1.A panel study on association of short-term air pollution exposure and peripheral blood microparticles in healthy adults
Bin ZHANG ; Xinghou HE ; Jiahui LIU ; Xuyang SHAN ; Yan FANG ; Huiying XU ; Erlu ZHAO ; Shengcong LIU ; Hongbing XU ; Jianping LI ; Wei HUANG
Journal of Environmental and Occupational Medicine 2026;43(1):1-7
Background Microparticles (MPs) are one of the main medium of inflammatory reaction with an important role in atherosclerotic progression. Studies on association of air pollution exposure and levels of peripheral blood MPs are limited among human. Objective To evaluate the effects of short-term exposure to air pollution on levels of peripheral blood MPs. Method A panel of 73 healthy adults was followed with 4 repeated follow-ups in Beijing, China, from November 2014 to January 2016. During each visit, we collected questionnaire information, fasting venous blood, urine, and exposures to fine particulate matter (PM2.5), black carbon, nitric oxide, nitrogen dioxide, nitrogen oxide, sulfur dioxide, carbon monoxide, and ozone. We used linear mixed-effect models to analyze associations of air pollution exposure with levels of total MPs (TMPs) and MPs derived from various cells. Stratified analysis was conducted by levels of C-reactive protein (CRP) and malondialdehyde (MDA). Results The results showed significant associations between air pollution exposure and peripheral blood TMPs at 2 h-6 d prior to the follow-ups (P<0.05), while no statistical associations were found for MPs derived from different cell types. Significant increases in TMPs of 7.8% (95%CI: 0.7%, 15.3%) and 14.3% (95%CI: 2.8%, 27.2%) were observed with each interquartile range (IQR) increase in PM2.5 (IQR=64.9 μg·m−3) at prior 18 h and NO (IQR=40.5 μg·m−3) at prior 48 h. Among participants with low levels of CRP and MDA, significantly positive associations were observed between air pollution exposure and levels of TMPs (P<0.05). Conclusion Short-term exposure to air pollution is significantly associated with increased levels of circulating MPs in healthy adults, and in people with lower systemic inflammation, peripheral blood MPs levels are more easily affected after exposure to air pollutants.
2.Correlation between iodine level in drinking water and conventional water quality indicators
Xiaoxue SHI ; Demei ZHOU ; Chun XIE ; Hongbing YE ; Yang LI ; Xuan LI ; Gang CHEN ; Mengjie YANG ; Hong XIANG
Chinese Journal of Endemiology 2025;44(7):558-562
Objective:To study the correlation between iodine level in drinking water and conventional water quality indicators.Methods:From June 2017 to July 2018, a simple random sampling method was used to select administrative villages (communities) from 88 counties (cities, districts) in Guizhou Province with a sampling size greater than 5%. One drinking water sample was collected from each administrative village (community), and conventional water quality indicators (including fluorine, aluminum, mercury, selenium, sulfate, total dissolved solids and total hardness) were tested in accordance with the methods outlined in the "Standards for Drinking Water Quality" (GB 5749-2006). The cerium sulfate catalytic spectrophotometric method was employed to test drinking water iodine level. Spearman method was utilized to analyze the correlation between iodine level in drinking water and conventional water quality indicators.Results:A total of 904 drinking water samples were tested, with a median iodine level of 1.90 μg/L and a range of 0.10 - 36.70 μg/L. There were 899 administrative villages (communities) with a water iodine level of less than 10 μg/L, accounting for 99.45%. There were only 5 administrative villages (communities) with a water iodine level of greater than 10 μg/L, accounting for 0.55%. Correlation analysis revealed that in Guizhou Province, the iodine level in drinking water was positively correlated with the levels of fluorine, aluminum, sulfate, total dissolved solids, and total hardness [correlation coefficients ( r) = 0.11, 0.07, 0.07, 0.08, 0.07, P < 0.05], and was a negatively correlated with mercury and selenium levels ( r = - 0.12, - 0.12, P < 0.001). Conclusions:External environment in Guizhou Province is generally deficient in iodine. The iodine level in drinking water is positively correlated with the levels of fluorine, aluminum, sulfate, total dissolved solids, and total hardness, and negatively correlated with the levels of mercury and selenium.
