Objective:Based on protection motivation theory(PMT),this study aimed to examine the current status of e-cigarette cessation intention and cessation behavior,as well as their associated factors,among adult e-cigarette users in China.Methods:This was a cross-sectional study.The data were de-rived from a nationwide"E-cigarette Use Survey"conducted in 2023,covering 31 provinces(municipali-ty,autonomous region)in China.A total of 550 current e-cigarette users aged 18-44 years were selec-ted as the study population.After adjusting for sociodemographic variables,multiple linear regression models were used to identify factors associated with e-cigarette cessation intention,while binary Logistic regression models were applied to examine factors associated with e-cigarette cessation behavior.In addi-tion,subgroup analyses were conducted according to smoking status to explore potential differences among exclusive e-cigarette users and dual users of e-cigarettes and combustible cigarettes.Results:The mean score of e-cigarette cessation intention was 3.52±0.96,and 31.64％of participants reported having at-tempted to quit e-cigarettes.After adjustment for covariates,cessation intention was associated with both the threat appraisal and coping appraisal pathways within the PMT framework.Specifically,in the threat appraisal pathway,severity(β=0.14)and vulnerability(β=0.12)were positively associated with ces-sation intention,whereas perceived extrinsic rewards(β=-0.12)were negatively associated.In the coping appraisal pathway,both response efficacy(β=0.26)and self-efficacy(β=0.28)were positive-ly associated with cessation intention.Regarding cessation behavior,only severity(OR=1.58)in the threat appraisal pathway was positively associated,and cessation intention was also positively associated with cessation behavior.Subgroup analyses further showed that,regardless of smoking status,cessation intention was positively associated with both the threat appraisal pathway(β=0.20,β=0.31)and the coping appraisal pathway(β=0.23,β=0.21).Conclusion:PMT provides a valuable theoretical framework for understanding e-cigarette cessation among adults.Factors related to the threat appraisal pathway are associated not only with cessation intention but also with actual cessation behavior.More-over,the associations of PMT-related factors vary across different smoking status subgroups.These findings suggest that future e-cigarette control policies and interventions could focus on enhancing risk perception and cognitive awareness,and develop more targeted cessation strategies for specific subgroups.

Introduction and Objective: Metabolic score for insulin resistance (METS-IR) and triglyceride glucose (TyG) are convenient insulin resistance (IR) indices, however, evidence on their association with hypothyroidism is scarce. This study aimed to investigate the association between IR indices and hypothyroidism, as well as their discriminative abilities. Methods: This nationwide, cross-sectional study utilized data from the Meinian Health Check-up database. A total of 10,357,932 adults who had health check-ups between 2017 and 2023, including those with hypothyroidism and those with normal thyroid function were analyzed in this study. Overt hypothyroidism (OHypo) was defined as an elevated thyroid stimulating hormone (TSH) with reduced free thyroxine (FT4), whereas an elevated TSH with normal FT4 was considered subclinical hypothyroidism (SHypo). Results: Both METS-IR and TyG were statistically significant associated with an increased risk of OHypo and SHypo across quartiles and showed non-linear “J-shape” associations (Figure 1). The area under receiver operating characteristics curve of both IR indices were the same (0.75 for OHypo and 0.65 for SHypo). Similar associations and discriminative abilities were found in participants with or without prediabetes and diabetes. Conclusion: Hypothyroidism is linked to IR. METS-IR and TyG has a better discriminative performance for OHypo. D. Shen: None. M. Sailimai: None. X. Yang: None. C. Yu: None. L. Li: None. B. Wang: None. J. Lv: None.

