中华流行病学杂志最新文献

{"title":"[Analysis on differences in healthcare-seeking behavior in patients with chronic obstructive pulmonary disease identified through different detection pathways in Songjiang District, Shanghai].","authors":"F L Li, Y X Zhang, Y L Wu, X Yin, J Li, M J Yu, W Wang, Q Wang, Y G Jiang, G M Zhao, N Wang","doi":"10.3760/cma.j.cn112338-20260122-00060","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20260122-00060","url":null,"abstract":"<p><p><b>Objective:</b> To compare demographic characteristics and healthcare-seeking behaviors of patients with chronic obstructive pulmonary disease (COPD) identified through community-based pulmonary function test (PFT) screening and symptom-prompted diagnosis via a regional health information platform in Songjiang district, Shanghai. <b>Methods:</b> A total of 2 038 COPD patients aged ≥40 years were included from a suburban population-based cohort and a regional healthcare information platform, including 216 screening diagnosed patients and 1 822 symptom-prompted diagnosed patients (the patients diagnosed in outpatients). Demographic characteristics and outpatient visits, hospitalizations, and respiratory-related visits during follow-up were compared. Associations between case-finding pathways and healthcare-seeking behaviors were analyzed by using a hurdle negative binomial regression model. <b>Results:</b> Compared with the screening-diagnosed group, the symptom-prompted diagnosed patients had higher proportion of women, lower prevalence of smoking and alcohol consumption, higher prevalence of respiratory comorbidities, and higher severity grade by Global Initiative for Chronic Obstructive Lung Disease. Compared with the screening diagnosed group, the symptom-prompted diagnosed group had higher risk for outpatient visits, respiratory illness-related outpatient visits, hospitalizations, and respiratory illness-related hospitalizations, with <i>OR</i>s of 17.28 (95%<i>CI</i>: 1.46-204.32), 13.30 (95%<i>CI</i>: 8.28-21.36), 2.26 (95%<i>CI</i>: 1.66-3.08), and 4.07 (95%<i>CI</i>: 2.10-8.31), respectively. In addition, the outpatient visit density, respiratory illness-related outpatient visit density, and hospitalization density were higher in the symptom-prompted diagnosed group than in screening diagnosed group, with <i>RR</i>s of 2.00 (95%<i>CI</i>: 1.80-2.22), 2.84 (95%<i>CI</i>: 2.35-3.43), and 1.52 (95%<i>CI</i>: 1.14-2.02) , respectively. <b>Conclusions:</b> Healthcare-seeking behaviors differed significantly by COPD case- finding pathway. The symptom-prompted diagnosed patients showed higher healthcare-seeking intensity, whereas community-based PFT screening was more likely to identify early-stage patients with lower healthcare dependence, supporting pathway-specific stratified management of COPD.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1668-1676"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Directed acyclic graph building and analyzing based on DAGitty].","authors":"S Chen, X Y Hu, J Li, J L Qi, Y Y Su, H X Liu","doi":"10.3760/cma.j.cn112338-20251229-00934","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20251229-00934","url":null,"abstract":"<p><p>Directed acyclic graph (DAG) is a common tool in structural causal models. By visualizing hypotheses about causal relationships between variables via nodes and edges, they help researchers identify bias sources, determine key variables and adjustment sets, and enhance the transparency of causal inference. However, as more variables are incorporated into a DAG, inter-variable relationships often become complex, forming large-scale multi-variable DAGs that pose significant analytical challenges. DAGitty, a browser-based platform integrating DAG drawing and analysis, supports DAG construction, identification of biasing paths, and automatic derivation of minimal sufficient adjustment sets, can greatly improve research efficiency. This paper systematically introduces DAGitty, clarifies its core functions and practical applications to provide reliable tool reference and standardized guidance for research of causal inference.