Background:Chronic systemic inflammation (CSI) is linked to esophageal and gastric cancer (EC and GC) risk. However, few studies have explored the potential role of CSI markers in the development of EC/GC, from normal mucosa, benign lesion to carcinomatous degeneration. Methods:This case-control study was based on a population-based EC&GC screening program in a high-incidence area of China. For esophageal lesions, 633 participants from groups with normal mucosa (E-con, N = 202), benign lesion (E-BL, N = 229), and precancerous lesion/cancer (E-case, N = 202, matched with E-con) were included. For gastric lesions, 156 pairs of samples from four groups with normal/superficial gastritis (G-con), atrophic gastritis (AG), intestinal metaplasia (IM), and precancerous lesion/cancer (G-case) were matched. Multivariable logistic regression was used to explore the association between CSI markers and esophageal/gastric lesions. Results:Among 13 CSI indicators, E-case group showed a slightly lower mean platelet volume (MPV) level than E-con or E-BL group. In logistic regression models, MPV was negatively associated with E-case risk compared to E-con (OR = 0.65, 95%CI: 0.46-0.92) or (E-con+E-BL) group (OR = 0.81, 95%CI: 0.68-0.97). The levels of 13 CSI markers were similar across four gastric lesion groups. However, lower MPV was associated with an increased risk of AG (OR = 0.70, 95%CI: 0.50-0.97), IM (OR = 0.62, 95%CI: 0.45-0.86), G-case (OR = 0.56, 95%CI: 0.37-0.86), and all three lesion (AG+IM+G-case, OR = 0.69, 95%CI: 0.52-0.93) compared to G-con group. Conclusion:MPV was negatively associated with the risk of esophageal precancerous lesion/cancer, and also likely associated with an decreased risk of AG and more severe lesions in Correa's cascade of pathological process of GC.

Epstein-Barr virus (EBV) infects more than 95% of adults worldwide but is associated with endemic nasopharyngeal carcinoma (NPC) specifically in southern China1-4. Here, through a stepwise host-EBV genome interaction analysis, we identify a genetic interaction between HLA-A*11:01 and the high-risk EBV variant 85841G as a key determinant of NPC risk. Individuals carrying a susceptible HLA-A background (HLA-A*11:01- or HLA-A*02:07+) and infected with the high-risk 85841G EBV form a dual-risk subgroup with substantially elevated, interaction-driven NPC risk, far exceeding the effects of host or virus alone. This dual-risk subgroup comprises 20.5% of the population and accounts for approximately 47% of NPC cases. We show that EBV 85841G encodes an EBNA3B peptide that binds to HLA-A*11:01 and elicits specific T cell responses capable of lysing EBV+ B cells transformed by 85841G-carrying strains, and is associated with reduced salivary viral load and lower NPC risk among A*11:01 carriers. Evolutionary analysis reveals that 85841G arose via ancient recombination events between northern and southern EBV and subsequently underwent clonal expansion in southern China, leading to co-enrichment of interacting host and viral risk factors that, in turn, contribute to NPC endemicity. These findings reveal a markedly stratified, interaction-driven risk architecture in NPC and highlight opportunities for precision prevention.

Evidence shows HPV vaccination reduces infection, precancer and cervical cancer, yet coverage in health-resource-limited of China remains uncertain. We assessed awareness, uptake and correlates among women attending cervical screening, and examined associations with screening outcomes. We conducted a cross-sectional study in eight county sites in 2023-2024 among women aged 35-64 y. A standardized questionnaire captured sociodemographic factors, awareness and vaccination. Cervical samples were tested for hrHPV. Outcomes were awareness, vaccination, hrHPV, HPV16/18 and CIN2+. Associations were estimated using modified Poisson models with site fixed effects and HC3 robust errors. Adjusted prevalence ratios (aPRs) and covariate-standardized marginal estimates were reported. We included 93,027 unique participants. Awareness was 45.15% and vaccination 6.73%. hrHPV prevalence was 11.38% and CIN2+ detection was 0.70%. In 2024 versus 2023, awareness was lower (40.66% vs 51.34%) while vaccination was higher (7.61% vs 5.53%; aPR 1.25, 95% CI 1.18-1.32). Awareness and uptake declined with age; coverage was 23.23% at ages 35-39 and 0.29% at ages 60-64. Urban residence and higher education were associated with uptake (urban aPR 1.19, 95% CI 1.11-1.27; bachelor's or higher aPR 1.73, 95% CI 1.58-1.90). The age-by-year interaction was significant, with standardized gains concentrated at ages 35-49. Vaccination was associated with lower HPV16/18 infection (aPR 0.66, 95% CI 0.52-0.85) but not with overall hrHPV or CIN2+. HPV vaccine awareness and uptake were low among women aged 35-64 y in health-resource-limited areas, with strong age, educational and urban-rural gradients and marked site heterogeneity. Uptake increased in 2024, mainly at ages 35-49, and vaccination was associated with a lower prevalence of HPV16/18 infection.

