中华疾病控制杂志

Relationship between follow-up systolic blood pressure variability and the risk of all-cause mortality in Chinese elderly: a retrospective cohort study

XU Jiahao, WU Jun, YIN Mingjuan, LIAO Shaobing, WU Liang, JING Wenyuan, TANG Xinming, NI Jindong

2024, 28(7): 745-752. doi: 10.16462/j.cnki.zhjbkz.2024.07.001

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Objective To investigate the relationship between follow-up systolic blood pressure variability (SBPV) and the risk of all-cause mortality in older adults across China. Methods Based on the follow-up dataset of the 2008-2018 China longitudinal healthy longevity survey (CLHLS), older adults aged 65 years or older with three consecutive times of recorded systolic blood pressure (SBP) and followed up until 2018 were selected as study subjects. A Cox regression analysis model was used to analyze the relationship between follow-up SBPV and all-cause mortality in older adults; analyses were conducted by gender and age subgroups to assess the interaction of follow-up SBPV; and finally, restricted cubic spline (RCS) was added to the model to explore the dose-response relationship between the two. Results (1) A total of 2 582 older adults were enrolled, including 1 253 (48.5%) males with a median age of 78 (71, 86) years. A total of 739 (28.6%) older adults died during a mean follow-up period of 3.29 years. (2) After correcting for relevant confounders, there was a significant positive association between follow-up SBPV and the risk of all-cause mortality (P ＜ 0.05). (3) Subgroup analyses showed no effect modification of gender and age on the association between different follow-up SBPV levels and the risk of all-cause mortality (P_interaction≥0.100). (4) Restricted cubic spline results showed that the dose-response relationship between follow-up SBPV and the risk of all-cause mortality was consistent in both gender, with the risk of all-cause mortality increasing linearly with increasing follow-up SBPV. (P_{overall SBPV} ＜ 0.001, P_{non-linearity SBPV}>0.05). Among the different age subgroups, follow-up SBPV was positively and linearly associated with the risk of all-cause mortality among those aged ＜ 70 years, while there was no dose-response relationship between the two in the remaining age subgroups (＜ 70 years old: P_{overall SBPV} ＜ 0.001, P_{non-linearity SBPV}>0.05; remaining age groups: P_{overall SBPV}>0.05, P_{non-linearity SBPV}>0.05). Conclusions Follow-up SBPV was significantly associated with the risk of all-cause mortality in the elderly in China, which was independent of mean follow-up systolic blood pressure. In addition to detecting systolic blood pressure in the elderly population, attention should be paid to fluctuations in systolic blood pressure since the long-term visit.

Impact of exercise frequency on self-care ability maintaining in older adults: a community-based cohort study

ZHU Ling, ZENG Jincai, WANG Ying, DU Zhicheng, ZHANG Wangjian, HAO Yuantao, YUAN Zhupei, GU Jing

2024, 28(7): 753-758. doi: 10.16462/j.cnki.zhjbkz.2024.07.002

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Objective To investigate the impact of exercise frequency on the maintenance of elderly individuals' self-care ability. Methods A cohort study was conducted in Nanyuan Community, Liwan District, Guangzhou, from 2012 to 2020. A total of 6 905 elderly individuals were enrolled in the baseline survey and followed up for the evaluation of their self-care ability. Among the 5 154 participants included in the analysis, a marginal structural Cox proportional hazards regression model was employed to assess the relationship between daily exercise frequency and the maintenance of self-care ability among the elderly. Results Over the past year, 48.58% of study subjects exercised daily. At the last follow-up, 4.2% of the elderly were unable to take care of themselves completely, and the median follow-up time was 3.63 years. After adjusting for confounding factors, compared to no exercise, occasional exercise and daily exercise reduced the risk of not maintaining self-care ability by 44.9% (HR=0.551, 95% CI: 0.432-0.701) and 39.9% (HR=0.601, 95% CI: 0.460-0.784), respectively. The stratified analysis found that neither occasional nor daily exercise was effective in reducing the risk of smokers not being able to sustain their independence. However, for non-smokers, occasional and daily exercise reduced the risk by 45.8% (HR=0.542, 95% CI: 0.419-0.702) and 39.7% (HR=0.603, 95% CI: 0.453-0.804), respectively. For alcohol consumers, neither occasional exercise nor consistent daily exercise can effectively reduce the risk of losing the ability to maintain self-care. However, the risks of not maintaining self-care ability were more significantly reduced by occasional and daily exercise among non-drinkers, with reductions of 45.1%(HR=0.549, 95% CI: 0.429-0.704) and 39.4% (HR=0.606, 95% CI: 0.459-0.800), respectively. Conclusions Exercise can help elderly individuals maintain their self-care ability. Alcohol consumption among the elderly can attenuate the positive effects of physical exercise on maintaining self-care ability. It is recommended that elderly individuals reduce or abstain from alcohol consumption and adopt scientific exercise methods.

