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CN 34-1304/R ISSN 1674-3679

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2025 Vol. 29, No. 8

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Public Health Theory and Education
Practice and exploration of cultivating compound and applied talents in occupational safety and health
MU Min, WANG Jia, JIANG Bingyou, YE Dongqing, YUAN Liang
2025, 29(8): 869-874. doi: 10.16462/j.cnki.zhjbkz.2025.08.001
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Healthy China, Occupational Health First. As an exceptionally crucial domain within public health, occupational safety and health spans the entire professional life cycle of workers. The innovative "integration of science, engineering, and medicine" (STEM) interdisciplinary applied talent cultivation model is designed to align with the new developmental context of occupational safety and health in China, addressing emerging national demands in this field. This study proposes a talent development pathway featuring "Three-Line Integration" and "Three-Chain Convergence" for occupational safety and health professionals. It improves the training framework for interdisciplinary applied talents, develops a "curriculum roadmap" for cultivating interdisciplinary talents in occupational safety and health, and establishes an innovative "Four-in-One" practical teaching system. The research aims to provide a reference for academic institutions nationwide in exploring comparable talent cultivation models.
Original Articles
Prevalence and influencing factors of kidney impairment in middle-aged and elderly people living with HIV
WU Yanjie, WANG Shanling, HUA Tingting, XIE Yali, WANG Tingting, SHEN Weiwei, WANG Liangyou, LIN Haijiang, HE Na
2025, 29(8): 875-881. doi: 10.16462/j.cnki.zhjbkz.2025.08.002
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  Objective  To investigate the prevalence and influencing factors of kidney impairment in middle-aged and elderly people living with human immunodeficiency virus(HIV; PLWH), and to provide scientific evidence for early prevention and intervention in this population.  Methods  A cross-sectional study was conducted based on the comparative HIV and aging research in Taizhou (CHART). PLWH aged 40 and above who participated in the baseline survey between January 2022 and July 2024 were enrolled. The estimated glomerular filtration rate (eGFR) was calculated using the chronic kidney disease epidemiology collaboration (CKD-EPI) formula. Descriptive statistical analysis was used to assess participants′ baseline characteristics and the prevalence of kidney impairment, while multivariable ordinal logistic regression was applied to identify influencing factors.  Results  A total of 692 middle-aged and elderly PLWH were included, comprising 527 males (76.16%) and 165 females (23.84%), with a median age of 56 years (IQR: 49-64). The prevalence of mild and moderate-to-severe kidney impairment was 23.55% (163/692) and 3.61% (25/692), respectively, with an overall prevalence of 27.17% (188/692). Multivariable ordinal logistic regression analysis revealed that age (55- < 70 years: aOR=3.75, 95% CI: 2.37-5.91; ≥70 years: aOR=29.47, 95% CI: 15.02-57.82), long-term use of two or more non-antiretroviral drugs (aOR=1.96, 95% CI: 1.15-3.35) and dyslipidemia (aOR=1.67, 95% CI: 1.12-2.48) were significantly associated with kidney impairment. Additionally, hyperuricemia was positively associated with kidney impairment, with a stronger association observed as severity increased. Compared to individuals with normal serum uric acid levels, those with hyperuricemia had higher odds of developing mild or greater kidney impairment (aOR=2.81, 95% CI: 1.62-4.88), and even greater odds of progressing to moderate-to-severe impairment (aOR=8.51, 95% CI: 3.44-21.07).  Conclusions  The prevalence of kidney impairment is relatively high in middle-aged and elderly PLWH, with mild impairment being the most common. Age, polypharmacy, dyslipidemia, and hyperuricemia are key influencing factors. It is recommended to regularly monitor renal function in middle-aged and elderly PLWH and implement comprehensive measures such as early screening, rational medication use, and metabolic regulation to reduce the risk of kidney damage.
