Background:Acute exacerbation of chronic obstructive pulmonary disease (COPD) (AECOPD) represents a pivotal event in the clinical course of COPD and contributes substantially to disease progression and healthcare burden. This study examined the incidence and demographic distribution of AECOPD among Chinese COPD patients aged ≥40 years and evaluated factors associated with its occurrence, providing population-based evidence to inform community prevention, standardized treatment, rehabilitation, and health management strategies. Methods:Data were derived from the Chinese Chronic Obstructive Pulmonary Disease Surveillance (2019-2020), a nationwide cross-sectional survey conducted in 125 surveillance counties (districts) across 31 provinces, autonomous regions, and municipalities in China. Using a multistage stratified cluster random sampling design, residents aged ≥40 years were enrolled. Participants completed standardized questionnaires, physical measurements, and pre- and post-bronchodilator spirometry administered by trained investigators. COPD was defined as a post-bronchodilator forced expiratory volume in one second (FEV₁)/forced vital capacity (FVC) <70%. The incidence of AECOPD and corresponding hospitalization rates were estimated and compared across subgroups. Stepwise multivariable logistic regression was used to identify factors associated with AECOPD, with Model I including sociodemographic, behavioral, and environmental factors and Model II additionally incorporating disease-related characteristics. Results:A total of 7455 COPD patients were included in the analysis. The overall incidence of AECOPD was 9.0% (95% confidence interval [CI]: 7.9-10.1%), and the hospitalization rate was 4.3% (95% CI: 3.5-5.0%). Higher incidence and hospitalization rates were observed among patients aged ≥65 years (10.8%, 5.7%) and those residing in southern region (10.3%, 5.0%). Elevated rates were also noted among individuals with body mass index (BMI) <18.5 kg/m² (16.1%, 10.0%), smoking history (9.1%, 4.3%), prior hospital admission for severe pulmonary disease in childhood (21.6%, 9.3%), exposure to biomass (10.8%, 5.3%), occupational exposure to harmful factors (10.5%, 4.9%), and a history of chronic respiratory diseases (28.2%, 14.9%). The highest rates were observed in patients with a modified Medical Research Council (mMRC) score ≥2 (40.7%, 23.0%). Rates were 22.4% and 11.5% among those with a COPD Assessment Test (CAT) score ≥10 and 33.0% and 19.5% among those with ≥3 comorbidities. By Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades, incidence and hospitalization rates were 4.6% and 1.7% (Stage I), 10.7% and 4.6% (Stage II), and 28.7% and 18.9% (Stages III-IV). Multivariable analyses identified residence in southern region, hospital admission for severe pulmonary disease in childhood, mMRC score ≥2, CAT score ≥10, GOLD stage III-IV, and a higher number of comorbidities as independent risk factors for AECOPD. Conclusion:AECOPD incidence and hospitalization rates remain substantial among community-dwelling COPD patients aged ≥40 years in China, with a significantly higher burden in southern region. Early-life severe respiratory disease, greater symptom severity, poorer lung function, and multiple comorbidities are strongly associated with increased AECOPD risk. Addressing regional disparities, strengthening comprehensive assessment and management, identifying high-risk individuals, and implementing targeted community-based interventions are essential to reduce AECOPD risk and mitigate the overall burden of COPD.