The influence of physical activity on the degenerative changes in muscle strength of the upper and lower limbs in elderly individuals

LU Gang, TAN Meitao, MA Jinxiang

2024, 28(7): 759-763. doi: 10.16462/j.cnki.zhjbkz.2024.07.003

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Objective This study seeks to investigate the impact of physical activity on degenerative changes in the upper and lower limbs of older adults. Methods Based on the China health and retirement longitudinal study (CHARLS) 2015 dataset. The upper and lower limb muscle strength and physical activity were measured in older adults with grip strength, sit-to-stand test, and international physical activity questionnaire (IPAQ). The multivariate linear regression analyses are used to explore the mediating and moderating effects of physical activity on degenerative changes in muscle strength. Results A total of 2 808 individuals aged 60 years and above were included in this study, 1 446 (51.50%) were males and 1 362 (48.50%) were females. A total of 658 individuals (23.43%) were identified as having insufficient physical activity. Physical activity attenuated the degenerative changes in upper and lower limb muscle strength, playing a partially mediating role, with mediating effects accounting for 4.55% (95% CI: 2.31%-7.00%, P＜0.001), and 6.90% (95% CI: 4.48%-10.00%, P ＜ 0.001) of the effect, respectively. Physical activity failed to moderate degenerative changes in upper limb muscle strength (age×physical activity: β=0.421, P > 0.05) but moderated degenerative changes in lower limb muscle strength (age×physical activity: β=-0.375, P ＜ 0.01). Conclusions Physical activity partially mediates age-induced degenerative changes in upper and lower limb muscle strength and high levels of physical activity mitigate the process of degenerative changes in lower limb muscle strength.

Joinpoint regression and age-period-cohort analysis of mortality trends of cardiovascular disease attributable to kidney dysfunction in China

ZHANG Yue, ZHANG Yingying, DING Ling, WU Jinyi, LEI Lijian

2024, 28(7): 764-769. doi: 10.16462/j.cnki.zhjbkz.2024.07.004

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Objective To analyze the long-term trends and effects of age, period and cohort on cardiovascular disease mortality attributed to kidney dysfunction (KI-CVD) in China from 1990 to 2019. Methods Data on the absolute number, crude death rate (CDR) and age-standardized mortality (ASDR) for KI-CVD in China were collected from global burden of disease study 2019. The annual percentage change (APC) and average annual percentage change (AAPC) were calculated to analyze the trends of CDR and ASDR by Joinpoint regression model. The age, period and cohort effects were estimated using an age-period-cohort model. Results The CDR of KI-CVD was generally increasing, from 12.65 per 100 000 in 1990 to 26.49 per 100 000 in 2019 (AAPC=3.35%, 95% CI: 3.06%-3.64%). ASDR showed a slight increase (AAPC=0.70%, 95% CI: 0.39%-1.00%). APC model analysis showed that from 1990 to 2019, age effect exhibited an upward trend with the increase of age. Period effect decreased first, then increased to steady and then decreased over time. Taking 2000-2004 as the reference group, the rate ratio of death was higher in 1990-1994, and lower in 2015-2019. Cohort effect showed an inverted "U" shape, with an upward trend in 1911-1939 cohort, peaking in 1931-1939 (RR=1.100, 95% CI: 1.046-1.158), then decreasing with the year of birth. Conclusions The CDR of KI-CVD in China is generally on the rise from 1990 to 2019 and the risk of death is affected by age, period and cohort effect.

