中国疾病预防控制中心

Background:The global macroeconomic impact of Tuberculosis (TB) lacks comprehensive quantification using standardized economic frameworks. Methods:This analysis utilized data from the Global Burden of Disease (GBD) 2021 to assess the economic burden of TB through the lens of the Value of a Statistical Life Year (VSLY) framework, integrating willingness-to-pay-based economic measures. The study monetized the total disability-adjusted life years (DALYs) associated with TB to estimate overall welfare losses. Country-specific gross domestic product (GDP) data, adjusted for purchasing power parity (PPP), were sourced from the World Bank and integrated with DALY estimates to calculate the Value of Lost Welfare (VLW). Results:In 2021, the global economic cost of TB, expressed as VLW, was estimated at US$1.98 trillion (95% uncertainty interval [UI]: 1.62, 2.45), representing 1.29% (95% UI: 1.05, 1.60) of global GDP. The economic impact of TB was disproportionately distributed across regions, with countries of low Socio-Demographic Index (SDI) facing the most severe burden, where VLW represented 7.83% (95% UI: 5.70, 11.20) of GDP. Lower-middle SDI regions experienced a VLW impact of 5.28% (95% UI: 4.30, 6.58). Sub-Saharan Africa (US$406.2 billion; 8.40% of GDP) and South Asia (US$822.5 billion; 5.70% of GDP) were identified as the most economically affected super-regions. India bore the highest absolute economic burden (US$477.5 billion). In contrast, high-SDI countries demonstrated a VLW-to-GDP ratio of just 0.10% (95% UI: 0.09, 0.12). Conclusions:Prioritizing TB control in economic policy is urgently needed. Equitable resource allocation to high-burden regions is vital to alleviate the disease's economic consequences and improve global health.

HepG2 cells were cultured into liver organoids (more native liver-like than 2D cultures) and integrated into a microfluidic chip, which regulates flow, nutrients, and waste to simulate in vivo hepatic microcirculation. Key findings: Cadmium (Cd) exposure shows a positive dose-response with liver damage; 40 ng/mL selenium (Se) alleviates 3 sets of liver biochemical dysfunctions under 40 μg/mL Cd co-exposure, but 160/640 ng/mL Se diminishes this protection. Metabolomics (40 μg/mL Cd vs. 640 ng/mL Se+Cd) identified two mechanisms: high Se induces oxidative stress and disrupts liver cellular metabolism. This study provides data/theory for rational Se use against Cd-induced liver dysfunction. The platform integrates organoid/organ-on-a-chip assessments with microfluidic metabolomics (a cross-scale toxicological system) and informs 3D cell model development.

Nickel exposure may increase the risk of adverse health outcome, but population-based data linking it to mortality in older adults are inconsistent and limited, especially neurological mortality. We enrolled 9727 adults aged 60 years and older from two cohorts. Urinary nickel levels were quantified via inductively coupled plasma mass spectrometry (ICP-MS). Participants (enrolled 2017/2018) were followed until death or December 31, 2024. The Kaplan-Meier (KM) method was used to analyze survival associations between urinary nickel and mortality. Cox proportional hazards models were applied to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Restricted cubic splines (RCS) were used to assess dose-response relationships, and subgroup analyses were performed to identify susceptible populations and potential effect modifiers. Over 4.75 years (mean follow-up), 2740 deaths (28.7%) occurred (1344 cardiovascular, 288 cancer, 312 respiratory, 163 neurological). A positive association was observed between higher urinary nickel levels and elevated risks of all-cause mortality (2.0% [0.8%-3.2%] per 1 μg/L increase) and neurological mortality (12.3% [8.4%-16.3%]). Dose-response analyses revealed a nonlinear inverted J-shaped pattern for all-cause and a non-monotonic upward pattern for neurological mortality. Subgroup analyses identified the oldest-old, women, and Han Chinese individuals as particularly susceptible to all-cause mortality, while neurological mortality risks were elevated across sexes, with the oldest-old and Han Chinese at higher risk. Refined neurological mortality analysis confirmed that each 1 μg/L increase in urinary nickel was significantly associated with higher mortality risks from AD (HR = 1.164, 95% CI: 1.029-1.316), other neurodegenerative diseases (NDD; HR = 1.120, 95% CI: 1.078-1.164), and non-NDD neurological diseases (HR = 1.135, 95% CI: 1.014-1.271). In conclusion, higher urinary nickel levels were associated with increased all-cause and neurological mortality, supporting nickel's role as a neurotoxicant. These findings demonstrate the public health risks of nickel exposure in aging populations, necessitating targeted interventions to reduce exposure in vulnerable groups.

Background Due to insufficient routine surveillance, the nationwide disease burden of hand, foot and mouth disease (HFMD) caused by coxsackievirus A6 (CVA6), an emerging serotype, in China remains unclear. This study aimed to estimate the incidence of CVA6-associated HFMD across the Chinese mainland. Methods CVA6 positive data from 511 locations across the Chinese mainland during 2008-2022 were integrated from the national pathogen surveillance system and literature, and reported HFMD cases during the same period were obtained from the national infectious disease surveillance system. The predicted positivity rate and incidence of CVA6-associated HFMD in children under five years of age across the Chinese mainland were estimated using a Bayesian geostatistical Gaussian model based on positivity data, reported cases, and environmental, socioeconomic, demographic, and vaccination factors. Results The model estimated that the average positivity rate of CVA6 in the Chinese mainland from 2008 to 2022 was 24.1%, with a 95% Bayesian credible interval (BCI) of 11.9-43.3%. The corresponding average annual incidence of CVA6-associated HFMD in children under five years of age was 506 (95% BCI: 272-805) per 100,000. The yearly incidence of CVA6-associated HFMD in children under five years of age peaked in 2018 (873 per 100,000; 95% BCI: 513-1309) before a subsequent decline after 2020. The incidence was highest in South China (1571 per 100,000; 95% BCI: 890-2420) and lowest in Northeast China (208 per 100,000; 95% BCI: 106-340). The estimated CVA6-associated HFMD incidence showed a consistent upward trend across different economic level groups before 2020, and tended to be higher in high-gross domestic product (GDP) per capita regions than in medium- and low-GDP regions. Conclusions Model-based estimates indicate a potentially high incidence of CVA6-associated HFMD on the Chinese mainland, particularly in South China, highlighting the need for enhanced surveillance of CVA6 and targeted control efforts in high-incidence regions.

The effect of heavy metals on male hormonal regulation-particularly the hypothalamic-pituitary-testicular (HPT) axis-remains poorly characterized. We aim to investigate associations between heavy metal exposure and HPT axis-related hormones. We analyzed data, including male participants aged 3-80 years, from a nationally representative survey. Five metals and twelve sex hormones were measured. We used multivariate linear regression and restricted cubic splines to assess associations and dose-response relationships. Mixture effects were quantified using quantile-based g computation. The modifying effects of vitamin D and folate were examined. The underlying mechanisms were explored through a narrative review and integrative bioinformatics analysis. A total of 6547 males were included. Metal exposure was predominantly associated with hormonal perturbations in adolescents and older adults. Specifically, metal mixture was associated with hormones in adolescent males [effect range: -5.10% (95% CI: -9.24, -0.76) to 18.12% (95% CI: 9.80, 27.07)] and older males [effect range: 3.17% (95% CI: 0.07, 6.37) to 10.94% (95% CI: 4.82, 17.43)]. Effect modifications were observed for vitamin D in children and adolescents, and for folate across all age groups. The PI3K-Akt signaling pathway was identified as a potential mechanism. Our findings provide novel insights into the association and potential pathway between heavy metals and male hormonal disturbance.