ObjectiveA cross-sectional survey was conducted to investigate the differences in preferences, gateway effects, and potential motivations for e-cigarette use among different genders of e-cigarette users in China, thereby providing ideas for the development of public prevention and intervention measures for e-cigarettes.MethodsThis study adopted a combination of online web questionnaires and offline distribution questionnaires to survey 640 e-cigarette users by snowball sampling and convenience sampling in China in 2023. We used the Potential E-Cigarette Dependence Scale, the E-Cigarette Preference Scale, and the General Information Scale to conduct the survey and assessment, and surveyed 360 individuals of those who only used traditional cigarettes for comparison.Results(1) The total number of participants in this research study was 1792, the mean age was 26.9 ± 9.0 years and the number of e-cigarette users was 640, of which 535 (83.6%) were males and 105 (16.4%) were females. (2) There was a statistically significant association between e-cigarette flavor preferences (flavor/nicotine) and gender (p < 0.05). Compared to males, females preferred e-cigarettes with scented/tobacco/fruit/beverage/nicotine (0 mg/12 mg) flavors. (3) Compared with males, females were more likely to “Transition to using traditional cigarettes after smoking e-cigarettes (Gateway effect)” (p < 0.05). (4) Whereas males were more likely to experience “Craving for traditional cigarettes after using e-cigarettes (Induction effect)” (p < 0.05). (5) There were significant gender differences in motivations for e-cigarette use. Males were more likely to use e-cigarettes to “quit traditional cigarettes,” whereas e-cigarette use was more closely related to self-perceptions of “feeling cool.” (6) Multi-factorial logistic regression analysis showed that there was a significant correlation between “e-cigarette liquid flavor (tobacco/fruit/beverage), e-cigarette liquid nicotine concentration (0 mg/12 mg)” and “Gender” (p < 0.05); Gateway effect was significantly correlated with “Gender and Age”(p < 0.05); E-cigarette addiction dependence was not significantly correlated with gender; Mild addiction to e-cigarettes was significantly correlated with “hope e-cigarettes carry nicotine, and the motivations for choosing e-cigarettes (to quit traditional cigarettes)” (p < 0.05). Severe addiction to e-cigarettes was significantly correlated with “hope e-cigarettes carry nicotine, and the motivations for choosing e-cigarettes (unable to use traditional cigarettes in public)” (p < 0.05).ConclusionAmong Chinese e-cigarette users, females preferred e-cigarettes with special flavors, and either without or with middling concentrations of nicotine. The gateway effect was more prominent in females and adolescents, and the induction effect was more notable in males. There was no significant correlation between addiction dependence on e-cigarettes and gender. E-cigarette use was more likely to be motivated by a desire to quit using traditional cigarettes in males, whereas women were more likely to be motivated by “self-perception.”

Over the past decade, China has experienced a surge in doctors and beds, along with significant increase in healthcare utilization. This study compares the need-based and demand-based projections with supply of doctors and beds in China from 2021 to 2025. We also evaluate the adequacy and equitable distribution of doctors and beds. By utilizing public data from 2008 to 2018, we employed the health need method, health demand method, and trend projection to estimate the need and demand for and supply of doctors and beds in China. By 2025, the projected need-based, demand-based, and supply of doctors will be 5.93 million, 3.89 million, and 4.40 million, respectively. Correspondingly, bed projections stand at 7.27 million, 6.58 million, and 11.06 million. The study found an inclination toward hospital care, amplified by the need and demand for doctors and beds in hospital sector. Notably, the findings indicate 64.0

