Population aging, high prevalence of chronic disease, such as hypertension and diabetes, low chronic disease control rate and chronic disease related risk factors commonly observed in population are serious public health problems faced by China today, which have resulting in severe challenges in the prevention and control of chronic kidney disease (CKD) in China. Although the prevalence rate of CKD showed decrease in the past decade, the awareness of CKD in population remains low. To facilitate early detection and treatment of CKD, it is necessary to strengthen health education or promotion and opportunistic screening in high-risk populations, and improve the accessibility of testing and diagnosis. It is suggested to continue the surveillance for disease burden of CKD and related factors and strengthen the control of risk factors to further reduce the incidence and burden of CKD.

Objective:To explore the association between pre-diabetes and glomerular hyperfiltration status in residents in China.Methods:The study subjects were the non-diabetes population in China Chronic Disease and Risk Factor Surveillance in 2018. According to the definition of prediabetes, the study subjects were divided into normoglycemic and pre-diabetes groups, and multivariate factorial logistic regression model was used to analyze the association between prediabetes and the risk for glomerular hyperfiltration and glomerular filtration rate decline, respectively. Restricted cubic spline was used to explore the dose-response relationship between different glycemic indexes and the risk for glomerular hyperfiltration.Results:A total of 129 735 eligible study subjects aged 18 to 74 years were included, including 45 336 persons with prediabetes. After adjusting for confounders, the OR for glomerular hyperfiltration in the prediabetes group was 1.26 (95% CI: 1.20-1.32) compared with the normoglycemic group, and prediabetes was not associated with decreased glomerular filtration rate ( OR=1.03, 95% CI: 0.96-1.12). Age-stratified results showed a 28% increase of risk for glomerular hyperfiltration in prediabetes group compared with normoglycemic group in those aged 18-59 year ( OR=1.28, 95% CI: 1.21-1.35), and a 15% increase of risk in old adults aged 60-74 years ( OR=1.15, 95% CI: 1.05-1.25); the risk for glomerular hyperfiltration in women with prediabetes ( OR=1.38, 95% CI: 1.29-1.47) was higher than that in men with prediabetes ( OR=1.14, 95% CI: 1.06-1.22); and the risk for prediabetes glomerular hyperfiltration was higher in those with insufficient physical activity ( OR=1.29, 95% CI: 1.22-1.36) than in those who were physically active ( OR=1.16, 95% CI: 1.04-1.29). Restricted cubic spline results showed that fasting plasma glucose, glycosylated hemoglobin and glomerular hyperfiltration risk all showed U-shaped associations, and 2 hours blood glucose glomerular hyperfiltration risk after taking sugar showed an approximate J-shaped association. Conclusions:The risk for glomerular hyperfiltration exists in the prediabetes population, and prediabetes is not associated with the decrease in glomerular filtration rate. Hyperglycemia control at an early and reversible stage is important to prevent glomerular hyperfiltration developing to hypofiltration and renal impairment.

Much evidence shows that meteorological factors are closely related to human health. By combining relevant domestic and foreign literature, this review found that there were currently many studies on the association between meteorological factors such as air temperature, sunshine duration, and relative humidity and suicide. Some studies have found that they are related to suicide, while others have not found such an association. There are relatively fewer studies on the association between other meteorological factors and suicide. The mechanisms for the association between air temperature and suicide include physiological and biochemical mechanisms, behavior and lifestyle mechanisms, brown adipose tissue theory, and psychological mechanisms. There is a lack of research on the mechanisms for the association between other meteorological factors and suicide. In the future, it is necessary to strengthen the research on the association between meteorological factors and suicide to clarify their causal relationship and mechanisms to provide a scientific basis for reducing suicides related to climate change.

