Male breast cancer(MBC)is rare,representing 0.5%–1%of all breast cancers,but its incidence is increasing due to improved diagnostics and awareness.MBC typically presents in older men,is human epidermal growth factor ...Male breast cancer(MBC)is rare,representing 0.5%–1%of all breast cancers,but its incidence is increasing due to improved diagnostics and awareness.MBC typically presents in older men,is human epidermal growth factor receptor 2(HER2)-negative and estrogen receptor(ER)-positive,and lacks routine screening,leading to delayed diagnosis and advanced disease.Major risk factors include hormonal imbalance,radiation exposure,obesity,alcohol use,and Breast Cancer Gene 1 and 2(BRCA1/2)mutations.Clinically,it may resemble gynecomastia but usually appears as a unilateral,painless mass or nipple discharge.Advances in imaging and liquid biopsy have enhanced early detection.Molecular mechanisms involve hormonal signaling,HER2/epidermal growth factor receptor(EGFR)pathways,tumor suppressor gene alterations,and epigenetic changes.While standard treatments mirror those for female breast cancer,emerging options such as cyclin-dependent kinase 4 and 6(CDK4/6),and poly(ADP-ribose)polymerase(PARP)inhibitors,immunotherapy,and precision medicine are reshaping management.Incorporating artificial intelligence,molecular profiling,and male-specific clinical trials is essential to improve outcomes and bridge current diagnostic and therapeutic gaps.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
Trauma is a major cause of morbidity and mortality across the globe accounting for significant health burden.Relevance of trauma care revolves round prevention,planning and execution of safety regulations.Acquisition ...Trauma is a major cause of morbidity and mortality across the globe accounting for significant health burden.Relevance of trauma care revolves round prevention,planning and execution of safety regulations.Acquisition of the actual data regarding the type of trauma,affected age group,timings of trauma occurrence,involved part of the body constitute the initial steps in the building of the composite overview of the epidemiology of trauma.In succession,would be the measures directed towards avoidance of trauma and capacity building of trauma center.展开更多
BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram ...BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram using internal and external validation to predict survival in patients with ampullary adenocarcinoma.METHODS Data were sourced from the surveillance,epidemiology,and end results stat database.The patients in the database were randomized in a 7:3 ratio into training and validation groups.Using Cox regression univariate and multivariate analyses in the training group,we identified independent risk factors for overall survival and cancer-specific survival to develop the nomogram.The nomogram was validated with a cohort of patients from the First Affiliated Hospital of the Army Medical University.RESULTS For overall and cancer-specific survival,12(sex,age,race,lymph node ratio,tumor size,chemotherapy,surgical modality,T stage,tumor differentiation,brain metastasis,lung metastasis,and extension)and 6(age;surveillance,epidemiology,and end results stage;lymph node ratio;chemotherapy;surgical modality;and tumor differentiation)independent risk factors,respectively,were incorporated into the nomogram.The area under the curve values at 1,3,and 5 years,respectively,were 0.807,0.842,and 0.826 for overall survival and 0.816,0.835,and 0.841 for cancer-specific survival.The internal and external validation cohorts indicated good consistency of the nomogram.CONCLUSION The dynamic nomogram offers robust predictive efficacy for the overall and cancer-specific survival of ampullary adenocarcinoma.展开更多
Breast cancer is the most common cancer among women worldwide. The term epidemiology generally deals with the branch of medicine and treatment that deals with a specific incident. Thus, considering the topic of breast...Breast cancer is the most common cancer among women worldwide. The term epidemiology generally deals with the branch of medicine and treatment that deals with a specific incident. Thus, considering the topic of breast cancer, this particular study deals with the distribution, determinants, and frequency of the disease. Breast cancer incidence and death data are critical to determining healthcare priorities. Women’s cancer is the most common, accounting for 25.1 percent of all malignancies. According to this specific report, more than 42,000 women die from breast cancer each year. Hence, it is apparent that it is the second leading cause of death among women, especially in the US. Family history/genetics, reproductive, hormone, benign proliferative breast disease, and mammographic density are the four main risk factors for breast cancer that can be meaningfully categorized. These elements are briefly discussed, and the risk estimators are provided. Numerous screening technologies have found breast cancer;some are linked to an increased risk of breast cancer, such as ultrasound techniques and MRI scanning. Breast cancer is more common in developed countries, while relative mortality is highest in developing countries. Women’s education is recommended for early detection and treatment in all nations. Health policymakers must prioritize plans to control and prevent this malignancy and increase awareness of risk factors and early detection in less developed countries.展开更多
Hepatocellular carcinoma(HCC)is one of the leading causes of cancer-related deaths globally,and its epidemiological characteristics and risk factors are continuously evolving.This review systematically elaborates on t...Hepatocellular carcinoma(HCC)is one of the leading causes of cancer-related deaths globally,and its epidemiological characteristics and risk factors are continuously evolving.This review systematically elaborates on the global disease burden of HCC,the main risk factors(including hepatitis B/C virus infection,non-alcoholic fatty liver disease,aflatoxin exposure,and unhealthy lifestyles),and the corresponding prevention strategies.The article provides a detailed analysis of the performance and limitations of key serological markers currently used for early diagnosis of HCC,such as alpha-fetoprotein,abnormal prothrombin,and alpha-fetoprotein variant L3.Furthermore,the review comprehensively summarizes the advancements in clinical treatment for HCC,ranging from radical approaches including surgical resection,liver transplantation,radiofrequency ablation to palliative therapies for patients with advanced disease such as transcatheter arterial chemoembolization,targeted therapy,immunotherapy,and further evaluates their efficacy,indications,and challenges.This article aims to provide a comprehensive reference for a deeper understanding of the current status of HCC prevention and control,improving early diagnostic rates,and optimizing clinical treatment strategies.展开更多
