Biomedical and Environmental Sciences

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Report on Cardiovascular Health and Diseases in China 2023: An Updated Summary (30 day view times: 69)

National Center for Cardiovascular Diseases The Writing Committee of the Report on Cardiovascular Health and Diseases in China

2024, 37(9): 949-992. doi: 10.3967/bes2024.162

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Since 1990, China has made considerable progress in resolving the problem of “treatment difficulty” of cardiovascular diseases (CVD). The prevalent unhealthy lifestyle among Chinese residents has exposed a massive proportion of the population to CVD risk factors, and this situation is further worsened due to the accelerated aging population in China. CVD remains one of the greatest threats to the health of Chinese residents. In terms of the proportions of disease mortality among urban and rural residents in China, CVD has persistently ranked first. In 2021, CVD accounted for 48.98% and 47.35% of deaths in rural and urban areas, respectively. Two out of every five deaths can be attributed to CVD. To implement a national policy “focusing on the primary health institute and emphasizing prevention” and truly achieve a shift of CVD prevention and treatment from hospitals to communities, the National Center for Cardiovascular Diseases has organized experts from relevant fields across China to compile the “Report on Cardiovascular Health and Diseases in China” annually since 2005. The 2024 report is established based on representative, published, and high-quality big-data research results from cross-sectional and cohort population epidemiological surveys, randomized controlled clinical trials, large sample registry studies, and typical community prevention and treatment cases, along with data from some projects undertaken by the National Center for Cardiovascular Diseases. These firsthand data not only enrich the content of the current report but also provide a more timely and comprehensive reflection of the status of CVD prevention and treatment in China.

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Association of Body Mass Index with All-Cause Mortality and Cause-Specific Mortality in Rural China: 10-Year Follow-up of a Population-Based Multicenter Prospective Study (30 day view times: 35)

Juanjuan Huang, Yuanzhi Di, Lingyu Shen, Jianguo Liang, Jiang Du, Xuefang Cao, Weitao Duan, Aiwei He, Jun Liang, Limei Zhu, Zisen Liu, Fang Liu, Shumin Yang, Zuhui Xu, Cheng Chen, Bin Zhang, Jiaoxia Yan, Yanchun Liang, Rong Liu, Tao Zhu, Hongzhi Li, Fei Shen, Boxuan Feng, Yijun He, Zihan Li, Yaqi Zhao, Tonglei Guo, Liqiong Bai, Wei Lu, Qi Jin, Lei Gao, Henan Xin

2025, 38(10): 1179-1193. doi: 10.3967/bes2025.128

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Objective This study aimed to explore the association between body mass index (BMI) and mortality based on the 10-year population-based multicenter prospective study. Methods A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023. Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality. Stratified analyses were performed based on the individual characteristics of the participants. Results Overall, 19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died. The underweight (< 18.5 kg/m²) presented an increase in all-cause mortality (adjusted hazards ratio [aHR] = 2.00, 95% confidence interval [CI]: 1.66–2.41), while overweight (≥ 24.0 to < 28.0 kg/m²) and obesity (≥ 28.0 kg/m²) presented a decrease with an aHR of 0.61 (95% CI: 0.52–0.73) and 0.51 (95% CI: 0.37–0.70), respectively. Overweight (aHR = 0.76, 95% CI: 0.67–0.86) and mild obesity (aHR = 0.72, 95% CI: 0.59–0.87) had a positive impact on mortality in people older than 60 years. All-cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m² (aHR = 0.95, 95% CI: 0.92–0.98) and increased slightly above that value, indicating a U-shaped association. The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses. Conclusion This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years. Therefore, it is essential to consider age differences when formulating health and weight management strategies.

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Climate-Sensitive Infectious Diseases under Global Climate Change (30 day view times: 28)

Qiao Liu, Min Liu, Jue Liu

2025, 38(9): 1129-1141. doi: 10.3967/bes2025.077

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Climate and weather significantly influence the duration, timing, and intensity of disease outbreaks, reshaping the global landscape of infectious diseases. Rising temperatures and shifts in precipitation patterns driven by climate change can directly impact the survival and reproduction of pathogens and vector organisms. Moreover, climate change is expected to exacerbate extreme weather events, including floods and droughts, which can disrupt infrastructure and increase the risk of water- and foodborne diseases. There are potential shifts in the temporal and spatial patterns of infectious disease transmission owing to climate change. Furthermore, climate change may alter the epidemiology of vaccine-preventable diseases. These climatic variations not only affect the ecological characteristics of pathogens and vectors but also indirectly influence human behaviors and socioeconomic conditions, further amplifying disease transmission risks. Addressing this challenge requires an interdisciplinary collaboration and comprehensive public health strategies. This review aims to synthesize the current evidence on the impact of climate change on climate-sensitive infectious diseases and elucidate the underlying mechanisms and transmission pathways. Additionally, we explored adaptive policy strategies to mitigate the public health burden of infectious diseases in the context of climate change, offering insights for global health governance and disease control efforts.

