Articles in press have been peer-reviewed and accepted, which are not yet assigned to volumes /issues, but are citable by Digital Object Identifier (DOI).
Chromosome 8 open reading frame 76 (C8orf76) co-expressed with cyclin-dependent kinase 4 (CDK4) as a prognostic indicator of colorectal cancer
Shang Guo, Chengcheng Liu, Zifeng Zhao, Zhongxin Li, Xia Jiang, Zengren Zhao
In press  doi: 10.3967/bes2024.177
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  Objective  To explore the correlation between chromosome 8 open reading frame 76 (C8orf76) and cyclin-dependent kinase 4 (CDK4) and the potential predictive effect of C8orf76 and CDK4 on the prognosis of colorectal cancer (CRC).  Methods  We constructed a protein-protein interaction network of C8orf76-related genes and analyzed the prognostic signatures of C8orf76 and CDK4. Clinicopathological features of C8orf76 and CDK4 were visualized using a nomogram.  Results  C8orf76 and CDK4 levels were positively correlated in two independent human CRC cohorts (n = 83 and n = 597). A consistent positive correlation was observed between C8orf76 and CDK4 expression in the CRC cell lines. The nomogram included prognostic genes (C8orf76 and CDK4) and pathological N and M stages. The concordance index (C-index) in our cohort was 0.776, which suggests that the ability of the indicators to predict the overall survival of patients with CRC in our cohort was strong.  Conclusions  We found that C8orf76 was positively correlated with CDK4 in both the cohorts as well as in CRC cell lines. Therefore, C8orf76 and CDK4 can be used as potential biomarkers to predict the prognosis of CRC.
Lumbar Spondylolysis in Chinese Adults: Prevalence and Musculoskeletal Condition
Dong Yan, Yandong Iiu, Ling Wang, Kai Li, Wenshuang Zhang, Yi Yuan, Jian Geng, Kangkang Ma, Fengyun Zhou, Zitong Cheng, Xiaoguang Cheng
In press  doi: 10.3967/bes2025.043
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  Objective   To determine the prevalence of lumbar spondylolysis (LS) and the proportion of spondylolytic spondylolisthesis (SS) in China. To evaluate the musculoskeletal status of patients with LS and SS.  Methods   Spine Computed Tomography (CT) images were collected from community populations aged 40 and above in a nationwide multi-center project. LS was diagnosed, and SS was graded by an experienced radiologist. Bone mineral density (BMD) and paraspinal muscle parameters were quantified based on CT images.  Results   117 patients of a total of 3,317 individuals were diagnosed with LS, corresponding to a prevalence rate of 3.53%. 63 of the 1,214 males (5.18%) and 54 of the 2,103 females (2.57%) were diagnosed with LS. SS occurred in 64/121 vertebrae (52.89%). BMD was not associated with LS (P = 0.341). The L5 extensor paraspinal muscle density was higher in the LS group than in the non-LS group. In the LS group, patients with SS had a lower L5 paraspinal extensor muscle cross-sectional area than those without SS (P = 0.003).  Conclusion   The prevalence of LS in Chinese adults was 3.53%, with prevalence rates of 5.18% in males and 2.57% in females. Patients with LS have higher muscle density, whereas those with SS have smaller muscle cross-sectional areas at the L5 level.
The Disease Burden of Asthma in China, 1990 to 2021 and Projections to 2050: Based on the Global Burden of Disease 2021
Ruiyi Zhang, Miaomiao Zhang, Yuchang Zhou, Jiahuan Guo, Xuankai Wang, Maigeng Zhou
In press  doi: 10.3967/bes2025.042
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  Objective  Asthma imposes a significant global health burden. This study examines changes in the asthma-related disease burden from 1990 to 2021 and projects future burdens for 2050 under different scenarios.  Methods  Using data from the Global Burden of Disease 2021 study, we analyzed asthma incidence, prevalence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021. We projected the disease burden for 2050 based on current trends and hypothetical scenarios in which all risk factors are controlled. Temporal trends in age-standardized incidence, prevalence, mortality, and DALY rates were explored using Annual Percent Change.  Results  In 2021, the age-standardized rates for asthma incidence, prevalence, mortality, and DALYs in China were 364.17 per 100,000 (95% uncertainty interval [UI]: 283.22–494.10), 1,956.49 per 100,000 (95% UI: 1,566.68–2,491.87), 1.47 per 100,000 (95% UI: 1.15–1.79), and 103.76 per 100,000 (95% UI: 72.50–145.46), respectively. A higher disease burden was observed among Chinese men and individuals aged 70 years or older. Compared to the current trend, a combined scenario involving improvements in environmental factors, behavioral and metabolic health, child nutrition, and vaccination resulted in a greater reduction in the disease burden caused by asthma.  Conclusion  Addressing modifiable risk factors is essential for further reducing the asthma-related disease burden.
Independent and Interactive Effects of Air Pollutants, Meteorological Factors, and Green Space on Tuberculosis Incidence in Shanghai
Qi Ye, Jing Chen, Yating Ji, Xiaoyu Lu, Jiale Deng, Nan Li, Wei Wei, Renjie Hou, Zhiyuan Li, Jianbang Xiang, Xu Gao, Xin Shen, Chongguang Yang
In press  doi: 10.3967/bes2025.041
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  Objective  To assess the independent and combined effects of air pollutants, meteorological factors, and greenspace exposure on new tuberculosis (TB) cases.  Methods  TB case data from Shanghai (2013–2018) were obtained from the Shanghai Center for Disease Control and Prevention. Environmental data on air pollutants, meteorological variables, and greenspace exposure were obtained from the National Tibetan Plateau Data Center. We employed a distributed-lag nonlinear model to assess the effects of these environmental factors on TB cases.  Results  Increased TB risk was linked to PM2.5, PM10, and rainfall, whereas NO2, SO2, and air pressure were associated with a reduced risk. Specifically, the strongest cumulative effects occurred at various lags: PM2.5 (RR = 1.166, 95% CI: 1.026–1.325) at 0–19 weeks; PM10 (RR = 1.167, 95% CI: 1.028–1.324) at 0–18 weeks; NO2 (RR = 0.968, 95% CI: 0.938-0.999) at 0–1 weeks; SO2 (RR = 0.945, 95% CI: 0.894–0.999) at 0–2 weeks; air pressure (RR = 0.604, 95% CI: 0.447–0.816) at 0–8 weeks; and rainfall (RR = 1.404, 95% CI: 1.076–1.833) at 0–22 weeks. Green space exposure did not significantly impact TB cases. Additionally, low temperatures amplified the effect of PM2.5 on TB.  Conclusion  Exposure to PM2.5, PM10, and rainfall increased the risk of TB, highlighting the need to address air pollutants for the prevention of TB in Shanghai.
