中华流行病学杂志最新文献

{"title":"[Association between novel high-density lipoprotein cholesterol metabolic phenotypes and all-cause and cardiovascular disease mortality in older adults in communities in Beijing].","authors":"X X Ye, S Y Du, C X Wang, Y H Wan, S M Chen, Y T Shi, X T Nie, T J Cao, W C Wang, W Y Cai, Z Y Chen, X H Zhang, Y Hu, J H Wang, S S Yang, M Liu, S S Wang, Y He","doi":"10.3760/cma.j.cn112338-20260108-00022","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20260108-00022","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the association of novel high-density lipoprotein cholesterol (HDL-C) metabolic phenotypes-metabolic HDL-C (mHDL-C) and its residual (mHDL-CΔ)-with all-cause and cardiovascular disease (CVD) mortality risks in community-dwelling older adults in Beijing. <b>Methods:</b> Based on the Beijing Healthy Aging Cohort Study, a total of 8 578 older adults (≥60 years) with complete baseline data were included and followed for survival outcomes. A random forest regression model was constructed to obtain mHDL-C and mHDL-CΔ. Cox proportional hazards regression models were used to analyze the associations of HDL-C, mHDL-C, and mHDL-CΔ with mortality risk. Predictive performance was evaluated using the net reclassification improvement (NRI), integrated discrimination improvement, and time-dependent area under the receiver operating characteristic curve. <b>Results:</b> In the follow up as of March 31, 2021, a total of 1 162 all-cause deaths occurred (the median survival: 2 257.50 days), including 558 CVD deaths. After adjusting for confounders, both HDL-C and mHDL-C levels were negatively associated with the all-cause mortality (<i>HR=</i>0.84, 95%<i>CI:</i> 0.79-0.91; <i>HR</i>=0.84, 95%<i>CI</i>: 0.76-0.91) and CVD mortality (<i>HR</i>=0.73, 95%<i>CI</i>: 0.65-0.81; <i>HR</i>=0.70, 95%<i>CI</i>: 0.61-0.80). In contrast, mHDL-CΔ was positively associated with both types of mortality (all-cause: <i>HR=</i>1.28, 95%<i>CI</i>: 1.17-1.40; CVD: <i>HR</i>=1.42, 95%<i>CI</i>: 1.25-1.61). mHDL-CΔ showed the best reclassification of all-cause mortality (NRI=0.122). <b>Conclusions:</b> In the older adults in communities in Beijing, the novel metabolic phenotypes mHDL-C and mHDL-CΔ were significantly associated with all-cause and CVD mortality risks. These indicators can reveal metabolic heterogeneity and residual mortality risk which cannot be detected by traditional HDL-C concentration, suggesting their potential as auxiliary predictors for mortality risk and as tools for cardiovascular risk stratification and precision prevention in this population.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1593-1603"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009022","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":"[Joint effects of short term exposure to heat and ozone on circulatory disease mortality in Beijing-Tianjin-Hebei region and surrounding areas].","authors":"J N Li, C Chen, Y Q Zhou, C F Li, W W Zhang, Q Liu, Y Liang, J L Fang, Y Wang, J N Wang, C Mao, X M Shi","doi":"10.3760/cma.j.cn112338-20260118-00051","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20260118-00051","url":null,"abstract":"<p><p><b>Objective:</b> To examine the independent and joint effects of short-term exposure to high temperature and ozone (O₃) on mortality from circulatory diseases and its subcategories in Beijing-Tianjin-Hebei region and surrounding areas. <b>Methods:</b> Daily mortality data of circulatory diseases, O₃ concentrations, and meteorological data were collected from 59 counties in Beijing-Tianjin-Hebei region and surrounding areas during the warm season (May-September) from 2013 to 2018. A two-stage time-series analytic strategy was employed. Independent effects of temperature and ozone were estimated by using Quasi-Poisson generalized linear models and random-effects Meta-analyses with mutual adjustment. Joint effects on circulatory mortality were evaluated through the inclusion of a product term. <b>Results:</b> During the study period, the mean daily maximum 8-hour average ozone concentration was (138.4±57.5) μg/m³, and the daily mean temperature was (24.0±4.1) ℃. The average daily death count of circulatory diseases per county <i>M</i>(<i>Q</i>₁,<i>Q</i>₃) was 4 (2, 6). Analyses on independent effects indicated that for each 10 μg/m³ increase in ozone concentration, the percentage change in circulatory mortality risk was 0.16% (95%<i>CI</i>: 0.02%-0.31%), with significant risk increases observed for cerebrovascular diseases. An increase in temperature from the <i>P</i>₇₅ to the <i>P</i>₉₉ was associated with a percentage change of 21.43% (95%<i>CI</i>: 16.32%-26.76%) in circulatory mortality risk. A significant synergistic effect between high temperature and ozone was identified. Specifically, as ozone concentrations