Over the past three decades， China has made significant progress in the prevention and control of viral hepatitis， and the incidence rates of new-onset pediatric hepatitis B virus infections and acute viral hepatitis in the population have reduced to a relatively low level； however， there is still a heavy disease burden of chronic viral hepatitis in China， which severely affects the health status of the population. This study systematically summarizes the achievements of viral hepatitis prevention and control in China， analyzes existing problems and challenges， and proposes comprehensive prevention and control strategies and measures to eliminate viral hepatitis as a public health threat based on the national conditions of China， in order to provide a reference for related departments in China on how to achieve the action targets for eliminating viral hepatitis as a public health threat by 2030.

BACKGROUND: Research has indicated that the disease burden of alopecia areata (AA) in China exceeds the global average. Therefore, accurate and updated epidemiological information is crucial for policymakers. In this study, we aimed to comprehensively assess the disease burden of AA in China. METHODS: The following four key indicators were utilized: the prevalence of cases; disability-adjusted life-years (DALYs); the age-standardized prevalence rate (ASPR); and the age-standardized DALY rate (ASDR) of AA according to the Global Burden of Disease (GBD) study 2021. We analyzed the epidemiological burden of AA in China during 2021, examined changes between 1990 and 2021, and performed a Bayesian age-period-cohort analysis to predict trends over the course of the next decade (2022-2030). Additionally, a Gaussian process regression model was applied to estimate the relationship between the gross domestic product (GDP) and the ASPR and ASDR of AA at the provincial level between 1992 and 2021. RESULTS: In 2021, the estimated number of patients with AA in China was approximately 3.49 million (95% uncertainty interval [UI], 3.37-3.62 million); of these patients, 1.20 million (95% UI, 1.16-1.25 million) were male and 2.29 million (95% UI, 2.20-2.37 million) were female. This large number of patients with AA resulted in a total of 114,431.25 DALYs (95% UI, 74,780.27-160,318.96 DALYs). Additionally, the ASPR and ASDR were 224.61 per 100,000 population (95% UI, 216.73-232.65 per 100,000 population) and 7.41 per 100,000 population (95% UI, 4.85-10.44 per 100,000 population), respectively; both of these rates were higher than the global averages. The most affected demographic groups were young and female individuals 25-39 years of age. Slight regional disparities were observed, with the northern and central regions of China bearing comparatively higher burdens. Between 1990 and 2021, the health loss and disease burden caused by AA in China remained relatively stable. The ASPR and ASDR of AA increased with the GDP when the annual GDP was less than 2 trillion Chinese yuan; however, a downward trend was observed as the GDP surpassed 2 trillion Chinese yuan. A slight upward trend in the disease burden of AA in China is predicted to occur over the next decade. CONCLUSIONS AA continues to be a public health concern in China that shows no signs of declining. Targeted efforts for young individuals and females are necessary because they experience a disproportionately high burden of AA.
Humans ; China/epidemiology* ; Alopecia Areata/epidemiology* ; Global Burden of Disease ; Female ; Male ; Adult ; Disability-Adjusted Life Years ; Middle Aged ; Prevalence ; Adolescent ; Young Adult ; Bayes Theorem ; Child ; Quality-Adjusted Life Years ; Child, Preschool

Objective To explore the correlation of serum matrix metalloproteinase-9(MMP-9)and heat shock protein-47(HSP-47)levels with prognosis in patients with acute cerebral hemorrhage.Methods One hundred and forty-five patients with acute cerebral hemorrhage attending our hospital from March 2018 to May 2022 were selected,and assigned into good prognosis group(n=80)and poor prognosis group(n=65)according to their postoperative prognosis.General information of patients was recorded.The early morning of the day after admission fasting peripheral venous blood samples were collected for the detection of serum MMP-9 and HSP47 levels.Multivariate Logistic regression analysis was conducted to screen the risk factors affecting poor prognosis in patients with acute cerebral hemorrhage,and the predictive value of serum MMP-9 and HSP47 levels on prognosis of patients with acute cerebral hemorrhage was evaluated by plotting ROC curve.Results Statistical difference was found in shape and volume of hematoma between two groups(P＜0.05).Serum MMP-9 and HSP47 levels in poor prognosis group were higher than that in good prognosis group(P＜0.05).Multivariate Logistic regression analysis denoted that duration of surgery,hematoma shape,hematoma volume,serum MMP-9 and HSP47 levels were all risk factors for poor prognosis in patients with acute cerebral hemorrhage(P＜0.05).Patients with the time of onset to surgery＞24 hours irregular shaped hematoma,large hematoma volume,and elevated serum levels of MMP-9 and HSP47 suffered a high risk of poor prognosis.ROC curve analysis demonstrated that AUC of serum MMP-9 and HSP47 levels for predicting the postoperative prognosis of patients with acute cerebral haemorrhage were 0.718 and 0.827,with a sensitivity of 81.5％and 80.0％,and a specificity of 50.0％and 81.2％,respectively.The AUC,sensitivity and specificity of combined detection of serum MMP-9 and HSP47 for prognosis prediction were 0.891,86.2％and 85.0％.Conclusion Serum MMP-9 and HSP47 levels are elevated in patients with poor prognosis after acute cerebral haemorrhage,and irregular shaped hematoma,hematoma volume,and serum MMP-9 and HSP47 levels are risk factors for poor prognosis after acute cerebral haemorrhage.Furthermore,serum MMP-9 and HSP47 are of great predictive value for the prognosis of patients with acute cerebral haemorrhage,and the predictive efficacy of combined detection of the two is better than that of separate test.

