Background:Gallbladder-related pathologies may influence colorectal carcinogenesis, yet systematic evaluation of their associations with precursor lesions remains limited. This study addresses critical knowledge gaps by investigating the dual-axis relationship between cholecystectomy/gallbladder pathologies and colorectal polyp risk while elucidating geographical and biological effect modifiers. Methods:In accordance with the MOOSE/Cochrane guidelines, 27 observational studies were analysed through PROSPERO (CRD420251012876). Comprehensive meta-analysis was performed to assess the effects of cholecystectomy across polyp subtypes and gallbladder pathology (stones/polyps) associations. Heterogeneity was quantified via I² statistics, and pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated via the DerSimonian-Laird random effects model to account for between-study variance. Subgroup analysis stratified by geography, pathology type, and adjustment model was performed with χ² tests for subgroup differences. Sensitivity analysis and publication bias were assessed through leave-one-out methods, funnel plots and Egger's test. Results:Cholecystectomy was associated with a 39% increased risk (OR = 1.39, 95% CI: 1.21-1.59), with East Asian populations exhibiting a nearly doubled risk compared with North American populations (OR=1.95(95%CI:1.44-2.63) vs OR=1.16(95%CI:1.00-1.34). Compared with unclassified polyps, adenomas were more strongly associated (OR = 1.37, 95% CI: 1.16-1.62). Medium-sized studies (OR = 1.69, 95% CI: 1.36-2.11) and those adjusted for health factors (OR = 1.34, 95% CI: 1.12-1.61) yielded higher estimates, whereas dietary adjustment nullified significance. Gallbladder pathology (stones/polyps) conferred a 27% higher risk overall, with gallbladder polyps showing greater risk (OR = 1.30, 95% CI: 1.17-1.38) than stones (OR = 1.20, 95% CI: 1.08-1.32). Older populations (≥50 years) had stronger associations OR=1.41(95%CI:1.20-1.66) vs OR=1.20(95%CI:1.10-1.30). Adjustment for smoking, alcohol, and BMI strengthened the estimates (OR = 1.43, 95% CI: 1.22-1.68). Sensitivity analysis supported the robustness of the primary findings, particularly for cholecystectomy. Conclusions:This comprehensive analysis establishes gallbladder status as an independent risk modulator for early colorectal lesions, with cholecystectomy demonstrating the highest risk magnitude. These findings advocate personalized surveillance strategies that integrate gallbladder history, particularly high-risk demographics. The mechanistic synergies between bile acid dysmetabolism and gut microbiota dysbiosis warrant further exploration as preventive targets. Systematic review registration:https://www.crd.york.ac.uk/prospero/, identifier CRD420251012876.

Background: The rapid evolution of endoscopic resection techniques for colorectal polyps has created a diverse but fragmented evidence base, making it challenging to determine the technique that optimally balances efficacy and safety. Objectives: To comprehensively compare the efficacy and safety of all mainstream colorectal polypectomy techniques. Design: A systematic review and Bayesian network meta-analysis (NMA), conducted in accordance with PRISMA-NMA guidelines. Data sources and methods: Databases searched included PubMed, Web of Science, Embase, Scopus, Cochrane Library, CNKI, Wanfang Database, and SinoMed. Model convergence was assured (Brooks-Gelman-Rubin diagnostic), and consistency was evaluated via node-splitting analysis. Treatment hierarchies for primary efficacy outcomes (R0 resection, En bloc resection, complete resection) and secondary safety outcomes (bleeding, perforation) were established using surface under the cumulative ranking curve (SUCRA) probabilities. Results: 100 RCTs (24,786 patients; 34,244 polyps) comparing 13 techniques were included. Underwater endoscopic mucosal resection (U-EMR) and EMR ranked highest for R0 resection (SUCRA: U-EMR 49%, EMR 30%) and En bloc resection. For complete resection, endoscopic submucosal dissection (ESD) ranked highest (SUCRA: ESD 49%). Cold forceps polypectomy (CFP) and cold snare polypectomy with submucosal injection (CSP-SI) were consistently the least effective across efficacy outcomes. Hot snare EMR (HS-EMR) was associated with the highest risk of bleeding, while cold snare polypectomy (CSP)-based techniques were generally safer for perforation. ESD demonstrated a favorable safety profile for bleeding. The evidence certainty was generally low to moderate. Conclusion: This NMA provides a comprehensive hierarchy of polypectomy techniques. U-EMR and EMR are among the most effective for R0 and En bloc resection, while CSP-based techniques are among the safest. HS-EMR carries a higher bleeding risk. These findings provide crucial evidence to guide clinical decision-making and future guideline development, while also highlighting key evidence gaps requiring further research. Trial registration: PROSPERO (CRD420251139746).

