Objective: To evaluate the immunogenicity and safety of a booster dose of varicella attenuated live vaccine administered at different time intervals in Chinese children aged 7-12 years. Methods: This study was conducted in Xuzhou City, Jiangsu Province, from October 2024 to October 2025 using an open-label design. Children aged 7 to 12 who had received the initial immunization of the attenuated live varicella vaccine were recruited as the research subjects. They were divided into 4 groups based on the time interval from primary immunization to booster immunization (3, 18, 36 and 60 months groups). The estimated sample size was 400 (100 in each group).Venous blood samples were collected before booster vaccination and 30 days after vaccination. Serum varicella antibodies were detected by the fluorescent antibody to membrane antigen assay. Geometric mean titer (GMT), geometric mean increase, seropositivity rate and seroconversion rate were calculated to evaluate the booster immune response. Adverse reactions within 30 days after vaccination were observed. Results: At 3, 18, 36, and 60 months post-primary immunization, seropositivity rates remained at high levels (92.05%-94.87%), while GMTs showed a significant declining trend (27.03, 21.59, 18.29, and 14.33, respectively, P<0.001). Following the booster dose at 3, 18, 36, and 60 months, GMTs in all groups increased significantly to 87.35, 113.55, 141.80, and 129.01, the antibody levels increased by 3.23, 5.26, 7.75 and 9.00 times respectively compared with those before the booster immunization (P<0.001). Seroconversion rates were 60.26%, 71.60%, 77.27%, and 65.91%, respectively (P>0.05), and the seropositivity rate reached 100% in all groups. The overall incidence of adverse reactions was 0.73%, with no serious adverse events observed. Conclusions: The live attenuated varicella vaccine demonstrates favorable immunogenicity and safety when administered as a booster dose to children aged 7-12 years. A booster inoculation given 36-48 months following primary immunization elicits a more robust antibody response. These findings provide reference evidence to support the implementation of a two-dose varicella vaccination strategy and to determine the optimal timing for booster vaccination among school-aged children in China.
Objective: To explore the relationship between waist-to-height ratio (WHtR) and the risk of chronic complications in adults in 11 provinces of China, and to evaluate its value in predicting the risk of diabetic complications. Methods: A total of 3 466 patients with type 2 diabetes from 60 monitoring sites across 11 provinces in China, with an average follow-up of 6.34 years, were included in this study. Patients were grouped into WHtR quartiles, and unconditional multivariate logistic regression models were used to analyze the association between WHtR and the risk of chronic diabetic complications. Results: Among the 3 466 patients, 267 developed microvascular complications, 425 developed macrovascular complications, and 75 developed diabetic foot. After adjusting for confounding factors and using patients with WHtR <0.45 as the reference group, patients with WHtR ≥0.55 had a 1.36-fold increased risk of developing microvascular complications (OR=2.36, 95%CI: 1.11-5.05), and a 4.36-fold increased risk of developing diabetic foot (OR=5.36, 95%CI: 1.16-24.88). At the same time, there was no significant difference in the risk of macrovascular complications. Conclusion: WHtR ≥0.55 increases the risk of microvascular complications and diabetic foot in patients with diabetes, and can serve as a simple screening indicator for the early detection and intervention of chronic complications in patients with type 2 diabetes.
The digital information environment has deeply integrated into the learning, living, and social scenarios of children and adolescents, and has had a profound impact on their physical and mental health. This article systematically reviews research from both domestic and international sources, clarifies the connotations and characteristics of the digital information environment, and analyzes its multi-dimensional impacts on the health of children and adolescents from four domains:physical health, mental health, cognitive function, and social adaptation. It also analyzes the internal mechanisms and key regulatory factors to provide a scientific basis for promoting the health of children and adolescents in the digital era.
