To describe the spatiotemporal characteristics of hepatitis B in China and to identify its possible hotspots and potential high-risk areas. A retrospective, province-level ecological analysis of hepatitis B surveillance data. Global Moran’s I and local Moran’s I were calculated using GeoDa 1.16 to explore the spatial clustering characteristics from 2004 to 2021, and the results of the spatiotemporal scan analysis were obtained using SaTScan 10.1 to identify cluster areas from 2004 to 2018. From 2004 to 2021, the number of hepatitis B incident cases in China increased from 916,426 in 2004 to 976,233 in 2021 (AAPC = 0.38%, P = 0.613), which is not statistically significant. From 2018 to 2021, High-High cluster areas of hepatitis B incidence rates in China were concentrated in the southeast; from 2004 to 2019, High-Low cluster areas of hepatitis B mortality rates were concentrated in Beijing and Shanghai. During the 18-year study period, the crude mortality rate showed a statistically significant decline with an average annual decline of 4.03%. Hepatitis B high-risk areas were concentrated in northwestern and southeastern coastal regions of China, while death counts were clustered in the northwestern and eastern regions.

PURPOSE:This meta-analysis evaluated the relationship between overweight/obesity and depressive disorders in children and adolescents.METHODS:We examined the databases of PubMed, Embase and Web of Science for pertinent observational studies released up until 20 February 2022. The pooled relative risks (RRs) and 95% confidence intervals (CIs) of obesity and overweight with depressive disorder were calculated by means of random-effects models. The Newcastle-Ottawa Quality Assessment Scale and Agency for Healthcare Research and Quality scale were adopted to evaluate the study quality.RESULTS:Finally, for this meta-analysis, we evaluated 22 observational publications covering 175 135 participants (5 cohort study articles, 1 case-control study article and 16 cross-sectional study articles). A significant positive association was found between obesity and the risk of depression (RR 1.32, 95% CI 1.09-1.60, I2  = 79.90%, Pheterogeneity  < 0.001) and in the association between obesity and depressive symptoms (RR 1.16, 95% CI: 1.00-1.35, I2  = 25.0%, Pheterogeneity  = 0.247). On sensitivity analysis, the pooled RRs remained robust. Subgroup analysis indicated that obese children and teenagers in western countries were more prone to depression.CONCLUSION:Evidence from this meta-analysis, based on observational studies, supported the idea that obese children and adolescents are more likely to experience depression and depressive symptoms.

Introduction: The relationship between pregnancy loss and the risk of cardiovascular diseases (CVDs) remains a matter of debate. Our intention in conducting this meta-analysis was to analyze the relationship between miscarriage and stillbirth and risk of CVDs. Methods: PubMed, Embase, and Web of Science were systematically searched up to May 30, 2023 for all relevant studies. The random-effects model was applied to estimate the pooled relative risks (RRs) and 95% confidence intervals (95% CIs). We evaluated RR estimates for the risk of CVDs with each additional miscarriage and stillbirth through generalized least squares regression. Results: Twenty-three articles were incorporated into the meta-analysis. For women with a history of miscarriage, the pooled RRs for the risk of total CVDs, coronary heart disease (CHD), stroke, and total CVD deaths were 1.16 (95 % CI 1.10-1.22), 1.26 (1.12-1.41), 1.13 (1.03-1.24), and 1.20 (1.01-1.42), respectively. For women with a history of stillbirth, the pooled RRs for the risk of total CVDs, CHD, stroke, and total CVD deaths were 1.60 (1.34-1.89), 1.30 (1.12-1.50), 1.37 (1.06-1.78), and 1.95 (1.05-3.63), respectively. With each additional miscarriage, the risk increased for total CVDs (1.08, 1.04-1.13), CHD (1.08, 1.04-1.13), and stroke (1.05, 1.00-1.10). With each additional stillbirth, the risk increased for total CVDs (1.11, 1.03-1.21) and CHD (1.13, 1.07-1.19). Conclusion: This meta-analysis indicates that both miscarriages and stillbirths are related to a higher risk of total CVDs, CHD, stroke, and total CVD deaths. The risk of total CVDs and CHD increased with the number of miscarriages or stillbirths.

