Community health service center is the main gatekeeper for breast cancer screening, while its efficacy of screening is difficult to guarantee for the re-striction of screening process by various factors.

To analyze the focus issue of breast cancer screening program in the real world and explore corresponding solutions.

A mixed-methods convergent design was used to collect quantitative and quali-tative data. In the quantitative study, typical sampling method was used to select one community health service center in each of the four districts of Tianjin as the investigation institution from April 2021 to November 2022, accidental sampling method was used to select age-eligible women within 3 km of the four institutions as resident survey respondents, so as to explore the issues existing in the on-site operation of breast cancer screening. In the qualitative study, 9 residents, 12 physicians participating in the screening and 4 leaders were selected through purposive sampling from June to November 2022 for semi-structured in-terviews. The grounded theory was used to analyze the interview content, and the grounded theory framework of the focus issues of breast cancer screening was plotted. Combined with literature and typical investigation data, a mixed methods study was conducted to determine the focus issues of breast cancer screening.

The quantitative study showed that in the advocacy work, the promotion method is traditional, the awareness rate and participation rate of residents was 46.3% (143/309) and 32.4% (100/309) , respectively; in the screening work, the institutions invested different human and material resources, and the average waiting time of screening residents accounted for 62.2% (40.5/65.1) of the total time; in the follow-up and referral work, the invested human and material resources were little, the mammography referral compliance of residents was 29.9% (59/197) . The qualitative study showed that a total of 38 comprehensive open codes were formed in the interview and converged into 10 axial codes and 3 core codes, including advocacy organization, screening organization, follow-up and referral. The mixed methods study showed that 3 focus issues were identified in final, including how to improve residents' participation rate, how to ensure adequate human and material resources in screening institutions, and how to improve residents' mammography referral compliance.

The efficacy of breast cancer screening is influenced by advocacy organization, screening organization, follow-up and referral. It is necessary to rationally allocate resources to ensure adequate human and material resources for screening institutions; innovate promotion methods, expand coverage of promotion and improve residents' health literacy, participation rates and mammography referral compliance, to ensure the substantial progress of breast cancer screening and provide reference for opti-mizing the efficacy of breast cancer screening.

It is of great significance to clarify the characteristics of the main population served by community health service institutions for the precise reform of community health service institutions in the next step.

To provide accurate data support for the next reform policy formulation and adjustment by analyzing the characteristics of the beneficiary population in terms of curative care expenditure (CCE) in community health service institutions in Beijing before and after the comprehensive reform.

The basic data of this study was obtained from the basic database of total health expenditure accounting in Beijing from 2016 to 2019, and other data was obtained from Beijing Health Statistical Yearbook, Beijing Health Financial Statistics Annual Report, and Beijing Health Expenditure Accounting Report from 2016 to 2019. The multi-stage stratified cluster sampling was adopted to select community health service institutions, and the annual out-patient data and in-patient data were included from HIS system. System of Health Accounts 2011 (SHA 2011) was used to calculate and analyze the situation of the beneficiaries of community health service institutions.

The CCE of community health service institutions in Beijing increased from 12.181 billion yuan to 22.245 billion yuan with an average annual increase of 19.07% from 2016 to 2019. The CCE of middle-aged and elderly patients over 40 years age accounted for more than 92% over the years, and CCE of patients in the age groups of 60s and 80s increased rapidly, with an average annual growth rate of 24.08% and 25.84%, respectively. Among the CCE, endocrine, nutritional and metabolic diseases, abnormal symptoms, signs and test results, circulatory system diseases accounted for the highest proportion. The CCE of endocrine, nutritional and metabolic diseases, nervous system diseases, abnormal symptoms, signs and test results increased rapidly, with an average annual growth rate of 40.11%, 48.40% and 32.43%, respectively.

The effectiveness of hierarchical diagnosis and treatment has begun to emerge after the comprehensive reform. Community medical service resources in Beijing are mainly consumed by middle-aged and elderly patients and patients with chronic non-communicable diseases such as endocrine and circulatory diseases. The comprehensive reforms guided more middle-aged and elderly people and patients with chronic diseases to community health service institutions. Community health service institutions should improve their service capacities in many aspects, such as service capacity, human resource, chronic disease management and medical consortium construction, to consolidate and maintain the effectiveness of the reform.

Difficult problems such as poor diagnosis and treatment capacity of diabetes in the community, low screening rate of complications, low standardized monitoring rate of blood glucose, and low rate of blood glucose compliance are the problems that general practitioners need to think about and solve when carrying out management of diabetes patients. It is necessary to explore and innovate the standardized management mode of diabetes in the community for making general practitioners become specialists in the general practice and achieve "precision management combining general care and specialty care".

To understand the management effect of diabetes "1358 model" on community diabetes patients based on "precision management combining general care and specialty care".

A total of 212 patients with diabetes who visited the outpatient clinic at the Hongkou District North Bund Street Community Health Service Center from May to July 2020 and had signed a contract with the community general practitioner were selected as the research subjects and divided into 106 cases in the control group and 106 cases in the intervention group by the random number table method. The patients in the control group received routine follow-up management, and the patients in the intervention group received the "1358 model" of diabetes based on "precision management combining general care and specialty care". One year after the intervention, the cognitive and behavioral levels of diabetes, the attainment of key indicators and the experience of visiting community health centers were compared between the two groups.

There was no statistically significant difference in the cognition and behavior related to diabetes management and the attainment rate of key indicators between the two groups (P>0.05). After intervention, the proportions of patients in the intervention group who monitored FPG within 1 month, monitored 2 hPG within 1 month, carried out comprehensive blood glucose monitoring within 1 month, monitored HbA_1c within 6 months, carried out self-monitoring of blood glucose, recorded a blood glucose diary, standardized the use of medication, followed the doctor's advice on diet, screened for peripheral vascular complications within 1 year, screened for urinary albumin/creatinine within 1 year, screened for carotid artery plaques within 1 year, screened for the inner ocular fundus within 1 year were higher than those of the control group, and the difference was statistically significant (P<0.05) ; however, there was no significant difference in the proportions of patients with regular exercise and weekly foot examination between the two groups (P>0.05). After the intervention, the rates of FPG attainment, HbA_1c attainment and ABC composite attainment of patients in the intervention group was higher than those of the control group, and the difference was statistically significant (P<0.05) ; however, there was no statistically significant difference in the 2 hPG attainment rate between the two groups (P<0.05). The proportions of patients who thought that the community diagnosis and treatment capacity was good, the community drugs basically met the demand, the community had testing equipment for blood glucose-related indexes, the community could solve the basic health problems, the community could carry out screening for complications, the community consultation and guidance for specialized diseases was convenient in the intervention group were higher than those of the control group, and the difference was statistically significant (P<0.05) .

The "1358 model" of diabetes based on "precision management combining general care and specialty care" is of positive significance in promoting and improving patients' health beliefs, standardizing blood glucose monitoring behavior, improving the rate of compliance with key indicators, and enhancing community medical experience, which can be promoted and applied in the community. This model may break through the bottleneck of insufficient resources of diabetes specialty in the community, and further improve the management level and service connotation of diabetes specialty of general practitioners.

Urban community health services are key to promoting the high-quality development of community health. However, previous studies have seldom explored the evolutionary logic and development trend of community health service policies. It is difficult to provide a comprehensive answer to the questions of the generation, evolution and trend of community health service policies in China.

To understand the current status, evolutionary logic and trend of community health service policies, in order to provide intellectual reference for promoting the high-quality development of community health services and implementing the hierarchical diagnosis and treatment system.

The Central People's Government website, National Health Commission, relevant official provincial websites, CNKI, China Community Health Association and other platforms were searched from December 2019 to March 2022 for community health service reform related policies published at national level (n=98) from January 1997 to March 2022. The included policies were analyzed with the help of the policy orientation analysis model.

The policy changes in urban community health services of China have gone through four stages since 1997, including initial exploration centered on the transformation and frame construction (from 1997 to 2002), normative construction focusing on the bottom of the public health network (from 2003 to 2008), prosperous development focusing on the mechanism reform (from 2009 to 2016), and deepening reform centered on quality improvement and empowerment (from 2017 to 2022). The changes in community health service policies in China follows the following evolutionary logic, including the dynamic mechanism from marketization to professionalization and social community linkage governance, target orientation from scale expansion to internal quality improvement, policy discourse changing from predominantly economics-based discourse to multiple tools coordination.

Community health service policies should promote the innovation of the dual collaborative governance framework and mechanism, strengthen the coordination among professional systems and their effective synergistic linkage with the social community governance systems; promote community value-based health care and trust-based health care with health as the core, establish and improve evaluation standards for the capacity and quality of specialized primary care; promote the diversified application and matching of policy tools to adapt to the diversified needs of community health and wellness interests.

Community health services play an effective role in delaying the progression of diabetes and managing diabetes complications. Previous studies have suggested that the subjective experiences of visits to community health centers by patients with diabetes contributes to their improved health outcomes. However, few studies have evaluated the correlation of glycemic control outcomes with specific service processes and objective experiences of programs received by diabetic patients in the community health service centers.

To explore the correlation between the community health service experiences and glycemic control outcomes in patients with diabetes mellitus.

A cross-sectional survey design and multi-stage, cluster random sampling method was used to select six community health service centers in the central urban area of Guangzhou, with one family doctor team randomly selected from each center. A total of 336 patients with diabetes who visited the corresponding family doctor teams from September to November 2019 were recruited as the study subjects. A questionnaire was conducted to collect baseline information, fasting plasma glucose (FPG) level, and Primary Care Assessment Tool (PCAT) scores. The glycemic control outcomes of patients were assessed based on the FPG level, and their experiences of community health services were assessed based on the PCAT scores. Logistic regression models were used to evaluate the effect of community health service experiences on glycemic control outcomes in diabetic patients.

The glycemic control rate of the included diabetic patients was 73.2% (246/336). The total PCAT score and the scores for each dimension of PCAT with good glycemic control outcomes were higher than those of patients with poor glycemic control outcomes, and the difference was statistically significant (P<0.05). The results of multivariate Logistic regression showed an effect of total PCAT score on glycemic control outcomes in diabetic patients〔OR (95%CI) =0.12 (0.06, 0.23) 〕, as well as the scores for each dimension of PCAT (P<0.05). The results of subgroup analysis showed that for diabetic patients with different genders, types of health insurance and hypertension history, the total score of PCAT had an effect on the glycemic control outcomes (P<0.05) .

Community health service experience is a protective factor for the glycemic control outcomes of diabetic patients. Enhancing community health service experience is of great significance for improving the glycemic control outcomes in patients with diabetes.