BACKGROUND:Elevated lipoprotein(a) [Lp(a)] is strongly associated with an increased risk of atherosclerotic cardiovascular disease; yet, large-scale studies on the epidemiology of elevated Lp(a) as well as its association with subclinical atherosclerosis in the Chinese population are limited. OBJECTIVES:This study aimed to estimate the prevalence of elevated Lp(a) in a large check-up population of China, and investigate its associations with both site-specific and multisite subclinical atherosclerosis. METHODS:Adults who underwent Lp(a) testing between 2017 and 2023 at Meinian health check-up centers in 30 provinces of China were included. Because the test results of Lp(a) were reported in either the mass unit (mg/dL) or the molar unit (nmol/L) and conversion between units was not recommended, separate analyses were conducted for each unit. Subclinical atherosclerosis was assessed using various imaging examinations at the carotid artery, the brain, and the coronary artery. The prevalence of elevated Lp(a) was estimated across the overall study population and various subpopulations. The logistic regression model was used to investigate the associations between elevated Lp(a) and subclinical atherosclerosis. RESULTS:A total of 2,788,206 and 167,114 participants with the mass unit and the molar unit were included. In the mass unit group, the prevalence of Lp(a) >30 and >50 mg/dL was 18.67% and 8.41%, respectively. Significantly higher prevalence was observed among women, elderly individuals, and individuals with various cardio-renal-metabolic risk factors (all P < 0.05). Compared with Lp(a) ≤30 mg/dL, individuals with Lp(a) >30 to ∼50 mg/dL exhibited 11%, 15%, 9%, and 11% greater odds of increased carotid intima-media thickness, carotid plaque, subclinical brain infarcts, and coronary artery calcification, respectively. The odds were even higher for those with Lp(a) >50 mg/dL. Furthermore, elevated Lp(a) was significantly associated with the extent of coronary artery calcification, as well as subclinical atherosclerosis at 1, 2, and 3 sites, with the association being more pronounced in cases with severe extent and multisite involvement. These results were similar in the molar unit group. CONCLUSIONS:A significant burden of elevated Lp(a) was found in China, highlighting the necessity of prioritized Lp(a) screening in high-risk groups. Elevated Lp(a) was identified as a significant risk factor for site-specific subclinical atherosclerosis, with stronger associations observed in severe extent and multisite involvement. Our findings suggest that individuals with elevated Lp(a) should undergo a comprehensive assessment of subclinical atherosclerosis at multiple sites to help prevent ASCVD.

Tooth loss, often considered as an inevitable result of ageing, is one of the most frequently stated problems with older adults worldwide, which entails a negative impact on physical and mental health, as well as quality of life. However, there is urban-rural gap among older adults in both oral health condition and dental service utilization. The study focused on the urban-rural gap in Chinese older population, aiming to describe their tooth loss and denture use status, and explore the associated factors, hoping to provide insights into improving the oral healthcare system in China and other developing countries. This cross-sectional study used data collected from May to September in 2020. A stratified, multi-stage cluster sampling design was used to produce nationally representative samples of 2709 adults aged 60 years and older. The dependent variable was denture use of the participant. Determinants included demographic characteristics, health status, social support, oral health knowledge and health service utilization. Descriptive analysis was conducted to describe the sample characteristics, and Generalized Linear Mixed Model was used to identify independent factors associated with denture use among older adults in rural and urban China respectively. There were significant urban-rural differences in tooth loss, denture use and health service utilization among Chinese older adults. Urban participants’ denture use was associated with oral health knowledge (OR = 1.29, 95

INTRODUCTION There needs to be more up-to-date evidence on the prevalence of e-cigarette use among Chinese adults. This study aims to investigate the prevalence and associated factors of e-cigarette use among adults aged 18-44 years in China. METHODS Cross-sectional design and convenience sampling were used. The data for this study were obtained from an online survey conducted in mainland China from April to May 2023. The target population was adults aged 18-44 years. Descriptive analysis was employed to report the prevalence of e-cigarette use, while adjusted multivariable logistic regression was performed to examine the association between e-cigarette use and related factors. RESULTS A total of 4256 participants were included in this study; 12.9% were current e-cigarette users, 5.9% were frequent users, and 7.0% were occasional users. The descriptive analysis results indicated that males and cigarette users had a higher prevalence of e-cigarette use. Multivariable analysis showed that e-cigarette use was significantly associated with female gender (AOR=0.76, 95% CI: 0.60-0.96), those aged 25-34 years with monthly income 6000-8999 CNY (AOR=2.01; 95% CI: 1.18-3.41), those aged 25-34 years with monthly income >= 9000 CNY (AOR=2.20; 95% CI: 1.26-3.82), college or undergraduate degree (AOR=1.91; 95% CI: 1.22-3.00), urban residence (AOR=1.72; 95% CI: 1.34-2.20), being a current smoker (AOR=3.32; 95% CI: 2.64-4.16), perception of harm (AOR=0.66; 95% CI: 0.60-0.73), and perception of benefit (AOR=2.31; 95% CI: 2.04-2.61). CONCLUSIONS The prevalence of current e-cigarette use among adults in China was 12.9% within our sample. In addition to sociodemographic factors, individuals with a higher perception of the harm associated with e-cigarettes were less likely to engage in e-cigarette consumption. Conversely, individuals who perceive the 'benefits' of e-cigarettes more favorably use them. Targeted interventions, such as health education, are recommended to help adults develop a correct understanding of e-cigarettes and lower the prevalence of e-cigarette use.

