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CN 34-1304/R ISSN 1674-3679

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2025 Vol. 29, No. 5

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Original Articles
Assessment of cadmium pollution levels and health risks of rice in typical regions of China
LI Kexin, ZHANG Yi, CHEN Yue, WANG Xiaochen, QU Yingli, DONG Peipei, LI Zheng, WU Bing, WEI Yuan, ZHANG Wenli, YANG Zhengxiong, DONG Xiaojie, HAO Ruiting, YE Xiu, ZHU Ying, XU Dongqun, LYU Yuebin, MAO Chen, SHI Xiaoming
2025, 29(5): 497-504. doi: 10.16462/j.cnki.zhjbkz.2025.05.001
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  Objective   To explore cadmium levels in rice in some parts of China and assess the health risks.   Methods   Selecting 12 districts and counties from four typical regions in our country, 1 195 rice samples were randomly selected to describe the cadmium levels of rice. The pollution degree of rice cadmium was classified, and the daily rice intake of the local population was investigated. Using the health risk assessment model recommended by the US Environmental Protection Agency, the health risks of rice cadmium in the four surveyed regions were evaluated. The hazard quotient and carcinogenic risk index were calculated, and the non-carcinogenic and carcinogenic risks of rice cadmium exposure were evaluated for health assessment.   Results   The geometric mean of cadmium content in rice samples from four typical regions was 0.06 mg/kg, which was lower than the cadmium limit for rice. The overall over-limit rate was 17.9%. Among them, the geometric mean of cadmium content in rice from region C was the highest, at 0.13 mg/kg, followed by regions B and D. The geometric mean of cadmium content in rice from region A was the lowest. The over-limit rate of cadmium in rice from region B was the highest, with only 53.70% of the products being classified as safe. The over-limit rate of cadmium in rice samples from the surveyed region B was the lowest, at 0.30%. The analysis indicated that the non-carcinogenic risk of cadmium exposure from rice in the four regions was all within the acceptable level (HQ < 1.00). For the total population, the carcinogenic risk in the four regions was within the acceptable level. However, in regions with high cadmium pollution in rice, such as regions B-Ⅲ and C-Ⅲ, the carcinogenic risk values were 0.000 11 and 0.000 21 respectively, suggesting potential carcinogenic risks. For different genders, the overall carcinogenic risk value was higher in male respondents than in female respondents. In region C, there was a potential carcinogenic risk for overall males, while the risk for females was lower.   Conclusions   In the four surveyed areas, 17.9% of the rice samples exceeded the cadmium limit for rice. The high-cadmium-contaminated areas of rice may pose a carcinogenic risk. The non-carcinogenic risks of cadmium contamination in rice in the four areas are all within the acceptable range.
Analysis of the characteristics of influenza-like illness cases and the association with two types of atmospheric particulate matter, PM10 and PM2.5, in Jiangsu Province from 2018 to 2023
MA Yuhang, JIANG Xin, CHEN Ziying, DAI Qigang, LIU Zhihao, HU Jianli, PENG Zhihang
2025, 29(5): 505-511. doi: 10.16462/j.cnki.zhjbkz.2025.05.002
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  Objective   To examine the epidemiological patterns of influenza-like illness (ILI) in Jiangsu Province from 2018 to 2023, to assess the relationships between ILI in various population groups and inhalable particulate matter (PM10) and fine particulate matter (PM2.5), and to offer evidence to support influenza prevention and control strategies.   Methods   Based on ILI data collected from influenza surveillance sentinel hospitals in prefecture-level cities across Jiangsu Province between 2018 and 2023, the distribution and trends of ILI and the proportion of ILI cases (ILI%) were outlined. A combined nested model of the distributed lag non-linear model (DLNM) and the generalized additive model (GAM) was used to assess the impacts of PM2.5 and PM10 on ILI across various population groups.   Results   From 2018 to 2023, ILI distribution in Jiangsu Province showed significant variations across years and regions (P < 0.05). Clear positive correlations were found between ILI and both PM2.5 and PM10 (r=0.35, P < 0.05). Higher concentrations of PM2.5 and PM10 have significant pathogenic effects on ILI with different lag periods. At P75 and P95 concentrations, PM2.5 significantly raised the ILI risk in the general population with a lag of 0-1 weeks (RRmax=1.27, 95% CI: 1.00-1.62), whereas PM10 at P75 and P95 concentrations markedly increased the ILI risk with a lag of 0-7 weeks (RRmax=1.27, 95% CI: 1.02-1.57). The degree of ILI impact varied among population groups.   Conclusions   High concentrations of PM2.5 and PM10 present significant but differently delayed pathogenic risks for ILI: PM2.5 mainly has short-term (0-1 week lag) effects, while PM10 has long-term cumulative (0-7 week lag) effects. Monitoring changes in PM2.5 and PM10 concentrations is essential. During high pollution periods, efforts should be made to reduce population exposure, with attention to the lag effects of PM2.5 and PM10. Prompt health risk warnings should be issued, and special measures should be taken to protect people aged 0- < 15 years old.
