目的分析中国1990—2021年紧张性头痛的疾病负担现状与变化趋势,确定重点防控人群,并预测2022—2035年的变化趋势,为制定紧张性头痛的防治措施提供依据。方法基于2021年全球疾病负担研究(Global Burden of Disease Study 2021,GBD 2021...目的分析中国1990—2021年紧张性头痛的疾病负担现状与变化趋势,确定重点防控人群,并预测2022—2035年的变化趋势,为制定紧张性头痛的防治措施提供依据。方法基于2021年全球疾病负担研究(Global Burden of Disease Study 2021,GBD 2021)数据库,获取1990—2021年中国紧张性头痛的疾病负担数据,包括发病率、患病率、伤残调整寿命年(disability-adjusted life year,DALY)等指标。利用Joinpoint回归模型分析紧张性头痛疾病负担的变化趋势,并采用贝叶斯年龄-时期-队列(Bayesian age-period-cohort,BAPC)模型按年龄、性别分层对中国紧张性头痛的疾病负担进行评估。结果1990—2021年中国紧张性头痛的发病数、患病数和DALY增幅分别为32.61%、39.08%、46.32%,均呈上升趋势。男性与女性的发病率和患病率在30~34岁和70~74岁年龄组分别出现上升拐点,呈现双峰分布,并在≥95岁年龄组达到峰值;DALY率在40~44岁年龄段达到峰值。1990—2021年女性DALY、发病率和患病率均高于男性。预计2022—2035年,中国居民的紧张性头痛发病率、患病率和DALY率将持续上升,但整体波动幅度较小。结论1990—2021年中国紧张性头痛的疾病负担上升,预计至2035年,中国居民的紧张性头痛疾病负担将持续加重,应采取全面预防措施,重点关注女性群体,并建立有效的防控体系。展开更多
目的分析2010—2020年恩施州手足口病(hand,foot and mouth disease,HFMD)的流行特征,探讨社会经济与气象因素的影响,并评估疫情防控措施对HFMD的干预效果。方法运用ArcGIS 10.8对恩施州88个乡级行政单元的HFMD病例进行时空特征可视化;...目的分析2010—2020年恩施州手足口病(hand,foot and mouth disease,HFMD)的流行特征,探讨社会经济与气象因素的影响,并评估疫情防控措施对HFMD的干预效果。方法运用ArcGIS 10.8对恩施州88个乡级行政单元的HFMD病例进行时空特征可视化;采用贝叶斯时空模型解析社会经济与气象因素对疾病分布的影响;使用SEIR模型估算易感人群人数与比例;构建时间序列模型,预测2020年发病趋势并量化疫情防控措施效果。结果2010—2020年累计报告病例58954例,年均发病率为11.90/10万,死亡率为0.01/10万,≤5岁儿童占发病人数的93.20%;居民储蓄存款每增加1个标准差单位,发病率下降1.1%(P<0.05);医院床位数与发病率呈正相关;气温升高(β=0.182)和降水增多(β=0.229)增加发病风险;疫情防控措施使发病数每月减少415例(P=0.049),但防控放松后,2020年12月发病数较2019年同期增长266.6%,呈现补偿性流行特征。结论本研究揭示了恩施州HFMD的时空分布特征及社会经济气象驱动因素,量化了疫情防控措施效果,为山区传染病精准防控提供了多维度依据。展开更多
Global environmental changes including climate warming,extreme weather events,ambient air pollution,freshwater contamination,and landscape transformation are reshaping the epidemiology of infectious diseases with unpr...Global environmental changes including climate warming,extreme weather events,ambient air pollution,freshwater contamination,and landscape transformation are reshaping the epidemiology of infectious diseases with unprecedented complexity,particularly in the post-COVID-19 era.This review synthesizes evidence from the past decade(2015-2024)to systematically elucidate how key environmental drivers modulate pathogen emergence,transmission dynamics,and clinical outcomes,with a focus on underlying mechanistic pathways.Specifically,we highlight:(1)the temperature-and precipitation-dependent transmission of vector-borne diseases(e.g.,malaria,dengue)via expanded vector habitats and accelerated pathogen incubation;(2)the exacerbation of respiratory infections(including COVID-19)by particulate matter(PM2.5)and nitrogen dioxide(NO2)through impaired mucosal immunity and enhanced inflammatory responses;(3)the persistence of diarrheal diseases in low-and middle-income countries(LMICs)linked to water insecurity and climate-induced