3.Investigation and analysis of iodine level in drinking water and iodine nutrition status of key populations in Guizhou Province in 2023
Demei ZHOU ; Hongbing YE ; Yang LI ; Hong XIANG ; Xuan LI ; Li YANG ; Jing GAO ; Chaozhong LEI
Chinese Journal of Endemiology 2025;44(9):719-725
Objective:To investigate the distribution of iodine in drinking water in external environment and the iodine nutrition status of key population in Guizhou Province, and to provide a basis for further precise implementation of prevention and control strategy of "adapting to local conditions, providing classified guidance, and scientifically supplementing iodine".Methods:From April to September 2023, a survey on the iodine level of residents' drinking water was conducted in administrative villages (neighborhood committees, hereafter referred to as administrative village) in 88 counties (districts) of 9 cities (prefectures) in Guizhou Province. At the same time, one township (town) was selected from each of the five districts of east, west, south, north and center of each county (district). From each township (town), 40 non-boarding students aged 8 - 10 years old from one primary school and 20 pregnant women were selected. Household edible salt sample and once random urine sample were collected for detection of salt iodine and urinary iodine levels.Results:The survey covered 16 492 administrative villages in 1 481 townships (towns), 88 counties (districts), 9 cities (prefectures) throughout the province. A total of 51 531 samples of residents' drinking water were collected, with a median water iodine level of 1.50 μg/L and a range of 0.01 - 98.70 μg/L. Among them, there were 16 284, 208, and 0 administrative villages with median water iodine levels < 10, 10 - < 40, and 40 - 100 μg/L, respectively, accounting for 98.74%, 1.26%, and 0, respectively. A total of 26 491 samples of household edible salt were collected from children and pregnant women, with a median salt iodine levels of 27.6 mg/kg. The coverage rate of iodized salt was 99.6% (26 395/26 491), and the qualified iodized salt consumption rate was 97.0% (25 708/26 491). And 17 657 urine samples from children and 8 834 urine samples from pregnant women were collected, with median urinary iodine levels of 222.1 and 164.4 μg/L, respectively. There were statistically significant differences in urinary iodine levels among children of different genders and ages ( Z = - 6.08, H = 19.17, P < 0.001). The results of correlation analysis showed that there was no correlation between urinary iodine of children and pregnant women and water iodine ( r = 0.01 0.02, P > 0.05), while urinary iodine of pregnant women was positively correlated with salt iodine ( r = 0.02, P = 0.041). Conclusions:The external environment of Guizhou Province is generally deficient in iodine. Under the universal salt iodization policy, children have sufficient iodine nutrition, and pregnant women have an appropriate level of iodine nutrition. Comprehensive prevention and control measures, mainly based on universal salt iodization, should be continuously carried out to eliminate the harm of iodine deficiency.
4.Relationship between preoperative blood glucose control and perioperative insulin resistance in patients with diabetes mellitus complicated by cervical cancer and its effect on prognosis
Hongbing QIU ; Yanan REN ; Xiaoming LI ; Zhen XIE
Journal of China Medical University 2025;54(4):318-322
Objective To investigate the relationship between preoperative blood glucose control and perioperative insulin resistance(IR)in patients with diabetes mellitus(DM)complicated by cervical cancer(CC)and its effect on prognosis.Methods A total of 100 patients were categorized into IR(n=61)and non-IR(n=39)groups based on their IR levels.Additionally,patients were classified into poor prognosis(n=34)and good prognosis(n=66)groups according to the occurrence of adverse events during the follow-up period.The clini-cal data of each group were compared to evaluate the association of glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG),and two-hour postprandial plasma glucose(2hPG)with perioperative IR,as well as correlation between HbA1c,FPG,and 2hPG levels and the homeostasis model assessment(HOMA)of IR with the risk of poor prognosis.Results HbA1c,FPG,2hPG,and HOMA-IR were identi-fied as risk factors for the prognosis of patients with DM and CC(P<0.05).Compared with the respective control groups,the IR group and poor prognosis group had higher preoperative levels of HbA1C,FPG,and 2hPG(P<0.05).Conclusion Poor preoperative blood glucose control is positively correlated with the risk of perioperative IR in patients with DM and CC.Moreover,HOMA-IR,HbA1c,FPG,and 2hPG are independent risk factors for poor prognosis in patients with DM and CC.
