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).
Climate-sensitive infectious diseases under global climate change
Qiao Liu, Min Liu, Jue Liu
In press  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.
Effectiveness of Pentavalent Rotavirus Vaccine — a Propensity Score Matched Test Negative Design Case-Control Study Using Medical Big Data in Three Provinces of China
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
In press  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.  Conclusions   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.
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.
Association between PM2.5 Chemical Constituents and Preterm Birth: The Undeniable Role of Preconception H19 Gene Variation
Yalong Wang, Panpan Sun, Xinying Wang, Junxi Zhang, Xiangyu Yu, Jian Chai, Ruo Du, Wenyi Liu, Fangfang Yu, Yue Ba, Guo Yu Zhou
In press  doi: 10.3967/bes2025.076
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MYCN-Mediated Transcriptional Activation of IDH2 Enhances Proliferation, Migration, and Invasion in Cervical Squamous Cell Carcinoma through the HIF1-α Pathway
Xiaojuan Liu, Hui Ma, Xiaoyan Li, Chunxing Ma, Lisha Shu, Huiying Zhang
In press  doi: 10.3967/bes2025.075
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Validation and Reproducibility of an Iodine-Specific Food Frequency Questionnaire for Evaluating Dietary Iodine Intake in the Elderly Population of Gansu Province, China
Qi Jin, Tao Wang, Meina Ji, Jizun Wang, Xing Ma, Xinyi Wang, Jiaqi Wang, Hexi Zhang, Yanling Wang, Wenxing Guo, Wanqi Zhang
In press  doi: 10.3967/bes2025.074
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Seasonal Effects of Air Pollutants on Stroke Deaths in Qingdao from 2014 to 2019
Jingkai Zhang, Bingling Wang, Lu Pan, Nan Ge, Jingya Yin, Yuan Fang, Hua Zhang, Jianjun Zhang, Xiutao Cao, Yan Ma, Li Cheng, Haiping Duan
In press  doi: 10.3967/bes2025.073
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Life-Course Trajectories of Body Mass Index, Insulin Resistance, and Incident Diabetes in Chinese Adults
Zhiyuan Ning, Jinglan Zhang, Bingbing Fan, Yanlin Qu, Chang Su, Tao Zhang
In press  doi: 10.3967/bes2025.072
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  Objective  This study aimed to explore the interplay between the life-course body mass index (BMI) trajectories and insulin resistance (IR) on incident diabetes.  Methods  This longitudinal cohort included 2,336 participants who had BMI repeatedly measured 3–8 times between 1989 and 2009, as well as glucose and insulin measured in 2009. BMI trajectories were identified using a latent class growth mixed model. The interplay between BMI trajectories and IR on diabetes was explored using the four-way effect decomposition method. Logistic regression and mediation models were used to estimate the interaction and mediation effects, respectively.  Results  Three distinct BMI trajectory groups were identified: low-stable (n = 1,625), medium-increasing (n = 613), and high-increasing (n = 98). Both interaction and mediation effects of BMI trajectories and IR on incident diabetes were significant (P < 0.05). The proportion of incident diabetes was higher in the IR-obesity than in the insulin-sensitivity (IS) obesity group (18.9% vs. 5.8%, P < 0.001). After adjusting for covariates, the odds ratios (95% confidence intervals) of the IR, IS-obesity, and IR-obesity groups vs. the normal group were 3.22 (2.05, 5.16), 2.05 (1.00, 3.97), and 7.98 (5.19, 12.62), respectively. IR mediated 10.7% of the total effect of BMI trajectories on incident diabetes (P < 0.001).  Conclusion  We found strong interactions and weak mediation effects of IR on the relationship between life-course BMI trajectories and incident diabetes. IS-obesity is associated with a lower risk of incident diabetes than IR-obesity.