The current status and factors associated with influenza vaccination literacy among pregnant and postpartum women in China
ZENG Fanyu, YANG Fengyun, ZHENG Min, QIU Xiu, LI Fen, YI Nianhua, WU Yinglan, MA Yuanying, WANG Lei, LI Changhui, GU Chunyi, JIN Longmei, QIAN Xu, JIANG Hong
2025, 29(8): 882-888. doi: 10.16462/j.cnki.zhjbkz.2025.08.003
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  Objective  To assess the level of health literacy about influenza vaccination among pregnant and postpartum women in China, and to explore the factors influencing vaccine literacy.  Methods  From January 17, 2024 to March 14, 2024, a stratified proportional sampling method was used to conduct surveys among pregnant and postpartum women in nine province/autonomous region/municipalities representing the Eastern, Central, Western, and Northeastern regions of China. The study utilized the Chinese version of the health literacy about vaccination in adulthood in Italian (HLVa-IT), to assess maternal functional vaccine literacy and interactive-critical vaccine literacy. Each scale considered achieving 80% of the total score as the standard for having vaccine literacy.  Results  A total of 2 035 valid questionnaires were collected from January 17 to March 14, 2024. 13.6% of these women had interactive-critical vaccine literacy. The results of the multivariate logistic stepwise regression analysis revealed that pregnant women who were not healthcare workers had a lower rate of functional vaccine literacy for influenza vaccination (aOR=2.236, 95% CI: 1.628-3.071, P < 0.001). Conversely, pregnant women whose insurance covered the cost of influenza vaccination during pregnancy (aOR=0.665, 95% CI: 0.479-0.923, P=0.015), those who had family support for influenza vaccination during pregnancy (aOR=0.355, 95% CI: 0.251-0.502, P < 0.001), those who had received influenza vaccination outside of pregnancy (aOR=0.691, 95% CI: 0.524-0.911, P=0.009), and those who perceived a decline in health status during pregnancy (aOR=0.754, 95% CI: 0.576-0.988, P=0.041) had higher rates of functional vaccine literacy for influenza vaccination. Additionally, pregnant women who were not healthcare workers (aOR=1.929, 95% CI: 1.121-3.318, P=0.018) and those who had not been informed by their doctors about vaccination during pregnancy (aOR=1.821, 95% CI: 1.070-3.098, P=0.027) had lower rates of critical-interactive vaccine literacy for influenza vaccination. On the other hand, pregnant women whose insurance covered the cost of influenza vaccination during pregnancy (aOR=0.537, 95% CI: 0.313-0.923, P=0.024), those who had family support for influenza vaccination during pregnancy (aOR=0.193, 95% CI: 0.114-0.328, P < 0.001), and those who had received influenza vaccination outside of pregnancy (aOR=0.505, 95% CI: 0.306-0.832, P=0.007) had higher rates of critical-interactive vaccine literacy for influenza vaccination.  Conclusions  The overall level of influenza vaccination literacy among pregnant women in China is relatively low, and their ability to comprehend, analyze, and utilize information about influenza vaccines needs improvement.
Analysis of brucellosis incidence and influencing factors in Yunnan Province based on multi-scale geographically weighted poisson regression model
ZHANG Lele, LI Ke, YUAN Rui, WANG Peng, YANG Xiangdong, YU Binbin, ZHANG Zhijie
2025, 29(8): 889-893. doi: 10.16462/j.cnki.zhjbkz.2025.08.004
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  Objective  To analyze the influencing factors of brucellosis incidence in various districts of Yunnan Province in 2022, and to reveal the spatial heterogeneity of their effects, so as to provide a reference for formulating scientific prevention and control measures in different regions.  Methods  Data on brucellosis incidence and related influencing factors were collected from 129 districts in Yunnan Province in 2022. The spatial autocorrelation of the brucellosis incidence was analyzed. The goodness of fit of the generalized linear Poisson model (GLM-Poisson), geographically weighted poisson regression (GWPR) model and multi-scale geographically weighted poisson regression (MGWPR) model was compared. Based on the optimal model, influencing factors of brucellosis incidence were analyzed.  Results  In 2022, 1 015 brucellosis cases were reported in Yunnan Province, showing an east-high-west-low spatial distribution pattern with spatial autocorrelation. The MGWPR model had the highest goodness of fit [percent deviance explained (D2)=0.77, Akaike′s information criterion corrected(AICc)=718.27, root mean square error (RMSE)=9.79]. Model results showed that sheep stock (β=0.13-1.49), cattle stock (β=-0.28-0.72), pig stock (β=0.23-0.31), GDP per capita (β=-0.66-1.29), proportion of primary industry GDP (β=-0.83-0.47), grassland area (β=-0.69-1.66), and annual precipitation (β=-1.31-0.40) had significant influences on the incidence of brucellosis at local or global scales. The effects of different factors were heterogeneous across different regions of Yunnan.  Conclusions  The MGWPR model performs better in addressing the spatial heterogeneity of regression relationships and is more suitable for exploring influencing factors of brucellosis in Yunnan. Various factors such as socioeconomic and natural factors significantly influence brucellosis incidence with spatial variations, suggesting that region-specific prevention measures should be formulated.