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Interpretation of Annual Report on Cardiovascular Health and Diseases in China 2024 (30 day view times: 27)

Mingbo Liu, Xinye He, Xiaohong Yang, Zengwu Wang

2025, 38(8): 893-917. doi: 10.3967/bes2025.099

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Cardiovascular diseases (CVD) and their risk factors are exerting an increasingly significant impact on public health, and the incidence rate of CVD continues to rise. This article provides an interpretation of essentials from the newly published Annual Report on Cardiovascular Health and Diseases in China (2024), aiming to offer scientific evidence for CVD prevention, treatment, and the formulation of relevant policies.

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Environmental Temperature and the Risk of Hand, Foot, and Mouth Disease Transmission in the Yangtze River Region of China (30 day view times: 23)

Yanqing Yang, Min Chen, Jin Li, Kaiqi Liu, Xueyan Guo, Xin Xu, Qian Liang, Xinglu Wu, Suwen Lei, Jing Li

2025, 38(3): 290-302. doi: 10.3967/bes2025.011

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Objective To assess health equity in the Yangtze River region to improve understanding of the correlation between hand, foot, and mouth disease (HFMD) and socioeconomic factors. Methods From 2014–2016, data on HFMD incidence, population statistics, economic indicators, and meteorology from 26 cities along the Yangtze River were analyzed. A multi-city random-effects meta-analysis was performed to study the relationship between temperature and HFMD transmission, and health equity was assessed with respect to socio-economic impact. Results Over the study period, 919,458 HFMD cases were reported, with Shanghai (162,303) having the highest incidence and Tongling (5,513) having the lowest. Males were more commonly affected (male-to-female ratio, 1.49:1). The exposure-response relationship had an M-shaped curve, with two HFMD peaks occurring at 4 °C and 26 °C. The relative risk had two peaks at 1.30 °C (1.834, 95% CI: 1.204–2.794) and 31.4 °C (1.143, 95% CI: 0.901–1.451), forming an M shape, with the first peak higher than the second. The most significant impact of temperature on HFMD was observed between –2 °C and 18.1 °C. The concentration index (0.2463) indicated moderate concentration differences, whereas the Theil index (0.0418) showed low inequality in distribution. Conclusion The incidence of HFMD varied across cities, particularly with changes in temperature. Economically prosperous areas showed higher risks, indicating disparities. Targeted interventions in these areas are crucial for mitigating the risk of HFMD.

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Hypertrophic Cardiomyopathy: Mechanisms of Pathogenicity (30 day view times: 22)

Baoxi Wang, Yueting Zhou, Yipin Zhao, Yong Cheng, Jun Ren, Guanchang Tan, Xiaohu Wang

2025, 38(8): 988-1000. doi: 10.3967/bes2025.096

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Hypertrophic cardiomyopathy (HCM) is a major contributor to cardiovascular diseases (CVD), the leading cause of death globally. HCM can precipitate heart failure (HF) by causing the cardiac tissue to weaken and stretch, thereby impairing its pumping efficiency. Moreover, HCM increases the risk of atrial fibrillation, which in turn elevates the likelihood of thrombus formation and stroke. Given these significant clinical ramifications, research into the etiology and pathogenesis of HCM is intensifying at multiple levels. In this review, we discuss and synthesize the latest findings on HCM pathogenesis, drawing on key experimental studies conducted both in vitro and in vivo. We also offer our insights and perspectives on these mechanisms, while highlighting the limitations of current research. Advancing fundamental research in this area is essential for developing effective therapeutic interventions and enhancing the clinical management of HCM.

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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 (30 day view times: 20)

Chenwei Zhang, Binbin Wan, Yukai Zhang, Tao Xiong, Yishan Li, Xuesen Su, Gang Liu, Yangyang Wei, Yuanyuan Sun, Jingfen Zhang, Xiao Yu, Yiwei Shi

2025, 38(10): 1270-1286. doi: 10.3967/bes2025.028

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Objective 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.

