Biomedical and Environmental Sciences

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).

The Impacts of Major Chronic Diseases on Changes in Healthy Life Expectancy Among Older Adults in China from 2011 to 2020

Xiang Cui, Fangchao Liu, Shenying Fang, Zixing Zhang, Jianli Wang, Jian Liao, Dongfeng Gu

In press doi: 10.3967/bes2025.064

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Objectives This study aimed to quantify the impact of major chronic diseases on changes in healthy life expectancy (HLE) from 2011 to 2020 in China using an age-specific disability weights (DW) estimation method. Methods HLE at age 60 (HLE₆₀) was used as the indicator of HLE in China. Cause-specific mortality rates were obtained from the cause-of-death database of the National Health Commission. Self-reported disease and disability status were derived from the China Health and Retirement Longitudinal Study. A total of 55,861 participants were included for DW estimation. Rates of disability, which was assessed using the Activities of Daily Living questionnaires, were estimated using data from 5,465 participants in 2011 and 9,910 participants in 2020. Age-specific DWs were calculated using a Bayesian logistic regression model. Changes in HLE₆₀ were decomposed into mortality and disability effects by cause, based on the estimated DWs. Results HLE₆₀ in China increased by 0.83 years from 2011 to 2020. Ischemic heart disease (IHD) contributed the most to the decline in HLE₆₀, remaining the leading cause of reduction in terms of mortality effects. Diabetes showed the greatest impact on HLE₆₀ due to disability, followed by stroke. The largest sex disparities in HLE₆₀ were associated with disability from arthritis. Conclusion HLE₆₀ in China improved from 2011 to 2020 and IHD remained the leading contributor to its decline, particularly through increased mortality. Disabilities related to diabetes, stroke, and arthritis had significant negative impacts. These findings highlight the need to strengthen integrated chronic disease prevention and rehabilitation services at community health centers.

Association between PM_2.5 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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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.

The Association between Serum Chloride Levels and Prognosis in Patients with Hepatic Coma in the Intensive Care Unit.

Shuxing Wei, Xiya Wang, Yuan Du, Ying Chen, Jinlong Wang, Yue Hu, Wenqing Ji, Xingyan Zhu, Xue Mei, Da Zhang

In press doi: 10.3967/bes2025.092

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Objective To explore the relationship between serum chloride levels and prognosis in intensive care unit (ICU) patients with hepatic coma. Methods We analyzed 545 ICU patients with hepatic coma from the MIMIC-IV database. Associations between serum chloride levels and 28-day and 1-year mortality were assessed using restricted cubic splines (RCS), Kaplan-Meier (KM) curves, and Cox regression. Subgroup analyses, external validation, and mechanistic studies were also conducted. Results A total of 545 patients were included. RCS analysis revealed a U-shaped association between serum chloride levels and mortality in hepatic coma patients. KM curves indicated lower survival rates among patients with low chloride levels (<103 mmol/L). Low chloride levels were independently linked to increased 28-day and 1-year all-cause mortality. In multivariate models, the hazard ratio (HR) for 28-day mortality in the low chloride group was 1.424 (95% CI: 1.041-1.949), while the adjusted HR for 1-year mortality was 1.313 (95% CI: 1.026-1.679). Subgroup analyses and External validation supported these findings. Cytological experiments suggest that low chloride may activate the phosphorylation of the NF-κB signaling pathway, promote the expression of pro-inflammatory cytokines, and reduce neuronal cell viability. Conclusions Low serum chloride is independently associated with increased mortality in hepatic coma patients.

Anthropometric Obesity Measures and Diabetes Progression from Prediabetes in Older Adults: A Comparison of American Diabetes Association and World Health Organization Criteria

Xiujuan Zhang, Huijie An, Virginia Byers Kraus, Xin Gao, Yunfan Li, Bowen Wang, Zhaoxue Yin

