority degree was 0.906. The coordination coefficient of the experts' opinions in the two rounds suggested that the results of the study were credible. The finally constructed indicator system contains 3 first-level indicators, 15 second-level indicators and 40 third-level indicators. The first-level indicators are resource allocation, basic medical and public health services, and management and security, with weights of 0.198, 0.490, and 0.312, respectively, and the latitude of "basic medical and public health services" has the highest weight (0.490), which suggests that the enhancement of medical and public health services should be taken as the key task of capacity building of grassroots bone health services. The highest weight (0.490) was given to "basic medical and public health services", suggesting that the improvement of medical and public health service capacity should be regarded as the key task of primary bone health capacity building. In addition, the weights of indicators in the dimensions of talent cultivation, service efficiency, and medical collaboration are also relatively high, which is significant to the improvement of service capacity.

The evaluation index system of bone health service capacity of primary healthcare organizations formed in this study has high authority and scientificity, which provides reference and basis for further assessing the current status of bone health medical service capacity of primary healthcare organizations in China, and helps to promote the enhancement of bone health service capacity of primary healthcare organizations, and provides a scientific basis for the development of medical decision-making.

Community-acquired pneumonia (CAP), one of the common infectious diseases, exhibits increasing morbidity and mortality with age, posing significant clinical challenges. Although Chinese patent medicines (CPMs) demonstrate efficacy in adult CAP treatment, high-quality evidence-based guidelines have been lacking. To address this gap, we organized a multidisciplinary expert panel to develop the Guideline on Treating Community-acquired Pneumonia with Chinese Patent Medicines, adhering to the principles of evidence-based, consensus-supplemented, and experience-referred and following standardized clinical practice guideline development procedures. Through literature review and Delphi questionnaires, six clinical questions were identified. Systematic evidence retrieval and synthesis of the best available evidence were conducted, integrating factors such as evidence quality, patient preferences, value orientations, and resource allocation. After two rounds of Delphi surveys and expert consensus meetings, the guideline was finalized and published in 2023 in Pharmacological Research. This updated edition systematically incorporates recent evidence, adds pharmacoeconomic evaluations and recommendation rationales, and presents 14 recommendations covering nine CPMs, covers 9 kinds of traditional Chinese patent medicines. The guideline has been restructured according to the first edition of reporting checklist for Chinese patent medicine guidelines (RIGHT for CPM) to enhance clinical applicability, accessibility, and operationalizability, thereby promoting the rational use of CPMs in adult CAP treatment.

The inheritance, innovation, and development of traditional Chinese medicine have received high attention from the country. However, the development of grassroots traditional Chinese medicine diagnosis and treatment in China is still uneven, and the operational efficiency of traditional Chinese medicine diagnosis and treatment services in different institutions varies greatly.

By analyzing the operation of traditional Chinese medicine diagnosis and treatment services in grassroots medical institutions in Tianjin in 2021, this study provides a reference for the development of traditional Chinese medicine in grassroots medical institutions.

In 2021, a comprehensive survey method was used to collect relevant data from a total of 270 primary healthcare institutions in 16 administrative regions of Tianjin (Dis1-6 being the six districts within the city, Dis7-10 being the four districts around the city, Dis11 being the Binhai New Area, and Dis12-16 being the five districts in the suburbs), and two methods, BCC and CCR models in Data Envelopment Analysis (DEA) and Stochastic Frontier Analysis (SFA), were comprehensively applied to analyze the operational efficiency of traditional Chinese medicine diagnosis and treatment services in institutions from different perspectives. Through literature research, the input indicators of the DEA model were set as the number of traditional Chinese medicine practitioners, the number of traditional Chinese medicine beds, and the number of traditional Chinese medicine diagnosis and treatment equipment; The output indicators were set as traditional Chinese medicine medical income, number of traditional Chinese medicine diagnosis and treatment personnel, number of discharged patients mainly using traditional Chinese medicine, and number of on-site traditional Chinese medicine service personnel. The SFA model was consistent with the indicators set by DEA, except for the addition of total income as an output indicator.