Characteristics and trend analysis of influenza epidemic in China, 2004-2021
DENG Ping, JINAG Yuqi, LONG Jiang, ZHAO Jinhua, ZHANG Yang, QIN Shenglin
2025, 29(5): 512-518. doi: 10.16462/j.cnki.zhjbkz.2025.05.003
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  Objective   To analyze the morbidity and mortality of influenza (referred to as influenza) in China from 2004 to 2021 in stages, and to provide scientific basis for influenza prevention and control strategies.   Methods   The data were obtained from the annual morbidity and mortality data of influenza from the Public Health Science Data Center. Excel 2019 software was used to establish the influenza morbidity and mortality database. R 4.3.1 software was used to further analyze and process the data. And Joinpoint 5.0.2 software was used to analyze the annual change trend of influenza across China, in each province (city and autonomous region) and within each age group., and the annual trend of influenza in each age group.   Results   A total of 8 103 459 cases of influenza were reported in China from 2004 to 2021, with an average annual reported incidence rate of 32.45/100 000 and an average annual reported case-fatality rate of 8.82/100 000. The average annual percentage change was 14.55% (95% CI: 9.00%-22.78%, P < 0.001), with an overall increasing trend. The top 3 provinces in terms of average annual reported morbidity were Beijing, Zhejiang, and Guangdong; the top 3 provinces in terms of average annual reported mortality were Beijing, Tianjin, and Chongqing; and the top 3 provinces in terms of average annual reported morbidity and mortality were Xinjiang, Qinghai, and Shandong, with only two provinces, Hainan and Tibet, showing no fatal cases. Shanxi, Zhejiang, and Anhui had the greatest increase in annual incidence rates (all P < 0.05). The age group of 0- < 15 years old had the highest incidence of influenza, accounting for 67.40% of the total number of cases (5 462 111/8 103 459), and the age group with the highest annual average reported mortality rate and annual average reported case-fatality rate was the group of ≥85 years old, and the annual reported incidence rates of all age groups showed an increasing trend.   Conclusions   From 2004 to 2021, incidence rate of influenza in China showed an increasing (2004-2019) and then decreasing (2019-2021) trend, and all provinces (autonomous regions and municipalities directly under the central government), except Tianjin and Guizhou, showed an overall increasing trend. It is recommended that additional influenza reporting and surveillance sites be established in densely populated areas such as Beijing and Tianjin, and in cities that are not rich in healthcare resources, such as Xinjiang and Qinghai, to reduce the disparity of healthcare services between regions and to increase the proportion of influenza vaccination for children and the elderly.
Analysis of the epidemiological characteristics of notifiable infectious diseases in the population aged 60 years and above in China from 2004 to 2019
XU Die, LIU Youhong, LIU Meiya, DING Sijing, CHENG Ziyi, LIU Zheheng, WANG Long, GOU Faxiang
2025, 29(5): 519-526. doi: 10.16462/j.cnki.zhjbkz.2025.05.004
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  Objective   To analyze the long-term trend of notifiable infectious diseases among the population aged 60 years and above in China from 2004 to 2019, and to provide a reference for the prevention and control of notifiable infectious diseases in this population.   Methods   The Joinpoint regression model was used to analyze the trends of standardized incidence and fatality rates of notifiable infectious diseases in the elderly population aged 60 years and above in China from 2004 to 2019. Annual percent change and average annual percent change (AAPC) were used to analyze the total, gender, mode of transmission, pathogen type, Long-term trends in inclusion in national immunization programmes and by communicable disease.   Results   The standardized incidence and fatality rates of notifiable infectious diseases among the elderly population in China from 2004 to 2019 showed an AAPC of 2.03% and 8.22%, respectively (all P < 0.05). Among these, the top five diseases with increasing standardized incidence rates were dengue, influenza, HIV, hand- foot- mouth disease, and syphilis. The AAPC for standardized incidence rates of diseases transmitted through blood/sexual contact was 17.33%, and the AAPC for viral pathogens was 7.58% (all P < 0.05). Among these, only the standardized fatality rate of HIV showed an increasing trend.   Conclusions   From 2004 to 2019, the standardized incidence and fatality rates of notifiable infectious diseases in the elderly population in China have shown an overall upward trend, especially for viral and blood/sexually transmitted infectious diseases, which have increased rapidly. Targeted prevention and control measures for notifiable infectious diseases should be developed for the elderly population.