Community traditional Chinese medicine (TCM) service is an important step in promoting the construction of Healthy China. There are abundant academic research results in the field of community TCM service in China, but there is a lack of collation of these research results. Systematically sorting out the relevant literature in the field of community TCM service by using the method of bibliometrics can provide a macroscopic understanding of the research progress and hotspots in this field and reference for future research.

To sort out the hotspots and development trends of community TCM service research in China by using bibliometric methods.

On May 2 in 2022, CNKI, Wanfang Data Knowledge Service Platform and VIP were searched for relevant research literature on community TCM service research in China from January 2000 to April 2022. By using CiteSpace software, the visual analysis of the co-occurrence of authors included in the literature, keywords co-occurrence, clustering, timeline distribution, and burst terms were performed and the relevant graphs were plotted.

A total of 1 440 papers were included, and the publication volume of community TCM services in China showed an overall increasing trend, with 75 papers (5.2%) published in 2000—2005, 382 papers (26.5%) in 2006—2011, and 983 papers (68.3%) in 2012—2022. The top three authors in the publication volume were Shi Yongxing (25 articles), Bao Yong (16 articles), and Liu Deng (14 articles). The top 5 high-frequency keywords in terms of centrality were "TCM" "Chinese medicine" "community" "general practitioner" and "general practice". The keyword clustering analysis formed 12 cluster labels, and the top three clusters by scale were "community" "TCM" and "general practitioner". The timeline distribution suggested that clusters such as "community" "TCM" "general practitioner" and "TCM nursing" were research hotspots in this field. From the perspective of burst terms, "family doctor" has the highest burst value (8.07), and "elderly people" "diabetes" "family doctor" "medical consortium" "general practice of TCM" and the "integrated medical care and elderly services" are future research directions.

The current status of community TCM service in China, development of TCM general practitioners and community TCM nurses, and the improvement of TCM service capabilities of community health care institutions are research hotspots. In the future, more attention will be paid to the digital compact TCM medical consortium based on the Internet platform and the contracted family doctor service model with the participation of TCM general practitioners, so as to better utilize the characteristics and advantages of community TCM services in integrated medical care and elderly services.

Although type 2 diabetes mellitus (T2DM) cannot be completely cured, however, there is a consensus that timely community management of T2DM patients following guidelines can lead to good glycemic control. However, blood glucose of the patients is chronically suboptimal due to T2DM-related clinical inertia. It is crucial for improving the effectiveness of diabetes control to determine the current status and influencing factors of clinical inertia in T2DM patients in community, but there is limited literature on this topic.

To investigate current status and influencing factors of clinical inertia during health management in T2DM patients in community.

From January to December 2020, T2DM patients receiving health management services from the national basic public health services in Qingjiangpu and Huaian Districts, Huaian City, Jiangsu Province, were recruited using cluster random sampling method to perform face-to-face questionnaire survey, physical examination, and laboratory tests. Clinical inertia was defined as the absence of intensification in antidiabetic treatment for patients with inadequate HbA_1c control (HbA_1c≥7.0%) in the past three months. Stepwise multiple Logistic regression analysis was performed to identify influencing factors of the detection of clinical inertia in T2DM patients in community.

A total of 3 346 T2DM patients with inadequate glycemic control (HbA_1c≥7.0%) were included in the study, with the overall detection rate of clinical inertia in T2DM patients of 93.96% (3 144/3 346), 94.84% (1 139/1 201) in men and 93.47% (2 005/2 145) in women, respectively. There were significant differences in the detection rate of clinical inertia among T2DM patients with different levels of dietary control, physical activity, blood glucose monitoring periods, diabetic complications, dyslipidemia (history), and history of coronary heart disease, stroke, and cancer. Stepwise multiple Logistic regression analysis showed that dietary control〔OR (95%CI) =0.585 (0.382, 0.894) 〕, glucose monitoring period≤1 week〔OR (95%CI) =0.470 (0.344, 0.644) 〕, presence of diabetic complications〔OR (95%CI) =0.606 (0.423, 0.868) 〕, dyslipidemia (history) 〔OR (95%CI) =0.725 (0.532, 0.988) 〕, history of coronary artery disease〔OR (95%CI) =0.659 (0.458, 0.949) 〕, and stroke〔OR (95%CI) =0.699 (0.511, 0.955) 〕were associated with a lower prevalence of clinical inertia in T2DM patients (P<0.05) .

There is a serious problem of clinical inertia in T2DM patients undergoing health management in community, the prevalence of clinical inertia is closely related to patients' dietary control, glucose monitoring period, presence of diabetic complications, and comorbid diseases (history) .

At present, polypharmacy is common among residents with high risk of unsafe medication due to the lack of drug reorganization and whole-course drug management. Community pharmacy services provided by community health service centers (CHSC) with regional advantages is in line with its functional orientation, but there is still a large gap between the supply of pharmacy services in CHSCs and the demand of the public.

To understand the current situation of community pharmacy services and the integration of pharmacists into family doctor team in Shanghai, as well as the problems faced by community pharmacy services, so as to provide suggestions for promoting the development of community pharmacy services.

A combination of qualitative and quantitative research was adopted. In December 2020, a stratified sampling method was used to conduct a questionnaire survey on 307 pharmacy staff on duty with licensed pharmacist qualification from 29 CHSCs, including 6 in the central urban area, 8 in the near urban area, and 15 in the far urban area. The questionnaire included the basic information of pharmaceutical staff, the development of community pharmacy services, and the participation of community pharmacists in the family doctor team. In the same period, a convenience sampling method was used to invite 29 key insiders, including 11 pharmacy section chiefs, 6 family doctor representatives, 12 community center directors and health commission managers from central urban area, near urban area and far urban area, to conduct a semi-structured focus interview on pharmacy service needs, pharmacy resource allocation and pharmacy service process.

The quantitative research results showed that the highest proportion of community pharmacists participating in training is 1-2 times〔139 (45.3%) 〕, and the main form of training is continuing education, accounting for 252 (82.1%). The three most frequently conducted pharmacy service projects by community pharmacists are prescription dispensing〔284 (92.5%) 〕, prescription review〔253 (82.4%) 〕, and pharmaceutical window or outpatient consultation guidance〔196 (63.8%) 〕. The three longest service hours occupied by pharmacists are prescription dispensing〔280 (91.2%) 〕, prescription review〔244 (79.5%) 〕, and prescription comment〔145 (47.2%) 〕. A total of 78 (25.4%) pharmacists joined the family doctor team. The qualitative study showed that the elderly residents in the community had a great demand for pharmacy service, but their awareness of rational drug use was weak. In the allocation of community pharmacy resources, the pharmacists are lacjing, the professional quality needs to be improved, the community pharmacy drug list remains uncompleted, and the role of informatization needs to be strengthened. In the process of community pharmacy service, the recognition degree of community pharmacists is not high, with single service content and relatively little targeted training on rational drug use, and pharmacists fail to play a role in the family doctor team.

At present, the resource allocation and supply capacity of community pharmacy service cannot meet the needs of residents, and the pharmacy service process needs to be improved and optimized. The role played by the only part of pharmacists joining the family doctor team is limited. Therefore, it is necessary to increase the incentive mechanism, clarify the service content and improve the service model.

Stroke high-risk population screening project is a national health project being vigorously promoted in China, but it is found that the participation rate of residents in it is low, which seriously affects the screening efficiency. Screening intention is an important predictor of screening behavior, however, there are few studies on the current status and influencing factors of the intention to screen for high-risk stroke among community residents.

To understand the current status of the intention to screen for high-risk stroke among community residents and explore the influencing factors.

A total of 648 residents of Guangdong Province were selected as survey respondents by using convenient sampling method from March to May 2022. Self-designed questionnaires (including General Data Questionnaire, Stroke High-Risk Screening Intention Scale, Stroke Health Knowledge Scale, Community Medical Service Trust Scale, Perceived Social Support Scale) were used to investigate the respondents. The scores of Stroke High-Risk Screening Intention Scale among residents with different characteristics were compared, and the factors affecting intention to screen for high-risk stroke among community residents were analyzed by multiple linear regression.

A total of 600 valid questionnaires were collected with the recovery rate of 92.6%. The average total score of the Stroke High-Risk Screening Intention Scale among residents was (101.30±14.98), of which 352 (58.7%) residents had a high level of intention for screening, 248 (41.3%) residents had a middle or low level of intention for screening. There were significant differences in the scores of Stroke High-Risk Screening Intention Scale among residents by gender, residential status, hypertension, hyperlipidemia, smoking status, awareness of high-risk stroke screening, implementation of previous high-risk stroke screening in the community, acceptance of previous high-risk stroke screening, self-perceived lifetime risk of stroke and self-perceived risk of stroke within 1 year (P<0.05). There was a positive correlation of the score of Stroke High-Risk Screening Intention Scale with the scores of Stroke Health Knowledge Scale, Community Medical Service Trust Scale and Perceived Social Support Scale (P<0.05). Multiple linear regression analysis showed that gender, hypertension, hyperlipidemia, community has implemented stroke high-risk screening, self-perceived lifetime risk of stroke, scores of Perceived Social Support Scale, Community Medical Service Trust Scale and Stroke Health Knowledge Scale were influencing factors of intention to screen for high-risk stroke among community residents (P<0.05) .

The overall intention of community residents in Guangdong Province for high-risk stroke screening is high, but the screening intention of some residents still needs to be improved. It is suggested that the community should focus on male residents with low intention of screening, strengthen education of the health knowledge of stroke, especially risk factors, to help residents understand their own risk of stroke and the importance of high-risk screening. The investment in screening equipment and medical facilities in community health service institutions should be increased, the construction of community medical and nursing personnel needs more attention at the national level, so as to enhance the trust of residents in community medical services. Meanwhile, the positive impact of social support on the level of intention to screen for high-risk stroke should also be emphasized, to effectively increase the level of intention of residents to participate in high-risk stroke screening through expanding the publicity at the social level and creating an atmosphere of universal participation in screening.