BACKGROUND Alcohol can cause alcoholic fatty liver,alcoholic steatohepatitis,alcoholic liver cirrhosis(ALC),and hepatocellular carcinoma.China has become the secondlargest country in the world in terms of alcohol cons...BACKGROUND Alcohol can cause alcoholic fatty liver,alcoholic steatohepatitis,alcoholic liver cirrhosis(ALC),and hepatocellular carcinoma.China has become the secondlargest country in the world in terms of alcohol consumption,lacking national epidemiological data on alcoholic liver disease(ALD).AIM To understand the incidence and characteristics of ALD in Hainan Province of China.METHODS From October 2022 to April 2023,a stratified proportional multi-stage whole population sampling method was adopted to select permanent residents of Haikou,Sanya,Qionghai,Dongfang,and Wuzhishan in Hainan Province to carry out questionnaire surveys,blood tests,and ultrasound examinations of the liver.RESULTS A total of 2704 valid questionnaires were obtained from residents aged 15-93 years old.The rates of drinking,hazardous drinking,and harmful drinking were 31.73%,14.53%,and 5.03%,respectively.The above rates were higher for males than for females,increasing with income,and the rates for ethnic minorities,such as Li,were higher than for Han Chinese(P<0.05).Drinking rates increased with literacy(P<0.05).Drinking rate and hazardous drinking rate decreased with age,were higher for residents of agricultural households than non-agricultural households,and higher for married than unmarried individuals(P<0.05).The total number of patients with ALD was 142,with a detection rate of 5.25%.ALD detection rate was higher for males than females,decreased with age,and higher with income(P<0.05).Patients with ALD included 48(33.8%)cases of mild ALD,64(45.1%)cases of alcoholic fatty liver,18(12.7%)cases of alcoholic steatohepatitis,and 12(8.5%)cases of ALC.The proportion of those who consumed more than 80 g of alcohol per day increased as they progressed from mild ALD to ALC stage.Diabetes mellitus and hyperlipidemia were easily combined in some cases,accounting for 25(17.6%)and 80(56.3%),respectively.The average daily alcohol consumption of ALD patients of Li ethnicity≥80 g was significantly more than that of Han ethnicity(χ2=5.652,P=0.02),and was predominantly among those who drank large amounts of alcohol intermittently(χ2=89.093,P<0.001).CONCLUSION The rates of drinking,hazardous drinking,harmful drinking,and detection of ALD in Hainan Province need to be paid attention to by advocating a healthy lifestyle,such as abstinence and limiting alcohol consumption.展开更多
In recent years,nosocomial infections caused by Clostridium difficile(C.difficile)have risen,becoming a leading cause of hospital-acquired diarrhea.The global prevalence of C.difficile infection(CDI)varies across regi...In recent years,nosocomial infections caused by Clostridium difficile(C.difficile)have risen,becoming a leading cause of hospital-acquired diarrhea.The global prevalence of C.difficile infection(CDI)varies across regions and populations.The diagnosis relies primarily on laboratory testing,including toxin,glutamate dehy-drogenase,and nucleic acid amplification tests.Treatment strategies for CDI in-clude antimicrobial therapy(e.g.,metronidazole,vancomycin,and fidamycin),fecal transplantation,and immunotherapy(e.g.,belotozumab),depending on the patient’s specificity and severity.This paper reviews recent research on CDI’s epidemiological characteristics,risk factors,diagnosis,treatment,and prevention,aiming to support hospitals and public health initiatives in implementing effective detection,prevention,and treatment strategies.展开更多
Wastewater-based epidemiology has emerged as a transformative surveillance tool for estimating substance consumption and monitoring disease prevalence,particularly during the COVID-19 pandemic.It enables the populatio...Wastewater-based epidemiology has emerged as a transformative surveillance tool for estimating substance consumption and monitoring disease prevalence,particularly during the COVID-19 pandemic.It enables the population-level monitoring of illicit drug use,pathogen prevalence,and environmental pollutant exposure.In this perspective,we summarize the key challenges specific to the Chinese context:(1)Sampling inconsistencies,necessitating standardized 24-hour composite protocols with high-frequency autosamplers(≤15 min/event)to improve the representativeness of samples.展开更多
BACKGROUND Data regarding complex Crohn’s perianal fistulas(CPF)epidemiology are limited,and optimal treatment strategies are elusive.An improved understanding of how CPF treatment options are used in the real-world ...BACKGROUND Data regarding complex Crohn’s perianal fistulas(CPF)epidemiology are limited,and optimal treatment strategies are elusive.An improved understanding of how CPF treatment options are used in the real-world setting and factors associated with CPF development,treatment failure,and reasons for undergoing multiple surgeries may help to inform optimal patient management strategies,reduce treatment burden,and improve outcomes in patients with CPF.AIM To describe the epidemiology,treatments,outcomes,and associated risk/protective factors for complex CPF.METHODS Electronic databases(MEDLINE,EMBASE,EBM Reviews,EconLit)were searched.Two reviewers independently used populations,interventions,comparators,outcomes,study designs,and time criteria to identify relevant studies.Observational studies published in English from January 1,2015 to February 17,2022 with>50 patients were included,even if complex CPF was not defined.Items of interest included complex CPF definitions,epidemiology,treatment patterns,morbidity,mortality,and risk factors associated with complex CPF development,treatment failure,and undergoing multiple surgeries.Data were reported using descriptive statistics.RESULTS Overall,140 studies were included.Complex CPF definitions were heterogeneous and rarely reported(24 studies).Hence,data mostly related to CPF in general.CPF prevalence was variable(range:1.5%-81.0%).Incidence was wide-ranging and mostly reported cumulatively at 1-year post-Crohn’s disease diagnosis(range:3.5%-50.1%).Overall healing and failure rates after treatment were in the range of 10.5%-80.2%and 3.6%-83.0%,respectively.Abscesses were the most frequently reported morbidity(n=18).No CPF-related deaths were reported.No consistent risk or protective factors were identified.CONCLUSION Epidemiology,treatment patterns,and risk factors for CPF vary,likely due to inconsistent CPF and clinical outcome definitions.Standardization would facilitate comparability,which may inform optimal complex CPF treatment strategies.展开更多
BACKGROUND Postoperative pulmonary complications(PPCs)are the most common complications following major upper abdominal surgeries,particularly hepatobiliary procedures,and significantly compromise surgical outcomes an...BACKGROUND Postoperative pulmonary complications(PPCs)are the most common complications following major upper abdominal surgeries,particularly hepatobiliary procedures,and significantly compromise surgical outcomes and patients’quality of life.Although the adoption of laparoscopy has lowered their incidence,PPCs remain a frequent and serious concern after hepatobiliary surgery.Existing research on risk factors specific to hepatobiliary surgeries is limited,particularly regarding the epidemiology and risk factors of PPCs in liver and gallbladder surgeries in China.Therefore,this study aimed to investigate the risk factors for PPCs in a large hepatobiliary center.AIM To identify the incidence and risk factors for PPCs following hepatobiliary surgery based on perioperative variables.METHODS Retrospective data were collected from patients who underwent liver,gallbladder,or pancreatic surgery at a hepatobiliary center in China between May 2023 and December 2023.We retrospectively reviewed comprehensive medical records to extract demographic and hospital admission information for determining PPC incidence.Statistically significant variables were initially screened through univariate analysis,followed by binary logistic regression modeling to identify independent predictors of PPCs.Hospitalization expenditures and duration of stay were further contrasted across the study cohorts.RESULTS This study included 1941 patients who underwent liver,gallbladder,or pancreatic surgery,of whom 78 developed PPCs,resulting in an incidence rate of 4.02%.Logistic regression analysis revealed two independent predictors of PPCs in hepatobiliary surgery patients:Age≥75 year(odds ratio=8.350,95%CI:3.521-19.798,P<0.001)and prolonged anesthesia(odds ratio=1.052,95%CI:1.015-1.091,P=0.006).Patients with PPCs had significantly elevated healthcare resource utilization,including higher total hospitalization costs,increased medication expenses,longer hospital stays,and extended postoperative admissions(all P<0.001).CONCLUSION Age≥75 years and prolonged anesthesia emerged as independent predictors of PPCs following hepatobiliary surgery.These complications were correlated with protracted hospitalization and increased healthcare costs.展开更多