Spatio-temporal Pattern and Socio-economic Influencing Factors of Tuberculosis Incidence in Guangdong Province: A Bayesian Spatiotemporal Analysis*
Huizong Wu, Xing Li, Jiawen Wang, Ronghua Jian, Jianxiong Hu, Yijun Hu, Yiting Xu, Jianpeng Xiao, Aiqiong Jin, Liang Chen
In press  doi: 10.3967/bes2025.071
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  Objective  To investigate the spatiotemporal patterns and socioeconomic factors influencing the incidence of tuberculosis (TB) in the Guangdong Province between 2010 and 2019.  Method  Spatial and temporal variations in TB incidence were mapped using heat maps and hierarchical clustering. Socioenvironmental influencing factors were evaluated using a Bayesian spatiotemporal conditional autoregressive (ST-CAR) model.  Results  Annual incidence of TB in Guangdong decreased from 91.85/100,000 in 2010 to 53.06/100,000 in 2019. Spatial hotspots were found in northeastern Guangdong, particularly in Heyuan, Shanwei, and Shantou, while Shenzhen, Dongguan, and Foshan had the lowest rates in the Pearl River Delta. The ST-CAR model showed that the TB risk was lower with higher per capita Gross Domestic Product (GDP) [Relative Risk (RR), 0.91; 95% Confidence Interval (CI): 0.86–0.98], more the ratio of licensed physicians and physician (RR, 0.94; 95% CI: 0.90-0.98), and higher per capita public expenditure (RR, 0.94; 95% CI: 0.90–0.97), with a marginal effect of population density (RR, 0.86; 95% CI: 0.86–1.00).  Conclusion  The incidence of TB in Guangdong varies spatially and temporally. Areas with poor economic conditions and insufficient healthcare resources are at an increased risk of TB infection. Strategies focusing on equitable health resource distribution and economic development are the key to TB control.
Job Preferences of Centers for Disease Control and Prevention Workers: A Discrete Choice Experiment in China
Yan Guo, Hanlin Nie, Hao Chen, Stephen Nicholas, Elizabeth Maitland, Sisi Chen, Lieyu Huang, Xiumin Zhang, Xuefeng Shi
In press  doi: 10.3967/bes2025.070
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  Objective  This study explored the job choice preferences of Center for Disease Prevention and Control (CDC) workers to provide CDC management information and recommendations for optimizing employee retention and motivation policies.  Methods  A discrete choice experiment was conducted in nine provinces across China. Seven key attributes were identified to analyze the job preferences of CDC workers. Mixed logit models, latent class models, and policy simulation tools were used.  Results  A valid sample of 5944 cases was included in the analysis. All seven attributes significantly influenced the job choices of CDC workers. Heterogeneity analyses identified two main groups based on different levels of preference for attribute utility. Income-prioritizers were concerned with income and opportunities for career development, whereas bianzhi-prioritizers were concerned with bianzhi and welfare benefits. The policy simulation analysis revealed that income-prioritizers had a relatively higher sensitivity to multiple job preference incentives.  Conclusion  Income and bianzhi were the two key attributes influencing the job choices and retention preferences of CDC workers. Heterogeneity in job preferences was also identified. Based on the preference characteristics of different subgroups, policy content should be skewed to differentiate the importance of incentives.
Dissecting the Causal Association between Body Fat Mass and Obsessive-compulsive Disorder: A Two-sample Mendelian Randomization Study
Meiling Hu, Zhennan Lin, Hongwei Liu, Yunfeng Xi, Youxin Wang
In press  doi: 10.3967/bes2025.069
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Objective Previous studies link lower body mass index (BMI) with increased obsessive-compulsive disorder (OCD) risk, yet other body mass indicators may offer superior prediction. We dissected the causal association between body fat mass (FM) and OCD.Methods Summary statistics from genome-wide association studies of European ancestry were utilized to conduct two-sample Mendelian randomization analysis. Heterogeneity, horizontal pleiotropy, and sensitivity analyses were performed to assess the robustness.Results The inverse variance weighting method demonstrated that a genetically predicted decrease in FM was causally associated with an increased OCD risk [odds ratio (OR) = 0.680, 95% confidence interval (CI): 0.528–0.875, P = 0.003]. Similar estimates were obtained using the weighted median approach (OR = 0.633, 95% CI: 0.438–0.915, P = 0.015). Each standard deviation increases in genetically predicted body fat percentage corresponded to a reduced OCD risk (OR = 0.638, 95% CI: 0.455–0.896, P = 0.009). The sensitivity analysis confirmed the robustness of these findings with no outlier instrument variables identified.Conclusion The negative causal association between FM and the risk of OCD suggests that the prevention or treatment of mental disorders should include not only the control of BMI but also fat distribution and body composition.