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Report on Cardiovascular Health and Diseases in China 2022: an Updated Summary (30 day view times: 20)

The Writing Committee of the Report on Cardiovascular Health and Diseases in China

2023, 36(8): 669-701. doi: 10.3967/bes2023.106

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In the past 30 years, the accessibility and quality index of medical care have made remarkable progress in China, ranking the first among middle-income countries. Many cardiovascular technologies are at or near the world's leading level, and significant progress has been achieved in China solving the problem of “treatment difficulty” of cardiovascular diseases (CVD). However, due to the prevalence of unhealthy lifestyles among Chinese residents, a huge population with CVD risk factors, accelerated population aging, and other reasons, the incidence and mortality rate of CVD are still increasing, and the turning point of the decline in disease burden has not appeared yet in China. In terms of proportions of disease mortality among urban and rural residents, CVD still ranks the first. In 2020, CVD accounted for 48.00% and 45.86% of the causes of death in rural and urban areas, respectively; two out of every five deaths were due to CVD. It is estimated that the number of current CVD patients in China is around 330 million, including 13 million stroke, 11.39 million coronary heart disease, 8.9 million heart failure, 5 million pulmonary heart disease, 4.87 million atrial fibrillation, 2.5 million rheumatic heart disease, 2 million congenital heart disease, 45.3 million peripheral artery disease, and 245 million hypertension cases. China has entered a new stage of transformation from high-speed development to high-quality development, and the prevention and control of CVD in China should also shift from previous emphasis on scale growth to strategies focusing more on strategic and key technological development in order to curb the trend of increasing incidence and mortality rates of CVD.

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Nutrition Guidelines of Complementary Feeding for Infants and Toddlers (WS/T 678—2020) (30 day view times: 18)

2023, 36(9): 899-901. doi: 10.3967/bes2023.117

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Molecular Characterization of New Recombinant Human Adenoviruses Detected in Children with Acute Respiratory Tract Infections in Beijing, China, 2022–2023 (30 day view times: 17)

Yinan Guo, Ri De, Fangming Wang, Zhenzhi Han, Liying Liu, Yu Sun, Yao Yao, Xiaolin Ma, Shuang Liu, Chunmei Zhu, Dong Qu, Linqing Zhao

2025, 38(9): 1071-1081. doi: 10.3967/bes2025.105

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Objective Recombination events are common and serve as the primary driving force of diverse human adenovirus (HAdV), particularly in children with acute respiratory tract infections (ARIs). Therefore, continual monitoring of these events is essential for effective viral surveillance and control. Methods Respiratory specimens were collected from children with ARIs between January 2022 and December 2023. The penton base, hexon, and fiber genes were amplified from HAdV-positive specimens and sequenced to determine the virus type. In cases with inconsistent typing results, genes were cloned into the pGEM-T vector to detect recombination events. Metagenomic next-generation sequencing (mNGS) was performed to characterize the recombinant HAdV genomes. Results Among 6,771 specimens, 277 (4.09%, 277/6,771) were positvie for HAdV, of which 157 (56.68%, 157/277) were successfully typed, with HAdV-B3 being the dominant type (91.08%, 143/157), and 14 (5.05%, 14/277) exhibited inconsistent typing results, six of which belonged to species B. The penton base genes of these six specimens were classified as HAdV-B7, whereas their hexon and fiber genes were classified as HAdV-B3, resulting in a recombinant genotype designated P7H3F3, which closely resembled HAdV-B114. Additionally, a partial gene encoding L1 52/55 kD was identified, which originated from HAdV-B16. Conclusion A novel recombinant, P7H3F3, was identified, containing sequences derived from HAdV-B3 and HAdV-B7, which is similar to HAdV-B114, along with additional sequences from HAdV-B16.

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Cardiovascular Health and Disease Report in China: Two Decades of Progress (30 day view times: 17)

Shuyao Su, Fangchao Liu

2025, 38(8): 891-892. doi: 10.3967/bes2025.098

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Joint Effect of Multiple Air Pollutant Exposure on Dyslipidemia in Chinese Primary School Children (30 day view times: 17)

Yuanduo Zhu, Yingying Han, Dandan Li, Yanlong Xu

2025, 38(10): 1302-1307. doi: 10.3967/bes2025.130

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NFKBIE: Novel Biomarkers for Diagnosis, Prognosis, and Immunity in Colorectal Cancer: Insights from Pan-cancer Analysis (30 day view times: 16)