Spatiotemporal patterns and epidemiological trends of scarlet fever epidemic in Yunnan Province from 2014 to 2023
LI Xiaojuan, WANG Shilian, SU Jianjuan, CUI Fengling, CHEN Jingwen, ZHANG Jingwen, XU Guo, HONG Rudan, DENG Shuzhen
2025, 29(5): 527-535. doi: 10.16462/j.cnki.zhjbkz.2025.05.005
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  Objective   To analyze the epidemiological trend and distribution characteristics of scarlet fever in Yunnan Province from 2014 to 2023, and to provide scientific basis for scarlet fever prevention and control strategies.   Methods   Joinpoint regression analysis was used to calculate the annual percentage of change. And spatial autocorrelation and spatio-temporal aggregation analysis were used to explore the spatial and temporal distribution characteristics of scarlet fever in Yunnan Province.   Results   A total of 18 210 cases of scarlet fever were reported in Yunnan Province from 2014 to 2023, with an average annual incidence of 3.88/100 000. The incidence of scarlet fever in Yunnan Province showed a wave upward trend in the past 10 years. The incidence of male was higher than that of female. The age group with the highest incidence was 5- < 10 years old (52.3%), followed by 0- < 5 years old (37.3%). 97.7 % of the cases were concentrated in preschool children (43.4%), students (31.9%) and scattered children (22.5%). The incidence of scarlet fever had obvious seasonality (M=0.526-1.308), with a bimodal distribution every year, concentrated in May-June and November-December. The top three areas with the highest average annual incidence were Lijiang City (11.07/100 000), Yuxi City (7.61/100 000) and Dali Bai Autonomous Prefecture (6.43/100 000). The results of spatio-temporal scanning analysis showed that there were five clustering areas of scarlet fever in Yunnan Province from 2014 to 2023. The clustering areas were mainly concentrated in Lijiang City and Dali Prefecture in northwest Yunnan, Honghe Prefecture, Yuxi City and Pu ′er City in south and southwest Yunnan, Wenshan Prefecture, Qujing City in east Yunnan and some areas of Zhaotong City in northeast Yunnan. There was no global spatial autocorrelation in the incidence of scarlet fever in Yunnan Province from 2014 to 2023 (all P>0.05). The local autocorrelation analysis showed that the high-high clustering areas were mainly concentrated in Ninglang County and Lanping County of Lijiang City, Yongping County of Dali Prefecture, Yimen County and Eshan County of Yuxi City, Shizong County of Qujing City and Luquan County of Kunming City in the northwest of Yunnan Province. The low-low aggregation areas are mainly concentrated in Lincang City, Dali Prefecture, Chuxiong Prefecture, part of Pu′er City, part of Diqing Prefecture in Northwest Yunnan, part of Qujing City in East Yunnan, and part of Kunming City in Central Yunnan.   Conclusions   Scarlet fever in Yunnan Province showed an upward trend. Kindergarten children and students are the high-risk groups of the disease. The incidence of scarlet fever in Yunnan Province has spatial clustering characteristics. We should pay close attention to the changes of epidemic trends and strengthen the monitoring of cases in high-risk areas and High-risk groups.
Epidemiological characteristics and incidence prediction of tuberculosis in Tianjin from 2017 to 2022
LI Wen, GAO Ying, ZHANG Guoqin, SHEN Yuzhen, WANG Yuan
2025, 29(5): 536-541. doi: 10.16462/j.cnki.zhjbkz.2025.05.006
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  Objective   To analyze the incidence trends of tuberculosis (TB) in Tianjin from 2017 to 2022, and to provide a basis for TB prevention and control.   Methods   Monthly TB data in Tianjin from 2017 to 2023 were collected. An autoregressive integrated moving average (ARIMA) model was built with R 4.2.2 software, validated with 2023 data, and used to predict 2025 incidence.   Results   From 2017 to 2022, Tianjin reported 22 342 new TB cases, with the annual incidence declining from 26.20 per 100 000 in 2017 to 24.29 per 100 000 in 2022 (P>0.05). The incidence showed seasonal fluctuations, slightly increase in March and November. The highest rates were in the four urban districts (29.97 per 100 000) and individuals aged 80 and older (64.72 per 100 000); males had a higher incidence (30.33 per 100 000) than females (18.53 per 100 000) (χ2 =1 257.246, P < 0.001). The optimal ARIMA(1, 1, 1)(0, 1, 1)12 model had an AIC of 67.586. Predictions matched the 2023 actual trends, with an average relative error of 13.73%. The model predicts a monthly TB incidence of 0.75 to 1.59 per 100 000 in 2025, with an annual rate of 16.78 per 100 000, indicating a downward trend.   Conclusions   TB incidence in Tianjin decreased from 2017 to 2022, predominantly affecting males and the elderly. Enhanced prevention and education efforts are needed in urban areas, especially in time of transition from winter to spring and from autumn to winter. The ARIMA(1, 1, 1)(0, 1, 1)12 model effectively predicts TB incidence, aiding control efforts.