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1677-1683"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on the evaluation contents and methods for digital technologies application in HIV/AIDS prevention and control].","authors":"Q S Wu, Z Y Yuan, Y L Wang, D Shan","doi":"10.3760/cma.j.cn112338-20260111-00030","DOIUrl":"10.3760/cma.j.cn112338-20260111-00030","url":null,"abstract":"<p><p>Digital technologies have been widely applied across the continuum of HIV/AIDS prevention and control. However, compared with the rapid expansion of practice, research on their effectiveness evaluation remains relatively lagging behind. Major challenges include the lack of a unified evaluation framework, inconsistent definitions and measurement of indicators, substantial variation in study designs and analytical methods, and limited comparability and integration of findings. This review systematically summarizes relevant domestic and international research and, drawing on the World Health Organization guideline on digital health interventions, the mHealth evidence reporting and assessment checklist, the reach, effectiveness, adoption, implementation, and maintenance framework commonly used in public health and implementation science, and the model for assessment of telemedicine commonly used in European telemedicine and health technology assessment, synthesizes research on the evaluation of digital HIV/AIDS prevention and control interventions from two perspectives: evaluation content and evaluation methods. The findings suggest that evaluation of digital HIV/AIDS interventions should focus on five core dimensions: coverage and accessibility, adoption and use behavior, implementation quality and fidelity, behavioral and health outcomes, and economic value and system sustainability. In terms of methodology, evaluation approaches have expanded from traditional randomized controlled trials, cohort studies, and before-and-after comparisons to a broader set of methods, including quasi-experimental studies, real-world studies, multi-source data analysis, data-driven modeling, and health economic evaluation. Overall, the evaluation of digital HIV/AIDS interventions is shifting from a primary focus on single health outcomes to a multidimensional approach that also considers processes, behaviors, outcomes, and system values. Future research should further standardize core indicators and measurement approaches, strengthen multisource data integration, and generate more evidence on ethics and compliance, privacy protection, user trust, cost-effectiveness, and long-term sustainability, thereby improving the scientific rigor, standardization, and practical value of evaluation in digital HIV/AIDS prevention and control.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1725-1732"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of incidence characteristics and influencing factors of metabolic syndrome among rural residents in Southern Xinjiang Uygur Autonomous Region].","authors":"S J Gu, M Tian, L Lu, Tusunkali Airefate, H Guo, S X Guo, X H Zhang, X Qian, J He","doi":"10.3760/cma.j.cn112338-20260105-00010","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20260105-00010","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the incidence characteristics and influencing factors of metabolic syndrome (MS) among rural residents in southern Xinjiang Uygur Autonomous Region, to provide scientific evidence for early prevention of MS. <b>Methods:</b> A rural population cohort of 12 813 permanent residents aged 18 and above in southern Xinjiang Uygur Autonomous Region was established in 2016. Latent Class Analysis (LCA) was conducted in the total population and new-onset MS population to explore phenotypic distribution characteristics. Chi-square tests and Cox proportional hazards regression models were used to analyze MS risk factors. <b>Results:</b> The incidence density of MS was 32.06 per 1 000 person-years. Male incidence density (37.25 per 1 000 person-years) exceeded that of females (27.89 per 1 000 person-years). Age >30 years, overweight/obesity, abnormal LDL-C, abnormal gamma-glutamyl transferase (GGT), high triglyceride-high waist circumference, and hypertension-high waist circumference phenotype were risk factors for MS (all <i>HR</i>>1.00, all <i>P</i><0.05). Stratified analysis indicated that abnormal LDL-C,abnormal GGT, high triglyceride-high waist circumference phenotype, and hypertension-waist circumference phenotype were risk factors for MS in the 31-60 age group. In men, abnormal GGT and high