The operation of traditional Chinese medicine diagnosis and treatment services in grassroots medical and health institutions in 7 districts was effective, Dis9 DEA was weakly effective, and DEA was ineffective in 8 districts. There were 8 districts with increasing returns to scale, 7 districts with unchanged returns to scale, and Dis3 showing decreasing returns to scale. There were 8 non DEA effective regions, and all 3 input indicators in each region have redundancy. The phenomenon of insufficient income from traditional Chinese medicine and medical services in the output indicators was more serious in each region. The efficiency of Dis1-6 technology in SFA results (0.733-0.838) was within the high efficiency range; Dis7-10 technology efficiency (0.691-0.912), 3 high efficiency zones and 1 medium efficiency zone; Dis11 technology efficiency of 0.885 was in the high efficiency zone; Dis12-16 (0.399-0.849) had 3 high efficiency zones and 2 medium efficiency zones. The DEA results were basically consistent with the SFA results, indicating that the number of traditional Chinese medicine practitioners had a positive impact on operational efficiency.

The overall operational efficiency of traditional Chinese medicine diagnosis and treatment services in grassroots medical institutions in various districts of Tianjin is relatively low, but the overall development trend is positive and has regional characteristics. Overall, Dis1-6 is better than Dis7-10, and Dis7-10 is better than Dis11-16. Each district should plan reasonably according to the actual situation, avoid excessive resource input and insufficient output, and especially increase support for Binhai New Area and the five districts in the suburbs.

General practitioners with sub-specialties can not only provide high-quality general medical services, but also provide a certain depth of specialized medical services. The combination of general practitioners with sub-specialties of different specialties can provide relatively comprehensive and certain depth of basic medical services for residents in their jurisdictions. Under the situation that the professional service capacity of mental health cannot meet the needs of residents, the necessity of encouraging some general practitioners to develop mental health subspecialties has become increasingly prominent. This article analyzes the necessity of training general practitioners with psychosis subspecialty, the advantages of developing psychosis subspecialty among general practitioners, the obstacles to promoting the development of psychosis sub-expertise of general practitioners in primary care are proposed: the construction of general practitioners training bases for psychosis sub-expertise, the learning platform for general practitioners with psychosis sub-expertise was expanded, construction of sub-specialty teachers of psychosis, policy and financial support, salary and promotion incentive policies, etc., are expected to help general practitioners develop psychosis sub-expertise.

At present, the unbalanced and inadequate development of primary healthcare services does not meet people's growing demand for them in the new era. Identifying the influencing factors and their action paths on the performance of primary healthcare services has always been an issue of common concern in the academic circles.

To clarify the combination of multiple factors and their action paths that affect the performance of primary healthcare services in China, and to provide decision-making basis for further improvement of primary healthcare services.

The study was conducted from November 2022 to August 2023, and the data were obtained from the 2021 China Health Statistics Yearbook and the 2021 China Statistical Yearbook. A fuzzy set qualitative comparative analysis (fsQCA) was conducted with the performance of primary healthcare services in 31 provinces (autonomous regions and municipalities) as the outcome variables, and application of big data, medical technology, government attention, system integration, medical resources and health demand as the conditional variables.

The quality of performance of primary healthcare services is the result of a combination of various factors. The results of configuration analysis show that there are 4 configurations to improve the performance of primary healthcare services, which can be classified into 3 patterns: "technology-environment" "organization-environment" and "technology-organization-environment". Configuration 1: Application of Big Data * - Medical Technology * - Government Attention * - System Integration * Medical Resources. Configuration 2: -Application of Big Data * - Medical Technology * System Integration * Medical Resources * - Health Demand. Configuration 3: Application of Big Data * Medical Technology * System Integration * Medical Resources * Health Demand. Configuration 4: Application of Big data * - Government Attention * System Integration * Medical Resources * Health Demand. (* means "and", - means "non"). The consistency of the four configuration solutions was 0.926, the coverage of the solution was 0.612, the original coverage ranged from 0.314 to 0.396, and the unique coverage was from 0.017 to 0.083. The configurations that improve the performance of primary healthcare services are different in eastern, central and western regions of China.