Corrected proof doi: 10.3967/bes2025.090

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Background This study examined the associations between obesity indices and the risk of diabetes progression from prediabetes in the older adults, comparing the difference in using ADA and WHO criteria. Methods Data were obtained from the Healthy Aging Evaluation Longitudinal Study in China. Among participants without diabetes at baseline, prediabetes was classified based on fasting plasma glucose using both ADA and WHO criteria. Body mass index (BMI) and waist circumference (WC) were categorized by data distribution and diagnostic cut-off values, respectively. Cox proportional hazards regression models estimated adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) for obesity-related indices and diabetes progression from prediabetes. Results Among 1127 participants classified as prediabetic by ADA criteria, 474 also met WHO criteria. Under ADA-defined prediabetes, the highest WC quartile (≥93cm) was significantly associated with increased diabetes risk with aHR 1.93 (1.06, 3.53, P<0.05), while BMI-related and cut-off-based abdominal obesity showed no significant associations (P>0.05). Under WHO-defined prediabetes, both the high tertile of WC (≥90cm) and general obesity (BMI ≥28.0 kg/m²) were significantly associated with progression to diabetes (P<0.05), with aHR 2.13 (1.06, 4.27) and 2.44 (1.19, 5.01), respectively. However, cut-off-based abdominal obesity and the high BMI tertile (≥25.75 kg/m²) were not significantly associated with progression to obesity (P>0.05). Conclusion : Elevated WC, rather than BMI-based indices or cut-off-based abdominal obesity, was significantly associated with progression to diabetes using ADA-defined prediabetes criteria. However, both evaluated WC and general obesity predicted progression to diabetes under WHO criteria.

Plasma Metabolites Mediate the Associations of Gut Microbial Diversity with Ambulatory Blood Pressure and its Variability

Zhenghao Tang, Zhennan Lin, Jianxin Li, Fangchao Liu, Jie Cao, Shufeng Chen, Keyong Huang, Hongfan Li, Dongsheng Hu, Jianfeng Huang, Dongfeng Gu, Xiangfeng Lu

In press doi: 10.3967/bes2025.089

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Objective Evidence suggests that depleted gut microbial α-diversity is associated with hypertension; however, whether metabolic markers affect this relationship remains unknown. We aimed to determine the potential metabolites mediating the associations of α-diversity with blood pressure (BP) and BP variability (BPV). Methods Metagenomics and plasma targeted metabolomics were conducted on 523 Chinese participants from the MetaSalt study. The 24-hour, daytime, and nighttime BP and BPV were calculated based on ambulatory BP measurements. Linear mixed models were used to characterize the relationships between α-diversity (Shannon and Chao1 index) and BP indices. Mediation analyses were performed to assess the contribution of metabolites to the observed associations. The influence of key metabolites on hypertension was further evaluated in a prospective cohort of 2,169 participants. Results Gut microbial richness (Chao1) was negatively associated with 24-hour systolic BP, daytime systolic BP, daytime diastolic BP, 24-hour systolic BPV, and nighttime systolic BPV (P < 0.05). Moreover, 26 metabolites were strongly associated with richness (Bonferroni P < 0.05). Among them, four key metabolites (imidazole propionate, 2-hydroxy-3-methylbutyric acid, homovanillic acid, and hydrocinnamic acid) mediated the associations between richness and BP indices (proportions of mediating effects: 14.1–67.4%). These key metabolites were also associated with hypertension in the prospective cohort. For example, each 1-standard deviation unit increase in hydrocinnamic acid significantly reduced the risk of prevalent (OR [95% CI] = 0.90 [0.82, 0.99]; P = 0.03) and incident hypertension (HR [95% CI] = 0.83 [0.71, 0.96]; P = 0.01). Conclusion Our results suggest that gut microbial richness correlates with lower BP and BPV, and that certain metabolites mediate these associations. These findings provide novel insights into the pathogenesis and prevention of hypertension.

Association Between Urinary Phthalate and Bisphenol Exposures and Obesity Based on Body Mass Index and Waist Circumference

Xin Peng, Bingsong Zhang, Zixuan Chen, Hongyuan Qi, Ying Zhu, Guoxiao Liang, Zhigang Huang

In press doi: 10.3967/bes2025.088

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Associations of Exposure to Typical Environmental Organic Pollutants with Cardiopulmonary Health and the Mediating Role of Oxidative Stress: A Randomized Crossover Study

Ning Gao, Bin Wang, Ran Zhao, Han Zhang, Xiaoqian Jia, Tianxiang Wu, Mengyuan Ren, Lu Zhao, Jiazhang Shi, Jing Huang, Shaowei Wu, Guofeng Shen, Bo Pan, Mingliang Fang