Objective:To understand the spatiotemporal distribution of pulmonary tuberculosis (TB) in Shaanxi Province from 2015 to 2023, and provide reference for the prevention and control of pulmonary TB in Shaanxi.Methods:The registration data of etiologically positive pulmonary TB cases in Shaanxi from 2015 to 2023 were collected from the tuberculosis subsystem of Chinese Disease Control and Prevention Information System. Descriptive method was used to analyze the basic characteristics of the etiologically positive pulmonary TB cases. Linear trend χ2 test was used to analyze trends in registration rate and pathogen positive rate. Software SPSS 25.0 was used for statistical analysis. Software ArcGIS 10.8 was used for global spatial autocorrelation and hotspot analysis to explore spatial clustering of the etiologically positive pulmonary TB cases. Software SaTScan 10.0 was used for spatiotemporal scan statistics, and software ArcGIS 10.8 was used to visualize the spatiotemporal clustering. Results:A total of 64 148 cases of etiologically positive pulmonary TB were registered in Shaanxi from 2015 to 2023, with an average annual registration rate of 18.33/100 000. The registration rate and pathgen positive rate all showed upward trends from 2015 to 2023, and the differences were significant (the trend χ2=4 555.18 and 19 330.43, both P<0.001). Global spatial autocorrelation and hotspot analysis showed that the registration rate of etiologically positive pulmonary TB in Shaanxi from 2017 to 2023 showed a spatial clustering. The hotspots were mainly in Zhenba and Xixiang counties of Hanzhong, six counties (districts) of Ankang, and Yanchuan and Yanchang counties of Yan'an. The coldspots were mainly in parts of the Guanzhong area, including Baoji, Xi'an, and Xianyang. A total of 4 spatiotemporal clustering areas were explored by spatiotemporal scanning analysis (all P<0.001), in which the first-level clustering areas covered 17 counties (districts), mainly Zhenping, Ziyang, Zhenba, in southern Shaanxi from 2019 to 2022, the second-level clustering areas covered 6 counties (districts), mainly Yanchuan, Yanchang, Qingjian, in northern Shaanxi from 2018 to 2021, the third-level clustering areas covered 14 counties (districts), mainly Yanta, Chang'an, Jingyang, in Guanzhong area from 2018 to 2019, and the fourth-level clustering areas covered 10 counties (districts) from 2019 to 2021. Conclusions:The registration rate of labortory confirmed pulmonary TB cases in Shaanxi showed an upward trend, with obvious differences in spatiotemporal clustering distribution. The clustering areas were mainly in southern Shaanxi, such as Zhenba, Zhenping, Hanbin, Langao, Pingli, Xunyang, Ziyang counties, and northern Shaanxi, such as Yanchuan and Yanchang counties, as well as in capital city, Xi'an and the adjacent Guanzhong area. It is necessary to develope targeted measures according to local conditions for the improvement of pulmonary TB prevention and control strategies in Shaanxi.

Objective:To analyze premature deaths from malignant tumors among Chinese residents from 1990 to 2021, and to quantify the extent to which changes in premature mortality from malignant tumors affect life expectancy among people aged 30 to 69 years.Methods:Using the Global Burden of Disease 2021 data on selected causes of death in China, the malignant tumor mortality rate was estimated for Chinese residents aged 30-69 years from 1990 to 2021, and life expectancy and de-malignant cause-of-death life expectancy were calculated based on the abridged life table for the Chinese population. Arriaga's decomposition method was used to assess the extent to which changes in malignant tumors mortality contributed to changes in life expectancy for people aged 30-69 years and Potential gains in life expectancy (PGLEs) for people aged 30- 69 years.Results:From 1990 to 2021, the standardized mortality rate of malignant tumors among Chinese people aged 30-69 years decreased from 154.29/100 000 to 98.58/100 000, and the change in the mortality rate of malignant tumors among people aged 30-69 years contributed to the increase of life expectancy of about 0.78 years, and the largest contribution was made by the age group aged 55-59 years, which was about 0.17 years. Among the top 10 malignant tumors, the largest "positive contributions" are stomach cancer, esophageal cancer, and liver cancer, with a cumulative contribution of 0.55 years, while pancreatic cancer hurts the increase of overall life expectancy. The PGLEs of malignant tumors for the population aged 30-69 years will be 1.69 years in 2021, which is higher for men (1.97 years) than for women (1.32 years). The top 5 malignant tumors causing loss of life expectancy in the population were tracheal, bronchus, and lung cancer, stomach cancer, esophageal cancer, colorectal cancer, and liver cancer, in that order. Compared with 1990, in 2021, PGLEs for malignant tumors among people aged 30-69 years increased in seven provinces (autonomous regions and municipalities), including Yunnan and Guizhou, and the rest saw a decline, with the largest decrease in Anhui Province.Conclusions:The standardized mortality rate of malignant tumors among Chinese residents aged 30-69 years declined from 1990 to 2021;the change in mortality rate of malignant tumors showed a positive effect on the growth of life expectancy, the change in PGLEs of malignant tumors varied among provinces (autonomous regions and municipalities), and premature deaths from tracheal, bronchus, and lung cancer and gastrointestinal malignant tumors still need to be paid attention to.