Prospective association between moderate-to-vigorous physical activity trajectories and cognitive function in middle-aged and older adults
TANG Lulu, YU Xiaoli, CHI Chunwei, QIU Changcui, WANG Li, ZHU Xiaoping
2025, 29(8): 894-899. doi: 10.16462/j.cnki.zhjbkz.2025.08.005
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  Objective  To explore the association between moderate-to-vigorous physical activity (MVPA) trajectories and cognitive function among middle-aged and older adults in Chinese communities.  Methods  We used data from the 2011 to 2018 waves of the China Health and Retirement Longitudinal Study (CHARLS), including sociodemographic characteristics, health status, lifestyle factors, and health-related behaviors. MVPA trajectories were identified using group-based trajectory model (GBTM) with a censored normal distribution. Linear mixed-effects model was used to examine the association between MVPA trajectories and cognitive function.  Results  A total of 4 989 individuals aged 45 years and older were included, with a median follow-up of 7.0 years. Two distinct MVPA trajectories were identified: low-fluctuating group (55.42%) and high-declining group (44.58%). High-declining group exhibited a significantly slower decline in cognitive function (β=0.11, 95% CI: 0.07-0.16, P < 0.001) compared to low-fluctuating group. Among those in high-declining group, individuals with primary school education had a slower rate of cognitive decline than illiterate (β=0.17, 95% CI: 0.10-0.23, P=0.023).  Conclusions  We identify two distinct trajectories of MVPA among middle-aged and older adults. The findings suggest that maintaining a higher level of physical activity over time may help slow cognitive decline, particularly among individuals with lower levels of education.
Association sleep duration and different levels of frailty in Chinese older adults
YE Ziyi, DU Yushan, ZHU Xiaohan, HE Xing, GUO Chao
2025, 29(8): 900-905. doi: 10.16462/j.cnki.zhjbkz.2025.08.006
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  Objective  To investigate the association between sleep duration and different levels of frailty among older adults.  Methods  A case control study design was employed, utilizing data from the 2018 China Health and Retirement Longitudinal Study (CHARLS). Multinomial logistic regression models were applied to examine the association between sleep duration and frailty progression among Chinese older adults.  Results  Among the 8 555 older adults included in the analysis, the prevalence rates of pre-frailty and frailty were 34.21% and 27.64%, respectively. After adjusting control variables, the results of the multinomial logistic regression analysis showed that a nighttime sleep duration of > 4- < 5 hours was significantly associated with both pre-frailty and frailty (all P < 0.05). A nighttime sleep duration of more than 9 hours was significantly associated with frailty (OR=1.80, 95% CI: 1.39-2.34), but showed no statistically significant association with pre-frailty. In addition, compared with a nap duration of 1- < 1.5 hours, a nap duration of more than 2.5 hours was significantly associated with pre-frailty (OR=1.63, 95% CI: 1.16-2.29). Compared with a total sleep duration of 7- < 8 hours, a total sleep duration of > 5- < 6 hours was significantly associated with both pre-frailty and frailty (all P < 0.05), and a total sleep duration of ≥10 hours was associated with frailty (OR=1.64, 95% CI: 1.28-2.10).  Conclusions  Both too long and too short sleep duration are associated with different levels of frailty in the elderly. Promoting scientifically appropriate nighttime and nap durations among older adults may help prevent the onset of pre-frailty and frailty.
Multilevel model analysis of factors influencing cognitive impairment in middle-aged and elderly adults in rural areas
BI Shengxian, WANG Qianwen, YANG Qijiao, PENG Xinyi, CHEN Yingchun
2025, 29(8): 906-912. doi: 10.16462/j.cnki.zhjbkz.2025.08.007
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  Objective  To investigate factors that influence cognitive impairment among middle-aged and elderly adults in rural areas and provide a scientific basis for targeted interventions.  Methods  A total of 5 927 middle-aged and elderly adults from rural areas were selected from five waves (2011-2020) of the China Health and Retirement Longitudinal Study. A three-level logistic regression model was used to analyze the effects of time, individual characteristics, and regional factors on cognitive impairment.  Results  Variation at the individual level was the primary contributor, standard deviation (s)=1.481, and regional-level clustering was also observed (s=0.444, P < 0.001). The risk of cognitive impairment in 2018 (OR=3.755, 95% CI: 3.131-4.502) and 2020 (OR=1.279, 95% CI: 1.040-1.572) was higher than in 2011. A lower risk was associated with being male (OR=0.432, 95% CI: 0.375-0.496), younger elderly (OR=0.481, 95% CI: 0.431-0.536), older elderly (OR=0.252, 95% CI: 0.203-0.312), participating in social activities (OR=0.597, 95% CI: 0.548-0.650), and higher annual sunshine duration (OR=0.809, 95% CI: 0.702-0.933). A higher risk was associated with primary education (OR=10.842, 95% CI: 2.119-55.490), being divorced/widowed/unmarried (OR=1.551, 95% CI: 1.333-1.803), lacking pension insurance (OR=2.126, 95% CI: 1.495-3.025), lacking health insurance (OR=1.528, 95% CI: 1.011-2.310), infrequent communication with children (OR=1.440, 95% CI: 1.130-1.836), insomnia (OR=1.124, 95% CI: 1.010-1.250), impaired instrumental activities of daily living (OR=1.691, 95% CI: 1.531-1.868), pain (OR=1.179, 95% CI: 1.073-1.296), and depression (OR=1.201, 95% CI: 1.099-1.313).  Conclusions  Cognitive impairment among rural middle-aged and elderly adults is influenced by factors at the temporal, individual, and regional levels. Comprehensive interventions should target individual-level determinants such as health behaviors, education, and social security, while also addressing community-level social engagement and mental health services, and policy-level resource allocation.