triglyceride-high waist circumference phenotypes carried higher MS risk; in women, abnormal LDL-C, overweight/obesity, and hypertension-high waist circumference phenotypes were associated with higher MS risk; those with a secondary school education or above had a lower risk of MS. <b>Conclusions:</b> The incidence density of MS was relatively high in rural areas of southern Xinjiang Uygur Autonomous Region, with gender and age differences in risk factors. It was recommended to focus on individuals aged 31-60 years with hypertension-high waist circumference and high triglyceride-high waist circumference phenotypes. Men should strengthen lipid and liver function monitoring, while women should enhance weight, blood pressure, and waist circumference management.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1612-1619"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Current status of delayed medical consultation and influencing factors in pulmonary tuberculosis patients aged 65 years and above in Henan Province, 2020-2024].","authors":"A H Zhao, Y M Ma, D L Li, M Gao, M J Li, D Y Sun, J W Sun","doi":"10.3760/cma.j.cn112338-20260311-00157","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20260311-00157","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To analyzes the current status of delayed medical consultation and influencing factors in pulmonary tuberculosis (TB) patients aged ≥65 years in Henan Province from 2020 to 2024, and provide scientific evidence for the improvement of the prevention and control of pulmonary TB in the elderly. &lt;b&gt;Methods:&lt;/b&gt; The information were collected from the Tuberculosis Information Management Subsystem of Chinese Information System for Disease Control and Prevention. Study participants were pulmonary TB patients aged ≥65 years who were registered and managed in Henan from January 1, 2020, to December 31, 2024. A retrospective epidemiological survey was conducted to collect information of elderly pulmonary TB patients with delayed medical consultation to understand the distribution and temporal variation trends of those with delayed medical consultation, and &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; test and multivariate logistic regression model were used to identify the influencing factors of delayed medical consultation. &lt;b&gt;Results:&lt;/b&gt; A total of 50 031 elderly pulmonary TB patients were included, in whom 26 783 had delayed medical consultation, with an overall delayed consultation rate of 53.53%. The median time (&lt;i&gt;Q&lt;/i&gt;&lt;sub&gt;1&lt;/sub&gt;, &lt;i&gt;Q&lt;/i&gt;&lt;sub&gt;3&lt;/sub&gt;) of delayed consultation was 16.0 (4.0, 37.0) days. The delayed consultation rate remained stable at 50.49%-50.94% from 2020 to 2022, then increased rapidly to 55.97% in 2023 and 58.41% in 2024, showing an accelerating upward trend (trend &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=193.65, &lt;i&gt;P&lt;/i&gt;&lt;0.001). In terms of regional distribution, the delayed consultation rate was lowest in Zhumadian (32.00%) and highest in Luohe (77.27%), the difference was significant (&lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=2 428.79, &lt;i&gt;P&lt;/i&gt;&lt;0.001). Multivariate logistic regression analysis revealed that the risk factors for delayed medical consultation included jobless/unemployment (a&lt;i&gt;OR=&lt;/i&gt;1.24, 95%&lt;i&gt;CI&lt;/i&gt;: 1.14-1.36), direct hospital visit (a&lt;i&gt;OR=&lt;/i&gt;3.86, 95%&lt;i&gt;CI&lt;/i&gt;: 3.07-4.85), referral (a&lt;i&gt;OR&lt;/i&gt;=3.45, 95%&lt;i&gt;CI&lt;/i&gt;:2.75-4.34), follow-up (a&lt;i&gt;OR&lt;/i&gt;=4.31, 95%&lt;i&gt;CI&lt;/i&gt;: 3.42-5.42), no complication (a&lt;i&gt;OR&lt;/i&gt;=2.15, 95%&lt;i&gt;CI&lt;/i&gt;:1.97-2.35), recurrence (a&lt;i&gt;OR&lt;/i&gt;=1.30, 95%&lt;i&gt;CI&lt;/i&gt;: 1.22-1.39), return visit (a&lt;i&gt;OR&lt;/i&gt;=1.84, 95%&lt;i&gt;CI&lt;/i&gt;:1.01-3.33), and lack of etiological results (a&lt;i&gt;OR&lt;/i&gt;=1.99, 95%&lt;i&gt;CI&lt;/i&gt;: 1.29-3.06). Conversely, protective factors were being man (a&lt;i&gt;OR&lt;/i&gt;=0.93, 95%&lt;i&gt;CI&lt;/i&gt;: 0.89-0.97), population at low risk (a&lt;i&gt;OR&lt;/i&gt;=0.59, 95%&lt;i&gt;CI&lt;/i&gt;: 0.53-0.65), and non-floating population (a&lt;i&gt;OR&lt;/i&gt;=0.89, 95%&lt;i&gt;CI&lt;/i&gt;: 0.82-0.96). &lt;b&gt;Conclusions:&lt;/b&gt; The