Trajectory Modelling: A Novel Approach to Dig Value of Longitudinal Cohort Studies
Siyan Zhan
In press  doi: 10.3967/bes2025.068
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Effects of Oral Vitamin D Supplementation on Vitamin D Levels and Glycemic Parameters in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Network Meta-analysis
Xiujuan Zhang, Hongfei Wang, Xia Gao, Yang Zhao
In press  doi: 10.3967/bes2025.066
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  Background  Epidemiological studies have shown that vitamin D status affects glycemic control in individuals with type 2 diabetes mellitus (T2DM). However, findings from intervention studies remain inconsistent. Therefore, a network meta-analysis was conducted to evaluate the comparative efficacy of various vitamin D supplementation strategies on glucose indicators in adults with T2DM.  Methods  Eligible studies published before September 12, 2024, were retrieved from PubMed, EMBASE, Cochrane Library, and Web of Science. A network meta-analysis of multiple dosage strategies—low (< 1,000 IU/day, LDS), medium (1,000–2,000 IU/day, MDS), high (2,000–4,000 IU/day, HDS), and extremely high (≥ 4,000 IU/day, EHDS)—was performed.  Results  The network meta-analysis of 40 RCTs indicated that, compared with placebo, vitamin D3 supplementation increased 25-hydroxyvitamin D [25-(OH)-D] levels, with pooled mean difference (MD) showing a stepwise increase from LDS to EHDS. Ranking probabilities showed a corresponding rise in 25-(OH)-D levels from LDS (46.7%) to EHDS (91.2%). EHDS reduced fasting blood glucose (FBG) relative to no treatment. LDS significantly decreased hemoglobin A1c (HbA1c), and vitamin D2 significantly affected FBG levels. MDS led to a significant change in fasting insulin (FIN) compared to both placebo (MD: −4.76; 95% CI −8.91 to −0.61) and no treatment (MD: −7.30; 95% CI −14.44 to −0.17).  Conclusion  The findings suggest that vitamin D supplementation may be a viable approach for improving glycemic control in adults with T2DM, with lower doses potentially offering benefit. The analysis also showed a dose-dependent increase in 25-(OH)-D levels.
Single-Cell and Multi-Dimensional Data Analysis of the Key Role of IDH2 in Cervical Squamous Cell Carcinoma Progression
Xiaojuan Liu, Zhenpeng Zhu, Chenyang Hou, Hui Ma, Xiaoyan Li, Chunxing Ma, Lisha Shu, Huiying Zhang
In press  doi: 10.3967/bes2025.067
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Does Prenatal SARS-CoV-2 Infection Exacerbate Postpartum Lower Urinary Tract Symptoms? A Multicenter Retrospective Cohort Study
Yuhan Lyu, Min Li, Huiqing Yao, Tianzi Gai, Lin Liang, Su Pan, Pingping Li, Yaxin Liang, Yue Yu, Xiaomei Wu
In press  doi: 10.3967/bes2025.065
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  Objective  Coronavirus disease 2019 (COVID-19) can result in fatigue and post-exertional malaise; however, whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection exacerbates lower urinary tract symptoms (LUTS) is unclear. This study investigated the association between prenatal SARS-CoV-2 infection and postpartum LUTS.  Methods  A multicenter, retrospective cohort study was conducted at two tertiary hospitals in China from November 1, 2022, to November 1, 2023. Participants were classified into infected and uninfected groups based on SARS-CoV-2 antigen results. LUTS prevalence and severity were assessed using self-reported symptoms and the Incontinence Impact Questionnaire-Short Form (IIQ-7). Pelvic floor muscle activity was measured using electromyography following the Glazer protocol. Group comparisons were performed to evaluate the association of SARS-CoV-2 infection with LUTS and electromyography parameters, with stratified analyses conducted using SPSS version 26.0.  Results  Among 3,652 participants (681 infected, 2,971 uninfected), no significant differences in LUTS prevalence or IIQ-7 scores were observed. However, SARS-CoV-2 infection was an independent factor influencing the electromyographic activity of the pelvic floor muscles (mean tonic contraction amplitudes), regardless of delivery mode (P = 0.001).  Conclusion  Prenatal SARS-CoV-2 infection was not significantly associated with an increased risk of postpartum LUTS but independently altered pelvic floor muscle electromyographic activity, suggesting potential neuromuscular effects.