Background:Adverse experiences are critical determinants of late-life depressive symptomatology. Understanding how these experiences influence later-life health outcomes remains a research priority. This study examines the longitudinal associations between self-reported adverse childhood experiences (ACEs) and adverse adult experiences (AAEs) with depressive symptoms in older adults, as well as the underlying mechanisms. Methods:A sample of 3941 adults aged ≥45 years from the China Health and Retirement Longitudinal Study (CHARLS) was analyzed. K-means for Longitudinal Data (KML), Logistic regression, and Bayesian Kernel Machine Regression (BKMR) models were employed to assess the effects of adverse experiences. Subgroup and mediation analyses were also performed. Results:The high depressive symptomatology cluster (n = 1432) demonstrated significant associations with six ACEs: childhood hunger (OR = 1.23, 95%CI:1.03-1.47), dangerous growth environments (OR = 1.34, 95%CI:1.09-1.65), childhood loneliness (OR = 1.45, 95%CI:1.20-1.74), bullying (OR = 1.2, 95%CI:1.01-1.43), parental depression (OR = 1.80, 95%CI:1.50-2.16), and parental disability (OR = 1.44, 95%CI:1.03-2.02). Comprehensive effect estimation of ACEs indicated an 85.9% probability of a high depression score for those with all adverse experiences. AAEs like prolonged bed rest (OR = 1.39, 95%CI:1.08-1.79), and lifetime discrimination (OR = 1.37, 95%CI:1.12-1.66) independently predicted symptom severity. Effect modification analysis revealed stronger ACE impacts among individuals with higher cognitive reserve (OR = 3.32, 95%CI:2.34-4.70). Mediation analysis identified arthritis or rheumatism as a partial mediator of the ACE-depression pathway (natural indirect effect = 1.04, 95%CI:1.02-1.05). Conclusions:Self-reported ACEs and AAEs demonstrate persistent associations with depressive symptoms in later life, mediated by chronic morbidity and moderated by cognitive reserve.

BACKGROUND:Young chronic obstructive pulmonary disease (COPD) refers to people with COPD between the ages of 20 and 50 years. Current epidemiological studies focus on local geography, and there is a lack of global-level analysis. This study provides in-depth analyses of the disease burden of young COPD at global, regional, and national levels. METHODS:This study used the Global Burden of Disease Study 2021 (GBD). The age-standardised prevalence rate (ASPR), age-standardised incidence rate (ASIR), age-standardised death rate (ASDR), and age-standardised disability-adjusted life years (DALYs) rate were used to describe the disease burden. The estimated annual percentage change (EAPC) during the study period was calculated. Joinpoint regression analysis examined the time trend from 1990 to 2021. Annual percentage change (APC) and average annual percentage change (AAPC) were calculated. Risk factors were reported by region and sex. RESULTS:In 2021, the global number of young COPD cases was 30,384,539, and the ASPR, ASIR, ASDR, and age-standardised DALYs rates fell slightly. Oceania reported the highest ASPR, ASDR, and age-standardised DALYs rate. High-income North America has the highest ASIR. In 2021, the prevalence, incidence, death, and DALYs rates exhibited similar trends, increasing with age. From 1990 to 2021, both the prevalence and death rates showed a consistent downward trend across all age groups. Joinpoint regression analysis indicated a slight increase in both the ASPR (APC: 0.13; 95% CI: 0.06 to 0.19) and the ASIR (APC: 0.17; 95% CI: 0.10 to 0.24) during the period from 1990 to 1994. The leading DALYs attributable to risk factors for young COPD are household air pollution from solid fuels (20.4%), ambient particulate matter pollution (17.9%), and smoking (13.5%). CONCLUSIONS:The global burden of ASPR, ASIR, ASDR, and age-standardised DALYs rates in young COPD has decreased, however, the absolute number of patients has increased. The global burden shows noticeable regional differences, with particularly high burdens observed in Oceania. Improving air quality, promoting smoking cessation, and increasing access to lung function tests, raising awareness of young COPD are key strategies for alleviating the burden of young COPD.

Background: Anaemia remains a widespread global public health concern. According to previous research reports, the prevalence rate of anaemia among Chinese adults is lacking. Additionally, the association between anaemia and four common anthropometric indices remains unclear. This study aimed to estimate the prevalence of anaemia and its association with anthropometric indices. Methods: The data was from a large, cross-sectional, nationally representative survey which was conducted from August 2018 to June 2019. A total of 190,236 individuals aged 18 years or old were invited, and 159,468 participants with complete data were included in this study. Anaemia was defined as the decrease in adjusted haemoglobin concentrations, <120 g/L for non-pregnant females and <130 g/L for males. Crude and weighted prevalence of anaemia in the overall population and different strata of Chinese adults were calculated. Weighted logistic regression and restricted cubic spline (RCS) were used to evaluate the association between anaemia and four anthropometric indices, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and body roundness index (BRI). Results: In China, the weighted anaemia prevalence was 9% (95% CI: 8.5-9.6%), 4.9% (95% CI: 4.4-5.4%), and 13.2% (95% CI: 12.4-13.9%) for the overall population, males, and females, respectively. The weighted prevalence of anaemia was higher among females, rural residents, southwestern residents, and individuals with primary-school-level or lower education than others. The prevalence was highest among young females (14.4%, 95% CI, 13.3-15.5%) and older males (11.8%, 95% CI, 12.4-14.3%). In the fully adjusted logistic regression model, per SD increase in BMI (OR = 0.96, 95% CI: 0.95-0.97), WC (OR = 0.99, 95% CI: 0.98-0.99), WHtR (OR = 0.15, 95% CI: 0.07-0.32), and BRI (OR = 0.90, 95% CI: 0.87-0.94) were associated with a decreased risk of anaemia. Furthermore, the RCS curves depicted L-shaped relationships between the study variables and anaemia (all p for nonlinear <0.05). Conclusions: The prevalence of anaemia among Chinese adults, especially among young females and underweight older adults, remained unexpectedly high. More attention should be paid to these populations.