A cohort study of the effect of cumulative exposure to LDL-C on cardiovascular disease among the uyghur population in southern Xinjiang

CHENG Jing, MA Rulin, HE Jia, RUI Dongsheng, LI Yu, ZHANG Xianghui, JIAN Leyao, LI Jiahang, GUO Shuxia, GUO Heng

2024, 28(7): 770-776. doi: 10.16462/j.cnki.zhjbkz.2024.07.005

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Objective To explore the effect of cumulative exposure to low-density lipoprotein cholesterol (LDL-C) on cardiovascular disease (CVD) among the Uyghur population in southern Xinjiang. Methods We recruited 2 950 Uyghurs from the 51st Corps of the 3rd division of Xinjiang Production and Construction Corps, who had measured LDL-C at least three times during the 2016-2022 survey period, and two adjacent measurement intervals ≥2 years. Cumulative LDL-C (cumLDL-C) exposure was calculated by the weighted sum of LDL-C measured value for each time interval (value × time). Participants were grouped according to the cumLDL-C tertiles. The Log-rank test was used to compare the differences in the cumulative incidence of CVD among the groups. Cox proportional hazard regression models were used to estimate the effect of cumLDL-C on CVD. Results During the follow-up period, 322(10.92%) CVD events occurred. The cumulative incidence of CVD from the first to third tertile group of cumLDL-C was 7.12%, 11.08%, and 14.55%, respectively ($ \begin{equation}\chi^2\end{equation}$=27.440, P ＜ 0.001). Cox proportional hazards model showed that after adjusting for multiple confounders, the risk of CVD in the third tertile of cumLDL-C compared with the first tertile was 1.51 times higher (HR=1.51, 95% CI: 1.12-2.06). Each standard deviation increase in cumLDL-C was associated with a 14% increased risk of CVD (HR=1.14, 95% CI: 1.01-1.28). Conclusions In the Uyghur population in southern Xinjiang, cumulative exposure to high LDL-C is an independent risk factor for CVD, and maintaining low LDL-C levels for a long period of time can help reduce the risk of CVD in this population.

A prospective cohort study on the long-term fasting plasma glucose variability and risk of stroke among patients with type 2 diabetes mellitus

GU Shujun, QIN Yu, YU Hao, GUAN Haoyu, CUI Lan, SHEN Chong, LU Yan, CHENG Tingting, ZHANG Ning, ZHOU Jinyi, SU Jian

2024, 28(7): 777-783. doi: 10.16462/j.cnki.zhjbkz.2024.07.006

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Objective To investigate the association between long-term fasting plasma glucose (FPG) variability and stroke in patients with type 2 diabetes mellitus (T2DM). Methods The participants were from a community-based diabetes cohort established in Changshu from 2013 to 2014 (n=6 247). Long-term glucose variability was assessed using the standard deviation (SD), coefficient of variation (CV), average real variability (ARV), and variability independent of the mean (VIM) across FPG measurements obtained at the more than three visits. The risk of stroke in patients with T2DM was estimated using Cox proportional risk regression models for SD, CV, ARV, VIM and stratified analysis were conducted according to age, gender and history of diabetes medication. Results After an average 7.26 years of follow-up, there were 1 080 incident cases of stroke, giving a crude incidence rate of 23.81/1 000 person-years. The long-term fasting plasma glucose variability was grouped by tertiles (T1-T3). After adjustment, Cox regression analysis showed that compared with the T1 group, FPG-SD, FPG-CV, FPG-ARV and FPG-VIM in T2 and T3 groups were significantly increased the risks of stroke (P_trend ＜ 0.01). Per 1 standard deviation(SD) higher of FPG-SD, FPG-CV, FPG-ARV and FPG-VIM, the risk of stroke was significantly increased, the HR (95% CI) were 1.09(1.02-1.16), 1.09(1.03-1.16), 1.08(1.02-1.16) and 1.10(1.03-1.16) respectively. Per 1 SD higher of FPG-SD, FPG-CV, FPG-ARV and FPG-VIM, the risk of ischemic stroke was significantly increased, the HR (95% CI) were 1.11(1.03-1.19), 1.11(1.04-1.18), 1.08(1.00-1.15), 1.04(1.04-1.17), respectively. Per 1 SD higher of FPG-ARV, the risk of hemorrhagic stroke was significantly increased, the HR(95% CI) was 1.25(1.05-1.48). Stratified analysis showed that in the patients of ≥65 years of age (except FPG-CV), women and oral hypoglycemic agents, per 1 SD higher of FPG-SD, FPG-CV, FPG-ARV and FPG-VIM, the risk of ischemic stroke increased significantly (P ＜ 0.05). Conclusions Long-term FPG glycemic variability is positively associated with the risk of stroke in type 2 diabetes patients.