Disease burden and trends of COPD in the Asia-Pacific region (1990–2019) and predictions to 2034
Jing Ma, Hong Mi
In press  doi: 10.3967/bes2025.040
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  Objective  The Asia-Pacific region has a high Chronic obstructive pulmonary disease (COPD) burden, but studies on its trends are limited. Using the Global Burden of Disease (GBD) 2019 data, we analyzed COPD trends in 36 countries from 1990 to 2019 and predicted future incidence trends through 2034.  Methods  COPD data by age and sex from the GBD 2019 database were analyzed for incidence, prevalence, mortality, and disability-adjusted life years (DALY) rates from 1990 to 2019. Joinpoint regression identified significant annual trends, and age-standardized incidence rates were predicted through 2034 using age–period–cohort models.  Results  The incidence, prevalence, mortality, and disease burden of COPD have been decreasing, and the incidence rates will continue to decrease or remain stable until 2034 in most selected countries and territories, except for a few Southeastern Asian countries. The Lao People’s Democratic Republic and Vietnam are projected to experience an increase in COPD incidence from 165.3 per 100,000 in 2019 to 177 per 100,000 in 2034 and from 179.9 per 100,000 in 2019 to 192.5 per 100,000 in 2034, respectively. Older males had a higher incidence than any other sex or age group. The sex gap in incidence rates continues to widen, though it is smaller and less significant in the younger age group than in those in the older one.  Conclusion  COPD rates are expected to decline until 2034 but remain a health risk, especially in countries with rising rates. Urgent action on tobacco control, air pollution, and public education is needed.
Global Burden of Clostridium difficile Infection-Related Diarrhea Mortality from 1990 to 2021: A Study Based on the 2021 Global Burden of Disease Database
Ying Li, Jie Li, Hesheng Chang, Yuehua Hu, Chengdong Xu
In press  doi: 10.3967/bes2025.039
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Factors in Work-related Musculoskeletal Disorders in Dentists: A Structural Equation Model
Shunhang Li, Jian Li, Xin Xu, Yushan Huang, Yilin Zhang, Xiaoshuang Xu, Weizhen Guan, Xiaoping Liu, Jing Li
In press  doi: 10.3967/bes2025.037
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Forecast of the Burden of Lower Respiratory Infections in the Elderly Aged 70 and Above in China from 1990 to 2050, GBD2021
Miaomiao Zhang, Ruiyi Zhang, Yuchang Zhou, Maigeng Zhou
In press  doi: 10.3967/bes2025.036
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  Objective  This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.  Methods  This study utilized Global Burden of Disease (GBD) 1990-2050 prediction data to analyze changes in mortality rates and disability-adjusted life year (DALY) rates for lower respiratory infections in the elderly population (aged 70 and above) in China from 1990 to 2050. It also discusses future trends in the burden of lower respiratory infections (LRI) in China under different scenarios.  Results  According to GBD predictions, the burden of lower respiratory infections in the elderly aged 70 years and above in China is lower than the global average. The burden has been decreasing from 1990 to 2020, but is projected to increase from 2020 to 2050. Scenario-based predictions suggest that, under scenarios involving improvements in nutrition and vaccination, the burden of lower respiratory infections in the elderly in China is expected to be the lowest in 2050.  Conclusions  This study indicates that the burden of lower respiratory infections in elderly people aged 70 years and above in China remains a significant public health issue and may worsen. The government should consider strengthening the preventive measures and management strategies for respiratory infections in the elderly population.
Perioperative Cardiac Arrest in Mechanically Ventilated Older Patients Undergoing Thoracic Surgery
Wenjun Liu, Shuyu Zhang, Sheng Wang
In press  doi: 10.3967/bes2025.035
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Future Projections of Temperature-related Excess Morbidity Due to Influenza Under Climate Change Scenarios: A Case Study in a Temperate Japanese City
Keita Wagatsuma
In press  doi: 10.3967/bes2025.034
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Deciphering the Role of VIM, STX8, and MIF in Pneumoconiosis Susceptibility: A Mendelian Randomization Analysis of the Lung-Gut Axis and Multi-Omics Insights from European and East Asian Populations
Chenwei Zhang, Binbin Wan, Yukai Zhang, Tao Xiong, Yishan Li, Xuesen Su, Gang Liu, Yangyang Wei, Yuanyuan Sun, Jingfen Zhang, Xiao Yu, Yiwei Shi
In press  doi: 10.3967/bes2025.028
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  Background  Pneumoconiosis, a lung disease caused by irreversible fibrosis, represents a significant public health burden. This study investigates the causal relationships between gut microbiota, gene methylation, gene expression, protein levels, and pneumoconiosis using a multi-omics approach and Mendelian randomization (MR).  Methods  We analyzed gut microbiota data from MiBioGen and Esteban et al. to assess their potential causal effects on pneumoconiosis subtypes (asbestosis, silicosis, and inorganic pneumoconiosis) using conventional and summary-data-based MR (SMR). Gene methylation and expression data from Genotype-Tissue Expression and eQTLGen, along with protein level data from deCODE and UK Biobank Pharma Proteomics Project, were examined in relation to pneumoconiosis data from FinnGen. To validate our findings, we assessed self-measured gut flora from a pneumoconiosis cohort and performed fine mapping, drug prediction, molecular docking, and Phenome-Wide Association Studies to explore relevant phenotypes of key genes.  Results  Three core gut microorganisms were identified: Romboutsia (OR = 0.249) as a protective factor against silicosis, Pasteurellaceae (OR = 3.207) and Haemophilus parainfluenzae (OR = 2.343) as risk factors for inorganic pneumoconiosis. Additionally, mapping and quantitative trait loci analyses revealed that the genes VIM, STX8, and MIF were significantly associated with pneumoconiosis risk.  Conclusions  This multi-omics study highlights the associations between gut microbiota and key genes (VIM, STX8, MIF) with pneumoconiosis, offering insights into potential therapeutic targets and personalized treatment strategies.
