RESUMEN
HONO is a critical precursor of â¢OH, but its sources are controversial due to its complex formation mechanism. This study conducted comprehensive observations in Zhengzhou from April 26 to May 11, 2022. Low NOx concentrations were observed during the Covid epidemic period (EP) (10.4 ± 3.0 ppb), compared to the pre-epidemic period (PEP) (12.5 ± 3.8 ppb). The mean HONO concentration during EP (0.53 ± 0.34 ppb) was 0.09 ppb lower than that during PEP (0.62 ± 0.53 ppb). The decrease in HONO concentration during EP came mainly at night due to the reduction in the direct emission (Pemi) (0.03 ppb/hr), the homogeneous reaction between â¢OH and NO (POH+NO) (0.02 ppb/hr), and the heterogeneous conversion of NO2 on the ground (0.01 ppb/hr). Notably, there was no significant change in daytime HONO concentration. The daytime HONO budget indicated that the primary HONO sources during PEP were the nitrate photolysis (Pnitrate), followed by the POH+NO, Pemi, the photo-enhanced reaction of NO2 on the ground (Pground+hv) and aerosol surface (Paerosol+hv). The primary HONO sources were Pnitrate, POH+NO, Pemi, and Paerosol+hv during EP, respectively. The missing source has a high correlation with solar radiation, there might be other photo-related HONO sources or the contributions of photosensitized reactions were underestimated. In the extremely underestimated cases, HONO production rates from the Pnitrate, Pground+hv, and Paerosol+hv increased by 0.17, 0.10, and 0.10 ppb/hr during PEP, 0.23, 0.13, and 0.16 ppb/hr during EP, and Pnitrate was still the primary source during both PEP and EP.
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Contaminantes Atmosféricos , COVID-19 , COVID-19/epidemiología , China/epidemiología , Contaminantes Atmosféricos/análisis , Monitoreo del Ambiente/métodos , SARS-CoV-2 , Pandemias , Ciudades , HumanosRESUMEN
Growing evidences showed that heavy metals exposure may be associated with metabolic diseases. Nevertheless, the mechanism underlying arsenic (As) exposure and metabolic syndrome (MetS) risk has not been fully elucidated. So we aimed to prospectively investigate the role of serum uric acid (SUA) on the association between blood As exposure and incident MetS. A sample of 1045 older participants in a community in China was analyzed. We determined As at baseline and SUA concentration at follow-up in the Yiwu Elderly Cohort. MetS events were defined according to the criteria of the International Diabetes Federation (IDF). Generalized linear model with log-binominal regression model was applied to estimate the association of As with incident MetS. To investigate the role of SUA in the association between As and MetS, a mediation analysis was conducted. In the fully adjusted log-binominal model, per interquartile range increment of As, the risk of MetS increased 1.25-fold. Compared with the lowest quartile of As, the adjusted relative risk (RR) of MetS in the highest quartile was 1.42 (95% confidence interval, CI: 1.03, 2.00). Additionally, blood As was positively associated with SUA, while SUA had significant association with MetS risk. Further mediation analysis demonstrated that the association of As and MetS risk was mediated by SUA, with the proportion of 15.7%. Our study found higher As was remarkably associated with the elevated risk of MetS in the Chinese older adults population. Mediation analysis indicated that SUA might be a mediator in the association between As exposure and MetS.
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Arsénico , Exposición a Riesgos Ambientales , Síndrome Metabólico , Ácido Úrico , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Arsénico/sangre , Arsénico/toxicidad , China/epidemiología , Pueblos del Este de Asia , Exposición a Riesgos Ambientales/efectos adversos , Síndrome Metabólico/epidemiología , Síndrome Metabólico/inducido químicamente , Síndrome Metabólico/sangre , Ácido Úrico/sangreRESUMEN
BACKGROUND: Foodborne diseases are a growing public health concern worldwide and households are a common setting. This study aimed to explore the epidemiological characteristics of household foodborne disease outbreaks in Zhejiang Province and propose targeted prevention and control measures. METHODS: Descriptive statistical methods were used to analyze household foodborne disease outbreak data collected from the Foodborne Disease Outbreaks Surveillance System in Zhejiang Province from 2010 to 2022. RESULTS: Household foodborne disease outbreaks showed an upward trend during the study period (Cox-Staurt trend test, p = 0.01563 < 0.05). These outbreaks mainly occurred from June to September, with 62.08% (352/567) of all reported outbreaks. The number of reported outbreaks varied in 11 prefectures, with a maximum of 100 and a minimum of only 7. Household foodborne disease outbreaks had a wide spectrum of etiologic factors. Mushroom toxins accounted for the largest proportion of all etiologies (43.39 %) and caused the highest proportion of hospitalization (54.18%) and death (78.26%). Such outbreaks are caused by accidently eating wild poisonous mushrooms. Bacterial infection (16.23%) was the second most common etiology, with Salmonella spp. and Vibrio parahaemolyticus being the primary pathogens. These outbreaks were caused by improper storage, improper processing or a combination of factors, and the foods involved were mainly aquatic animals, eggs and cooked meat. Other identified etiologies included plant toxins (9.52%), chemicals (7.23%), animal toxins (3.70%), and viruses (1.76%). Among the above-mentioned etiologies, mushroom toxins, bacteria, and animal toxins had seasonal characteristics. Analysis of regions and etiologies revealed that the proportion of various etiologies was different in 11 prefectures. Wild mushrooms (43.39%), aquatic animals (9.88%), and toxic plants (8.47%) were the top three foods involved in these outbreaks. The most common factors contributing to household foodborne disease outbreaks were inedibility and misuse (59.08%), followed by multiple factors (7.58%), improper storage (7.41%), and improper processing (7.41%). CONCLUSIONS: Household foodborne disease outbreaks were closely related to the lack of knowledge regarding foodborne disease prevention. Therefore, public health agencies should strengthen residents' surveillance and health education to improve food safety awareness and effectively reduce foodborne diseases in households. In addition, timely publicity and early warning by relevant government departments, the introduction of standards to control the contamination of pathogenic bacteria in raw materials, and strengthened supervision of the sale of substances that may cause health hazards, such as poisonous mushrooms and nitrites, will also help reduce such outbreaks.