Household cooking oil fumes (COF) are a common indoor pollutant, but the degree of exposure and relationship with small airway dysfunction (SAD) remain unclear. Using data from a national chronic obstructive pulmonary disease survey (2019-2020) in China, here, we analyzed gender-specific COF exposure and its association with SAD. Exposure was categorized as direct or indirect based on cooking frequency and perceived COF. Among 62,627 participants, direct COF exposure was reported by 89.9% of women and 43.5% of men, whereas indirect exposure was more common in men (14.0%) than in women (1.9%). Multilevel logistic and linear regression analyses showed that direct exposure was associated with higher SAD risk (OR = 1.13, 95% CI: 1.03-1.24) and lower small airway function in women, with a stronger effect in those with obesity (OR = 1.39, P for interaction = 0.007). In men, indirect exposure was associated with higher SAD risk (OR = 1.14, 95% CI: 1.06-1.22) and similar functional decline. We also evaluated joint and additive interactions of COF with biomass use for cooking, PM2.5 exposure, and smoking. Synergistic effects were observed between indirect COF and biomass use (OR = 1.27, RERI = 0.27) in men. Combined exposure to COF and high PM2.5 or smoking amplified SAD risk in both genders. These findings indicate that household COF exposure is associated with a higher risk of SAD, with distinct gender-specific patterns. Based on the observed associations, greater public health efforts should be made to reduce COF exposure, especially among obese women and individuals with combined exposure to COF and other risk factors, such as the use of biomass for cooking, high PM2.5 exposure, or smoking.

OBJECTIVE:To assess the influenza, pneumococcal, and COVID-19 vaccine willingness and coverage profiles of Chinese older adults with their influencing factor, and to analyze differences across types and discrepancies between willingness and actual vaccination. METHODS:A nationwide cross-sectional survey was conducted starting from September 2022 in China, including participants aged 60 years or older. Multi-stage stratified random sampling and on-site questionnaire surveys were carried out. The outcomes included the vaccine willingness and actual vaccination uptake of influenza, pneumococcal, and COVID-19 measured by questionnaire. Various multivariable logistics regressions were conducted to determine the influencing factors, and sensitivity analyses were conducted. The gap between uptake and willingness was based on the observed differences in determinants from multivariable analyses. RESULTS:As of November 4, 2022, 38,184 eligible questionnaires were identified, with 53.97 % males and a median age of 68 years. The vaccination rate for COVID-19, influenza in previous season and pneumococcal was 85.86 %, 22.44 % and 7.72 %, while the willingness rates were 71.34 %, 73.84 % and 47.41 %. In multivariable logistic regression for vaccination, age was positively associated with influenza but negatively with COVID-19. Chronic comorbidity was positively associated with pneumococcal vaccination but negatively associated with COVID-19. Females had higher vaccination rates for both influenza and COVID-19. Participants with higher education levels had higher vaccination rates across all types. And willingness to be vaccinated was one of the strongest factors in promoting vaccination. Multivariable logistic regression in participants with willingness further confirmed attitudinal factors were still vital predictors of vaccination behavior. In addition, distinct regional patterns were observed for influenza and COVID-19 vaccination. CONCLUSION:In the post-COVID-19 era, respiratory tract infections vaccine uptake and willingness among Chinese older adults vary. A gap persists between willingness and actual behavior, highlighting the need for coordinated strategies from healthcare institutions, researchers, and government to reduce vaccine hesitancy and enhance uptake.

What is already known about this topic?:Breast cancer has emerged as the most prevalent cancer among women globally and is increasingly affecting younger populations. However, the relationship between individual socioeconomic status (SES) and breast cancer risk remains incompletely understood. What is added by this report?:This population-based cohort study revealed a breast cancer incidence rate of 48.9 per 100,000 person-years. Women with high SES demonstrated a significantly elevated risk of breast cancer compared to those with low SES [hazard ratio (HR)=1.42, 95% confidence interval (CI): 1.05, 1.92]. Self-perceived SES appeared to moderate this association, with an increased breast cancer risk particularly evident among women who had both low objectively assessed and self-perceived SES. What are the implications for public health practice?:These findings underscore the need for tailored breast cancer screening programs and targeted health education initiatives that account for differences across SES groups.