BACKGROUND:Studies on the impact and attention of cover papers within open-access journals from the same publisher remain lacking. The objective of this study was to explore the effect of being featured as a cover paper on the impact and attention of papers for PLOS journals using propensity score matching (PSM). METHODS:Cover and non-cover papers published in five PLOS journals (i,e., PLOS Biology, PLOS Computational Biology, PLOS Genetics, PLOS Pathogens, PLOS Neglected Tropical Diseases) between 2008 and 2017 were selected. Three scientometric indicators, citations (as scholarly impact indicator), and Altmetric attention score (AAS) and Mendeley readers (as social and academic attention indicators) of each paper were collected from altmetric.com. Two datasets were obtained via 1:2 propensity score matching: one spanning 2008-2017 for analyzing citations and reader counts, and another covering 2011-2017 for AAS analysis. Then, the Wilcoxon signed-rank test, univariate analysis, and multivariate linear regression analysis were conducted to explore the impact and attention of cover papers versus non-cover papers. RESULTS:Among 24,080 papers, 1,760 were successfully matched for analysis of citation frequency and readership, and 1,212 were successfully matched for Altmetric attention analysis. After PSM, cover papers exhibited significantly higher citations (v = 560, P < 0.001), much more readers (v = 528, P < 0.001), and higher AAS (v = 1384, P < 0.001) than non-cover papers. Further multivariate regression analysis of the PSM-adjusted data revealed significant associations, with regression coefficients of 0.145 for citations, 0.174 for readership, and 0.691 for AAS (P < 0.05). CONCLUSIONS:The findings of this study suggested that being featured on the cover was statistically positively associated with an article's academic impact and public visibility, especially in terms of the societal attention. However, the relationship was weak.

China is one of the regions with high incidence of influenza, previous researches have primarily focused on the seasonal characteristics, spatio-temporal distribution, and associated influencing factors of influenza, while paying less attention to the public health significance of influenza-like illness (ILI) outbreaks. ILI is clinically defined as a syndrome characterized by fever accompanied by cough or sore throat. This case definition leads to distinct epidemiological characteristics, disease burden, and prevention strategies compared to laboratory-confirmed influenza. Currently, systematic epidemiological research on ILI outbreaks in Chinese mainland still has gaps. Therefore, a spatio-temporal modeling study was conducted to identify high-risk areas and potential risk factors for ILI outbreaks. The study utilized data on ILI outbreaks from the Chinese National Influenza Center. Spatial autocorrelation analysis, median center and standard deviational ellipse analysis were performed using ArcGIS 10.7 software to identify high-risk areas and spatial-temporal evolution of ILI outbreaks. Space-time scanning analysis was conducted using SaTScan 10.1.2 software to determine spatio-temporal clusters of ILI outbreaks. A Bayesian hierarchical model was adopted to explore the socioeconomic and meteorological factors influencing ILI outbreaks from a spatial-temporal perspective. The outbreaks of ILI showed a distinct seasonality, with those in northern regions predominantly occurring during winter, whereas southern regions experienced more outbreaks, mainly in winter and spring. High clustering of ILI outbreaks was primarily concentrated in province levels such as Guangdong, Guangxi, Shandong, Jiangsu, Anhui, Zhejiang, and Fujian. The Bayesian model revealed that higher temperatures (RR = 0.958, 95

Objective:To evaluate associations between unhealthy lifestyles, metabolic diseases, and colorectal polyps, with emphasis on subtype-specific effects. Methods:We systematically searched PubMed, Embase, Cochrane Library, and SinoMed (up to July 2024) for studies reporting odds ratios (ORs) of colorectal polyps associated with lifestyle or metabolic factors. Heterogeneity was quantified using I (2) statistics, with random-effects models applied as the primary analytical approach. Subgroup analyses were conducted to investigate potential effect modifiers, and meta-regression was performed to explore continuous sources of heterogeneity, while sensitivity analyses and funnel plots evaluated robustness and bias. Results:Alcohol (OR = 1.63, 95%CI:1.48-1.78), high-fat diet (OR = 1.45, 95%CI:1.33-1.57), and smoking (OR = 1.79, 95%CI:1.69-1.90) significantly increased polyp risk across subtypes. Smoking showed subtype- and region-specific effects, with the highest risk for sessile serrated lesions (SSLs; (OR = 3.06, 95%CI:2.41-3.90)) and in the US, South Korea, and Israel. Type 2 diabetes had the strongest metabolic association (OR = 2.17,95%CI:1.82- 2.60), followed by hyperlipidemia (OR = 1.50, 95%CI:1.32-1.70) and hypertension (OR = 1.33, 95%CI:1.10-1.61). Heterogeneity stemmed from pathological classification and geographic variation, with no significant publication bias. Conclusion:Unhealthy lifestyles (alcohol, high-fat diet, smoking) and metabolic diseases (type 2 diabetes, hyperlipidemia, hypertension) independently increase colorectal polyp risk, with smoking demonstrating pronounced subtype and regional variability. These findings can inform the development of risk-stratified screening protocols and targeted public health interventions.