Association between sensation seeking and HIV risk behaviors using latent class analysis among college students in Zhuhai, China
ZENG Xiaomei, ZHOU Yi, LI Jinbin, XIE Yufan, TAN Xiaoxia, LIN Kaihao, YAN Yao, JIANG Hongbo
2025, 29(5): 542-548. doi: 10.16462/j.cnki.zhjbkz.2025.05.007
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  Objective   To examine the relationship between sensation seeking and the latent classes of human immunodeficiency virus (HIV) risk behaviors in college students, and to provide suggestions for the intervention of HIV risk behaviors in colleges.   Methods   Between October and December 2019, a multistage cluster sampling method was used to collect data on demographic information, sensation seeking, HIV risk behaviors among 1 430 students from 6 universities in Zhuhai, China. Six HIV risk behaviors which includes substance use before sex, alcohol use before sex, unprotected sex, casual sexual partners, commercial sexual partners and multiple sexual partners were analyzed using latent class analysis (LCA). After adjustment for gender, grade, major, sexual orientation and other factors, multivariable logistic regression were performed to explore the association between sensation seeking and the latent classes of HIV risk behaviors.   Results   College students in Zhuhai were classified into a low-risk behavior group (83.0%) and a high-risk behavior group (17.0%) according to LCA. The multivariable logistic regression analysis showed that higher levels of sensation seeking (OR=1.02, 95% CI: 1.00-1.05, P=0.018) and disinhibition (OR=1.18, 95% CI: 1.08-1.29, P < 0.001) were more likely to be in the high-risk behavior group.   Conclusions   There was an aggregation of HIV risk behaviors among college students in Zhuhai, and students with higher levels of sensation seeking were more likely to be in the high-risk behavior group. During HIV and sexual health education, targeted interventions should be tailored according to the latent classes of HIV risk behaviors and the trait of sensation seeking.
Association of systemic inflammatory response index and all-cause mortality in patients with cardiovascular and cerebrovascular diseases
SHI Yunchu, DU Fengjun, HUANG Yueqing, LU Zilong, XU Chunxiao, GUO Xiaolei, REN Jie, MA Jixiang
2025, 29(5): 549-557. doi: 10.16462/j.cnki.zhjbkz.2025.05.008
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  Objective   The aim of this study was to analyse the relationship between a novel marker of inflammation, the systemic inflammatory response index (SIRI), and all-cause mortality in patients with cardiovascular and cerebrovascular diseases (CVD).   Methods   This study was based on data from the UK biobank cohort of 35 598 subjects selected for CVD at baseline. Restricted cubic spline, Cox regression model and survival curves were used to investigate the relationship between SIRI and all-cause mortality in patients with CVD. The predictive value of SIRI for patient survival was assessed by time-dependent receiver operating characteristic curve analysis. Data were analysed in subgroups according to variables such as race, smoking and alcohol consumption.   Results   A median follow-up period of 14.19 years revealed that 5 755 all-cause deaths occurred in patients with CVD. A significant J-shaped nonlinear relationship (Pnonlinear < 0.001) between SIRI and all-cause mortality in CVD patients was identified by restricted cubic spline (RCS) analysis, with an optimal range of 0.79-1.05. In patients with CVD, the high SIRI group (SIRI>1.05) exhibited a 49% elevated risk of all-cause mortality (HR=1.49, 95% CI: 1.41-1.58) in comparison to the low SIRI group (SIRI≤1.05). Furthermore, the Q3 group exhibited a 15% elevated risk of morbidity (HR=1.15, 95% CI: 1.06-1.26), while the Q4 group demonstrated a 77% increased risk of morbidity (HR=1.77, 95% CI: 1.63-1.92) in comparison to the Q1 group. The results of the subgroup analyses demonstrated a statistically significant increase in the risk of all-cause mortality in the high SIRI group relative to the low group across all different subgroups, with the exception of those with annual incomes greater than ￡100 000. Additionally, a significant interactive effect between BMI and SIRI on the risk of all-cause mortality was observed.   Conclusions   The results demonstrated a significant association between elevated levels of SIRI and an increased risk of mortality in patients with cardiovascular and CVD. Furthermore, elevated levels of SIRI were identified as a more accurate predictor of mortality risk at a follow-up period of one year.