Trends Analysis on Vaccination Coverage of Influenza in Shandong Province, China
Guijie Luan, Liang Sun, Weiyan Zhang, Yao Liu, Shaonan Liu
In press  doi: 10.3967/bes2025.063
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National Trends in Influenza Vaccination Rates in South Korea Before and During the COVID-19 Pandemic, 2011–2022
Kyeongeun Kim, Kyeongmin Lee, Yejun Son, Seoyoung Park, Raphael Udeh, Jiseung Kang, Hayeon Lee, Soeun Kim, Jaeyu Park, Hyeon Jin Kim, Damiano Pizzol, Lee Smith, Jiyoung Hwang, Dong Keon Yon
In press  doi: 10.3967/bes2025.061
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  Objective  Despite the global decrease in influenza infections during the coronavirus disease 2019 (COVID-19) pandemic, seasonal influenza remains a significant health issue. South Korea, known for its robust pandemic response and high influenza vaccination rates, offers a unique context for examining changes in vaccination trends during the pandemic. Using nationally representative data, we aimed to understand the impact of the pandemic on influenza vaccination behavior over a 12-year period and to identify vulnerable groups.  Methods  We analyzed influenza vaccination rates in South Korea between 2011–2022, focusing on pandemic-related impacts. The data of 2,426,139 adults (≥ 19 years) from the Korea Community Health Survey were used to assess demographic and sociological factors influencing vaccination behaviors.  Results  We observed an increase in influenza vaccination rates during the pre-COVID-19 period from 2011–2013 (weighted prevalence: 46.68% [95% confidence interval (CI): 46.55–46.82]) to 2017–2019 (weighted prevalence: 52.50% [95% CI: 52.38–52.63]). However, a significant decline was observed in 2022, the late-COVID-19 pandemic period (weighted prevalence: 55.78% [95% CI: 55.56–56.01]), compared with the mid-pandemic period in 2021 (weighted prevalence: 59.12% [95% CI: 58.91– 59.32]), particularly among populations traditionally prioritized for influenza vaccination, including older adults (≥ 65 years) and patients with chronic diseases and low educational and income levels.  Conclusion  The influenza vaccination rate in South Korea was significantly affected by the COVID-19 pandemic, showing a notable decrease among vulnerable demographic groups. This suggests the need for targeted public health strategies to address vaccine hesitancy and improve vaccination rates, particularly among high-risk populations.
(Meta)transcriptomic Insights into the Role of Ticks in Poxvirus Evolution and Transmission: A Multicontinental Analysis
Yuxi Wang, Jingjing Hu, Jingjing Hou, Xiaojie Yuan, Weijie Chen, Yanjiao Li, Qile Gao, Yue Pan, Shuiping Lu, Qi Chen, Siru Hu, Zhongjun Shao, Chenglong Xiong
In press  doi: 10.3967/bes2025.062
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  Objective  Poxviruses are zoonotic pathogens that infect humans, mammals, vertebrates, and arthropods. However, the specific role of ticks in transmission and evolution of these viruses remains unclear.  Methods  Transcriptomic and metatranscriptomic raw data from 329 sampling pools of seven tick species across five continents were mined to assess the diversity and abundance of poxviruses. Chordopoxviral sequences were assembled and subjected to phylogenetic analysis to trace the origins of the unblasted fragments within these sequences.  Results  Fifty-eight poxvirus species, representing two subfamilies and 20 genera, were identified, with 212 poxviral sequences assembled. A substantial proportion of AT-rich fragments were detected in the assembled poxviral genomes. These genomic sequences contained fragments originating from rodents, archaea, and arthropods.  Conclusion  Our findings indicate that ticks play a significant role in the transmission and evolution of poxviruses. These viruses demonstrate the capacity to modulate virulence and adaptability through horizontal gene transfer, gene recombination, and gene mutations, thereby promoting co-existence and co-evolution with their hosts. This study advances understanding of the ecological dynamics of poxvirus transmission and evolution and highlights the potential role of ticks as vectors and vessels in these processes.