Background: Nicotine dependence, also known as tobacco dependence, is a common chronic disease and a major risk factor for chronic respiratory diseases. The present study was designed to determine the prevalence of nicotine dependence and its changes among smokers aged 40 years and older in China, to analyze the characteristics of nicotine dependence among smokers, and to provide a reference for smoking cessation interventions. Methods: The data were sourced from nationally representative large-sample surveys conducted during 2014-2015 and 2019-2020 in the Chinese population, covering 125 counties (districts) in 31 provinces, autonomous regions and municipalities. Variables related to smoking and nicotine dependence among residents >= 40 years old were collected in face-to-face interviews. A total of 20,062 and 18,975 daily smokers were included in the 2014-2015 and 2019-2020 surveys, respectively. The severity of nicotine dependence was evaluated according to the Fagerstr & ouml;m Test for Nicotine Dependence and Heaviness of Smoking Index. The level and change in nicotine dependence among daily smokers aged >= 40 years were estimated using a complex weighted sampling design, and their influencing factors were analyzed. Results: Levels of nicotine dependence among daily smokers aged >= 40 years in China could be divided into very low, low, medium, high, and very high, accounting for 31.1%, 27.9%, 13.4%, 20.5%, and 7.1% of the total, respectively. The average Fagerstr & ouml;m Test for Nicotine Dependence score was 3.9 (95% confidence interval [CI]: 3.8-4.0), with the prevalence of medium-high nicotine dependence being 41.0% (95% CI: 39.0-42.9%) and that of high and very high nicotine dependence being 27.6% (95% CI: 26.0-29.3%), both of which were significantly higher in men than in women (both P < 0.001). Among daily smokers, those with a low education level, age at smoking initiation < 18 years, and with smoking duration of >= 20 years had a higher degree of nicotine dependence. In terms of geographic region, the level of medium-high nicotine dependence in South China was higher than in other areas, and the decline in the prevalence of high nicotine dependence was the greatest in Northwest China ( P < 0.001). The prevalence of medium-high and high and very high nicotine dependence was significantly higher in men with chronic respiratory symptoms, chronic obstructive pulmonary disease (COPD), and/or chronic respiratory diseases than in men without these conditions (all P < 0.05). The prevalence of high and very high nicotine dependence in women with chronic respiratory symptoms and chronic respiratory diseases was significantly higher than that in women without these conditions (both P < 0.05). Compared with that during 2014-2015, the prevalence of high nicotine dependence among daily smokers decreased during 2019-2020 by 4.5 percentage points in the total population ( P < 0.001) and by 4.8 percentage points in men ( P < 0.001), with no significant change seen in women ( P > 0.05). Additionally, the prevalence of high nicotine dependence in men with chronic respiratory symptoms and COPD decreased by 6.7 and 4.7 percentage points, respectively ( P < 0.05), but showed no significant change in women with these conditions ( P > 0.05). Multivariate logistic regression analysis showed that the risk of medium-high nicotine dependence was higher among daily smokers who were male; 50-59 years old; unmarried/divorced/widowed/separated; engaged in agriculture, forestry, husbandry, fishery and water conservancy; had a low education level; started smoking before the age of 18 years; and smoked for more than 20 years. Conclusions: The past few years have seen a slight decline in the prevalence of high (severe) nicotine depen-dence among smokers aged >= 40 years in China. However, 41.0% of daily smokers had medium-high nicotine dependence, and 27.6% had high or very high nicotine dependence, with notable differences in population and geographic distributions. Development of tailored interventions, optimization of smoking cessation service sys-tems, and integration of smoking cessation into the management of chronic diseases will effectively reduce the burden of nicotine dependence in China.

BACKGROUND:The proportion of healthcare workers (HCWs) who receive and recommend seasonal influenza vaccination to their patients remains low in China. This study aims to understand why HCWs infrequently use and recommend the influenza vaccine and how to improve utilization. METHODS:A cross-sectional questionnaire survey and a focus group interview were conducted among primary HCWs in Hubei Province in September 2018 and May 2019. We analyzed qualitative data using descriptive methods and a general inductive approach following a quantitative analysis. In addition, we used the Health Belief Model (HBM) framework to summarize predictors of HCW vaccination and recommendation. RESULTS:Primary HCWs acquired basic knowledge about influenza infection and vaccination and were less likely to receive and recommend influenza vaccination. However, from the focus group, HCWs reported influenza was a mild disease and would not recommend vaccination for patients who looked healthy. HCWs raised concerns about adverse events, cost-effectiveness, and contraindications to influenza vaccination. HCWs reported, "I would be more likely to recommend vaccination if my employer required that I do so." CONCLUSIONS:Health education materials for HCWs could be improved by providing scientific evidence on the burden of influenza disease, the benefits of vaccination, and national and international policies on influenza vaccination. In addition, interventions that may improve influenza vaccination coverage include workplace requirements for influenza vaccination of HCWs and requirements for HCWs to recommend influenza vaccination to high-risk groups in addition to providing no-cost and on-site vaccination.