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Brotes de Enfermedades , Enfermedades Transmitidas por los Alimentos , China/epidemiología , Humanos , Enfermedades Transmitidas por los Alimentos/epidemiología , Enfermedades Transmitidas por los Alimentos/microbiología , Composición Familiar , Contaminación de Alimentos/análisis , Contaminación de Alimentos/estadística & datos numéricos , Vibrio parahaemolyticus/aislamiento & purificación , Salmonella/aislamiento & purificación , AnimalesRESUMEN
Background: Under the current pandemic of Corona Virus Disease 2019 (COVID-19), The relationship between fatigue and COVID-19 has been found. Infection with COVID-19 is associated with fatigue long after the acute phase of COVID-19. Understanding the association of thyroid hormones levels with post-COVID condition, such as fatigue, is necessary to improve quality of life. Methods: This population-based cohort study was conducted in Dalian, China, from December 2022, to March 2023, using a Yidu Core platform in the First Affiliated Hospital of Dalian Medical University, that integrates medical records, laboratory tests, and all diagnosis and treatment information based on patients in hospital. Eligible individuals were 40 patients with COVID-19, Divided them into fatigue group and non-fatigue group following up by telephone using the FS-14 scale after 6 months. The primary outcomes were the diagnoses of fatigue. The association between thyroid hormones levels and post-COVID condition, such as fatigue, was assessed using logistic regression analysis. Results: Compared with the non-fatigue group, the FT3 level in fatigue group was lower (p<0.05). FT3 was negatively correlated with fatigue after 6 months (OR 0.257, p<0.05). After adjusting for confounding factors such as age and gender, low FT3 was a risk factor for fatigue in patients with COVID-19, (OR 0.225, p<0.05). And the FT3 is less than 2.47 mol/L, it is the best critical value for predicting long-term fatigue, with a sensitivity of 92.3% and a specificity of 48.1%. Conclusions: Most people still have fatigue 6 months after COVID-19 infection. FT3 serves as the important index to predict fatigue in patients with COVID-19. it should be closely monitored during infection.
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COVID-19 , Fatiga , Triyodotironina , Humanos , COVID-19/complicaciones , COVID-19/epidemiología , Fatiga/etiología , Fatiga/epidemiología , Femenino , Masculino , Persona de Mediana Edad , Triyodotironina/sangre , Adulto , China/epidemiología , SARS-CoV-2 , Anciano , Estudios de CohortesRESUMEN
BACKGROUND: HIV notification and testing integrated into partner service (PS) practices among HIV-positive individuals have been proven to be an efficient approach for case finding, although it remains a weak link in China. Although nonmarital sexual activities accounted for a large proportion of newly diagnosed HIV-positive cases in China, little is known about PS uptake and associated factors within nonmarital partnerships. OBJECTIVE: This study aimed to describe HIV PS utilization and its associated factors among HIV-positive individuals with nonmarital sexual partners. METHODS: We recruited newly diagnosed HIV-positive individuals who had nonmarital sexual partners in 2022 in Zhejiang Province and offered them PS. We described the PS uptake cascade within sexual partner categories and analyzed the associated factors with 3 primary outcomes from the participants' perspective: nonmarital partner enumeration, HIV testing, and HIV positivity. RESULTS: In this study, 3509 HIV-positive individuals were recruited as participants, and they enumerated 2507 nonmarital sex partners (2507/14,556, 17.2% of all nonmarital sex partners) with contact information. Among these, 43.1% (1090/2507) underwent an HIV test, with an HIV-positive rate of 28.3% (309/1090). Heterosexual commercial partners were the least likely of being enumerated (441/4292, 10.3%) and had the highest HIV-positive rate (40/107, 37.4%). At the participant level, 48.1% (1688/3509) of the participants enumerated at least one nonmarital sex partner with contact information, 52.7% (890/1688) had a sex partner tested for HIV, and 31% (276/890) had at least one nonmarital sex partner who tested positive. Multivariate analysis indicated that gender and transmission route were associated with both nonmarital sex partner enumeration and HIV testing. Age and occupation were associated with nonmarital sex partner enumeration and HIV positivity. Compared with participants who had no regular nonmarital sex partner, those who had a regular nonmarital sex partner were more likely to enumerate nonmarital sex partners (adjusted odds ratio [aOR] 3.017, 95% CI 2.560-3.554), have them get tested for HIV (aOR 1.725, 95% CI 1.403-2.122), and have an HIV-positive nonmarital sex partner (aOR 1.962, 95% CI 1.454-2.647). CONCLUSIONS: The percentage of partner enumeration was low, and HIV testing rate was moderate among nonmarital partnerships of HIV-positive individuals. More efforts should be made to improve PS practices among HIV-positive individuals and address the gap in partner enumeration, especially for heterosexual commercial nonmarital partnerships. Additionally, enhancing PS operational skills among health care personnel could increase the overall efficiency of PS uptake in China.
