Influenza pandemics in history all caused immeasurable losses of human life and health. With climate change, population ageing, and increased population mobility due to globalization, the preparedness for influenza pandemics faces even greater challenges. To minimize the negative impacts of a pandemic, comprehensive assessments of influenza pandemic preparedness are needed. This paper introduces a series of guidances and assessment tools developed by different countries and international organizations for influenza pandemic preparedness, and compares their strengths and limitations to provide references and recommendations for the development of assessment tools for influenza pandemic preparedness in China. 历史上每次全球范围的流感大流行都给人类带来了难以估量的生命健康损失，随着气候变化、人口老龄化、全球化所致人口流动性增强，流感大流行的应对也面临更大挑战。为了尽可能降低大流行带来的负面影响，需要对流感大流行准备情况进行全面评估。本文概述了不同国家和国际组织在流感大流行准备方面开发的一系列指导政策和评估工具，针对其优势和局限性进行了讨论。以期在新的流感大流行防控形势下，为我国的流感大流行准备评估工具开发提供参考和建议。.
Objective: To evaluate the immunogenicity and safety of a booster dose of varicella attenuated live vaccine administered at different time intervals in Chinese children aged 7-12 years. Methods: This study was conducted in Xuzhou City, Jiangsu Province, from October 2024 to October 2025 using an open-label design. Children aged 7 to 12 who had received the initial immunization of the attenuated live varicella vaccine were recruited as the research subjects. They were divided into 4 groups based on the time interval from primary immunization to booster immunization (3, 18, 36 and 60 months groups). The estimated sample size was 400 (100 in each group).Venous blood samples were collected before booster vaccination and 30 days after vaccination. Serum varicella antibodies were detected by the fluorescent antibody to membrane antigen assay. Geometric mean titer (GMT), geometric mean increase, seropositivity rate and seroconversion rate were calculated to evaluate the booster immune response. Adverse reactions within 30 days after vaccination were observed. Results: At 3, 18, 36, and 60 months post-primary immunization, seropositivity rates remained at high levels (92.05%-94.87%), while GMTs showed a significant declining trend (27.03, 21.59, 18.29, and 14.33, respectively, P<0.001). Following the booster dose at 3, 18, 36, and 60 months, GMTs in all groups increased significantly to 87.35, 113.55, 141.80, and 129.01, the antibody levels increased by 3.23, 5.26, 7.75 and 9.00 times respectively compared with those before the booster immunization (P<0.001). Seroconversion rates were 60.26%, 71.60%, 77.27%, and 65.91%, respectively (P>0.05), and the seropositivity rate reached 100% in all groups. The overall incidence of adverse reactions was 0.73%, with no serious adverse events observed. Conclusions: The live attenuated varicella vaccine demonstrates favorable immunogenicity and safety when administered as a booster dose to children aged 7-12 years. A booster inoculation given 36-48 months following primary immunization elicits a more robust antibody response. These findings provide reference evidence to support the implementation of a two-dose varicella vaccination strategy and to determine the optimal timing for booster vaccination among school-aged children in China. 目的： 评价7~12岁儿童水痘减毒活疫苗不同时间间隔加强免疫的免疫原性和安全性。 方法： 2024年10月至2025年10月在江苏省徐州市采用开放标签设计，招募完成水痘减毒活疫苗初次免疫的7~12岁儿童为研究对象，根据初次免疫至加强免疫的时间间隔分为4个组（3、18、36和60个月组），样本量估计为400名（每组100名），采集加强免疫前及免疫后30 d静脉血，采用膜抗原荧光抗体法检测血清中的水痘抗体，计算几何平均滴度（GMT）、几何平均增长倍数、阳性率和阳转率，评价加强免疫效果，并观察接种后30 d内的不良反应。 结果： 在412名研究对象中，初次免疫后3、18、36和60个月，血清抗体阳性率仍维持在较高水平（92.05%~94.87%），GMTs随时间呈下降趋势（分别为27.03、21.59、18.29和14.33，P<0.001）。间隔3、18、36和60个月加强免疫后，各组GMT较加强免疫前均显著升高，分别为87.35、113.55、141.80和129.01，抗体水平较加强免疫前分别增长3.23、5.26、7.75和9.00倍（P<0.001），抗体阳转率分别为60.26%、71.60%、77.27%和65.91%（P>0.05），血清阳性率均达100.00%。各组加强免疫后不良反应发生率为0.73%，未观察到严重不良事件。 结论： 水痘减毒活疫苗在7~12岁儿童中加强免疫具有良好的免疫原性和安全性，初次免疫后36~48个月接种可诱导更强抗体应答。本研究为我国学龄儿童实施两剂次水痘疫苗免疫策略及加强免疫时机提供了参考依据。.
Ideology and politics elements in professional curriculum can play an important role in cultivating qualified professionals with correct morality. Applying visualization technology in ideology and politics education can integrate teaching resources sufficiently, facilitate students' understanding, thus improve their learning efficiency and teachers' teaching performance. This paper summarizes the current research status of the visualization of ideology and politics elements in professional curriculum, explore its cutting-edge development trends, and provide references for the development visualization of ideology and politics elements and improvement of its teaching quality for Epidemiology curriculum. 课程思政是通过挖掘专业课程的思想政治元素，在课程教学各环节贯彻执行思想政治教育，以完成“立德树人”任务的教育教学理念。将可视化技术融入课程思政，能够充分整合教学资源，直观展现思政元素，便于学习理解，进而提高学生学习效率及教师教学效果。本文旨在总结目前课程思政资源可视化的研究现状，探讨其前沿发展趋势，并为发展《流行病学》课程思政资源可视化及提升课程思政教学质量提供参考。.