Objective: To investigate the burden of endometriosis (EMs)-related and polycystic ovary syndrome (PCOS)-related infertility among women aged 15-49 years in China and globally, and to project trends over the next 15 years. Methods: Data were sourced from the 2021 Global Burden of Disease (GBD) database. Disease burden indicators, including the age-standardized prevalence rate (ASPR) and age-standardized years lived with disability rate (ASYR) for EMs- and PCOS-related infertility, were calculated and analyzed among women aged 15-49 years in China and globally. Linear regression models and Joinpoint regression analysis were used to further analyze the trend changes in disease burden in China and globally. The Bayesian age-period-cohort (BAPC) model was employed to predict disease trends over the next 15 years. Results: From 1990 to 2021, ASPR and ASYR of EMs-related infertility among women aged 15-49 years in China and globally showed a declining trend. The ASPR of EMs-related infertility declined faster in China than globally, with an average annual percentage change (AAPC) of -1.42% in China and -0.95% globally. By 2021, the ASPR and ASYR for EMs-related infertility in Chinese women aged 15-49 years were lower than the global average and those of all sociodemographic index (SDI) regions. In 2021, the highest ASPR and ASYR were observed in Chinese women aged 40-44 years, while globally, the highest rates were in the 25-29 age group. From 1990 to 2021, the ASPR and ASYR of PCOS-related infertility among women aged 15-49 years showed an increasing trend in both China and globally. The increase in ASPR among Chinese women aged 15-49 years was significantly higher than the global average and that of all SDI regions, with an AAPC of 1.93% in China and 0.99% globally. In 2021, the highest ASPR for PCOS-related infertility in China was observed in women aged 25-29 years, while the fastest increases in ASPR and ASYR both globally and in China occurred in women aged 20-24 years. The BAPC model predicts that by 2036, the ASPR and ASYR of EMs-related infertility among women aged 15-49 years will decrease to 32.98 per 100 000 and 0.21 per 100 000 in China, and to 55.57 per 100 000 and 0.33 per 100 000 globally, respectively. In contrast, the ASPR and ASYR of PCOS-related infertility among women aged 15-49 years will increase to 620.39 per 100 000 and 3.46 per 100 000 in China, and to 774.34 per 100 000 and 4.45 per 100 000 globally, respectively. Conclusions: The ASPR and ASYR for EMs-related infertility among women aged 15-49 years are declining in China and globally, with China's burden lower than the global average, and this trend is expected to continue over the next 15 years. In contrast, the ASPR and ASYR for PCOS-related infertility among women aged 15-49 years are increasing persistently, with a faster increase in China than globally and across all SDI regions. This indicates that PCOS has become a key priority for the prevention and management of infertility among women aged 15-49 years in China, with particular attention needed for women aged 20-29 years, and underscoring the need for targeted interventions addressing age-specific and socioeconomic disparities.
Objective: The purpose of this study is to understand the current situation of anxiety and depression among adolescents in Jinan, and to explore the relationship between their life behavior patterns and the two, so as to provide a scientific basis for formulating effective prevention and control strategies and measures to reduce the incidence of anxiety and depression among adolescents. Methods: The study adopted a stratified cluster sampling method to conduct a questionnaire survey among middle school students in Jinan from September to November 2023. Cluster analysis method was used to reveal the common characteristics of adolescents with anxiety, depression and both, and binary logistic regression was used to analyze the relationship between different demographic characteristics, different life behavior patterns and anxiety and depression. Results: A total of 13 171 middle school students were surveyed in this study, of which 25.78%, 15.88% and 13.09% were having anxious, depressed and experiencing both emotions, respectively. After controlling for other variables, female, students with <8 hours of sleep per day and internet addiction were more likely to experience anxiety, while ≤2 hours of video screen time per day was a protective factor for anxiety (OR=0.568, 95%CI: 0.512-0.632). In the depression group, the risk of depression among female students, urban students, students with <3 days of exercise per week, students with <8 hours of sleep per day, and students with internet addiction was 1.349, 1.140, 1.157, 2.962, and 4.977 times higher than that of the control group, respectively. Video screen time ≤2 hours per day was also a protective factor for depression (OR=0.528, 95%CI: 0.468-0.595). Furthermore, the risk of anxiety, depression and comorbidity of anxiety and depression among students in the high video screen time pattern was 2.368, 2.722 and 2.830 times higher than that in the high exercise frequency pattern, respectively. Conclusions: Female students, students with <8 hours of sleep per day and internet addiction were the common risk factors of anxiety and depression. Urban students and students with <3 days of exercise per week increased the risk of depression. High video screen time increased the risks of anxiety, depression, and their comorbidity, while video screen time ≤2 hours per day exerted a protective effect. It is recommended that prevention and control interventions among adolescents focus on reducing video screen time, increasing physical activity, and ensuring adequate sleep.