increased from 65 μg/m³ to 214 μg/m³, the percentage change in circulatory mortality risk associated with high-temperature exposure rose from 9.93% (95%<i>CI</i>: 2.52%-17.89%) to 27.17% (95%<i>CI</i>: 20.48%-34.23%); the strongest modification effect was observed for cerebrovascular diseases. Furthermore, high temperature was found to significantly potentiate the mortality risk associated with ozone. When temperatures reached <i>P</i>₉₁ and <i>P</i>₈₉, the percentage changes in O₃-related mortality risk for circulatory and cerebrovascular diseases became statistically significant (0.29% and 0.42%, respectively), and peaked at <i>P</i>₉₉, rising to 0.92% and 1.26%, respectively. A more pronounced association trend with combined exposure was observed among females. <b>Conclusions:</b> Significant synergistic effects of high temperature and ozone on circulatory mortality were observed. Individuals with cerebrovascular disease and women were identified as vulnerable populations. It is suggested to strengthen joint monitoring and early warning systems for compound extreme environmental events and improve the protection of vulnerable populations.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1576-1583"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009092","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 prevalence of sleep disturbance in 4 151 outpatients with chronic pain and mediating effect of depressive symptoms].","authors":"R R Yang, W S Li, C X Du, W W Zhang, L X Yan, J Q Dong, Y Y Jiang","doi":"10.3760/cma.j.cn112338-20260127-00074","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20260127-00074","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the prevalence of sleep disturbance in outpatients with chronic pain and evaluate the mediating effect of depressive symptoms on the association between sleep disturbance and pain severity. <b>Methods:</b> A cross-sectional survey was conducted in 2023 in outpatients with chronic pain from medical institutions in Beijing, Jiangxi, and Chongqing based on multistage stratified sampling. The patients who were aged ≥45 years and had pain duration ≥3 months were included. The information about their sociodemographic characteristics, pain severity, sleep status, and depressive symptoms were collected by using structured questionnaires. Correlation analysis and multiple linear regression models were applied to evaluate the association between sleep disturbance and pain severity. After controlling for potential confounders, a mediation effect model was used to analyze the mediating effect of depressive symptoms. <b>Results:</b> A total of 4 151 study participants were included. Sleep disturbance was identified in 1 784 participants (42.98%), and depressive symptoms were identified in 378 participants (9.11%). Moderate pain was reported by 2 535 participants (61.07%), mild pain by 1 079 participants (25.99%), and severe pain by 537 participants (12.94%). Sleep disturbance was positively associated with pain severity (<i>r</i>=0.239, <i>P</i><0.001), and sleep disturbance was also positively associated with depressive symptoms (<i>r</i>=0.186, <i>P</i><0.001); depressive symptoms were likewise positively associated with pain severity (<i>r</i>=0.235, <i>P</i><0.001). After adjustment for covariates, each one-point increase in the sleep disturbance score was associated with a 0.287-point increase in the Patient Health Questionnaire-2 (PHQ-2) score (<i>β</i>=0.287), and each one-point increase in the sleep disturbance score was associated with a 0.156-point increase in the pain score (<i>β</i>=0.156). After depressive symptoms were added to the model, the direct effect of sleep disturbance on pain severity remained significant (<i>β</i>=0.143), and each one-point increase in the PHQ-2 score was associated with a 0.048-point increase in the pain score (<i>β</i>=0.048). Depressive symptoms partially mediated the association between sleep disturbance and pain severity, accounting for 8.75% of the total effect. <b>Conclusions:</b> The prevalence of sleep disturbance was high in outpatients with chronic pain in Beijing, Jiangxi, and Chongqing. Sleep disturbance was associated with pain severity and might be also indirectly associated with pain severity through depressive symptoms. In clinical practice, more attention should be paid to the comprehensive assessment and management of sleep quality and emotional status in patients with chronic pain to mitigate pain severity and improve overall health outcomes.