Objective:To investigate the current situation of the fatalism of the disabled elderly in hospital, and to analyze the influencing factors, so as to provide a basis for the later development of targeted intervention programs.Methods:This was a cross-sectional survey study. From December 2 to 29, 2023, the convenience sampling method was used to investigate the disabled elderly hospitalized in 7 tertiary general hospitals in Sichuan Province by the general information questionnaire, the Activity of Daily Living scale and the Fatalism Scale. And its influencing factors were conducted by the multivariate linear regression.Results:A total of 280 questionnaires were distributed in this survey, and 269 questionnaires were effectively recovered, with an effective recovery rate of 96.07%(269/280). There were 136 males and 133 females, aged 60-69 years old with 61 cases, 70-79 years old with 103 cases, ≥80 years old with 105 cases. The score of the fatalism in hospitalized disabled elderly was (48.87 ± 10.02) points, of which the pre-determined dimension score was (18.73 ± 4.17) points, the luck dimension score was (12.75 ± 3.42) points, and the pessimistic dimension score was (17.39 ± 4.72) points. Multivariate linear regression showed that the frequency of visits to relatives and friends and the level of education were protective factors for the occurrence of fatalism (t=-3.02, -2.81, both P<0.05), and economic pressure was a risk factor for the occurrence of fatalism (t=4.35, P<0.01).Conclusions:The fatalistic view of the disabled elderly in the hospital is at a medium level.Medical staff can start from the influencing factors, formulate relevant intervention measures, and improve the level of the patient's fatalism.

Objective To explore the relationship between basic motor skills and social interaction ability in school-age children with moderate autism,and the mediating role of executive function and the realization path.Methods A cross-sectional design was used to investigate 117 school-age children with autism from Sep.to Dec.2020.The level of basic motor skills was assessed by the test of gross motor development(TGMD),the impairment of executive function was assessed by the behavior rating inventory of executive function(BRIEF),and the social disorder was assessed by the social responsive scale-second edition(SRS-2).Pearson correlation analysis was used to explore the interrelationship,and structural equation modeling was applied to explore the path relationship.Results There was a significant negative correlation between the level of basic motor skills and SRS-2 scores(r=-0.312,P＜0.001).There were significant negative correlations between the level of basic motor skills and the BRIEF scores of inhibition(r=-0.336,P＜0.001),switching(r=-0.325,P＜0.001),affective control(r=-0.338,P＜0.001),task initiation(r=-0.240,P=0.009),working memory(r=-0.278,P=0.002),and planning(r=-0.224,P=0.015).The SRS-2 score was positively correlated with the BRIEF scores of inhibition(r=0.378,P＜0.001),switching(r=0.299,P=0.001),affective control(r=0.417,P＜0.001),task initiation(r=0.246,P=0.007),working memory(r=0.409,P＜0.001),and monitoring(r=0.258,P=0.005).Executive function played a complete intermediary role between basic motor skills and social interaction ability(B=-1.912,95％confidence interval:-3.116 to-1.069).Conclusion In school-age children with moderate autism,executive function and social interaction ability change positively with the level of basic motor skills.Basic motor skills can affect social interaction ability through the mediating role of executive function,and inhibition and affective control are important pathways to achieve this.