Aim: Early-stage phenotypes of carotid atherosclerosis (CAS), such as increased carotid intima-media thickness (cIMT), and advanced-stage phenotypes, such as carotid plaque (CP), are at risk for adverse ischemic stroke events. There is limited evidence regarding the causal association between dietary patterns and the risk of CAS in Chinese adults. We therefore examined multiple dietary patterns associated with the risk of CAS and identified the optimal dietary pattern for preventing CAS. Methods: We analyzed data collected from the prospective MJ Health Check-up Study (2004–2020), including 13,989 participants 18–80 years of age without CAS. The dietary intake was measured using validated food frequency questionnaires, and dietary pattern scores were calculated for four a priori and four a posteriori dietary patterns. The Cox model was used to estimate the adjusted hazard ratios (HRs) relating various dietary pattern scores to the risk of CAS. Results: During 43,903.4 person-years of follow-up, 3732 incidents of increased cIMT and 2861 incident CP events were documented. Overall, the seven dietary patterns, except for the high-protein diet, exhibited significant associations with the risk of increased cIMT and CP. Comparing the highest and lowest quartiles, the a posteriori high-fiber dietary pattern (HFIDP) score demonstrated the strongest inverse associations with the risk of increased cIMT (HR 0.65 [95% confidence interval (CI) 0.59–0.71]) and CP (HR 0.65 [95% CI 0.59–0.73]); conversely, another a posteriori high-fat dietary pattern (HFADP; i.e., incorporating high-fat and processed foods) demonstrated the strongest positive associations with the risk of increased cIMT (HR 1.96 [95% CI 1.75–2.20]) and CP (HR 1.83 [95% CI 1.61–2.08]) (all p for trend < 0.01). Conclusions: Multiple dietary patterns are significantly associated with the risk of early- and advanced-stage phenotypes of CAS. Notably, a high adherence to an HFIDP and low adherence to an HFADP may confer the greatest risk reduction for CAS.