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Trazado de Contacto , Infecciones por VIH , Parejas Sexuales , Humanos , China/epidemiología , Masculino , Estudios Transversales , Femenino , Adulto , Trazado de Contacto/métodos , Trazado de Contacto/estadística & datos numéricos , Persona de Mediana Edad , Infecciones por VIH/epidemiología , Infecciones por VIH/diagnóstico , Adolescente , Adulto Joven , Prueba de VIH/estadística & datos numéricos , Prueba de VIH/métodos , Encuestas y Cuestionarios , Síndrome de Inmunodeficiencia Adquirida/epidemiologíaRESUMEN
Background: Drug users are a high-risk group for HIV infection and are prominent HIV carriers. Given the emergence of new drugs, we explored current drug-using behaviors, HIV infections, and the correlation between drug-using behaviors and HIV infection risk among drug users from 2014 to 2021. Objective: We aimed to identify the prevalence of HIV infection risk among drug users and explore drug use behaviors based on the updated data, which could provide evidence for the precision of HIV prevention strategies among drug users. Methods: Data were collected from sentinel surveillance of drug users in rehabilitation centers and communities in Hangzhou (2014-2021), including sociodemographic characteristics, HIV awareness, drug use, risky sexual behaviors, and HIV infection status. Multivariate logistic regression was used to identify the factors influencing HIV infection and risky sexual behaviors among drug users. Results: In total, 5623 drug users (male: n=4734, 84.19%; age: mean 38.38, SD 9.94 years) were included. New drugs dominated among the participants (n=3674, 65.34%). The main mode of drug use was noninjection (n=4756, 84.58%). Overall, for 27.45% (n=1544) of injected drugs in the last month before the investigation, the average daily injection frequency was 3.10 (SD 8.24). Meanwhile, 3.43% of participants shared needles. The incidence of sexual behaviors after drug use was 33.13% (n=1863), with 35.75% (n=666) of them using a condom in the last time. Overall, 116 participants tested positive for HIV antibodies (infection rate=2.06%). New drug users exhibited more postuse sexual behaviors than traditional drug users (odds ratio [OR] 7.771, 95% CI 6.126-9.856; P<.001). HIV-aware drug users were more likely to engage in risky sexual behaviors (OR 1.624, 95% CI 1.152-2.291; P=.006). New-type drug users were more likely to engage in unprotected sexual behavior (OR 1.457, 95% CI 1.055-2.011; P=.02). Paradoxically, drug users with greater HIV awareness were more prone to engaging in unprotected sexual behavior (OR 5.820, 95% CI 4.650-7.284; P<.001). Women engaged less in unprotected sex than men (OR 0.356, 95% CI 0.190-0.665; P=.001). HIV rates were higher among injecting drug users (OR 2.692, 95% CI 0.995-7.287; P=.04) and lower among drug users who used condoms during recent sex than those who did not (OR 0.202, 95% CI 0.076-0.537; P=.001). Higher education levels were associated with higher HIV infection rates. However, there was no significant correlation between HIV cognition level and HIV infection. Conclusions: New drug types and noninjection were the main patterns in last 7 years. Using new types of drugs, rather than traditional drugs, was associated with an increased risk of HIV infection. Injection drug use was a risk factor for HIV infection. HIV awareness among drug users was high, but the incidence of risky sexual behaviors remained high. Therefore, it is important to promote the behavioral transformation of high-risk populations from cognition to attitude, and then to taking protective measures.
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Consumidores de Drogas , Infecciones por VIH , Asunción de Riesgos , Trastornos Relacionados con Sustancias , Humanos , Masculino , China/epidemiología , Infecciones por VIH/epidemiología , Estudios Transversales , Femenino , Adulto , Consumidores de Drogas/estadística & datos numéricos , Consumidores de Drogas/psicología , Persona de Mediana Edad , Trastornos Relacionados con Sustancias/epidemiología , Prevalencia , Factores de Riesgo , Conducta Sexual/estadística & datos numéricos , Adulto Joven , Vigilancia de Guardia , AdolescenteRESUMEN
Surprisingly, the 1977 "Russian flu" H1N1 pandemic influenza virus was genetically indistinguishable from strains that had circulated decades earlier but had gone extinct in 1957. This essay puts forward the most plausible chronology to explain the reemergence of the 1977 H1N1 pandemic virus: (1) in January-February 1976, a self-limited small outbreak of a swine H1N1 influenza virus occurred among Army personnel at Fort Dix, New Jersey; (2) in March 1976, the US launched a nationwide H1N1 swine influenza vaccine program; (3) other countries then also launched their own H1N1 R&D efforts; (4) a new H1N1 outbreak, genetically unrelated to the Fort Dix swine virus but indistinguishable from previously extinct H1N1 viruses, was detected early in 1977 in China; (5) the leading Chinese influenza virologist later disclosed that the Chinese military had conducted large H1N1 vaccine R&D studies in 1976. It is likely that the resurrected H1N1 influenza viruses were laboratory-stored strains that were unfrozen and studied as part of the emergency response to a perceived epidemic threat, and that accidentally escaped. The fear of a possible H1N1 pandemic was the critical factor that gave rise to the actual H1N1 pandemic, resulting in an avoidable "self-fulfilling prophecy pandemic."