The diagnosis and treatment level of medically unexplained disease (MUD) in the community is closely related to the overall health service capacity of primary healthcare centers. However, general practitioners are not competent enough to diagnose and treat such diseases as shown in current studies. By combing the historical evolution of the introduction of the clinical pathway model into the field of general practice in China, this paper shows that the application of clinical pathway model in China is in a critical period of transition from simple diseases to complex diseases, and from general hospital specialties to general practice in primary care institutions, which confirms a broad application prospect in the diagnosis and treatment of MUD for clinical pathway model. This paper then summarizes the key bottleneck problems faced by the community general practice clinical pathway in China, which mainly include low recognition of clinical pathway by medical staff, difficulty in selecting types of MUD, and the inconsistency between paper form or simple electronic clinical pathway and the rapid development of medical informatization. It is further proposed on the basis that the construction of clinical pathways for diagnosis and treatment of MUD in the community should be based on general practice thinking as the core, and further exploration should be carried out and taking the clinical decision-making information platform of regional medical coordination as a new mode of clinical pathway by breaking through specialty thinking, focusing on dominant diseases, standardizing community diagnosis coding, etc. This paper provides a certain theoretical basis and strategic ideas for the future construction of clinical pathways for diagnosis and treatment of MUD in community general practice.

Community-based intervention is an important part of palliative care for advanced cancer patients. However, its role in the health management of advanced cancer patients remains to be supported by medical evidence.

To evaluate the efficacy of community-involved hospice care for patients with advanced cancer.

Wanfang Data Knowledge Service Platform, CNKI, VIP were searched by using Chinese keywords such as "community" "medical model" and "advanced cancer", Cochrane Library, PubMed and Web of Science were searched by using English keywords such as "Community-based" "Model of Palliative Care" "Advanced Cancer" "Quality of Life", to obtain randomized controlled trials (RCTs) related to the efficacy of community-involved hospice care from 2007-01-01 to 2022-05-10 by using Cochrane system evaluation method on 2022-05-22. The quality of RCTs meeting the inclusion criteria was evaluated, and the valid information was extracted for meta-analysis.

A total of 11 RCTs in English and 9 RCTs in Chinese were included in the study, involving 2 356 and 1 238 patients, respectively. Meta-analysis showed that compared with routine cancer care, community-involved hospice care could improve quality of life and symptom severity in patients with advanced cancer, demonstrated by increasing Functional Assessment of Chronic Illness Therapy-Palliative Care scale socre〔MD (95%CI) =3.77 (0.83, 6.71) , P=0.01〕and Quality of Life Instruments for Cancer Patients scale total score〔MD (95%CI) =12.53 (2.36, 22.69) , P=0.02〕, reducing Functional Assessment of Cancer Therapy scale total score〔MD (95%CI) =-2.61 (-3.53, -1.70) , P<0.01〕 and Edmonton Symptom Assessment System score〔MD (95%CI) =-2.45 (-4.70, -0.20) , P=0.03〕. However, the improvement of community-involved hospice care on depressive symptoms and overall survival rates of patients remains controversial, and its effect on economic indicators such as admission rates, hospitalization days/numbers needs to be further explored.

Community-involved hospice care can improve the quality of life and symptom severity of patients with advanced cancer, however, its improvement in hospice care in the depressive symptoms and overall survival rates of the patients remains controversial, and its improvement in economic indicators such as admission rate and hospital stay/inpatients admissions remains to be further explored.

Previous studies have shown that self-rated health would be used as a simple assessment indicator for frailty, and individuals with poor self-rated health status are at higher risk of frailty. However, the association between self-rated health and frailty may be different and the effectiveness of self-rated health in frailty assessment may vary in apathetic older adults.

To explore the moderating role of apathy in the association between self-rated health and frailty among community-dwelling older adults, so as to provide theoretical guidance for the application of the self-rated health in the assessment of frailty in apathetic older adults.

From November 2021 to March 2022, a total of 384 community-dwelling older adults were selected as respondents by convenience sampling method, including 179 cases in Nanjing Dongshan Community and 205 cases in Lianyungang Qinghu Community. Questionnaire surveys were conducted using the General Information Questionnaire, Fried Frailty Phenotyp (FFP) , Geriatric Depression Scale (GDS-3) , and the self-reported health (SRH) . Generalized linear model was used to analyze the association between self-rated health and frailty of community-dwelling older adults. The model 1 of the SPSS macro program process compiled by Hayes was used to analyze the moderating role of apathy on the association between the self-rated health and frailty, with simple slope analyze performed and simple slope graphs plotted.

The median FFP and SRH item scores of 384 community-dwelling older adults were 1.00 (2.00) and 4.00 (1.00) , respectively, with the detection rate of apathy of 55.5% (213/384) . The results of the generalized linear model showed that the relationship between the self-rated health and frailty of community-dwelling older adults was significant (b=0.310, P<0.001) . The results of the moderating effect test showed that apathy played a moderating role in the relationship between self-rated health status and frailty in community-dwelling older adults (b=0.355, t=3.074, P=0.002) , and the results of simple slope analysis showed that the simple slope of the non-apathy group and apathy group was 0.100 (t=1.209, P=0.228) and 0.455 (t=5.206, P<0.001) respectively.

There is an association between self-rated health and frailty in community-dwelling older adults, and the application of the self-rated health can help community health workers assess frailty in older adults. Apathy plays a moderating role in the relationship between self-rated health and frailty. Compared with the non-apathetic older adults, the association between self-rated health and frailty is significant in apathetic older adults. Strengthening the self-rated health assessment of older adults is beneficial to the identification of their frailty.

The development of traditional Chinese medicine (TCM) has been listed as a national development strategy with vigorous improvement of TCM service capacity in primary care institutions as the important elements, however, there are few studies on the disease spectrum of TCM in community health service institutions.

To analysis the TCM disease spectrum in outpatient clinics of contracted residents by family doctors in Shenzhen community health service centers (abbreviated as CHSC) and understand the capability of TCM in Shenzhen health centers, thus providing a theoretical basis for promoting the development of TCM in primary care in China.

From May to June 2022, the records of outpatient consultations with treatment cost of 10 Shenzhen CHSCs from 2021-01-01 to 2021-06-30 were extracted by the unified information platform of the Health Commission of Shenzhen Municipality (Hangchuang Community Health Service Center Business System) . The 385 138 records with purpose of TCM treatment, matching diagnosis and treatment costs, first diagnosis can be coded in Classification and Codes of Diseases and ZHENG of Traditional Chinese Medicine (TCD) were collected. The disease spectrum was analyzed based on the classification of disease in TCD, mainly involving department categories, specialty system classifications, and TCM disease terms.

A total of 385 138 records of TCM diagnosis and treatment were selected in this study, including 170 077 (44.16%) male cases and 215 061 (55.84%) female cases, with an average age of (36.7±9.4) years. All of the 7 TCD categories of disease spectrum were involved, including internal medicine accounting for 56.98% (219 445 cases) , pediatrics accounting for 20.56% (79 201 cases) , otolaryngology accounting for 12.45% (47 965 cases) , gynecology accounting for 7.95% (30 620 cases) , surgery accounting for 1.51% (5 797 cases) , orthopedics accounting for 0.37% (1 407 cases) and ophthalmology accounting for 0.18% (703 cases) . Apart from the specialty system classifications of tumor diseases, cancer diseases in each category, classifications of middle canthal disease, black eye disease, pupillary disease, traumatic eye disease in Ophthalmology, the disease spectrum involves all specialty system classifications in 7 categories. The cumulative diagnosis and treatment volume of several disease spectrums accounted for 90.00% of the total diagnosis and treatment in each category. The top 5 system diseases in the spectrum included respiratory system diseases accounting for 54.19% (208 701 cases) , musculoskeletal system diseases accounting for 19.05% (73 369 cases) , gynecological system diseases accounting for 7.95% (30 620 cases) , cardiovascular and cerebrovascular system diseases accounting for 7.15% (27 539 cases) , and the digestive system diseases accounting for 4.98% (19 162 cases) . Patients aged <15 years and 15-24 years mainly suffered from diseases related to the respiratory and digestive systems, and the incidence of diseases such as paralysis, dizziness, headache, insomnia, fatigue were increased with the increase of age; cold ranked the first for patients aged below 45 years, the paralysis of muscle and joint pain ranked the first for patients aged above 45 years.

The TCM diseases spectrum in Shenzhen CHSCs is wide, but the categories are relatively concentrated and single, mainly involving internal medicine, concentrating on respiratory system diseases, musculoskeletal system diseases, gynecological system diseases, cardiovascular and cerebrovascular system diseases, and digestive system diseases. It is necessary to strengthen and expand the TCM diagnosis and treatment capabilities in CHSCs to better meet diverse health needs of the residents.

Dyslipidemia is the most important and causal independent risk factor for atherosclerotic cardiovascular disease (ASCVD) . The prevalence of dyslipidemia in elderly residents in Guangdong Province is high, and it is urgent to analyze the specific prevalence of dyslipidemia and its influencing factors among the elderly, and to carry out targeted preventive and control measures for dyslipidemia.

To investigate the epidemiological status of dyslipidemia and its risk factors among elderly residents included in the national basic public health service in Yuexiu District, Guangzhou.

A total of 41 469 elderly residents aged 65 years and above with complete important variables were selected as subjects from the information system of community health service center in Yuexiu District, Guangzhou City in 2020, the 2020 health checkup data was used to describe the epidemiological characteristics of the included patients such as basic information, BMI and blood lipid levels. Restricted cubic spline (RCS) fitting Logistic regression model was used to analyze the relationship between age, BMI and the prevalence of dyslipidemia.

The prevalence of dyslipidemia in 41 469 elderly residents was 53.65% (22 247/41 469) , with a standardized prevalence of 53.89%. The prevalence of hypercholesterolemia (HTC) , hypertriglyceridemia (HTG) , mixed hyperlipidemia and low high-density lipoprotein cholesterol was 21.43%, 16.50%, 14.51% and 3.80%, with the standardized prevalence of 21.57%, 16.53%, 14.61%, 3.78%, respectively. Multivariate Logistic regression analysis showed that gender, age, education level, exercise status, and BMI were all influencing factors for dyslipidemia in elderly residents, among which female, low age group, and high BMI were risk factors for dyslipidemia in elderly residents (P<0.05) . The results of RCS fitting showed a non-linear relationship between age, BMI and the prevalence of dyslipidemia in elderly residents. The overall prevalence of dyslipidemia in elderly residents showed a decreasing trend with the increase of age. The risk of dyslipidemia showed on increasing and then decreasing trend with the increase of BMI, the OR increased significantly at low BMI, while decreased at high BMI.

The prevalence of dyslipidemia is relative high among elderly residents aged 65 years and above included in the national basic public health services in Yuexiu District, Guangzhou. The prevalence of dyslipidemia in the elderly group tends to decrease with the increase of age, and the risk of dyslipidemia prevalence tends to increase and then decrease with the increase of BMI, suggesting special features in the management of dyslipidemia among the elderly, the analysis of risk factors for dyslipidemia in the elderly should be focused on and early preventive and control measures should be carried out.