Is There an Association Between Per- and Poly-Fluoroalkyl Substances and Serum Pepsinogens? Evidence from Linear Regression and Bayesian Kernel Machine Regression Analyses
Jing Wu, Shenglan Yang, Yiyan Wang, Yuzhong Yan, Ming Li
In press  doi: 10.3967/bes2025.060
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Waist Circumference Status and Distribution in Chinese Adults: China Nutrition and Health Surveillance (2015–2017)
Jing Nan, Mulei Chen, Hongtao Yuan, Qiuye Cao, Dongmei Yu, Wei Piao, Fusheng Li, Yuxiang Yang, Liyun Zhao, Shuya Cai
In press  doi: 10.3967/bes2025.059
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Cover
2025-5 Cover
2025, 38(5).  
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2025-5 Contents
2025, 38(5): 1-2.  
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Editorial
Building China’s Burden of Disease Research System: Priorities and Pathways
Peng Yin, Maigeng Zhou
2025, 38(5): 527-528.   doi: 10.3967/bes2025.055
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Original Article
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
2025, 38(5): 529-538.   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.
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
2025, 38(5): 539-546.   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.  Conclusion  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.
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
2025, 38(5): 547-556.   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 (migraine and tension-type headache [TTH]) 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, migraine, and TTH 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 accounted 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.
Disease Burden and Trends of COPD in the Asia-Pacific Region (1990–2019) and Predictions to 2034
Jing Ma, Hong Mi
2025, 38(5): 557-570.   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 and territories 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.
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
2025, 38(5): 571-584.   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 relative survival rates (RSRs)/net survival rates (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.
Identifying High-Risk Areas for Type 2 Diabetes Mellitus Mortality in Guangdong, China: Spatiotemporal Clustering and Socioenvironmental Determinants
Haiming Luo, Wenbiao Hu, Yanjun Xu, Xueyan Zheng, Qun He, Lu Lyu, Ruilin Meng, Xiaojun Xu, Fei Zou
2025, 38(5): 585-597.   doi: 10.3967/bes2025.048
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  Objective   This study aimed to identify high-risk areas for type 2 diabetes mellitus (T2DM) mortality to provide relevant evidence for interventions in emerging economies.  Methods   Empirical Bayesian Kriging and a discrete Poisson space-time scan statistic were applied to identify the spatiotemporal clusters of T2DM mortality. The relationships between economic factors, air pollutants, and the mortality risk of T2DM were assessed using regression analysis and the Poisson Log-linear Model.  Results   A coastal district in East Guangdong, China, had the highest risk (Relative Risk [RR] = 4.58, P < 0.01), followed by the 10 coastal districts/counties in West Guangdong, China (RR = 2.88, P < 0.01). The coastal county in the Pearl River Delta, China (RR = 2.24, P < 0.01), had the third-highest risk. The remaining risk areas were two coastal counties in East Guangdong, 16 districts/counties in the Pearl River Delta, and two counties in North Guangdong, China. Mortality due to T2DM was associated with gross domestic product per capita (GDP per capita). In pilot assessments, T2DM mortality was significantly associated with carbon monoxide.  Conclusion   High mortality from T2DM occurred in the coastal areas of East and West Guangdong, especially where the economy was progressing towards the upper middle-income level.
Lumbar Spondylolysis in Chinese Adults: Prevalence and Musculoskeletal Conditions
Dong Yan, Yandong Liu, Ling Wang, Kai Li, Wenshuang Zhang, Yi Yuan, Jian Geng, Kangkang Ma, Fengyun Zhou, Zitong Cheng, Xiaoguang Cheng
2025, 38(5): 598-606.   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, and 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   One hundred and seventeen 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 smaller 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.