Higher olive oil intake was linked to a decreased risk of CVD and stroke incidence and CVD and all-cause mortality.

Abstract Background The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and triglyceride-glucose (TyG) index are novel indexes for insulin resistance (IR). We aimed to evaluate associations of TG/HDL-C and TyG with arterial stiffness risk. Methods We enrolled 1979 participants from the Rural Chinese Cohort Study, examining arterial stiffness by brachial-ankle pulse wave velocity (baPWV). Logistic and linear regression models were employed to calculate effect estimates. For meta-analysis, we searched relevant articles from PubMed, Embase and Web of Science up to August 26, 2023. The fixed-effects or random-effects models were used to calculate the pooled estimates. We evaluated dose-response associations using restricted cubic splines. Results For cross-sectional studies, the adjusted ORs (95%CIs) for arterial stiffness were 1.12 (1.01–1.23) and 1.78 (1.38–2.30) for per 1 unit increment in TG/HDL-C and TyG. In the meta-analysis, the pooled ORs (95% CIs) were 1.26 (1.14–1.39) and 1.57 (1.36–1.82) for per 1 unit increment of TG/HDL-C and TyG. Additionally, both TG/HDL-C and TyG were positively related to PWV, with β of 0.09 (95% CI 0.04–0.14) and 0.57 (95% CI 0.35–0.78) m/s. We also found linear associations of TG/HDL-C and TyG with arterial stiffness risk. Conclusions High TG/HDL-C and TyG were related to increased arterial stiffness risk, indicating TG/HDL-C and TyG may be convincing predictors of arterial stiffness.

Background: Although relationships between the intake of whole grains and refined grains and the incidence of cardiovascular disease (CVD) events and all-cause mortality have been investigated, the conclusions have been inconclusive. Objectives: We aimed to comprehensively summarize the evidence about the correlation between consuming whole grains and refined grains and risks of CVD events and all-cause mortality and to evaluate the meta-evidence quality. Methods: We searched PubMed, Embase, and Web of Science until 15 March, 2022. Random-effects models were employed to calculate summary relative risks (RRs) and 95% confidence intervals (CIs). We explored potential linear or nonlinear relationships using restricted cubic splines. The NutriGrade tool was employed to rate meta-evidence quality. Results: Twenty-four articles (68 studies; 46 for whole grains and 22 for refined grains) with 1,624,407 participants were included. Per 30-g increase in daily whole grain consumption, the RRs and 95% CIs of stroke, coronary heart disease (CHD), heart failure (HF), CVD, and all-cause mortality were 0.98 (0.96, 1.00), 0.94 (0.92, 0.97), 0.97 (0.89, 1.07), 0.92 (0.88, 0.96), and 0.94 (0.92, 0.97), respectively. Whole grain consumption was linearly associated with CHD (P-nonlinearity = 0.231) and nonlinearly associated with CVD (P-nonlinearity = 0.002) and all-cause mortality (P-nonlinearity = 0.001). Except for a positive correlation between refined grain consumption and all-cause mortality in the restricted cubic spline, no significant influence of refined grain intake on stroke, CHD, HF, and CVD was detected. The meta-evidence quality for the association of whole grain consumption with stroke, CHD, HF, CVD, and all-cause mortality was moderate, moderate, low, high, and high, respectively. For refined grains, all meta-evidence was of low quality. Conclusions: Consuming whole grains, rather than refined grains, can assist in preventing CHD, CVD, and all-cause mortality. Relationships between consumption of refined grains and health outcomes should be interpreted cautiously because of the low quality of meta-evidence.