At present, increasing the investment of medical resources at the grass-roots level is still a universal measure to improve the performance of primary healthcare services in China, but attention should also be paid to effectively combine technological, organizational and environmental (T-O-E) conditions. The action paths of the influencing factors are notably different in the eastern, central and western regions of China. Therefore, regions should choose different action paths based on their own development endowments and conditions, reasonably allocate limited medical resources, improve TOE conditions in a targeted manner, so as to improve the performance of healthcare services and realize the high-quality development of primary healthcare services.

This study provides a review of the current status of service capabilities, strategies for improving service capabilities, and improvement measures of grassroots traditional Chinese medicine clinics in Haizhou District, Lianyungang City. It describes the current work status of grassroots traditional Chinese medicine clinics in the construction of characteristic departments, family doctor contract services, and medical prevention integration. It is found that there are problems in the operation of traditional Chinese medicine clinics, such as uneven resource allocation, non-standard management, insufficient facilities and equipment, and the need to improve service capabilities. A survey and analysis were conducted on the construction of traditional Chinese medicine clinics in 19 grassroots medical and health institutions to identify common and individual problems. Targeted suggestions and improvement st rategies were proposed to enhance the service capabilities of traditional Chinese medicine clinics, form a characteristic of medical prevention integration, and give full play to the functions and roles of grassroots medical care. Residents received high-quality traditional Chinese medicine services in the community.

Since its implementation, residents' electronic health records have achieved phased results. The target of the filing rate in Shenzhen, Guangdong Province has been achieved, and the utilization rate has become the core index of theoptimization management of this work.

To understand the use of electronic health records of residents in Bao'an District, Shenzhen, and to analyze the influencing factors. It provides a basis for improving the utilization rate of health records and optimizing the allocation of community health resources.

As of 2022-12-31, Shenzhen Community Health Service information system had a total of 4 077 665 electronic health records of Bao 'an District residents. 403 700 electronic health records were selected by systematic sampling method, and 401 853 meeting the requirements of the study were selected for analysis.

The utilization rates of health records in 1 year, 2 years and 3 years were 59.30% (238 131/401 853), 74.90% (301 032/401 853) and 80.10% (321 853/401 853). The results of multivariate Logistic regression analysis showed that age, nationality, resident type, marital status, education level, profession, payment methods for medical expenses, duration of filing, as well as whether the health records were signed by a family doctor, the elderly, the hypertension and the diabetes were residents' electronic health records influencing factors of 1, 2 and 3 years use (P<0.05). Among them, compared with residents aged 21-45, the use rate of electronic health records in 1, 2 and 3 years was higher for residents aged 0-1, 2-3 and 4-6 years (OR>1.00, P<0.05) ; the usage rate of electronic health records for residents aged 46-60 and ≥61 years was lower in 1, 2 and 3 years (OR<1.00, P<0.05) ; compared with non-resident residents of Shenzhen, the use rate of electronic health records of residents with permanent residence in Shenzhen was higher at 1, 2 and 3 years (OR>1.00, P<0.05) ; compared with the residents participating in the basic medical insurance for urban employees, the use rate of electronic health records of residents with basic medical insurance, full self-payment and other medical expenses payment methods for urban residents was lower in 1, 2 and 3 years (OR<1.00, P<0.05) ; compared with residents with a filing period of<1 year, the use rate of electronic health records of residents with a filing period of≥1 year was lower at 1, 2 and 3 years (OR<1.00, P<0.05) ; compared with the residents without the corresponding project identification, the 1-year utilization rate of electronic health records with family doctor contract identification, elderly project identification, hypertension project identification, and diabetes project identification was higher[OR (95%CI) was 3.77 (3.70-3.84), 2.73 (2.53-2.94), 4.40 (4.11-4.72), 3.10 (2.78-3.47), P<0.05], respectively, and the 2-years and 3-years usage rates were also higher (OR>1.00, P<0.05) .

The usage rate of electronic health records among residents in Bao'an District has risen compared to previous levels, but there is still potential for further enhancement. Priority should be given to non-elderly people, middle-aged and elderly people identified by the hypertension/diabetes program, and residents who have not signed a family doctor, basic medical insurance for urban residents, payment methods for self-payment and other medical expenses, and non-household registration residents.