Falls among older adults will cause a heavy burden on society and families. The development of effective falls prevention intervention policies for community-dwelling older adults is an important initiative to address this global public health problem.

To analyze and compare the content composition, key initiatives and implementation strategies of current falls prevention intervention policies for community-dwelling older adults in different countries from the perspective of policy tools.

Six countries in Asia, North America, and Europe, including Japan, Singapore, Thailand, the United States, Germany, and Russia, were selected as sample countries according to the degree of population aging and economic income level. Refer to the websites of relevant government departments such as the Ministry of Health, the Center for Disease Control and Prevention and directly affiliated institutions, as well as websites of nongovernmental organizations, such as Prevention of Falls Network Europe, National Council On Aging, U.S., Association of Fall Prevention, Japan, and National Association of Statutory Health Insurance Funds, Germany, the national policy documents of prevention interventions for community-dwelling older adults from January 2010 to June 2022 were searched by using "older adults" "fall/drop/accidental injuries" "prevention" as keywords. The text analysis was performed from the dimensions of policy tools such as demand-side type, supply-side type and environmental-side type, and injury prevention strategies such as education prevention strategies and evaluation strategies.

Among the 24 policy documents, there were 212 coded targets in the dimension of policy tools, with environmental-side type, supply-side type and demand-side type policy tools accounting for 45.3% (96/212), 40.6% (86/212) and 14.1% (30/212), respectively. Among high-income countries, the public service tools under supply-side type policy tools were mostly applied in the United States and Germany, accounting for 40.5% (17/42) and 13.8% (8/58) ; the infrastructure construction tools under supply-side type policy tools were focused in Singapore〔24.1% (7/29) 〕. Among low and middle income countries, the environmental-side type policy tools were mostly applied in Russia and Thailand, accounting for 51.3% (20/39) and 55.6% (10/18), respectively. Public service was mostly applied among the supply-side type policy tools, accounting for 17.5% (37/212) ; technical standard was mostly applied among the environmental-side type policy tools, accounting for 10.8% (23/212) ; medicare payment was mostly applied among the demand-side type policy tools, accounting for 4.7% (10/212). In addition, there were 105 coded targets in the dimension of injury prevention strategies, with the education prevention strategies accounting for the highest proportion of 31.4% (33/105), the engineering strategy accounting for the lowest proportion of 5.7% (6/105). High-income countries are at the stage of multi-sectoral collaborative policy implementation, low and middle income countries are at the stage of policy implementation by the Ministry of Health stage.

Six countries focus on public service and infrastructure development under supply-side type policy tools; the application of demand-side type policy tools can be summarized as intervention services managed by medical insurance, intervention projects supported by financial funds, service purchases attracted by price subsidies, planning, organization, advocacy, and standard setting of environmental-side type policy tools. In combination with the priorities and specific measures of the six countries, it is suggested to learn from advanced experience in improving public services, strengthening evidence-based projects, standardizing technical standards, supporting financial incentives, expanding medical insurance programs, and providing price subsidies, thus further optimizing falls prevention intervention policies for community-dwelling older adults.

The continuous increase in numbers of people with osteoporosis, and individuals with low bone mass in the community, brings severe challenges to the prevention and treatment of osteoporosis in the community.

To investigate the basic conditions related to the prevention and control of osteoporosis in communities, including the basic process and cost of enrolling the target population, and the prevalence and risk factors of osteoporosis in the target population, so as to provide evidence for supporting a general practice team to develop precise osteoporosis prevention and control measures.

This study selected 322 cases (including outpatient patients and older physical examinees) from Waitan Community Health Service Center, Shanghai from May to August 2021. General information, bone density test results and risk factors of osteoporosis were collected by a questionnaire.

The cost of enrolling the target population in the community was 57.344 yuan per person. Among the 322 cases, 27 (8.4%) had normal bone mass, 157 (48.8%) had low bone mass, and 138 (42.8%) had osteoporosis. The prevalence of bone density abnormalities (low bone mass and osteoporosis) reached 91.6%. There were statistically significant differences in gender ratio and BMI among normal bone mass, low bone mass and osteoporosis groups (P<0.05). The average bone mineral density (BMD) values of normal bone mass, low bone mass and osteoporosis groups were (-0.72±0.27) AU/mm³, (-1.88±0.38) AU/mm³, and (-3.17±0.53) AU/mm³, respectively. In terms of exercise habits, the prevalence of individuals doing little exercise in normal bone mass, low bone mass and osteoporosis groups was 37.0% (10/27), 49.7% (78/157) and 64.5% (89/138), respectively. In terms of exercise intensity, the prevalence of individuals exercising at moderate-intensity in normal bone mass, low bone mass and osteoporosis groups was 74.1% (20/27), 79.6% (125/157) and 80.4% (111/138), respectively. Three groups had no significant differences in the other osteoporosis risk factors, such as surgical treatment history, smoking history, allergy history and disease history. There was also no significant intergroup difference in dietary habits. Of all cases, 48.8% (157/322) never drank beer, liquor and red wine, 32.0% (103/322) drank coffee 4-6 times per week, and 31.4% (101/322) ate pickled vegetables, smoked foods, or sauces 4-6 times per week.

The community is a favorable setting for conducting prevention, treatment and clinically research programs regarding osteoporosis owing to short participant enrollment period and low cost. As the exercise and eating habits of the elderly in the community are unhealthy, the general practice team should accurately guide them to rapidly improve their dietary structure and develop a healthy exercise habit according to their own status, by which the onset and progression of osteoporosis can be proactively controlled.

As the most basic unit of infectious disease prevention and control, community health service institutions are the frontline and important gateway for the prevention and control of infectious disease. Primary care physicians are responsible for epidemic surveillance, vaccination, health promotion and assistance to centers for disease control in investigating and disposing outbreaks and public health emergencies in their districts, and play an active role in disease prevention and control by groups, susceptible population protection, infectious source control and health education, as well as the effective prevention and control of infectious diseases.

To understand the ability of primary care physicians to diagnose and treat infectious diseases in the community, analyse their existing problems and shortcomings, design and conduct a series of intensive training related to infectious diseases for improving the capacity of infectious disease prevention and control at the primary level; To evaluate the effectiveness of online continuing medical education, so as to provide a reference for better continuing medical education on infectious diseases in the community.

All participants of the National Community Infectious Diseases Continuing Education Conference held by the Department of Family Medicine of the University of Hong Kong-Shenzhen Hospital in November 2021 were selected as research subjects from November 2021 to March 2022. The questionnaires were distributed to all registered attendees before and after the conference through the QR code of the questionnaire star, and the content of pre-conference questionnaire included demographic characteristics of the participants, participation in infectious disease training in the community since started working, diagnosis and treatment of infectious diseases in the community, subjective attitudes towards the prevention and control of infectious diseases in the community (willingness to manage infectious diseases in the community, satisfaction with their own infectious disease management skills), expertise in infectious disease prevention and control and knowledge related to conference content, attitude towards hepatitis B. The content of the post-conference questionnaire mainly included knowledge about the content of conference, attitude towards hepatitis B and satisfaction survey of this online conference. A total of 301 primary care physicians completed the questionnaire before and after the conference, and a total of 194 completed the questionnaire before and after the conference.

Among all participants, 166 (55.1%) had attended infectious disease training in the community, of whom 49 (29.5%) were satisfied with their infectious disease diagnosis and treatment ability; 135 (44.8%) had not attended the training, of whom 22 (16.3%) were satisfied with their infectious disease diagnosis and treatment ability. 143 (86.1 %) of 166 participants who had attended infectious disease training in the community indicated their willingness to manage community infectious diseases, 99 (73.3%) of 135 participants who had not attended infectious disease training in the community indicated their willingness to manage community infectious diseases. 66 (27.3%) of participants who were satisfied with their infectious disease diagnosis and treatment ability indicated their willingness to manage community infectious diseases. The top three infectious disease tests conducted by the institutions were hepatitis B, AIDS, and hepatitis C; the top three infectious diseases treated in the past six months were hepatitis B, influenza, hand, foot and mouth disease. Different self-evaluation and willingness to train may affect the willingness to manage community infectious diseases (P<0.05). Among the participants who completed the questionnaire both before and after the conference, the highest correct answer rate for compulsory management of statutory infectious diseases before the conference was 89.7%, the lowest accuracy rate for the type of disinfection of the COVID-19 infection was only 17.0%, the correct rates of other questions ranged from 34.0% to 40.7%. The correct rates of the questions after the conference were higher than those before the conference, and the correct rates ranged from 48.9% to 52.6%. The score of attitude towards hepatitis B after the conference was higher than that before the conference (P<0.05). In terms of feedback after conference, 254 (98.1%) expressed satisfaction in the total of 259 questionnaires. In terms of suggestions for online conference, 179 (69.1%) and 174 (67.2%) participants believed that online fluency and online interaction need to be improved.

The primary care physicians receive relatively less infectious diseases training in the community, inadequate infectious diseases training in the community can improve the confidence of self-competence, attitude of active management of infectious diseases and diagnosis and treatment ability in the primary care physicians. The future direction of continuing medical education should focus on the training of emerging infectious diseases and novel medical concepts, relevant experts should be invited to comment on the necessity and effectiveness of training in the community.

Hypertensive patients with moderate or high risk of ASCVD had low lipid goal attainment rate. And those with high risk of ASCVD and concomitant other high risk factors had unsatisfactory lipid control status. Attention should be paid to the management of blood lipid in hypertension patients to improve their blood lipid control rate and reduce their risk of ASCVD.

There is a contradiction between a large population with severe mental illness and insufficient capacity to receive and treat them in China. Most of these patients long-termly live in the community, so it is essential for community health institutions to provide this population with timely and effective primary mental health services.

To analyze the characteristics of newly increased and decreased patients with severe mental illness in a community in Beijing from 2011 to 2021, so as to provide evidence for the implementation of community-based prevention and treatment of mental illnesses.

In January 2022, information of registered patients with severe mental illness (schizophrenia, bipolar disorder, schizoaffective disorder, persistent delusional disorder, mental disorders associated with epilepsy or mental retardation accompanied by mental disorders) in a community of Beijing was obtained through Beijing Municipal Mental Health Information Management System, including demographic characteristics, disease status and the status of file creation. The yearly morbidity, mortality and years of life lost (YLL) rates were calculated for years between 2011 and 2021. With the patient information up to December 31, 2010 as the baseline, the information of newly increased and deceased patients from 2011 to 2021 was counted.