5.Research progress of stereotactic body radiation therapy for hepatocellular carcinoma with porta vein tumor thrombus
Shungang LI ; Xueyao WANG ; Shusen JIANG ; Hongbing YAO
Chinese Journal of General Surgery 2025;34(7):1514-1522
Portal vein tumor thrombus(PVTT)is a common manifestation of advanced hepatocellular carcinoma(HCC),associated with poor prognosis and significant treatment challenges.Although various therapeutic options-including surgery,systemic therapies,and local treatments such as interventional procedures and radiotherapy-are available for HCC with PVTT,monotherapies often yield limited efficacy,highlighting the need for combined treatment strategies.With the advancement of radiotherapy technologies,stereotactic body radiation therapy(SBRT)has gained increasing recognition due to its high precision,ablative doses,and fewer treatment fractions.SBRT plays a crucial role in palliative care,conversion therapy,neoadjuvant,and adjuvant settings.Recent studies have demonstrated that SBRT,either alone or in combination with other modalities,significantly improves overall survival and local control rates in patients with HCC and PVTT.This review summarizes the current research progress of SBRT in the management of HCC with PVTT,emphasizing both monotherapy and combined approaches with surgery,interventional therapy,targeted agents,and immunotherapy,aiming to provide insights for clinical decision-making.
6.Association of increased greater tubercle angle and critical shoulder angle with rota-tor cuff tears
Hua JIANG ; Yu YAN ; Panpan LI ; Kang CHEN ; Hongbing MA ; Yong ZENG ; Xin TANG ; Guoqing CUI
Journal of Peking University(Health Sciences) 2025;57(4):740-747
Objective:The greater tuberosity angle(GTA)and critical shoulder angle(CSA)are commonly referred to as radiographic markers which were used to described morphology of the greater tu-berosity and acromion respectively.At present,most international studies focus on the correlation be-tween the above two parameters and rotator cuff tears(RCTs),and their diagnostic value and risk assess-ment.This study attempts to find out the trend of GTA and CSA changes and risk threshold of RCTs,as well as the protective factors and risk factors.Methods:In this study,130 individuals from May 2019 to December 2020 were recruited.According to Southern California Orthopedic Institute(SCOI)classifica-tion,the individuals were divided into four groups retrospectively:Group A,negative control group;Group B,partial tears(articular side);Group C,partial tears(bursal side);Group D,full-thickness tears.GTA and CSA were measured respectively on true anteroposterior position X-ray of shoulder with arm in neutral rotation and performed by the same trained technician team in single-blind.The correla-tions between RCTs and relevant factors were analyzed.Results:According to the area under the receiver operating characteristic curve(AUC),GTA and CSA of RCTs(Groups B,C and D)were 0.736 and 0.673 with 95%confidence interval(CI),the cut-off value of GTA and CSA of RCTs were 70.5° and 39.5° respectively.Comparing with the control group,RCTs groups had significant statistical differences in age and body mass index(BMI)(P<0.05),especially the full-thickness RCTs(Group D),which was older than Groups A,B and C(P<0.05,cut-off value:56.5 years old)and shorter than Groups A and B(P<0.05,cut-off value:1.58 m).Analyzed from scatter plot and regression analysis,there was no linear correlation between GTA and CSA.There were no significant differences in gender,dominant shoulders and smoking between the RCTs groups and the control group(P>0.05).Conclusion:Larger GTA(>70.5°)and CSA(>39.5°)would be highly predictive in diagnosing RCTs without linear cor-relation,and GTA has a higher diagnostic value in contrast.Subacromial impingement and shoulder de-generation occurred before RCTs.Patients with age>56.5 years and height<1.58 m were more likely to develop disease of full-thickness RCTs and no statistic differences in weight and BMI.Gender,domi-nant shoulder and smoking were neither risk factors nor protective factors.