The high incidence of chronic diseases is associated with the inadequate knowledge of health and disease risks. At the national level, traditional health education remains popular in community health services. The health education conducted by primary healthcare providers are often limited, and lacks specificity in the content. Additionally, community residents generally show a low enthusiasm for participating in health education. The quality and effectiveness of health education for chronic disease patients need an improvement.

To explore the effectiveness of individualized health education interventions generated through the application of an information-based knowledge base model on middle-aged and elderly patients with chronic diseases in the community. The findings are expected to provide insights to further enhance the management of community-based chronic diseases.

In 2021, a total of 7 390 patients at the age of 50-70 years with the chronic diseases of hypertension, diabetes, coronary heart disease, and stroke in Beijing Dongcheng District Community Health Service Center were selected as study subjects. A one-year cluster randomized controlled trial was conducted. Patients in both groups received routine follow-up management strategies for chronic diseases, with the preservation of the existing basic public health services for chronic diseases. Those in the intervention group were additionally given individualized health education programs generated through an information-based knowledge base model, including health education prescriptions and individualized health management. Follow-up visits and interventions were conducted every three months, for a total of 12 months. An end-point survey was conducted one year after recruitment. The primary outcome measures were the differences between the baseline and end-point results of the knowledge awareness of chronic diseases, self-management attitudes, self-efficacy, medication adherence, and acceptance of health information technology.

A total of 7 390 patients with the four types of chronic diseases were included in the study, involving 3 673 patients in the intervention group and 3 717 in the control group. There were no significant differences in the age distribution, gender, education level, and employment status between groups (P>0.05). However, there was a significant difference in the type of medical insurance coverage between groups (P<0.05). After the intervention, patients in the intervention group demonstrated significantly higher correct awareness rates of overall disease knowledge, basic knowledge of chronic diseases, diabetes knowledge, coronary heart disease knowledge, and stroke knowledge compared to pre-intervention levels (P<0.05), while that of hypertension knowledge was not statistically significant (P>0.05). In the control group, there were no significant changes in the correct awareness rates of overall disease knowledge, basic knowledge of chronic diseases, hypertension knowledge, diabetes knowledge, or coronary heart disease knowledge before and after the intervention (P>0.05). However, the correct awareness rate of stroke knowledge in the control group was significantly lower after the intervention compared to pre-intervention levels (P<0.05). The scores of the self-management attitude questionnaire, self-efficacy questionnaire, medication adherence questionnaire, and health information acceptance questionnaire in the intervention group were significantly higher than those of the control group after the intervention (P<0.05). Additionally, in the intervention group, the scores on the self-management attitude questionnaire, self-efficacy questionnaire, medication adherence questionnaire, and health information acceptance questionnaire after the intervention were significantly higher compared to pre-intervention levels (P<0.05). In the control group, the scores of the self-efficacy questionnaire and medication adherence questionnaire improved significantly after the intervention compared to pre-intervention levels (P<0.05), while no significant changes in the scores of the self-management attitude questionnaire and health information acceptance questionnaire were detected (P>0.05) .

Knowledge awareness of chronic diseases, self-management attitude, and health information acceptance are more significantly improved in the intervention group than the control group. Both groups showed improvements in self-efficacy and medication adherence following the intervention, especially in the intervention group. Overall, an individualized health education based on an information-based knowledge base model is beneficial for enhancing the health literacy of patients with chronic diseases.

Based on the case of the Central Health Center, the ROCCIPI framework was used to identify and analyze the problems of integrating traditional Chinese medicine (TCM) into grassroots township health centers from seven dimensions. On this basis, it puts forward the strategy of implementing precision strategy, building connotative ability, strengthening TCM awareness and promoting multi-platform communication, in order to better realize the integration of TCM into modern primary health.