Generalized Functional Linear Models: Efficient Modeling for High-dimensional Correlated Mixture Exposures
Bingsong Zhang, Haibin Yu, Xin Peng, Haiyi Yan, Siran Li, Shutong Luo, Renhuizi Wei, Zhujiang Zhou, Yalin Kuang, Yihuan Zheng, Chulan Ou, Linhua Liu, Yuehua Hu, Jindong Ni
In press  doi: 10.3967/bes2025.024
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  Objective  Humans are exposed to complex mixtures of environmental chemicals and other factors that can affect their health. Analysis of these mixture exposures presents several key challenges for environmental epidemiology and risk assessment, including high dimensionality, correlated exposure, and subtle individual effects.  Methods  We proposed a novel statistical approach, the generalized functional linear model (GFLM), to analyze the health effects of exposure mixtures. GFLM treats the effect of mixture exposures as a smooth function by reordering exposures based on specific mechanisms and capturing internal correlations to provide a meaningful estimation and interpretation. The robustness and efficiency was evaluated under various scenarios through extensive simulation studies.  Results  We applied the GFLM to two datasets from the National Health and Nutrition Examination Survey (NHANES). In the first application, we examined the effects of 37 nutrients on BMI (2011–2016 cycles). The GFLM identified a significant mixture effect, with fiber and fat emerging as the nutrients with the greatest negative and positive effects on BMI, respectively. For the second application, we investigated the association between four perfluoroalkyl substances (PFAS) and gout risk (2007–2018 cycles). Unlike traditional methods, the GFLM indicated no significant association, demonstrating its robustness to multicollinearity.  Conclusion  GFLM framework is a powerful tool for mixture exposure analysis, offering improved handling of correlated exposures and interpretable results. It demonstrates robust performance across various scenarios and real-world applications, advancing our understanding of complex environmental exposures and their health impacts on environmental epidemiology and toxicology.
Association between Solid Cooking Fuel Use and Frailty Trajectories: Findings from a Nationwide Cohort in China
Yang Liu, Bingjie Wu, Bingbing Fan, Chunxia Li, Chang Su, Aidong Liu, Tao Zhang
In press  doi: 10.3967/bes2025.022
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  Objective   Burning solid cooking fuel contributes to household air pollution and is associated with frailty. However, how solid cooking fuel use contributes to the development of frailty has not been well illustrated.  Methods   This study recruited 8,947 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study, 2011–2018. Group-based trajectory modeling was employed to identify frailty trajectories. Multinomial logistic regression was used to assess the association between solid cooking fuel use and frailty trajectories. Population-attributable fractions were used to estimate the frailty burden from solid fuel use.  Results   We identified three frailty trajectories: low-stable (n = 5,789), moderate-increasing (n = 2,603), and fast-increasing (n = 555). Solid fuel use was associated with higher odds of being in the moderate-increasing (OR: 1.24, 95% CI: 1.08–1.42) and fast-increasing (OR: 1.48, 95% CI: 1.14–1.92) trajectories. These associations were strengthened by longer solid fuel use (P for trend < 0.001). Switching to clean fuel significantly reduced the risk of being in these trajectories compared with persistent solid fuel users. Without solid fuel, 8% of moderate- and 19% of fast-increasing trajectories demonstrated frailty development like the low-stable group.  Conclusion   Solid cooking fuel use is associated with frailty trajectories in middle-aged and older Chinese populations.
Burden of Headache Disorders in China and its Provinces, 1990–2021
Zhe Liu, Xuehua Hu, Lin Yang, Jinlei Qi, Jiangmei Liu, Lijun Wang, Maigeng Zhou, Peng Yin
In press  doi: 10.3967/bes2025.019
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  Objective  To analyze the prevalence and burden of headache disorders in China and its provinces from 1990 to 2021.  Methods  Using data from the Global Burden of Disease Study (GBD) 2021, the number of prevalent cases, prevalence rate, disability-adjusted life years (DALYs), and age-standardized DALY rates were analyzed by sex, age group, and province for headache disorders and their subtypes (migraines and tension-type headaches [TTHs]) between 1990 and 2021. Percentage changes during this period were also estimated.  Results  In 2021, approximately 426 million individuals in China were affected by headache disorders, with an age-standardized prevalence rate of 27,582.61/100,000. The age-standardized DALY rate for all headache disorders was 487.15/100,000. Between 1990 and 2021, the number of prevalent cases increased by 37.78%, while the prevalence of all headache disorders, migraines, and TTHs increased by 6.92%, 7.57%, and 7.86%, respectively. The highest prevalence was observed in the 30–34 age group (39,520.60/100,000). Migraine accounts for a larger proportion of DALYs attributable to headache disorders, whereas TTH has a greater impact on its prevalence. In 2021, the highest age-standardized DALY rates for headache disorders were observed in Heilongjiang (617.85/100,000) and Shanghai (542.86/100,000).  Conclusion  The prevalence of headache disorders is increasing in China. Effective health education, improve diagnosis and treatment are essential, particularly for middle-aged working populations and women of childbearing age.