The role of multiple elements in esophageal cancer (EC) remains unclear, especially in low-level metal exposure area. To investigate the causal relationship between elements and EC risk, we conducted a case–cohort study nested within the Taizhou Longitudinal Study, in which the baseline fasting serum concentrations of 21 elements in a subcohort of 926 randomly selected subjects and 256 participants with incident EC were measured. Baseline urine levels of four arsenic species were also measured among 826 subcohort subjects and 232 EC cases to further elucidate the potential impact of arsenic on EC risk. Cox proportional hazards regression was used to estimate adjusted hazard ratios for EC associated with elements and false discovery rate (FDR) correction was performed for multiple testing. The results indicated that elevated serum level of arsenic was associated with a reduced risk of EC, with a p-value for trend of 0.002 after FDR correction. When analyzing urinary arsenic species, we found urinary dimethylarsinic acid (DMA) was weakly correlated with serum arsenic. DMA was inversely associated with EC risk after excluding the first two years of follow-up and showed a significant interaction with smoking. Overall, this case–cohort study did not suggest positive associations between any of serum elements examined and EC risk. Nevertheless, the inverse associations of serum arsenic and urinary DMA with EC risk should be interpreted cautiously. Further population-based and experimental studies that incorporate metabolome and consider multiple biomarkers of exposure are required.

BACKGROUND:Cervical cancer remains a significant health burden in China. National policies now allow human papillomavirus (HPV) DNA as a primary screening test, but many health resource-limited counties have not adopted it because programs cannot fund reagents or laboratory platforms. We conducted a multicenter study in 10 pilot counties where HPV DNA screening was introduced with project-supported reagents, platforms, and training. METHODS:We analyzed data from 10 pilot counties designated by the National Cervical Cancer Prevention Program. A total of 63,223 women aged 35 to 64 years were screened with three strategies: (i) cytology alone, (ii) HPV DNA testing with cytology triage, and (iii) HPV DNA testing with visual inspection with acetic acid/Lugol iodine (VIA/VILI) triage. Key indicators included screen positivity rate, colposcopy rate, cervical intraepithelial neoplasia (CIN) 2+ detection, positive predictive value (PPV), and number needed to refer (NNR). Inverse probability weighting was used to adjust for loss to follow-up. RESULTS:HPV-based strategies were superior to cytology across all indicators. CIN2+ detection was two to three times higher, with the highest PPV in the HPV + cytology group (21.9%) and the lowest NNR (5.73), indicating higher referral efficiency. Loss to follow-up rate was also significantly reduced under the HPV + VIA/VILI strategy. These advantages were most prominent among women aged ≥45 years. CONCLUSIONS:Within the first year of implementation, HPV DNA-based screening is feasible and more effective in health resource-limited areas of China and flexible triage models can be adapted. IMPACT:The findings support the integration of HPV DNA testing into national cervical cancer screening programs and highlight needs for robust follow-up systems in underserved populations.