Chenyang Hou, Peng Wang, Fengxu Yan, Yanyan Bo, Zhenpeng Zhu, Xiran Wang, Shan Liu, Dandan Xu, JiaJia Xiao, Jun Xue, Fei Guo, Qingxue Meng, Rensen Ran, Weizheng Liang

2025, 38(10): 1320-1325. doi: 10.3967/bes2025.124

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Effectiveness of Pentavalent Rotavirus Vaccine — a Propensity Score Matched Test Negative Design Case-Control Study Using Medical Big Data in Three Provinces of China (30 day view times: 16)

Yuexin Xiu, Lin Tang, Fuzhen Wang, Lei Wang, Zhen Li, Jun Liu, Dan Li, Xueyan Li, Yao Yi, Fan Zhang, Lei Yu, Jingfeng Wu, Zundong Yin

2025, 38(9): 1032-1043. doi: 10.3967/bes2025.056

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Objective The objective of our study was to evaluate the vaccine effectiveness (VE) of the pentavalent rotavirus vaccine (RV5) among < 5-year-old children in three provinces of China during 2020–2024 via a propensity score-matched test-negative case-control study. Methods Electronic health records and immunization information systems were used to obtain data on acute gastroenteritis (AGE) cases tested for rotavirus (RV) infection. RV-positive cases were propensity score matched with RV-negative controls for age, visit month, and province. Results The study included 27,472 children with AGE aged 8 weeks to 4 years at the time of AGE diagnosis; 7.98% (2,192) were RV-positive. The VE (95% confidence interval, CI) of 1–2 and 3 doses of RV5 against any medically attended RV infection (inpatient or outpatient) was 57.6% (39.8%, 70.2%) and 67.2% (60.3%, 72.9%), respectively. Among children who received the 3rd dose before turning 5 months of age, 3-dose VE decreased from 70.4% (53.9%, 81.1%) (< 5 months since the 3rd dose) to 63.0% (49.1%, 73.0%) (≥ 1 year since the 3rd dose). The three-dose VE rate was 69.4% (41.3%, 84.0%) for RVGE hospitalization and 57.5% (38.9%, 70.5%) for outpatient-only medically attended RVGE. Conclusion Three-dose RV5 VE against rotavirus gastroenteritis (RVGE) in children aged < 5 years was higher than 1-2-dose VE. Three-dose VE decreased with time since the 3rd dose in children who received the 3rd dose before turning five months of age, but remained above 60% for at least one year. VE was higher for RVGE hospitalizations than for medically attended outpatient visits.

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Integrating Internet Search Data and Surveillance Data to Construct Influenza Epidemic Thresholds in Hubei Province: A Moving Epidemic Method Approach (30 day view times: 15)

Caixia Dang, Feng Liu, Hengliang Lyu, Ziqian Zhao, Sijin Zhu, Yang Wang, Yuanyong Xu, Yeqing Tong, Hui Chen

2025, 38(9): 1150-1154. doi: 10.3967/bes2025.109

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Effect of Home Blood Pressure Telemonitoring Plus Additional Support on Blood Pressure Control: A Randomized Clinical Trial (30 day view times: 15)

MENG Wen Wen, BAI Yong Yi, YAN Li, ZHENG Wei, ZENG Qiang, ZHENG Yan Song, ZHA Lin, PI Hong Ying, SAI Xiao Yong

2023, 36(6): 517-526. doi: 10.3967/bes2023.063

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Objective Current clinical evidence on the effects of home blood pressure telemonitoring (HBPT) on improving blood pressure control comes entirely from developed countries. Thus, we performed this randomized controlled trial to evaluate whether HBPT plus support (patient education and clinician remote hypertension management) improves blood pressure control more than usual care (UC) in the Chinese population. Methods This single-center, randomized controlled study was conducted in Beijing, China. Patients aged 30–75 years were eligible for enrolment if they had blood pressure [systolic (SBP) ≥ 140 mmHg and/or diastolic (DBP) ≥ 90 mmHg; or SBP ≥ 130 mmHg and/or DBP ≥ 80 mmHg with diabetes]. We recruited 190 patients randomized to either the HBPT or the UC groups for 12 weeks. The primary endpoints were blood pressure reduction and the proportion of patients achieving the target blood pressure. Results Totally, 172 patients completed the study, the HBPT plus support group (n = 84), and the UC group (n = 88). Patients in the plus support group showed a greater reduction in mean ambulatory blood pressure than those in the UC group. The plus support group had a significantly higher proportion of patients who achieved the target blood pressure and maintained a dipper blood pressure pattern at the 12th week of follow-up. Additionally, the patients in the plus support group showed lower blood pressure variability and higher drug adherence than those in the UC group. Conclusion HBPT plus additional support results in greater blood pressure reduction, better blood pressure control, a higher proportion of dipper blood pressure patterns, lower blood pressure variability, and higher drug adherence than UC. The development of telemedicine may be the cornerstone of hypertension management in primary care.