In press doi: 10.3967/bes2025.087

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Objective The study aim was to investigate the effects of exposure to multiple environmental organic pollutants on cardiopulmonary health with a focus on the potential mediating role of oxidative stress. Methods A repeated-measures randomized crossover study involving healthy college students in Beijing was conducted. Biological samples, including morning urine and venous blood, were collected to measure concentrations of 29 typical organic pollutants, including hydroxy polycyclic aromatic hydrocarbons (OH-PAHs), bisphenol A and its substitutes, phthalates and their metabolites, parabens, and five biomarkers of oxidative stress. Health assessments included blood pressure measurements and lung function indicators. Results Urinary concentrations of 2-hydroxyphenanthrene (2-OH-PHE) (β = 4.35% (95% confidence interval (CI): 0.85%, 7.97%)), 3-hydroxyphenanthrene (β = 3.44% (95% CI: 0.19%, 6.79%)), and 4-hydroxyphenanthrene (4-OH-PHE) (β = 5.78% (95% CI: 1.27%, 10.5%)) were significantly and positively associated with systolic blood pressure. Exposures to 1-hydroxypyrene (1-OH-PYR) (β = 3.05% (95% CI: −4.66%, −1.41%)), 2-OH-PHE (β = 2.68% (95% CI: −4%, −1.34%)), and 4-OH-PHE (β = 3% (95% CI: −4.68%, −1.29%)) were negatively associated with the ratio of forced expiratory volume in the first second to forced vital capacity. These findings highlight the adverse effects of exposure to multiple pollutants on cardiopulmonary health. Biomarkers of oxidative stress, including 8-hydroxy-2'-deoxyguanosine and extracellular superoxide dismutase, mediated the effects of multiple OH-PAHs on blood pressure and lung function. Conclusion Exposure to multiple organic pollutants can adversely affect cardiopulmonary health. Oxidative stress is a key mediator of the effects of OH-PAHs on blood pressure and lung function.

Relationship between Coarse Cereal Consumption and Body Fat Percentage among Chinese School-aged Children

Tingting Gao, Wei Cao, Titi Yang, Peipei Xu, Juan Xu, Qian Gan, Hongliang Wang, Hui Pan, Yingying Zhao, Kai You, Qingbin Xing, Wenhua Zhao, Zhenyu Yang, Qian Zhang

In press doi: 10.3967/bes2025.086

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Objective The rising prevalence of childhood obesity is closely associated with suboptimal dietary patterns. To address this public health concern, we conducted a comprehensive study to examine the association between coarse cereal consumption and body fat percentage (BFP) in Chinese children and adolescents. Methods The study included 48,305 children aged 6–17 years from 28 districts/counties in 14 provinces across seven regions of China (24,152 girls and 24,153 boys). BFP was examined using bioelectrical impedance analysis in the early morning. Coarse cereal consumption was assessed using a Food Frequency Questionnaire and categorized into three groups: 0 g/d/1000 kcal, 0–10 g/d/1000 kcal, and > 10 g/d/1000 kcal (daily consumption of coarse cereals × 1000/total energy consumption). Quantile regression model was used to analyze the association between coarse cereals and BFP, adjusting for potential confounders such as age, pubertal development stage, urban/rural and regional factors, total daily dietary energy consumption, sedentary time, moderate-to-high physical activity, household income, parental education, and consumption of other foods. Results Boys aged 6–10, 11–14, and 15–17 years had median daily coarse cereal consumptions of 6.6 g, 7.1 g, and 5.7 g, with BFP of 19.6%, 19.5%, and 17.5% (all P < 0.05). Girls in the same age groups showed consumption of 7.1 g, 8.4 g, and 6.7 g, with BFP of 20.3%, 26.4%, and 31.0% (all P < 0.05). The quantile regression results for boys showed that daily consumption of coarse cereals was significantly correlated with their BFP in the 0.15, 0.25, and 0.50 quartiles, with regression coefficients of −0.257, −0.221, and −0.330, respectively, after adjusting for potential confounders (P < 0.05). For girls, there was a significant correlation with PBF at the 0.05, 0.15, 0.25, 0.50, 0.75, and 0.85 quartiles, with regression coefficients of −0.258, −0.366, −0.372, −0.431, −0.472, and −0.503 (P < 0.05 for all). Conclusions Coarse cereals consumption among Chinese children and adolescents remains relatively low. Higher consumption was inversely associated with BFP in children aged 6–17 years. Future interventional studies should assess how increased coarse cereal consumption prevents childhood obesity.

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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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.

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.

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.