BACKGROUND Although epidemiological data on non-alcoholic fatty liver disease in China are available,data on cardiometabolic risk factors have not been addressed under the metabolic dysfunction-associated steatotic li...BACKGROUND Although epidemiological data on non-alcoholic fatty liver disease in China are available,data on cardiometabolic risk factors have not been addressed under the metabolic dysfunction-associated steatotic liver disease(MASLD)consensus.AIM To synthesize the epidemiological characteristics of MASLD/metabolic dysfunction-associated steatohepatitis(MASH),especially their associated cardiometabolic risk factors in China.METHODS We searched EMBASE,MEDLINE,Central Cochrane,CNKI,and Wangfan for studies from January 1,2013 to December 31,2023.Studies involving individuals with MASLD/MASH in China that reported epidemiological outcomes were included.Meta-analysis was performed to assess the prevalence of MASLD/MASH.Exploratory outcomes included extrahepatic comorbidities and genetic variants related to MASLD.RESULTS In total,561 studies involving 6632718 participants were included in this analysis.The prevalence of MASLD and MASH and the annual incidence of MASLD were 30.4%[95%confidence interval(CI):29.4-31.3],6.7%(95%CI:2.2-13.4),and 37 cases per 1000 person-years(95%CI:28-47),respectively.In addition,the prevalence rates of MASLD in individuals with dyslipidemia,obesity,and hypertension were 59.9%(95%CI:52.6-67.0),53.9%(95%CI:47.9-59.9),and 44.3%(95%CI:41.1-47.6),respectively.The prevalence of lean MASLD(body mass index<24 kg/m2)was 12.0%(95%CI:10.0-14.0),and 21.7%of the total MASLD population in China had lean MASLD.CONCLUSION This study provides a comprehensive overview of the epidemiology and disease burden of MASLD/MASH in China,providing additional evidence for optimizing MASLD/MASH management in China and a reference for the global understanding of MASLD/MASH epidemiology.展开更多
Introduction: Influenza A (Flu A) and B (Flu B) viruses are responsible for severe acute respiratory infections (SARI) worldwide, with a morbidity of 5 million and mortality of 29,000 - 650,000 deaths per year. Influe...Introduction: Influenza A (Flu A) and B (Flu B) viruses are responsible for severe acute respiratory infections (SARI) worldwide, with a morbidity of 5 million and mortality of 29,000 - 650,000 deaths per year. Influenza B viruses are an important cause of respiratory infections in humans, but they tend to be underappreciated due to the predominance of Influenza A. No molecular study on Influenza B has been carried out in the DRC. This study was conducted to document the molecular evolution of the hemagglutinin (HA) gene in the circulating Influenza B strains over the eight consecutive epidemic seasons (from 2015 to 2022). Methods: Samples were collected from outpatient cases suspected of influenza-like illness (ILI) and in all hospitalized patients with SARI from January 2015 to December 2022. Molecular analysis was done to determine influenza type and subtype, and then segments encoding the HA gene of Influenza B viruses were performed. Results: Of 8497 samples collected and tested, 639 (7.5%) were positive for influenza viruses, including 389 (60.8%) for Influenza A viruses and 248 (38,8%) for Influenza B viruses. Of the positive Influenza B samples, 91 were sequenced, including 26 belonging to the B/Yamagata lineage and 65 to the B/Victoria lineage. The HA gene of Influenza B viruses circulating in the DRC showed deletions in the HA1 region. Molecular analysis of Influenza B viruses reflects the genetic diversity of Influenza B/Yam virus clades (Y2, Y3, Y3V1A) alternating with Influenza B/Victoria virus clades (V1A, V1A.3) depending on the year and influenza seasons. The phylogenetic analysis of these Influenza B strains shows compatibility with the corresponding vaccine strains that the WHO had validated for each influenza season. Conclusion: This study underscores the importance of continuous molecular surveillance of Influenza B viruses in the DRC to understand their epidemiology and evolutionary dynamics. Identifying mutations, such as HA deletions, is critical for assessing their impact on transmissibility vaccine efficacy and guiding effective vaccination and control strategies.展开更多
Antimicrobial resistance(AMR)has become a critical global public health challenge in the 21st century.Since the initial isolation of a blaNDM-1-carrying and carbapenem-resistant Klebsiella pneumoniae from an Indian ho...Antimicrobial resistance(AMR)has become a critical global public health challenge in the 21st century.Since the initial isolation of a blaNDM-1-carrying and carbapenem-resistant Klebsiella pneumoniae from an Indian hospital in 2009[1],the escalating prevalence of New Delhi metallo-β-lactamase(NDM)-encoding genes(blaNDM)has transformed carbapenem resistance into a worldwide phenomenon,transcending national and regional boundaries[2].Up to 90 distinct NDM variants have been reported globally according to the NCBI GenBank Pathogens database.Plasmidmediated horizontal gene transfer(HGT),which occurs both within and across bacterial species,has significantly accelerated the global dissemination of blaNDM-related genes and the associated resistance[3].Carbapenem-resistant pathogens were responsible for 200,000 deaths globally in 2019[4].Although NDM-1 has been relatively well characterized[5],the epidemiological profiles of other NDM variants require continued surveillance and indepth investigation.The novel NDM-9 variant(GenBank accession no.KC999080)was first identified in 2013 from a clinically significant isolate of Klebsiella pneumoniae ST107 strain PPH1303 with a high level of resistance to carbapenems recovered from the urine culture of a pediatric patient in Beijing,China,who had acute lymphocytic leukemia and had undergone allogeneic stem cell transplantation[6].展开更多
Acquired Immunodeficiency Syndrome(AIDS)caused by Human Immunodeficiency Virus(HIV)infection poses a serious threat to global public health.This article comprehensively reviews the epidemiological characteristics of H...Acquired Immunodeficiency Syndrome(AIDS)caused by Human Immunodeficiency Virus(HIV)infection poses a serious threat to global public health.This article comprehensively reviews the epidemiological characteristics of HIV infection,including the global and domestic epidemic situation,transmission routes,and characteristics of high-risk groups.It also introduces comprehensive prevention and control strategies in detail.Through analysis,it aims to provide a reference for further optimizing HIV prevention and control work.展开更多
BACKGROUND Gestational diabetes mellitus(GDM)is a growing public health concern,particularly in regions with diverse ethnic populations.Understanding the incidence and risk factors of GDM is crucial for early preventi...BACKGROUND Gestational diabetes mellitus(GDM)is a growing public health concern,particularly in regions with diverse ethnic populations.Understanding the incidence and risk factors of GDM is crucial for early prevention and management,especially in underrepresented areas like Guizhou Province,China,where geographic and ethnic diversity may influence the disease’s prevalence and risk profiles.AIM To investigate the incidence of GDM and identify its associated risk and protective factors among different ethnic groups in Guizhou Province,providing essential data for early prevention strategies.METHODS A multi-center retrospective study was conducted,dividing participants into GDM and non-GDM groups according to standardized diagnostic criteria.Data were collected from 103629 deliveries across 40 hospitals in Guizhou.Various demographic,clinical,and laboratory parameters were analyzed using logistic regression to identify risk and protective factors for GDM.RESULTS Among the 103629 deliveries,18957 cases of GDM were identified,with an incidence of approximately 18.3%.The risk of GDM was higher in the Han ethnic group compared to minority ethnic groups.The Dong ethnic group had the lowest incidence among the minorities.Key risk factors identified included older age(especially>35 years),higher pre-pregnancy body mass index(BMI),light physical activity,gravidity,family history of diabetes,hemoglobin,aspartate aminotransferase,alanine aminotransferase,and direct bilirubin.Protective factors included higher education level,total protein,and albumin.There were also differences based on blood type,with type A associated with higher risk.CONCLUSION The incidence rate in Guizhou is 18.3%.Older age(especially>35 years),Han ethnicity,lower education level,higher pre-pregnancy BMI,light physical activity,and higher gravidity are the main risk factors for GDM.Laboratory findings indicate that higher hemoglobin,higher liver function parameters(alanine aminotransferase,aspartate aminotransferase,and direct bilirubin),and lower total protein and albumin are associated with a higher risk of GDM.Blood type A has a higher risk of GDM compared to blood types AB and O.展开更多