Study on the disease burden and changing trends of trachea, bronchus, and lung cancer attributable to air pollution in China from 1990 to 2021
DING Lei, WANG Xinghua, LIANG Yali, ZHU Yu
2025, 29(8): 913-921. doi: 10.16462/j.cnki.zhjbkz.2025.08.008
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  Objective  This study aims to investigate the disease burden and temporal trends of tracheal, bronchus, and lung (TBL) cancer attributable to air pollution in China from 1990 to 2021, providing a scientific foundation for optimizing prevention and control strategies.  Methods  Data on TBL cancer-related deaths and disability-adjusted life years (DALYs) caused by air pollution in China (1990-2021) were retrieved from the Global Burden of Disease database (GBD 2021). Joinpoint 5.0.2 regression analysis was applied to assess trends in the number of deaths, age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). Age-period-cohort (APC) models were used to explore age, period, and cohort effects on mortality risk, while a Bayesian age-period-cohort (BAPC) model was developed to project ASMR and ASDR trends from 2022 to 2036.  Results  The annual death toll increased from 108.470 thousand in 1990 to 211.370 thousand in 2021 [average annual percent change (AAPC)=2.140%, P < 0.001]. However, ASMR declined from 13.558 to 10.106 per 100 000 (AAPC=-0.972%, P<0.001), and ASDR decreased from 336.299 to 226.502 per 100 000 (AAPC=-1.299%, P<0.001). APC analysis demonstrated statistically significant variations in mortality outcomes across age groups, periods, and birth cohorts (P < 0.001). The BAPC model projected a sustained decline in ASMR and ASDR for the total population and males from 2022 to 2036, whereas an upward trend was predicted for females.  Conclusions  Analysis reveals that after 2004, China′s ASMR and ASDR for TBL cancer attributable to air pollution among the entire population show a continuous downward trend. However, predictive models indicate that these indicators for women may begin to rise. Enhanced air pollution mitigation and health interventions are imperative, with prioritized attention to female populations.
Trends in health literacy levels among residents of Anhui Province from 2021 to 2024 and its association with medical out-of-pocket expenses
XIE Jianrong, FU Yuansheng, XU De, WANG Zhimin, XIA Yuanrui, FAN Yinguang
2025, 29(8): 922-929. doi: 10.16462/j.cnki.zhjbkz.2025.08.009
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  Objective  To analyze the trend in health literacy levels among residents in Anhui Province from 2021 to 2024 and its correlation with medical out-of-pocket expenses, providing a basis for optimizing health promotion strategies.  Methods  A stratified multi-stage sampling method combined with simple random sampling and probability proportional to size (PPS) sampling was applied to conduct a health literacy survey among permanent residents aged 15-69 in Anhui Province during 2021-2024. After excluding individuals with chronic diseases, univariate and multivariate logistic regression models were used to analyze the association between health literacy and medical out-of-pocket expenses.  Results  Health literacy levels among residents in Anhui Province from 2021 to 2024 were 27.31%, 29.06%, 31.09% and 32.55%, respectively, showing an increasing trend (trend χ2 =114.576, P < 0.001). The results of the multivariate logistic regression model analysis showed that, after controlling for confounding variables, compared with the group with limited health literacy, the group with adequate health literacy had lower medical out-of-pocket expenses (OR=0.90, 95% CI: 0.86-0.96), presenting a negative association between health literacy level and medical out-of-pocket expenses. Among the different dimensions of health literacy, three aspects of health literacy were negatively associated with medical out-of-pocket expenses (all P < 0.05). Among the six categories of health issue literacy, scientific views of health, basic medical care, and health information were also negatively associated with medical out-of-pocket expenses (all P < 0.05).  Conclusions  From 2021 to 2024, the health literacy levels among residents in Anhui Province has steadily improved, but there is still a gap compared to developed provinces. Medical out-of-pocket expenses are a key factor affecting the level of health literacy among residents, and insufficient health literacy is often accompanied by higher medical burdens.