The prevalence and influencing factors of dyslipidemia in aged 35-<75 years Zhuang minority adults in Guangxi

JIANG Yu, ZENG Xiaoyun, SU Li, LIU Shun, XIE Yihong, QIU Xiaoqiang, HUANG Dongping

2024, 28(7): 784-790. doi: 10.16462/j.cnki.zhjbkz.2024.07.007

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Objective To investigate the prevalence and influencing factors of dyslipidemia in Zhuang minority adults aged 35- < 75 years in Guangxi, providing scientific evidences for the prevention and control of cardiovascular and cerebrovascular diseases. Methods A structure questionnaire, physical examination and blood biochemical test were conducted based on the Guangxi minority population cohort. Factor analysis was used to explore the dietary patterns and the logistic regression analysis model was used to explore the influencing factors. Results A total of 11 175 subjects were included, the median age was 55.00(47.00, 64.00) years, 45.30% were males, 85.70% were rural residents, and the prevalence of dyslipidemia was 30.26%. After adjusted for the gender, age, and occupation, smoking (OR=1.47, 95% CI: 1.37-1.61), overweight (OR=1.43, 95% CI: 1.28-1.59), obesity (OR=1.78, 95% CI: 1.52-2.09), abdominal obesity (OR=1.78, 95% CI: 1.59-1.99), no hypertension history but being detected as high blood pressure in this study (OR=1.22, 95% CI: 1.10-1.35), ever diagnosed as hypertension but currently without medication (OR=1.29, 95% CI: 1.12-1.48), hyperuricemia (OR=1.82, 95% CI: 1.63-2.04), detected as hyperglycemia and ever diagnosed as diabetes were risk factors of dyslipidemia; while as a protective factor (OR=0.47, 95% CI: 0.37-0.61). Conclusions The prevalence of dyslipidemia in Zhuang minority adults was high. Smoking cessation, weight control, etc. should be focused on the health education. The blood aged 35- < 75 years lipid monitoring and control should be strengthened in those overweight, obesity, hypertension, hyperglycemia and hyperuricemia population.

The impact of inhalable particulate matter exposure on daily mortality among residents in five typical cities in Inner Mongolia

WEI Nana, YANG Shengmei, ZHANG Xiangnan, ZHANG Chenguang, LI Jing, LI Li, YIN Minghui, FAN Yaochun, QIN Yuhan

2024, 28(7): 791-797. doi: 10.16462/j.cnki.zhjbkz.2024.07.008

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Objective To investigate the influence of exposure to inhalable particulate matter (PM₁₀) on daily mortality among residents in five representative cities in central and western Inner Mongolia, and dentify sensitive populations and provide a basis for relevant departments to formulate air pollution prevention measures. Methods We collected daily meteorological data, air pollutant concentrations, and resident mortality data from five typical urban areas in Inner Mongolia from 2017 to 2021. Using a two-stage statistical analysis strategy (generalized additive model combined with meta-analysis), we constructed a time series model while controlling for confounding factors such as meteorological conditions and temporal trends. We assessed the effects of short-term exposure to atmospheric PM₁₀ on population mortality. Results During the research period, the daily average concentration of PM₁₀ in the atmosphere of five typical cities was (89.9±98.2) μg/m³, with a total of 126 401 deaths among residents. Meta analysis showed that for every increase in PM₁₀ (lag0-2) exposure concentration 10 μg/m³, the non-accidental total mortality, male, female, and circulatory system disease mortality increased by 0.16%(95% CI: 0.01%-0.36%), 0.13% (95% CI: 0.01%-0.25%), 0.23% (95% CI: 0.09%-0.37%) and 0.21% (95% CI: 0.08%-0.34%), respectively. Conclusions Short-term exposure to atmospheric particulate matter PM₁₀ in five typical cities in Inner Mongolia increases the risk of non-accidental total mortality and cardiovascular disease mortality among local residents. Women are more sensitive than men. The effect values vary slightly in different regions.

Analysis of influencing factors of microbial aerosol concentration in centralized air conditioning and ventilation system of subway platforms