Unlike the well-studied cervical cancer caused by human papillomavirus (HPV), there is a lack of epidemiological data on HPV, which covers the entire lower genital tract and has regional characteristics. This study investigated the HPV distribution in cervical, vaginal and vulvar lesions to provide a reference for their integrated management. This cross-sectional study was designed using the data from the Second Hospital of Shanxi Medical University between January 2014 and December 2023. Study participants underwent colposcopy and targeted biopsy. Pathological diagnosis of cervical, vaginal and vulvar lesions were performed. Participants were divided into different groups according to pathological diagnosis. The clinical characteristics and HPV infection status were analyzed. The attributable risk percentage (AR

OBJECTIVE:Vaginal cancer is a rare malignancy, and the research on it is not comprehensive yet. To explore the characteristics of human papillomavirus (HPV) infection in patients with vaginal intraepithelial neoplasia (VaIN) and vaginal cancer. MATERIALS AND METHODS:This study included patients who underwent colposcopy and biopsy of suspected sites at the Second Hospital of Shanxi Medical University from January 2014 to December 2023 due to abnormal cytology results and/or positive HPV test. Those diagnosed with benign inflammatory reaction of the vagina (ie, vaginitis), VaIN and vaginal cancer according to histologic results were selected as the study objects. Clinical data such as age, menopause, clinical manifestations and previous screening history were collected. We aimed to analyze the distribution and characteristics of HPV in VaIN and vaginal cancer patients. RESULTS:A total of 5,180 patients were included in this study. Of the total, 2,739 patients had VaIN1, 641 had VaIN2/3, and 251 had vaginal cancer. There were 235 patients with vaginal squamous cell carcinoma (VaSCC) and 16 patients with vaginal adenocarcinoma. A total of 4,548 patients were infected with HPV. The HPV positive rate was 95.5% in VaIN2/3, 86.0% in VaSCC and 43.8% in adenocarcinoma of the vagina. The most common 5 HPV types were HPV16, 52, 58, 53, and 18. The positive rate of HPV18 in the adenocarcinoma of the vagina was the highest. CONCLUSION:HPV16, 52, 58, 53, and 18 are the predominant genotypes in VaIN and vaginal cancer in Shanxi, China. HPV testing provides additional benefits for the detection of vaginal lesions during cervical cancer screening. Active HPV vaccination may help reduce the burden of these lesions.

The associations between metabolic dysfunction-associated fatty liver disease (MAFLD) and its subtypes (diabetes mellitus [DM]-MAFLD, overweight [OW]-MAFLD, and lean MAFLD) with carotid and femoral atherosclerosis are not well understood in the Chinese population. This prospective study included participants from southeast China aged between 35–75 years. MAFLD and its subtypes, bilateral carotid and femoral intima-media thickness (CIMT, FIMT, and IMT), plaque (CP, FP, and Plaque), and atherosclerosis (CAS, FAS, and AS), were assessed using ultrasound imaging. Multivariate logistic regression analysis was used to evaluate these associations through odds ratios (ORs) and their corresponding 95

The association between mycotoxins and esophageal cancer (EC) risk remains poorly understood, highlighting the need for evidence from population-based prospective studies. We conducted a case-cohort study nested within the Taizhou Longitudinal Study to investigate this relationship, analyzing baseline urinary mycotoxins in 866 randomly selected subcohort members and 240 incident EC cases (including seven cases from the subcohort). Using ultra-high performance liquid chromatography-triple quadrupole-tandem mass spectrometry, we measured three mycotoxins: ochratoxin A (OTA), T-2 toxin (T-2), and fumonisin B1 (FB1). While FB1 was detectable in over 88% of urine samples, OTA and T-2 were detected in less than 30% of samples. EC cases showed slightly higher detection rates for all three mycotoxins compared to the subcohort subjects. Weighted Cox proportional hazards regression analyses for case-cohort studies revealed that, after adjusting for potential confounders, the urinary levels of three mycotoxins-OTA (hazard ratio [HR] = 1.07, 95% confidence interval [CI]: 0.73-1.56), T-2 (HR = 1.01, 95% CI: 0.51-2.00), and FB1 (HR = 0.94, 95% CI: 0.53-1.64)-as well as co-exposure to these three mycotoxins (HR = 1.33, 95% CI: 0.34-5.28), showed no significant association with EC risk. These results remained consistent even after excluding the first 2 years of follow-up to minimize the influence of potential reverse causation. Our case-cohort study found no clear associations between urinary mycotoxins-OTA, T-2, or FB1-and EC risk in the studied population.