Intestinal infectious diseases (IIDs) can impact the growth and development of children and weaken adults. This study aimed to establish a spatial panel model to analyze the relationship between factors such as population, economy and health resources, and the incidence of common IIDs. The objective was to provide a scientific basis for the formulation diseases prevention measures. Data on monthly reported cases of IIDs in each district and county of Zhejiang Province were collected from 2011 to 2021. The spatial distribution trend was plotted, and nine factors related to population, economy and health resources were selected for analysis. A spatial panel model was developed to identify statistically significant spatial patterns of influencing factors (P < 0.05). The results revealed that each type of IIDs exhibited a certain level of clustering. Each IIDs had a significant radiation effect, HEV (b = 0.28, P < 0.05), bacillary dysentery (b = 0.38, P < 0.05), typhoid (b = 0.36, P < 0.05), other infectious diarrheas (OIDs) (b = 0.28, P < 0.05) and hand, foot and mouth disease (HFMD) (b = 0.39, P < 0.05), indicating that regions with high morbidity rates spread to neighboring areas. Among the population characteristics, density of population acted as a protective factor for bacillary dysentery (b=-1.81, P < 0.05), sex ratio acted as a protective factor for HFMD (b=-0.07, P < 0.05), and aging rate increased the risk of OIDs (b = 2.39, P < 0.05). Urbanization ratio posed a hazard factor for bacillary dysentery (b = 5.17, P < 0.05) and OIDs (b = 0.64, P < 0.05) while serving as a protective factor for typhoid (b=-1.61, P < 0.05) and HFMD (b=-0.39, P < 0.05). Per capita GDP was a risk factor for typhoid (b = 0.54, P < 0.05), but acted as a protective factor for OIDs (b=-0.45, P < 0.05) and HFMD (b=-0.27, P < 0.05). Additionally, the subsistence allowances ratio was a risk factor for HEV (b = 0.24, P < 0.05). The incidence of IIDs in Zhejiang Province exhibited a certain degree of clustering, with major hotspots identified in Hangzhou, Shaoxing, and Jinhua. It would be essential to consider the spillover effects from neighboring regions and implement targeted measures to enhance disease prevention based on regional development.

Objective Research on factors contributing to depressive symptoms in cancer patients at a national level, encompassing a comprehensive set of variables was limited. This study aimed to address this gap by identifying the factors associated with depressive symptoms among cancer patients through a nationwide cross-sectional analysis. Methods Various factors, including demographic, socioeconomic, behavioral patterns, general and self-rated health status, chronic conditions, dietary habits, and cancer-related factors, were examined. Data was from the National Health and Nutrition Examination Survey. Univariate and multivariate logistic regression analyses were performed to identify associated factors. The receiver-operating characteristic (ROC) curve was used to evaluate the performance of the logistic model. Results The findings showed that five sociodemographic factors, two behavioral styles, self-rated health status, comorbid arthritis, two dietary factors and two cancer-related factors were strongly associated with depressive symptoms. Compared with those aged 20-39 years, cancer individuals aged 40-59 years (OR = 0.48, P < 0.05) and those 60 years or older (OR = 0.18, P < 0.05) had lower odds of depression. Positive factors included being never married (OR = 1.98, P < 0.05), widowed, divorced or separated (OR = 1.75, P < 0.05), unemployment (OR = 1.87, P < 0.05), current smoking (OR = 1.84, P < 0.05), inadequate sleep (OR = 1.96, P < 0.05), comorbid arthritis (OR = 1.79, P < 0.05), and poor self-rated health status (OR = 3.53, P < 0.05). No significant association was identified between the Healthy Eating Index 2015 and the Dietary Inflammatory Index with depression (P > 0.05). Shorter cancer diagnosis duration was associated with reduced odds of depression (P < 0.05). The logistic model had an area under the curve of 0.870 (95% CI: 0.846-0.894, P < 0.05). Conclusions Cancer patients should receive enhanced family and social support while cultivating a healthy lifestyle and diet. Incorporating plenty of fruits, greens, and beans is highly recommended, along with establishing a comprehensive health management framework.