Analysis of the epidemic characteristics and influencing factors of residents aged 18 and above overweight and obesity in some regions of the Xinjiang Uygur Autonomous Region
XIAYIDA Wusimanjiang, XIAMUSIYE Muyiduli, YILIXIATI Kulaixi, SHAWULAXI Rejiafu, MAIDINA Abudusilimu, ABULIMITI Muhetaer, ZHANG Siyu, DING Yongqi, ZHANG Rong
2025, 29(5): 558-562. doi: 10.16462/j.cnki.zhjbkz.2025.05.009
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  Objective   The purpose of this study is to understand the epidemiological characteristics and influencing factors of overweight and obesity among residents aged 18 and above in some regions of the Xinjiang Uygur Autonomous Region, and to provide reference for the relevant prevention and control strategies and measures.   Methods   Based on the Chronic Disease and Risk Factor Surveillance Program for Chinese Resident in 2023, 4 933 permanent residents ≥18 years of age were selected as the study subjects at 8 monitoring sites in the Xinjiang, and were subjected to body measurements and questionnaires. SAS 9.4 software was used for data analysis. The differences in categorical variables between different groups were compared by chi-square test. Multifactorial logistic regression analysis model was used to analyze the influencing factors of the prevalence of overweight and obesity.   Results   The prevalence rates of overweight and obesity among the surveyed subjects in this study were 38.15% (1 882/4 933) and 34.38% (1 696/4 933), respectively. The results of multivariate logistic analysis showed that the age group of 45- < 60 (overweight: OR=1.90, 95% CI: 1.57-2.29; obesity: OR=2.06, 95% CI: 1.71-2.49), married (overweight: OR=1.46, 95% CI: 1.17-1.81; obesity: OR=1.54, 95% CI: 1.22-1.94), and physical labor (overweight: OR=1.46, 95% CI: 1.11-1.92; obesity: OR=1.47, 95% CI: 1.10-1.98) were positively correlated with the risk of overweight and obesity (all P < 0.05).   Conclusions   The overweight and obesity rates among adult residents in Xinjiang are relatively high. The age group of 45- < 60, married and physical labor are among the risk factors for overweight and obesity. Precise health education and publicity should be carried out, and family health intervention models should be explored to block the risks of obesity from multiple dimensions, including lifestyle, diet and physical exercise.
Analysis of the incidence and mortality of liver cancer in Liuzhou City from 2012 to 2019
SHEN Danyu, ZHOU Lifang, LAN Jian, CHEN Ningyu, LIU Yun
2025, 29(5): 563-568. doi: 10.16462/j.cnki.zhjbkz.2025.05.010
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  Objective  This study aims to analyze the incidence and mortality rates of liver cancer in Liuzhou City, and to assess the current prevention and control measures.  Methods  Data on the incidence, mortality, and population statistics related to liver cancer in Liuzhou City were collected. The crude incidence and mortality rates, as well as the age-standardized incidence and mortality rates for both the Chinese and global populations, were calculated. Joinpoint 5.0.2 software was utilized to analyze trends in morbidity and mortality rates.  Results  A total of 3 844 liver cancer cases were reported, resulting in a incidence rate of 33.99 per 100 000 individuals. The age-standardized incidence rate was 34.44 per 100 000 for the Chinese population and 26.89 per 100 000 for the global population. There were 3 116 liver cancer-related deaths, yielding a crude mortality rate of 27.55 per 100 000. The age-standardized mortality rate was 28.01 per 100 000 for the Chinese population and 21.76 per 100 000 for the global population. In terms of gender, both incidence and mortality rates were higher in males compared to females. Additionally, both rates increased with age, peaking in the ≥85 years age group. From the changing trends, the incidence of liver cancer initially increased and then decreased. The age-standardized incidence rate for the Chinese population declined from 35.53 per 100 000 to 33.01 per 100 000. In contrast, the mortality rate for liver cancer exhibited a gradual upward trend, with the age-standardized mortality rate for the Chinese population rising from 28.94 per 100 000 to 30.84 per 100 000, but there were no significant difference (all P>0.05).  Conclusions  Although the incidence of liver cancer among residents of Liuzhou shows a downward trend, the morbidity and mortality rates remain high, indicating a significant disease burden. Therefore, it is essential to enhance implement liver cancer screening and early diagnosis and treatment protocols, and promote healthy lifestyle choices through diverse health education initiatives.