OBJECTIVE:To describe temporal changes associated with deployment of an optical character recognition (OCR)-enabled One-Identity (One-ID) digital platform for rural cervical cancer screening, focusing on over-screening rates, CIN2+ detection, colposcopy follow-up, and CIN2+ management. METHODS:A multi-county pre-post observational study was conducted in six rural counties in Shanxi, Yunnan, and Sichuan Provinces (2021-2024), encompassing 153,978 encounters. The digital platform integrates OCR identity capture, deterministic One-ID linkage, and real-time duplicate alerts. Over-screening proportions before and after digital deployment were compared, changes in CIN2+ detection rate were evaluated, and colposcopy follow-up and CIN2+ management were assessed. Differences were tested with χ2 or Fisher's exact tests. RESULTS:Among 153,978 encounters, the proportion of over-screening decreased from 12.64% in 2023 to 0.17% in 2024 with an absolute reduction of 12.17% (95% CI: 11.94-12.40; P < 0.001). The share of women receiving a first screening within the preceding 3 y increased from 78.3% to 88.2% (P < 0.001). Colposcopy completion improved from 64.1% to 84.9%. The CIN2+ detection rate rose from 0.35% (2021-2023 pooled) to 0.67% in 2024 (P < 0.001) and CIN2+ management completion increased from 56.0% to 76.2% (95% CI: 13.3-27.2; P < 0.001). These improvements were consistent across age groups, counties, and screening strategies. CONCLUSIONS:The OCR-enabled One-ID platform substantially reduced over-screening, increased CIN2+ detection rate, and strengthened case follow-up/management, particularly where baseline tracking was weak, supporting scalable digital reinforcement of rural screening programmes.

BACKGROUND:We aimed to assess the contribution of repeated fasting blood glucose (FBG) measurements along with single collection of 2-hour postprandial glucose (2h PG) and glycated hemoglobin (HbA1c) on diabetes mellitus (DM) prevalence estimation, and investigate the association between the insulin-related markers and DM risk in a southeastern Chinese population. MATERIALS AND METHODS:We included 6515 participants aged 35-75 years with complete glycemic data. McNemar's test was utilized to compare the difference between WHO and ADA criteria in DM diagnosis. Newly diagnosed DM cases were classified as 1defect (DEF), 2DEF, or 3DEF DM according to the abnormalities of three glycemic indices. The sensitivity and specificity of diagnosing DM using different glycemic markers were assessed. The association between different index and DM was analyzed using log-binomial regression and receiver operating characteristic curves. RESULTS:The age- and sex-standardized prevalence of DM was 14.0% and 14.7% by the WHO and ADA criteria, respectively. 2h PG, HbA1c, and FBG detected 89.65%, 40.69%, and 15.24% of newly diagnosed DM population, respectively. . All cases identified by repeated FBG were also detected by either 2h PG or HbA1c. The disposition index showed the highest area under the curve (0.82) in DM prediction, followed by the product of triglyceride and fasting glucose (TyG, 0.72). The estimated previous diagnosis, treatment, and control rate of DM was 38.6%, 34.9%, and 29.4%, respectively. CONCLUSION:It is recommended that 2h PG and HbA1c should be used in population-based studies. The disposition index and TyG could potentially be used as DM predictors.

Background:Dietary patterns influence women's risk of breast cancer, but few studies have investigated the association with benign breast nodules, a well-established risk factor for breast cancer, especially by subtypes of the disease. Methods:A cross-sectional study of 3,483 women enrolled in the Fuqing Cohort Study in southeast China was conducted from 2020 to 2021. Dietary patterns were identified from food frequency questionnaires using principal component analysis, and the scores for these patterns were divided into quartiles. Univariate and multivariate logistic regression models were used to calculate odds ratios (OR) with 95% confidence interval (CI) for the association between dietary patterns and benign breast nodules. Results:We found four dietary patterns among the women: animal-based dietary pattern, plant-based dietary pattern, fried food/dessert pattern, and nuts pattern. Compared with the lowest quartile, women in the highest quartile of the scores for the animal-based dietary pattern were more likely to have cystic breast nodules (OR = 1.61, 95% CI = 1.12-2.32, and the P-value for trend test = 0.007), especially in postmenopausal women. In addition, women with a high score for fried food/dessert pattern also had higher odds of breast cystic nodules (P-value for trend test = 0.012), with an OR (95% CI) of 1.46 (1.01-2.09) for the fourth quartile group. However, there were no associations between these dietary patterns and solid breast nodules. Conclusion:Animal-based dietary pattern and fried food/dessert pattern were positively associated with cystic breast nodules. These findings suggested the role of unhealthy dietary habits in the development of breast nodules.