Objective: To investigate the associations between in utero per- and polyfluoroalkyl substances exposure and gestational age acceleration, as well as the relationship of this acceleration with birth outcomes, using a small sample of monozygotic (MZ) twins. Methods: We studied 20 MZ twin pairs and their mothers from the Wuhan Twin Birth Cohort. Cord blood DNA methylation was measured using Illumina Infinium Methylation EPIC 935K array. Gestational age acceleration was calculated using three established clocks (Knight, Bohlin, and Haftorn), yielding the metrics ageAcc.Knight, ageAcc.Bohlin, and ageAcc.Haftorn. Birth outcomes included weight, length, and head circumference. Data were analyzed using Spearman and Pearson correlation analyses and linear mixed models. Results: In individual-level analyses, positive correlations were observed between perfluorooctanesulfonic acid (PFOS) and all three gestational age acceleration (Spearman ρ=0.55, 0.35, and 0.36, respectively). 6∶2 chlorinated polyfluoroalkyl ether sulfonic acid (6∶2 Cl-PFESA) were also positively correlated with ageAcc.Knight (ρ=0.33). After covariate adjustment, the positive associations of PFOS, perfluorodecanoic acid (PFDA), and 6∶2 Cl-PFESA with ageAcc.Knight remained significant in linear mixed models. In within-twin-pair analyses, higher maternal PFOS concentrations in mid- and late pregnancy were associated with a greater intra-twin difference in ageAcc.Bohlin (mid-pregnancy: ρ=0.46, P=0.040; late pregnancy: ρ=0.53, P=0.018). ageAcc.Bohlin was inversely correlated with head circumference at the individual level (r=-0.33, P=0.035). The within-pair difference in ageAcc.Bohlin showed a positive correlation with the head circumference difference (r=0.48, P=0.032). Conclusion: In-utero PFOS exposure may have an association with gestational age acceleration, which may influence neonatal head circumference development.
Objective: To explore the association between urinary arsenic and neurological mortality among Chinese older adults aged ≥60 years. Methods: A total of 9 826 participants from the China National Human Biomonitoring and the Healthy Ageing and Biomarkers Cohort Study who were aged ≥60 years were enrolled as the study population. Inductively coupled plasma-mass spectrometry was utilized to quantify the urinary arsenic concentration. Detailed profiles of death cases from 2017 to 2024 were obtained from the national Death Surveillance Points system, along with the death questionnaires specified for the respective cohorts. The Cox proportional hazards models were applied to assess the association between the urinary arsenic concentration and neurological mortality. Results: A total of 46 607.42 person-years of follow-up was conducted, with a median of 4.03 years per person. The age at baseline was (77.89±13.11) years. A total of 4 630 (47.1%) participants were male. The median urinary arsenic concentration was 21.66 μg/L. A total of 165 (1.7%) participants died from neurological causes during follow-up. After adjusting for confounders, compared with the Q1 group of the urinary arsenic concentration, the risk of neurological mortality increased by 23.9% (HR=1.239, 95%CI: 0.719-2.135), 81.4% (HR=1.814, 95%CI: 1.100-2.991), and 65.5% (HR=1.655, 95%CI: 1.039-2.636) in the Q2, Q3 and Q4 group, respectively. Restricted cubic spline analysis revealed a significant nonlinear dose-response association between the urinary arsenic concentration and the risk of neurological mortality: as the urinary arsenic concentration increased, the risk of neurological mortality initially increased and tended to plateau at higher doses. Subgroup analyses indicated that the association between the urinary arsenic concentration and the risk of neurological mortality was stronger among women (HR=2.101, 95%CI: 1.179-3.743) and participants with hypertension (HR=2.542, 95%CI: 1.452-4.449). Conclusion: The urinary arsenic concentration was positively associated with the risk of neurological mortality in Chinese older adults aged ≥60 years.
Objective: To analyze the survival status and influencing factors among HIV-infected individuals in Henan Province during different confirmation periods from 1995 to 2023, and to provide a scientific basis for optimizing the "early detection, early treatment" strategy. Methods: The data were derived from the Chinese Information System for Disease Control and Prevention. HIV-infected individuals was divided into four periods based on confirmation period: 1995-2007, 2008-2013, 2014-2016, and 2017-2023. A retrospective cohort study was conducted. The life table method was used to calculate survival probability, the Kaplan-Meier method was used to estimate median survival time and to draw the survival curve; the log-rank test was used to compare differences between groups, and the Cox proportional hazards regression model was used to analyze the influencing factors of survival. Results: Among the 109 520 HIV-infected individuals, the all-cause mortality density was 3.83/100 person-years, the average survival time was 18.30 years, with a median of 22.57 years; the cumulative survival probabilities at 1, 5, 10, 20, and 30 years were 88.23%, 76.81%, 67.68%, 53.35%, and 40.99% respectively; the survival time of those who received antiretroviral therapy (ART) (27.22 years) was significantly more than that of those who did not receive ART (0.75 years, χ2=61 676.44, P<0.001). Multivariate Cox regression showed that male (aHR=1.31, 95%CI: 1.28-1.34), ≥45 years old (aHR=1.67, 95%CI: 1.48-1.88 for 45-59 years old; aHR=2.82, 95%CI: 2.49-3.19 for ≥60 years old), farmer or migrant worker (aHR=1.43, 95%CI: 1.38-1.48), blood transmission (aHR=1.19, 95%CI: 1.16-1.23), no CD4+ T lymphocytes (CD4) counts (aHR=3.49, 95%CI: 3.37-3.61), not receiving ART (aHR=5.22, 95%CI: 5.07-5.38) were risk factors for survival. The mortality risk of married individuals (aHR=0.85, 95%CI: 0.82-0.89) or divorced/widowed individuals (aHR=0.88, 95%CI: 0.84-0.91) was lower than that of unmarried individuals, and having junior high school (aHR=0.90, 95%CI: 0.88-0.93) or senior high school education (aHR=0.66, 95%CI: 0.63-0.69) was associated with lower mortality risk relative to primary school education. The detailed causes of death were mainly cardiovascular and cerebrovascular diseases (23.32%) and malignant tumors (13.04%). Conclusions: With the continuous optimization and popularization of ART strategies, the long-term survival status among HIV-infected individuals in Henan Province has significantly improved from 1995 to 2023. It is necessary to strengthen early detection and early treatment, focus on key populations such as the elderly, farmers, and migrant workers, promote the co-management of HIV infection and chronic non-communicable diseases like cardiovascular and cerebrovascular diseases, and further improve the quality of life.