OBJECTIVE:To assess cigarette demand among Chinese smokers through a cigarette purchase task (CPT) and to evaluate cigarette prices under different hypothetical scenarios in order to meet the goals of smoking prevalence reduction in China.METHODS:In the study, 447 participants completed a hypothetical CPT at baseline assessments of a trial, thus, cigarette demand curves were individually fitted for each participant using an exponentiated version of the exponential demand model. Typically, five demand indices were derived, intensity (consumption when free), breakpoint (first price at which consumption is suppressed to 0), maximum output (Omax), maximum price (Pmax, price at which Omax occurred), and elasticity (the ratio of the change in quantity demanded to the change in price). A one-way analysis of variance was used to explore the correlations between the cigarette purchase task indices and socio-demographic and smoking characteristics. The one-way decay model was employed to simulate the smoking cessation rates and determine optimal cigarette prices in a series of scenarios for achieving 20% smoking prevalence.RESULTS:The price elasticity drawn from CPT was 0.54, indicating that a 10% price increase could reduce smoking by 5.4% in the participated smokers. Smokers with higher income were less sensitive to cigarette prices (elasticity=-2.31, P=0.028). Cigarette purchase task indices varied significantly among the smokers with different prices of commonly used cigarettes, tobacco dependence, and smoking volume. The smokers who consumed cigarettes of higher prices reported higher breakpoint, Omax and Pmax, but lower intensity (P=0.001). The smokers who were moderately or highly nicotine dependent reported higher intensity, breakpoint, Omax and Pmax, and they had lower intensity (P=0.001). The smokers who had a higher volume of cigarettes reported higher intensity and Omax, and lower intensity (P < 0.001). To achieve the goal of reducing smoking prevalence to 20% in mainland China, we estimated the desired increase on smoking cessation rate and prices accordingly in a series of scenarios, considering the gender variance and reduced smoking initiation. In scenario (a), to achieve a smoking prevalence goal of 20%, it would be necessary for 24.81% of the current smokers to quit smoking when there were no new smokers. Our fitting model yielded a corresponding value of 59.64 yuan (95%CI 53.13-67.24). Given the assumption in scenario (b) that only males quitted smoking, the desired cessation rates would be 25.82%, with a higher corresponding price of 62.15 yuan (95%CI 55.40-70.06) to induce desired cessation rates. In the proposed scenario (c) where 40 percent of the reduction in smoking prevalence came from reduced smoking initiation, and females and males equally quitted smoking due to increased cigarette prices, the price of a pack of cigarettes would be at least 37.36 yuan (95%CI 32.32-42.69) (equals to $ 5.20) per pack to achieve the cessation rate of 14.89 percent. In scenario (d) where only males quitted smoking due to increased cigarette prices considering the reduced smoking initiation, the respective smoking cessation rates should be 15.49% with the desired prices of 38.60 yuan (95%CI 33.53-44.02). After adjusting for education levels and income levels in scenario (c), the price of cigarettes would be at least 37.37 yuan/pack (equals to $ 5.20) (95%CI 30.73-44.94) and 37.84 yuan/pack (equals to $ 5.26) (95%CI 31.94-44.53), respectively.CONCLUSION:Cigarette purchase task indices are significantly associated with income levels and prices of commonly used cigarettes, levels of tobacco dependence, and smoking volume, which is inspiring in studying price factors that influence smoking behavior. It is suggested that higher cigarette prices, surpassing the current actual market level, is imperative in mainland China. Stronger policy stra-tegies should be taken to increase tobacco taxes and retail cigarette prices to achieve the Healthy China 2030 goal of reducing smoking prevalence to 20%.

The Health Action Process Approach (HAPA) is a two-stage (pre-intentional and post-intentional) behavioral change model that distinguishes between motivation and volition in behavior change process. This study aims to develop HAPA-based assessments for smoking cessation among current smokers. The HAPA-based measures were developed and the draft measures included nine constructs, namely, risk perception in smoking-induced cancer, risk perception in smoking-induced systemic disease, positive outcome expectancy, negative outcome expectancy, self-efficacy in quitting smoking, self-efficacy in maintaining, self-efficacy in re-initiating, quitting planning and coping planning in smoking cessation, with a total of 26 items. A cross-sectional survey was conducted in China in 2022. Principal Component Analysis was used for Exploratory Factor Analysis (EFA). Cronbach’s α coefficient was calculated to evaluate the internal consistency. Variables such as severity of smoking addiction were selected to evaluate the correlation between the HAPA scale and these variables. Of the 928 participants, 76.4% (709/928) were male and the median age was 35 years. Five factors were extracted by EFA. The factor loadings of each item were all greater than 0.60, and the cumulative variance contribution rate was 90.15%. The Cronbach’s α coefficient of each HAPA-based subscales was 0.929–0.986. The HAPA-based measurements are comprehensive, reliable and valid in the assessment of smokers’ smoking cessation cognition, which can be used to guide the design and implementation of intervention and the development of theory.