Research on the current status and impact factors of successful aging among elderly residents in different areas of China
YAO Hui, LUO Ying, GOU Yuanjie, ZHANG Hairong, WANG Xiaohui
2025, 29(5): 569-573. doi: 10.16462/j.cnki.zhjbkz.2025.05.011
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  Objective  To analyze the current status of successful aging of rural and non-rural older adults in China and to explore its influencing factors.  Methods  Based on Rowe and Kahn′s model of successful aging, the chi-square test was used to compare the differences in successful aging rates between rural and non-rural older adults using data from the 2020 China health and retirement longitudinal study, and multifactorial logistic regression was employed to identify influencing factors.  Results  The successful aging rate among older adults in China was 17.03%, with 12.20% for rural older adults and 27.25% for non-rural older adults. Education level, self-rated health, nighttime sleep duration, and physical activity significantly influenced successful aging rates in both rural and non-rural older adults (all P<0.05). In addition, age (≥80 years vs. 60-<70 years, OR=0.413, 95% CI: 0.218-0.784) and gender (male vs. female, OR=1.872, 95% CI: 1.495-2.344) were significant factors for rural older adults (all P<0.05), and social medical insurance (insured vs. uninsured, OR=2.426, 95% CI: 1.071-5.493) and drinking status (less than once a month vs. none of these, OR=1.597, 95% CI: 1.247-2.045) were significant factors for non-rural older adults (all P<0.05).  Conclusions  The successful aging rate in China is relatively low, with rural older adults faring worse than their non-rural counterparts. Influencing factors vary between the two groups. To address population aging, it is crucial to enhance old-age security systems, promote social participation among older adults, and prioritize support for those who are advanced in age, women, rural residents, and individuals with lower educational attainment.
Comorbidity patterns and temporal trends in hospitalized middle-aged and elderly patients with chronic obstructive pulmonary disease in Zhanjiang, China, 2016-2022
DU Peiwen, LIANG Lizhong, WU Jiayuan, CHEN Chao, LIU Meilian, CHEN Ling, LIU Weiyu, LIU Jianze, ZENG Zhirong
2025, 29(5): 574-579. doi: 10.16462/j.cnki.zhjbkz.2025.05.012
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  Objective  To investigate the comorbidity patterns and temporal trends among hospitalized middle-aged and elderly patients with chronic obstructive pulmonary disease (COPD) in Zhanjiang, China, and to provide evidence for regional management of COPD comorbidities.  Methods  Data from the electronic medical record front pages of 230 056 middle-aged and elderly COPD patients admitted to hospitals at all levels in Zhanjiang City from 2016 to 2022 were collected. Association rule analysis was used to examine disease associations, and the annual percentage change (APC) of comorbidity proportions was calculated to analyze comorbidity trends.  Results  The comorbidity rate among hospitalized middle-aged and elderly COPD patients was 90.29%. The comorbidity rate in women was higher (92.33%) than that in men (89.18%) (χ2=594.96, P<0.001). The top five comorbidities were hypertension, heart failure, cerebrovascular disease, chronic gastritis, and cor pulmonale. Association rule analysis revealed significant associations (all P<0.05) among hypertension (χ2=505.78), heart failure (χ2=164.76), and chronic gastritis (χ2=96.17). In Zhanjiang City, the comorbidity rate among these patients showed an increasing trend, rising from 87.03% in 2016 to 93.00% in 2022 (APC=1.34%, P<0.001).  Conclusions  From 2016 to 2022, middle-aged and elderly COPD hospitalized patients in Zhanjiang City exhibited a high and increasing prevalence of comorbidities, with cardiovascular/cerebrovascular diseases and digestive tract disorders being the predominant concurrent conditions. Medical authorities should prioritize the management of cardiovascular/cerebrovascular diseases and gastrointestinal conditions to alleviate the burden of these major comorbidities.
Epidemiological characteristics of brucellosis and its correlation with meteorological factors in Shandong Province from 2010 to 2021
YU Xiaolin, GAO Yanxin, WANG Shuang, FANG Ming, DING Shujun, KOU Zengqiang
2025, 29(5): 580-587. doi: 10.16462/j.cnki.zhjbkz.2025.05.013
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  Objective  To analyze the epidemiological characteristics of brucellosis and the impact of meteorological factors on the incidence of brucellosis in Shandong Province from 2010 to 2021, and to provide a reference basis for the prediction, early warning and scientific prevention and control of brucellosis.  Methods  The epidemiological data of brucellosis in Shandong Province from 2010 to 2021 and the meteorological data such as daily average temperature, air pressure, relative humidity and wind speed were collected. The data were analyzed using descriptive epidemiological methods. Meteorological factors were analyzed by correlation analysis and distributed lag nonlinear model analysis.  Results  The average annual incidence of human brucellosis in Shandong Province from 2010 to 2021 was 2.35 per 100 000. Human brucellosis occurred in all months of the past year, with the peak incidence concentrated from March to August, accounting for 66.11%. Counties with the highest annual incidence were mainly located in the northern part of the province. The ratio of male to female was 2.55∶1.00, and the age was mainly concentrated in the 30-<70 age group, accounting for 83.70%. The occupation was mainly farmers, accounting for 85.51%. Then, we selected the region with high incidence as the study area, with median was used as reference. The highest risk was observed at an average daily temperature of -12.50 ℃ (lag 40-110 days, RR=1.40), an average daily air pressure of 989.86 hPa (lag 60-80 days, RR=3.51), a daily relative humidity of 78.00% (lag 38-80 days, RR=1.25), and a daily average wind speed of 6.80 m/s (lag 148-150 days, RR=1.38).  Conclusions  The incidence of brucellosis in Shandong Province was concentrated in spring and summer, mainly in farmers, and the high-incidence areas were mainly located in the northern part of the province. Meteorological factors, such as daily average temperature, air pressure, relative humidity and wind speed, were related to the incidence of brucellosis, which can be used as early warning parameters to provide references for the development of prevention and control strategies.