BACKGROUND:Pre-chronic obstructive pulmonary disease (COPD) indicators are associated with COPD development, but their associations with lung function decline in persons without COPD and their longitudinal transitions remain uncertain. METHODS:In this prospective cohort study, 3526 subjects without COPD from the 2014-2015 national COPD surveillance in China were investigated for a second time during 2018-2020. Four potential pre-COPD indicators at baseline were chronic bronchitis, preserved ratio impaired spirometry (PRISm), low peak expiratory flow (PEF), and spirometric small airway dysfunction (sSAD). To include the incident COPD subjects in the lung function decline analysis for consistent indicators, forced expiratory volume in 1 s (FEV1) <80% predicted was used instead of PRISm. Lung function outcomes were the declines in post-bronchodilator FEV1, forced vital capacity (FVC), and FEV1/FVC. RESULTS:Subjects with initial chronic bronchitis had faster declines in FEV1 and FVC compared with those without initial chronic bronchitis among smokers. Consistent chronic bronchitis was associated with faster declines in FEV1 and FVC among non-smokers. Consistent sSAD was associated with faster declines in FEV1/FVC among smokers and non-smokers. Consistent FEV1 <80% predicted and consistent low PEF were associated with a faster decline in FEV1/FVC among smokers. Incident COPD developed from sSAD in almost half of the cases. CONCLUSIONS:Initial chronic bronchitis and consistent FEV1 <80% predicted, sSAD, and low PEF are associated with excessive lung function decline among smokers, while consistent chronic bronchitis and sSAD are associated with excessive lung function decline among non-smokers. Initial sSAD accounts for a larger proportion of incident COPD than initial chronic bronchitis, PRISm, and low PEF.

Background: Influenza vaccination coverage is low among persons with non-communicable diseases (NCDs) in China. Chinese health workers (HWs) do not routinely recommend influenza vaccination despite evidence that recommendations increase vaccine uptake. This study aims to assess whether interventions increased primary care HWs' recommendation for influenza vaccination and measure their impact on influenza vaccine uptake in persons with NCDs. Methods: We conducted a cluster randomized controlled study in public primary healthcare clinics in Hubei from November 2018 through April 2019. In the intervention clinics, primary care HWs received training on the benefits of influenza vaccination and were asked to recommend influenza vaccine in routine primary healthcare for persons with NCDs. In the control clinics, primary care HWs did not receive training and provided standard services. We conducted questionnaire surveys before and after the intervention to collect information about recommendations made and receipt of influenza vaccines. Results: A total of 896 primary care HWs and 4552 persons with NCDs were included. After intervention, a higher percentage of HWs recommended influenza vaccines in intervention clinics compared to control clinics. Vaccinated primary care HWs were more likely to recommend vaccination. Persons with NCDs reported higher influenza vaccination coverage in intervention than control clinics, and primary care HWs' recommendation increased vaccination uptake among persons with NCDs. Conclusions: Vaccinated primary care HWs were more likely to recommend influenza vaccination than unvaccinated HWs. Promoting primary care HWs' vaccination and encouraging them to recommend influenza vaccination during routine primary healthcare could increase influenza vaccine receipt among persons with NCDs. Registration number ChiCTR2200067140.

[This corrects the article DOI: 10.1016/j.lanwpc.2023.100984.].