Temperature and humidity are known to influence seasonal patterns of hand, foot and mouth disease (HFMD) transmission. However, the effect of air pollution and climate-air pollution interaction on the intensity of HFMD epidemics is poorly understood. This study aims to quantify the exposure-response effects of air pollution on HFMD risk by level of meteorological indicators in Zhejiang Province. A spatiotemporal Bayesian hierarchical model was used to determine the exposure-response association between air pollution, meteorological factors and the relative risk (RR) of HFMD. The model was fitted to monthly HFMD case data for the 92 counties in Zhejiang Province between January 2013, and December 2021. We assessed both linear interaction effects between air pollutants and meteorological factors on HFMD, and the modification role of extreme weather conditions on the nonlinear air pollutant-HFMD association. A 10 μg/m³ increase in PM10 and NO2 concentration raised the HFMD risk by 6.6% (RR = 1.066, 95% CI: 1.042, 1.092) and 20.8% (RR = 1.208, 95% CI: 1.162, 1.256) respectively. HFMD was negatively associated with O3 (RR = 0.980, 95% CI: 0.968, 0.993), SO2 (RR = 0.820, 95% CI: 0.776, 0.868) and CO (RR = 0.770, 95% CI: 0.621, 0.956). Temperature, humidity, and precipitation positively interacted with most air pollutants on HFMD, while wind speed had a negative interaction effect. In higher temperature conditions, the HFMD risk associated with PM10 increased. Elevated humidity levels amplified the risk associated with PM10, as did CO concentrations within a certain range. Heavy rainfall intensified the risk of HFMD associated with PM10, SO2, and CO. Results of this study showed that air pollution was associated with HFMD incidence, with different climate factors playing various modification roles in the associations and primarily leading to increased risk under extreme conditions. These findings provide a theoretical basis for personal protection and government prevention and control measures.

Objective To understand the changes in the reported incidence of notifiable infectious diseases and the prevalence trends of key infectious diseases during the SARS-CoV-2 epidemic in Shangcheng District of Hangzhou City from 2020 to 2021. Methods According to the adjustment of response level to major public health emergencies by Zhejiang provincial government, the year of 2020 was divided into five stages, pre-epidemic phase, first-level response phase, second-level response phase, third-level response phase and regular prevention and control phase; meanwhile, the years 2015-2019 and the year of 2021 were also divided into five periods according to the stage division method based on the year of 2020. We compared the reported incidence of notifiable infectious diseases in 2020 and 2021 with the level in the same period during 2015-2019, and analyzed the incidence trend of key infectious diseases during the epidemic period of 2020-2021. Results In 2020, the reported incidence rates of notifiable infectious diseases（except SARS-CoV-2 infection） in five stages were 1,039.82/100,000, 117.79/100,000, 9.52/100,000, 31.89/100,000 and 314.39/100,000, respectively. Compared with the same period during 2015-2019, the fixed-base growth rates were +83.47%,-87.61%,-97.72%,-95.00% and-91.73%, respectively. The reported incidence rate of each period in 2021 was slightly higher than that in 2020, but it still decreased compared with the same period during 2015-2019. The reported incidence rates of intestinal infectious diseases, respiratory infectious diseases（excluding SARS-CoV-2 infection）,blood-borne and sexually transmitted diseases at each period in 2020 showed downward trends compared with the same period during 2015-2019,and the time interval between onset date and diagnosis date during the primary and secondary response periods increased compared with the same period during 2015-2019. During the SARS-Co V-2 epidemic from 2020 to 2021,the incidence peaks of influenza,other infectious diarrhea and hand-foot-mouth disease were postponed,and the durations of the prevalence period were shortened. Conclusion The prevention and control measures taken during the SARS-Co V-2 epidemic from 2020 to 2021 effectively reduced the reported incidence rates of notifiable infectious diseases,with the largest change in category C infectious diseases. At the same time,the incidence peaks of some diseases were delayed and the durations of some diseases were shortened. Continuous promotion of prevention and control measures can effectively keep the incidence of various notifiable infectious diseases at low levels.

BackgroundSpecific underlying diseases were reported to be associated with severe COVID-19 outcomes, but little is known about their combined associations. The study was aimed to assess the relations of number of and specific underlying diseases to COVID-19, severe symptoms, loss of smell, and loss of taste.MethodsA total of 28,204 adult participants in the National Health Interview Survey 2021 were included. Underlying diseases (including cardiovascular diseases, cancer, endocrine diseases, respiratory diseases, neuropsychiatric diseases, liver and kidney diseases, fatigue syndrome, and sensory impairments), the history of COVID-19, and its symptoms were self-reported by structured questionnaires. Multivariable logistic regression models were used to assess the combined relation of total number of underlying diseases to COVID-19 and its symptoms, while mutually adjusted logistic models were used to examine their independent associations.ResultsAmong the 28,204 participants (mean ± standard deviation: 48.2 ± 18.5 years), each additional underlying disease was related to 33, 20, 37, and 39% higher odds of COVID-19 (odds ratio [OR]: 1.33, 95% confidence interval [CI]: 1.29–1.37), severe symptoms (OR: 1.20, 95% CI: 1.12–1.29), loss of smell (OR: 1.37, 95% CI: 1.29–1.46), and loss of taste (OR: 1.39, 95% CI: 1.31–1.49). In addition, independent associations of sensory impairments with COVID-19 (OR: 3.73, 95% CI: 3.44–4.05), severe symptoms (OR: 1.37, 95% CI: 1.13–1.67), loss of smell (OR: 8.17, 95% CI: 6.86–9.76), and loss of taste (OR: 6.13, 95% CI: 5.19–7.25), cardiovascular diseases with COVID-19 (OR: 1.13, 95% CI: 1.03–1.24), neuropsychiatric diseases with severe symptoms (OR: 1.41, 95% CI: 1.15–1.74), and endocrine diseases with loss of taste (OR: 1.28, 95% CI: 1.05–1.56) were observed.ConclusionA larger number of underlying diseases were related to higher odds of COVID-19, severe symptoms, loss of smell, and loss of taste in a dose–response manner. Specific underlying diseases might be individually associated with COVID-19 and its symptoms.