Objective: To investigate the association between blood selenium (Se) level and depressive symptoms among the older adults aged ≥65 years in 18 longevity regions of China. Methods: Based on the 2021 China Healthy Ageing and Biomarkers Cohort Study, 5 278 participants were enrolled. In this study, inductively coupled plasma-mass spectrometry was used to measure blood Se levels, and the Patient Health Questionnaire-9 was used to assess depressive symptoms; a score of ≥10 was defined as indicative of depressive symptoms. Multivariable logistic regression models and restricted cubic spline (RCS) analyses were utilized to examine the association and dose-response relationship between blood Se levels and depressive symptoms. Results: The mean age of participants was (84.15±11.28) years old, and 55.2% were female. A total of 332 older adults with depressive symptoms were detected, with a detection rate of 6.3%. Compared with those without depressive symptoms, older adults with depressive symptoms have lower blood Se levels (P<0.001), which are (105.02±29.77) μg/L and (112.53±31.84) μg/L, respectively. Multivariate logistic regression results showed a negative association between blood Se levels and the risk of depressive symptoms. After adjusting for all covariates, for every 10 μg/L increase in blood Se levels, the risk of depressive symptoms decreased by 5% (OR=0.95, 95%CI: 0.91-0.99). Compared with the Q1, the ORs (95%CIs) of blood Se in Q2, Q3, and Q4 were 0.85 (0.63-1.15), 0.69 (0.49-0.95), and 0.67 (0.47-0.94), respectively. Furthermore, RCS analysis revealed a near-linear negative dose-response relationship between blood Se levels and the risk of depressive symptoms (P for linear =0.055). Conclusion: Blood Se level is significantly associated with decreased risk of depressive symptoms among older adults aged 65 and older in 18 longevity regions of China.
Objective: To explore the prospective associations between rest-activity rhythms (RARs) with obesity and adiposity-related indicators in children. Methods: In April 2023, children in grades 3 to 4 were enrolled from two schools in Chuzhou city, Anhui Province, using cluster random sampling. At baseline, triaxial accelerometers were used to monitor physical activity and sleep continuously for 7 consecutive days. Using R studio software, non-parametric indices(relative amplitude, inter-daily stability, intra-daily variability, average activity during the most active 10 h and least active 5 h, and their midpoints) were calculated. Parametric indices (amplitude, 24 h periodic mean activity, and acrophase) were also derived. At baseline and during the 1.5-year follow-up (October 2024), body fat-related indices, including percent body fat (PBF), fat mass (FM), and visceral fat area (VFA), were measured using a bioelectrical impedance analyzer. Linear mixed-effects models were employed to analyze the associations between RARs and obesity and body fat-related indices. Results: The final analysis included 534 children with a median (Q1, Q3) age of 9.72 (9.17, 10.20) years at baseline; 265 (48.18%) were girls. Relative amplitude and amplitude were associated with reductions in PBF (β=-0.87, 95%CI: -0.53 - -0.20; β=-1.23, 95%CI: -1.89 - -0.56), FM (β=-0.49, 95%CI: -0.89 - -0.08; β=-0.70, 95%CI: -1.10 - -0.30), and VFA (β=-2.70, 95%CI: -4.83 - -0.58; β=-3.66, 95%CI: -5.78 - -1.55) at follow-up (all P values <0.05). Amplitude was associated with reductions in BMI (β=-0.28, 95%CI: -0.51 - -0.05) and waist circumference (β=-0.87, 95%CI: -1.33 - -0.40)(both P<0.05). Conclusions: Robust circadian rhythms, characterized by higher daytime activity and stable nighttime sleep, are protective factors for obesity and adiposity-related indicators in children, suggesting that fostering regular rest-activity patterns helps prevent childhood obesity.