It was common to see that older adults were reluctant to be vaccinated for coronavirus disease 2019 (COVID-19) in China. There is a lack of practical prediction models to guide COVID-19 vaccination program. A nationwide, self-reported, cross-sectional survey was conducted from September 2022 to November 2022, including people aged 60 years or older. Stratified random sampling was used to divide the dataset into derivation, validation, and test datasets at a ratio of 6:2:2. Least absolute shrinkage and selection operator and multivariable logistic regression were used for variable screening and model construction. Discrimination and calibration were assessed primarily by area under the receiver operating characteristic curve (AUC) and calibration curve. A total of 35057 samples (53.65% males and mean age of 69.64 ± 7.24 years) were finally selected, which constitutes 93.73% of the valid samples. From 33 potential predictors, 19 variables were screened and included in the multivariable logistic regression model. The mean AUC in the validation dataset was 0.802, with sensitivity, specificity, and accuracy of 0.732, 0.718 and 0.729 respectively, which were similar to the parameters in the test dataset of 0.755, 0.715 and 0.720, respectively, and the mean AUC in the test dataset was 0.815. There were no significant differences between the model predicted values and the actual observed values for calibration in these groups. The prediction model based on self-reported characteristics of older adults was developed that could be useful for predicting the willingness for COVID-19 vaccines, as well as providing recommendations in improving vaccine acceptance.

Introduction:Solid fuel combustion is a significant source of household air pollution and an important risk factor for chronic obstructive pulmonary disease (COPD). This study presents the rates and change in the use of solid fuels for cooking and heating in China. Methods:Based on data from the Chinese Chronic Obstructive Pulmonary Disease Surveillance, the research estimated the rates and change of solid fuels usage for cooking and heating from 2014-2015 to 2019-2020 and the rate of primary cooking solid fuels usage in 2019-2020, and analyzed the association between solid fuels usage and COPD. Results:The rates of solid fuels usage for cooking and heating significantly decreased, dropping from 45.3% to 28.0% and from 33.5% to 23.2%, respectively. Usage rates were higher among rural residents, with 47.2% using it for cooking and 37.7% for heating in 2019-2020. The usage of solid fuels for cooking is associated with increased risk of COPD. Among rural residents, combined usage of biomass and coal for cooking (OR=1.29, 95% CI: 1.12, 1.48) and using coal as primary fuel for cooking (OR=1.18, 95% CI: 1.00, 1.38) are associated with higher risk of COPD. The usage of biomass for cooking is associated with an increased risk of COPD in urban residents (OR=1.17, 95% CI: 1.03, 1.32). Conclusions:The study demonstrates a significant decline in the use of household solid fuels. Nevertheless, high utilization rates persist among individuals in rural settings and those from lower socioeconomic backgrounds. It is of great public health importance to propose targeted fuel substitution measures for various solid fuels in different regions to reduce the risk of COPD.

BACKGROUND:Breast cancer (BC) risk-stratification tools for Asian women that are highly accurate and can provide improved interpretation ability are lacking. We aimed to develop risk-stratification models to predict long- and short-term BC risk among Chinese women and to simultaneously rank potential non-experimental risk factors. METHODS:The Breast Cancer Cohort Study in Chinese Women, a large ongoing prospective dynamic cohort study, includes 122,058 women aged 25-70 years old from the eastern part of China. We developed multiple machine-learning risk prediction models using parametric models (penalized logistic regression, bootstrap, and ensemble learning), which were the short-term ensemble penalized logistic regression (EPLR) risk prediction model and the ensemble penalized long-term (EPLT) risk prediction model to estimate BC risk. The models were assessed based on calibration and discrimination, and following this assessment, they were externally validated in new study participants from 2017 to 2020. RESULTS:The AUC values of the short-term EPLR risk prediction model were 0.800 for the internal validation and 0.751 for the external validation set. For the long-term EPLT risk prediction model, the area under the receiver operating characteristic curve was 0.692 and 0.760 in internal and external validations, respectively. The net reclassification improvement index of the EPLT relative to the Gail and the Han Chinese Breast Cancer Prediction Model (HCBCP) models for external validation was 0.193 and 0.233, respectively, indicating that the EPLT model has higher classification accuracy. CONCLUSIONS:We developed the EPLR and EPLT models to screen populations with a high risk of developing BC. These can serve as useful tools to aid in risk-stratified screening and BC prevention.