Background There are many studies on the association of tea and its extracts with colorectal adenomas, but the results have varied. The study aims to investigate the effect of tea and its extracts on colorectal adenomas using meta analysis and systematic review. Methods Literature was obtained through PubMed, Cochrane Library, Embase and Chinese BioMedical Literature Service System since the establishment of the database until April 31, 2023. Search terms include adenomas, polyps, colorectal, rectal, rectum, tea, epigallocatechin, drinking and beverages. Meta-regression analysis was used to infer the source of heterogeneity. Heterogeneity was assessed using I 2 statistics and Q test. The effect measures were odds ratio (OR) and 95% confidence interval (95% CI). Stata17.0 software was used for data processing. Results The findings indicated that study design ( t = 0.78, P = 0.454), types of tea intake ( t = 1.35, P = 0.205), occurrences ( t = -0.19, P = 0.852), regions ( t = 1.13, P = 0.281) and grades of adenomas ( t = 0.06, P = 0.952) were statistical homogeneity. Tea and its extracts were negatively correlated with the risk of colorectal adenomas (OR = 0.81, 95% CI: 0.66–0.98). No publication bias was found in this study ( t = -0.22, P = 0.828) and the results are robust. Conclusion This study suggests that tea and its extracts have a certain protective effect on colorectal adenomas, which provides scientific evidence for preventive strategies for colorectal adenomas. As for the causal relationship between tea and its extracts on colorectal adenomas, further prospective studies are needed.

BACKGROUND:Intestinal infectious diseases (IIDs) are a significant public health issue in China, and the incidence and distribution of IIDs vary greatly by region and are affected by various factors. This study aims to describe the spatio-temporal trends of IIDs in the Chinese mainland and investigate the association between socioeconomic and meteorological factors with IIDs.METHODS:In this study, IIDs in mainland China from 2006 to 2017 was analyzed using data obtained from the China Center for Disease Control and Prevention. Spatio-temporal mapping techniques was employed to visualize the spatial and temporal distribution of IIDs. Additionally, mean center and standard deviational ellipse analyses were utilized to examine the spatial trends of IIDs. To investigate the potential associations between IIDs and meteorological and socioeconomic variables, spatiotemporal zero-inflated Poisson and negative binomial models was employed within a Bayesian framework.RESULTS:During the study period, the occurrence of most IIDs has dramatically reduced, with uneven reductions in different diseases. Significant regional differences were found among IIDs and influential factors. Overall, the access rate to harmless sanitary toilets (ARHST) was positively associated with the risk of cholera (RR: 1.73, 95%CI: 1.08-2.83), bacillary dysentery (RR: 1.32, 95%CI: 1.06-1.63), and other intestinal infectious diseases (RR: 1.88, 95%CI: 1.52-2.36), and negatively associated with typhoid fever (RR: 0.66, 95%CI: 0.51-0.92), paratyphoid fever (RR: 0.71, 95%CI: 0.55-0.92). Urbanization is only associated with hepatitis E (RR: 2.48, 95%CI: 1.12-5.72). And GDP was negatively correlated with paratyphoid fever (RR: 0.82, 95%CI: 0.70-0.97), and bacillary dysentery (RR: 0.77, 95%CI: 0.68-0.88), and hepatitis A (RR: 0.84, 95%CI: 0.73-0.97). Humidity showed positive correlation with some IIDs except for amoebic dysentery (RR: 1.64, 95%CI: 1.23-2.17), while wind speed showed a negative correlation with most IIDs. High precipitation was associated with an increased risk of typhoid fever (RR: 1.52, 95%CI: 1.09-2.13), and high temperature was associated with an increased risk of typhoid fever (RR: 2.82, 95%CI: 2.06-3.89), paratyphoid fever (RR: 2.79, 95%CI: 2.02-3.90), and HMFD (RR: 1.34, 95%CI: 1.01-1.77).CONCLUSIONS:This research systematically and quantitatively studied the effect of socioeconomic and meteorological factors on IIDs, which provided causal clues for future studies and guided government planning.