infrastructure failure;and(4)zoonotic spillover risks amplified by urbanization and deforestation-driven human-wildlife interface disruption.Integrating the One Health socioecological framework,we further summarize methodological advances from high-resolution genomic surveillance to climate-informed machine learning models that have improved causal inference and predictive accuracy.Our synthesis confirms that environmental factors are not merely contextual but central,modifiable determinants of infectious disease risk,with disproportionate impacts on vulnerable populations.To mitigate future threats,we emphasize the urgency of interdisciplinary collaboration,integrated environmental-health monitoring platforms,and climate-resilient public health policies tailored to post-pandemic challenges.This review provides a timely roadmap for translating environmental epidemiology insights into actionable strategies to strengthen global health resilience.展开更多
文摘目的分析中国1990—2021年紧张性头痛的疾病负担现状与变化趋势,确定重点防控人群,并预测2022—2035年的变化趋势,为制定紧张性头痛的防治措施提供依据。方法基于2021年全球疾病负担研究(Global Burden of Disease Study 2021,GBD 2021)数据库,获取1990—2021年中国紧张性头痛的疾病负担数据,包括发病率、患病率、伤残调整寿命年(disability-adjusted life year,DALY)等指标。利用Joinpoint回归模型分析紧张性头痛疾病负担的变化趋势,并采用贝叶斯年龄-时期-队列(Bayesian age-period-cohort,BAPC)模型按年龄、性别分层对中国紧张性头痛的疾病负担进行评估。结果1990—2021年中国紧张性头痛的发病数、患病数和DALY增幅分别为32.61%、39.08%、46.32%,均呈上升趋势。男性与女性的发病率和患病率在30~34岁和70~74岁年龄组分别出现上升拐点,呈现双峰分布,并在≥95岁年龄组达到峰值;DALY率在40~44岁年龄段达到峰值。1990—2021年女性DALY、发病率和患病率均高于男性。预计2022—2035年,中国居民的紧张性头痛发病率、患病率和DALY率将持续上升,但整体波动幅度较小。结论1990—2021年中国紧张性头痛的疾病负担上升,预计至2035年,中国居民的紧张性头痛疾病负担将持续加重,应采取全面预防措施,重点关注女性群体,并建立有效的防控体系。
文摘目的本研究基于开滦队列,探讨长期随访期间残余胆固醇(remnant cholesterol,RC)的变异性与心脏传导阻滞(cardiac conduction block,CCB)的关联。方法采用回顾性队列研究,以连续参加2006、2008、2010年度体检的开滦研究人群作为研究队列,根据纳入和排除标准,最终入选39299例观察对象,计算随访期间RC的变异性,RC的变异性通过标准差(standard deviation,SD)、平均真实变异性(average real variability,ARV)、变异系数(coefficient of variation,CV)、独立于均值的变异(variation independent of mean,VIM)测量。以RC的变异性四分位进行分组,将观察对象分成4组,每2年进行1次随访,以发生CCB、死亡或随访结束(2019年12月31日)为随访终点,采用Kaplan-Meier法计算不同分组发生终点事件的累积发病率,并用Log-Rank检验比较各组终点事件累积发生率的差异。用Cox比例风险模型及限制性立方样条曲线(restricted cubic spline,RCS)分析RC的变异性与CCB及其亚型的关联。结果39299例观察对象在平均随访7.43年后,发生CCB者共916人。以CCB为结局事件,校正混杂因素后,以RC-SD四分位分组,与RC-SD最低发病密度组(Q2)相比,Q1组发生CCB的HR值为1.344(95%CI:1.110~1.626,P=0.002),Q3、Q4组发生CCB的HR值分别1.068(95%CI:0.878~1.299,P=0.509)、1.311(95%CI:1.089~1.579,P=0.004)。以RC-ARV、RC-CV、RC-VIM四分位分组均得出类似的结论。RCS曲线表明,RC-SD与CCB之间呈U型关联(P_(overall)<0.05,P_(nonlinearity)<0.05)。敏感性分析、分层分析进一步验证了此结论。结论RC的变异性与CCB呈U型关联,该研究为预防CCB的发生提供了新的方向。对策我国血脂管理策略应从追求“低水平稳定”,向兼顾“指标长期平稳性”转型升级。即将“维持血脂在适宜区间的生理性波动”这一新理念,系统整合至国家心脑血管疾病防治规划、基层公共卫生服务项目及全民健康教育体系,以此推动慢性病管理迈向更加精准、科学的新阶段。