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Subtipo H1N1 del Virus de la Influenza A , Vacunas contra la Influenza , Gripe Humana , Pandemias , Humanos , Gripe Humana/epidemiología , Gripe Humana/historia , Gripe Humana/virología , Historia del Siglo XX , Estados Unidos/epidemiología , China/epidemiología , Personal Militar , New Jersey/epidemiología , AnimalesRESUMEN
OBJECTIVES: Disaster experiences have long-term effects on disaster preparedness. This study examined the long-term (10-y) effect of disaster severity of the 2008 Wenchuan earthquake on survivors' disaster preparedness and the moderating effects of household vulnerability. METHODS: The data were collected in January 2018 covering 30 counties in Wenchuan earthquake-stricken areas. The dependent variable was survivors' disaster preparedness (including overall, material, knowledge and awareness, and action preparedness) in 2018. Disaster severity included survivors' housing damage and county death rate caused by the earthquake in 2008. Household vulnerability is a set of conditions that negatively affects the ability of people to prepare for and withstand disaster, proxied by households' per-capita income and the highest years of schooling of household members. We performed multivariable linear regression models to answer the research questions. RESULTS: A higher county death rate was associated with better overall preparedness (ß = 0.043; P < 0.05) and knowledge and awareness preparedness (ß = 0.018; P < 0.05), but housing damage was not significantly associated with disaster preparedness. The positive association of county death rate with overall preparedness (ß = -0.065; P < 0.05) becomes weaker when a household has a higher per-capita income. Also, with the household per-capita income increasing, the associations of county death rate with material preparedness (ß = -0.037; P < 0.05) and action preparedness (ß = -0.034; P < 0.01) become weaker. CONCLUSIONS: Disaster severity has positive and long-term effects on survivors' disaster preparedness. Also, the positive and long-term effects are affected by household vulnerability. Specifically, the positive and long-term effects of disaster severity on disaster preparedness are more substantial when a household is more vulnerable.
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Terremotos , Sobrevivientes , Humanos , China/epidemiología , Sobrevivientes/estadística & datos numéricos , Sobrevivientes/psicología , Terremotos/estadística & datos numéricos , Encuestas y Cuestionarios , Masculino , Femenino , Persona de Mediana Edad , Adulto , Defensa Civil/estadística & datos numéricos , Defensa Civil/métodos , Defensa Civil/normas , Planificación en Desastres/métodos , Planificación en Desastres/estadística & datos numéricosRESUMEN
The dynamics of tuberculosis transmission model with different genders are to be established and studied. The basic regeneration numbers R0=RF+RM are to be defined, where RF and RM to be the basic reproduction number of tuberculosis transmission in female and male populations, respectively. The existence and global stability of the disease-free equilibrium was discussed when R0<1. The global dynamic behaviours of the corresponding limit system under some conditions are to be provided, including the existence, uniqueness, and global stability of the disease-free equilibrium and endemic equilibrium. The numerical simulation shows that the endemic equilibrium may be unique and stable when R0>1, and the system will undergo Hopf bifurcation based on some parameter values. Finally, we applied this model to analyse the transmission of tuberculosis in China, estimated the incidence of tuberculosis in China in 2035, and gave the conclusion that controlling the incidence of tuberculosis in male populations could better reduce the incidence of tuberculosis in China.
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Modelos Biológicos , Tuberculosis , Humanos , Masculino , Femenino , Tuberculosis/transmisión , Tuberculosis/epidemiología , China/epidemiología , Número Básico de Reproducción , Incidencia , Simulación por Computador , Factores SexualesRESUMEN
The COVID-19 pandemic caused notable changes to the food-related habits of consumers worldwide due to their concerns about the risk of infection and the requirement to follow government mandates. To investigate the impact of the pandemic on Chinese consumers' food safety knowledge, food safety behaviors, and their most recent food poisoning experiences, we compared the results from an online survey (n = 583, Dec 2019) conducted before the pandemic was officially announced with an identical survey (n = 599, Aug 2023) conducted seven months after the Chinese government downgraded restrictions related to COVID-19. Post-pandemic there was a significant decrease in consumers' food safety knowledge and self-reported food safety behaviors and a significant increase in their self-reported experiences of food poisoning. Despite respondents stating that their food safety knowledge and behaviors had improved since the start of the pandemic, the data obtained from the two surveys and the respondents self-reporting of foodborne illness suggest that in fact their safety knowledge and behaviors had decreased. These findings highlight the need to reinforce food safety education and behaviors during times when the food system is disrupted, and consumers are focusing on what they perceive to be more immediate issues.
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COVID-19 , Inocuidad de los Alimentos , Enfermedades Transmitidas por los Alimentos , Conocimientos, Actitudes y Práctica en Salud , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , China/epidemiología , Femenino , Masculino , Adulto , Enfermedades Transmitidas por los Alimentos/epidemiología , Enfermedades Transmitidas por los Alimentos/prevención & control , Persona de Mediana Edad , Adulto Joven , Encuestas y Cuestionarios , SARS-CoV-2 , Comportamiento del Consumidor , Población Urbana , Adolescente , Anciano , PandemiasRESUMEN
Background: Although there is consistent evidence that smoking is a risk factor associated with tuberculosis (TB), whether smoking cessation improves treatment outcomes and reduces the risk of TB recurrence remains understudied. Methods: We conducted a prospective cohort study with a seven-year follow-up in China. We recruited newly-diagnosed TB patients and classified them as non-smokers, ex-smokers, and current smokers. Current smokers were invited to participate in a smoking cessation intervention programme. We used a Cox proportional hazards model to assess the risk of death among TB patients and the risk of recurrence among successfully treated patients. Results: In total, 634 (79.2%) patients completed anti-TB treatments and 115 (14.4%) patients died. We confirmed the existence of a dose-response relationship between smoking frequency and the risk of TB recurrence (the slope of the fitted line >0; P < 0.05). Compared to those who continued smoking, the risk of death and recurrent TB for the patients who quit smoking during treatment decreased. The HR of mortality for smokers who smoked 30 or more cigarettes was 2.943 (95% confidence interval (CI) = 1.035-8.368), while the HR of mortality for those who smoked 30 or more cigarettes, but quit during treatment was 2.117 (95% CI = 1.157-3.871). However, the risk of recurrence remained high for ex-smokers who had a smoking history of 25 years or more. Conclusions: Our study provides further evidence supporting the World Health Organization's call for co-management of smoking and other risk factors as part of routine TB treatment.