IntroductionThis study aimed to investigate the status of COVID-19 infection and the associated factors among Chinese residents after the implementation of the 10 New Rules to optimize COVID response.MethodsParticipants were recruited using convenience sampling. The study used self-filled questionnaires to examine COVID-19 infection and associated factors among Chinese residents, from December 29, 2022, to January 2, 2023. For the statistical analysis, descriptive and quantitative analyses were used. The potential risk factors for COVID-19 infection were identified by multivariable logistic regression analysis.ResultsAfter the adjustments in control strategies against COVID-19, the infection rate of COVID-19 was high among respondents, and 98.4% of individuals who tested positive showed symptoms including cough, fever, fatigue, headache, sore throat, nasal congestion, sputum production, muscle and joint pain, and runny nose. The main problems respondents reported were the shortage of drugs and medical supplies, the increased burden on families, and the unreliable information source of COVID-19 infection. Logistic regression showed that isolating patients with COVID-19 at home was associated with a lower risk of COVID-19 infection (OR = 0.58, 95%CI: 0.42–0.81).ConclusionCOVID-19 infection among residents is closely related to age, gender, and epidemic prevention measures. The government needs to strengthen education for individuals and centrally manage and properly address difficulties that may arise during COVID-19.

OBJECTIVES:Evidence of oral microbiota perturbations has been accumulated for lung cancers. This review focused on the oral microbiota alterations in population suffering from lung cancer. In addition, we also discussed conflicting data about the association between oral microbiota dysbiosis and risk of lung cancer. METHODS:A systematic search was conducted in Medline, Embase, PubMed, and Cochrane Library databases. The studies evaluated diversity and abundance of oral microbes in healthy and lung cancer individuals as well as association of periodontal disease and pathogens with lung cancer. Of 3559 studies, 28 included studies were performed in qualitative analysis, and 25 studies were used in meta-analyses for quantitative assessment. Heterogeneity was analyzed by using I² and chi-squared Q test statistics. Statistical analyses were performed by using the RevMan 5.4 software. RESULTS:Compared with the control, lung cancer patients had lower alpha diversity (Shannon: SMD = -0.54; 95% CI, -0.90 to -0.19; P < .01, I2 = 71%). In nested case-control studies, individuals with decreased alpha diversity tended to have an increased risk of lung cancer (observed species: HR = 0.90; 95% CI, 0.85-0.96; P < .01, I2 = 0%; Shannon: HR = 0.89; 95% CI, 0.83-0.95; P < .01, I2 = 0%). Overall, no strong evidence of association of relative abundance with specific oral microbes with lung cancers was found because of inconsistent data. No associations were found between periodontal pathogens and lung cancer risk (red complex: HR = 1.12, 95% CI: 0.42-3.02, P = .82, I2 = 62%; orange complex: HR =1.77, 95% CI: 0.78-3.98, P = .17, I2 = 36%), expect for Fusobacterium nucleatum (HR = 2.27, 95% CI: 1.13-4.58, P = .02, I2 = 0%). The positive association of periodontal disease with lung cancer risk was found (HR = 1.58, 95% CI: 1.25-2.00, P < .001, I2= 0%) with increase of periodontal diseases severity (HR = 2.39, 95% CI: 1.57-3.66, P < .001, I2 = 0%). However, such association was not found in never-smoker participants (HR = 1.00, 95% CI: 0.76-1.31, P = .37, I2= 7%). CONCLUSIONS:Lower alpha diversity of oral microbiome may be associated with a greater risk of lung cancer and might serve as a predictive signal of lung cancer risk. There was no strong evidence of relative abundance of oral microbial taxa and periodontal pathogens in lung cancer patients. Fusobacterium nucleatum might be a potential microbial candidate of biomarkers in lung cancer. Periodontal disease may be positively associated with lung cancer risk by confounding of smoking, but not an independent risk factor.

BackgroundDietary factors may affect the incidence of colorectal serrated polyps (SP). However, its effects on SP are unclear as epidemiological studies on this topic have showed inconsistent results. The present systematic review and meta-analysis sought to evaluate the effects of dietary factors on SPs.MethodsStudies regarding the association between dietary factors and SPs were identified by searching PubMed, Cochrane library, Embase and Chinese Biomedical Literature database from inception until 27 February 2023. Search terms include serrated, hyperplastic, adenoma, polyps, colorectal, rectal, rectum and risk. Heterogeneity was assessed using I2 statistics. The meta-analysis was conducted by using a random-effects model, and the pooled effects were expressed with odds ratios (OR) and 95% confidence intervals (95% CI). Probable sources of heterogeneity were identified through meta-regression. Subgroup analysis were based on lesion types, study designs, countries, and so on.Results28 studies were ultimately eligible after scanning, and five dietary factors including vitamin D, calcium, folate, fiber and red or processed meat were excerpted. Higher intakes of vitamin D (OR = 0.95, 95%CI:0.90–1.02), calcium (OR = 0.97, 95%CI: 0.91–1.03) and folate (OR = 0.82, 95% CI: 0.6–1.13) were not significantly associated with SP. Fiber intake (OR = 0.90, 95% CI: 0.82–0.99) was a protective factor against SPs. Red meat intake increased the risk of SPs by 30% for the highest versus lowest intakes (OR = 1.30, 95% CI: 1.13–1.51). For different lesion types, higher folate intake was associated with a decreased risk of HPs (OR = 0.59, 95%CI: 0.44–0.79), and higher vitamin D intake decreased the risk of SPs including SSA/P (OR = 0.93, 95%CI: 0.88–0.98).ConclusionsHigher dietary fiber intake plays an effective role in preventing SP, while red meat intake is associated with an increased risk of SP. This evidence provides guidance for us to prevent SP from a dietary perspective.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?, RecordID=340750.