Increased Tertiary Lymphoid Structures are Associated with Exaggerated Tissue Damage in the Lung of Smoker Patients with Pulmonary Tuberculosis
Yue Zhang, Liang Li, Zikang Sheng, Yafei Rao, Xiang Zhu, Yu Pang, Mengqiu Gao, Xiaoyan Gai, Yongchang Sun
In press  doi: 10.3967/bes2025.020
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  Objective   Cigarette smoking exacerbates progression of pulmonary tuberculosis (TB) . The role of tertiary lymphoid structures (TLS) in chronic lung diseases has gained attention, but it remains unclear whether smoking-exacerbated lung damage in TB is associated with TLS. This study aims to analyze the characteristics of pulmonary TLS in smoking TB patients and therefore to explore the possible role of TLS in smoking-related lung injury in TB.  Methods   Lung tissues from 36 male patients (18 smokers and 18 non-smokers) who underwent surgical resection due to pulmonary TB were included in this study. Pathological and immunohistological analysis was conducted to evaluate the quantity of TLS, and chest CT was used to assess the severity of lung lesions. The correlation between TLS quantity and TB lesion severity scores was analyzed. Immune cells and chemokines for TLS formation were also evaluated and compared between smoker and nonsmoker patients.  Results   Smoking TB patients had significantly more TLS than non-smokers (P < 0.001). TLS quantity in both lung parenchyma and peribronchial regions correlated with TB lesion severity on chest CT (parenchyma: r = 0.5767; peribronchial: r = 0.7373; both P < 0.001). Immunohistochemical analysis showed increased B cells, T cells, and CXCL13 expression in smoker patients with TB (P < 0.001).  Conclusion   Smoking TB patients exhibited increased pulmonary TLS, which was associated with exacerbated lung lesions on chest CT, suggesting that cigarette smoking may exacerbate lung damage by promoting TLS formation.
Changes in Esophageal Cancer Survival: A Global Review of Survival Analysis from Cancer Registration Data over the Past three Decades
Zhuojun Ye, Danni Yang, Yu Jiang, Yuxuan Xiao, Zhuoying Li, Yuting Tan, Huiyun Yuan, Yongbing Xiang
In press  doi: 10.3967/bes2025.018
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  Objective  To describe survival trends and global patterns of esophageal cancer (EC) using survival data from population-based cancer registries.  Methods  We systematically searched PubMed, EMBASE, Web of Science, SEER, and SinoMed databases for articles published up to 31 December 2023. Eligible EC survival estimates were evaluated according to country or region, period, sex, age group, pathology, and disease stage.  Results  After 2010, Jordan exhibited the highest age-standardized 5-year RSRs/NSRs at 41.1% between 2010 and 2014, while India had the lowest, at 4.1%. Survival rates generally improved with diagnostic age across most countries, with significant increases in South Korea and China, of 12.7% and 10.5% between 2000 and 2017, respectively. Survival was higher among women compared to men, ranging from 0.4%-10.9%. Survival rates for adenocarcinoma and squamous cell carcinoma were similar, differing by about 4%. In China, the highest age-standardized RSRs/NSRs was 33.4% between 2015 and 2017. Meanwhile, the lowest was 5.3%, in Qidong (Jiangsu province) between 1992-1996.  Conclusion  Global EC survival rates have improved significantly in recent decades, but substantial geographical, sex, and age disparities still exist. In Asia, squamous cell carcinoma demonstrated superior survival rates compared to adenocarcinoma, while the opposite trend was observed in Western countries. Future research should clarify the prognostic factors influencing EC survival and tailor prevention and screening strategies to the changing EC survival patterns.
Re-exploration for Dietary Iodine Intake in Chinese Adults Using the Obligatory Iodine Loss Hypothesis
Xiaobing Liu, Jun Wang, Yajie Li, Hongxing Tan, Deqian Mao, Yanyan Liu, Weidong Li, Wei Yu, Junan Yan, Jianhua Piao, Chongzheng Guo, Xiaoli Liu, Xiaoguang Yang
In press  doi: 10.3967/bes2025.017
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  Objective  This study aimed to explore minimum iodine excretion and to build a dietary iodine recommendation for Chinese adults using the obligatory iodine loss hypothesis.  Methods  Data from 171 Chinese adults (19–21 years old) were collected and analyzed based on three balance studies in Shenzhen, Yinchuan, and Changzhi. The single exponential equation was accordingly used to simulate the trajectory of 24 h urinary iodine excretion as the low iodine experimental diets offered (iodine intake: 11−26 μg·day−1) and to further deduce the dietary reference intakes (DRIs) for iodine, including estimated average requirement (EAR) and recommended nutrient intake (RNI).  Results  The minimum iodine excretion was estimated as 57, 58, and 51 μg·day−1 in three balance studies, respectively. Moreover, it was further suggested as 57, 58, and 51 μg·day−1 for iodine EAR, and 80, 81, and 71 μg·day−1 for iodine RNI or expressed as 1.42, 1.41, and 1.20 μg·day−1·kg−1 of body weight.  Conclusion  The iodine DRIs for Chinese adults were established based on the obligatory iodine loss hypothesis, which provides scientific support for the amendment of nutrient requirements.
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2025-4 Contents
2025, 38(4): 1-2.  