Objective:To investigate the relationship of several adiposity-related anthropometric parameters, including BMI, waist circumference (WC), waist-to-hip ratio (WHR), body fat percentage (BFP) and indoles in plasma with the incidence of atherosclerotic cardiovascular disease (ASCVD) in adults in China.Methods:In China Kadoorie Biobank (CKB) study, blood samples were collected from 2 183 participants in the first resurvey in 2008 to detect indoles. Participants' body weight, body height, WC, hip circumference, and BFP were measured at baseline survey in 2004 and resurvey in 2008, the BMI and WHR were calculated with standardized methods. The long-term follow-up of all participants started from the completion of the resurvey in 2008 until the occurrence of incident ASCVD, death, loss to follow-up or until December 31, 2018. CKB ascertained outcome status (incident ASCVD) through death and disease registries and national health insurance databases, supplemented by active follow-up. Multivariate linear regression model was used to estimate the associations of anthropometric measurements at baseline survey and the first resurvey, and changes in these measurements with 3 indoles [indole, indole-3-acetic acid (IAA), and indole-3-propionic acid (IPA)]. Cox proportional hazard regression model was used to estimate the associations between indoles and the risk for ASCVD.Results:Anthropometric measurements at baseline survey or the first resurvey were negatively associated with plasma IPA level. The regression coefficient ( β) of baseline BMI (per 1.0 kg/m 2) with 0.1 standard deviation ( SD) IPA was -0.23 (95% CI: -0.36 - -0.10) (false discovery rate=0.004). After adjusting for baseline BMI, the β of baseline WC, WHR and BFP with 0.1 SD IPA were -0.09 (95% CI: -0.18 - -0.01), -0.12 (95% CI: -0.19 - -0.05), and -0.20 (95% CI: -0.32 - -0.08), respectively. The annual change in BMI (difference between BMI in 2008 and 2004 divided by the time interval) was associated with indole and IAA, with β of 1.40 (95% CI: 0.58 - 2.21) and -1.07 (95% CI: -1.91 - -0.23), respectively, at each 0.1 increase of SD. Over a median ( Q1, Q3) follow-up of 10.46 (10.36, 10.53) years after 2008 resurvey, 236 cases of ASCVD were recorded. IAA and IPA levels were negatively associated with the risk for ASCVD, with hazard ratios for one SD increase of IAA and IPA of 0.87 (95% CI: 0.76 - 0.99) and 0.84 (95% CI: 0.73 - 0.96), respectively. Conclusions:Our results suggested that anthropometric measurements and their changing trends affect the levels of plasma imicrobial tryptophan metabolite levels, decreased levels of IAA and IPA levels are associated with increased risk of ASCVD and indoles in plasma including IPA and IAA might be the mediating factors for adiposity-induced ASCVD.

Objective:To understand the usage situation of e-cigarettes among residents aged 18-65 in Beijing, explore the relationship between e-cigarette use and cigarette smoking as well as smoking cessation behaviors, and provide scientific support for the developing and improving policies and measures related to e-cigarettes.Methods:Using 19 684 residents data from the Beijing Non-communication Chronic Disease and Risk Factors Surveillance in 2022, complex sampling weighted methods were used to estimate proportions, and complex sampling logistic regression analysis was applied to explore the relationship between e-cigarette use, cigarette smoking, and smoking cessation.Results:Among all study participants, the proportion of those who had ever used e-cigarettes was 3.36%, with the current e-cigarette use at 1.26%. The proportion of current e-cigarette users (1.87%) and the former e-cigarette users (3.47%) were higher ( χ2=64.70, P<0.001) among males compared to females (0.60% and 0.64% respectively). The top three reasons for using e-cigarettes were wanting to quit smoking, perceiving e-cigarettes as less harmful, and enjoying the flavors of e-cigarettes. 83.54% of e-cigarette users started with cigarettes. The results of the complex sampling multivariable logistic regression analysis showed that current smoking ( OR=61.35, 95% CI: 36.98-101.76) and former smoking ( OR=31.20, 95% CI: 15.52-62.71) were positively associated with e-cigarette, while current e-cigarette use ( OR=0.13, 95% CI: 0.04-0.39) was negatively associated with quitting cigarette smoking. Conclusions:The proportion of e-cigarette use in Beijing was relatively low. E-cigarette use was associated with cigarette use and was not conducive to smoking cessation. Therefore, stronger regulatory measures and health education campaigns regarding the risks of e-cigarettes should be implemented.