From 2011 to 2021, the newly increased patients outnumbered the deceased ones, and the prevalence rate increased year by year since 2012, reaching 3.77‰ in 2021. Compared with the baseline, patients with severe mental illness in 2021 presented the following features: higher education level, a higher proportion of employers, a higher proportion of 60-year-olds and older, a lower proportion of schizophrenics, a higher proportion of patients with bipolar disorder, and a shorter duration of non-creation of files, and the differences were statistically significant (P<0.05). During the period, there were 212 newly increased patients, and most of them suffered from schizophrenia (57.08%, 121/212) or bipolar disorder (36.32%, 77/212). The age of the first onset was mostly between 19 and 45 years (65.57%, 139/212). The number of patients with 5 years or less of duration of non-creation of files was the most (40.57%, 86/212), and the average median was 8.5 (15.5) years. Among the 90 deceased cases, schizophrenics accounted for the highest percentage (86.67%, 78/90), and those aged over 60 years accounted for 74.44% (67/90). The top three causes of death were somatic disease (84.44%, 76/90), suicide (7.78%, 7/90), and accidental death (2.22%, 2/90). The YLL rate fluctuated between -0.250‰ and 1.436‰ during the period.

The period of 2011 to 2021 witnessed more newly increased community residents with severe mental illness than deceased ones, an increased prevalence trend of severe mental illness, a shortened duration of non-creation of files, and the aged as the major deceased group, and somatic diseases as the major cause of death. Targeted measures should be taken to cope with the above changes.

The difficulty of getting pediatric services still exists in China. It is a general trend that community health centers (CHCs) provide pediatric services. There are rare studies on the spectrum of pediatric illnesses in CHCs.

To understand the current status of pediatric diagnosis and treatment in Shenzhen's CHCs by analyzing the spectrum of pediatric illnesses treated in clinics, and to analyze the gap between actual practical status with the training contents based on Spectrum of Diseases for Resident Rotation in Pediatric Medicine (hereinafter referred to as Pediatric Training Rules) specified in General Residency Training Rules in the Standardized Training Contents and Standards for Residents (2022 Edition) .

Through checking the outpatient medical records in CHCs in Shenzhen's 10 districts during April to September 2021, pediatric care expenditure data of children〔including babies (<1 year old), toddlers (1-3 years old), preschoolers (4-6 years old), gradeschoolers (7-12 years old) and teens (13-18 years old) stratified by age〕 contracting family doctor services were collected. The actual spectrum of diseases and diagnosis and treatment behaviors were analyzed, and compared with the Pediatric Training Rules to assess the practical application of the contents required to be mastered in the Pediatric Training Rules.

A total of 961 605 children were included, among whom preschoolers accounted for the highest percentage (38.22%, 367 486/961 605), followed by gradeschoolers (27.57%, 265 151/961 605), toddlers (21.90%, 210 621/961 605), teens (8.49%, 81 594/961 605), and babies (3.82%, 36 753/961 605). The top five diseases in the spectrum and diagnosis and treatment behaviors were respiratory diseases, calcium and vitamin supplements, pediatric physical examination and health care, trauma and postoperative dressing change, and skin diseases, accounting for 67.92% of the total diagnostic and therapeutic workload. Younger age was associated with increased concentrated diagnosis and treatment behaviors. Physical examination and health care (27.60%, 10 142/36 753), calcium and vitamin supplements (25.48%, 9 364/36 753) were the main diagnosis and treatment behaviors in babies. Five diseases in the spectrum and diagnosis and treatment behaviors accounting for ≥80% of the total diagnostic and therapeutic workload in babies, while in teens, 13 diseases in the spectrum and diagnosis and treatment behaviors accounting for ≥80% of the total diagnostic and therapeutic workload. Except for babies, respiratory diseases were the primary reason for seeking treatment in children of other age groups. The proportion of workload of trauma treatment and postoperative dressing change was the highest in teens. Except neonatal asphyxia, neonatal pneumonia, poliomyelitis, infantile tetany and viral myocarditis, the pediatric diseases encountered in these CHCs were covered by the disease spectrum required to be mastered in the Pediatric Training Rules, and the top five healthcare & treatments were respiratory disease treatment〔333 172 (34.65%) 〕, pediatric physical examination and health care〔70 703 (7.35%) 〕, acute infectious diseases treatment〔20 893 (2.17%) 〕, infantile diarrhea〔13 622 (1.42%) 〕, and pediatric abdominal pain〔12 526 (1.30%) 〕. The amount of diagnosis and treatment workload for pediatric anemia, pediatric leukemia, rickets, infantile diabetes, malnutrition, neonatal jaundice, nephritis and nephrotic syndrome, infantile epilepsy, simple obesity, and infantile convulsion accounted for less than 1.00% of the total amount, among which pediatric anemia, pediatric leukemia, neonatal jaundice, nephritis and nephrotic syndrome, infantile epilepsy and simple obesity were mainly transferred for treatment or prescribed a laboratory test.

In general, the CHCs provide a large number of pediatric diagnosis and treatment services, but the services for younger children are still insufficient. Pediatric Training Rules focus on internal diseases, and relevant trainings have some differences with the actual diagnosis and treatment services. The treatments for some diseases in the spectrum in the rules are too specialized, and the diseases are less frequently encountered in community settings, and such patients mainly are transferred for treatment or examined using a laboratory test. Therefore, the pediatric rotation in standardized general residency training should be planned as a whole since the disease spectrum includes many diseases rather than only internal diseases, and actions should be made to expand the training content, improve outpatient teaching, and strengthen the training for physicians to improve their abilities in diagnosis and treatment of young children.

How to implement effective and reasonable support and comprehensive services for patients with advanced cancer during chemotherapy is an issue worthy of attention in community health services at present. According to the latest data, the mortality rate of malignant tumors among residents in Shanghai has become the second place after cardiovascular and cerebrovascular diseases. The current attention to patients with advanced cancer during chemotherapy is also gradually increasing. Therefore, this study tries to understand the demand for primary care among such patients and the influencing factors.

To investigate the demand and influencing factors for community health services during chemotherapy of partial patients with advanced cancer in Shanghai, and to explore how to develop community interventions and services to address the demand of such patients.

Patients with advanced cancer during chemotherapy who regularly visited or hospitalized at Shanghai Ninth People's Hospital, Wusong Hospital and Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine from December 2021 to March 2022 were selected as the study subjects. Based on previous relevant questionnaires, government specifications and interview results, the final version of the demand for community health services of partial patients with advanced cancer during chemotherapy in Shanghai was formed, with a total of 3 demand dimensions (psychological, medical care, social support) and 38 demand items. The contents include patients' general information (demographic and sociological information: gender, age, religious beliefs, education level, marital status, source of medical expenses, disposable monthly household income, whether to participate in a patient group; tumor diagnosis: type and time of diagnosis, pain score, combining with other diseases), 6 items of psychological and psychological demand, 24 items of medical care demand, and 8 items of social support demand. A 3-point scale was adopted: 1 was unnecessary, 2 was necessary, and 3 was very necessary. The higher the score, the higher the degree of patients' demand, which was ranked according to the average score of each demand item. Univariate and multivariate Logistic regression analyses were used to explore the influencing factors of the demand for community health services of patients with advanced cancer during chemotherapy.

The average scores of each demand dimension were ranked in order of psychological demand (2.31 points), medical care demand (2.27 points) and social support demand (2.18 points). The top five average scores of all demand items were "preparation of biochemical tests such as routine blood, liver and kidney functions before chemotherapy" (2.48 points), "education on chemotherapy knowledge" (2.48 points), "care of PICC catheterization during chemotherapy" (2.45 points), "management of myelosuppression after chemotherapy" (2.43 points) " and "providing of updated information on treatment, examination and rehabilitation" (2.42 points), mainly focus on the medical care demand dimension. Multivariate Logistic regression analysis showed that education level and disposable monthly household income were influencing factors of psychological demand of patients with advanced cancer during chemotherapy (P<0.05) ; age and medical expenses were influencing factors of medical care of patients with advanced cancer during chemotherapy (P<0.05) ; age and whether to join a patient group were influencing factors of social support of patients with advanced cancer during chemotherapy (P<0.05) .

Patients with advanced cancer during chemotherapy have specific demand for community health services, with different levels of demand in psychological, medical care and social support dimensions, which are influenced by various factors such as age, education level, and household income. This study provides references for community health service centers to carry out relevant medical services. In the future, new service items with high level of demand can be piloted, community interventions such as psychological and medical care for patients with advanced cancer during chemotherapy, and their quality of survival should be followed up.

With the increasing aging and the transformation of the disease spectrum of residents, there is increasing national attention to the development of Traditional Chinese Medicine (TCM) services. It is of great significant in better utilizing the proper value of TCM community services in the future to understand the current situation and influencing factors of TCM community services utilization.

To understand the current situation and influencing factors of TCM community services utilization among residents in the main urban areas of Chongqing from demander's perspective, so as to provide reference for the sustainable development of TCM community services.

On December 1, 2021, 23 community health service centers were selected by quota sampling method in proportion to the population in 9 central urban areas of Chongqing, and the residents in each community health service center and its surrounding communities by incidental sampling method were selected to conduct questionnaire surveys. The actual number of questionnaires distributed was 840 with 806 valid questionnaires and effective rate of 96.0%. Based on Anderson's health service utilization behavior analysis framework, the factors influencing individual service utilization behavior were summarized into three categories: tendency characteristics, enabling resources and demand factors. At the same time, the dimension of personal TCM culture was added. Binary Logistics regression was used to analyze the influence of the four dimensions on the utilization of TCM in the community.

The utilization rate of TCM community services among the surveyed residents was only 35.9% (289/806), 12 indicators in 4 dimensions were associated with the TCM community services utilization, including propensity characteristics (age, marital status), enabling resources (type of medical insurance, medical expenditure in the last 2 weeks, whether the institutions can meet the basic medical needs of families, whether institutions provide TCM services), demand factors (chronic diseases, self-perception of physical condition in 2 weeks, demand for TCM community services), personal TCM culture (TCM referral willingness, TCM culture trust level, community TCM cultural atmosphere) (P<0.05) .

There are multidimensional and multifactorial influences on the TCM community services utilization among residents. Therefore, targeted measures should be taken to promote residents' utilization of TCM community services.

With the deepening of the new medical reform, the "short slabs" of the current financial compensation mechanism for primary care institutions has been gradually revealed. Compensation mechanism still needs to be further improved for the existence of painful and difficult problems such as insufficient "endogenous power" of primary care institutions, low efficiency in the use of financial funds, and the compensation mechanism still needs to be improved.