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Editorial
Identification of High-Risk Populations: The Cornerstone of Effective and Cost-Efficient Cancer Screening
Wei Cao, Fei Wang, Ni Li
2025, 38(4): 401-402.   doi: 10.3967/bes2025.044
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Original Article
Role of Gold Nanorods Functionalized by Nucleic Acid Nanostructures Carrying Doxorubicin in Synergistic Anti-Cancer Therapy
Hao Wu, Huangshui Ma, Xinghan Wu, Qiang Sun, Lin Feng, Ruifang Jiang, Yanhong Li, Quan Shi
2025, 38(4): 403-415.   doi: 10.3967/bes2024.152
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  Objective   Cancer remains a significant global health challenge, necessitating the development of effective treatment approaches. Developing synergistic therapy can provide a highly promising strategy for anti-cancer treatment through combining the benefits of various mechanisms.  Methods   In this study, we developed a synergistic strategy for chemo-photothermal therapy by constructing nanocomposites using gold nanorods (GNRs) and tetrahedral framework nucleic acids (tFNA) loaded with the anti-tumor drug doxorubicin (DOX).  Results   Our in vitro studies have systematically clarified the anti-cancer behaviors of tFNA-DOX@GNR nanocomposites, characterized by their enhanced cellular uptake and proficient lysosomal escape capabilities. It was found that the key role of tFNA-DOX@GNR nanocomposites in tumor ablation is primarily due to their capacity to induce cytotoxicity in tumor cells via a photothermal effect, which generates instantaneous high temperatures. This mechanism introduces various responses in tumor cells, facilitated by the thermal effect and the integrated chemotherapeutic action of DOX. These reactions include the induction of endoplasmic reticulum stress, characterized by elevated reactive oxygen species levels, the promotion of apoptotic cell death, and the suppression of tumor cell proliferation.  Conclusion   This work exhibits the potential of synergistic therapy utilizing nanocomposites for cancer treatment and offers a promising avenue for future therapeutic strategies.
Construction of a Prognostic Model for Lysosome-dependent Cell Death in Gastric Cancer Based on Single-cell RNA-seq and Bulk RNA-seq Data
Peng Ni, Kaixin Guo, Tianyi Liang, Xinshuang Fan, Yanqiao Hua, Yangye Gao, Shuaiyin Chen, Guangcai Duan, Rongguang Zhang
2025, 38(4): 416-432.   doi: 10.3967/bes2024.159
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  Objective  To identify prognostic genes associated with lysosome-dependent cell death (LDCD) in patients with gastric cancer (GC).  Methods  Differentially expressed genes (DEGs) were identified using The Cancer Genome Atlas - Stomach Adenocarcinoma. Weighted gene co-expression network analysis was performed to identify the key module genes associated with LDCD score. Candidate genes were identified by DEGs and key module genes. Univariate Cox regression analysis, and least absolute shrinkage and selection operator regression and multivariate Cox regression analyses were performed for the selection of prognostic genes, and risk module was established. Subsequently, key cells were identified in the single-cell dataset (GSE183904), and prognostic gene expression was analyzed. Cell proliferation and migration were assessed using the Cell Counting Kit-8 assay and the wound healing assay.  Results  A total of 4,465 DEGs, 95 candidate genes, and 4 prognostic genes, including C19orf59, BATF2, TNFAIP2, and TNFSF18, were identified in the analysis. Receiver operating characteristic curves indicated the excellent predictive power of the risk model. Three key cell types (B cells, chief cells, and endothelial/pericyte cells) were identified in the GSE183904 dataset. C19orf59 and TNFAIP2 exhibited predominant expression in macrophage species, whereas TNFAIP2 evolved over time in endothelial/pericyte cells and chief cells. Functional experiments confirmed that interfering with C19orf59 inhibited proliferation and migration in GC cells.  Conclusion  C19orf59, BATF2, TNFAIP2, and TNFSF18 are prognostic genes associated with LDCD in GC. Furthermore, the risk model established in this study showed robust predictive power.
Threshold-Effect Associations of Serum 25-hydroxyvitamin D on Bone Turnover Markers and GC rs2282679 Variants in Chinese Women of Childbearing Age
Xiaoyun Shan, Yuting Li, Xiayu Zhao, Yichun Hu, Siran Li, Huidi Zhang, Yang Cao, Rui Wang, Lichen Yang
2025, 38(4): 433-446.   doi: 10.3967/bes2024.151
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  Objective  This study aimed to investigate possible serum 25-hydroxyvitamin D [25(OH)D] cutoffs for the associations between 25(OH)D and Bone turnover markers (BTMs), and how GC gene variation influences such cutoffs in Chinese women of childbearing age.  Methods  In total, 1,505 non-pregnant or non-lactating women (18–45 years) were recruited from the 2015 Chinese Adult Chronic Disease and Nutrition Surveillance. Serum 25(OH)D, osteocalcin (OC), procollagen type 1 N-terminal propeptide (P1NP), β-CrossLaps of type 1 collagen containing cross-linked C-telopeptide (β-CTX), and single nucleotide polymorphisms were determined. Locally weighted regression and smoothing scatterplot and segmented regression were performed to estimate the 25(OH)D thresholds.  Results  The median serum 25(OH)D was 16.63 (11.96–22.55) ng/mL and the prevalence of low serum 25(OH)D (< 12 ng/mL) was 25.2%. Women with the lowest 25(OH)D had the highest β-CTX. After adjustment for the confounders, 25(OH)D cutoffs for OC [14.04 (12.84–15.23) ng/mL], β-CTX [13.94 (12.49–15.39) ng/mL], and P1NP [13.87 (12.37–15.37) ng/mL] in the whole population, cutoffs for OC [12.30 (10.68–13.91) ng/mL], β-CTX [12.23 (10.22–14.23) ng/mL], and P1NP [11.85 (10.40–13.31) ng/mL] in women with the GC rs2282679 G allele, and cutoffs for OC [12.75 (11.81–13.68) ng/mL], β-CTX [13.05 (11.78–14.32) ng/mL], and P1NP [12.81 (11.57–14.06) ng/mL] in women with the GC rs2282679 T allele, were observed. Below these cutoffs, BTMs were negatively associated with 25(OH)D, while above these cutoffs, BTMs plateaued.  Conclusion  In Chinese women of childbearing age, there were thresholds effect of serum 25(OH)D concentrations on BTMs. The results indicated that serum 25(OH)D concentrations < 13.87 ng/mL in this population had adverse influences on maintaining bone remodeling. BTMs were suppressed at a relatively lower serum 25(OH)D in women with the GC rs2282679 G allele compared with those with the T allele.