Study on the trend analysis and forecast of the prevalence of three types of unintentional injuries among people under 20 years of age in China, 1990-2021
ZHOU Jiyu, WANG Shihong, WANG Yongjie, CHEN Hao, CHEN Chanjin, ZHANG Zhiyi, ZHANG Zewu, KONG Danli, DING Yuanlin
2025, 29(8): 930-936. doi: 10.16462/j.cnki.zhjbkz.2025.08.010
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  Objective  To analyze the incidence rate, mortality rate, and disability adjusted life years (DALYs) of three types of unintentional injuries falls, drowning, and [fire, heat, and hot objects injury (FHHI)] in China from 1990 to 2021, and to predict the disease burden from 2022 to 2032, providing a reference for formulating corresponding prevention and control strategies.  Methods  Based on the 2021 Global Burden of Disease (GBD) database, data on the incidence rate, mortality rate, and DALYs rate of falls, drowning, and FHHI in the population under 20 years old in China from 1990 to 2021 were collected. The annual estimated percentage change (EAPC) was used to analyze the trend of these three types of unintentional injuries, and the autoregressive integrated moving average (ARIMA) model was used to predict the incidence rate, mortality rate, and DALYs rate of these injuries from 2022 to 2032.  Results  From 1990 to 2021, the incidence of falls and FHHI in China′s population under 20 years old showed a downward trend, but the changes were not statistically significant (EAPC=-0.80%, -0.20%, P > 0.05), while the incidence of drowning showed a decreasing trend (EAPC=-4.30%, P < 0.05). The mortality rate and DALYs rate of the three types of injuries showed a downward trend (mortality rate EAPC=-3.44%, -5.92%, -7.60%, P < 0.05; DALYs rate EAPC=-3.15%, -6.01%, -7.32%, P < 0.05). In 2021, the incidence rate, mortality rate, and DALYs rate of these three injuries were higher in males than in females. The highest incidence of falls and FHHI occurred in the 15- < 20 age group, while the highest incidence of drowning was observed in the 10- < 15 age group. ARIMA model predictions showed that from 2022 to 2032, the incidence of falls and drowning will continue to decrease, while the incidence of FHHI would increase. By 2032, the predicted incidence rates of these three injuries would be 1 968.51/100 000, 15.87/100 000, and 80.29/100 000, respectively. The predicted mortality rate and DALYs rate from 2022 to 2032 showed a downward trend for all three types of injuries, with the mortality rates in 2032 predicted to be 0.31/100 000, -2.18/100 000, and-0.68/100 000, and the DALYs rates predicted to be 68.91/100 000, -368.03/100 000, and-55.68/100 000.  Conclusions  From 2022 to 2032, the incidence of FHHI in China′s population under 20 years old is expected to increase, while the incidence of falls and drowning will decrease. The mortality rate and DALYs rate of all three types of unintentional injuries are also expected to decline. This suggests that greater attention should be paid to fire prevention for adolescents and children, along with strengthening safety education to protect the lives and health of young people and children.
Spatio-temporal pattern and associate factors of bacillary dysentery disease in Shandong Province from 2005 to 2021
WANG Shuzi, ZHANG Jiyu, DAI Bingqin, HAN Yang, ZHANG Yixin, SUN Chengxi
2025, 29(8): 937-942. doi: 10.16462/j.cnki.zhjbkz.2025.08.011
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  Objective  To investigate spatio-temporal trends of bacillary dysentery in Shandong Province and explore the association between bacillary dysentery and meteorological, population, economic, hygiene and environmental factors.  Methods  A Bayesian space-time model was employed to identify the spatio-temporal heterogeneity of bacillary dysentery cases and quantify the potential association between bacillary dysentery cases and meteorological and social environmental variables in Shandong Province from 2005 to 2021.  Results  During 2005-2021, 145 644 bacillary dysentery cases were reported in Shandong Province. Temporally, the risk of bacillary dysentery showed a decreasing trend, and peaked from June to September. Geographically, hot-spot areas were distributed in Weihai, Zibo, Yantai, Jinan, and Weifang cities. The incidence risk for bacillary dysentery was associated with the monthly average temperature (RR=1.030, 95% CI: 1.025-1.034), monthly rainfall (RR=1.001, 95% CI: 1.001-1.001), natural population growth rate (RR=1.005, 95% CI: 1.002-1.007), gross domestic product (GDP) per capita (RR=0.999, 95% CI: 0.999-0.999), GDP per capita growth rate (RR=0.987, 95% CI: 0.980-0.994), number of health technicians (RR=0.999, 95% CI: 0.999-0.999), and green coverage (RR=0.993, 95% CI: 0.992-0.995).  Conclusions  The incidence risk for bacillary dysentery was associated with meteorological and social environmental factors. It is necessary to pay attention to high-risk areas, provide health advisories, and make preparations for epidemic response during epidemic periods.