To explore and establish a service output, more simple and easy-to-use, scientific and reasonable financial compensation calculation model based on equivalent method, so as to provide a reference for the financial compensation of government-run community health service institutions.

Based on the cost calculation of the equivalent method, the policy analysis and literature review method were used to sort out the financial compensation policies, and the important parameters of the model were determined through expert consultation to build the financial compensation calculation model and financial compensation budget model. The application effect of the model was further evaluated by calculating the financial compensation of 14 community health care institutions in Beijing from 2019 to 2021.

The constructed financial compensation calculation model was mainly composed of three parts, including service equivalent (D), compensation standard per equivalent (P_G) and adjustment coefficient (T), the financial compensation budget model was built on this basis. 14 institutions were taken as examples to calculate the financial compensation, the average calculated financial compensation amount of each institution in 2021 was 45.961 0 million yuan, and the average actual subsidy income of each institution was 44.546 8 million yuan, slightly lower than the calculated financial compensation amount. The average budgeted service equivalent for the 14 institutions in 2022 was 1 139 900 000 equivalents and the average budgeted financial compensation was 50.234 3 million yuan.

The data source of financial compensation calculation model based on equivalent method is standardized and easily available, which is convenient for promotion and use. It was suggested to explore a new model of financial compensation and flexibly use the adjustment coefficients, so that the financial compensation model can better meet the needs of high-quality development.

Problems existing in the operation of a family doctor team, such as unclear work content, inappropriate division of labor, and assigning a team member to a position below his true potential, restrict the overall development of the family doctor team.

To perform a standardized workload-based analysis of the services delivered by the family doctor team in a central urban community health institution in Shanghai, to understand the major factors associated with the development of the family doctor team, and to provide guidance for the improvement of the work pattern of the team.

The family doctor team of Xietu Subdistrict Community Health Center, Xuhui District, Shanghai was selected during July to Novermber 2021. The service projects, parameters of standardized workload and the number of services carried out by the team between August and September 2019, and between August and September 2021 were collected, respectively. The team services were analyzed from three aspects: 1. dividing the team services into essential medical services and public health services according to the nature of the service items, then calculating the total amount of standardized workload and total time used in performing the two kinds of services; 2. dividing the team services into five parts (involving community-based mobilization, screening, diagnosis, intervention and follow-up) according to the idea of integration of medical and preventive services, then calculating the total amount of standardized workload and total time used in performing each part; 3. using the TOPSIS method to comprehensively evaluate the value of all service items included in community-based mobilization, screening and follow-up.

The standardized workload of the team in delivering public health services increased to 16 961 in August 2021 from 11 486 in August 2019, and increased to 18 089 in September 2021 from 10 433 in September 2019, demonstrating an average increase of 59.9%. Pearson correlation analysis showed that the standardized workload involved in delivering essential medical services had no correlation with that involved in delivering public health services (r=-0.72, P=0.27). The total amount of standardized workload of the five parts of community health work was ranked as follows in a descending order: community-based diagnosis, community-based follow-up, community-based intervention, community-based mobilization, and community-based screening. The total standardized workload and total time used of the latter three were relatively less. According to TOPSIS evaluation results, 13 projects such as updating health records of patients with chronic diseases, follow-up management of patients with hypertension or diabetes, and information maintenance of contracted residents can be considered to be outsourced or to reduce the execution labor cost.

The family doctor team has not yet formed an effective work model to deliver integrated medical and preventive services, which leads to excessive waste of human resources in the implementation of public health services that need not to be performed by family doctors, affecting the delivery of essential medical services. It is suggested to strengthen the training of professional skills related to community-based interventions for family doctors, and increase relevant facilities and equipment, optimize the allocation of human resources in all parts of community health work, mainly reducing the implementation cost of community-based mobilization, screening and follow-up.

During the promotion of category-based management for community healthcare institutions (class 1 institutions obtain the financial security, and class 2 institutions implement a performance management system), how to appropriately determine the security level and scientifically evaluate the performance is a difficulty to tackle for health administrative departments.

To assess the operational efficiency of community healthcare institutions with the data envelopment analysis (DEA) using the information of costs of these institutions calculated using the equivalent method, then attempt to develop an input and management model of integrating cost accounting and performance management for these institutions, providing a theoretical basis for accurate and scientific input of various resources into the community through cost measurement with equivalent method, and a data basis for performance assessment in communities with different characteristics through efficiency evaluation.

The real data (financial status and staffing) of 14 community healthcare institutions during 2019 to 2020 were collected from their financial reports, hospital information system, maternal and child healthcare information system, chronic disease management information system, as well as focus group interviews. The equivalent method was used to calculate the total costs of medical services and public health services. The super-efficiency DEA was used to evaluate and analyze the operational efficiency of the 14 sample institutions.

(1) The average cost of one equivalent service (a general medical outpatient service lasting for 15 minutes was defined as one standard service equivalent unit) was 67.64 yuan in 2019 and 69.80 yuan in 2020 for the 14 institutions. The average cost of one equivalent essential medical service was higher than that of one equivalent public health service in both 2019 (167.14 yuan vs 18.86 yuan) and 2020 (215.43 yuan vs 19.78 yuan). The institutions demonstrated significant differences in the average cost of one equivalent essential medical service and the average cost of one equivalent public health service. (2) Each institution had its own peculiar characteristics. For example, S1 institution mainly provided essential medical services, and had higher total equivalent essential medical services and efficiency than other institutions, while S9 institution focused on providing public health services, and had the highest efficiency in delivering public health services. (3) In 2020, the 14 institutions provided 134 800 equivalent COVID-19-related services, with a cost of 1.037 8 million yuan. (4) In 2019 and 2020, only two institutions were relatively overall efficient, and ≥50.0% institutions were pure technically efficient. The institutions with overall operational inefficiency were mainly caused by scale inefficiency primarily due to increasing returns to scale.

The equivalent method provides a relatively unified "scale" to standardize the service efficiency of different types of community healthcare institutions, provides support for health administrative departments implementing category-based compensation for the institutions, benefiting the featured and high-level development of community healthcare institutions. Either institutions delivering essential medical services or those delivering public health services, mainly present increasing returns to scale, suggesting that the efficiency of these institutions can be improved by increasing the human/financial/material input into the institutions and providing precise compensation for them.

The need for elder care has become more pressing as population aging is accelerating in China. The General Office of the State Council of the People's Republic of China has promulgated a number of opinions between 2013 and 2021 aiming at promoting the implementation of integrated medical and elderly care services, enhancing the quality of geriatric services, and strengthening aging services in the new era. And then primary care institutions and elderly care facilities have put the issue on the critical agenda, namely how to take actions to divide labor and cooperate to ensure the elderly to get security and support. This paper discusses the importance and necessity of the model of elderly care institutions operated by community health institutions, and analyzes its benefits and drawbacks from five dimensions: service providers, service scope, service forms, service receivers, and operational effects, with the expectation of gradually implementing the actions to improve the national level of integrated medical and elderly care, to develop a high-quality community-based integrated medical and elderly care model, and to promote the concept of healthy aging.

Lifestyle factors are important modifiable influencing factors for cognitive decline and dementia. Understanding the status and influencing factors of community-dwelling middle-aged and elderly adults adhering to the lifestyles conducive to dementia risk reduction will be a basis for medical workers to formulate individualized interventions for primary prevention of dementia, yet there are still few related studies.

To understand the status and influencing factors of dementia risk reduction lifestyle in community-dwelling middle-aged and elderly adults.

Five hundred and six middle-aged and elderly adults (aged 45 years and older) who had received free health check-ups in a community health center were selected from five communities in Chongqing's Shapingba District by convenience sampling from January to October 2021. The self-designed general information questionnaire and the Dementia Risk Reduction Lifestyle Scale (DRRLS) were used to investigate. The level of DRRLS score in the participants was compare by sociodemographic characteristics. Ordinal and multinomial Logistic regression analysis was performed to identify the influencing factors of the levels of DRRLS scores.

The average score of DRRLS was (88.00±13.27). The median scores of items in mental activity and brain-benefiting exercise were at a low level (≤2.00). The level of DRRLS score in the participants varied significantly by gender, age, personal monthly income and experience of receiving dementia-related health education (P<0.05). Ordinal and multinomial Logistic regression revealed that gender, educational level, personal monthly income and experience of receiving dementia-related health education were important influencing factors of the level of DRRLS score (P<0.05) .

In general, the lifestyles for dementia risk reduction were assessed at a moderate level in the community-dwelling middle-aged and elderly adults. In the primary prevention of dementia, the effects of mental activity and brain-benefiting exercise should be emphasized. Moreover, priority in community health management should be given to men, those with a low educational level or no previous experience of receiving dementia-related health education, and relevant health education and preventive interventions should be strengthened for them. All these efforts will urge these adults to adopt a lifestyle for dementia risk reduction and brain health promotion.

Maintaining brain health is an advanced goal of healthy ageing. Eating a diet with appropriate nutrients has been identified as a promising approach to reducing the risk of dementia, but community-dwelling residents have inadequate or no health guidance from medical workers since there is no detailed and comprehensive clinical dietary nutrients management program for brain health promotion for community-dwelling people .

To search, evaluate and summarize the evidence on dietary nutrients management for brain health promotion in community-dwelling people, providing an evidence-based basis for clinical implementation of such management for this group of population.

In March 2022, we searched UpToDate, BMJ Best Practice, JBI Model of Evidence-based Healthcare, National Institute on Aging, Registered Nurses' Association of Ontario, the Cochrane Library, PubMed, CNKI, Medlive and other databases to collect literature (involving clinical decisions, recommended practices, guidelines, evidence summaries, expert consensuses and systematic reviews) regarding dietary nutrients management for brain health promotion in community-dwelling people. The retrieval period was from January 1, 2017 to March 29, 2022. Two researchers systematically trained in evidence-based medicine independently screened literature, extracted data, and evaluated the quality of the included literature. Then evidence was extracted from the included literature, and its quality was graded, then the best evidence was summarized.

A total of 28 studies with an overall high methodological quality were included, including three clinical guidelines, five expert consensuses, one clinical decision and 19 systematic reviews. Finally, 23 pieces of best evidence were summarized, involving seven aspects of intervention timing, dietary nutrients assessment and screening, dietary patterns and components, specific nutrients, coffee intake, body weight management, health education and guidance.

Eating a diet with appropriate nutrients can promote brain health of residents. Community medical workers should develop an individualized dietary nutrients management program for brain health for them in accordance with the practical clinical situation, residents' current dietary nutrients status and preferences, and insights from the best evidence.