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Recurrencia , Cese del Hábito de Fumar , Tuberculosis , Humanos , Cese del Hábito de Fumar/estadística & datos numéricos , China/epidemiología , Masculino , Femenino , Estudios Prospectivos , Adulto , Persona de Mediana Edad , Estudios de Seguimiento , Tuberculosis/mortalidad , Tuberculosis/prevención & control , Factores de Riesgo , Antituberculosos/uso terapéutico , Anciano , Fumar/epidemiología , Modelos de Riesgos Proporcionales , Adulto JovenRESUMEN
Background: The implementation of a zero-COVID policy for 3 years in China during the COVID-19 pandemic significantly impacted a broad spectrum of acute respiratory tract infections (ARTIs). The epidemiological characteristics of ARTI pathogens in children following the cessation of the zero-COVID policy remain unclear. Methods: Etiologically diagnostic data from 82,708 children with ARTIs at the Children's Hospital of Soochow University during 2016-2023 were analyzed for 8 pathogens (human respiratory syncytial virus [HRSV], influenza A [FluA], FluB, human parainfluenza virus [HPIV], adenovirus [ADV], human rhinovirus [HRV], bocavirus [BoV], and mycoplasma pneumoniae [MP]). The changes in respiratory infections in Suzhou, China during the first year (2020, Phase I) and the second and third years of the pandemic (2021-2022, Phase II) and the first year after the end of zero-COVID policy (2023, Phase III) versus that in the pre-pandemic years (2016-2019) were compared. Results: When compared with the average pre-pandemic levels, the pathogen-positive rate decreased by 19.27% in Phase I (OR: 0.70; 95% CI: 0.67-0.74), increased by 32.87% in Phase II (OR: 1.78; 95% CI: 1.72-1.84), and increased by 79.16% in Phase III (OR: 4.58; 95% CI: 4.37-4.79). In Phase I, the positive rates of HRSV, FluA, ADV, and MP decreased by 26.72, 58.97, 72.85, and 67.87%, respectively, and the positive rates of FluB, HPIV, HRV, and BoV increased by 86.84, 25, 32.37, and 16.94%, respectively. In Phase III, the positive rates of HRSV, FluA, FluB, HPIV, ADV, and HRV increased by 39.74, 1046.15, 118.42, 116.57, 131.13, and 146.40%, respectively, while the positive rate of BoV decreased by 56.12%. MP was inhibited during the epidemic, and MP showed a delayed outbreak after the ending of the zero-COVID policy. Compared with the average pre-pandemic levels, the MP-positive rate in Phase III increased by 116.7% (OR: 2.86; 95% CI: 2.74-2.99), with the highest increase in 0-1-year-old children. Conclusion: The strict and large-scale implementation of the zero-COVID policy in the early stages of the COVID-19 pandemic was the main driving factor for the sharp reduction in the rate of children's respiratory pathogenic infections. The termination of this policy can cause a resurgence or escalation of pathogenic infections.
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COVID-19 , Infecciones del Sistema Respiratorio , SARS-CoV-2 , Humanos , COVID-19/epidemiología , China/epidemiología , Infecciones del Sistema Respiratorio/epidemiología , Niño , Preescolar , Lactante , Pandemias , Femenino , Política de Salud , Masculino , Adolescente , Gripe Humana/epidemiologíaRESUMEN
BACKGROUND: Cancer is a major health concern in China. Understanding the epidemiology of cancer can guide the development of effective prevention and control strategies. This study aimed to comprehensively analyze the cancer burden, time trends, and attributable risk factors of cancers in China and compare them with those in India. METHODS: We utilized the GLOBOCAN database for 2022, Cancer Incidence in Five Continents (C15 plus) series, and Global Burden of Disease (GBD) 2021 to extract data on cancer incidence, mortality, disability-adjusted life years (DALYs), and risk factors. Time-trend analysis was performed using a join-point regression model. Correlations between cancer DALY rates and risk factors were analyzed using linear regression. RESULTS: In 2022, China experienced 4,824,703 new cancer cases and 2,574,176 cancer-related deaths. Cancers also caused approximately 71.2 million DALYs in China in 2021. Compared with India, China has higher incidence, mortality, and DALY rates for various cancers. Breast and thyroid cancers in China have shown a rapid increase in the age-standardized incidence rate (ASIR), along with a substantial burden of lung, stomach, esophageal, and colorectal cancer. However, stomach and liver cancers in China showed a downward trend in ASIR. In 2021, diet low in milk was a major risk factor among females for colorectal cancer DALYs in China (23% of age-standardized DALYs) and India (22.9%). In China, smoking has been associated with increased DALYs due to lung cancer. CONCLUSIONS: China has a heavier cancer burden than India. The heavy burden of lung, stomach, esophageal, and colorectal cancers, combined with the rising incidence of breast and thyroid cancers, pose a critical challenge to public health in China. Cancer burden may be reduced through public health initiatives that prioritize primary prevention, prompt identification, and therapeutic intervention.