ZHENG Yi, LI Houcheng, PENG Zihao, CAI Jing, YANG Jun, HE Na

2024, 28(7): 798-807. doi: 10.16462/j.cnki.zhjbkz.2024.07.009

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Objective To characterize the microbial aerosols in the centralized air conditioning and ventilation system of urban subway stations, and to explore the influencing factors of microbial aerosol concentration in the centralized air conditioning and ventilation system of subway stations in mega cities, and conduct analysis on fungal aerosol concentration and related influencing factors. Methods Applying random sampling strategy, this study selected 120 subway stations across 15 subway lines in a mega city. For each station, Andersen stage impactors were used to collect aerosol samples, covering 6 particle size segments (≥7.00 μm, 4.70- < 7.00 μm, 3.30- < 4.70 μm, 2.10- < 3.30 μm, 1.10- < 2.10 μm, 0.65- < 1.10 μm). The concentration of bacterial and fungal aerosols was detected using culture method. Spearman rank correlation analysis, Mann Whitney U test, and Kruskal Wallis test were conducted to identify the potential influencing factors of microbial aerosol concentration. Results The median concentrations (interquartile range, IQR) of bacterial and fungal aerosols in the centralized air conditioning and ventilation system were 163 (148) CFU/m³ and 346 (205) CFU/m³, respectively. The results of the Spearman rank correlation analysis indicated that the correlation between different influencing factors and microbial aerosol concentration varied. For instance, we found a significant positive correlation of temperature with total bacteria aerosol concentration (r=0.22, P < 0.001) and total fungal aerosol concentration (r=0.17, P < 0.001). Inhalable particulate matter (PM₁₀) mass concentration was significantly and positively correlated with total bacterial aerosol concentration (r=0.10, P < 0.05); however, its correlation with total fungal aerosol concentration was weak and did not reach statistical significance (r=0.06, P > 0.05). The results of Spearman rank correlation analysis showed that factors such as station type, platform opening year, season, and meteorological conditions might significantly affect the microbial aerosol concentration of the station′s centralized air conditioning and ventilation system. Conclusions Temperature, relative humidity, PM₁₀ mass concentration, cleaning interval, number of people passing through during sampling, station type, meteorological conditions may significantly affect the microbial aerosol concentration in the centralized air conditioning and ventilation system of subway stations. In the future, it is urgent to pay attention to these factors. Our findings may support the microbial risk prevention and control for subway stations.

Construction of a multilocus map of single nucleotide polymorphisms in pneumoconiosis susceptibility genes

ZHU Fenglin, WANG Shuguang, JIN Yuting, CHEN Yiran, LIU Xinyu, YE Dongqing, WANG Jia

2024, 28(7): 808-814. doi: 10.16462/j.cnki.zhjbkz.2024.07.010

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Objective To construct a single nucleotide polymorphisms (SNPs) multilocus map of pneumoconiosis susceptibility genes. Methods Based on RFLP technology, we integrated the reported SNPs of susceptibility genes, and designed different amplification fragments and digestion fragments which cover several different susceptibility gene locus. Then the multiple bands of different lengths obtained by agarose gel electrophoresis were used to identify the genetic typing rapidly. In addition, the cohort of coal workers′ pneumoconiosis(CWP) and dust receiving population in a mining area in northern Shaanxi was used for detection, and the genetic differentiation of different polymorphic loci of susceptible genes in the cohort was analyzed by fixation index (Fst). Results The SNPs of five susceptible genes were successfully constructed, which included IL-1β rs16944 T>C, IL-6 rs1800796 G>C, IL-8 rs4073 A>T, HSP70-1 rs562047 C>G, TGF-β rs1800469 T>C. These SNPs genotypes can be identified effectively. Fst analysis showed that the Fst of IL-1β rs16944 and TGF-β rs1800469 was > 0.05-0.15, indicating that, moderate genetic differentiation occurred. Conclusions The susceptibility loci rs16944 and rs1800469 were more susceptible to disease selection pressure, which was related to the susceptibility risk of pneumoconiosis.

Study on the status and influence factors of depression, anxiety and insomnia among rural residents in Hubei Province