Objective: Analyze the operation of the WeChat official account of the Chinese Journal of Epidemiology, so as to better use the WeChat official account platform to disseminate academic research results, improve the journal's influence and service ability for readers and authors. Methods: By searching all the tweets on the WeChat official account of the "Chinese Journal of Epidemiology" operated by the Chinese Journal of Epidemiology, we analyzed the tweets sent on the WeChat official account from May 2021 to March 31, 2026. Using metrics such as overall reach, average post reach, headline reach, peak reach, and WeChat communication index (WCI), we evaluated the performance of the official account. Linear regression was employed to analyze trends in key indicators, while VOSviewer 1.6.20 software was used for keyword co-occurrence analysis. Results: As of March 31, 2026, the WeChat official account of the "Chinese Journal of Epidemiology" had published 237 articles, with an average read count of 3 302.86 per article and a WCI of 154.66. Linear regression analysis revealed that the average read count, average "like" count, average "share" count, and average "star" count all showed an upward trend (all P<0.05). The "Standard-Protocol-Guideline" and "Expert Forum/Editorial" sections ranked highest in average read count (8 235.00 and 3 655.11 reads respectively), while articles on emerging infectious diseases achieved an average read count of 4 369.20. Articles from other sections also garnered significant attention through diverse presentation formats. Conclusions: The Chinese Journal of Epidemiology's WeChat official account tweets have high communication power and influence, and have become a mature and influential academic exchange platform for epidemiology. In addition to keeping an eye on the academic achievements of this journal, we should strengthen the operation and maintenance of WeChat official account, enrich the content and form of tweets, strengthen the operation and maintenance of WeChat official account, and further improve the ability to serve the readers and authors.
Objective: To characterize the baseline features of the West China Bone Health Cohort and to identify major factors of osteoporosis and fragility fractures. Methods: A prospective epidemiological survey was conducted based on outpatients at West China Fourth Hospital of Sichuan University and community residents from Hongguang, Chengdu. Demographic characteristics, lifestyle factors, biochemical indicators, and imaging data were collected (etiological study). Medical records of inpatients admitted to the osteoporosis department of the same hospital between 2017 and 2024 were retrospectively analyzed (prognostic study). Descriptive analysis, univariate and multivariate logistic regression model were performed to explore risk factors of osteoporosis and fragility fractures. Results: A total of 3 918 participants was enrolled in the prospective survey, and 6 737 inpatients were included in the retrospective analysis. Multivariate logistic regression analysis showed that in the prospective survey, age (aOR=1.06, 95%CI: 1.05-1.08), female sex (aOR=10.76, 95%CI: 7.39-15.94), and smoking (former smoking: aOR=1.58, 95%CI: 1.02-2.45; current smoking: aOR=1.90, 95%CI: 1.21-2.97) were risk factors for osteoporosis, while BMI (aOR=0.87, 95%CI: 0.84-0.89) and education (aOR=0.80, 95%CI: 0.65-0.99) were protective factors. In the retrospective analysis, age (aOR=1.07, 95%CI: 1.06-1.08) and monocyte count (aOR=1.91, 95%CI: 1.03-3.54) were positively associated with the risk of fragility fracture, while lymphocyte count (aOR=0.83, 95%CI: 0.75-0.92) was negatively associated with the risk. Conclusions: Age, female sex, smoking, low BMI, and low educational attainment were the main factors associated with osteoporosis, whereas age and abnormal inflammatory markers were closely related to fragility fractures. These findings highlight the importance of early identification and intervention among high-risk populations.