目的 了解2016-2022年浙江省金华市金东区脑卒中发病趋势,为完善脑卒中防治策略提供依据.方法 通过浙江省慢性病监测信息系统收集2016-2022年金东区脑卒中发病资料,采用2010年全国人口普查数据进行标化,分析不同性别、年龄和疾病亚型脑卒中发病率;采用平均年度变化百分比(AAPC)分析脑卒中发病趋势.结果 2016-2022年金东区报告脑卒中发病9 159例,粗发病率为386.52/10万,标化发病率为276.75/10万;脑卒中粗发病率呈上升趋势(AAPC=3.704％,95％CI:0.792％～6.700％,P＜0.05),标化发病率未见明显变化趋势(P＞0.05).男性脑卒中粗发病率为438.69/10万,高于女性的334.66/10万(x2=14.028,P＜0.05);男性脑卒中标化发病率为316.58/10万,高于女性的237.31/10万(x2=6.985,P＜0.05).脑卒中粗发病率随年龄增长呈上升趋势(x2=5 290.180,P＜0.05),其中45～＜65岁居民脑卒中粗发病率呈逐年下降趋势(AAPC=-9.135％,95％CI:-15.003％～-2.861％,P＜0.05);其他年龄组居民脑卒中粗发病率均未见明显变化趋势(P＞0.05).缺血性脑卒中粗发病率为306.08/10万,高于出血性脑卒中的76.89/10万(x2=137.184,P＜0.05).结论2016-2022年金东区脑卒中粗发病率呈上升趋势,以缺血性脑卒中为主;男性和中老年人群是脑卒中防治的重点.

Background Despite significant progress in sanitation status and public health awareness, intestinal infectious diseases (IID) have caused a serious disease burden in China. Little was known about the spatio-temporal pattern of IID at the county level in Zhejiang. Therefore, a spatio-temporal modelling study to identify high-risk regions of IID incidence and potential risk factors was conducted. Methods Reported cases of notifiable IID from 2008 to 2021 were obtained from the China Information System for Disease Control and Prevention. Moran’s I index and the local indicators of spatial association (LISA) were calculated using Geoda software to identify the spatial autocorrelation and high-risk areas of IID incidence. Bayesian hierarchical model was used to explore socioeconomic and climate factors affecting IID incidence inequities from spatial and temporal perspectives. Results From 2008 to 2021, a total of 101 cholera, 55,298 bacterial dysentery, 131 amoebic dysentery, 5297 typhoid, 2102 paratyphoid, 27,947 HEV, 1,695,925 hand, foot and mouth disease (HFMD), and 1,505,797 other infectious diarrhea (OID) cases were reported in Zhejiang Province. The hot spots for bacterial dysentery, OID, and HEV incidence were found mainly in Hangzhou, while high-high cluster regions for incidence of enteric fever and HFMD were mainly located in Ningbo. The Bayesian model showed that Areas with a high proportion of males had a lower risk of BD and enteric fever. People under the age of 18 may have a higher risk of IID. High urbanization rate was a protective factor against HFMD (RR = 0.91, 95% CI: 0.88, 0.94), but was a risk factor for HEV (RR = 1.06, 95% CI: 1.01–1.10). BD risk (RR = 1.14, 95% CI: 1.10–1.18) and enteric fever risk (RR = 1.18, 95% CI:1.10–1.27) seemed higher in areas with high GDP per capita. The greater the population density, the higher the risk of BD (RR = 1.29, 95% CI: 1.23–1.36), enteric fever (RR = 1.12, 95% CI: 1.00–1.25), and HEV (RR = 1.15, 95% CI: 1.09–1.21). Among climate variables, higher temperature was associated with a higher risk of BD (RR = 1.32, 95% CI: 1.23–1.41), enteric fever (RR = 1.41, 95% CI: 1.33–1.50), and HFMD (RR = 1.22, 95% CI: 1.08–1.38), and with lower risk of HEV (RR = 0.83, 95% CI: 0.78–0.89). Precipitation was positively correlated with enteric fever (RR = 1.04, 95% CI: 1.00–1.08), HFMD (RR = 1.03, 95% CI: 1.00–1.06), and HEV (RR = 1.05, 95% CI: 1.03–1.08). Higher HFMD risk was also associated with increasing relative humidity (RR = 1.20, 95% CI: 1.16–1.24) and lower wind velocity (RR = 0.88, 95% CI: 0.84–0.92). Conclusions There was significant spatial clustering of IID incidence in Zhejiang Province from 2008 to 2021. Spatio-temporal patterns of IID risk could be largely explained by socioeconomic and meteorological factors. Preventive measures and enhanced monitoring should be taken in some high-risk counties in Hangzhou city and Ningbo city.