As population aging progresses, the prevalence of multimorbidity and polypharmacy is increasing in older adults, which may increase the risk of potentially inappropriate medication, causing adverse health outcomes.

To systematically assess the prevalence and associated factors of potentially inappropriate medication in community-dwelling Chinese older adults, in order to provide a reference for developing relevant intervention strategies.

In June 2022, we searched databases of CNKI, CQVIP, Wanfang Data, SinoMed, PubMed, EmBase, and Web of Science from inception to June 2022 for studies on potentially inappropriate medication in community-dwelling older adults in China. Two reviewers independently selected studies, extracted data and assessed the quality of included studies according to the Agency for Healthcare Research and Quality methodology checklist. Meta-analysis was conducted using Stata 12.0.

A total of 24 studies were included, including two with high quality and 22 with moderate quality. Meta-analysis showed that the pooled prevalence of potentially inappropriate medication was 34.8%〔95%CI (31.3%, 38.3%) 〕in community-dwelling older adults in China. Pooled estimates showed 75 years or above〔OR (95%CI) =1.261 (1.074, 1.481) 〕, five or more comorbidities〔OR (95%CI) =3.287 (1.405, 7.691) 〕, and taking five or more medications〔OR (95%CI) =1.800 (1.305, 2.481) 〕or taking 10 or more medications〔OR (95%CI) =4.380 (2.612, 7.347) 〕were associated factors of potentially inappropriate medication.

Potentially inappropriate medication is common in community-dwelling older adults in China, whose risk is associated with older age, multimorbidity and polypharmacy. Prevention and management of potentially inappropriate medication should be paid attention to individuals with the above characteristics.

Diabetes self-management is an important measure to reduce the adverse impact of the disease and improve the outcome in patients with diabetes. Existing diabetes self-management studies mainly focus on the evaluation of short-term intervention effects, but rarely report the long-term effects.

To evaluate the short- and long-term effects of group-based self-management activities on comprehensive glycemic control in type 2 diabetes patients in the community.

In 2014, 500 adults with type 2 diabetes were recruited from Fangshan District, Beijing, and randomly divided into a control group (n=241) and an intervention group (n=259). Both groups received routine diabetes follow-up services. The intervention group also received a three-month group-based self-management activities. We conducted four surveys at different times (at baseline, and three months, two years and five years post-intervention) to collect patient demographics, disease condition, comprehensive glycemic control indicators〔body mass index (BMI), blood pressure, fasting plasma glucose (FGP), glycated hemoglobin (HbA_1c), high-density lipoprotein cholesterol (HDL-C), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C) 〕. Generalized estimating equations were used to analyze the main effect of the self-management activities and the interaction effect of the activities with post-intervention time.

After adjusting for potential confounders, the main effects of the self-management activities on BMI, systolic blood pressure, diastolic blood pressure, FPG, HbA_1c, HDL-C, TG an LDL-C were not statistically significant (P>0.05). The main effects of time of intervention on various indicators were statistically significant (P<0.05). Specifically, the BMI, systolic blood pressure, diastolic blood pressure, FPG, HbA_1c, HDL-C and LDL-C increased, and TG decreased in the patients after intervention. We found the self-management activities and the intervention time had an interaction effect on BMI〔β (95%CI) =-0.33 (-0.62, -0.05) 〕, FPG〔β (95%CI) =-1.03 (-1.71, -0.35) 〕, and TG〔β (95%CI) =-0.54 (-0.93, -0.14) 〕: the BMI of the intervention group was 0.31 kg/m² lower than that of the control group at baseline, and was 0.64 kg/m² lower than that of the control group at three months post-intervention; the FPG of the intervention group was 0.19 mmol/L higher than that of the control group at baseline, but was 0.84 mmol/L lower than that of the control group at two years post-intervention; the TG of the intervention group was 0.03 mmol/L higher than that of the control group at baseline, but was 0.51 mmol/L lower than that of the control group at five years post-intervention.

Group-based self-management activities have a short-term effect on controlling BMI, and may have a long-term effect on controlling FPG and TG in patients with type 2 diabetes.

With the rapid population aging in China, cognitive impairment in older adults has become a growing public health concern.

To examine the association between nighttime sleep duration and cognitive impairment among community-dwelling older adults.

Data were derived from the cohort of Older Adult Health and Modifiable Environmental Factors established in Fuyang City from July to September 2018, among whom a total of 4 837 older adults with complete data on cognitive function and sleep time were included in this study. General demographic characteristics〔gender, age, living area (urban or rural), education level, occupation, marital status〕, living habits, the history of chronic diseases, sleep duration, and overall cognitive function were extracted. Binary Logistic regression models were used to analyze the association between nighttime sleep duration and cognitive impairment. Restrictive cubic splines were used to further determine potential dose-response relationships between them.

The participants had a mean nighttime sleep duration of (6.95±1.75) hours, among whom 1 773 (36.65%) slept ≤6 hours per day, 2 088 (43.17%) slept >6-8 hours per day, and 976 (20.18%) slept >8 hours per day. The detection rate of cognitive impairment was 37.44% (1 811/4 837). After adjusting for gender, age, living area, education level and other confounding factors, the detection rate of cognitive impairment was 1.26〔95%CI (1.09, 1.46) 〕 times higher in older adults with nighttime sleep duration of ≤6 hours, and was 1.22〔95%CI (1.03, 1.46) 〕 times higher in older adults with nighttime sleep duration of >8 hours than in those with nighttime sleep duration of >6-8 hours (P<0.05). The detection rate of cognitive impairment in male older adults with nighttime sleep duration of >8 hours was 1.35〔 (95%CI (1.06, 1.72) 〕 times higher than in those with nighttime sleep duration of >6-8 hours (P<0.05). The detection rate of cognitive impairment in female older adults with nighttime sleep duration of≤6 hours was 1.29〔95%CI (1.06, 1.58) 〕 times higher than in those with nighttime sleep duration of >6-8 hours (P<0.05). The restriction cube spline curve showed an approximate U-shaped relationship between nighttime sleep duration and the risk for cognitive impairment, with the lowest risk at 7 hours.

Both shorter and longer nighttime sleep duration may be independent and dose-dependent risk factors for cognitive impairment in older adults. The optimal sleep time is about 7 hours. The association between longer sleep duration and cognitive impairment is pronounced in males, while the association between shorter sleep duration and cognitive impairment is pronounced in females.

Myopia is an important cause of visual impairment and has become a public health problem all over the world. In China, myopia has a high incidence rate and age of onset of which is becoming younger. There is no clinical method to reverse myopia in children. Therefore, it is important to standardize the screening for ametropia to realize early detection and intervention of myopia. As a primary care institution, a community health center may accurately understand the prevalence of myopia in teenagers in its service coverage area. So giving full play to the role of community health center has important practical significance for the containment of myopia in children and adolescents.

To explore the feasibility of community-based prevention and control of myopia in school-age children.

A cohort study was conducted. The information about visual acuity and refractive status of students in a primary school in Beijing's Chaoyang District from September 2019 to September 2021 were collected for statistical analysis, among which four groups of data in September 2019, September 2020, March 2021 and September 2021 were finally included according to the inclusion and exclusion criteria, with a total of 5 558 records. Then, based on the data, an electronic students' refractive database was established, with uncorrected visual acuity, corrected visual acuity, refractive status (power of a spherical lens, power of a cylindrical lens, axis) , prevalence of wearing glasses or orthokeratology incorporated. The warning levels of vision screening were set to be 0, 1, 2 and 3 from low to high. The visual change, visual warning level, spherical equivalent (SE) of students were compared by grade. The visual changes and warning level evolution at different times were compared at the individual level. Corresponding interventions were implemented for different warning levels, and the intervention results were analyzed and discussed.

There were statistically significant differences in uncorrected distance visual acuity (UDVA) among students by grade (F=100.413, P<0.05) . The UDVA differed significantly in male or female students (F=47.168, 53.042, P<0.05) . Compared with the lower grade students (grades 1 and 2) , middle and higher grade students (grades 3, 4, 5 and 6) had lower UDVA (P<0.003) . The UDVA decreased with the increase in grade in male and female students, and the decline in female students was faster. The composition of the warning levels of myopia risk assessed based on the UDVA in male and female students in all grades was similar, mainly composed of 0, 1, and 3 levels. With the increase in grade, the number of low warning level (level 0) gradually decreased, while that of high warning level (level 3) gradually increased. The SE in students differed obviously by grade (F=474.728, P<0.05) . The SE also differed much in male or female students (F=121.704, 123.807, P<0.05) . With the increase of grade, SE tended to be negative, and the difference in SE between left and right eyes was statistically significant (t=-4.67, P<0.05) . The negative trend of SE for the right eye was more remarkable, suggesting that the warning level of the right eye was higher, and the right eye was more prone to myopia. The follow-up of three consecutive years for assessing individual visual changes revealed that the results of four UDVA screening differed significantly in all students and female students (F=8.727, 10.221, P<0.05) . The UDVA result screened in March 2021 for all students decreased significantly compared with that screened in September 2019 or September 2020 (P<0.008) , so did the UDVA result screened in September 2021 (P<0.008) . During the evolution of warning level, higher warning level was associated with lower possibility of returning to the low warning level, and the possibility of progressing to a higher warning level increased with the growth of warning level.

The visual acuity and refractive status of students in this primary school in Beijing's Chaoyang District were not optimistic. With the increase in grade, the UDVA decreased and the number of high warning level gradually increased. To actively contain myopia in school-age children, it is suggested to establish a community-based vision screening and warning mechanism, and to promote the containing of myopia by home-school-community collaboration efforts.

In 2019, the National Health Commission issued the Capacity Standards for Community Health Service Center (2018 version), which proposed that the 56 common disease species should be offered diagnosis and treatment services by CHSC, but it did not specify the common disease species of children in the community, which to some extent affects the assessment and construction of CHSC capacity in the community.

To investigate and analyze the common childhood disease species and their characteristics in community health services, in order to provide a reference basis for further community child health service capacity building.

In April 2020, a convenience sampling method was adopted to select community health service agencies in 11 different level cities in China as the sample unit. A self-designed questionnaire was administered to cover the subject's basic condition, the common childhood disease conditions suitable for diagnosis and treatment in the community, and their sequencing. Filled out online voluntarily anonymously by child health service personnel at the sample institution, 3 090 cases were successfully investigated. Respondents ranked the common degree of children's related disorders from low to high, assigning 1 to 5 points to each of the top 5 common childhood disorders, which is, assigning 5 points to ranked 1, 1 point to ranked 5, and 0 points to unselected, calculating a total and sorting by total score.