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Neoplasias , Humanos , China/epidemiología , India/epidemiología , Factores de Riesgo , Neoplasias/epidemiología , Incidencia , Femenino , Masculino , Años de Vida Ajustados por Discapacidad , Carga Global de Enfermedades , Costo de EnfermedadRESUMEN
Importance: Prior trials showed that dual antiplatelet therapy could reduce the risk of early new stroke in patients with acute mild ischemic stroke or transient ischemic attack (TIA) within 24 hours of symptom onset. However, it is currently uncertain whether dual antiplatelet therapy can reduce the risk of early new stroke in patients with a more delayed initiation time window. Objective: To evaluate the efficacy and safety of clopidogrel and aspirin among patients with mild ischemic stroke or TIA when initiated within 24 hours, from more than 24 hours to 48 hours, and from more than 48 hours to 72 hours. Design, Setting, and Participants: The Intensive Statin and Antiplatelet Therapy for Acute High-Risk Intracranial or Extracranial Atherosclerosis randomized clinical trial was a double-blind, placebo-controlled, multicenter, 2-by-2 factorial randomized clinical trial conducted at 222 hospitals in China from September 17, 2018, to October 15, 2022. All patients with acute mild ischemic stroke and TIA were included in this subgroup analysis and categorized into 3 groups according to time from symptom onset to randomization (group 1: ≤24 hours; group 2: >24 to ≤48 hours; and group 3: >48 to 72 hours). Patients were followed up for 90 days. Interventions: All patients received clopidogrel combined with aspirin (clopidogrel 300 mg loading dose on day 1, followed by 75 mg daily on days 2 to 90, and aspirin 100 to 300 mg on the first day and then 100 mg daily for days 2 to 90) or aspirin alone (100 to 300 mg on day 1 and then 100 mg daily for days 2 to 90) within 72 hours after symptom onset. Main Outcomes and Measures: The primary outcome was new stroke (ischemic or hemorrhagic) within 90 days. The primary safety outcome was moderate-to-severe bleeding, according to Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries criteria. Results: This analysis included a total of 6100 patients (3050 in the clopidogrel-aspirin group and 3050 in the aspirin group). The median age was 65 years (IQR, 57-71 years), and 3915 patients (64.2%) were male. In the population with time to randomization of 24 hours or less, stroke occurred in the next 90 days in 97 of 783 patients (12.4%); among those randomized from more than 24 hours to 48 hours, in 211 of 2552 patients (8.3%) among those randomized from more than 24 hours to 48 hours, and in 193 of 2765 patients (7.0%). The clopidogrel-aspirin group had a lower risk of new stroke within 90 days compared with the aspirin alone group both in patients with time to randomization of from 48 to 72 hours (5.8% vs 8.2%; hazard ratio [HR], 0.70 [95% CI, 0.53-0.94]), of more than 24 to 48 hours (7.6% vs 8.9%; HR, 0.85 [95% CI, 0.65-1.12]), and of 24 hours or less (11.5% vs 13.4%; HR, 0.83 [95% CI, 0.55-1.25]) (P = .38 for interaction). Among those with time to randomization of more than 48 to 72 hours, moderate-to-severe bleeding occurred in 12 patients (0.9%) in the clopidogrel-aspirin group and in 6 patients (0.4%) in the aspirin-alone group (HR, 2.00 [95% CI, 0.73-5.43]), while moderate-to-severe bleeding in those with time to randomization of more than 24 hours to 48 hours occurred in 9 patients (0.7%) in the clopidogrel-aspirin group and in 4 patients (0.3%) in the aspirin-alone group (HR, 2.25 [95% CI, 0.68-7.39]) and in those with time to randomization of within 24 hours, occurred in 6 patients (1.5%) in the clopidogrel-aspirin group and in 3 patients (0.8%) in the aspirin-alone group (HR, 1.57 [95% CI, 0.36-6.83]) (P = .92 for interaction). Conclusions and Relevance: In this randomized clinical trial of antiplatelet therapy in China, patients with mild ischemic stroke or TIA had consistent benefit from dual antiplatelet therapy with clopidogrel and aspirin vs aspirin alone when initiated within 72 hours after symptom onset, with a similar increase in the risk of moderate-to-severe bleeding. Patients should receive dual antiplatelet therapy with clopidogrel and aspirin within 72 hours after symptom onset. Trial Registration: ClinicalTrials.gov Identifier: NCT03635749.