Objective: To identify the risk factors for the progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD) using a competing risks joint model. Methods: This study was based on the Alzheimer's Disease Neuroimaging Initiative database. Three gradient boosting tree algorithm, namely CatBoost, XGBoost, and LightGBM, were employed to reduce the dimensionality of the high-dimensional lipoprotein and metabolite data (including 250 amino acids, lipids, and energy metabolism-related components, etc.). A random survival forest model (RSF) was used to screen out key demographic, cognitive function scores and metabolic variables. A competing risk joint model was constructed to identify the risk factors for the progression from MCI to AD. Results: A total of 8 lipoprotein and metabolite variables were identified by the three algorithms [creatinine, lactate, glycine, large high-density lipoprotein phospholipids percent (L_HDL_PL_PCT), acetic acid, tyrosine, β-hydroxybutyric acid and valine]. The RSF model identified 14 main variables, including cognitive function indicators [Functional Activities Questionnaire (FAQ), Alzheimer's Disease Assessment Scale-13 items (ADAS13), Alzheimer's Disease Assessment Scale word recognition item 4 (ADASQ4), and Alzheimer's Disease Assessment Scale-11 items (ADAS11)], lipoprotein and metabolites (acetic acid, L_HDL_PL_PCT, β-hydroxybutyrate, glycine, and creatinine), and baseline characteristics [age, years of education, marital status, retirement status, and apolipoprotein E ε4 allele (APOE-ε4)]. The univariate competing risk joint model showed that the longitudinal changes of ADAS11, ADAS13, ADASQ4, FAQ, and glycine, as well as baseline age, marital status, and APOE-ε4, were positively associated with the progression of MCI to AD (P<0.05). The results of the multivariate competing risk joint model further indicated that the longitudinal changes of ADAS13, ADASQ4, FAQ, and glycine, as well as baseline age, marital status, and APOE-ε4 were positively associated with AD incidence (P<0.05). Conclusions: Longitudinal increases in ADAS13, ADASQ4, FAQ, and glycine, as well as older age, unfavorable marital status, and APOE-ε4 carriage at baseline, were all risk factors for progression from MCI to AD.
Objective: To analyze the recovery pattern in CD4+T lymphocyte (CD4) count among HIV-infected individuals after antiretroviral therapy (ART) in Taizhou City, Zhejiang Province, and to explore the influencing factors of these pattern and their association with the risk of death. Methods: Based on the Basic Information System of AIDS Comprehensive Prevention and Control Data of the Chinese Disease Prevention and Control Information System, adult (≥18 years old) HIV-infected individuals who received ART in Taizhou City from January 1, 2006, to December 31, 2024, were included. A retrospective cohort study design and logistic regression analysis were adopted to analyze the pattern of CD4 count recovery. The association between different CD4 change pattern groups and the risk of death was analyzed using the Kaplan-Meier method and the Cox proportional hazards regression model. Results: A total of 3 465 HIV-infected individuals were included. According to the pattern of CD4 counts recovery, the participants were divided into four groups: the recovery-restricted group (43.7%,1 516/3 465), the delayed recovery group (12.6%,435/3 465), the rapid recovery group (38.9%,1 347/3 465), and the long-term stable group (4.8%, 167/3 465). The median increase in CD4 count in the recovery-restricted group during both baseline and follow-up periods was lower than that in the other three groups. Multivariate logistic regression analysis showed that a higher baseline CD4 count was associated with both delayed and rapid recovery. Starting ART in 2016 or later is neither conducive to delayed nor rapid recovery, but is beneficial for long-term stability. A later WHO clinical stage (stage Ⅲ, Ⅳ) was an independent risk factor for rapid recovery and long-term stability, and women were more likely to maintain long-term stability. Multivariate Cox analysis showed that compared with the recovery-restricted group, the delayed recovery group (aHR=0.25, 95%CI:0.15-0.42), the rapid recovery group (aHR=0.50,95%CI: 0.37-0.69), and the long-term stable group (aHR=0.30,95%CI:0.10-0.86) had a significantly reduced risk of death. Furthermore, in patients who achieved immune recovery (CD4>500 cells/μl), the ability to maintain a long-term stable CD4 count >500 cells /μl was a protective factor for the risk of death (aHR=0.46, 95%CI:0.25-0.86). Conclusions: HIV-infected individuals with restricted recovery of CD4 counts had a higher risk of death. The year of starting ART, later WHO clinical stage, and female gender were independent predictors of the recovery pattern of CD4 counts. Early intervention, focusing on female HIV-infected individuals, promoting immune reconstitution and maintaining their long-term stability are of great significance in reducing the mortality risk of HIV-infected individuals.
Objective: To identify dietary patterns among Chinese adults and examine their associations with colorectal neoplasia. Methods: Based on a national multicenter randomized controlled trial of colorectal cancer screening, 4 257 subjects who underwent colonoscopy and had complete dietary data were included. The intake frequencies of various types of food of the subjects were obtained through a food frequency questionnaire. The sociodemographic and lifestyle information of the subjects were obtained through a questionnaire survey. Factor analysis was used to extract dietary patterns, and multivariate logistic regression models were used to analyze the correlation between colorectal neoplasia and dietary patterns. Results: Three dietary patterns were extracted: the Healthy Balanced Pattern was characterized by the primary consumption of dairy products, fruits, whole grains, and eggs; the Vegetable-Refined Grain Pattern was characterized by the primary consumption of refined grains and vegetables; the High-Protein Meat Pattern was characterized by the primary consumption of red meat, white meat, and processed, salted, or smoked food. Multivariate logistic regression analysis showed that as the Healthy Balanced Pattern score increased from Q1 to Q4, the risk of non-advanced adenoma and advanced neoplasia both showed a decreasing trend (P for trend <0.001). For the Vegetable-Refined Grain Pattern, the risk of non-advanced adenoma in the Q2-Q3 groups was higher than that in the Q1 group, but the linear trend test was not statistically significant; however, as the score levels of the Vegetable-Refined Grain Pattern increased from Q1 to Q4, the risk of advanced neoplasia significantly increased (P for trend < 0.001). As the score levels of the High-Protein Meat Pattern increased from Q1 to Q4, the risk of non-advanced adenoma and advanced neoplasia both showed an increasing trend (P for trend < 0.001). Subgroup analyses showed that sex and age showed significant interactions in the associations between the three dietary patterns and the risks of non-advanced adenoma and advanced neoplasia (P for interaction <0.05). Conclusions: Dietary patterns are associated with colorectal neoplasia. The Healthy Balanced Pattern is associated with reduced risk, whereas the Vegetable-Refined Grain Pattern and High-Protein Meat Pattern are associated with increased risk of colorectal neoplasia.