ObjectiveTo describe the prevalence of thyroid nodules (TNs), their ultrasonographic characteristics, and the cancer risk assessment using the Thyroid Imaging Reporting and Data System (TIRADS) in a natural population, while also exploring their association with multiple metabolic disorders. This study aims to provide insight into the disease burden of TNs in the coastal area of Southeast China.DesignA cross-sectional study.Setting and participantsA total of 6221 participants from the baseline survey of the Fuqing Cohort Study, an ongoing population-based study in a coastal city of Southeast China, were included.Primary and secondary outcome measuresTNs and its detailed ultrasonographic characteristics, risk grading in TIRADS, and metabolic factors.ResultsThe age- and sex-standardized prevalence of TNs was found to be 67.2%, with a higher prevalence observed in females and an increase with age. Additionally, multiple, solid, and < 10 mm TNs were common. Approximately 39.2% of participants were diagnosed with grade 3, while 2.3% were classified as grade ≥ 4a according to TIRADS. Metabolic syndrome was associated with TNs, but this association was significant only in females. The relationship between metabolic disorders and the characteristics and grade of TNs in TIRADS varied by sex.ConclusionThe prevalence of TNs in the coastal area of Southeast China is notable, with 2.3% of the population classified as grade ≥ 4a in TIRADS, indicating a high risk of cancer and necessitating further assessment for thyroid cancer. The association between TNs and metabolic disorders varies by sex and requires further confirmation.

Few population-based studies on nasopharyngeal carcinoma (NPC) prognosis exist. Such real-world data with complete follow-up are needed to enable accurate estimation of survival probabilities and monitor progress in early detection and treatment. In a population-based study of 2529 patients with incident NPC in southern China diagnosed in 2010–2013, we developed a passive-active-passive follow-up strategy involving data linkage and direct contact to track patients’ vital status, cause of death, and migration through December 31, 2018. We calculated 5-year survival probabilities by the Kaplan-Meier method, and estimated avoidable deaths comparing hypothetical scenarios and real-world observations. Early-stage (I–II) patients accounted for 11·5%, and 21·1% were treated in medical-university-affiliated or province-level hospitals. With a mean follow-up time of 5·5 years after diagnosis (98.3% complete), 5-year overall and NPC-specific survival probabilities were 70·1% and 74·5%. The 5-year overall survival probabilities for stage I, II, III, IVa, IVb, and IVc were 91·3%, 87·8%, 79·8%, 63·9%, 57·7%, and 34·4%, respectively. Survival of non-metastatic (I-IVb) population-based patients diagnosed in 2010–2013 was comparable to that of a hospital-based southern Chinese NPC cohort diagnosed in 1997–2007. Based on observed data, if all patients were diagnosed at stages I–II, then total avoidable deaths within 5 years after diagnosis would be 156 per 1000 patients. Real-world population-based NPC survival lags behind that of large hospital-based cohorts, but earlier diagnosis has the potential to substantially reduce mortality from NPC. Our results highlight the importance of improving the accessibility of health resources and promoting early detection of NPC.

BACKGROUND:Definitions of nonalcoholic fatty liver disease (NAFLD), metabolic dysfunction-associated FLD (MAFLD), and steatotic liver disease (SLD) have been proposed to better guide clinical practice and epidemiological studies. The effects of the nomenclature on the incidence of FLD and its associations with obesity phenotypes, insulin resistance (IR), and liver fibrosis were examined in this study. METHODS:NAFLD, MAFLD, and metabolic dysfunction-associated steatotic liver disease (MASLD) were diagnosed on the basis of ultrasound examination and metabolic disorders among 6,718 community-dwelling individuals from southeast China. Six obesity phenotypes, seven IR surrogates, and the NAFLD Fibrosis Score (NFS) were applied to evaluate their association with FLDs through multivariable logistic regression models, restricted cubic splines, and receiver operating characteristic curves. RESULTS:The prevalence of FLD, NAFLD, MAFLD, and MASLD was 35.47%, 33.34%, 34.77%, and 32.79%, respectively. The associations of obesity-FLD, IR-FLD, and FLD-NFS were statistically significant across all the FLD definitions. Patients with MAFLD demonstrated slightly higher odds ratios (ORs) than those with FLD, NAFLD, and MASLD. However, alcoholic-FLD (AFLD), which is included in the MAFLD nomenclature, showed lower ORs with obesity and IR and lower NFS, significantly differently from other FLDs. Among all obesity and IR indices, triglyceride and glucose index body mass index (TyG-BMI), the TyG-waist height ratio (TyG-WHtR), and the TyG-waist circumstance (TyG-WC) were the best at predicting FLDs and ORs with respect to NFS. CONCLUSION:The nomenclature of MAFLD covers a wider range of FLD than NAFLD and MASLD do, but the heterogeneity of AFLD is nonnegligible. Compared with MASLD, NAFLD remains a practical and efficient definition for large-scale population screening, especially in resource-limited settings. TyG-BMI, TyG-WHtR, and TyG-WC could better predict FLD and associated fibrosis, affirming their potential as simple and cost-effective tools to support health monitoring and early intervention.