Synaptic Vesicle Glycoprotein 2A Slows down Amyloidogenic Processing of Amyloid Precursor Protein via Regulating Its Intracellular Trafficking
Qian Zhang, Xiaoling Wang, Yuli Hou, Jingjing Zhang, Congcong Liu, Xiaomin Zhang, Yaqi Wang, Yujian Fan, Junting Liu, Jing Liu, Qiao Song, Peichang Wang
2025, 38(5): 607-624.   doi: 10.3967/bes2025.049
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  Objective  To reveal the effects and potential mechanisms by which synaptic vesicle glycoprotein 2A (SV2A) influences the distribution of amyloid precursor protein (APP) in the trans-Golgi network (TGN), endolysosomal system, and cell membranes and to reveal the effects of SV2A on APP amyloid degradation.  Methods  Colocalization analysis of APP with specific tagged proteins in the TGN, ensolysosomal system, and cell membrane was performed to explore the effects of SV2A on the intracellular transport of APP. APP, β-site amyloid precursor protein cleaving enzyme 1 (BACE1) expressions, and APP cleavage products levels were investigated to observe the effects of SV2A on APP amyloidogenic processing.  Results  APP localization was reduced in the TGN, early endosomes, late endosomes, and lysosomes, whereas it was increased in the recycling endosomes and cell membrane of SV2A-overexpressed neurons. Moreover, Arl5b (ADP-ribosylation factor 5b), a protein responsible for transporting APP from the TGN to early endosomes, was upregulated by SV2A. SV2A overexpression also decreased APP transport from the cell membrane to early endosomes by downregulating APP endocytosis. In addition, products of APP amyloid degradation, including sAPPβ, Aβ1-42, and Aβ1-40, were decreased in SV2A-overexpressed cells.  Conclusion  These results demonstrated that SV2A promotes APP transport from the TGN to early endosomes by upregulating Arl5b and promoting APP transport from early endosomes to recycling endosomes-cell membrane pathway, which slows APP amyloid degradation.
Letter
Perioperative Cardiac Arrest in Mechanically Ventilated Older Patients Undergoing Thoracic Surgery
Wenjun Liu, Shuyu Zhang, Sheng Wang
2025, 38(5): 625-628.   doi: 10.3967/bes2025.035
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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
2025, 38(5): 629-632.   doi: 10.3967/bes2025.039
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Effects of Ozone Exposure on Cardiopulmonary Function and Adaptive Responses in Han and Tibetan Children during Physical Activity at High Altitudes
Mengyao Bian, Ling Qi, Qian Guo, Yuchen Zhao, Xiaoli Duan
2025, 38(5): 633-638.   doi: 10.3967/bes2025.054
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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
2025, 38(5): 639-643.   doi: 10.3967/bes2025.037
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Co-Circulation of Respiratory Pathogens that Cause Severe Acute Respiratory Infections during the Autumn and Winter of 2023 in Beijing, China
Jingzhi Li, Da Huo, Daitao Zhang, Jiachen Zhao, Chunna Ma, Dan Wu, Peng Yang, Quanyi Wang, Zhaomin Feng
2025, 38(5): 644-648.   doi: 10.3967/bes2025.050
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Correction
Correction
2025, 38(5): 649-649.  
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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](12304) [PDF 3875KB](5248)
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](16323) [FullText HTML](7660) [PDF 2336KB](7660)
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](8749) [FullText HTML](3071) [PDF 11333KB](3071)
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](9705) [FullText HTML](3568) [PDF 2552KB](3568)
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](8685) [FullText HTML](4063) [PDF 1561KB](4063)
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](6606) [PDF 528KB](2778)
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](7796) [FullText HTML](2877) [PDF 3641KB](2877)
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](5067) [PDF 8784KB](2015)
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](3613) [FullText HTML](1684) [PDF 10064KB](1684)
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](7369) [PDF 610KB](1874)
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](5144) [FullText HTML](2019) [PDF 4691KB](2019)
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](5522) [FullText HTML](1722) [PDF 2914KB](1722)
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](3632) [FullText HTML](1857) [PDF 2174KB](1857)
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](3143) [PDF 803KB](1241)
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](6182) [FullText HTML](1891) [PDF 31943KB](1891)
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](3321) [FullText HTML](1504) [PDF 1202KB](1504)
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](5415) [FullText HTML](2315) [PDF 2249KB](2315)
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](5362) [FullText HTML](1445) [PDF 9101KB](1445)
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](3875) [FullText HTML](1893) [PDF 2205KB](1893)
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](4639) [FullText HTML](1680) [PDF 671KB](1680)

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Vol 38, No 5

(May, 2025)

ISSN 0895-3988

CN 11-2816/Q

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