The top 5 disease categories for children in the community were acute upper respiratory infection, diarrhea, bronchitis, pneumonia, and eczema. Of the top 10 ranked community common childhood disorders, 3 were respiratory, 3 were facial and dermatologic, 2 were infectious, and 1 each was a digestive and growth and development related disorder. The top 5 common childhood diseases ranked by different regions, different levels of cities and different posts were consistent, but the ranking order was different, but there were differences in the 6th-10th disease species and order.

The current coverage of common childhood diseases in community health services is high. There is regional, urban, and post heterogeneity in common childhood disease species in communities. Construction of community child health service capacity should be oriented to improve the capacity of diagnosis and treatment service of common childhood diseases in the community, and fully consider the disease species variability in different regions, cities, and posts.

Severe community-acquired pneumonia (SCAP) progresses rapidly, with high mortality, multiple complications, and heavy economic burden. Despite the continuous improvement of clinical diagnosis and treatment programs, its morbidity and mortality remain high. Traditional Chinese Medicine (TCM) has proven its significant clinical efficacy in treating SCAP, but there is still no a standardized TCM-based clinical diagnosis and treatment protocol for SCAP, and insufficient research on the distribution of clinical TCM syndromes of SCAP.

To study the characteristics and distribution of clinical TCM symptoms of SCAP, providing ideas for clinical diagnosis and treatment of SCAP.

SCAP inpatients were recruited from Department of Respiratory Medicine, the First Affiliated Hospital of Henan University of CM from December 2012 to March 2021. Their symptoms and signs were summarized. Factor analysis and cluster analysis were performed on the data using SPSS Statistics (version 26.0) .

One hundred and sixty-six patients were included, including 119 men and 47 women, the ratio is 2.53∶1, with an average age of (70.1±15.8) years old. Altogether, 13 TCM syndromes were summarized, among which phlegm-heat obstructed lung syndrome had a high prevalence〔34.33% (57 /166) 〕; cough and expectoration were prevalent in more than 50% of the patients. Twelve common factors were obtained by factor analysis of TCM symptoms, explaining 62.842% of the total variance. By cluster analysis, the common factors were clustered into four major categories: phlegm-heat obstructed lung syndrome, xiexian-zhengtuo syndrome, qi-yin deficiency syndrome, and phlegm-damp obstructed lung syndrome.

Men is accounting for a larger percentage of SCAP. Clinical TCM syndromes of SCAP mainly include phlegm-heat obstructed lung syndrome, xiexian-zhengtuo syndrome, qi-yin deficiency syndrome, and phlegm-damp obstructed lung syndrome.

The percentage of older population of the total population is increasing in developed areas of developing countries, and the impact and contribution of population composition factors towards cancer mortality are still unclear.

To analyze the epidemiological characteristics and trend of cancer mortality among community-living residents in central Pudong New Area of Shanghai from 2007 to 2020.

From January to December 2021, we retrospectively collected the death data during 2007 to 2020 of registered permanent residents living in Dongming Road Community of Pudong New Area from the all-cause death monitoring database, and population composition data from Pudong New Area Public Security Bureau. We used the crude mortality rate (CMR) , standardized mortality rate (SMR, with reference to the SMR of the general Chinese population in 2010) , and average annual percent change (AAPC) to analyze the status and trends of cancer mortality, and used the decomposition method to estimate the contribution rates of demographic and non-demographic factors to the change of cancer mortality.

From 2007 to 2020, a total of 2 446 cancer-induced deaths were reported by the Dongming Road Community, accounting for 28.48% of the total reported deaths (8 589 cases) . The CMR of cancers was 268.56/10⁵, in which the CMR due to lung cancer, colorectal cancer, and gastric cancer was 69.61/10⁵, 33.05/10⁵ and 31.84/10⁵, respectively. The SMR of cancers was 71.46/10⁵ , in which the SMR due to lung cancer, colorectal cancer, and gastric cancer was 33.12/10⁵, 15.46/10⁵, and 15.29/10⁵, respectively. During this period, the CMR for cancers among men, women and the whole population remained stable (Z=1.82, -0.54, 0.87, P>0.05) . The CMR and SMR in men were higher than those in women (u=6.69, P<0.001; Z=-13.22, P<0.001) . The SMR in men showed a downward trend (AAPC=-1.80%, Z=-2.19, P<0.05) , while in women, it remained stable (Z=-1.63, P>0.05) . As in the whole population, it showed a downward trend year by year (AAPC=-1.73%, Z=-3.09, P=0.010) . Furthermore, the CMR for cancers in those aged 65-79 showed a downward trend gradually (AAPC=-4.17%, Z=-1.80, P<0.01) . The difference between the CMR of cancers during 2007—2013 and that during 2014—2020 was 3.80/10⁵. The added value of demographic factors to mortality was 28.97/10⁵, with a contribution rate of 53.51%. And the added value of non-demographic factors to mortality -25.17/10⁵, with a contribution rate of 46.49%.

In Dongming Road Community from 2007 to 2020, both SMRs for cancers in the whole population and male residents demonstrated a downward trend, and the CMR for cancers in those aged 65-79 demonstrated a year-by-year downward trend. Older age may be the major demographic factor contributing to the stability of CMR of cancers.

Elderly patients in community outpatient clinics often suffer from multiple chronic conditions and were particularly vulnerable to potentially inappropriate prescribing (PIP) .

To analyze the influencing factors of prescriptions for elderly patients becoming PIP in community outpatient clinics.

In March 2021, a combination of cluster sampling and simple random sampling was used to select drug prescriptions from elderly patients who visited a community health service center in Beijing from January 1 to December 31, 2019. The prescriptions were evaluated by two pharmacists with intermediate titles based on 2019 American Geriatrics Society Beers Criteria (abbreviated as Beers criteria) and Criteria of Potentially Inappropriate Medications for Older Adults in China (abbreviated as China criteria) , respectively. At the same time, the researchers collected the relevant data of the prescriber, elderly patients and the content of the prescription, and compared the differences in the characteristics of the prescriber, the prescription object and the prescription content of the prescriptions with different evaluation results. Binary Logistic regression method was used to analyze the factors affecting PIP prescribing and to conduct sensitivity analysis (selected prescriptions for patients≥65 years of age) . Descriptive analysis was used to describe the distribution of inappropriate medicine in PIP.

A total of 815 outpatient prescriptions for elderly patients were included, including 266 (32.6%) PIP under the Beers criteria or 182 (22.3%) PIP under the Chinese criteria, respectively. According to the Beers criteria, the differences were statistically significant when comparing the age of prescribers, the age of elderly patients, the proportion of those with the diagnosis of hypertension and insomnia, the number of drug varieties, and the proportion of those with the drug categories of cardiovascular system drugs, antithrombotic drugs, central nervous system drugs, and gastrointestinal system drugs between PIP and non-PIP (P<0.05) . According to the China criteria, the differences were statistically significant when comparing the age or title distribution of prescribers, the proportion of those with the diagnosis of hypertension, coronary heart disease, diabetes, insomnia and osteoarthritis, and the proportion of those with the drug categories of cardiovascular system drugs, antithrombotic drugs, non-insulin hypoglycemic drugs, central nervous system drugs and non-steroidal anti-inflammatory drugs (NSAIDs) between PIP and non-PIP (P<0.05) . The binary Logistic regression results showed that, no matter under the Beers criterion or the Chinese criterion: the prevalence of coronary heart disease or insomnia in elderly patients had an impact on the prescription of PIP, and the inclusion of antithrombotic agents in the prescription was an influencing factor affecting the formation of PIP (P<0.05) . The results of the sensitivity analysis showed that hypertension, coronary heart disease and insomnia in elderly patients have an impact on the prescribing of PIP; the inclusion of antithrombotic medication in the prescription was an influencing factor affecting the formation of PIP (P<0.05) . According to the Beers' criterion, 266 PIP involved a total of 302 cases of inappropriate drug use, of which antithrombotic drugs accounted for 46.4% (140/302) , central nervous system drugs accounted for 16.2% (49/302) , endocrine system diabetes (non-insulin) drugs accounted for 13.9% (42/302) . According to the Chinese criterion, 182 PIP involved inappropriate medications in a total of 205 cases, of which antithrombotic drugs accounted for 44.9% (92/205) , central nervous system drugs accounted for 25.9% (53/205) , oral NSAIDs accounted for 14.1% (29/205) .

Among the community outpatient prescriptions for elderly patients, PIP accounted for a relatively high proportion. In the future, emphasis should be placed on community physicians' knowledge of safe and rational drug use, the use of antithrombotic drugs should be standardized, and the review of drug prescriptions for patients with hypertension, coronary artery disease and insomnia should be strengthened.

Postmenopausal osteoporosis (PMOP) has an increasing incidence as aging advances. As the traditional Chinese medicine (TCM) constitution theory is of great significance in guiding PMOP prevention and treatment, studying the associated factors of yang-deficiency constitution, a common imbalanced constitution in PMOP patients, will contribute to the development of personalized treatment of PMOP.

To perform an analysis of the distribution of TCM constitution and associated factors of yang-deficiency constitution in PMOP patients in the community.

From November 2017 to July 2018, an interviewer-administered questionnaire survey for screening PMOP was conducted with a random sample of residents (45-80 years old) from 10 communities of Beijing's Chaoyang and Fengtai Districts. The general data collected include age, age at menopause, retirement status, types of job (mental, physical, or both) , educational level, monthly household income, height, weight, body mass index (BMI) , grip strength-weight index, history of fractures, history of falls, family history of osteoporosis, nighttime sleep duration, habits of eating leftovers, diet type (meat-based, plant-based, or meat-plant based) . TCM constitution was analyzed using the TCM Constitution Questionnaire. The associated factors of yang-deficiency constitution in PMOP cases were analyzed by multivariate Logistic regression.

Four hundred and thirty-two cases were found with PMOP, four of them were excluded due to missing data of TCM constitution, and the other 428 cases were finally included. The residents with gentleness constitution numbered the most (n=175) . Among residents with biased constitution, those with yang-deficiency constitution numbered the most (n=107) . Through multivariate Logistic regression analysis, it was found that BMI<18.5 kg/m², frequently eating leftovers, and meat-based diet were associated with increased risk of PMOP in yang-deficiency residents (P<0.05) .

This cross-sectional survey indicates that yang-deficiency constitution may be highly prevalent in PMOP residents, and was associated with BMI<18.5 kg/m² often eating leftovers, and meat-based diet.