DU Bingxue, ZHANG Ling, ZHU Changcai, WANG Lei, LI Dan

2024, 28(7): 815-820. doi: 10.16462/j.cnki.zhjbkz.2024.07.011

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Objective To investigate the prevalence and influence factors of depression, anxiety, and insomnia among rural residents in Hubei Province, and to provide scientific basis for taking targeted intervention measures. Methods A cross-sectional study was conducted between October 2021 and February 2022 using multi-stage random sampling method. We used the patient health questionnaire (PHQ-9), generalized anxiety disorder scale (GAD-7), and insomnia severity index (ISI) to effectively screen 7 212 rural residents from 25 counties (cities) in Hubei Province for the prevalence of depression, anxiety, and insomnia. Multifactor logistic regression analysis model was used to analyze the factors associated with depression, anxiety, and insomnia. Results The screen-positive rates of depression, anxiety and insomnia were 3.6% (95% CI: 3.1%-4.0%), 2.3% (95% CI: 2.0%-2.7%) and 14.8% (95% CI: 14.0%-15.7%), respectively. Multivariate logistic regression analysis model showed that chronic disease, poor health and living outside Wuhan were common risk factors for depression and anxiety among rural residents in Hubei Province. The OR (95% CI) of chronic diseases for depression and anxiety were 2.8 (2.0-4.0) and 1.8 (1.2-1.7), respectively; the OR (95% CI) of poor health was 4.5 (3.4-5.9) and 4.5 (3.2-6.3), respectively; the OR (95% CI) of people living outside Wuhan was 3.1 (2.1-4.7) and 2.0 (1.3-3.0), respectively. Chronic illness, poor health, female and non-married status were identified as risk factors for insomnia, with an OR (95% CI) of 2.4 (2.0-2.8), 2.9 (2.5-3.4), 1.5 (1.3-1.7), and 1.3 (1.1-1.5), respectively. Conclusions Rural residents in Hubei Province have a certain degree of depression, anxiety, and insomnia. Psychological interventions aimed at individuals with chronic diseases, poor health status, female gender, and unmarried status need to be strengthened to promote the physical and mental health of rural residents.

The moderating effect of nature connectedness on cyberbullying victimization and suicide ideation among university students

LI Yongzhan

2024, 28(7): 821-826. doi: 10.16462/j.cnki.zhjbkz.2024.07.012

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Objective To explore the moderating effect of nature connectedness on the relationship between cyberbullying victimization and suicide ideation among college students, so as to provide reference for intervening college students′ cyberbullying and suicide. Methods A stratified cluster of 1 568 college students from 7 universities in Henan Province were randomly selected; a questionnaire survey was conducted using the general situation questionnaire, cyber bullying behavior scale, Beck suicide ideation scale and nature connectedness scale. SPSS 23.0 software was used to enter data and perform statistical analysis, and Pearson correlation analysis was used to investigate the correlation between variables. A multivariate logistic regression analysis model was used to test the moderating effect to explore the main effects and interactions between cyberbullying victmization and nature connectedness on suicide ideation. Results The scores of cyberbullying victimization of college students were significantly different in gender, grade, place of origin, class leader or not (all P < 0.05). The report rate of suicide ideation among college students was 7.21%, with statistically significant differences observed across cyberbullying victimization or not, gender, and grade (all P < 0.05). Cyberbullying victimization was positively correlated with suicide ideation (r=0.45, P < 0.001), while nature connectedness was negatively correlated with suicide ideation (r=-0.38, P < 0.001). Nature connectedness moderated the relationship between cyberbullying victimization and suicide ideation (OR=1.33, 95% CI: 1.06-1.77, P < 0.001). Conclusions Suicide ideation among college students is closely related to cyberbullying victimization and nature connectedness. Family, school, and society can intervene in cyberbullying and suicide ideation among college students by improving their nature connectedness.

Mendelian randomization study on the causal relationship between interleukins and pulmonary tuberculosis

WANG Xingbin, ZHAO Changming, HUANG Qiuli, WANG Ling, ZHANG Yaxin, YANG Dejie, WANG Zhaofen

2024, 28(7): 827-832. doi: 10.16462/j.cnki.zhjbkz.2024.07.013

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Objective This study aims to determine the causal association between multiple interleukin (IL) levels and the risk of tuberculosis by using a two-sample Mendelian randomization (MR) method. Methods The data on interleukins and tuberculosis were obtained from the the pooled data of three published genome-wide association studies(GWAS) accomplished in European populations. According to preset thresholds and requirements of linkage disequilibrium, the single nucleotide polymorphism(SNP) loci closely related to a variety of interleukins were extracted from the summarized data as instrumental variables, the causal effect of nine interleukin levels on the risk of tuberculosis was assessed by using inverse variance weighting (IVW), mr-egger regression, and weighted median estimation. At the same time, the horizontal pleiotropy and heterogeneity were tested to ensure the stability of the results, and the directional test was used to check reverse causality effect. Results According to the IVW results, there were no causal relationships among interleukins of IL-1RA, IL-2RA, IL-6, IL-6RA, IL-8, IL-17, IL-18 and pulmonary tuberculosis (P>0.05). Higher levels of IL-16 were correlated with an increased risk of tuberculosis (OR=1.210, 95% CI: 1.032-1.419, P=0.019, P_adjusted=0.086). In contrast, rised IL-27 levels suggested a lower risk of tuberculosis (OR=0.875, 95% CI: 0.788-0.97, P=0.011, P_adjusted=0.086). These findings remained robust and consistent across all three MR testing methods with no reverse causality. Conclusions No causal relationship has been found among interleukins of IL-1RA, IL-2RA, IL-6, IL-6RA, IL-8, IL-17, IL-18 and pulmonary tuberculosis. Higher IL-16 levels are linked to an increased risk of developing tuberculosis, while the increase in IL-27 levels is associated with a decreased risk of pulmonary tuberculosis.