Exploring the Efficacy of BMSC Transplantation via Various Pathways for Treating Cholestatic Liver Fibrosis in Mice
Junjie Ren, Zixu Li, Xinrui Shi, Tingting Lyu, Xiaonan Li, Min Ge, Qizhi Shuai, Tingjuan Huang
2025, 38(4): 447-458.   doi: 10.3967/bes2024.180
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  Objective  To compare the therapeutic efficacy of portal and tail vein transplantation of bone marrow-derived mesenchymal stem cells (BMSCs) against cholestatic liver fibrosis in mice.   Methods  BMSCs were isolated and co-cultured with starvation-activated hepatic stellate cells (HSCs). HSC activation markers were identified using immunofluorescence and qRT-PCR. BMSCs were injected into the liver tissues of bile duct ligation (BDL) mice via the tail and portal veins. Histomorphology, liver function, inflammatory cytokines, and the expression of key proteins were all determined in the liver tissues.  Results  BMSCs inhibited HSC activation by reducing α-SMA and collagen I expression. Compared to tail vein injection, DIL-labeled BMSCs injected through the portal vein maintained a high homing rate in the liver. Moreover, BMSCs transplanted through the portal vein resulted in greater improvement in liver color, hardness, and gallbladder size than did those transplanted through the tail vein. Furthermore, BMSCs injected by portal vein, but not tail vein, markedly ameliorated liver function, reduced the secretion of inflammatory cytokines, including TNF-α, IL-6, and IL-1β, and decreased α-SMA + hepatic stellate cell (HSC) activation and collagen fiber formation.  Conclusion  The therapeutic effect of BMSCs on cholestatic liver fibrosis in mice via portal vein transplantation was superior to that of tail vein transplantation. This comparative study provides reference information for further BMSC studies focused on clinical cholestatic liver diseases.
Homocysteine Levels and Determinants among Chinese Women at Mid-pregnancy, Late Pregnancy, and Postpartum
Zhenyu Guo, Hongtian Li, Yirui Ma, Ying Meng, Yubo Zhou, Jianmeng Liu
2025, 38(4): 459-468.   doi: 10.3967/bes2024.155
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  Objective   Data on homocysteine (Hcy) status and its determinants are limited among women during pregnancy and postpartum. This cross-sectional study aimed to investigate Hcy levels during pregnancy and postpartum, and to explore the determinants like geographic factor.  Methods   This study was conducted in women at mid-pregnancy, late-pregnancy and postpartum from southern, central and northern China. Approximately 132 women were included in each stratum by the three phases and regions. Plasma Hcy concentrations were assessed using high-performance liquid chromatography (HPLC), with hyperhomocysteinemia defined as > 10.0 µmol/L. Quantile regression was to estimate medians and interquartile ranges (IQRs), and logistic regression to examine the determinants of hyperhomocysteinemia.  Results   For 1,190 women included, the median (IQR) Hcy concentration was 5.66 (4.62, 7.37) μmol/L. The adjusted median in mid-pregnancy, late-pregnancy and postpartum women was 4.75 (4.13, 5.54), 5.72 (4.81, 6.85) and 7.09 (5.65, 8.75) μmol/L, respectively, showing an increasing trend (P < 0.001). This increasing trend persisted across the three regions. Higher Hcy concentrations were observed in women residing in northern region and those with younger age or lower economic status. A total of 106 (8.9%) women had hyperhomocysteinemia, with a higher prevalence in those residing in northern region (16.0%), or in postpartum women (16.5%).  Conclusion   Hcy levels, varying with geographic region, maternal age and economic status, are increased from mid-pregnancy to late-pregnancy and postpartum, indicating a need to monitor Hcy levels in pregnant and postpartum women to control potential risks related to elevated Hcy levels.
Antibiotic-Depleted Lung Microbiota Modulates Surfactant Proteins Expression and Reduces Experimental Silicosis
Qiang Zhou, Meiyu Chang, Ning Li, Yi Guan, Sanqiao Yao
2025, 38(4): 469-483.   doi: 10.3967/bes2025.012
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  Objective   Recent studies have overturned the traditional concept of the lung as a “sterile organ” revealing that pulmonary microbiota dysbiosis and abnormal surfactant proteins (SPs) expression are involved in the progression of silicosis. This study aimed to investigate the relationship between abnormal SPs expression and dysbiosis of lung microbiota in silica-induced lung fibrosis, providing insights into mechanisms of silicosis.  Methods   Lung pathology, SPs expression, and microbiota composition were evaluated in silica-exposed mice. A mouse model of antibiotic-induced microbiota depletion was established, and alveolar structure and SPs expression were assessed. The roles of the lung microbiota and SPs in silicosis progression were further evaluated in mice with antibiotic-induced microbiota depletion, both with and without silica exposure.  Results   Silica exposure induced lung inflammation and fibrosis, along with increased expression of SP-A expression. Antibiotics (Abx)-induced microbiota depletion elevated SP-A and SP-D expression. Furthermore, silica exposure altered lung microbiota composition, enriching potentially pathogenic taxa. However, antibiotic-induced microbiota depletion prior to silica exposure reduced silica-mediated lung fibrosis and inflammation.  Conclusion   Lung microbiota is associated with silica-induced lung injury. Overproduction of SP-A and SP-D, induced by Abx-induced microbiota depletion, may enhance the resistance of mouse lung tissue to silica-induced injury.