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Aspirina , Clopidogrel , Accidente Cerebrovascular Isquémico , Inhibidores de Agregación Plaquetaria , Humanos , Clopidogrel/uso terapéutico , Aspirina/uso terapéutico , Aspirina/administración & dosificación , Masculino , Femenino , Accidente Cerebrovascular Isquémico/tratamiento farmacológico , Accidente Cerebrovascular Isquémico/prevención & control , Persona de Mediana Edad , Inhibidores de Agregación Plaquetaria/uso terapéutico , Anciano , Método Doble Ciego , Ataque Isquémico Transitorio/tratamiento farmacológico , China/epidemiología , Tiempo de Tratamiento/estadística & datos numéricos , Factores de Tiempo , Resultado del TratamientoRESUMEN
BACKGROUND: From 2004 onwards, the Chinese government has freely offered complimentary Chinese herbal medicine (CHM) to Chinese HIV/AIDS patients, alongside the prescribed first line therapy of highly active antiretroviral therapy (HAART). Thus, we aimed to explore the effectiveness and safety of CHM for patients with HIV/AIDS. METHODS: The data from the Guangxi pilot database and antiviral treatment sites database have been respectively developed into two datasets in this prospective cohort real-world study, the CHM combined HAART group (the integrated group) and the HAART group. A 1:1 propensity score matching (PSM) was performed and the longitudinal data were analyzed using a generalized estimating equation (GEE) model with an autocorrelation matrix and log link function attached to the Gamma distribution. RESULTS: A final sample of 629 patients, 455 and 174 in the integrated group and HAART group respectively, were obtained from the full dataset. As covariates for PSM, gender, age, baseline CD4+ and CD4+/ CD8+ were assessed based on the results of the logistic regression analyses. Following PSM, 166 pairs from the full dataset were matched successfully, with 98 pairs in the baseline CD4+ > 200 subgroup, and 55 pairs in the baseline CD4+ ≤ 200 subgroup. In the full dataset, HAART group achieved higher CD4+ count (OR = 1.119, 95%CI [1.018, 1.230]) and CD4+/CD8+ ratio (OR = 1.168, 95%CI [1.045, 1.305]) than the integrated group, so did in the CD4+ > 200 subgroup. For the CD4+ ≤ 200 subgroup, the CD4+ (OR = 0.825, 95%CI [0.694, 0.980]) and CD4+/CD8+ (OR = 0.826, 95%CI [0.684, 0.997]) of the integrated group were higher than those of the HAART group. The safety outcomes showed that there were no significant differences in BUN, ALT and AST levels between the groups but Cr showed significantly higher levels in HAART groups of all three datasets. CONCLUSIONS: Compared to HAART alone, CHMs combined with HAART had better effects in improving the immune function of HIV/AIDS in patients with baseline CD4+ count ≤ 200. The results of the two subgroups are in opposite directions, and chance does not explain the apparent subgroup effect. A study with larger sample size and longer follow-up period is warranted in order to increase study credibility.
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Terapia Antirretroviral Altamente Activa , Medicamentos Herbarios Chinos , Infecciones por VIH , Puntaje de Propensión , Humanos , Masculino , Femenino , Medicamentos Herbarios Chinos/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Adulto , China/epidemiología , Persona de Mediana Edad , Recuento de Linfocito CD4 , Estudios ProspectivosRESUMEN
HIV-1 CRF08_BC is a significant subtype in China, though its origin and spread remain incompletely understood. Previous studies using partial genomic data have provided insights but lack comprehensive analysis. Here, we investigate the early evolutionary and spatiotemporal dynamics of HIV-1 CRF08_BC in China and Myanmar using near-complete genome sequences. We analyzed 28 near-complete HIV-1 CRF08_BC genomes from China and Myanmar (1997-2013). Phylogenetic, molecular clock, and Bayesian discrete trait analyses were performed to infer the virus's origin, spread, and associated risk groups. Based on Bayesian time-scaled inference with the best-fitting combination of models determined by marginal likelihood estimation (MLE), we inferred the time to the most recent common ancestor (TMRCA) and evolutionary rate of HIV-1 CRF08_BC to be at 3 October 1991 (95% HPD: 22 February1989-27 November 1993) and 2.30 × 10-3 substitutions per site per year (95% HPD: 1.96 × 10-3-2.63 × 10-3), respectively. Our analysis suggests that HIV-1 CRF08_BC originated in Yunnan Province, China, among injecting drug users, and subsequently spread to other regions. This study provides valuable insights into the early dynamics of HIV-1 CRF08_BC through combined genomic and epidemiological data, which may inform effective prevention and mitigation efforts. However, the limited genomic data influenced the extent of our findings, and challenges in collecting accurate risk group information during surveillance were evident.
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Teorema de Bayes , Evolución Molecular , Genoma Viral , Infecciones por VIH , VIH-1 , Filogenia , VIH-1/genética , VIH-1/clasificación , Humanos , Infecciones por VIH/transmisión , Infecciones por VIH/epidemiología , Infecciones por VIH/virología , China/epidemiología , Mianmar/epidemiología , MasculinoRESUMEN
Humans can be exposed to multiple pollutants in the air and surface water. These environments are non-static, trans-boundary and correlated, creating a complex network, and significant challenges for research on environmental hazards, especially in real-world cancer research. This article reports on a large study (377 million people in 30 provinces of China) that evaluated the combined impact of air and surface water pollution on cancer. We formulate a spatial evaluation system and a common grading scale for co-pollution measurement, and validate assumptions that air and surface water environments are spatially connected and that cancers of different types tend to cluster in areas where these environments are poorer. We observe "dose-response" relationships in both the number of affected cancer types and the cancer incidence with an increase in degree of co-pollution. We estimate that 62,847 (7.4%) new cases of cancer registered in China in 2016 were attributable to air and surface water pollution, and the majority (69.7%) of these excess cases occurred in areas with the highest level of co-pollution. The findings clearly show that the environment cannot be considered as a set of separate entities. They also support the development of policies for cooperative environmental governance and disease prevention.