Survival analysis of MSM with HIV/AIDS in China from 2010 to 2021

GUAN Mingyue, JIN Yichen, CAI Chang, CHEN Fangfang, QIN Qianqian, TANG Houlin

2024, 28(7): 833-838. doi: 10.16462/j.cnki.zhjbkz.2024.07.014

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Objective To understand the survival and influencing factors of MSM (men who have sex with men) with HIV/AIDS in China from 2010 to 2021, in order to provide reference for effective AIDS prevention and control in the MSM population. Methods The data were obtained from the China disease control and prevention information system. Retrospective cohort study was used to calculate the mortality density of the patients. Cumulative survival of patients was analyzed, and Cox proportion hazards regression model was performed to assess the risk factors for patient deaths. Results Between 2010 and 2021, 309 964 MSM with HIV/AIDS were reported with 20 371 deaths, and the all-cause mortality density was 1.47 per 100 person-years. The mean survival time of the patients was 10.21 (95% CI: 10.204-10.225) years, and the cumulative survival rates in 1, 5, and 10 years were 96.56 %, 93.06 %, and 88.73 %. The results of multivariate Cox proportional risk regression model showed that patients with confirmed age≥60 years were 4.022 (95% CI: 3.792-4.266) times the risk of death of patients aged 15- < 30 years. Compared with patients with first CD4⁺T-lymphocytes >500 copies/μL, the risk of death for patients with first CD4⁺T-lymphocytes undetected and first CD4⁺T-lymphocytes < 200 copies/μL was 7.072(95% CI: 6.696-7.470) times and 3.842(95% CI: 3.657-4.036) times respectively. Patients who did not receive ART had a 14.400(95% CI: 13.881-14.939) times greater risk of death than those who did receive ART. Conclusions Older age at confirmation, first CD4⁺T-lymphocytes undetected or first CD4⁺T-lymphocytes < 200 copies/μL, and not receiving ART are the main risk factors for death of MSM with HIV/AIDS in China, and early detection, diagnosis, and treatment of MSM need to be strengthened. At the same time, focus needs to be placed on the detection and treatment of elderly MSM, to further reduce the risk of death of MSM with HIV/AIDS.

Analysis of the role of public health security based on China ′s overall national security concept

PENG Ziyi, HUANG Zhongyue, MENG Yueli, DU Shuai, QIU Wuqi, MAO Ayan

2024, 28(7): 839-843. doi: 10.16462/j.cnki.zhjbkz.2024.07.015

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In recent years, the spread of public health security threats has become increasingly obvious, which has a profound impact on people′s lives and health, social stability, and economic security, and constantly promotes public health security to become an important part of national security. Based on the combing of the concepts and characteristics of national security, this study summarizes and analyzes the connotation of public health security and its role and influence on national security from the perspective of the overall national security concept, to provide a reference for China to deal with public health security problems and improve public health security guarantee ability.

Hotspot mining of public health science and technology policies and identification and analysis of frontier themes in fund projects