rate of delayed medical consultation in elderly pulmonary TB patients in Henan remained stable from 2020 to 2022, then increased rapidly in 2023 and 2024, with an unbalanced regional distribution. More attention should be paid to the early detection of elderly pulmonary TB, especially in women, farmers, floating population, cases identified by passive screening (direct hospital vi","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1637-1643"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis on epidemiology trends of chronic obstructive pulmonary disease in residents aged 40 years and above in Hubei Province, 2014-2024].","authors":"Y M Tang, S Z Zhu, L W Fang, Q Li, M Y Shen, M G Zhou, T J He, L Zhang","doi":"10.3760/cma.j.cn112338-20251218-00906","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20251218-00906","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the prevalence of chronic obstructive pulmonary disease (COPD) and its change trend in residents aged ≥40 years in Hubei Province from 2014 to 2024, and provide data support for COPD prevention and control. <b>Methods:</b> The COPD prevalence data were from three cross-sectional surveys of the China COPD surveillance from 2014 to 2024. Complex weighted sampling were used to analyze the prevalence of COPD and the changing trend of related factors in people with different demographic characteristics. A multivariate logistic regression model was used to analyze the correlated factors of COPD in Hubei. <b>Results:</b> The prevalence rates of COPD in people aged ≥40 years in Hubei in 2014-2015, 2019-2020 and 2024 were 12.5% (95%<i>CI</i>: 10.1%-14.8%), 10.7% (95%<i>CI</i>: 7.8%-13.6%) and 8.1% (95%<i>CI</i>: 5.8%-10.5%), respectively, with no statistical significance in downward trend (<i>t</i>=-2.06, <i>P</i>=0.079). The exposure rates of occupational dust and/or harmful gases, the use rate of coal fuel for household heating, the exposure rate of low BMI, the prevalence of dyspnea and any respiratory symptom decreased significantly. The protection rate against occupational exposure to dust or harmful gas increased significantly. The results of multivariate Logistic regression showed that the COPD risk was higher in rural population (<i>OR</i>=1.38, 95%<i>CI</i>: 1.06-1.81), men (<i>OR</i>=3.45, 95%<i>CI</i>: 1.80-6.61), those with older age (50- years old: <i>OR</i>=2.81, 95%<i>CI</i>: 2.05-3.85; 60- years old: <i>OR</i>=3.04, 95%<i>CI</i>: 1.29-7.16; ≥70 years old: <i>OR</i>=8.43, 95%<i>CI</i>: 4.51-15.73), retired group (<i>OR</i>=2.60, 95%<i>CI</i>: 1.12-6.02), smokers (<i>OR</i>=2.48, 95%<i>CI</i>: 1.75-3.52), people with family history of chronic respiratory diseases (<i>OR</i>=1.54, 95%<i>CI</i>: 1.29-1.84).The unemployed (<i>OR</i>=0.73, 95%<i>CI</i>: 0.54-0.97), middle-high per capita annual income (<i>OR</i>=0.46, 95%<i>CI</i>: 0.27-0.79), people with normal BMI (<i>OR</i>=0.21, 95%<i>CI</i>: 0.11-0.42), overweight people (<i>OR</i>=0.19, 95%<i>CI</i>: 0.10-0.33), and obese people (<i>OR</i>=0.07, 95%<i>CI</i>: 0.02-0.30) had lower risk for COPD. <b>Conclusions:</b> From 2014 to 2024, there was no statistically significant downward trend in the prevalence of COPD in residents aged ≥40 years in Hubei. Rural residents, men, the elderly, smokers, and those with a family history of chronic respiratory diseases were the population at high risk for COPD. It is necessary to further strengthen the surveillance for COPD and associated factors.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1628-1636"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Visualization of period prevalence in dynamic populations: a teaching design and preliminary application].","authors":"Y J Zheng","doi":"10.3760/cma.j.cn112338-20260401-00220","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20260401-00220","url":null,"abstract":"<p><p>There is a persistent inconsistency between the definition of period prevalence (PP) and its practical calculation, which poses a challenge in teaching epidemiology. This paper proposes a visual teaching design for a \"three-tiered relationship diagram of disease duration, case numbers and population size within a dynamic population\", based on a unified timeline. First, cases are classified into four categories according to the relationship between disease duration and the