Primary healthcare institution undertakes a significant responsibility in medical and health provision. As the medical industry has undergone continuous development, which is evident in the obvious improvement of facilities and medical treatment environment of community health service institutions, and the effectively upgraded health information systems, the public's demand for specialized medical treatment in community health service institutions is becoming increasingly prominent. This article discusses the significance of developing specialized medical technology in community, the connotation of general-specialized combination, as well as the implementation strategies and methods. The article points out that the construction and development of specialized diagnosis and treatment technology in community health service centers can enhance the ability of community general practitioners to practice, improve the level of primary medical care technology, upgrade the level of community health services and meet the public's demand for specialized diagnosis and treatment. The goal of general-specialty integration can be achieved either by developing specialized diagnostic and treatment techniques on the basis of general practice, or by collaborating with higher-level hospitals to introduce a series of specialized techniques. In terms of specific implementation strategies, it is necessary to find appropriate specialized technologies according to the local needs, develop advanced technologies, carry out scientific research around specialized diseases, and build technical resources by opening specialized outpatient clinics, allocating medical conditions, etc., and cultivate community talents along with the four construction work, so as to implement the development strategy of the all-specialized combination of community diagnosis and treatment technologies in the four-plus-one way.

The concept landscape of frailty has evolved from a single dimension which emphasising predominantly physical frailty into a multidimensional concept encompassing physical, psychological and social frailty. Conducting researches on multidimensional frailty armong community-dwelling older adults is an important way to address the current fragmentation of community-based elderly care services and enhance the comprehensive health of this population. In this paper, firstly, we review the evolution of the concept of multidimensional frailty; secondly, classify and describe the multidi. mensional frailty assessment tools that can be applied to community-dwelling older adults; thirdly, analysis the influencing factors of multidimensional frailty in community-dwelling older adults as well as the interactions between the dimensions of frailty, finally, assess the predictive value of multidimensional frailty in community-dwelling older adults in relation to health outcomes. Existing evidences suggest that the multidimensional frailty is found to be the result of a combination of physiological, psychological, and social factors, and that assessing multidimensional frailty in community-dwelling older adults can predict a variety of health outcomes such as disability, disease risk, and mortality, and that the different dimensions of frailty are correlated and interact with each others. However, there is no a standardized tool for evaluating multidimensional frailty in the community-dwelling older adults, and the underlying mechanisms of its occurrence and development have not been clarified. So, the follow-up studies could explore the developmental trajectory of multidimensional debility based on large prospective cohort studies, in order to provide a referable basis for the development of intervention strategies to reverse or delay the frail process in community-dwelling older adults.

There is a significant shortage of general practitioners at primary healthcare institutions in China, and their low job satisfaction is a crucial factor leading to the scarcity of talents.

To understand the job satisfaction and related factors among general practitioners (GPs) from primary healthcare institutions in Chengdu.

From December 2018 to January 2019, a questionnaire survey was conducted on all registered general practitioners working at primary healthcare institutions in Chengdu (n=1 549). The questionnaire included their basic information, job satisfaction, and their suggestions for improving job satisfaction. Multivariate Logistic regression was used to analyze the factors influencing job satisfaction among GPs.

A total of 1 539 valid questionnaires were collected, with an effective response rate of 99.35%. The overall job satisfaction of general practitioners was (114.0±17.2), indicating a "moderate" level. The average score of job workflow dimensions was the lowest (10.6±2.5), indicating "dissatisfaction". Other dimensions scored at a "moderate" level. The scores for salary and welfare dimension were relatively low at (11.8±2.8) and (11.6±2.8) respectively. There were statistically significant differences in overall job satisfaction among GPs of different genders and age groups (P<0.05) ; however, no statistical significance was found among GPs with different educational backgrounds, titles, and years of work experience (P>0.05). The results of multivariate Logistic regression analysis showed that age was a significant factor affecting overall job satisfaction of GPs (P<0.05). GPs aged 30-39 [OR (95%CI) =0.132 (0.035-0.494) ] and 40-49 [OR (95%CI) =0.207 (0.065-0.664) ] had lower job satisfaction compared to those aged 50 and above (P<0.05). A total of 419 individuals made suggestions for improving their job satisfaction, resulting in a total of 427 suggestions. Among these, "improving benefits" ranked the highest (25.53%, 109/427) .

The overall job satisfaction of GPs in primary healthcare institutions in Chengdu is generally moderate, with the least satisfaction regarding workflow and the greatest desire for improved benefits. Age is a factor influencing job satisfaction among GPs. It is recommended to take effective measures to enhance job satisfaction among GPs by addressing their areas of dissatisfaction, such as streamlining workflow and implementing a system of "fair distribution according to work performance".