7.Association between lung nodules and lung cancer risk in high-risk populations
Chenying JIN ; Chen ZHU ; Chen JI ; Qiao LI ; Yating FU ; Lili WU ; Lei SHI ; Lingbin DU ; Meng ZHU ; Hongbing SHEN ; Hongxia MA
Chinese Journal of Epidemiology 2025;46(2):273-279
Objective:To investigate the association between different types of lung nodules and the risk of lung cancer in a population at high risk of lung cancer and to provide an epidemiologic basis for the comprehensive management of lung nodules.Methods:Using the free lung cancer screening program of low-dose CT (LDCT) in Wenling, Zhejiang Province, we collected baseline and imaging information of high-risk groups for lung cancer who underwent LDCT screening from April 2019 to October 2021 and patients with previous history of lung cancer, tuberculosis, pneumoconiosis, and silicosis were excluded. A total of 28 539 study subjects were included in the analysis, and the follow-up ended on 31 December 2023. Based on the characteristics of the detected pulmonary nodules, the study subjects were classified with no nodules, with solid nodules, with pure ground glass nodules, and with part solid nodules groups. The association between different characteristics of lung nodules and the risk of lung cancer development was analyzed using the Cox proportional hazard regression model with a new diagnosis of lung cancer during the follow-up period as the outcome.Results:The overall detection rate of lung nodules with a mean diameter of ≥3 mm was 76.5%, of which 53.7%, 18.2%, and 4.6% were detected in the solid nodule, pure ground glass nodule, and partially solid nodule groups, respectively. There were statistically significant differences between the different nodule groups in terms of age, gender, BMI, history of toxic exposure education level, smoking status, history of lung disease, and family history of lung cancer (all P<0.05). The median follow-up time of the study population was 3.4 years, and 485 new lung cancer cases were diagnosed during the follow-up period. After adjusting for covariates, the results of multifactorial Cox proportional hazard regression model analysis showed that the risk of lung cancer was higher in pure ground glass nodules and part solid nodules compared with solid nodules, with HR values (95% CI) of 1.89 (1.52-2.35) and 6.49 (5.18-8.14), respectively. The results of subgroup analysis showed that patients in the group of part solid nodules had the highest risk of lung cancer in all strata of the population, followed by patients with pure ground glass nodules. Patients in the solid nodule group who were older or had previous lung disease had a higher risk of lung cancer, and the risk of lung cancer in the part solid nodule group differed between genders. Conclusions:The proportion of lung nodules detected is high in the high-risk group of lung cancer, and among them, patients with pure ground glass and part solid nodules have a higher risk of developing lung cancer. Attention should be paid to the annual follow-up management for patients with solid nodules who are older or who have had lung diseases, as well as for female patients with part solid nodules.