Hydrogen Sulfide Alleviates Lipid Peroxidation-Mediated Carbonyl Stress in Uranium-Intoxicated Kidney Cells via Nrf2/ARE Signaling
Jialin Liu, Min Wang, Rui Zhang, Jifang Zheng, Xixiu Jiang, Qiaoni Hu
2025, 38(4): 484-500.   doi: 10.3967/bes2025.021
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  Objective  To explore the protective effects and underlying mechanisms of H2S against lipid peroxidation-mediated carbonyl stress in the uranium-treated NRK-52E cells.  Methods  Cell viability was evaluated using CCK-8 assay. Apoptosis was measured using flow cytometry. Reagent kits were used to detect carbonyl stress markers malondialdehyde, 4-hydroxynonenal, thiobarbituric acid reactive substances, and protein carbonylation. Aldehyde-protein adduct formation and alcohol dehydrogenase, aldehyde dehydrogenase 2, aldo-keto reductase, nuclear factor E2-related factor 2 (Nrf2), and cystathionine β-synthase (CBS) expression were determined using western blotting or real-time PCR. Sulforaphane (SFP) was used to activate Nrf2. RNA interference was used to inhibit CBS expression.  Results  GYY4137 (an H2S donor) pretreatment significantly reversed the uranium-induced increase in carbonyl stress markers and aldehyde-protein adducts. GYY4137 effectively restored the uranium-decreased Nrf2 expression, nuclear translocation, and ratio of nuclear to cytoplasmic Nrf2, accompanied by a reversal of the uranium-decreased expression of CBS and aldehyde-metabolizing enzymes. The application of CBS siRNA efficiently abrogated the SFP-enhanced effects on the expression of CBS, Nrf2 activation, nuclear translocation, and ratio of nuclear to cytoplasmic Nrf2 and concomitantly reversed the SFP-enhanced effects of the uranium-induced mRNA expression of aldehyde-metabolizing enzymes. Simultaneously, CBS siRNA reversed the SFP-mediated alleviation of the uranium-induced increase in reactive aldehyde levels, apoptosis rates, and uranium-induced cell viability.  Conclusion  H2S induces Nrf2 activation and nuclear translocation, which modulates the expression of aldehyde-metabolizing enzymes and the CBS/H2S axis. Simultaneously, the Nrf2-controlled CBS/H2S axis may at least partially promote Nrf2 activation and nuclear translocation. These events form a cycle-regulating mode through which H2S attenuates the carbonyl stress-mediated NRK-52E cytotoxicity triggered by uranium.
Letter
Development and Validation of Machine Learning Models for Lung Cancer Risk Prediction in High-Risk Population: A Retrospective Cohort Study
Yu Su, Haoran Zhan, Shangyao Li, Yitong Lu, Ruhuan Ma, Hai Fang, Tingting Xu, Yu Tian
2025, 38(4): 501-505.   doi: 10.3967/bes2025.038
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Risk Factors and Predictive Model for Acute Mountain Sickness among Han Chinese Travelers to Xizang Autonomous Region
Qianhui Gong, Qiong Li, Zhichao Xu, Xiaowei Chen, Xiaobing Shen
2025, 38(4): 506-510.   doi: 10.3967/bes2025.030
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Kitchen Ventilation Attenuate the Association of Solid Fuel Use with Sarcopenia: A Cross-Sectional and Prospective Study
Yinghao Yuchi, Wei Liao, Jia Qiu, Ruiying Li, Ning Kang, Xiaotian Liu, Wenqian Huo, Zhenxing Mao, Jian Hou, Lei Zhang, Chongjian Wang
2025, 38(4): 511-515.   doi: 10.3967/bes2025.031
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Experimental Study on Distribution and Deposition Characteristics of Phi-X174 and MS2 Bacteriophages in an Air Chamber
Baoying Zhang, Cuicui Ma, Yanyan Wang, Jin Shen
2025, 38(4): 516-518.   doi: 10.3967/bes2025.032
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Role of the Gut–Brain Axis in Chronotype-Driven Alzheimer’s Disease: A Mendelian Randomization Study
Jingting Kong, Mengxue Wang, Xuezi Zhang, Zan Wang, Qingguo Ren
2025, 38(4): 519-524.   doi: 10.3967/bes2025.033
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Bone Injury and Fracture Healing Biology
Ahmad Oryan, Somayeh Monazzah, Amin Bigham-Sadegh
2015, 28(1): 57-71.   doi: 10.3967/bes2015.006
[Abstract](12049) [PDF 3875KB](5143)
Report on Cardiovascular Health and Diseases in China 2021: An Updated Summary
The Writing Committee of the Report on Cardiovascular Health and Diseases in China
2022, 35(7): 573-603.   doi: 10.3967/bes2022.079
[Abstract](15422) [FullText HTML](7227) [PDF 2336KB](7227)
The Serum Exosome Derived MicroRNA-135a, -193b, and-384 Were Potential Alzheimer's Disease Biomarkers
YANG Ting Ting, LIU Chen Geng, GAO Shi Chao, ZHANG Yi, WANG Pei Chang
2018, 31(2): 87-96.   doi: 10.3967/bes2018.011
[Abstract](8603) [FullText HTML](3001) [PDF 11333KB](3001)
Burden of Cirrhosis and Other Chronic Liver Diseases Caused by Specific Etiologies in China, 1990−2016: Findings from the Global Burden of Disease Study 2016
LI Man, WANG Zhuo Qun, ZHANG Lu, ZHENG Hao, LIU Dian Wu, ZHOU Mai Geng
2020, 33(1): 1-10.   doi: 10.3967/bes2020.001
[Abstract](9464) [FullText HTML](3456) [PDF 2552KB](3456)
Report on Cardiovascular Health and Diseases in China 2022: an Updated Summary
The Writing Committee of the Report on Cardiovascular Health and Diseases in China
2023, 36(8): 669-701.   doi: 10.3967/bes2023.106
[Abstract](7722) [FullText HTML](3611) [PDF 1561KB](3611)
Effects of Short-Term Forest Bathing on Human Health in a Broad-Leaved Evergreen Forest in Zhejiang Province, China
MAO Gen Xiang, LAN Xiao Guang, CAO Yong Bao, CHEN Zhuo Mei, HE Zhi Hua, LV Yuan Dong, WANG Ya Zhen, HU Xi Lian, WANG Guo Fu, YAN Jing
2012, 25(3): 317-324.   doi: 10.3967/0895-3988.2012.03.010
[Abstract](6363) [PDF 528KB](2664)
Trends in Lipids Level and Dyslipidemia among Chinese Adults, 2002-2015
SONG Peng Kun, MAN Qing Qing, LI Hong, PANG Shao Jie, JIA Shan Shan, LI Yu Qian, HE Li, ZHAO Wen Hua, ZHANG Jian
2019, 32(8): 559-570.   doi: 10.3967/bes2019.074
[Abstract](7446) [FullText HTML](2709) [PDF 3641KB](2709)
Protein Requirements in Healthy Adults:A Meta-analysis of Nitrogen Balance Studies
LI Min, SUN Feng, PIAO Jian Hua, YANG Xiao Guang
2014, 27(8): 606-613.   doi: 10.3967/bes2014.093
[Abstract](4889) [PDF 8784KB](1930)
Stability of SARS Coronavirus in Human Specimens and Environment and Its Sensitivity to Heating and UV Irradiation
SHU-MING DUAN, Xin-sheng Zhao, RUI-FU WEN, JING-JING HUANG, GUO-HUA PI, SU-XIANG ZHANG, JUN HAN, SHENG-LI BI, LI RUAN, XIAO-PING DONG, SARS RESEARCH TEAM
2003, 16(3): 246-255.  