What is already known about this topic?Psychological and lifestyle factors are known to potentially play a significant role in the development of breast cancer. However, current evidence-based studies present controversial findings on the associations between depression, sleep duration, and breast cancer risk.What is added by this report?This study investigated the potential risk factors of depressive symptoms and short sleep duration for breast cancer within the Breast Cancer Cohort Study in Chinese Women. The findings revealed that women experiencing depressive symptoms and short sleep duration exhibited a heightened risk of developing breast cancer, particularly among the older population.What are the implications for public health practice?Public policy ought to prioritize early health education interventions targeting psychological factors in order to facilitate the prevention of breast cancer.

OBJECTIVE:To evaluate HPV-negative cervical high-grade precancerous lesions or cancer in China.METHODS:Histologically confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+) were searched in a multicentric clinical study. All patients underwent cobas HPV testing, liquid-based cytology, DNA ploidy analysis, and colposcopy-guided biopsy. According to clinical practice, patients underwent p16ink4a staining and cone biopsy. Comparisons were made between HPV-negative and -positive patients for clinical characteristics.RESULTS:The study found 61 cases of cobas HPV-negative CIN2+ among 797 cases of histologically confirmed CIN2+, including 38 CIN2, 20 CIN3, and 3 invasive cancers. The prevalence of HPV-negative CIN2+ and CIN3+ was 7.7% (95% confidence interval [CI] 5.8-9.5) and 5.7% (95% CI 3.5-8.0), respectively. Among 24 cases with p16 staining, 20 showed p16 positivity. The proportions of normal or minor abnormalities in terms of colposcopy, cytology, and DNA ploidy were higher in HPV-negative cases than in HPV-positive cases. When adding cytology to the screening of symptomatic or previously HPV-positive women, the prevalence of HPV-negative CIN2+ or CIN3 would decrease by approximately 50%.CONCLUSION:Less than one-tenth of CIN2+ are missed by HPV-only screening, and they have smaller lesions than HPV-positive cases. Colposcopy should be considered for symptomatic or previously HPV-positive women with HPV-negative results.

What is already known about this topic?:Breast cancer awareness plays a crucial role in promoting screening attendance, enabling early detection, and improving survival rates associated with breast cancer. Nevertheless, a persistent issue is the low public awareness of breast cancer warning signs and risk factors.What is added by this report?:Breast cancer awareness rate was 10.2%, with particularly low rates among never-screened and inadequately screened women. Factors associated with low awareness levels included low income, agricultural occupation, limited educational attainment, smoking, and the absence of professional recommendations.What are the implications for public health practice?:Consideration should be given to effective health education and delivery strategies aimed at women who have never been screened or have received inadequate screening.

Background Lung injury might take place before chronic obstructive pulmonary disease (COPD) occurs. A clearer definition of "pre-COPD" based on the effects of potential indicators on increasing risk of COPD development and a prediction model involving them are lacking. Methods A total of 3526 Chinese residents without COPD aged 40 years or older derived from the national cross-sectional survey of COPD surveillance in 2014-2015 were followed up for a mean of 3.59 years. We examined the associations of chronic bronchitis, preserved ratio impaired spirometry (PRISm), low peak expiratory flow (PEF), spirometric small airway dysfunction (sSAD), low maximal mid-expiratory flow (MMEF), low forced expiratory flow 50% of pulmonary volume (FEF50), and low FEF75 with subsequent COPD and constructed a prediction model with LASSO-Cox regression. Findings 235 subjects in the cohort developed COPD during the follow-up. Subjects with PRISm, low PEF, sSAD, low MMEF, low FEF50, and low FEF75 had an increased risk of developing COPD (adjusted hazard ratio [HR] ranging from 1.57 to 3.01). Only chronic bronchitis (HR 2.84 [95% CI 1.38-5.84] and 2.94 [1.43-6.04]) and sSAD/low MMEF (HR 2.74 [2.07-3.61] and 2.38 [1.65-3.43]) showed effects independent of the other indicators and their concurrence had the strongest effect (HR 5.89 and 4.80). The prediction model including age, sex, low MMEF, low FEF50, and indoor exposure to biomass had good performance both internally and temporally. The corrected C-index was 0.77 (0.72-0.81) for discrimination in internal validation. For temporal validation, the area under the receiver operating characteristic curve was 0.73 (0.63-0.83). Good calibration was indicated in plot for internal validation and by Hosmer-Lemeshow test for temporal validation. Interpretation Individuals with concurrent chronic bronchitis and sSAD/low MMEF indicating pre-COPD optimally require more high attention from physicians. Our prediction model could serve as a multi-dimension tool to predict COPD comprehensively.