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1661-1667"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008990","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 masticatory function and mild cognitive impairment in middle-aged and older adults and mediating effect analysis in China].","authors":"J Li, X F Jia, H J Wang, C Su, J Bai, F F Huang, J G Ji, A D Liu","doi":"10.3760/cma.j.cn112338-20260109-00027","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20260109-00027","url":null,"abstract":"<p><p><b>Objective:</b> To explore the association between chewing dysfunction and the prevalence of mild cognitive impairment (MCI) among middle-aged and older adults in China, and to examine the mediating role of dietary patterns in this association. <b>Methods:</b> Participants aged ≥55 years with complete data on demographics, lifestyle, disease history, dietary surveys, anthropometric measurements, chewing function, and cognitive function were selected from the 2022-2023 China Health and Nutrition Survey. Dietary information was collected through three consecutive 24-hour dietary recalls combined with the household weighing and recording method, and dietary patterns were extracted using factor analysis. Chewing function was assessed using a self-reported scale evaluating the ability to chew eight common food items. Cognitive function was assessed using the Mini-Mental State Examination, and MCI was defined according to education-specific cutoff points. Multivariable logistic regression models were applied to analyze the association between chewing dysfunction and MCI, and mediating effect models were used to test the mediating role of dietary patterns. <b>Results:</b> A total of 2 407 participants were included. The prevalence of MCI and chewing dysfunction was 24.56% and 31.53%, respectively. After adjustment for potential confounders, chewing dysfunction was significantly associated with a higher likelihood of MCI (<i>OR</i>=2.08, 95%<i>CI</i>: 1.67-2.58). This association was modified by age and educational level: the strongest association was observed among individuals aged 55-59 years, and significant associations were identified among those with primary school education or below and those with junior middle school education. Four dietary patterns were identified by factor analysis: a southern pattern characterized by high intakes of rice and products, pork, and aquatic products; a northern pattern characterized by high intakes of vegetables and pork; a modern pattern characterized by high intakes of fruits, eggs, dairy products, and nuts; and a plant-based pattern characterized by high intakes of tubers, rice and products, and legumes products. The modern dietary pattern (mediating effect accounting for 3.98% of the total effect, <i>P</i>=0.023) played a significant mediating role in the association between chewing dysfunction and MCI. Specifically, chewing dysfunction reduced the intake of fruits, eggs, dairy products, and nuts, thereby potentially increasing the likelihood of MCI. <b>Conclusions:</b> Chewing dysfunction may increase the likelihood of MCI among middle-aged and older adults in China. The modern dietary pattern characterized by high intakes of fruits, eggs, dairy products, and nuts is an important mediator of this association, suggesting that maintaining good chewing function and optimizing dietary structure may be important strategies for preventing MCI in middle-aged and older adults.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1584-1592"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009004","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 of exposure to fine particulate matter and its components with frailty in middle-aged and older adults in Beijing-Tianjin-Hebei region and surrounding areas].","authors":"Q Liu, C Chen, J L Fang, W W Zhang, J N Li, C F Li, J N Wang, Y Wang, X M Shi","doi":"10.3760/cma.j.cn112338-20251220-00911","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20251220-00911","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the association of exposure to fine particulate matter (PM_2.5) and its components with frailty in middle-aged and older adults in Beijing-Tianjin-Hebei region and surrounding area, and identify key components contributing to frailty. <b>Methods:</b> Based on a cross-sectional study in ten cities across Beijing-Tianjin-Hebei region and surrounding areas, we collected data on PM_2.5 and its components from the nearest air monitoring superstation. Personal and health-related information, including disease history, were collected through questionnaire survey and physical examinations. Frailty status was evaluated by a frailty index (FI) using the accumulation-of-deficits approach. Multiple linear regression models were applied to evaluate the impacts of exposure to PM_2.5 and its components on FI. <b>Results:</b> A total of 1 875 study participants were included, with a mean age of (64.95±13.42) years, in whom 927 were men (49.4%). During the study period, the 90-day moving average concentration (lag090 days) of PM_2.5 was (53.92±10.51) μg/m³, and the mean FI was 0.15±0.09. Multiple linear regression model analysis indicated that PM_2.5 exposure during the lag090-lag0180 days moving-average was associated with an increased FI risk in middle-aged and older adults, with the strongest effect observed at lag090 days. An IQR increase in PM_2.5 at lag090 days was associated with a 1.30% increase in FI risk (95%<i>CI</i>: 0.29%-2.31%). Subgroup analyses showed no significant associations between PM_2.5 exposure and FI across subgroups defined by gender, age, education, smoking, alcohol use, or physical activity. Elemental carbon (EC), organic carbon (OC), calcium (Ca), and copper (Cu) exposures were associated with increased FI. The IQR increase in EC, OC, Ca, and Cu exposures were associated with 0.83% (95%<i>CI</i>: 0.45%-1.21%), 3.63% (95%<i>CI</i>: 1.17%-6.09%), 1.35% (95%<i>CI</i>: 0.51%-2.20%), and 1.50% (95%<i>CI</i>: 0.76%-2.24%) increases in FI risk, respectively. <b>Conclusion:</b> The exposures to PM_2.5 and EC, OC, Ca and Cu components might increase the risk for frailty in middle-aged and older adults in Beijing-Tianjin-Hebei region and surrounding area.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1569-1575"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009062","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":"[Depressive symptoms and the risk for cardiovascular diseases, cancer, and chronic obstructive pulmonary disease: a prospective cohort study].","authors":"X Wu, J Su, Y Qin, J Yang, R Q Han, H Yu, P F Luo, R Tao, J Y Zhou","doi":"10.3760/cma.j.cn112338-20251224-00923","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20251224-00923","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the association of depressive symptoms with the incidence of cardiovascular disease (CVD), cancer, and chronic obstructive pulmonary disease (COPD). &lt;b&gt;Methods:&lt;/b&gt; Baseline data were derived from the China Chronic Disease and Risk Factor Surveillance Survey conducted in Jiangsu Province in 2010. Depressive status of the study participants was evaluated by using Patient Health Questionnaire-9 (PHQ-9). A total of 7 709 study participants who completed the baseline survey were included in the follow-up, and additional data on the incidence of target diseases or deaths were collected from Jiangsu Provincial Cardiovascular and Cerebrovascular Disease Reporting System, Tumor Registry System, and Cause of Death Registry System, thus establishing a prospective cohort. The follow-up ended on December 31, 2021. In the follow-up, 220 study participants were lost to follow-up (2.85%, 220/7 709). In addition, 271 study participants with confirmed diagnoses of CVD, cancer or COPD at baseline survey were excluded. Finally, a total of 7 218 study participants were included in the final analysis. Cox proportional hazards regression model was used to analyze the association between depressive symptoms and the risk for CVD, cancer and COPD. Stratified analyses were further conducted according to baseline characteristics, including sex, age, marital status, educational level and smoking status. &lt;b&gt;Results:&lt;/b&gt; During the follow-up period, a total of 692 cases of CVD, 362 cases of cancer, and 112 cases of COPD occurred. After adjusting for potential confounding factors, compared with the group with PHQ-9 score of 0, the &lt;i&gt;HR&lt;/i&gt;s for CVD incidence were 1.44 (95%&lt;i&gt;CI&lt;/i&gt;: 1.06-1.94) in the group with score of 5-9, and 2.00 (95%&lt;i&gt;CI&lt;/i&gt;: 1.24-3.22) in the group with score of ≥10. For cancer incidence, the &lt;i&gt;HR&lt;/i&gt; was 0.67 (95%&lt;i&gt;CI&lt;/i&gt;: 0.51-0.89) in the group with PHQ-9 score of 1-4 compared with the group with the score of 0. As for COPD incidence, the &lt;i&gt;HR&lt;/i&gt;s were 1.90 (95%&lt;i&gt;CI&lt;/i&gt;: 1.25-2.89), 2.42 (95%&lt;i&gt;CI&lt;/i&gt;: 1.26-4.66), and 3.52 (95%&lt;i&gt;CI&lt;/i&gt;: 1.40-8.87) in the groups with PHQ-9 score of 1-, 5-, and ≥10, respectively. Compared with the study participants without depressive symptoms at baseline survey, those with depressive symptoms had 1.55-fold (&lt;i&gt;HR&lt;/i&gt;=1.55, 95%&lt;i&gt;CI&lt;/i&gt;: 1.20-2.00) increased risk for CVD and 2.16-fold (&lt;i&gt;HR&lt;/i&gt;=2.16, 95%&lt;i&gt;CI&lt;/i&gt;: 1.26-3.69) increased risk for COPD. In stratified analyses by baseline characteristics including sex, age, marital status, educational level, and smoking status, no significant interaction effects were found between depressive symptoms and the aforementioned baseline characteristics on the risk for CVD, cancer, and COPD (all interaction &lt;i&gt;P&lt;/i&gt;&gt;0.05). &lt;b&gt;Conclusions:&lt;/b&gt; Depressive symptoms might be associated with increased risks for CVD and COPD. The prevention and management of depressive symptoms