Background::Evaluating the impact of digestive system diseases is vital for devising effective prevention strategies. However, comprehensive reports on the burden of digestive system diseases in China are lacking. Our study aimed to provide an overview of the burden and trends of digestive system diseases from 1990 to 2019 in China and its provinces.Methods::This cross-sectional study utilized the Global Disease Burden Study 2019 to estimate the incidence, mortality rate, disability-adjusted life years (DALYs), years of life disability, years of life lost, and changes in the burden of digestive diseases across Chinese provinces from 1990 to 2019. The analysis of disease burden primarily examines the characteristics of sub-disease distribution, time trends, age distribution, and sex distribution. Additionally, we compared provincial age-standardized DALYs for digestive diseases with the expected rates based on the socio-demographic index (SDI).Results::In 2019, there were 499.2 million cases of digestive system diseases in China, resulting in 1,557,310 deaths. Stomach cancer, colon and rectal cancer, and esophageal cancer are the top three diseases associated with mortality and DALY related to digestive system diseases. Meanwhile, cirrhosis and other chronic liver diseases, gastroesophageal reflux disease, and gallbladder and biliary diseases are the top three kinds of diseases with the highest prevalence among digestive system diseases. The risk of gastric cancer sharply increases among men after the age of 40 years, leading to a significant disparity in burden between men and women. As the SDI increased, the DALYs associated with digestive system diseases in China and its provinces showed a downward trend.Conclusion::Our study highlights the inverse correlation between DALYs associated with digestive system diseases and the SDI.

Objective: To investigate the characteristics of AHFtest-based HIV antibody self-testing among male adolescents at ages of 15 to 24 years, so as to provide insights into the promotion of HIV antibody self-testing. Methods: Data were collected from male adolescents at ages of 15 to 24 years that applied for HIV antibody self-testing in the AHFtest platform from 2019 to 2021, with mailing address showing as Zhejiang Province, and demographics, applying cause and testing results were analyzed. Results: A total of 268 male adolescents were enrolled, with a median age of 22.00 (interquartile range, 3.00) years. There were 160 cases with an educational level of junior college/bachelor (59.70%), 147 students (54.85%), 175 men who had sex with men (65.30%), and 126 cases with a history of previous HIV antibody self-testing (47.01%). The main causes for applying for HIV antibody self-testing through AHFtest were "easy to operate" (259 cases, 96.64%) and "privacy protect" (102 cases, 38.06%). There were 203 subjects that applied once HIV antibody self-testing (75.75%), and 65 subjects that applied multiple self-testing (24.25%). There were 123 subjects that uploaded their test results (45.90%), including 3 cases with HIV antibody positive, and 125 subjects that did not tell others the self-testing results (46.64%). Conclusions Among male applicants at ages of 15 to 24 years in Zhejiang Province from 2019 to 2021, students are predominant occupation. Easy to operate and privacy protect are the main cause for the application, but the proportion of detection results uploading is relatively low.

BACKGROUND:Bacterial infections and impaired angiogenesis have been obstacles to diabetic wound healing,and the problem of multidrug resistance cannot be ignored,so there is an urgent need to find a new therapeutic strategy. OBJECTIVE:To prepare platelet-camouflaged silver nanoparticle hydrogel and observe its therapeutic effect on diabetic wounds. METHODS:(1)In vitro test:The ultra-small silver nanoparticles(usAgNPs)were obtained by reflux heating.usAgNPs-PL/CMC hydrogel was prepared by coupling it with platelets(PL)and adding it to the carboxymethyl cellulose(CMC)hydrogel.The microstructures,swelling properties,and mechanical properties of the hydrogel were characterized.The antibacterial activity of the hydrogel was tested by 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)5[(phenylamino)carbonyl]-2H-tetrazolium hydroxide method,reactive oxygen species method,bacterial biofilm method,and bacterial activity.(2)In vivo test:Forty SD rats were randomly divided into sham operation group,model group,CMC hydrogel group,usAgNPs/CMC hydrogel group,and usAgNPs-PL/CMC hydrogel group,with eight rats in each group.The type 1 diabetes model was established in the other four groups except the sham operation group.After successful model establishment,a skin wound(20 mm in diameter)deep to the fascia layer was made on the back of rats of the five groups.Rats in the sham operation group and model group were injected with normal saline.The rats in the CMC hydrogel group,usAgNPs/CMC hydrogel group,and usAgNPs-PL/CMC hydrogel group were implanted with the corresponding hydrogel,separately.The wound healing condition and healing quality were observed after 14 days of treatment. RESULTS AND CONCLUSION:(1)In vitro test:The usAgNPs-PL/CMC hydrogel had a uniform three-dimensional network structure,good mechanical properties,and strong water absorption ability,which could remarkably inhibit the growth of Escherichia coli and Staphylococcus aureus,and had a good inhibition and clearance effect on the formation of biofilms of the two bacteria,and had a good antibacterial ability.(2)In vivo test:After 14 days of treatment,the wounds of the usAgNPs-PL/CMC hydrogel group were basically closed.The wound healing rate was the highest,and the number of wound colonies was significantly lower than that of the model group.After 14 days of treatment,hematoxylin-eosin and Masson staining showed that the tissue structure of regenerated dermis appeared on the wounds of the usAgNPs-PL/CMC hydrogel group,usAgNPs/CMC hydrogel group,and CMC hydrogel group,and the epidermis of the new granulation tissue was complete and thick.Parallel mature collagen fibers were observed in the usAgNPs-PL/CMC hydrogel group.After 7 days of treatment,CD31 immunohistochemistry and Ki67 immunofluorescence staining showed that the usAgNPs-PL/CMC hydrogel group had the highest number of microvessels and fibroblasts.(3)The results showed that usAgNPs-PL/CMC hydrogel could accelerate wound healing in type 1 diabetic rats by rapidly inhibiting bacteria and promoting angiogenesis.