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Contaminación del Aire , Exposición a Riesgos Ambientales , Neoplasias , China/epidemiología , Humanos , Neoplasias/epidemiología , Neoplasias/etiología , Neoplasias/inducido químicamente , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Exposición a Riesgos Ambientales/efectos adversos , Contaminación del Agua/efectos adversos , Incidencia , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/efectos adversosRESUMEN
This study aims to investigate the relationship between bullying victimization and mobile phone addiction (MPA) among college students, taking into consideration the mediating role of self-control and the moderating role of physical activity. A self-report survey was administered to college students from 4 universities in Guangxi, Liaoning, and Hunan provinces in China. Participants were asked to report their experiences of bullying victimization, level of MPA, self-control, and physical activity. Descriptive statistics, correlation analysis, and regression analysis were conducted to analyze the data. Mediation and moderation models were subsequently established to examine the relationships between variables. The results indicated a positive correlation between bullying victimization and MPA among college students. Additionally, bullying victimization was negatively correlated with self-control. Bullying victimization significantly predicted MPA, and self-control partially mediated this relationship. Furthermore, physical activity moderated the association between bullying victimization and self-control among college students. The findings suggest that self-control plays a partial mediating role in the relationship between bullying victimization and MPA among college students. Moreover, physical activity weakens the association between bullying victimization and self-control. Therefore, promoting physical activity to reduce MPA among college students who have experienced bullying victimization is highly recommended.
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Acoso Escolar , Teléfono Celular , Víctimas de Crimen , Ejercicio Físico , Autocontrol , Estudiantes , Humanos , Masculino , Femenino , Estudiantes/psicología , Acoso Escolar/psicología , Universidades , Adulto Joven , Víctimas de Crimen/psicología , Autocontrol/psicología , China/epidemiología , Adulto , Conducta Adictiva/psicología , Adolescente , Encuestas y Cuestionarios , AutoinformeRESUMEN
BACKGROUND: Early identification of children at high risk of developing myopia is essential to prevent myopia progression by introducing timely interventions. However, missing data and measurement error (ME) are common challenges in risk prediction modelling that can introduce bias in myopia prediction. METHODS: We explore four imputation methods to address missing data and ME: single imputation (SI), multiple imputation under missing at random (MI-MAR), multiple imputation with calibration procedure (MI-ME), and multiple imputation under missing not at random (MI-MNAR). We compare four machine-learning models (Decision Tree, Naive Bayes, Random Forest, and Xgboost) and three statistical models (logistic regression, stepwise logistic regression, and least absolute shrinkage and selection operator logistic regression) in myopia risk prediction. We apply these models to the Shanghai Jinshan Myopia Cohort Study and also conduct a simulation study to investigate the impact of missing mechanisms, the degree of ME, and the importance of predictors on model performance. Model performance is evaluated using the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC). RESULTS: Our findings indicate that in scenarios with missing data and ME, using MI-ME in combination with logistic regression yields the best prediction results. In scenarios without ME, employing MI-MAR to handle missing data outperforms SI regardless of the missing mechanisms. When ME has a greater impact on prediction than missing data, the relative advantage of MI-MAR diminishes, and MI-ME becomes more superior. Furthermore, our results demonstrate that statistical models exhibit better prediction performance than machine-learning models. CONCLUSION: MI-ME emerges as a reliable method for handling missing data and ME in important predictors for early-onset myopia risk prediction.
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Aprendizaje Automático , Miopía , Humanos , Miopía/diagnóstico , Miopía/epidemiología , Femenino , Niño , Masculino , Modelos Logísticos , Modelos Estadísticos , Medición de Riesgo/métodos , Medición de Riesgo/estadística & datos numéricos , Factores de Riesgo , Curva ROC , Teorema de Bayes , China/epidemiología , Estudios de Cohortes , Edad de InicioRESUMEN
BACKGROUND: Numerous reports indicate that both obesity and type 2 diabetes mellitus (T2DM) are factors associated with cognitive impairment (CI). The objective was to assess the relationship between abdominal obesity as measured by waist-to-hip ratio adjusted for body mass index (WHRadjBMI) and CI in middle-aged and elderly patients with T2DM. METHODS: A cross-sectional study was conducted, in which a total of 1154 patients with T2DM aged ≥ 40 years were included. WHRadjBMI was calculated based on anthropometric measurements and CI was assessed utilizing the Montreal Cognitive Assessment (MoCA). Participants were divided into CI group (n = 509) and normal cognition group (n = 645). Correlation analysis and binary logistic regression were used to explore the relationship between obesity-related indicators including WHRadjBMI, BMI as well as waist circumference (WC) and CI. Meanwhile, the predictive power of these indicators for CI was estimated by receiver operating characteristic (ROC) curves. RESULTS: WHRadjBMI was positively correlated with MoCA scores, independent of sex. The Area Under the Curve (AUC) for WHRadjBMI, BMI and WC were 0.639, 0.521 and 0.533 respectively, and WHRadjBMI had the highest predictive power for CI. Whether or not covariates were adjusted, one-SD increase in WHRadjBMI was significantly related to an increased risk of CI with an adjusted OR of 1.451 (95% CI: 1.261-1.671). After multivariate adjustment, the risk of CI increased with rising WHRadjBMI quartiles (Q4 vs. Q1 OR: 2.980, 95%CI: 2.032-4.371, P for trend < 0.001). CONCLUSIONS: Our study illustrated that higher WHRadjBMI is likely to be associated with an increased risk of CI among patients with T2DM. These findings support the detrimental effects of excess visceral fat accumulation on cognitive function in middle-aged and elderly T2DM patients.