The mediating effect of self-esteem and psychological capital on the relationship between harsh parenting and school adjustment in college freshmen
YU Wanwan, CHEN Ming
2025, 29(5): 588-593. doi: 10.16462/j.cnki.zhjbkz.2025.05.014
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  Objective  To examine the relationship between harsh parenting and school adjustment among college freshmen, with particular focus on the mediating roles of self-esteem and psychological capital.  Methods  A total of 1 805 first-year undergraduates were investigated by harsh parenting questionnaire, positive psycap questionnaire, self-esteem scale, and China college student adjustment scale. Pearson correlation analysis was employed to examine the relationships between variables, Harman′s single-factor test was conducted to assess common method bias, and multiple regression analysis was used to test for multicollinearity. The bias-corrected nonparametric percentile Bootstrap method was applied to examine the mediating effect.  Results  Harsh parenting was significantly negatively correlated with self-esteem, psychological capital, and school adjustment (all P<0.001). While no relationship with of harsh parenting on school adjustment was observed (β=-0.021, P=0.093), three significant indirect pathways emerged: 1) independent mediation through self-esteem (indirect effect: -0.039, 95% CI: -0.052-0.029) independent mediation through psychological capital (indirect effect: -0.053, 95% CI: -0.080-0.027) serial mediation through both self-esteem and psychological capital (indirect effect: -0.117, 95% CI: -0.144-0.091). These pathways accounted for 23.04%, 16.96%, and 50.87% of the total effect, respectively.  Conclusions  Harsh parenting demonstrates a significant association with college freshmen′s school adjustment, with both self-esteem and psychological capital serving as crucial mediating variables in the relationship between harsh parenting and school adjustment among college freshmen.
The impact of work-family support on job burnout among primary health care workers and the mediating role of career identity and job satisfaction
YANG Ming, SUN Jiayi, LIU Sicheng, FANG Guixia
2025, 29(5): 594-599. doi: 10.16462/j.cnki.zhjbkz.2025.05.015
Abstract(18) HTML (9) PDF(5)
Abstract:
  Objective  To analyze the current status of job burnout among primary health care workers and explore the impact of work-family support, job satisfaction, and career identity on job burnout and their interrelationships.  Methods  A multi-stage sampling method was used to investigate 8 135 primary health care workers from 320 primary health care institutions in a central Chinese province. Univariate and hierarchical linear regression analyses, along with mediation effect analysis, were used to assess the impact of work-family support, career identity, and job satisfaction on primary health care workers′ job burnout, and to examine the mediating roles of career identity and job satisfaction.  Results  The prevalence of job burnout among the 8 135 primary health care workers was 62.59%. Work-family support was significantly positively correlated with career identity and job satisfaction and negatively correlated with job burnout (all P<0.05). Work-family support (β=-0.192, P<0.001), career identity (β=-0.352, P<0.001), and job satisfaction (β=-0.179, P<0.001) were negative related with job burnout. Career identity and job satisfaction partially mediated the impact of work-family support on job burnout, with mediation effect proportions of 32.80% and 22.30%, respectively.  Conclusions  Work-family support can reduce the probability of job burnout among primary health care workers, and both career identity and job satisfaction are mediating factors in the impact of work-family support on job burnout.