IntroductionVarious foods or food groups and nutrients are correlated with serum uric acid levels. However, the findings were not consistent across different populations, and the mechanisms remain unclear.MethodsIn the baseline survey of the Fuqing Cohort, 4,326 participants were selected from Southeast coastal Chinese communities, and their dietary patterns were derived from a validated food frequency questionnaire using principal component analysis. Logistic regression was used to estimate the risk of hyperuricemia across the quintiles of each dietary pattern. Additionally, we performed mediation analysis to assess the potential mediating role of metabolic factors.ResultsBased on the parallel analysis, four principal components were retained, explaining 46% of the total variance. Higher consumption of animal-based food (meat, fish, and seafood), bean products, sweets, desserts, and fried foods is significantly associated with an increased risk of hyperuricemia (Odds ratio for highest quintile of this dietary pattern vs. lowest: 1.36; 95% CI: 1.07, 1.72). Participants under 60 years showed a notably higher relative risk, which was significantly mediated by body mass index in combination with low-density lipoprotein and/or fatty liver.ConclusionGreater adherence to a high-protein diet, along with fried food, sweets, and desserts, increases the risk of hyperuricemia, particularly in people under 60 years of age. Moderate consumption of an animal-based diet and significantly reducing the intake of sweets and fried foods may help prevent the risk of hyperuricemia.

OBJECTIVE:To evaluate detection rates of multisite lesions (cervical, vaginal, vulvar) among women attending colposcopy clinics. METHODS:Our cross-sectional study included 20,486 patients between 2014 and 2023 in Shanxi China. Detection rates for cervical, vaginal, and vulvar lesions were retrospectively analyzed across strata by HPV status, cytological diagnosis, and clinical manifestations (vaginal bleeding/discharge). Multinomial logistic regression was applied to calculate odds ratios for high-grade lesions and squamous cell carcinoma (SCC). RESULTS:High-risk HPV (hr-HPV) infection was detected in 16,636 of 20,486 women (81.2%), and 9,137 (44.6%) had ASC-US+ cytology. Following cervical lesion detection on histopathology among hr-HPV-positive women (CIN2/3: 19.9%; SCC: 5.3%; AIS/ADC: 0.4%), additional lesions were identified at other anatomical sites: vaginal lesions (VaIN2/3: 3.6%; SCC: 1.1%; AIS/ADC: 0.04%) and vulvar lesions (VIN2/3: 0.4%; SCC: 0.1%) were further identified. Overall, 21.6% of hr-HPV-positive women exhibited high-grade lesions (CIN/VaIN/VIN2/3), with 5.6% demonstrating multi-focal SCC and 0.4% showing AIS/ADC. Stratified analysis revealed that patients even with negative HPV or cytology result still had relative high detection rate of high-grade lesions. Among these HPV-negative women, those reporting vaginal bleeding/discharge carried an elevated risk, with 3.2% having high-grade lesions and 10.5% having SCC. The integrative examination combining hr-HPV, cytology, and vaginal bleeding/discharge identified 3,753 high-grade lesions and 1,154 cancers. CONCLUSION:Integrating the assessment of hr-HPV testing, cytology, and clinical symptoms (e.g., vaginal bleeding or discharge) could help finding more cases of multisite lesions (cervical, vaginal, vulvar). This is especially important for some high-risk women, including those who visit the colposcopy clinics, and more attention should be paid to the multisite examination.