Objectives Sedentary behavior (SB) and physical inactivity have been associated with an increased risk of all‐cause mortality. Evidence in China is scarce, and it is unclear whether physical activity (PA) attenuates or even eliminates the harmful effects of prolonged SB in the Chinese population. Methods We conducted a prospective cohort study of 17 084 Chinese adults. PA and sitting time (ST) were assessed using the IPAQ. Cox proportional hazards models were used to estimate the risk of PA and ST with all‐cause mortality. Interaction plots were used to visualize the interaction effects. Results During a median follow‐up of 6.01 years, a total of 1106 deaths occurred. PA level was inversely associated with the incidence of all‐cause mortality, while ST showed a detrimental association (all p trend < 0.05). In the stratified analysis, ST was associated with all‐cause mortality in the low PA, while the association was attenuated in the moderate PA group: the HRs (95% CI) comparing ST of 4–8, 8–11, and ≥11 to <4 h/day were 1.15 (0.73–1.81), 1.55 (0.92–2.59), and 2.70 (1.52–4.80), respectively. In the high PA group, no significant association was found across all ST levels. In the joint analysis, compared with the high PA and ST <4 h/day, the harmful effect was found only in the combined low PA and moderate PA groups with ST ≥11 h/day (HR:2.71, 95% CI:1.69–4.35). In addition, a significant interaction association was found. Conclusion Our study, based on a prospective cohort, suggests that the detrimental effect of ST on all‐cause mortality is attenuated or eliminated by high PA levels in the Chinese population.

Background The World Health Organization recommends that all adults with HIV adhere to antiretroviral therapy (ART). Good adherence to ART is beneficial to patients and the public. Furthermore, mHealth has shown promise in improving HIV medication adherence globally. Objective The aim of this meta-analysis is to analyze the effectiveness of mHealth on adherence to antiretroviral therapy in patients living with HIV. Methods Randomized controlled trials (RCTs) of the association between mHealth and adherence to ART published until December 2021 were searched in electronic databases. Odds ratios (ORs), weighted mean differences, and 95% CIs were calculated. This meta-analysis was performed using the Mantel-Haenszel method or the inverse variance test. We evaluated heterogeneity with the I2 statistic. If I2 was ≤50%, heterogeneity was absent, and a fixed effect model was used. If I2 was >50%, heterogeneity was present, and a random effects model was used. Results A total of 2163 participants in 8 studies were included in this meta-analysis. All included studies were RCTs. The random effects model was used for a meta-analysis of the effects of various intervention measures compared to routine nursing; the outcome was not statistically significant (OR 1.54, 95% CI 0.99-2.38; P=.05). In the subgroups, only short messaging service (SMS)-based interventions significantly increased adherence to ART (OR 1.76, 95% CI 1.07-2.89; P=.03). Further analysis showed that only interactive or bidirectional SMS could significantly increase ART adherence (OR 1.69, 95% CI 1.22-2.34; P=.001). After combining the difference in CD4 cell count before and after the interventions, we concluded that there was no statistical heterogeneity among the studies (I2=0%; tau2=0.37; P=.95). Conclusions Interactive or bidirectional SMS can enhance intervention effects. However, whether mHealth can improve adherence to ART in patients with HIV needs further study. Owing to a lack of the required significant staff time, training, and ongoing supervision, there is still much more to do to apply mHealth to the clinical use of ART for patients living with HIV. Trial Registration PROSPERO CRD42022358774; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=358774

Aims: To investigate the association of methylation risk score (MRS) and its interactions with environmental factors with type 2 diabetes mellitus (T2DM) risk. Methods: We conducted a nested case-control study with 241 onset cases and 241 matched controls. Conditional logistic regression models were employed to identify risk CpG sites. Simple and weighted MRSs were constructed based on the methylation levels of ATP-binding cassette G1 gene, fat mass and obesity associated gene, potassium voltage-gated channel member 1 gene, and thioredoxin-interacting protein gene previously associated with T2DM to estimate the association of MRS with T2DM risk. Stratified analyses were used to investigate interactions between MRS and environmental factors. Results: A total of 10 CpG loci were identified from the aforementioned genes to calculate MRS. After controlling for potential confounding factors, taking tertile 1 as reference, the odds ratios (ORs) and 95% confidence intervals (CIs) for T2DM of tertile 3 was 2.39 (1.36-4.20) for simple MRS and 2.59 (1.45-4.63) for weighted MRS. With per SD score increment in MRS, the OR (95% CI) was 1.66 (1.29-2.14) and 1.60 (1.24-2.08) for simple and weighted MRSs, respectively. J-curved associations were observed between both simple and weighted MRSs and T2DM risks. Additionally, multiplication interactions for smoking and hypertension with simple MRS on the risk of T2DM were found, similarly for smoking and obesity with weighted MRS on the risk of T2DM (all P-interaction < .05). Conclusion: Elevated simple and weighted MRSs were associated with increased risk of T2DM. Environmental risk factors may influence the association between MRS and T2DM.