Background: This study aimed to explore and compare the effect of weight change, and waist circumference (WC) change, on the risk of nonalcoholic fatty liver disease (NAFLD) in individuals with metabolically healthy overweight or obesity (MHOW/O) and metabolically unhealthy overweight or obesity (MUOW/O) in a health checkup cohort in China. Methods: 5625 adults with overweight or obesity, and free from NAFLD at baseline were included. Metabolically healthy was defined as not having any components of metabolic syndrome. Weight/WC changes were calculated as the relative difference between the first and second visits of check-up. NAFLD was assessed based on abdominal ultrasound. Results: During a median follow-up of 2.1 (IQR: 1.1-4.3) years, 1849 participants developed NAFLD. In MHOW/O participants, the multivariable adjusted HRs (95 % CIs) for NAFLD in weight change <= -5.0 %, and - 4.9-- 1.0 % were 0.36 (0.23-0.59), 0.59 (0.43-0.80), respectively, compared to the weight stable group (-0.9% to 0.9 %). The corresponding HRs (95 % CIs) for the association between WC change (<= 6.0 %, - 5.9 to -3.0 %) and NAFLD in MHOW/O participants were 0.41 (0.27-0.62), and 0.74 (0.54-1.01), respectively, compared to the WC stable group (- 2.9-2.9 %). Similar patterns were observed in MUOW/O participants. A more marked gradient of cumulative incidence of NAFLD across weight/WC change categories was observed in MHOW/O than in MUOW/O individuals. Conclusions: A more evident association between weight/WC loss and risk of NAFLD was observed in MHOW/O than in MUOW/O individuals. Our findings indicate the practical significance of encouraging all individuals with overweight and obesity to achieve a clinically relevant level of weight/WC loss to prevent NAFLD, even among metabolic healthy groups.

Introduction There is an urgent issue to relieve the burdens caused by tobacco use through feasible and effective smoking cessation interventions, particularly in a middle-income country with less accessible smoking cessation services and high demand for quitting smoking. Financial incentives have shown effective in changing health behaviours, thus needing to test its portability to a wider implementation and effectiveness of increasing smoking cessation rates.Methods and analysis This is a three-arm cluster randomised controlled trial. 462 eligible participants will be assigned to 2 financial incentive groups—rewards or deposits, or the control group. All participants including those in the control group will receive text messages to help quitting smoking developed by the US National Cancer Institute over a 3-month intervention period. In addition to text messages, reward group participants will be rewarded with CNY200 and CNY400 (CNY100 approximately US$15) for sustained smoking abstinence at 1 month and 3 months follow-up assessments; participants in the deposit group will accumulate CNY200 and CNY600 in the deposit accounts after verified smoking abstinence at 1 month and 3 months follow-up assessments, and all the deposits will be given at once right after the 3-month follow-up visit. The primary outcome is biochemically verified smoking abstinence rate sustained for 6 months after enrolment.Ethics and dissemination This trial protocol has been approved by the Ethics Committee of Peking University Health Science Centre (date: 23 February 2023; ethical approval number: IRB00001052-22172). Results and findings of this trial will be disseminated in peer-reviewed journals and professional conferences.Trial registration number ChiCTR-IOR-2300069631.