BACKGROUND Physical inactivity is a significant yet underappreciated risk factor for cardiovascular disease(CVD),particularly among older adults.The aim of this study was to analyze the global burden of CVD attributab...BACKGROUND Physical inactivity is a significant yet underappreciated risk factor for cardiovascular disease(CVD),particularly among older adults.The aim of this study was to analyze the global burden of CVD attributable to physical inactivity in individuals aged 70 years and older from 1990 to 2021 using the Global Burden of Disease data.METHODS We assessed trends in disability-adjusted life years(DALYs)and deaths,decomposed changes into population growth,aging,and epidemiological factors,and examined health inequalities across sociodemographic index(SDI)regions.RESULTS From 1990 to 2021,a substantial rise in DALYs was observed,especially in low and middle SDI regions,with a 120.06% increase in the low SDI region,but a 23.10% decline in the high SDI region.Decomposition analysis identified population aging and growth as primary drivers for the burden,contributing 66.39% and 83.56% to the increase in middle and low SDI regions,respectively.By contrast,epidemiological improvements alleviated burden in the high SDI region(54.91%).Gender disparities persisted,with women experiencing a higher burden.Inequality analysis indicated a shift in CVD burden towards the low SDI region,with declining concentration indices for DALYs(-0.03 to-0.13)and deaths(-0.07 to-0.15).The Bayesian age-period-cohort projections suggest continued increases in DALYs and deaths through 2050,with women disproportionately affected.CONCLUSIONS These findings highlight the urgent need for targeted interventions promoting physical activity,improving healthcare access,and implementing region-specific prevention strategies.展开更多
The spread of hepatitis B virus(HBV)infection has gradually decreased in Italy in the last 5 decades as shown by the steady reduction in the incidence rates of acute hepatitis B,from 10/100000 inhabitants in1984 to 0....The spread of hepatitis B virus(HBV)infection has gradually decreased in Italy in the last 5 decades as shown by the steady reduction in the incidence rates of acute hepatitis B,from 10/100000 inhabitants in1984 to 0.85/100000 in 2012,and by the reduced prevalence of hepatitis B surface antigen(HBsAg)-positive cases among chronic hepatitis patients with different etiologies,from 60%in 1975 to about 10%in 2001.The prevalence of HBsAg chronic carriers in the general population also decreased from nearly 3%in the 1980s to 1%in 2010.Linked to HBV by its characteristics of defective virus,the hepatitis delta virus(HDV)has shown a similar epidemiological impact on the Italian population over time.The incidence of acute HDV infection decreased from 3.2/100000 inhabitants in 1987 to 0.8/100000 in 2010 and the prevalence of HDV infection in HBsAg chronic carriers decreased from24%in 1990 to 8.5%in 2006.Before the beneficial effects of HBV mass vaccination introduced in 1991,the decreased endemicity of HBV and HDV infection in Italy paralleled the improvement in screening blood donations,the higher standard of living and impressive reduction in the birth rate associated with a marked reduction in the family size.A further contribution to the decline in HBV and HDV infections most probably came from the media campaigns to prevent the spread of human immunodeficiency virus infection by focusing the attention of the general population on the same routes of transmission of viral infections such as unsafe sexual intercourse and parenteral exposures of different kinds.展开更多
AIM: To investigate the epidemiology of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in the two major ethnic groups in Kazakhstan. METHODS: A cross-sectional prospective study of HBV and HCV seropreva...AIM: To investigate the epidemiology of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in the two major ethnic groups in Kazakhstan. METHODS: A cross-sectional prospective study of HBV and HCV seroprevalence was performed among individuals born in Kazakhstan with no history of chronic hepatitis or liver disease. RESULTS: There were 290 volunteers (140 Russians and 150 Kazakhs) aged 10 to 64 years, males accounted for 46%. Active HBV infection (HBsAg positive) was present in 3.8%, anti-HBc in 30%. The prevalence was similar in females and males (33% vs 25%) (P = 0.18). The prevalence of anti-HBc increased from 19% in 10-29 years old volunteers to 53% in 50-years and older volunteers. The prevalence of HBV infection was higher in married than in single adults (38% vs 26%, respectively) (P = 0.2) and more common in Kazakhs (35%) than in Russians (24%) (P = 0.07). HCV infection was present in 9 subjects (3.2%), 5 of them also were positive for anti-HBc in the absence of HBsAg. CONCLUSION: The frequency of active HBV infection (3.8%) coupled with a high prevalence of HBV exposure in those > 50 years of age increases with age, which suggests that horizontal transmission likely relates tothe use of contaminated needles. The low prevalence of HCV infection suggests that HBV and HCV are acquired differently in this group of subjects.展开更多
The recent progress in human genome epidemiology(HuGE) is already having a profound impact on the practice of medicine and public health.First,the success of genome-wide association studies has greatly expanded the di...The recent progress in human genome epidemiology(HuGE) is already having a profound impact on the practice of medicine and public health.First,the success of genome-wide association studies has greatly expanded the direction and content of epidemiological researches,including revealing new genetic mechanisms of complex diseases,identifying new targets for therapeutic interventions,and improving application in early screening of high-risk populations.At the same time,large-scale genomic studies make it possible to efficiently explore the gene-environment interactions,which will help better understand the biological pathways of complex diseases and identify individuals who may be more susceptible to diseases.Additionally,the emergence of systems epidemiology aims to integrate multi-omics together with epidemiological data to create a systems network that can comprehensively characterize the diverse range of factors contributing to disease development.These progress will help to apply HuGE findings into practice to improve the health of individuals and populations.展开更多
文摘Male breast cancer(MBC)is rare,representing 0.5%–1%of all breast cancers,but its incidence is increasing due to improved diagnostics and awareness.MBC typically presents in older men,is human epidermal growth factor receptor 2(HER2)-negative and estrogen receptor(ER)-positive,and lacks routine screening,leading to delayed diagnosis and advanced disease.Major risk factors include hormonal imbalance,radiation exposure,obesity,alcohol use,and Breast Cancer Gene 1 and 2(BRCA1/2)mutations.Clinically,it may resemble gynecomastia but usually appears as a unilateral,painless mass or nipple discharge.Advances in imaging and liquid biopsy have enhanced early detection.Molecular mechanisms involve hormonal signaling,HER2/epidermal growth factor receptor(EGFR)pathways,tumor suppressor gene alterations,and epigenetic changes.While standard treatments mirror those for female breast cancer,emerging options such as cyclin-dependent kinase 4 and 6(CDK4/6),and poly(ADP-ribose)polymerase(PARP)inhibitors,immunotherapy,and precision medicine are reshaping management.Incorporating artificial intelligence,molecular profiling,and male-specific clinical trials is essential to improve outcomes and bridge current diagnostic and therapeutic gaps.