To examine the independent and joint associations of dietary inflammation index (DII) and physical activity (PA) with mortality risk. We analyzed data for 20,165 study participants aged >= 18 from The Rural Chinese Cohort Study. The Cox proportional hazard model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) of mortality associated with DII and PA. The dose-response association between DII and mortality risk was intuitively generated by the restricted cubic splines model. During the mean 5.03-year follow-up, a total of 1110 cases of all-cause mortality were identified. Compared with people in quartile 1 of DII, positive asso-ciations were found in quartile 4 for all-cause (HR 1.27; 95%CI 1.06-1.52), CVD (HR 1.45; 95%CI 1.09-1.91), and other mortality (HR 1.52; 95%CI 1.10-2.09), while a linear association was demonstrated. Compared with people of quartile 1 of DII and high intensity of PA, those with quartile 4 of DII and low intensity of PA had higher risk of all-cause (HR 1.96; 95%CI 1.50-2.56), CVD (HR 2.68; 95%CI 1.71-4.19), and other mortality (HR 1.83; 95%CI 1.19-2.83). A pro-inflammatory diet was significantly associated with increased risk of mortality and lower PA may strengthen the effect.

We quantitatively evaluated the dose-response association of low and normal ankle brachial index (ABI) with the risk of morbidity and mortality from cardiovascular diseases (CVDs). PubMed, Embase, and Web of Science were systematically searched for cohort studies. Random effects or fixed effects models were used to estimate the pooled relative risks (RRs) and 95% confidence intervals (95% CIs). Generalized least squares regression was used to assess study-specific dose-response associations per 0.1 ABI decrease. Restricted cubic splines were used to evaluate linear or nonlinear trends. Twelve cohort studies (57 031 participants) were included in this meta-analysis. For low vs normal ABI levels, the pooled RRs were 2.03 (95% CI, 1.72–2.41; I 2 = 52.9%; pheterogeneity=0.030) and 2.29 (95% CI, 1.98–2.64; I 2 = 39.5%; pheterogeneity =0.158) for CVD morbidity and CVD mortality, respectively. For per 0.1 ABI decrease from 1.40 the risk for CVD morbidity and CVD mortality increased by 8% (1.08, 95% CI 1.04–1.11) and 11% (1.11, 95% CI 1.07–1.15), respectively. Restricted cubic splines showed inverse linear associations for CVD morbidity and CVD mortality. As a non-invasive index, lower ABI was significantly associated with the increased risk of morbidity and mortality from CVDs in an inverse linear manner.