Sex-specific Association of Telomere Length with Individualized Expected Years of Life Lost among 203,731 Males and 241,668 Females

Feifei Xu, Chenjie Li, Yifan Wang, Xiao Wang, Yumnah Babar, Shuang Liang, Fan Yang, Zhazheng He, Honggang Yi, Juncheng Dai

In press doi: 10.3967/bes2025.053

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Objective Telomere length is a key aging biomarker, but its sex-specific impact on individualized life expectancy remains uncertain. This study explores sex differences in leukocyte telomere length (LTL) and individualized expected years of life lost (YLL). Methods A prospective cohort of 445,399 participants (203,731 males and 241,668 females) from the UK Biobank was analyzed. LTL values were log-transformed, and YLL was calculated using life tables. Multiple linear regression was applied to examine sex-specific associations. Results In males, each standard deviation (S.D.) increase in LTL was linked to a 0.965-year decrease in YLL (95% CI: –1.025, –0.900; P < 0.001). In females, longer LTL was related to a 0.102-year increase in YLL (95% CI: 0.057, 0.146; P < 0.001). Among postmenopausal females, LTL showed a protective effect similar to that in males (0.387-year decrease, 95% CI: −0.446, –0.328; P < 0.001), while premenopausal females exhibited a detrimental association (0.705-year increase, 95% CI: 0.625, 0.785; P < 0.001). Comparable trends were observed across major aging-related diseases, pointing to a consistent biological pattern. Conclusion The influence of LTL on life expectancy varies significantly by sex, with protective associations seen in males and postmenopausal females. This suggests hormonal involvement in telomere dynamics. The results support integrating sex-specific perspectives into aging and telomere research and clinical practice.

Association of Longitudinal Change in Fasting Blood Glucose with Risk of Cerebral Infarction in a Patients with Diabetes

Taiyang Luo, Xuan Deng, Xueyu Chen, Yuhe Liu, Shuohua Chen, Haoran Sun, Ziwei Yin, Shouling Wu, Yong Zhou, Xingdong Zheng

In press doi: 10.3967/bes2025.052

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Objective To investigate the association between long-term glycemic control and cerebral infarction risk in patients with diabetes through a large-scale cohort study. Methods This prospective, community-based cohort study included 12,054 patients with diabetes. From 2006 to 2012, 38,272 fasting blood glucose (FBG) measurements were obtained from these participants. FBG trajectory patterns were generated using latent mixture modelling. Cox proportional hazards models were applied to assess the subsequent risk of cerebral infarction associated with different FBG trajectory patterns. Results At baseline, the mean age of the participants was 55.2 years. Four distinct FBG trajectories were identified based on FBG concentrations and their changes over the 6-year follow-up period. After a median follow-up of 6.9 years, 786 cerebral infarction events were recorded. Different trajectory patterns were associated with significantly varied outcome risks (Log-Rank P < 0.001). Compared with the low-stability group, Hazard Ratio (HR) adjusted for potential confounders were 1.37 for the moderate-increasing group, 1.23 for the elevated-decreasing group, and 2.08 for the elevated-stable group. Conclusion Sustained high FBG levels were found to play a critical role in the development of ischemic stroke among patients with diabetes. Controlling FBG levels may reduce the risk of cerebral infarction.

Analysis of Tongue and Face Image Features of Anemic Women and Construction of Risk-Screening Model

Hongyuan Fu, Yi Chun, Yahan Zhang, Yu Wang, Yulin Shi, Tao Jiang, Xiaojuan Hu, Liping Tu, Yongzhi Li, Jiatuo Xu

In press doi: 10.3967/bes2025.047

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Objective To identify the key features of facial and tongue images associated with anemia in female populations, establish anemia risk-screening models, and evaluate their performance. Methods A total of 533 female participants (anemic and healthy) were recruited from Shuguang Hospital. Facial and tongue images were collected using the TFDA-1 tongue and face diagnosis instrument. Color and texture features from various parts of facial and tongue images were extracted using Face Diagnosis Analysis System (FDAS) and Tongue Diagnosis Analysis System version 2.0 (TDAS v2.0). Least Absolute Shrinkage and Selection Operator (LASSO) regression was used for feature selection. Ten machine learning models and one deep learning model (ResNet50V2 + Conv1D) were developed and evaluated. Results Anemic women showed lower a-values, higher L- and b-values across all age groups. Texture features analysis showed that women aged 30–39 with anemia had higher angular second moment (ASM)and lower entropy (ENT) values in facial images, while those aged 40–49 had lower contrast (CON), ENT, and MEAN values in tongue images but higher ASM. Anemic women exhibited age-related trends similar to healthy women, with decreasing L-values and increasing a-, b-, and ASM-values. LASSO identified 19 key features from 62. Among classifiers, the Artificial Neural Network (ANN) model achieved the best performance [area under the curve (AUC): 0.849, accuracy: 0.781]. The ResNet50V2 model achieved comparable results [AUC: 0.846, accuracy: 0.818]. Conclusion Differences in facial and tongue images suggest that color and texture features can serve as potential TCM phenotype and auxiliary diagnostic indicators for female anemia.