Analysis on the changes and influencing factors of newborn birth weight before and after the COVID-19 epidemic
WANG Xiaoxiao, DU Liyan, LIN Hong, CHEN Lina, ZHANG Yingkui
2025, 29(8): 943-948. doi: 10.16462/j.cnki.zhjbkz.2025.08.012
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  Objective  To analyze the changes in birth weight of neonates before and after the coronavirus disease 2019 (COVID-19) epidemic and its influencing factors.  Methods  Birth surveillance data from 2017 to 2023 in Hebei Province were collected, and the study subjects were divided into three groups: the pre-COVID-19 group (2017-2019), the during-COVID-19 group (2020-2022) and the post-COVID-19 group (2023).  Results  The average birth weight of newborns in Hebei Province was (3 287.06±504.97) g, which was lower than that before the COVID-19 epidemic (3 351.86±493.70) g. The prevalence of low birth weight also increased from 3.77% (5 279/140 147) to 4.99% (1 135/22 755), and the prevalence of macrosomia decreased from 9.00% (12 618/140 147) before the COVID-19 epidemic to 6.84% (1 556/22 755) after the epidemic. The multivariate logistic regression analysis model after adjusting for other risk factors showed that the incidence of low birth weight after the COVID-19 epidemic was 1.163 times higher than that before the COVID-19 epidemic (OR=1.163, 95% CI: 1.061-1.275), of which the incidence of mature low-birth weight was 1.248 times that before the COVID-19 epidemic (OR=1.248, 95% CI: 1.104-1.412), and the incidence of preterm low-birth weight was 1.246 times that before the COVID-19 epidemic (OR=1.246, 95% CI: 1.150-1.350), there was no significant effect on preterm low birth weight during the COVID-19 epidemic (P>0.05). The COVID-19 epidemic, advanced maternal age, low level of education, inadequate number of prenatal check-ups, female infants, high level of delivery hospitals, and pregnancy complications are risk factors for low birth weight, The rate of preterm low-birth weight in tertiary hospitals is higher than that in primary and secondary hospitals.  Conclusions  After the COVID-19 epidemic, the birth weight of newborns in Hebei Province has decreased compared with that before the COVID-19 epidemic, and the incidence of low birth weight infants has increased. High risk populations should be identified, prenatal check ups and prenatal care should be strengthened, and the occurrence of low weight should be reduced.
Analysis on disease burden and epidemiological trends of HIV/AIDS co-infection with drug-resistant tuberculosis in China on the global perspective
CHEN Chen, FU Han, LIU Yulong, CHEN Shiqi, WANG Fei, LIU Ruru, ZHANG Yiwei, WANG Xin
2025, 29(8): 949-955. doi: 10.16462/j.cnki.zhjbkz.2025.08.013
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  Objective  To analyze the disease burden and trends of human immunodeficiency virus (HIV)-induced acquired immune deficiency syndrome (AIDS) co-infection with drug-resistant tuberculosis-including multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB)-in China from 1995 to 2021, and to provide scientific evidence for optimizing prevention and control strategies.  Methods  Data on age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) were extracted from the Global Burden of Disease (GBD) 2021 database. Joinpoint regression models were used to calculate annual percentage change (APC) and average annual percent change (AAPC) for both incidence and mortality rates and to identify turning points.  Results  From 1995 to 2021, the age-standardized incidence rate (ASIR) and mortality rate (ASMR) of HIV/AIDS-associated multidrug-resistant tuberculosis (MDR-TB) in China decreased from 1.40 per 10 000 and 0.33 per 10 000 to 0.61 per 10 000 and 0.16 per 10 000, respectively, but increased again after 2015. Although baseline values were low, both ASIR and ASMR of HIV/AIDS-associated extensively drug-resistant tuberculosis (XDR-TB) exhibited statistically significant upward trends [AAPC: 5.83% (t=15.12, P < 0.05) and 6.38% (t=9.96, P < 0.05), respectively]. Sex analysis revealed that female demonstrated greater declines in ASIR and ASMR for both HIV/AIDS-MDR-TB and HIV/AIDS-XDR-TB than male. Significant increases in incidence and mortality of HIV/AIDS-MDR-TB were observed in the 5- < 15 year group. All age groups showed increasing incidence and mortality of HIV/AIDS-XDR-TB during the study period.  Conclusions  China needs to establish a precise prevention and control system for HIV/AIDS drug-resistant tuberculosis, with a focus on enhancing screening among male and adolescent populations, promoting rapid diagnostic techniques, and standardizing the management of anti-tuberculosis drugs.