study period, with a clear distinction between new and pre-existing cases. Second, the person-time (area under the curve) interpretations of the integrals of real-time case counts, cumulative case counts, their maximum value, and population size over time are explained. Third, a theoretical PP formula based on the person-time ratio is established, from which two simplified formulas are derived. The relationships among the three formulas are clarified, and their application is demonstrated using examples of type 2 diabetes and influenza. Centered on the relational graph, this teaching design integrates conceptual analysis, formula derivation, and case validation. A small-scale pilot teaching session has shown preliminary effectiveness, and directions for future application and research are discussed.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1706-1711"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Association between air pollution exposure and metabolic dysfunction-associated steatotic liver disease in adults in China].","authors":"Y T Huang, A X Lyu, C Q Yu, D J Y Sun, P Pei, H D Du, J S Chen, Z M Chen, J Lyu, L M Li, Y J Pang","doi":"10.3760/cma.j.cn112338-20251103-00783","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20251103-00783","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the associations of exposure to single pollutants and their mixture with metabolic dysfunction-associated steatotic liver disease (MASLD) and MASLD with significant liver fibrosis in adults in China. <b>Methods:</b> A total of 23 806 participants from the third resurvey of the China Kadoorie Biobank were included. An elastic-net logistic regression model was used to calculate the weighted environmental risk score (WERS). Logistic regression models were used to evaluate the associations of the exposures to single pollutant [fine particulate matter (PM_2.5), inhalable particulate matter (PM₁₀), nitrogen dioxide (NO₂), and warm-season ozone (O₃)], and their mixture (WERS) with the risk for MASLD and MASLD with significant liver fibrosis. Restricted cubic spline models were used to evaluate non-linear relationships. Logistic regression models were also used to estimate the population attributable fraction (PAF) for air pollutants and major risk factors. <b>Results:</b> The mean age of the study participants was (65.3±9.1) years. Among them, 13 428 had MASLD, including 2 457 with significant liver fibrosis. Exposure to PM_2.5, PM₁₀, NO₂, and warm-season O₃ was positively associated with MASLD risk, with <i>OR</i>s of 1.27 (95%<i>CI</i>: 1.05-1.53), 1.77 (95%<i>CI</i>: 1.36-2.31), 1.20 (95%<i>CI</i>: 1.08-1.33), and 1.53 (95%<i>CI</i>: 1.20-1.95) per 1-<i>SD</i> increase, respectively. PM_2.5 showed a non-linear association with MASLD risk (<i>P</i> for nonlinear=0.007). The association between PM_2.5 and MASLD was mild at low exposure levels but increased obviously at higher concentrations. PM₁₀ and warm-season O₃ exposures were positively associated with significant liver fibrosis in MASLD patients. Each 1-unit increase in WERS (representing simultaneous 1-<i>SD</i> increases in the four pollutants) was associated with a 40% higher risk for MASLD (95%<i>CI</i>: 18%-65%) and a 42% higher risk for significant liver fibrosis (95%<i>CI</i>: 1%-100%). Compared with people with low exposure to air pollutants, the PAFs for MASLD in those with higher exposures to PM_2.5, PM₁₀, and warm-season O₃ ranged from 25.4% to 66.4%. <b>Conclusion:</b> Exposures to PM_2.5, PM₁₀, NO₂, and warm-season O₃, as well as their mixture, were associated with increased risk for MASLD and MASLD with significant liver fibrosis in adults in China.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1553-1561"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Epidemiological trends and spatiotemporal distribution of syphilis in youth aged 15-24 years in Guangzhou, 2005-2024].","authors":"J J Peng, X D Ye, H L Wang, Q Luo, W P He, Z C Du","doi":"10.3760/cma.j.cn112338-20260313-00161","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20260313-00161","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the epidemiological trend and spatial-temporal distribution of syphilis in young people aged 15-24 years in Guangzhou from 2005 to 2024, and compare the differences in epidemiological characteristics