LIN Huangtao, LI Yuexin, ZHU Rui, WEN Mingyue, ZHU Quanrong, JIA Jinzhong

2024, 28(7): 844-855. doi: 10.16462/j.cnki.zhjbkz.2024.07.016

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Objective From the perspective of policy and fund projects, this paper explors and excavates policy hotspots and cutting-edge topics in the field of public health science research. Understand the distribution of fund project themes under different policy orientations, sort out key research areas of public health, and provide empirical basis and scientific reference for relevant management and decision-making departments. Methods Using the BTM topic word model, combined with indicators such as topic intensity and topic novelty, theme analysis and text mining were conducted on the text data of science and technology policies in the field of public health and National Natural Science Foundation projects from 1990 to 2019. Results A total of 8 policy themes in the field of public health were excavated, among which the most popular policy themes include "Environmental factors and public health and safety guarantee" and "Grassroots health services". A total of 26 research topics from public health fund projects were identified, including 6 cutting-edge hot topics, with the highest intensity being "susceptibility to chronic disease genes". There is a distribution of research topics for funding projects in various public health science and technology policy themes. Except for the policy theme of "Biological Foundations of Human Health and Diseases", other policy themes have a distribution of cutting-edge topics of funding project hotspots. The number of fund projects related to research directions in the policy theme of "grassroots health services" is relatively small. Conclusions The goal orientation of public health policy science and technology themes is reflected in fund projects, with the key being demand driven, breaking through bottlenecks. The condensed scientific questions stem from social needs. From the perspective of fund project management, we must adhere to the two legged approach of public health science and technology policy goal orientation and scientific freedom exploration, strengthen the deployment of disciplinary systems, enhance original innovation capabilities, and serve national needs.

Effect of lead exposure on thyroid hormone levels in occupationally exposed populations: a Meta-analysis

PENG Xiaokun, HAN Junyu, JING Nan, YANG Qianlei, ZHANG Hengdong, AN Yan

2024, 28(7): 856-863. doi: 10.16462/j.cnki.zhjbkz.2024.07.017

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Abstract:
Objective Meta-analysis was used to explore the relationship between blood lead levels and thyroid hormone (TH) levels in people with occupational lead exposure. Methods Meta-analysis was performed using Stata14.0. Chinese and English databases, including CNKI, Wanfang Data Knowledge Service Platform, Chinese Science and Technology Journal Database, PubMed, Web of Science were searched. Cross-sectional studies on the relationship between lead exposure and thyroid hormone levels published from the databases establishment to October 2022 were collected. Results A total of 14 literatures were included for analysis. The results showed that compared with control population, the blood lead level was higher in people with occupational lead exposure. There was no statistical significance (all P > 0.05) in the average concentrations of thyroid stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free triiodothyronine (FT4) and free thyroxine (FT4) between the two groups. When the blood lead level in the exposed group was higher than 200 μg/L, the TSH level increased, and the difference between the exposed group and the control group was statistically significant (P < 0.05). Conclusions High blood lead level is associated with elevated TSH level in people with occupational lead exposure.

Screening and quantitative assessment of drought-sensitive intestinal infectious diseases in Changsha from 2016 to 2020

WANG Xuanshu, ZHOU Huilin, LI Min, KUANG Wentao, LUO Piaoyi, ZHAO Wan, WU Qiping, HONG Huilin, ZHAO Jin, ZHA Wenting, YANG Xuewen

2024, 28(7): 864-868. doi: 10.16462/j.cnki.zhjbkz.2024.07.018

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Objective To analyze the occurrence of drought events and the epidemic characteristics of intestinal infectious diseases in Changsha from 2016 to 2020, and the impact of drought on intestinal infectious diseases was evaluated at a multiple scale, so as to provide a basis for formulating scientific prevention and control plans for the prevention of intestinal infectious diseases during drought. Methods The data of the incidence of enteric infectious diseases and meteorological data during the period from 2016 to 2020 in Changsha were collected. The Wilcoxon rank sum test was used to compare the changes in the daily incidence of intestinal infectious diseases, and to determine the sensitivity of drought related intestinal infectious diseases. The cross-correlation function was used to preliminarily analyze the optimal lag period of the incidence of intestinal infectious diseases. A distributed lag nonlinear model based on time series was established to compare and analyze the effects of different levels of drought on the incidence of intestinal infectious diseases at different lag days. es between non-drought days and drought days (Z=-2.108, P=0.035). Correlation analysis revealed that the correlation coefficients between drought events and OID reached their peak on the third day (r=0.261). The distributed lag non-linear model indicated that the daily risk of infectious diarrhea diseases (IDD) was highest on the second day (RR=1.034, 95% CI: 0.971-1.101), while the cumulative risk peaked on the 14th day (RR=1.032, 95% CI: 0.995-1.070), with a cumulative RR of 1.235 (95% CI: 1.091-1.398) from day 0 to day 14, respectively. The 2Dcontour plots demonstrated that the risk of onset and the duration of effects increased with higher drought severity. Conclusions Other infectious diarrhea is a drought sensitive intestinal infectious disease in Changsha. The risk of OID increased with the increase of drought severity, and the impact of severe drought last the longest.

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Editor

Editor-in-Chief Ye Dongqing M.D.

Assistant editor Fan Yinguang M.D.

Assistant editor Pan Haifeng M.D.

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