Methology
Multi-omics data integration progress based on the Chinese healthy aging research cohort
LIU Ludi, HE Jialin, YE Bingqi, YANG Jialu, XIA Min, LIU Yan
2025, 29(8): 956-960. doi: 10.16462/j.cnki.zhjbkz.2025.08.014
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With the acceleration of population aging in China, assessing the dynamic changes in the body at the molecular level during the aging process and discovering new biomarkers are of great significance for reducing the disease burden of the elderly population and improving their quality of life. Western countries have earlier initiated specialized and diverse research projects on aging and elderly health, establishing multiple large-scale longitudinal population cohorts. China has also successively launched several healthy aging studies, accumulating a wealth of aging-related health data. However, domestic research still faces challenges such as insufficient data sharing, low levels of informatization and standardization in sample resource repositories, and a lack of comprehensive, high-precision, and nationally representative standardized multi-omics databases. Through the integration of multi-omics data in the Chinese healthy aging research cohort, it will promote the integration and cleaning of multi-omics data in nationally representative cohorts, providing a reference for the formulation of data integration standards in large-scale population cohort studies in China.
Review
Research progress on family-based management strategies and interventions for non-communicable diseases
GUO Zhiran, ZHANG Yue, ZHOU Yaguan, XU Xiaolin
2025, 29(8): 961-967. doi: 10.16462/j.cnki.zhjbkz.2025.08.015
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Abstract:
Chronic non-communicable diseases (NCDs) have emerged as a critical global public health challenge. In China, the prevalence of NCDs continues to rise, posing significant challenges to effective disease management. Families, as the most immediate support unit for patients with chronic conditions, play a pivotal role in providing daily care and emotional support. The integration of family-centered chronic disease management in clinical practice has been well recognized in recent years. This review synthesizes the current evidence on family-based management strategies and interventions for NCDs, aiming to provide the clinical evidence for its implementation in China.
Short Reports
Analysis of the mediating relationship between socioeconomic in gender and frailty in middle-aged and older adults
CUI Longyan, ZHANG Dongxian
2025, 29(8): 968-973. doi: 10.16462/j.cnki.zhjbkz.2025.08.016
Abstract(5) HTML (3) PDF(1)
Abstract:
  Objective  To explore the mediating effect of socioeconomic status (SES) between gender and frailty, and to provide further prevention of frailty.  Methods  Older adults aged 45 years and above in the 2018 China Health and Retirement Longitudinal Study(CHARLS) were selected, the χ2 test was used to analyze the detection of frailty in older adults with different characteristics, and the mediating effect model using the Bootstrap method was used to validate the role of SES in the relationship between gender and frailty.  Results  The detection rate of frailty in middle-aged and older adults aged 45 years and above was 34.70%, and it was higher in women (37.59%) than in men (30.57%) (χ2 =34.672, P < 0.001). After controlling for age, marital status, and residence, women had a higher risk of frailty than men (OR=1.318, 95% CI: 1.181-1.470, P < 0.001); women had lower SES levels than men (β=-1.282, P < 0.001); and SES was negatively associated with frailty (OR=0.928, 95% CI: 0.916-0.948, P < 0.001). Bootstrap test showed that the natural indirect effect (NIE) of SES on frailty was 0.056 (95 % CI: 0.040-0.073, P < 0.001), accounting for 25.5% of the total effect.  Conclusions  SES has a mediating effect between gender and frailty, and the prevention and treatment of frailty should be tailored to the characteristics of SES in individuals of different genders.
The effect of unhealthy lifestyle on the association between adverse childhood experiences and multimorbidity
FENG Hongman, XU Xianghui, LIU Mingyue, CHEN Xinyang, LI Xiaoming
2025, 29(8): 974-981. doi: 10.16462/j.cnki.zhjbkz.2025.08.017
Abstract(8) HTML (5) PDF(1)
Abstract:
  Objective  This study aimed to examine the association between adverse childhood experiences (ACEs) and multimorbidity in middle-aged and older adults, and to investigate whether unhealthy lifestyle mediates this relationship.  Methods  We analyzed data from 7 513 participants aged ≥45 years in the China Health and Retirement Longitudinal Study from 2011 to 2018. Demographic characteristics, ACEs exposure, unhealthy lifestyle behaviors and chronic disease diagnoses were assessed. Group differences in multimorbidity prevalence were evaluated using t-tests or χ2 tests. Unconditional logistic regression models quantified the effects of ACEs and lifestyle on multimorbidity. Mediation analysis was conducted using the Bootstrap method.  Results  The prevalence of multimorbidity among the 7 513 participants was 36.34% (95% CI: 35.25%-37.44%). Multivariate analysis revealed that each additional ACE was associated with an 10.4% increase in the risk of multimorbidity (95% CI: 1.058-1.152). Compared to individuals with one ACE, those with 3 and ≥4 ACEs had 38.3% (95% CI: 1.023-1.870) and 43.2% (95% CI: 1.065-1.926) higher risks of multimorbidity, respectively. Additionally, each additional unhealthy lifestyle behavior increased multimorbidity risk by 14.4% (95% CI: 1.077-1.216). Compared to those with healthy lifestyles, individuals with ≥4 unhealthy behaviors had a 99.1% higher risk (95% CI: 1.365-2.903). Mediation analysis revealed that unhealthy lifestyle did not have a significant mediating effect on multimorbidity in middle-aged and older adults (all P>0.05)  Conclusions  ACEs were positively correlated with multimorbidity, no significant mediating role of an unhealthy lifestyle was found between ACEs and multimorbidity among middle-aged and older adults.