between the student group and the non-student group. <b>Methods:</b> The syphilis surveillance data in young people aged 15-24 years in Guangzhou from 2005 to 2024 were collected through Chinese Information System for Disease Control and Prevention. The student's group and the non-students' group were classified according to occupation registration. Joinpoint regression model was used to analyze the trend of annual incidence. Bayesian structural time series model was used to analyze the seasonal changes and softwareArcGIS 10.2 was used for global spatial autocorrelation analysis and local hotspot analysis. <b>Results:</b> The reported incidence increased from 15.17/100 000 in 2005 to 55.74/100 000 in 2024, with an average annual percentage change (AAPC) of 7.28% (<i>P</i><0.001). The incidence of latent syphilis showed an upward trend (AAPC=10.37%, <i>P</i><0.001). The incidence increase in age group 15-19 years (AAPC=11.66%, <i>P</i><0.001) was greater than that in age group 20-24 years (AAPC=6.36%, <i>P</i><0.001). The upward trend of incidence in the non-student group (AAPC=11.68%, <i>P</i><0.001) was greater than that in the student group (AAPC=8.71%, <i>P</i><0.001). The cases were mainly non-students (94.52%), individuals aged 20-24 years (75.67%), and people with latent syphilis (68.07%). The incidence peak in the student group occurred in November, and the incidence peaks in the non-student group occurred in May and during July - September. Positive spatial autocorrelation in syphilis case counts was observed among the overall youth population and non-students in 2019 and 2021-2024, while syphilis cases among students showed positive spatial autocorrelation over the 2005-2024 period (<i>Z</i>=2.571, <i>P</i>=0.010). The hot spots of the youth group and the non-student group were in Baiyun, Huadu and Panyu district. of Guangzhou, and the hotspots of the non-student group were distributed in Baiyun District, while the hotspots of the student group were distributed in Tianhe District. <b>Conclusions:</b> The reported incidence of syphilis in young people aged 15-24 years increased in Guangzhou from 2005 to 2024, and the change patterns of spatiotemporal distribution of syphilis in students and non-students varied. It is necessary to strengthen the screening of non-student groups in the floating population and improve the screening and follow-up in summer when the incidence is high, strengthen the monitoring for the student group in colleges and universities, and carry out health education and intervention after the holiday.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1655-1660"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Using sequence and cluster analysis to characterize variables that unfold over time in life-course epidemiology studies].","authors":"Y Zhang, K L He, X L Xu","doi":"10.3760/cma.j.cn112338-20251231-00940","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20251231-00940","url":null,"abstract":"<p><p>The life-course epidemiology emphasizes that the timing, duration, and interactions of exposures can have life-time health effects, yet it remains challenging to characterize complex dynamic trajectories in epidemiology studies. This study presents practice guidance for implementing sequence and cluster analysis in epidemiological studies to identify long-term trajectories, with an example of constructing a female-specific reproductive life sequence. By ordering the occurrence of reproductive events over women's lifespans, we encoded multiple reproductive events and their timing into ordered-state sequences, then using sequence dissimilarity measures and cluster analysis to identify typical reproductive patterns, describe heterogeneity across patterns, and assess their values for type 2 diabetes risk stratification. This study seeks to provide a guide for researchers on how sequence analysis can be used to reconstruct key life-course event trajectories from multi-source, non-longitudinal data, providing a novel methodological perspective for life-course epidemiology, as well as offering a useful reference for characterizing population health trajectories and examining the impact of cumulative exposures across the life-course.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1684-1690"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}