Epidemiological characteristics and influencing factors of human cystic echinococcosis in Tibet Autonomous Region, 2019-2023
AI Jiajia, JI Xiaoyao, BAIMA Yangjin, ZHENG Jingying, BAI Yang, ZHU Chang, CIREN Lamu, GONGSANG Quzhen
2025, 29(5): 600-605. doi: 10.16462/j.cnki.zhjbkz.2025.05.016
Abstract(16) HTML (9) PDF(4)
Abstract:
  Objective  To analyze the prevalence of human cystic echinococcosis (CE) and its associated factors in Tibet Autonomous Region from 2019 to 2023, providing a scientific basis for formulating more precise prevention strategies.  Methods  The data for this study were sourced from the echinococcosis surveillance and control system in Tibet Autonomous Region. χ2 test and constructed a generalized additive model (GAM) were used to analyze inter group differences and factors related to human CE prevalence in each county/districts.  Results  A total of 510 063 individuals were screened in Tibet Autonomous Region from 2019 to 2023, with 2 214 CE cases detected, resulting in an average prevalence of 0.43%. Higher CE prevalence was observed in females (0.52%), ≥60 years age group (0.95%), those living in pastoral counties (1.09%), and residents of the Ali Prefecture (0.95%). The prevalence in 2019 (0.29%) was significantly lower than in other years. Both univariate and multivariate analyses revealed significant nonlinear effects of elevation and domestic dog infection rate on human CE prevalence (all P<0.001).  Conclusions  The human CE prevalence in Tibet Autonomous Region is influenced by various factors, including elevation, domestic dog infection rates, livestock prevalence and dog population. We propose that, in future prevention and control efforts, there should be targeted enhancements to the prevention and control measures aimed at priority populations and influencing factors, accompanied by the implementation of corresponding improvement measures to enhance the effectiveness of prevention and treatment.
Review
A systematic review of Mendelian randomization for behavioral and nutrient-related factors of intracranial aneurysm
WANG Yuge, LIU Junyu, CAO Fang, YAN Junxia
2025, 29(5): 606-615. doi: 10.16462/j.cnki.zhjbkz.2025.05.017
Abstract(9) HTML (7) PDF(0)
Abstract:
  Objective  To evaluate the association between behavioral and nutrient-related factors and intracranial aneurysm (IA) by summarizing evidences from Mendelian randomization (MR) studies for further elucidating the etiology and pathogenesis of IA.  Methods  PubMed, Embase, Web of Science, CNKI and Wanfang were systematically searched to screen out related studies. The included literatures were classified by narrative integration method for qualitative systematic review.  Results  A total of 12 studies published between 2018 and 2023 were included, of which 4 were judged to be of high quality. These studies explored the relationship between behavior (smoking, coffee intake, physical activity, alcohol and tea consumption) and nutrition-related factors (homocysteine, serum magnesium, serum iron, serum calcium, and polyunsaturated fatty acids) and IA and its subtypes, but they had the problem of being published repeatedly. Four MR studies based on different instrumental variables screening criteria in the same european population all supported smoking as a risk factor for IA and its subtypes; the results regarding coffee intake, physical activity, homocysteine, serum magnesium, and serum calcium were discrepancy. One MR study each suggested that serum iron and polyunsaturated fatty acids were associated with IA and its subtypes.  Conclusions  Smoking can increase the risk of IA and its subtypes, the association of other behavioral and nutrient-related factors with IA and its subtypes needs further investigation. The MR study itself has limitations, which requires careful causal inference based on other evidences.
Short Report
A case-crossover study on the impact of fine particulate matter on outpatient visits of pediatric neurological diseases in Shijiazhuang
LIANG Ziyue, GAO Xu, CHEN Fengge, KANG Hui, ZHANG Hong, ZHANG Ying
2025, 29(5): 616-620. doi: 10.16462/j.cnki.zhjbkz.2025.05.018
Abstract(20) HTML (9) PDF(8)
Abstract:
  Objective  To investigate the relationship between atmospheric fine particulate matter (PM2.5) concentration and outpatient visits for pediatric neurological diseases in Shijiazhuang.  Methods  Data on air pollutants, meteorological data, and outpatient visits of pediatric neurological diseases in Shijiazhuang from 2012 to 2021 were collected. A case-crossover design was used to establish a conditional logistic regression model to analyze the association between PM2.5 and the outpatient visits of pediatric neurological diseases.  Results  The single pollutant model results showed that for every 10 μg/m3 increase in PM2.5 concentration, the outpatient visits of pediatric neurological diseases increased by 0.160% (95% CI: 0.056%-0.265%). Stratified analysis indicated that girls [ER(95% CI)=0.235(0.073-0.398)] and children aged 7-14 years [ER(95% CI)=0.317(0.110-0.525)] were sensitive populations to PM2.5 exposure. The harmful effects of PM2.5 exposure on the pediatric nervous system were stronger in Cold season [ER(95% CI)=0.294(0.171-0.417)].  Conclusions  Exposure to PM2.5 in Shijiazhuang can increase the outpatient visits of pediatric neurological diseases, with varying effects by gender, age, and season.

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