A study on the characteristics of spatial and temporal distribution and aggregation of acquired immune deficiency syndrome in China from 2012 to 2021
WANG Chaoyi, ZHANG Chunhui, ZHANG Yiyu, YANG Jinghan, KONG Yujia, SHI Fuyan, WANG Suzhen
2025, 29(8): 982-987. doi: 10.16462/j.cnki.zhjbkz.2025.08.018
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  Objective  The purpose of this study was to analyze the spatial and temporal patterns of acquired immune deficiency syndrome(AIDS) incidence and areas of concentration in China from 2012 to 2021, and to provide an evidence for prevention and control.  Methods  Data on AIDS incidence and demographic information in China from 2012 to 2021 were obtained from the Public Health Science Data Centre, the China Health and Health Statistics Yearbook, and the National Bureau of Statistics. Descriptive analysis, spatial autocorrelation analysis, spatiotemporal scan statistics, and standard deviation ellipse (SDE) methods were used to analyze trends in disease prevalence, spatiotemporal characteristics, and characteristics of affected regions, respectively.  Results  From 2012 to 2019, the incidence of AIDS in China was on the rise annual percentage change(APC)(APC=7.62%, 95% CI: 6.52%-9.92%, P < 0.001), and from 2019 to 2021, there was a decline in the incidence rate(APC=-7.64%, 95% CI: -14.12%-0.74%, P=0.030). Global autocorrelation analysis showed that the Moran′s I value increased from 0.240 in 2012 to 0.414 in 2021, indicating an increase in positive spatial autocorrelation. In the local spatial autocorrelation analysis, Guizhou Province, Yunnan Province and Guangxi Zhuang Autonomous Region remained in a "high-high" cluster pattern, whereas Inner Mongolia Autonomous Region and Liaoning Province were consistently in a "low-low" cluster pattern; Henan Province and Sichuan Province changed patterns over time. Hotspot analysis showed that hotspot clusters had formed in Guizhou and other provinces, indicating a spreading trend. The spatio-temporal scan revealed that Yunnan Province, Guizhou Province, Sichuan Province, Chongqing City and Guangxi Zhuang Autonomous Region were the key areas of the epidemic, and the SDE method suggested that the focus of the disease shifted from Sichuan Province and Chongqing City to the southeast.  Conclusions  This study reveals the spatio-temporal characteristics of the AIDS epidemic in China; Prevention and control should be based on these patterns to allocate resources accurately and strengthen interventions in key regions.
Development and application of outpatient dialysis event monitoring system
BAI Yi, MA Ru, SHAO Honglin, SU Chunyan, WANG Shaoli, ZHAO Xintian, YUAN Xiaoning, XING Yan, ZHANG Huizhi
2025, 29(8): 988-992. doi: 10.16462/j.cnki.zhjbkz.2025.08.019
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Abstract:
  Objective  To meet the need for precise prevention and control, this study established and applied a surveillance system for dialysis event (DE) in outpatient settings, enabling risk monitoring, real-time alerts, and data-driven decision support based on health information technology.  Methods  The surveillance system was developed based on the designed key technical information and principles. The self-developed platform was implemented in a tertiary care hospital hemodialysis unit for a 12-month prospective surveillance in 2024. We described three-tier metrics: (1) DE incidence (2) Hemodialysis-associated infection incidence (3) System performance indicators.  Results  The system monitored 587 patients undergoing 40 253 hemodialysis sessions through automated data extraction. It recognized and reported 423 DEs (incidence: 1.05%), and one hemodialysis-associated infection (incidence: 0.17%). These findings were consistent with results from parallel traditional manual surveillance. Compared to the conventional methods, the timeliness and proactive reporting rate of the active monitoring system had increased by 57.97% and 21.40% respectively.  Conclusions  As a standardized monitoring tool, this system has important practical value in promoting the digital transformation of infection management in outpatient hemodialysis. The real-time surveillance data generated not only provides technical support for establishing infection baseline data, but also provides reference and inspiration for further improving the level of infection monitoring and prevention in outpatient hemodialysis.

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