[Abstract](7321) [PDF 610KB](1850)
Evidence on Invasion of Blood, Adipose Tissues, Nervous System and Reproductive System of Mice After a Single Oral Exposure: Nanoplastics versus Microplastics
YANG Zuo Sen, BAI Ying Long, JIN Cui Hong, NA Jun, ZHANG Rui, GAO Yuan, PAN Guo Wei, YAN Ling Jun, SUN Wei
2022, 35(11): 1025-1037.   doi: 10.3967/bes2022.131
[Abstract](3444) [FullText HTML](1604) [PDF 10064KB](1604)
TaqMan Real-time RT-PCR Assay for Detecting and Differentiating Japanese Encephalitis Virus
SHAO Nan, LI Fan, NIE Kai, FU Shi Hong, ZHANG Wei Jia, HE Ying, LEI Wen Wen, WANG Qian Ying, LIANG Guo Dong, CAO Yu Xi, WANG Huan Yu
2018, 31(3): 208-214.   doi: 10.3967/bes2018.026
[Abstract](4964) [FullText HTML](1934) [PDF 4691KB](1934)
Metabolomic Profiling Differences among Asthma, COPD, and Healthy Subjects: A LC-MS-based Metabolomic Analysis
LIANG Ying, GAI Xiao Yan, CHANG Chun, ZHANG Xu, WANG Juan, LI Ting Ting
2019, 32(9): 659-672.   doi: 10.3967/bes2019.085
[Abstract](5429) [FullText HTML](1676) [PDF 2914KB](1676)
Application of Nanopore Sequencing Technology in the Clinical Diagnosis of Infectious Diseases
ZHANG Lu Lu, ZHANG Chi, PENG Jun Ping
2022, 35(5): 381-392.   doi: 10.3967/bes2022.054
[Abstract](3487) [FullText HTML](1790) [PDF 2174KB](1790)
Evaluating the Nutritional Status of Oncology Patientsand Its Association with Quality of Life
ZHANG Ya Hui, XIE Fang Yi, CHEN Ya Wen, WANG Hai Xia, TIAN Wen Xia, SUN Wen Guang, WU Jing
2018, 31(9): 637-644.   doi: 10.3967/bes2018.088
[Abstract](6063) [FullText HTML](1824) [PDF 31943KB](1824)
Health Effect of Forest Bathing Trip on Elderly Patients with Chronic Obstructive Pulmonary Disease
JIA Bing Bing, YANG Zhou Xin, MAO Gen Xiang, LYU Yuan Dong, WEN Xiao Lin, XU Wei Hong, LYU XIAO Ling
2016, 29(3): 212-218.   doi: 10.3967/bes2016.026
[Abstract](3049) [PDF 803KB](1200)
The Emergence, Epidemiology, and Etiology of Haff Disease
PEI Pei, LI Xiao Yan, LU Shuang Shuang, LIU Zhe, WANG Rui, LU Xuan Cheng, LU Kai
2019, 32(10): 769-778.   doi: 10.3967/bes2019.096
[Abstract](5239) [FullText HTML](2225) [PDF 2249KB](2225)
Correlation between Anxiety, Depression, and Sleep Quality in College Students
ZHANG Yu Tong, HUANG Tao, ZHOU Fang, HUANG Ao Di, JI Xiao Qi, HE Lu, GENG Qiang, WANG Jia, MEI Can, XU Yu Jia, YANG Ze Long, ZHAN Jian Bo, CHENG Jing
2022, 35(7): 648-651.   doi: 10.3967/bes2022.084
[Abstract](3031) [FullText HTML](1372) [PDF 1202KB](1372)
Supplementation of Fermented Barley Extracts with Lactobacillus Plantarum dy-1 Inhibits Obesity via a UCP1-dependent Mechanism
XIAO Xiang, BAI Juan, LI Ming Song, ZHANG Jia Yan, SUN Xin Juan, DONG Ying
2019, 32(8): 578-591.   doi: 10.3967/bes2019.076
[Abstract](5247) [FullText HTML](1391) [PDF 9101KB](1391)
Mutual Impact of Diabetes Mellitus and Tuberculosis in China
CHENG Jun, ZHANG Hui, ZHAO Yan Lin, WANG Li Xia, CHEN Ming Ting
2017, 30(5): 384-389.   doi: 10.3967/bes2017.051
[Abstract](4487) [FullText HTML](1609) [PDF 671KB](1609)
Hypertension Prevalence, Awareness, Treatment, and Control and Their Associated Socioeconomic Factors in China: A Spatial Analysis of A National Representative Survey
WANG Wei, ZHANG Mei, XU Cheng Dong, YE Peng Peng, LIU Yun Ning, HUANG Zheng Jing, HU Cai Hong, ZHANG Xiao, ZHAO Zhen Ping, LI Chun, CHEN Xiao Rong, WANG Li Min, ZHOU Mai Geng
2021, 34(12): 937-951.   doi: 10.3967/bes2021.130
[Abstract](3726) [FullText HTML](1817) [PDF 2205KB](1817)

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Vol 38, No 4

(April, 2025)

ISSN 0895-3988

CN 11-2816/Q

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