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.
文摘Trauma is a major cause of morbidity and mortality across the globe accounting for significant health burden.Relevance of trauma care revolves round prevention,planning and execution of safety regulations.Acquisition of the actual data regarding the type of trauma,affected age group,timings of trauma occurrence,involved part of the body constitute the initial steps in the building of the composite overview of the epidemiology of trauma.In succession,would be the measures directed towards avoidance of trauma and capacity building of trauma center.
基金Supported by the Appropriate Technology Promotion Program in Chongqing,No.2023jstg005.
文摘BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram using internal and external validation to predict survival in patients with ampullary adenocarcinoma.METHODS Data were sourced from the surveillance,epidemiology,and end results stat database.The patients in the database were randomized in a 7:3 ratio into training and validation groups.Using Cox regression univariate and multivariate analyses in the training group,we identified independent risk factors for overall survival and cancer-specific survival to develop the nomogram.The nomogram was validated with a cohort of patients from the First Affiliated Hospital of the Army Medical University.RESULTS For overall and cancer-specific survival,12(sex,age,race,lymph node ratio,tumor size,chemotherapy,surgical modality,T stage,tumor differentiation,brain metastasis,lung metastasis,and extension)and 6(age;surveillance,epidemiology,and end results stage;lymph node ratio;chemotherapy;surgical modality;and tumor differentiation)independent risk factors,respectively,were incorporated into the nomogram.The area under the curve values at 1,3,and 5 years,respectively,were 0.807,0.842,and 0.826 for overall survival and 0.816,0.835,and 0.841 for cancer-specific survival.The internal and external validation cohorts indicated good consistency of the nomogram.CONCLUSION The dynamic nomogram offers robust predictive efficacy for the overall and cancer-specific survival of ampullary adenocarcinoma.
文摘Breast cancer is the most common cancer among women worldwide. The term epidemiology generally deals with the branch of medicine and treatment that deals with a specific incident. Thus, considering the topic of breast cancer, this particular study deals with the distribution, determinants, and frequency of the disease. Breast cancer incidence and death data are critical to determining healthcare priorities. Women’s cancer is the most common, accounting for 25.1 percent of all malignancies. According to this specific report, more than 42,000 women die from breast cancer each year. Hence, it is apparent that it is the second leading cause of death among women, especially in the US. Family history/genetics, reproductive, hormone, benign proliferative breast disease, and mammographic density are the four main risk factors for breast cancer that can be meaningfully categorized. These elements are briefly discussed, and the risk estimators are provided. Numerous screening technologies have found breast cancer;some are linked to an increased risk of breast cancer, such as ultrasound techniques and MRI scanning. Breast cancer is more common in developed countries, while relative mortality is highest in developing countries. Women’s education is recommended for early detection and treatment in all nations. Health policymakers must prioritize plans to control and prevent this malignancy and increase awareness of risk factors and early detection in less developed countries.
基金Shaanxi Provincial Department of Education Special Scientific Research Program(Project No.:24JK0634)。
文摘Hepatocellular carcinoma(HCC)is one of the leading causes of cancer-related deaths globally,and its epidemiological characteristics and risk factors are continuously evolving.This review systematically elaborates on the global disease burden of HCC,the main risk factors(including hepatitis B/C virus infection,non-alcoholic fatty liver disease,aflatoxin exposure,and unhealthy lifestyles),and the corresponding prevention strategies.The article provides a detailed analysis of the performance and limitations of key serological markers currently used for early diagnosis of HCC,such as alpha-fetoprotein,abnormal prothrombin,and alpha-fetoprotein variant L3.Furthermore,the review comprehensively summarizes the advancements in clinical treatment for HCC,ranging from radical approaches including surgical resection,liver transplantation,radiofrequency ablation to palliative therapies for patients with advanced disease such as transcatheter arterial chemoembolization,targeted therapy,immunotherapy,and further evaluates their efficacy,indications,and challenges.This article aims to provide a comprehensive reference for a deeper understanding of the current status of HCC prevention and control,improving early diagnostic rates,and optimizing clinical treatment strategies.
基金Supported by the Hainan Medical University Academic Enhancement Support Program,No.XSTS2025001National Clinical Key Speciality Capacity Building Project,No.202330+3 种基金Hainan Province Clinical Medical Center,No.2021818Specific Research Fund of The Innovation Platform for Academicians of Hainan Province,No.YSPTZX202313Joint Project on Health Science and Technology Innovation in Hainan Province,No.SQ2023WSJK0301Hainan Province Education Reform Project,No.hnjg2024-67.