Objectives: Although shift work has been reported as having a link to dementia, evidence remains inconsistent, and a comprehensive dose-response meta-analysis of the association is still lacking. We therefore conducted this meta-analysis to explore the association between shift work and the risk of dementia. Study design: Systematic review and dose-response meta-analysis. Methods: PubMed, Embase, and Web of Science databases were systematically searched. Fixed or random-effects models were used to estimate the summary relative risks (RRs) and 95% confidence intervals (95% CIs). Generalized least squares regressionwas used to estimate dose-response associations, and restricted cubic splines were used to examine possible linear or non-linear associations. Results: Five articles (10 studies) with 72,999 participants and 23,067 cases were eventually included in the meta-analysis. The summary RRs and 95% CIs of dementia risk with shift work and night shift work versus daytime work were 1.13 (95% CI: 1.05-1.21, I-2 = 46.70%) and 1.13 (95% CI: 1.03-1.24, I2 = 9.20%), respectively. The risk of dementia increased by 1% (RR = 1.01, 95% CI: 1.01-1.02, I-2 = 41.3%) with each 1year increase in the duration of shift work. We found a non-linear dose-response association between the duration of shift work and the risk of dementia (Pnon- linearity = 0.006). Though the shape of the curve was steeper with the duration of shift work <7 years, the increase was more gradual after 7 years. Conclusion: Our findings suggest that shift work may be a risk factor for future dementia and that controlling the length of shift work is a feasible measure that may contribute to prevent dementia. (c) 2023 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Background and aim: We aimed to investigate the association of triglyceride-glucose (TyG) index and its dynamic change with risk of hypertension in rural Chinese and, further, to explore whether the TyG index mediates the obesity-related hypertension.Methods and results: A prospective cohort study, including 10,309 subjects without hypertension at baseline, was conducted in 2007-2008 and followed up in 2013-2014. TyG index was calcu-lated as Ln[fasting triglycerides (mg/dL) x fasting glucose (mg/dL)/2]. Logistic regression model was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). Mediation analysis was performed to examine the contribution of the TyG index to the association of obesity-hypertension incidence. During a median follow-up of 6 years, 2073 subjects developed hyper-tension. In multivariate logistic model adjusted for age, sex, alcohol drinking, smoking, physical activity and education, monthly income, family history of hypertension, TC, and HDL-C, the risk of hypertension was 1.14 (1.07-1.22) for per-SD increase in TyG. After additional controlling for obesity, this association was nonsignificant (1.06, 0.99-1.13) and (1.05, 0.99-1.13) for BMI and WC, respectively. Increasing trends were found for hypertension incidence as the TyG change increased, with or without adjustment for obesity (all Ptrend < 0.05). With per-SD increment in TyG change, the risks of hypertension incidence were 1.14 (1.07-1.22) for absolute TyG change, and 1.15 (1.08-1.22) for relative TyG change in multivariate logistic model; the results were sig-nificant after further adjustment for BMI or WC, respectively. The TyG index partially mediated the obesity-incident hypertension association: 6.84% for BMI and 6.68% for WC, respectively. Conclusions: Elevated TyG index and its dynamic change were positively associated with risk of incident hypertension in rural Chinese population, and the TyG index may play a partially medi-ating role in obesity-related incident hypertension.(c) 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Ital-ian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Objective:To build a new teaching mode of health economics course based on situation creation and evaluate the application effects.Methods:From September 2016 to December 2021, a total of 215 postgraduates from grade 2016 to 2021 who took Health Economics course in the School of Public Health of Zhengzhou University were selected as participants. Among them, 106 of the 215 postgraduates from grade 2019 to 2021 were designated as the study group, and the new teaching mode based on situational creation method was applied. The rest 109 postgraduates from grade 2016 to 2018 were designated as the control group, using the traditional teaching mode. By comparing the course assessment results of both groups and the respondents from 20 postgraduates interviewed, the effects of the new teaching mode were comprehensively evaluated. T-test were used for measurement data.Results:The scores of class performance [(87.36±5.34) vs. (84.47±5.38)], homework scores [(88.82±5.62) vs. (85.95±6.76)], final examination results [(84.75±5.18) vs. (82.20±4.10)] and total scores[(86.48±4.11) vs. (84.97±4.52)] from study group were all significantly higher than those from the control group (all P<0.05). Meanwhile, the current study revealed that postgraduates interviewed from the study group showed higher praise and enthusiasm for this reform. Conclusions:The teaching mode of situation creation for health economics course has achieved good results and can inform the reform of related courses.

目的 掌握三门峡市居民健康素养现状,分析其影响因素,为进一步实施干预措施提供依据.方法 2017年,采用多阶段抽样的方法,应用《中国城乡居民健康素养调查问卷》对三门峡市15～69岁居民健康素养进行调查.结果 2017年三门峡市居民健康素养水平为22.9％,其中生活方式与行为素养是8.0％、健康技能素养是16.6％、基本理念和知识素养是24.0％.六类健康问题素养水平由低到高分别是慢性病防治素养10.2％、传染病防治素养12.3％、健康信息素养15.5％、基本医疗素养17.0％、科学健康观素养26.9％、安全与急救素养49.3％.多因素Logistic回归分析结果显示,年龄、受教育程度以及家庭年收入均为该市居民健康素养的影响因素.与15～24岁组比较,55～64岁组(OR=0.552,95％CI:0.350～0.871)健康素养较低.与小学及以下文化程度组相比,初中组(OR=1.596,95％CI:1.251～2.037)、高中/职高/中专组(OR=3.506,95％CI:2.692～4.567)、大专/本科及以上组(OR=6.638,95％CI:4.769～9.241)健康素养均较高;与家庭年收入1万元以下组相比,1万元以上组(OR=2.017,95％CI:1.591～2.558)、3万元及以上组(OR=2.595,95％CI:2.008～3.354)、5 万元以上组(OR=3.581,95％CI:2.317～5.533)、7 万元及以上组(OR=2.138,95％CI:1.175～3.890)健康素养均较高.结论 三门峡市2017年居民总体健康素养水平高于同期河南省和全国的水平.老年人和低学历人群的总体健康素养水平偏低,加强对该人群的健康教育和健康促进工作,将有助于提高三门峡市居民的健康素养水平.