The professional capacity and infrastructure of general practitioners in grass-roots medical and health institutions in China are relatively weak, and the energy of specialists in general hospitals is limited and resources are abundant. Strengthening the cooperation between general practitioners and specialists can effectively improve the quality of community medical care and promote the health of patients. This paper systematically sorts out the typical practices and experiences of the construction of outpatient clinics of integration of general practice and specialty, and takes the source, connotation, construction path and construction path of the concept of full-specialty combination of outpatient clinics development effectiveness, existing problems and strategic recommendations are elaborated. Point out the challenges that may be faced in the construction of outpatient clinics of integration of general practice and specialty management model. In addition, this paper summarizes the possible challenges of the construction of integrated outpatient clinics, and puts forward five suggestions for the different practice methods of integrated outpatient clinics in different regions: improve the rules and regulations for the construction of outpatient clinics of integration of general practice and specialty, coordinate and unify the outpatient path of outpatient clinics of integration of general practice and specialty, pay attention to the protection of outpatient clinics of integration of general practice and specialty teams, clarify the population of outpatient clinics of integration of general practice and specialty services, and improve the health evaluation system for the outcomes of outpatient clinics of integration of general practice and specialty. In order to provide reference for the country to carry out the construction of outpatient clinics of integration of general practice and specialty in depth. Further expanding the community service function and deepening the cooperation with specialist physicians is an important direction for the future exploration of the construction of outpatient clinics of integration of general practice and specialized health care service. The joint participation and promotion of the government, medical institutions and general and specialist physicians can better promote the construction and development of community general and specialized outpatient clinics.

With the comprehensive implementation of the family doctor system in China, community health service resources have been widely utilized. However, there is a lack of research on the utilization tendency of primary outpatient medical resources for adult diabetic patients using objective medical visit data.

To understand the characteristics of outpatient visits for diabetic patients in the community, analyze the factors influencing frequent visits by patients enrolled in family doctor services, correctly identify the utilization tendency of primary outpatient medical resources by enrolled patients, and provide a basis for promoting the high-quality development of family doctor contract services.

In August 2023, outpatient visit records of adult diabetic patients from 13 community health service centers in Minhang District, Shanghai, for the year 2021 were retrieved. Personal information such as names and contact details were forcibly anonymized, while data on sex, age, enrollment in family doctor services, triggered diagnosis records, frequency of medical treatment, department of medical treatment, and Chinese medicine services during visits were collected. The characteristics of outpatient visits for adult diabetic patients in the community were analyzed, and multiple logistic regression and decision tree models were used to analyze the factors influencing frequent visits by enrolled patients.

There were 66 838 adult patients, resulting in 1 281 972 outpatient records. Among them, 48.96% (32 723) were male; the median age of the patients who visited the hospital was 71 (66, 77) years old; the median number of diagnosis types was 6 (3, 10) ; the median frequency of visits was 15 (9, 26), 10.28% (6 871) of the adult patients frequently visited the hospital for 362 068 times; 1-2 departments were the main ones (60.38%), and 9.33% (6 233) of the patients with≥5 departments involved; 39.53% (26 423) visited Chinese medicine services. During the year, Contracted patients accounted for 92.77% (62 005) of all the patients, while non-contracted patients only accounted for 7.23% (4 833). There were significant differences between contracted patients and non-contracted patients in sex, age, complexity of illness, frequency of medical treatment, department of medical treatment, Chinese medicine service (P<0.05). The results of multivariate Logistic regression analysis showed that sex, age, complexity of illness, department of medical treatment, Chinese medicine service were the influencing factors of frequent visits by contracted patients (P<0.05). The results of decision tree model analysis showed that the complexity of the disease was the most important factor affecting the frequent visits of contracted patients.

The signing rate of adult diabetic patients in community primary clinics in Minhang District of Shanghai was high, the effect of family doctor signing system was remarkable, the aging of adult diabetic patients in community primary clinics was prominent, the contracted patients' condition was more complicated, and the demand for Chinese medicine treatment was stronger. The frequent visits of contracted patients were affected by many factors, especially the complexity of their condition. Therefore, it is suggested that relevant departments identify frequent patients efficiently according to the patients' condition, so as to make more rational use of medical resources in primary clinics.