文摘BACKGROUND Alcohol can cause alcoholic fatty liver,alcoholic steatohepatitis,alcoholic liver cirrhosis(ALC),and hepatocellular carcinoma.China has become the secondlargest country in the world in terms of alcohol consumption,lacking national epidemiological data on alcoholic liver disease(ALD).AIM To understand the incidence and characteristics of ALD in Hainan Province of China.METHODS From October 2022 to April 2023,a stratified proportional multi-stage whole population sampling method was adopted to select permanent residents of Haikou,Sanya,Qionghai,Dongfang,and Wuzhishan in Hainan Province to carry out questionnaire surveys,blood tests,and ultrasound examinations of the liver.RESULTS A total of 2704 valid questionnaires were obtained from residents aged 15-93 years old.The rates of drinking,hazardous drinking,and harmful drinking were 31.73%,14.53%,and 5.03%,respectively.The above rates were higher for males than for females,increasing with income,and the rates for ethnic minorities,such as Li,were higher than for Han Chinese(P<0.05).Drinking rates increased with literacy(P<0.05).Drinking rate and hazardous drinking rate decreased with age,were higher for residents of agricultural households than non-agricultural households,and higher for married than unmarried individuals(P<0.05).The total number of patients with ALD was 142,with a detection rate of 5.25%.ALD detection rate was higher for males than females,decreased with age,and higher with income(P<0.05).Patients with ALD included 48(33.8%)cases of mild ALD,64(45.1%)cases of alcoholic fatty liver,18(12.7%)cases of alcoholic steatohepatitis,and 12(8.5%)cases of ALC.The proportion of those who consumed more than 80 g of alcohol per day increased as they progressed from mild ALD to ALC stage.Diabetes mellitus and hyperlipidemia were easily combined in some cases,accounting for 25(17.6%)and 80(56.3%),respectively.The average daily alcohol consumption of ALD patients of Li ethnicity≥80 g was significantly more than that of Han ethnicity(χ2=5.652,P=0.02),and was predominantly among those who drank large amounts of alcohol intermittently(χ2=89.093,P<0.001).CONCLUSION The rates of drinking,hazardous drinking,harmful drinking,and detection of ALD in Hainan Province need to be paid attention to by advocating a healthy lifestyle,such as abstinence and limiting alcohol consumption.
文摘In recent years,nosocomial infections caused by Clostridium difficile(C.difficile)have risen,becoming a leading cause of hospital-acquired diarrhea.The global prevalence of C.difficile infection(CDI)varies across regions and populations.The diagnosis relies primarily on laboratory testing,including toxin,glutamate dehy-drogenase,and nucleic acid amplification tests.Treatment strategies for CDI in-clude antimicrobial therapy(e.g.,metronidazole,vancomycin,and fidamycin),fecal transplantation,and immunotherapy(e.g.,belotozumab),depending on the patient’s specificity and severity.This paper reviews recent research on CDI’s epidemiological characteristics,risk factors,diagnosis,treatment,and prevention,aiming to support hospitals and public health initiatives in implementing effective detection,prevention,and treatment strategies.
基金supported by the National Natural Science Foundation of China(Grant no.42307534)Discovery Project(DP220101790)+1 种基金The University of Queensland ScholarshipAustralian Research Council Discovery Project(DP220101790).
文摘Wastewater-based epidemiology has emerged as a transformative surveillance tool for estimating substance consumption and monitoring disease prevalence,particularly during the COVID-19 pandemic.It enables the population-level monitoring of illicit drug use,pathogen prevalence,and environmental pollutant exposure.In this perspective,we summarize the key challenges specific to the Chinese context:(1)Sampling inconsistencies,necessitating standardized 24-hour composite protocols with high-frequency autosamplers(≤15 min/event)to improve the representativeness of samples.
基金Supported by Takeda Pharmaceuticals USA,Inc.Medical writing support was provided by Luke Humphreys,PhD,of Oxford PharmaGenesis,Oxford,UK and was funded by Takeda Development Center Americas,Inc.
文摘BACKGROUND Data regarding complex Crohn’s perianal fistulas(CPF)epidemiology are limited,and optimal treatment strategies are elusive.An improved understanding of how CPF treatment options are used in the real-world setting and factors associated with CPF development,treatment failure,and reasons for undergoing multiple surgeries may help to inform optimal patient management strategies,reduce treatment burden,and improve outcomes in patients with CPF.AIM To describe the epidemiology,treatments,outcomes,and associated risk/protective factors for complex CPF.METHODS Electronic databases(MEDLINE,EMBASE,EBM Reviews,EconLit)were searched.Two reviewers independently used populations,interventions,comparators,outcomes,study designs,and time criteria to identify relevant studies.Observational studies published in English from January 1,2015 to February 17,2022 with>50 patients were included,even if complex CPF was not defined.Items of interest included complex CPF definitions,epidemiology,treatment patterns,morbidity,mortality,and risk factors associated with complex CPF development,treatment failure,and undergoing multiple surgeries.Data were reported using descriptive statistics.RESULTS Overall,140 studies were included.Complex CPF definitions were heterogeneous and rarely reported(24 studies).Hence,data mostly related to CPF in general.CPF prevalence was variable(range:1.5%-81.0%).Incidence was wide-ranging and mostly reported cumulatively at 1-year post-Crohn’s disease diagnosis(range:3.5%-50.1%).Overall healing and failure rates after treatment were in the range of 10.5%-80.2%and 3.6%-83.0%,respectively.Abscesses were the most frequently reported morbidity(n=18).No CPF-related deaths were reported.No consistent risk or protective factors were identified.CONCLUSION Epidemiology,treatment patterns,and risk factors for CPF vary,likely due to inconsistent CPF and clinical outcome definitions.Standardization would facilitate comparability,which may inform optimal complex CPF treatment strategies.
基金Supported by the Beijing Tsinghua Changgung Hospital Fund,China,No.12023C01005.
文摘BACKGROUND Postoperative pulmonary complications(PPCs)are the most common complications following major upper abdominal surgeries,particularly hepatobiliary procedures,and significantly compromise surgical outcomes and patients’quality of life.Although the adoption of laparoscopy has lowered their incidence,PPCs remain a frequent and serious concern after hepatobiliary surgery.Existing research on risk factors specific to hepatobiliary surgeries is limited,particularly regarding the epidemiology and risk factors of PPCs in liver and gallbladder surgeries in China.Therefore,this study aimed to investigate the risk factors for PPCs in a large hepatobiliary center.AIM To identify the incidence and risk factors for PPCs following hepatobiliary surgery based on perioperative variables.METHODS Retrospective data were collected from patients who underwent liver,gallbladder,or pancreatic surgery at a hepatobiliary center in China between May 2023 and December 2023.We retrospectively reviewed comprehensive medical records to extract demographic and hospital admission information for determining PPC incidence.Statistically significant variables were initially screened through univariate analysis,followed by binary logistic regression modeling to identify independent predictors of PPCs.Hospitalization expenditures and duration of stay were further contrasted across the study cohorts.RESULTS This study included 1941 patients who underwent liver,gallbladder,or pancreatic surgery,of whom 78 developed PPCs,resulting in an incidence rate of 4.02%.Logistic regression analysis revealed two independent predictors of PPCs in hepatobiliary surgery patients:Age≥75 year(odds ratio=8.350,95%CI:3.521-19.798,P<0.001)and prolonged anesthesia(odds ratio=1.052,95%CI:1.015-1.091,P=0.006).Patients with PPCs had significantly elevated healthcare resource utilization,including higher total hospitalization costs,increased medication expenses,longer hospital stays,and extended postoperative admissions(all P<0.001).CONCLUSION Age≥75 years and prolonged anesthesia emerged as independent predictors of PPCs following hepatobiliary surgery.These complications were correlated with protracted hospitalization and increased healthcare costs.