Objective Excessive salt intake is causally associated with an increased risk of cardiovascular disease. Salt-reduction strategies have been rapidly deployed across China since 2017. This study aimed to investigate the association of salt-reduction knowledge and behaviors and salt intake in Chinese population. Study Design This study was a national cross-sectional study in China. Methods This cross-sectional study was based on data collected during a Chinese adult chronic disease and nutrition surveillance program in 2018 with 7,665 study participants. Salt intake was assessed by calculating 24 h urine sodium from morning urine samples. Logistic regression and mean impact value (MIV) based on the back propagation (BP) artificial neural network were used to screen the potential influencing factors. Results A total of 7,665 participants were included in the analysis, with an average age of 54.64 ± 13.26 years, and with men accounting for 42.6%. Only 19.3% of the participants were aware of the Chinese Dietary Guidelines, and only 7.3% of them could accurately identify the level of salt intake recommended in the Chinese Dietary Guidelines. Approximately 41% of the participants adopted salt-reduction behaviors, among whom the number of participants who used less salt when cooking was the highest, and the number of participants who used low sodium salt was the lowest. In the logistic regression, only “No extra salt was added at the table” group showed the effect of salt-reduction, the odds ratio (OR) being 0.78 (95% confidence interval [CI]: 0.64–0.95). The MIV result based on the BP neural network showed that the most important salt-reduction behavior was using less salt when cooking, while reducing eating-out behavior and using salt-limiting tools were the least important. Conclusion The research shows that the popularization of salt-reduction knowledge and behaviors can reduce the population's salt intake. However, there is still considerable scope for promoting salt-reduction knowledge and behaviors, while the promotion of salt-reduction tools and low-sodium salt still needs to be strengthened.