Importance Epidemiologic studies on carotid atherosclerosis (CAS) based on nationwide ultrasonography measurements can contribute to understanding the future risk of cardiovascular diseases and identifying high-risk populations, thereby proposing more targeted prevention and treatment measures. Objectives To estimate the prevalence of CAS within the general population of China and to investigate its distribution among populations with potential risk factors and variation across diverse geographic regions. Design, Setting, and Participants This multicenter, population-based cross-sectional study used China’s largest health check-up chain database to study 10 733 975 individuals aged 20 years or older from all 31 provinces in China who underwent check-ups from January 1, 2017, to June 30, 2022. Main Outcomes and Measures Carotid atherosclerosis was assessed and graded using ultrasonography as increased carotid intima-media thickness (cIMT), carotid plaque (CP), and carotid stenosis (CS). The overall and stratified prevalences were estimated among the general population and various subpopulations based on demographic characteristics, geographic regions, and cardiovascular disease risk factors. Mixed-effects regression models were used to analyze the risk factors for CAS. Results Among 10 733 975 Chinese participants (mean [SD] age, 47.7 [13.4] years; 5 861 566 [54.6%] male), the estimated prevalences were 26.2% (95% CI, 25.0%-27.4%) for increased cIMT, 21.0% (95% CI, 19.8%-22.2%) for CP, and 0.56% (95% CI, 0.36%-0.76%) for CS. The prevalence of all CAS grades was higher among older adults (eg, increased cIMT: aged ≥80 years, 92.7%; 95% CI, 92.2%-93.3%), male participants (29.6%; 95% CI, 28.4%-30.7%), those residing in northern China (31.0%; 95% CI, 29.1%-32.9%), and those who had comorbid conditions, such as hypertension (50.8%; 95% CI, 49.7%-51.9%), diabetes (59.0%; 95% CI, 57.8%-60.1%), dyslipidemia (32.1%; 95% CI, 30.8%-33.3%), and metabolic syndrome (31.0%; 95% CI, 29.1%-32.9%). Most cardiovascular disease risk factors were independent risk factors for all CAS stages (eg, hypertension: 1.60 [95% CI, 1.60-1.61] for increased cIMT, 1.62 [95% CI, 1.62-1.63] for CP, and 1.48 [95% CI, 1.45-1.51] for CS). Moreover, the magnitude of the association between several cardiovascular disease risk factors and increased cIMT and CP differed between the sexes and geographic regions. Conclusions and Relevance These findings suggest that nearly one-quarter of Chinese adults have increased cIMT or CP. The burden of this disease is unevenly distributed across geographic regions and subpopulations and may require different levels of local planning, support, and management. Addressing these disparities is crucial for effectively preventing and managing cardiovascular and cerebrovascular diseases in China.

BACKGROUND & AIMS:China is an endemic area for hepatitis E virus (HEV) infection. Estimating the prevalence and incidence of HEV infection in China plays a pivotal role in informing public health policies to prevent and control hepatitis E. This study aimed to investigate the prevalence of anti-HEV IgG and incidence of HEV seroconversion in China. METHODS:This study was based on the Meinian health check-up database in China. Participants who underwent testing for anti-HEV IgG at check-up centers in 24 provinces between 2017 and 2022 were included. In the cross-sectional analyses, overall prevalence and stratified prevalence in subpopulations with various characteristics were estimated and standardized according to the 2020 census of the Chinese population. In the longitudinal analyses, the occurrence of anti-HEV IgG positivity during the follow-up was defined as an incident HEV seroconversion. Overall and stratified incidence rates were estimated and expressed as per 100 person-years. Poisson regression was used to explore risk factors associated with HEV seroconversion. RESULTS:A total of 85,238 and 11,154 participants were included in the cross-sectional and longitudinal analyses, respectively. The prevalence of anti-HEV IgG in the general population was 18.02%. During a median follow-up of 1.2 years, the incidence rate of HEV seroconversion was 1.79 per 100 person-years. Age ≥60 years, low socioeconomic status, living in coastal areas, living in areas with high drainage density, and living in areas with high anti-HEV IgG prevalence were independent risk factors for HEV seroconversion. CONCLUSIONS:Our findings would help inform policymaking for hepatitis E prevention and control in China as well as in other endemic regions of the world.