Bone Injury and Fracture Healing Biology

Ahmad Oryan, Somayeh Monazzah, Amin Bigham-Sadegh

2015, 28(1): 57-71. doi: 10.3967/bes2015.006

[Abstract](12510) [PDF 3875KB](5336)

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](17143) [FullText HTML](8040) [PDF 2336KB](8040)

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](8860) [FullText HTML](3123) [PDF 11333KB](3123)

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](9943) [FullText HTML](3677) [PDF 2552KB](3677)

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](9517) [FullText HTML](4450) [PDF 1561KB](4450)

Effects of Short-Term Forest Bathing on Human Health in a Broad-Leaved Evergreen Forest in Zhejiang Province, China

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Current Issue

Vol 38, No 7

(August, 2025)

ISSN 0895-3988

CN 11-2816/Q

2024 Impact Factor 4.1
2024 Journal Citation Reports

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Causal Associations between Particulate Matter 2.5 (PM_2.5), PM_2.5 Absorbance, and Inflammatory Bowel Disease Risk: Evidence from a Two-Sample Mendelian Randomization Study

Xu Zhang, Zhimeng Wu, Lu Zhang, Binglong Xin, Xiangrui Wang, Xinlan Lu, Guifang Lu, Mudan Ren, Shuixiang He, Yarui Li

Association of Co-Exposure to Polycyclic Aromatic Hydrocarbons and Metal(loid)s with the Risk of Neural Tube Defects: A Case-Control Study in Northern China

Xiaoqian Jia, Yuan Li, Lei Jin, Lailai Yan, Yali Zhang, Jufen Liu, Le Zhang, Linlin Wang, Aiguo Ren, Zhiwen Li

Association between Organochlorine Exposures and Lung Functions Modified by Thyroid Hormones and Mediated by Inflammatory Factors among Healthy Older Adults

Xiaojie Guo, Huimin Ren, Jiran Zhang, Xiao Ma, Shilu Tong, Song Tang, Chen Mao, Xiaoming Shi

The Impacts of Climate Change on the Environment and Human Health in China: A Call for more Ambitious Action

Shilu Tong, Yu Wang, Yonglong Lu, Cunde Xiao, Qiyong Liu, Qi Zhao, Cunrui Huang, Jiayu Xu, Ning Kang, Tong Zhu, Dahe Qin, Ying Xu, Buda Su, Xiaoming Shi

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Causal Associations between Particulate Matter 2.5 (PM2.5), PM2.5 Absorbance, and Inflammatory Bowel Disease Risk: Evidence from a Two-Sample Mendelian Randomization Study

Xu Zhang, Zhimeng Wu, Lu Zhang, Binglong Xin, Xiangrui Wang, Xinlan Lu, Guifang Lu, Mudan Ren, Shuixiang He, Yarui Li

Association of Co-Exposure to Polycyclic Aromatic Hydrocarbons and Metal(loid)s with the Risk of Neural Tube Defects: A Case-Control Study in Northern China

Xiaoqian Jia, Yuan Li, Lei Jin, Lailai Yan, Yali Zhang, Jufen Liu, Le Zhang, Linlin Wang, Aiguo Ren, Zhiwen Li

Association between Organochlorine Exposures and Lung Functions Modified by Thyroid Hormones and Mediated by Inflammatory Factors among Healthy Older Adults

Xiaojie Guo, Huimin Ren, Jiran Zhang, Xiao Ma, Shilu Tong, Song Tang, Chen Mao, Xiaoming Shi

The Impacts of Climate Change on the Environment and Human Health in China: A Call for more Ambitious Action

Shilu Tong, Yu Wang, Yonglong Lu, Cunde Xiao, Qiyong Liu, Qi Zhao, Cunrui Huang, Jiayu Xu, Ning Kang, Tong Zhu, Dahe Qin, Ying Xu, Buda Su, Xiaoming Shi

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Causal Associations between Particulate Matter 2.5 (PM_2.5), PM_2.5 Absorbance, and Inflammatory Bowel Disease Risk: Evidence from a Two-Sample Mendelian Randomization Study