should be considered in the prevention and control of CVD and ","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1604-1611"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009088","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":"[Joint effects of heatwave exposure and apolipoprotein E genotype on risk for cognitive impairment in older adults].","authors":"J Wu, L B Ren, S J Li, Y L Jiang, Y T Wang, Y Zeng, Y Yao, Y J Pang","doi":"10.3760/cma.j.cn112338-20260111-00031","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20260111-00031","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the associations of heatwave exposure and apolipoprotein E (ApoE) genotype, as well as their interaction, with the risk for cognitive impairment in older adults. <b>Methods:</b> Study participants were from the Chinese Longitudinal Healthy Longevity Survey. Individuals aged ≥65 years who completed ApoE genotyping and the Mini-Mental State Examination in 2008 were enrolled as the baseline cohort and follow up was conducted until 2021. Annual mean heatwave days were defined using daily maximum temperature (T_max) data matched to the latitude and longitude of the areas where the study participants lived. A time-dependent Cox proportional hazards regression model and restricted cubic splines were used to evaluate the associations of ApoE ε4 genotype status and heatwave exposure with the risk for cognitive impairment, and multiplicative and additive interactions were examined. <b>Results:</b> A total of 4 412 older adults with normal cognition at baseline were included. The mean follow-up duration was 7.38 years, during which 1 317 cases of cognitive impairment were newly identified. After adjusting for confounders, ApoE ε4 genotype carriers had a higher risk for cognitive impairment compared with non-carriers (<i>HR</i>=1.23, 95%<i>CI</i>: 1.08-1.40). Heatwave exposure was positively associated with cognitive impairment risk; each 10-day increase in annual mean heatwave days was associated with an 11% higher risk for cognitive impairment (<i>HR</i>=1.11, 95%<i>CI</i>: 1.02-1.20). Restricted cubic spline analyses showed a stable positive association between annual mean heatwave days and cognitive impairment risk in 0-20 days, followed by a plateau, with no significant nonlinear relationship (<i>P</i> for nonlinearity=0.186). Joint analyses indicated that individuals who were ApoE ε4 genotype carriers and exposed to high levels of heatwaves had higher risk for cognitive impairment; however, no significant interaction was observed, either on the multiplicative scale (<i>P</i>=0.296) or the additive scale (95%<i>CI</i>s of the relative excess risk due to interaction included 0). <b>Conclusions:</b> Both ApoE ε4 genotype carriage and heatwave exposure were independently associated with increased risk for cognitive impairment in older adults. In the context of climate warming, it is necessary to strengthen heatwave prevention and health management in old population to reduce potential cognitive health risks.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1562-1568"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009124","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":"[Advances in multi-source medical data-driven identification and spatiotemporal cluster analysis of acute respiratory infections].","authors":"X C Hu, X F Wei, Y T Chi, X C Zhang, Y Li, Z J Li, W B Hu, W Z Yang","doi":"10.3760/cma.j.cn112338-20260330-00208","DOIUrl":"10.3760/cma.j.cn112338-20260330-00208","url":null,"abstract":"<p><p>Acute respiratory infections (ARIs) are characterized by high morbidity, strong transmissibility, and non-specific clinical manifestations, posing substantial challenges to conventional single-source surveillance systems for early warning. This review systematically summarizes recent advances in ARIs identification and spatiotemporal cluster analysis based on multi-source medical data, focusing on three core technical domains. In terms of medical text information extraction, methodologies have progressively evolved from keyword matching to deep semantic understanding powered by large language models; regarding multimodal medical data fusion, the review covers data-level, feature-level, and decision-level fusion strategies; and in spatiotemporal cluster analysis, both traditional statistical methods and artificial intelligence-based models are discussed. Current research faces key challenges including inconsistent data standards, ambiguous boundaries in data ethics and application scope, incomplete spatial information, and insufficient model interpretability. Future efforts should prioritize advancing medical data standardization and interoperability, and developing hybrid modeling frameworks that balance computational efficiency with interpretability, thereby enabling the transition of ARIs surveillance from passive identification to proactive and precision-oriented early warning.