BACKGROUND:This study aimed to assess the effectiveness of high-risk human papillomavirus (HR-HPV) primary testing for cervical cancer screening in China's rural areas.METHODS:Women aged 21-64 years were recruited. Cervical cytology was diagnosed following the Bethesda 2001 classification system, HPV infection (HR-HPV, HPV-16, HPV-18, and other 12 genotypes) identified by Cobas-4800, and colposcopy and biopsy performed when required. Primary outcomes were defined as the cumulative incidence of cervical intraepithelial neoplasia grade 2/3/higher (CIN2/3+) and its relative risk at baseline and at the 36-month follow-up.RESULTS:The study included 9,218 women; mean age was 45.15 years (SD: 8.74); 81% completed the follow-up. The most frequent type of cytological lesions (12.4% ) were ASCUS (8.4%) and LSIL (2.2%). HR-HPV infection (16.3%) was more prevalent in HPV-16 than in HPV-18 (3 vs 1.5%); a positive relationship with the severity of the lesions, from 29.8% in ASCUS to 89.6% in HSIL was found. At baseline, 3.5% of the patients underwent colposcopy; 20% had a positive diagnosis. At the 36-month follow-up, the cumulative incidences of CIN2+ and CIN3+ were higher in women with HR-HPV infection (16.9 vs 0.5% and 8.2 vs 0.2%). The relative risk of CIN2/3+ was lower in HR-HPV-negative women compared to those with a negative cytology at baseline (0.4; 95%CI: 0.3-0.4).CONCLUSIONS:High-risk HPV-based screening may significantly reduce the risk of CIN2/3+ compared with cytology testing. This may be a new resource for public health demands in China's rural areas.

Background Magnesium (Mg) is both an essential macro-element and a known catalyst, and it plays a vital role in various physiological activities and mechanisms in relation to chronic kidney disease (CKD). However, epidemiological evidence involving this is limited and not entirely consistent. This study aims to explore the association of serum Mg concentrations with the risk of CKD among general Chinese adults. Methods A total of 8,277 Chinese adults were included in the wave of 2009 from the China Health and Nutrition Survey (CHNS). The primary outcome was the risk of CKD, which was defined as the estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m 2 . Multivariable logistic regression model was used to examine the relationship of serum Mg concentrations with the risk of CKD. Results Included were 8,277 individuals, with an overall CKD prevalence of 11.8% ( n = 977). Compared with the first quartile of serum Mg, the multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for participants in the second, third, and fourth quartiles of serum Mg were 0.74 (0.58, 0.93), 0.87 (0.69, 1.11) and 1.29 (1.03, 1.61), respectively. Similar results were observed in our several sensitivity analyses. Restricted cubic spline analysis demonstrated a nonlinear (similar “J”-shaped) association between serum Mg concentrations and the risk of CKD ( P nonlinearity <0.001), with a threshold at around a serum Mg value of 2.2 mg/dL. Conclusions Our results suggested a similar “J”-shaped association between serum Mg concentration and the risk of CKD among Chinese adults. Further large prospective studies are needed to verify these findings.

The associations between several blood inflammatory indicators and risk of vascular plaques remain inconclusive. A total of 4596 native rural residents in Southeast China were enrolled from the Fuqing cohort study. Blood cell counts and their composite indexes including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and 2 novel indicators (systemic immune inflammation index (SII) and systemic immune inflammation response index (SIRI)) were considered as inflammatory indicators. Common carotid and femoral intima-media thickness (IMT) and plaques were assessed using B-mode ultrasound. Unconditional or multinomial logistic regression was used to evaluate potential associations. The prevalence of multiple femoral plaques (defined as IMT ≥1.5 mm) was significantly higher among participants with the highest tertile of total leukocyte count (odds ratio, 1.78), neutrophil count (1.88), monocyte count (2.51), platelet count (1.68), NLR (1.93), PLR (1.57), SII (2.10), and SIRI (2.94). Higher levels of neutrophil count, platelet count, NLR, and SII were also found to have significant linear dose-response relationships with the prevalence of stenosis, especially in femoral arteries. In conclusion, several blood inflammatory biomarkers may contribute to, or are associated with, the presence of IMT ≥1.5 mm or stenosis especially in femoral arteries.