Objective: To identify and validate differential mRNA N6-methyladenosine (m6A) methylation sites associated with mild cognitive impairment (MCI), providing potential molecular evidence for its early prevention and intervention. Methods: A case-control study was conducted among older adults recruited from multiple community health centers in Shenzhen, including a pilot cohort (5 pairs) and a validation cohort (25 pairs). Single-based m6A quantitative polymerase chain reaction was used to quantify plasma mRNA m6A methylation levels. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed, followed by the construction of a protein-protein interaction network to identify hub genes. The differential methylation levels of key genes were validated in an expanded cohort. For normally distributed data, t-tests were used; for non-normal data, Mann-Whitney U or χ2 tests were applied. Partial correlation analysis and Firth logistic regression were conducted to verify the associations further. Results: A total of 126 differential mRNA m6A methylation sites were identified, including 73 upregulated and 53 downregulated sites. Five hub genes (ZFHX3, PARD3, ARHGEF2, GLB1, and LRIG3) were selected, based on protein-protein interaction network topology. Validation experiments showed that the mRNA m6A methylation levels of these five genes were significantly higher in the MCI group than in healthy controls (all P<0.001). After adjustment for potential confounders, partial correlation analysis revealed that the methylation levels of all five genes were negatively correlated with MMSE scores (r=-0.719- -0.426, all P<0.05). Firth logistic regression confirmed that these genes were independently associated with MCI (OR=1.57-2.88, all P<0.001). Conclusion: This study screened and verified a range of MCI-related differential m6A methylation sites, suggesting that abnormal m6A methylation of specific gene mRNAs may be associated with MCI, providing research clues for further exploration of the molecular mechanism of MCI and potential plasma molecular markers.
Ideology and politics elements in professional curriculum can play an important role in cultivating qualified professionals with correct morality. Applying visualization technology in ideology and politics education can integrate teaching resources sufficiently, facilitate students' understanding, thus improve their learning efficiency and teachers' teaching performance. This paper summarizes the current research status of the visualization of ideology and politics elements in professional curriculum, explore its cutting-edge development trends, and provide references for the development visualization of ideology and politics elements and improvement of its teaching quality for Epidemiology curriculum.
Objective: To explore the association between major chronic diseases and their cumulative number and the risk of hearing impairment in middle-aged and older adults in China. Methods: Based on data from the China Health and Retirement Longitudinal Study from 2011 to 2020, middle-aged and older adults without hearing impairment in 2011 were included as the baseline population. Follow-up for hearing impairment outcomes was conducted in 2013, 2015, 2018, and 2020. A multivariate Cox proportional hazards regression model was used to analyze the association between major chronic diseases, their cumulative number, and the risk of hearing impairment, with HRs and 95%CIs calculated. Subgroup analyses were performed by age (<65 years and ≥65 years) and sex. Results: Among the 8 144 middle-aged and older adults included in the study, with a mean follow-up of 7.78 person-years, 1 094 new cases of hearing impairment were identified, yielding an incidence density of 17.68 per 1 000 person-years. The multivariate Cox proportional hazards regression model analysis revealed that, for individual major chronic diseases, diabetes (HR=1.27, 95%CI: 1.01-1.60), heart disease (HR=1.66, 95%CI: 1.40-1.96), arthritis (HR=1.20, 95%CI: 1.06-1.37), and chronic kidney disease (HR=1.29, 95%CI: 1.02-1.62) were statistically significantly associated with hearing impairment risk. In contrast, hypertension, chronic lung disease, and stroke showed no statistically significant association with hearing impairment. Compared with middle-aged and older adults without any major chronic diseases, the HRs (95%CIs) for individuals with a cumulative number of 1, 2, and ≥3 major chronic diseases were 1.24 (1.07-1.43), 1.51 (1.27-1.79), and 1.86 (1.50-2.31), respectively, indicating a significant trend of increasing risk of hearing impairment with a greater number of chronic diseases (P<0.001). Subgroup analyses indicated that having 1, 2, and ≥3 major chronic diseases increased the risk of hearing impairment in both middle-aged adults (<65 years) and older adults (≥65 years). However, the trend was more pronounced in the <65 years age group compared to the ≥65 years group. Additionally, males were more susceptible to the effects in the early stages, whereas females exhibited a cumulative increase in risk. Conclusions: Major chronic diseases and their cumulative number are risk factors for hearing impairment. In the prevention and control of hearing impairment, focused attention should be given to middle-aged and older adults with major chronic diseases. Furthermore, in clinical practice, emphasis should be placed on gender-specific considerations, which will be of significant importance for the early prevention and intervention of hearing impairment.