Objective:To investigate the prevalence of baseline dyslipidemia in HIV-infected people before starting antiviral therapy (ART) in China.Methods:The data were collected from HIV/AIDS ART database of Chinese Disease Prevention and Control Information System. A national sample of HIV- infected people who initiated ART from 2018 to 2023 was used to collect baseline information, including sociodemographic characteristics and laboratory test results. According to the Chinese Lipid Management Guidelines (2023) and the National Cholesterol Education Program Adult Treatment Panel Ⅲ guidelines, triglyceride (TG) ≥1.7 mmol/L or total cholesterol (TC) ≥5.2 mmol/L were identified as dyslipidemia. Statistical analysis was performed with software SAS 9.4. An unconditional logistic regression model was used to analyze the factors influencing TG and TC abnormalities in HIV-infected patients before ART.Results:A total of 359 952 adults infected with HIV were included in this study, the prevalence rate of dyslipidemia was 38.41% (138 263/359 952). The abnormal rates of TG and TC were 31.40% (113 041/359 952) and 13.75% (49 494/359 952), respectively. In all age groups except for the 25-44 age groups, the abnormal rates of TG and TC were higher in HIV-infected women than in HIV-infected men. In HIV-infected patients, women, those aged 45-64 years, those lived in northeast region, those had heterosexual transmission, and those with BMI ≥28.0 kg/m 2, CD4 +T lymphocytes counts ≥500 cells/μl had higher rates of baseline dyslipidemia (all P<0.05). Conclusions:The abnormal rate of TG in HIV-infected people before ART was higher in China from 2018 to 2023, especially in HIV-infected women, and the abnormal rate of TG and TC increased with age. Attention should be paid to the clinical diagnosis and ART selection in the treatment of HIV infection.

Global public health is currently undergoing unprecedented and complex changes. The COVID-19 pandemic has exposed vulnerabilities and weaknesses of the global health system, urging nations globally to prioritize pandemic prevention and response strategies. Simultaneously, emerging infectious diseases such as mpox and avian influenza, as well as re-emerging infectious diseases including tuberculosis, AIDS, and viral hepatitis, continue to pose threats to global public health security. Moreover, the prevalence of chronic diseases remains significant, while concerns pertaining to environmental health and the well-being of children and adolescents are growing increasingly prominent. Addressing these challenges requires the formulation of effective public health policies, strengthened international cooperation, enhanced health education, improved public health literacy, and the establishment of a more resilient global public health system.

Objective:To construct an index system for the systematic evalaution of response capabiity for public health risk in mass gathgering and improvemet of preparedness and level of public health risk response.Methods:Based on the theory of health emergency management and the public health practice to support domestic and international mass events, the theoretical framework was constructed. Authoritative experts in relevant fields were invited to conduct multiple rounds of expert consultation for the construction of an evaluation index system, with Delphi method.Results:In this study, 12 authoritative experts in relevant professional fields were selected to participate in the survey, with an expert response rate of 100.0% and an average authority coefficient of 0.89. The final Kendall's W coefficient was 0.408 for the second-level indicators, and 0.416 for the third-level indicators (all P<0.001). Finally, an evaluation index system consisting of 4 first-level indicators (surveillance, risk assessment, laboratory support and response), 15 second-level indicators, and 75 third-level indicators was constructed. Conclusion:The evaluation index system constructed in this study can provide a reference for evaluation of the response capability for the public health risk in mass gathering.