The high disease burden of type 2 diabetes seriously affects the quality of life of patients, and with the deep integration of the Internet and healthcare, the application of electronic tools and information technology to has become a trend for disease management. The aim of this study was to evaluate the effectiveness of different forms and durations of E-health interventions in achieving glycemic control in type 2 diabetes patients. PubMed, Embase, Cochrane, and Clinical Trials.gov were searched for randomized controlled trials reporting different forms of E-health intervention for glycemic control in type 2 diabetes patients, including comprehensive measures (CM), smartphone applications (SA), phone calls (PC), short message service (SMS), websites (W), wearable devices (WD), and usual care. The inclusion criteria were as follows: (1) adults (age≥18) with type 2 diabetes mellitus; (2) intervention period ≥1 month; (3) outcome HbA1c (%); and (4) randomized control of E-health based approaches. Cochrane tools were used to assess the risk of bias. R 4.1.2 was used to conduct the Bayesian network meta-analysis. A total of 88 studies with 13,972 type 2 diabetes patients were included. Compared to the usual care group, the SMS-based intervention was superior in reducing HbA1c levels (mean difference (MD)-0.56, 95% confidence interval (CI): -0.82 to -0.31), followed by SA (MD-0.45, 95% CI: -0.61 to -0.30), CM (MD-0.41, 95% CI: -0.57 to -0.25), W (MD-0.39, 95% CI: -0.60 to -0.18) and PC (MD-0.32, 95% CI: -0.50 to -0.14) (p < 0.05). Subgroup analysis revealed that intervention durations of ≤6 months were most effective. All type of E-health based approaches can improve glycemic control in patients with type 2 diabetes. SMS is a high-frequency, low-barrier technology that achieves the best effect in lowering HbA1c, with ≤6 months being the optimal intervention duration. Systematic review registration https://www.crd.york.ac.uk/prospero , identifier CRD42022299896.

Objective We aimed to estimate the trends in physical growth of preschool children in Beijing, and to explore gender and regional disparities. Methods A total of 6406 and 6196 children aged 3-6 years were extracted from 2005 and 2014 national physical fitness surveillance surveys in Beijing. Height and weight were directly measured and growth indicators were calculated using national reference standards. The trends in the prevalence were tested by t-test, chi-square test and generalized linear models. Results Compared to 2005, the stunting and underweight prevalence of boys and girls decreased in 2014（P＜0.05）, while the overweight prevalence increased（P＜0.05）. In 2005, children in rural area had higher prevalence of stunting, underweight and wasted than those in urban area 2005（P＜0.05）, but the differences disappeared in 2014. The prevalence of overweight for children in urban area was 4.5% higher than that for children in rural area in 2005（P＜0.01）, while, in 2014, the prevalence of the latter was 2.2% higher than the former（P＜0.05）. Interaction tests indicated that children in rural area had 1.59 times higher odds of being overweight than children in urban area in 2014 compared with 2005. Conclusion The stunting, underweight and wasted prevalence of preschool children significantly decreased in Beijing between 2005 to 2014. There have been physical growth disparities between regions, with children in rural area bearing higher overweight risks than those in urban area. Effective interventions are in dire need to promote early development.

目的 了解北京市3～7岁学龄前儿童营养不良和超重肥胖率的变化情况,评价城乡儿童生长发育趋势差异.方法 数据来源于北京市2000-2020年间5次国民体质监测,共计纳入31 117名3～6岁儿童,计算生长发育指标,采用x2检验和Cochran-Armitage趋势检验进行分析.结果 2000-2020年北京市学龄前儿童生长迟缓、低体重、消瘦率分别从 1.5％、1.4％、0.9％下降到0.6％、0.6％、0.8％,超重率、肥胖率从17.1％、4.8％上升到20.1％、9.6％.2020 年城乡男女童生长迟缓率和低体重率均低于1％,2010年后农村男女童肥胖率超过城市男女童,2014年后农村男女童超重率超过城市男女童.趋势检验显示2000-2020年农村儿童营养不良率下降(生长迟缓、低体重P＜0.001),超重、肥胖率上升(P＜0.001);城市女童呈两极化趋势,消瘦率上升(Z=2.426,P=0.015),肥胖率也呈上升趋势(Z=3.405,P=0.001).结论 农村学龄前儿童营养不良率下降,超重肥胖率持续增高反超城市儿童,需要有效的营养政策和健康战略应对儿童生长发育的城乡不平衡问题.