文摘BACKGROUND Although epidemiological data on non-alcoholic fatty liver disease in China are available,data on cardiometabolic risk factors have not been addressed under the metabolic dysfunction-associated steatotic liver disease(MASLD)consensus.AIM To synthesize the epidemiological characteristics of MASLD/metabolic dysfunction-associated steatohepatitis(MASH),especially their associated cardiometabolic risk factors in China.METHODS We searched EMBASE,MEDLINE,Central Cochrane,CNKI,and Wangfan for studies from January 1,2013 to December 31,2023.Studies involving individuals with MASLD/MASH in China that reported epidemiological outcomes were included.Meta-analysis was performed to assess the prevalence of MASLD/MASH.Exploratory outcomes included extrahepatic comorbidities and genetic variants related to MASLD.RESULTS In total,561 studies involving 6632718 participants were included in this analysis.The prevalence of MASLD and MASH and the annual incidence of MASLD were 30.4%[95%confidence interval(CI):29.4-31.3],6.7%(95%CI:2.2-13.4),and 37 cases per 1000 person-years(95%CI:28-47),respectively.In addition,the prevalence rates of MASLD in individuals with dyslipidemia,obesity,and hypertension were 59.9%(95%CI:52.6-67.0),53.9%(95%CI:47.9-59.9),and 44.3%(95%CI:41.1-47.6),respectively.The prevalence of lean MASLD(body mass index<24 kg/m2)was 12.0%(95%CI:10.0-14.0),and 21.7%of the total MASLD population in China had lean MASLD.CONCLUSION This study provides a comprehensive overview of the epidemiology and disease burden of MASLD/MASH in China,providing additional evidence for optimizing MASLD/MASH management in China and a reference for the global understanding of MASLD/MASH epidemiology.
文摘Introduction: Influenza A (Flu A) and B (Flu B) viruses are responsible for severe acute respiratory infections (SARI) worldwide, with a morbidity of 5 million and mortality of 29,000 - 650,000 deaths per year. Influenza B viruses are an important cause of respiratory infections in humans, but they tend to be underappreciated due to the predominance of Influenza A. No molecular study on Influenza B has been carried out in the DRC. This study was conducted to document the molecular evolution of the hemagglutinin (HA) gene in the circulating Influenza B strains over the eight consecutive epidemic seasons (from 2015 to 2022). Methods: Samples were collected from outpatient cases suspected of influenza-like illness (ILI) and in all hospitalized patients with SARI from January 2015 to December 2022. Molecular analysis was done to determine influenza type and subtype, and then segments encoding the HA gene of Influenza B viruses were performed. Results: Of 8497 samples collected and tested, 639 (7.5%) were positive for influenza viruses, including 389 (60.8%) for Influenza A viruses and 248 (38,8%) for Influenza B viruses. Of the positive Influenza B samples, 91 were sequenced, including 26 belonging to the B/Yamagata lineage and 65 to the B/Victoria lineage. The HA gene of Influenza B viruses circulating in the DRC showed deletions in the HA1 region. Molecular analysis of Influenza B viruses reflects the genetic diversity of Influenza B/Yam virus clades (Y2, Y3, Y3V1A) alternating with Influenza B/Victoria virus clades (V1A, V1A.3) depending on the year and influenza seasons. The phylogenetic analysis of these Influenza B strains shows compatibility with the corresponding vaccine strains that the WHO had validated for each influenza season. Conclusion: This study underscores the importance of continuous molecular surveillance of Influenza B viruses in the DRC to understand their epidemiology and evolutionary dynamics. Identifying mutations, such as HA deletions, is critical for assessing their impact on transmissibility vaccine efficacy and guiding effective vaccination and control strategies.
基金supported financially by the National Key Research and Science Program of the Ministry of Science and Technology of the People’s Republic of China(2022YFC2303900)the Beijing Natural Science Foundation(7232242).
文摘Antimicrobial resistance(AMR)has become a critical global public health challenge in the 21st century.Since the initial isolation of a blaNDM-1-carrying and carbapenem-resistant Klebsiella pneumoniae from an Indian hospital in 2009[1],the escalating prevalence of New Delhi metallo-β-lactamase(NDM)-encoding genes(blaNDM)has transformed carbapenem resistance into a worldwide phenomenon,transcending national and regional boundaries[2].Up to 90 distinct NDM variants have been reported globally according to the NCBI GenBank Pathogens database.Plasmidmediated horizontal gene transfer(HGT),which occurs both within and across bacterial species,has significantly accelerated the global dissemination of blaNDM-related genes and the associated resistance[3].Carbapenem-resistant pathogens were responsible for 200,000 deaths globally in 2019[4].Although NDM-1 has been relatively well characterized[5],the epidemiological profiles of other NDM variants require continued surveillance and indepth investigation.The novel NDM-9 variant(GenBank accession no.KC999080)was first identified in 2013 from a clinically significant isolate of Klebsiella pneumoniae ST107 strain PPH1303 with a high level of resistance to carbapenems recovered from the urine culture of a pediatric patient in Beijing,China,who had acute lymphocytic leukemia and had undergone allogeneic stem cell transplantation[6].
文摘Acquired Immunodeficiency Syndrome(AIDS)caused by Human Immunodeficiency Virus(HIV)infection poses a serious threat to global public health.This article comprehensively reviews the epidemiological characteristics of HIV infection,including the global and domestic epidemic situation,transmission routes,and characteristics of high-risk groups.It also introduces comprehensive prevention and control strategies in detail.Through analysis,it aims to provide a reference for further optimizing HIV prevention and control work.
基金National Natural Science Foundation of China,No.81960284Science and Technology Support Program of Science and Technology Department of Guizhou Province,No.Qian Ke He Zhi Cheng[2022]Yi Ban 183.