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 ","pages":"1712-1719"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593412","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":"[A clinical pathway for exercise prescription in populations with sarcopenia-osteoporosis based on primary healthcare institutions].","authors":"S P Zi, S Huang, Z F Kong, K Y Yu, J W Liu, D X Zheng, C Yang, Y P Yao, L Chen, Y Deng, X Y Xu, Y G Ye, M Y Xia, X X Liu, M J Hu, J Z M Deji, Y C Weng, X Jiang, M Y Fan, J Y Li","doi":"10.3760/cma.j.cn112338-20260122-00061","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20260122-00061","url":null,"abstract":"<p><p>Exercise intervention is a critical non-pharmacological strategy for the prevention and management of sarcopenia and osteoporosis. Nevertheless, practical challenges still exist in the standardized implementation and promotion of exercise prescriptions in primary healthcare settings in China. Integrating domestic and international evidence-based research and relevant guidelines, and considering the context of primary care services in China, this study developed a clinical pathway for exercise prescription targeting individuals with sarcopenia and/or osteoporosis for primary care settings. Delphi expert consensus method was used, and experts of chronic disease management, sports medicine, rehabilitation medicine, and public health were invited to participate in this study. Through two rounds of consultation, the scientific validity and operational feasibility of the pathway content were evaluated and refined, and finally the clinical pathway was developed. The key components of the pathway include screening of the target population, prescription grading and formulation, implementation and adjustment of the exercise prescription, as well as self-management and follow-up. It provides a structured reference framework for the standardized delivery of exercise interventions in primary healthcare settings.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1698-1705"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009016","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":"[Comparison of inpatient disease statistics based on two coding rules].","authors":"Q He, H Y Zong, Y Yang, R Tang, J B Chen, J Y Li, L Li, G Q Hu","doi":"10.3760/cma.j.cn112338-20260408-00234","DOIUrl":"https://doi.org/10.3760/cma.j.cn112338-20260408-00234","url":null,"abstract":"<p><p><b>Objective:</b> To compare the impact of principal diagnosis coding rules and etiologic diagnosis coding rules based on the underlying cause of death coding logic on disease statistics for nonfatal medical records. <b>Methods:</b> This study analyzed 20 744 medical records of inpatients from a grade Ⅲ general hospital in Changsha, China, between November 1, 2022 and October 31, 2023. On the basis of clinical diagnostic records, professional medical record coders determined and coded diagnoses according to the principal diagnosis and etiologic diagnosis coding rules, respectively, in which <i>χ</i>² test was used to compare discordance between the two coding results across patient groups. Disease spectrum differences under the two coding rules were further described by sex and age group. <b>Results:</b> In the 20 744 medical records used in the study, the discordance rate between the two coding results was 30.0% (95%<i>CI</i>: 29.3%-30.6%). The <i>χ</i>² tests indicated that the discordance rate varied significantly by sex, age group, and clinical department (all <i>P</i><0.05). Comparison of the disease spectrum under the two coding rules showed that the largest increase in the number of reported cases was observed for tumors (8 219 <i>vs.</i> 12 563). Meanwhile, Factors influencing health status and contact with health services showed the most notable change in ranking (2^nd <i>vs.</i> 18^th). Additionally, disease rankings and frequencies also varied by sex and age group. <b>Conclusions:</b> The two coding rules substantially affected the disease spectrum of inpatients, and their impact varied by sex, age group, and clinical department. Given that principal diagnosis coding focuses on clinical treatment and management, whereas etiologic diagnosis coding emphasizes the initiating cause of disease or injury, policymakers and researchers should consider the influence of differences in coding rules on disease composition and rankings when interpreting and using disease statistics generated under these two coding rules.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"47 9","pages":"1691-1697"},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009050","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}