8.Association between hypertension subtypes and risk for all-cause mortality and cardio-cerebrovascular mortality in the elderly in communities of Beijing
Rongrong LI ; Shengshu WANG ; Haowei LI ; Shimin CHEN ; Junhan YANG ; Huaihao LI ; Yueting SHI ; Yinghui BAO ; Shengyan DU ; Wenchang WANG ; Jianhua WANG ; Xianghua FANG ; Hongbing YANG ; Ding MA ; Shanshan YANG ; Miao LIU ; Yao HE
Chinese Journal of Epidemiology 2025;46(3):366-375
Objective:To study the association between subtypes of hypertension and risk for all-cause mortality and cardio-cerebrovascular mortalities in the elderly in communities of Beijing.Methods:The data were collected from the Beijing Healthy Aging Cohort Study. The elderly in 5 urban areas (former Xicheng, former Xuanwu, Fangshan, Haidian and Tongzhou) and 4 rural areas (Yanqing, Miyun, Huairou and Daxing) in Beijing were selected as the study subjects by multi-stage stratified cluster random sampling. The baseline survey was conducted from July 2009 to September 2015. The follow-up was conducted until March 31, 2021, and a total of 6 326 participants were enrolled. Cox proportional hazard regression model was used to analyze the association of SBP, DBP, normal blood pressure, high normal blood pressure, simple systolic hypertension, simple diastolic hypertension and systolic diastolic hypertension with all-cause mortality and cardio-cerebrovascular mortality.Results:By March 31, 2021, the median follow-up time was 6.30 years, the all-cause mortality density was 201.67/10 000 person-years, and the cardio-cerebrovascular mortality density was 90.20/10 000 person-years. Multivariate Cox proportional hazard regression model analysis showed that the risk for all-cause mortality increased by 5.6% ( HR=1.056, 95% CI: 1.020-1.092), and the risk for cardio-cerebrovasculvar mortality increased by 12.5% ( HR=1.125, 95% CI: 1.071-1.182) for every 10 mmHg increase in SBP. The risk for all-cause mortality increased by 8.6% ( HR=1.086, 95% CI: 1.023-1.152), and the risk for cardio-cerebrovascular mortality increased by 19.9% ( HR=1.199, 95% CI: 1.101-1.306) for every 10 mmHg increase in DBP. Compared with the normal blood pressure group, the risk for all-cause mortality increased by 64.8% ( HR=1.648, 95% CI: 1.049-2.591) and the risk for cardio- cerebrovascular mortality increased by 112.8% ( HR=2.128, 95% CI: 1.069-4.233) in the simple diastolic hypertension group. The risk for all-cause mortality increased by 34.4% ( HR=1.344, 95% CI: 1.023-1.467) and the risk for cardio-cerebrovascular mortality increased by 111.3% ( HR=2.113, 95% CI: 1.384-3.225) in the systolic-diastolic hypertension group. Conclusions:In the elderly in communities of Beijing, beside systolic-diastolic hypertension. It is necessary to pay close attention to the simple diastolic hypertension, which has lower prevalence, and give targeted prevention and treatment.
9.Association of urinary albumin-to-creatinine ratio and cardiovascular health score with cardio-cerebrovascular mortality and all-cause mortality in urban elderly residents in Beijing
Junhan YANG ; Haowei LI ; Shimin CHEN ; Rongrong LI ; Huaihao LI ; Yueting SHI ; Yinghui BAO ; Shengyan DU ; Wenchang WANG ; Shanshan YANG ; Jianhua WANG ; Xianghua FANG ; Hongbing YANG ; Ding MA ; Shengshu WANG ; Miao LIU ; Yao HE
Chinese Journal of Epidemiology 2025;46(3):385-392
Objective:To investigate the association of urinary albumin-to-creatinine ratio (UACR) in normal range and cardiovascular health (CVH) score with cardio-cerebroascular and all-cause mortality in urban elderly residents in Beijing.Methods:Based on Beijing Healthy Aging Cohort Study, data from 1 817 elderly participants with normal UACR were analyzed, and UACR was used as both continuous and categorical variable. "Life's Essential 8" was used to develop a CVH score. Statistical analysis was performed by using software SPSS 26.0 and R 4.2.1, including two independent samples t-test, χ2 test and non-parametric test. Multivariable Cox proportional hazard regression models stratified by CVH score and the restricted cubic spline were used to