文摘BACKGROUND Gestational diabetes mellitus(GDM)is a growing public health concern,particularly in regions with diverse ethnic populations.Understanding the incidence and risk factors of GDM is crucial for early prevention and management,especially in underrepresented areas like Guizhou Province,China,where geographic and ethnic diversity may influence the disease’s prevalence and risk profiles.AIM To investigate the incidence of GDM and identify its associated risk and protective factors among different ethnic groups in Guizhou Province,providing essential data for early prevention strategies.METHODS A multi-center retrospective study was conducted,dividing participants into GDM and non-GDM groups according to standardized diagnostic criteria.Data were collected from 103629 deliveries across 40 hospitals in Guizhou.Various demographic,clinical,and laboratory parameters were analyzed using logistic regression to identify risk and protective factors for GDM.RESULTS Among the 103629 deliveries,18957 cases of GDM were identified,with an incidence of approximately 18.3%.The risk of GDM was higher in the Han ethnic group compared to minority ethnic groups.The Dong ethnic group had the lowest incidence among the minorities.Key risk factors identified included older age(especially>35 years),higher pre-pregnancy body mass index(BMI),light physical activity,gravidity,family history of diabetes,hemoglobin,aspartate aminotransferase,alanine aminotransferase,and direct bilirubin.Protective factors included higher education level,total protein,and albumin.There were also differences based on blood type,with type A associated with higher risk.CONCLUSION The incidence rate in Guizhou is 18.3%.Older age(especially>35 years),Han ethnicity,lower education level,higher pre-pregnancy BMI,light physical activity,and higher gravidity are the main risk factors for GDM.Laboratory findings indicate that higher hemoglobin,higher liver function parameters(alanine aminotransferase,aspartate aminotransferase,and direct bilirubin),and lower total protein and albumin are associated with a higher risk of GDM.Blood type A has a higher risk of GDM compared to blood types AB and O.
基金supported by the Jiangsu Commission of Health(LR2022004&LKZ2023005)the Project of Zhongda Hospital Affiliated to Southeast University for Cultivating Academic Talent(CZXM-GSPRC22)+2 种基金the Zhongda Hospital Affiliated to Southeast University,Jiangsu Province High-Level Hospital Pairing Assistance Construction Funds(ZDLYG10)the Zhongda Hospital Affiliated to Southeast University,Jiangsu Province High-Level Hospital Construction Funds(GSP-LCYJFH17)the Nanjing Commission of Health(YKK24257).
文摘BACKGROUND Physical inactivity is a significant yet underappreciated risk factor for cardiovascular disease(CVD),particularly among older adults.The aim of this study was to analyze the global burden of CVD attributable to physical inactivity in individuals aged 70 years and older from 1990 to 2021 using the Global Burden of Disease data.METHODS We assessed trends in disability-adjusted life years(DALYs)and deaths,decomposed changes into population growth,aging,and epidemiological factors,and examined health inequalities across sociodemographic index(SDI)regions.RESULTS From 1990 to 2021,a substantial rise in DALYs was observed,especially in low and middle SDI regions,with a 120.06% increase in the low SDI region,but a 23.10% decline in the high SDI region.Decomposition analysis identified population aging and growth as primary drivers for the burden,contributing 66.39% and 83.56% to the increase in middle and low SDI regions,respectively.By contrast,epidemiological improvements alleviated burden in the high SDI region(54.91%).Gender disparities persisted,with women experiencing a higher burden.Inequality analysis indicated a shift in CVD burden towards the low SDI region,with declining concentration indices for DALYs(-0.03 to-0.13)and deaths(-0.07 to-0.15).The Bayesian age-period-cohort projections suggest continued increases in DALYs and deaths through 2050,with women disproportionately affected.CONCLUSIONS These findings highlight the urgent need for targeted interventions promoting physical activity,improving healthcare access,and implementing region-specific prevention strategies.
文摘The spread of hepatitis B virus(HBV)infection has gradually decreased in Italy in the last 5 decades as shown by the steady reduction in the incidence rates of acute hepatitis B,from 10/100000 inhabitants in1984 to 0.85/100000 in 2012,and by the reduced prevalence of hepatitis B surface antigen(HBsAg)-positive cases among chronic hepatitis patients with different etiologies,from 60%in 1975 to about 10%in 2001.The prevalence of HBsAg chronic carriers in the general population also decreased from nearly 3%in the 1980s to 1%in 2010.Linked to HBV by its characteristics of defective virus,the hepatitis delta virus(HDV)has shown a similar epidemiological impact on the Italian population over time.The incidence of acute HDV infection decreased from 3.2/100000 inhabitants in 1987 to 0.8/100000 in 2010 and the prevalence of HDV infection in HBsAg chronic carriers decreased from24%in 1990 to 8.5%in 2006.Before the beneficial effects of HBV mass vaccination introduced in 1991,the decreased endemicity of HBV and HDV infection in Italy paralleled the improvement in screening blood donations,the higher standard of living and impressive reduction in the birth rate associated with a marked reduction in the family size.A further contribution to the decline in HBV and HDV infections most probably came from the media campaigns to prevent the spread of human immunodeficiency virus infection by focusing the attention of the general population on the same routes of transmission of viral infections such as unsafe sexual intercourse and parenteral exposures of different kinds.
基金the Office of Research and Development Medical Research Service Department of Veterans AffairsPublic Health Service grant DK56338 which funds the Texas Gulf Coast Digestive Diseases Centerthe Eugene B. Casey Foundation and the William and Sonya Carpenter Fund, Baylor College of Medicine
文摘AIM: To investigate the epidemiology of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in the two major ethnic groups in Kazakhstan. METHODS: A cross-sectional prospective study of HBV and HCV seroprevalence was performed among individuals born in Kazakhstan with no history of chronic hepatitis or liver disease. RESULTS: There were 290 volunteers (140 Russians and 150 Kazakhs) aged 10 to 64 years, males accounted for 46%. Active HBV infection (HBsAg positive) was present in 3.8%, anti-HBc in 30%. The prevalence was similar in females and males (33% vs 25%) (P = 0.18). The prevalence of anti-HBc increased from 19% in 10-29 years old volunteers to 53% in 50-years and older volunteers. The prevalence of HBV infection was higher in married than in single adults (38% vs 26%, respectively) (P = 0.2) and more common in Kazakhs (35%) than in Russians (24%) (P = 0.07). HCV infection was present in 9 subjects (3.2%), 5 of them also were positive for anti-HBc in the absence of HBsAg. CONCLUSION: The frequency of active HBV infection (3.8%) coupled with a high prevalence of HBV exposure in those > 50 years of age increases with age, which suggests that horizontal transmission likely relates tothe use of contaminated needles. The low prevalence of HCV infection suggests that HBV and HCV are acquired differently in this group of subjects.
基金supported by the National Natural Science Foundation of China(Grant No.81521004 and No.81922061)。
文摘The recent progress in human genome epidemiology(HuGE) is already having a profound impact on the practice of medicine and public health.First,the success of genome-wide association studies has greatly expanded the direction and content of epidemiological researches,including revealing new genetic mechanisms of complex diseases,identifying new targets for therapeutic interventions,and improving application in early screening of high-risk populations.At the same time,large-scale genomic studies make it possible to efficiently explore the gene-environment interactions,which will help better understand the biological pathways of complex diseases and identify individuals who may be more susceptible to diseases.Additionally,the emergence of systems epidemiology aims to integrate multi-omics together with epidemiological data to create a systems network that can comprehensively characterize the diverse range of factors contributing to disease development.These progress will help to apply HuGE findings into practice to improve the health of individuals and populations.