Background and aims: We aimed to evaluate the joint effect of physical activity (PA) and blood lipid levels on all-cause and cardiovascular disease (CVD) mortality.Methods and results: We analyzed 17,236 participants from the Rural Chinese Cohort Study. Cox's proportional-hazards regression models were used to assess the hazard ratios (HRs) and 95% confidence intervals (CIs) between the joint effect of PA and blood lipid levels and risk of allcause and CVD mortality. Restricted cubic splines were used to estimate the dose-response relationship of PA with risk of all-cause and CVD mortality. During a median follow-up of 6.01 years there were 1106 deaths (484 from CVD) among participants. For all-cause mortality, compared with the group with dyslipidemia and extremely light PA (ELPA), the HRs with dyslipidemia and light PA (LPA), moderate PA (MPA), and heavy PA (HPA) were 0.56 (95% CI 0.45-0.70 ), 0.59 (0.46-0.75), and 0.59 (0.45-0.78), respectively, while the HRs of groups with normal lipid levels and ELPA, LPA, MPA, and HPA were 0.88 (0.72-1.04), 0.59 (0.48-0.73), 0.53 (0.41-0.67), and 0.38 (0.29-0.50), respectively. We observed similar effects on CVD mortality. Restricted cubic splines showed a curvilinear relationship between PA and risk of all-cause and CVD mortality with normal lipid levels and with dyslipidemia.Conclusion: Higher PA reduces the risk of all-cause and CVD mortality. Higher levels of PA are needed in the population.(c) 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Although the association of dietary inflammatory potential, evaluated by the dietary inflammatory index (DII), with all-cause and cause-specific mortality has been reported, evidence remains equivocal, no relevant dose-response meta-analysis having been conducted. To examine the dose-response association of dietary inflammatory potential with risk of all-cause, cancer, and cardiovascular disease (CVD) mortality, PubMed, EMBASE and Web of Science were systematically searched up to 9 August 2021. Cohort studies were included if DII was reported as at least three levels or per incremental increase, and if the associations of DII with all-cause, cancer, and CVD mortality were assessed. Generalized least squares regression was used to estimate study-specific dose-response associations, and the random effect model was used to pool the relative risks (RRs) and 95% confidence intervals (95% CIs) of all cause, cancer, and CVD mortality per 1-unit increase in DII. Restricted cubic splines were used to intuitively display the dose-response association between dietary inflammatory potential and mortality. Among the 1,415 studies retrieved, 15 articles (17 cohort studies involving 397,641 participants) were included in this meta-analysis. With per 1-unit increase in DII, the risks were significantly increased for all-cause mortality (RR: 1.04; 95% CI: 1.03, 1.05, I2 = 51.8%; P-heterogeneity = 0.009), cancer mortality (RR: 1.02; 95% CI: 1.00, 1.04, I2 = 58.6%; P-heterogeneity = 0.013), and CVD mortality (RR: 1.04; 95% CI: 1.02, 1.06, I2 = 85.7%; P-heterogeneity <0.001), respectively. Restricted cubic splines showed significant positive linear associations between DII and the above three outcomes. Our study indicated that pro-inflammatory diets may increase the risk of all-cause, cancer, and CVD mortality in a linear manner.

The association of cardiorespiratory fitness (CRF) with all-cause and cause-specific mortality remains unclear in Chinese population. This study aimed to evaluate the risk of all-cause, cardiovascular disease (CVD), cancer and other-cause mortality in Chinese adults using estimated CRF (eCRF). We analysed data for 15,566 participants aged ≥20 years recruited in The Rural Chinese Cohort Study during 2007 to 2008 and followed for mortality during 2013 to 2014. eCRF was calculated with sex-specific longitudinal non-exercise algorithms. Cox proportional-hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality risk according to baseline eCRF. During a median of 6.01 years of follow-up, 859 deaths occurred, including 359 from CVD, 221 from cancer, and 279 from other causes. Each 1 metabolic equivalent increment in eCRF was associated with decreased risk of all-cause mortality (men: HR 0.70, 95% CI [0.66–0.74]; women: 0.59, [0.54–0.64]); CVD mortality (men: 0.70 [0.64–0.77]; women: 0.55, [0.48–0.62]); and other-cause mortality (men: 0.68 [0.62–0.75]; women: 0.57, [0.49–0.66]). The area under receiver operating characteristic curve was significantly higher for eCRF than its modifiable components (waist circumference, body mass index and resting heart rate) in predicting all-cause and cause-specific mortality incidence (all p  < .001). eCRF was inversely associated with all-cause, CVD and other-cause mortality.

目的:分析不稳定型心绞痛(UA)患者择期经皮冠状动脉介入(PCI)术后创伤后应激障碍(PTSD)的影响因素.方法:选取2018年5月1日～2021年3月31日择期行PCI治疗的121例UA患者作为研究对象.术后3 d采用PTSD筛查量表(PCL-C)评估患者PTSD情况,设计基线资料调查表,询问并记录患者基线资料,纳入相关影响因素,经Logistic回归分析找出UA患者择期PCI术后PTSD的影响因素.结果:121例UA患者择期PCI术后有56例(46.28％)发生PTSD;UA患者中发生PTSD的社会支持不良、疾病恐惧进展感觉强烈、创伤后成长低水平、消极应对占比高于未发生患者(P<0.05);经Logistics回归分析显示,社会支持不良、疾病恐惧进展感觉强烈、创伤后成长低水平、消极应对是UA患者择期PCI术后PTSD的影响因素(P<0.05).结论:UA患者择期PCI术后PTSD受社会支持不良、疾病恐惧进展感觉强烈、创伤后成长低水平、消极应对影响,应针对以上因素提出针对性干预方案.