文摘目的分析2010—2020年恩施州手足口病(hand,foot and mouth disease,HFMD)的流行特征,探讨社会经济与气象因素的影响,并评估疫情防控措施对HFMD的干预效果。方法运用ArcGIS 10.8对恩施州88个乡级行政单元的HFMD病例进行时空特征可视化;采用贝叶斯时空模型解析社会经济与气象因素对疾病分布的影响;使用SEIR模型估算易感人群人数与比例;构建时间序列模型,预测2020年发病趋势并量化疫情防控措施效果。结果2010—2020年累计报告病例58954例,年均发病率为11.90/10万,死亡率为0.01/10万,≤5岁儿童占发病人数的93.20%;居民储蓄存款每增加1个标准差单位,发病率下降1.1%(P<0.05);医院床位数与发病率呈正相关;气温升高(β=0.182)和降水增多(β=0.229)增加发病风险;疫情防控措施使发病数每月减少415例(P=0.049),但防控放松后,2020年12月发病数较2019年同期增长266.6%,呈现补偿性流行特征。结论本研究揭示了恩施州HFMD的时空分布特征及社会经济气象驱动因素,量化了疫情防控措施效果,为山区传染病精准防控提供了多维度依据。
基金the Natural Science Basic Research Program of Shaanxi Province,China[2023-JC-QN-0858]the Free Exploration Program of the Second Affiliated Hospital,School of Medicine,Xi’an Jiaotong University[2020YJ(ZYTS)605]the National Natural Science Foundation of China[81900620].
文摘Global environmental changes including climate warming,extreme weather events,ambient air pollution,freshwater contamination,and landscape transformation are reshaping the epidemiology of infectious diseases with unprecedented complexity,particularly in the post-COVID-19 era.This review synthesizes evidence from the past decade(2015-2024)to systematically elucidate how key environmental drivers modulate pathogen emergence,transmission dynamics,and clinical outcomes,with a focus on underlying mechanistic pathways.Specifically,we highlight:(1)the temperature-and precipitation-dependent transmission of vector-borne diseases(e.g.,malaria,dengue)via expanded vector habitats and accelerated pathogen incubation;(2)the exacerbation of respiratory infections(including COVID-19)by particulate matter(PM2.5)and nitrogen dioxide(NO2)through impaired mucosal immunity and enhanced inflammatory responses;(3)the persistence of diarrheal diseases in low-and middle-income countries(LMICs)linked to water insecurity and climate-induced infrastructure failure;and(4)zoonotic spillover risks amplified by urbanization and deforestation-driven human-wildlife interface disruption.Integrating the One Health socioecological framework,we further summarize methodological advances from high-resolution genomic surveillance to climate-informed machine learning models that have improved causal inference and predictive accuracy.Our synthesis confirms that environmental factors are not merely contextual but central,modifiable determinants of infectious disease risk,with disproportionate impacts on vulnerable populations.To mitigate future threats,we emphasize the urgency of interdisciplinary collaboration,integrated environmental-health monitoring platforms,and climate-resilient public health policies tailored to post-pandemic challenges.This review provides a timely roadmap for translating environmental epidemiology insights into actionable strategies to strengthen global health resilience.