Abstract Background COPD and hypertension not only share some risk factors, but also interact in terms of disease progression and death. There are about 300 million hypertensive patients in China, but there is a scarcity of evidence on the prevalence and associated factors of COPD in hypertension population. This study aimed to analyze the prevalence and associated factors of COPD among hypertensive patients in China. Methods Data were collected as part of a large-scale and nationally representative sample survey conducted in 125 counties (districts) in 31 provinces (autonomous regions and municipalities) of mainland China aged 40 or above, 2014 -15, which consisted of 24,664 hypertensive patients. The prevalence and associated factors of COPD were analyzed among hypertensive patients population using the Chi-square test and multivariate logistic regression model. Results The prevalence of COPD among hypertensive patients aged ≥ 40 years was 15.6% (95% confidence interval [95% CI],0.15–0.16), with a prevalence of 21.9% (95% CI,0.21–0.23) for men and 9.0% (95% CI,0.08–0.10) for women. Among the hypertensive patients, the prevalence of COPD was significantly higher in those who were male (odds ratio [OR], 2.05; 95% CI, 1.82–2.31), aged 70 years or older (OR, 6.00; 95% CI, 5.09–7.01), underweight (OR, 1.54; 95% CI, 1.18–2.05), current smoker(OR, 1.72; 95% CI, 1.53–1.93), with hospital admission due to severe pulmonary diseases in childhood (OR, 1.82; 95% CI, 1.41–2.36), history of tuberculosis (OR, 1.39; 95% CI, 1.08–1.79), with family history of lung diseases (OR, 1.64; 95% CI, 1.50–1.80), with indoor exposure to biomass for cooking or heating (OR, 1.10; 95% CI, 1.01–1.21), and with exposure to dust /chemicals in the workplace (OR, 1.20; 95% CI, 1.10–1.30), compared with their counterparts. Conclusions The prevalence of COPD is high in hypertensive patients aged 40 or above in China, which is associated with male gender, older age, less education, low weight, smokers, disease or family history of lung-related diseases, and exposure to dust /chemicals or biofuels. It would be of value to carry out health education, screening and comorbidity co-management for COPD relying on the hypertension community-based health management service among hypertensive patients aged 40 or above.

我国的预防艾滋病母婴传播工作实施20余年以来,经历了从无到有,从一个试点地区,到全国覆盖,从单一的预防艾滋病母婴传播,到整合的预防艾滋病、梅毒和乙肝母婴传播综合干预服务不断发展的历程.2001年,在联合国儿童基金会的支持下,我国在河南省上蔡县启动了预防艾滋病母婴传播试点工作.2003年,扩展到5个省的8个县(市、区).

What is already known about this topic?:Human papillomavirus (HPV) type-specific strategies play a key role in the prevention of cervical intraepithelial neoplasia (CIN), but evidence on the HPV type-specific prevalence in CIN is limited.What is added by this report?:This multicentric study estimates the prevalence of high-risk HPV types in CIN cases and the associations of HPV infection patterns with high-grade CIN in China in 2017-2018.What are the implications for public health practice?:Population-based prevention strategies should give preference to HPV-16 and 18, and strategies for non-16/18 high-risk HPV are essential for the elimination of cervical cancer.