Objective:To investigate the correlation among physical activity,mild depressive symptoms and frontal alpha power asymmetry in college students.Methods:Seventy college students with mild depressive symp-toms who conformed to the standard of the Self-Rating Scale for Depression(SDS)of 53-62 and 70 normal col-lege students were recruited.The frontal alpha power was measured under quiet and closed-eye state,and the total physical activity(PA)was assessed with the International Physical Activity Questionnaire.Results:The college students with mild depressive symptoms had lower Total PA scores,right frontal alpha power and frontal alpha a-symmetry(FAA)than the normal controls(P＜0.001).In college students with mild depressive symptoms,the to-tal PA scores(r=-0.29,P＜0.05)and FAA(r=-0.41,P＜0.001)were negatively correlated with SDS scores,and the total PA scores were positively correlated with FAA(r=0.34,P＜0.01).Conclusion:The college students with mild depressive symptoms may have reduced physical activity and asymmetric right lateralization of frontal alpha power.There is a correlation among depressive symptoms,physical activity and frontal alpha power a-symmetry in college students with mild depressive symptoms.

Objective:To investigate the association between hyperuricemia and the risk for stroke occurrence, as well as the mediating effect of hypertension on this association.Methods:In this study, the China Chronic Diseases and Nutrition Surveillance system in 2015 was used as baseline data. We identified hospital admissions for stroke using the electronic homepage of inpatient medical records from 2013-2020, and death data were obtained from the 2015-2020 National Mortality Surveillance System. A retrospective cohort was established after matching and linking the database. The Cox proportional hazard regression model was used to analyze the relationship between hyperuricemia and the risk of stroke and its subtypes. Restricted cubic spline analysis was conducted to examine the dose-response relationship between serum uric acid levels and the risk for stroke. Mediation analysis was performed to investigate the mediating effect of hypertension on the association between hyperuricemia and the risk for stroke and its subtypes. Subgroup analyses were conducted based on gender and age groups.Results:A total of 124 352 study subjects were included, with an accumulative follow-up time of 612 911.36 person-years. During the follow-up period, 4 638 cases of stroke were found, including 3 919 cases of ischemic stroke and 689 cases of hemorrhagic stroke. The incidence density of stroke was 756.72 per 100 000 person-years, 641.37 per 100 000 person-years for ischemic stroke, and 114.60 per 100 000 person-years for hemorrhagic stroke. Multivariable Cox proportional hazards regression models showed that after adjusting for covariates, compared to those without hyperuricemia, individuals with hyperuricemia had a 16% higher risk for stroke [hazard ratio ( HR)=1.16, 95% CI: 1.06-1.27], a 12% higher risk of ischemic stroke ( HR=1.12, 95% CI: 1.01-1.24), and a 39% higher risk of hemorrhagic stroke ( HR=1.39, 95% CI: 1.11-1.75). Mediation analysis showed that hypertension partially mediated the associations between hyperuricemia and the risk for stroke, ischemic stroke, and hemorrhagic stroke, with mediation proportions of 36.07%, 39.98%, and 25.34%, respectively. The mediating effect is pronounced in the male population and individuals below 65. Conclusion:Hyperuricemia is a risk factor for stroke, and hypertension partially mediates the effect of hyperuricemia on stroke.