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Trends in Lipids Level and Dyslipidemia among Chinese Adults, 2002-2015 (30 day view times: 15)

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

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Objective To investigate the trends of lipid profiles and dyslipidemia among Chinese adults from 2002 to 2015. Methods Data were collected from three nationally representative cross-sectional surveys. Fasting venous blood samples were collected and serum lipids were tested by biochemical analysis and enzymatic determination. Lipid levels and the prevalence of dyslipidemia among adults were analyzed with complex sampling weighting adjustment for age and gender. Results The weighted means of TC, TG, and LDL-c significantly increased linearly from 3.93, 1.12, and 2.12 mmol/L in 2002 to 4.59, 1.41, and 2.78 mmol/L in 2010 and then to 4.63, 1.47, and 2.87 mmol/L in 2015, respectively; by contrast, HDL-c levels decreased significantly from 1.30 mmol/L to 1.26 mmol/L over the same period. Similar trends in mean non-HDL-c and lipid-related ratios were observed. The weighted dyslipidemia prevalence linearly increased; in particular, hypercholesterolemia increased from 1.6% to 5.6% and then to 5.8%, hypertriglyceridemia increased from 5.7% to 13.6% and then to 15.0%, low HDL-c increased from 18.8% to 35.5% and then to 24.9%, and high LDL-c increased from 1.3% to 5.6% and then to 7.2% (P for trend < 0.001). Conclusion Dyslipidemia increased among Chinese adults from 2002 to 2015. Development of a comprehensive strategy to decrease lipid levels in this population is urgently required.

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Therapeutic Strategies for Tuberculosis: Progress and Lessons Learned (30 day view times: 14)

Qingfeng Sun, Shanshan Li, Mengqiu Gao, Yu Pang

2024, 37(11): 1310-1323. doi: 10.3967/bes2024.168

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Tuberculosis (TB) remains a significant global health challenge, ranking second only to COVID-19 as the leading cause of death from a single infectious agent, with 1.3 million TB-related deaths reported in 2022. Treatment efficacy has been compromised by the emergence of drug-resistant strains, including rifampin-resistant TB (RR-TB), multidrug-resistant TB (MDR-TB), and extensively drug-resistant TB (XDR-TB). Although first-line drugs like isoniazid, rifampicin, pyrazinamide, and ethambutol form the cornerstone of TB therapy, the rise of resistant strains necessitates the use of second-line drugs, which often come with increased toxicity and limited accessibility. Recent advances have focused on repurposing existing compounds and developing new drugs with novel mechanisms of action. Promising agents such as second-generation bedaquiline analogs (TBAJ-587, TBAJ-876), sudapyridine (WX-081), delamanid, pretomanid, and TBI-166 (pyrifazimine) have shown efficacy against resistant Mtb strains. Innovative treatment regimens like the BPaLM protocol—combining bedaquiline, pretomanid, linezolid, and moxifloxacin—offer shorter, all-oral therapies with higher cure rates. Personalized treatment durations and dose optimizations are becoming feasible through risk stratification algorithms and pharmacokinetic/pharmacodynamic studies. Immunotherapy is emerging as a complementary strategy to enhance the host’s immune response against Mtb. Agents such as vitamin D, corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), statins, metformin, and biological agents like interleukins and granulocyte-macrophage colony-stimulating factor are under exploration. Additionally, cell therapies involving mesenchymal stem cells and immune effector cells present new therapeutic avenues. Despite these advancements, significant challenges remain in achieving the World Health Organization’s “End TB Strategy” goals, particularly as the COVID-19 pandemic has diverted resources and attention. Ongoing research and global collaboration are crucial to develop novel therapeutic strategies, optimize treatment regimens, and ultimately reduce the global burden of TB.

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Dietary Guide for Hyperuricemia and Gout Patients (WS/T 560—2017) (30 day view times: 14)

2023, 36(9): 897-898. doi: 10.3967/bes2023.118

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Cover (30 day view times: 13)

2025, 38(10).

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