Objective: To investigate the association between estradiol, testosterone levels, and cognitive impairment among older adults aged ≥65 years in 18 longevity-areas of China. Methods: This study utilized data from the cross-sectional survey of the 2021 China Healthy Ageing and Biomarkers Cohort Study. Information on socio-demographic characteristics, lifestyle, disease history, plasma estradiol, and testosterone levels was collected through face-to-face questionnaires, physical examinations, and laboratory tests. Cognitive function was assessed using the Mini-Mental State Examination, and cognitive impairment was defined based on education level. Multivariable logistic regression models were used to analyze the associations between sex hormones and cognitive impairment. Dose-response relationships were examined using restricted cubic splines, and subgroup analyses were performed to evaluate potential effect modifications. Results: A total of 5 721 older adults were included, of whom 1 653 (28.9%) had cognitive impairment. After adjusting for confounders, among males, each IQR increase in testosterone level was associated with a 16.5% decrease in the risk of cognitive impairment (OR=0.835, 95%CI: 0.718-0.971). Compared with the Q1 group, the Q3 (OR=0.668, 95%CI: 0.487-0.915) and Q4 (OR=0.623, 95%CI: 0.444-0.870) groups showed a significantly lower risk, and a linear dose-response relationship was observed (P for overall=0.031). Among females, no statistically significant associations were found between estradiol or testosterone levels and cognitive impairment. Subgroup analyses showed that the associations between testosterone and cognitive impairment in older males were largely consistent across subgroups, with no statistically significant interactions detected. Conclusions: Among older males in 18 longevity areas of China, higher testosterone levels were independently associated with a lower risk of cognitive impairment. No significant associations were found among older females.
Objective: To investigate the association between levels of follicle-stimulating hormone (FSH), testosterone (T), and estradiol (E2) and high-sensitivity C-reactive protein (hs-CRP) in participants aged ≥65 years residing in 18 longevity regions of China. Methods: Based on the 2021 China Healthy Ageing and Biomarkers Cohort Study, 5 556 participants were enrolled. Plasma FSH, T, and E2 levels were measured using chemiluminescent immunoassay, while hs-CRP levels were determined via latex immunoturbidimetry. Multiple linear regression models were used to analyze the change in hs-CRP concentration (β value) per 1 standard deviation increase in sex hormones, along with its 95%CI. Restricted cubic spline models were applied to explore nonlinear associations, and analyses were stratified by sex. Results: The age of male participants was (82.9±10.6) years. Median sex hormone levels were as follows: male: FSH 22.3 IU/L, T 411.4 ng/dl, E2 30.5 pg/ml; female: FSH 77.4 IU/L, T 22.1 ng/dl (E2 detection rate in females was only 10.6%). Multiple linear regression model revealed that after adjusting for confounding factors: for each one-standard-deviation increase in male T (166.0 ng/dl), hs-CRP decreased by 0.290 mg/L on average; β (95%CI)=-0.290 (-0.340 - -0.231); for each standard deviation increase in E2 (10.8 pg/ml), hs-CRP decreased by 0.124 mg/L on average, β (95%CI)=-0.124 (-0.171 - -0.067). For each standard deviation increase in female T (44.5 ng/dl), hs-CRP decreased by 0.051 mg/L on average, β (95%CI)=-0.051 (-0.098 - -0.004). Neither male nor female FSH was statistically associated with hs-CRP. Restricted cubic spline analysis revealed a negative nonlinear association between T in both sexes and hs-CRP (all P for nonlinear <0.001); male E2 showed a negative association with hs-CRP (P for overall <0.001). Conclusion: Among participants aged ≥65 years in 18 longevity regions of China, male T and E2 were negatively associated with hs-CRP. Female T was also negatively associated with hs-CRP.