analyse the association of UACR with the risk for cardio-cerebrovascular and all-cause mortality. Results:By March 31, 2021, the median follow-up time M ( Q1, Q3) was 11.28 (10.84, 11.36) years, a total of 308 deaths were recorded during follow-up, and the mortality density was 163.87/10 000 person-years. The age of the participants was (71.4±6.6) years, and 1 070 participants were women. The results showed that the risk for both cardio-cerebrovascular disease and all-cause mortality decreased with the decrease of UACR in the low CVH score group ( HR=0.500, 95% CI: 0.341-0.734; HR=0.793, 95% CI: 0.647-0.971), and in the high CVH score group, there was a decreasing trend in the risk for cardio-cerebrovascular mortality with the decrease of UACR ( HR=0.665, 95% CI: 0.447-0.990). Compared with the participants with low CVH score and higher UACR, the risk for cardio-cerebrovascular and all-cause mortality decreased by 68.9% and 45.6%, respectively, in the participants with high CVH score and lower UACR ( HR=0.311, 95% CI: 0.131-0.739; HR=0.544, 95% CI: 0.360-0.822), and the risk for all-cause mortality decreased by 26.7% in the participants with high CVH score and higher UACR ( HR=0.733, 95% CI: 0.542-0.993). Conclusions:In urban elderly residents in Beijing, higher UACR were associated with a significantly increased risk for cardio-cerebrovascular and all-cause mortality, and in the low-CVH score group, decreased UACR was protective factor against cardio-cerebrovascular and all-cause mortality. The combined effect of cardiovascular health status and normal UACR had a greater protection against the risk for cardio-cerebrovascular and all-cause mortality.
10.Association between a body shape index and all-cause mortality in the elderly in communities of Beijing
Huaihao LI ; Shengshu WANG ; Haowei LI ; Rongrong LI ; Shimin CHEN ; Junhan YANG ; Yueting SHI ; Yinghui BAO ; Shengyan DU ; Wenchang WANG ; Jianhua WANG ; Xianghua FANG ; Hongbing YANG ; Ding MA ; Miao LIU ; Shanshan YANG ; Yao HE
Chinese Journal of Epidemiology 2025;46(3):393-401
Objective:To describe and analyze the distribution characteristics of a body shape index (ABSI) and its association with all-cause mortality in the elderly in communities of Beijing.Methods:The baseline and follow-up data of 10 423 subjects in Beijing Healthy Aging Cohort Study were used. The endpoint outcome was all-cause mortality in follow-up. The associations of ABSI, BMI and waist circumference with all-cause mortality were analyzed with a Cox proportional hazard regression model.Results:The mean follow-up time in this cohort was 6.36 years and the all-cause mortality was 15.27%. The restricted cubic spline results showed that ABSI showed a "U" association with all-cause mortality in the total population. After adjustment for confounding factors, compared with the normal ABSI group, the risk for all-cause mortality was higher in the low ABSI group ( HR=1.69, 95% CI: 1.32-2.17) and high ABSI group ( HR=1.75, 95% CI: 1.40-2.18). Compared with the normal BMI group, low BMI was associated with an increased risk for all-cause mortality ( HR=1.70, 95% CI: 1.40-2.08). Compared with the normal waist circumference group, central obesity was associated with a decreased risk for all-cause mortality ( HR=0.89, 95% CI: 0.80-0.99). The results of gender specific analysis on ABSI association with all-cause mortality were similar to that in total population, but the strength of association varied among different age groups. Cross-grouping results showed that older people with normal BMI and waist circumference and abnormal ABSI had an increased risk of all-cause mortality ( HR=1.91, 95% CI: 1.22-2.99). Conclusions:In Beijing, ABSI is correlated with the risk for all-cause mortality in the elderly population, which is more sensitive and specific than the traditional indicators (BMI and waist circumference). They can be used as one of the physical measurement indicators for all-cause mortality risk prediction in the health risk assessment and management in the elderly.

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