Objective: To investigate the causal association between snoring and chronic obstructive pulmonary disease (COPD), and the role of obesity in their relationship. Methods: Based on the individual-level data from the United Kingdom Biobank prospective cohort, a Cox proportional hazards regression model was carried out to estimate the association between snoring at baseline survey and the risk for COPD (n=254 757, 3 438 COPD cases). Multivariable logistic regression analysis was conducted to assess the association between COPD and the probability of snoring (n=22 096, 3 481 snorers). Univariable Mendelian randomization (MR), multivariate MR (MVMR) analyses were conducted on causal association of snoring and obesity [BMI, waist circumference adjusted for BMI (WCadjBMI)], and COPD. Results: Snoring at baseline survey was positively associated with the risk for COPD in the prospective cohort analysis (HR=1.20, 95%CI: 1.12-1.29). With applying MR approach, genetically predicted one-fold increased probability of snoring was associated with 77% (inverse-variance weighted: OR=1.77, 95%CI: 1.04-3.00) higher risk for COPD. After adjustment for obesity, snoring at baseline survey was not statistically associated with the risk for COPD (HR=1.07, 95%CI: 1.00-1.14, P=0.067). No significant association was observed between COPD at baseline survey and the probability of snoring (OR=0.91, 95%CI: 0.81-1.02). No causal association between snoring and COPD was observed in the MVMR analysis. Conclusions: The prospective cohort and MR analysis showed consistent evidence that obesity contributed to the association between snoring and COPD. Management of obesity, especially the general obesity, might be an important strategy for the prevention of COPD. 目的： 探讨打鼾与慢性阻塞性肺疾病（COPD）的因果关联，以及肥胖在该关联中的作用。 方法： 基于英国生物银行的前瞻性队列个体数据，采用Cox比例风险回归模型分析基线打鼾与COPD发病风险的关联（n=254 757，随访期间3 438名研究对象新发COPD）；并采用多因素logistic回归模型分析COPD与打鼾发生概率之间可能的关联（n=22 096，3 481名研究对象在基线至第二次重复调查期间新发打鼾）。采用单变量孟德尔随机化（MR）、多变量MR（MVMR）探讨打鼾、肥胖［BMI、经BMI校正的腰围（WCadjBMI）］与COPD的因果关联。 结果： 前瞻性队列分析中，基线打鼾与COPD发病风险呈正相关（HR=1.20，95%CI：1.12~1.29）。MR分析中，遗传预测的打鼾发生概率每升高1倍，COPD发病风险升高77%（逆方差加权法：OR=1.77，95%CI：1.04~3.00）。调整肥胖后，基线打鼾与COPD发病风险无统计学关联（HR=1.07，95%CI：1.00~1.14，P=0.067），基线患COPD与打鼾发生概率之间无统计学关联（OR=0.91，95%CI：0.81~1.02）。MVMR分析中未观察到打鼾与COPD的因果关联。 结论： 前瞻性队列与MR研究一致表明，肥胖因素作用于打鼾与COPD之间的关联。进行肥胖管理，特别是全身性肥胖管理，可能有助于预防COPD发病。.
Objective: To investigate the causal associations between 47 potential risk factors and the risks of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) using Mendelian randomization (MR). Methods: Genome-wide association study summary statistics for 47 exposures, as well as for BE and EAC, were included. The causal associations were evaluated using the random-effects inverse variance weighted method. Horizontal pleiotropy was assessed using MR-Egger and MR-PRESSO methods. The Benjamini-Hochberg method was applied for multiple testing correction. Results: The MR analysis showed that waist-to-hip ratio, body fat percentage, trunk fat mass, trunk fat percentage, whole-body fat mass, and never smoking were causally associated with the risk of BE (adjusted P<0.05). Body mass index, waist circumference, hip circumference, body fat percentage, trunk fat mass, trunk fat percentage, whole-body fat mass, basal metabolic rate, duration of regular smoking, educational attainment (college or above), and years of education were causally associated with the risk of EAC (adjusted P<0.05). Conclusions: Genetically predicted obesity-related traits and never smoking were causally associated with the risk of BE. Obesity-related traits, basal metabolic rate, duration of regular smoking, educational attainment (college or above), and years of education were causally associated with the risk of EAC. 目的： 利用孟德尔随机化（MR）方法探讨47个相关因素与Barrett食管（BE）和食管腺癌（EAC）发病风险之间的因果关联。 方法： 纳入47个因素的全基因组关联研究（GWAS）数据及BE和EAC的GWAS数据，采用随机效应逆方差加权法评估因果关联，并应用MR-Egger和MR-PRESSO方法检验多效性。采用Benjamini-Hochberg方法进行多重检验校正。 结果： MR分析结果显示腰臀比、体脂率、躯干脂肪质量、躯干脂肪率、全身脂肪质量、从不吸烟均与BE发病风险之间有因果关联（校正P<0.05）。BMI、腰围、臀围、体脂率、躯干脂肪质量、躯干脂肪率、全身脂肪质量、基础代谢率、定期规律吸烟时间、文化程度（大学及以上）及受教育年数与EAC发病风险之间有因果关联（校正P<0.05）。 结论： 遗传预测的肥胖相关指标和从不吸烟与BE发病风险之间有因果关联，肥胖相关指标、基础代谢率、定期规律吸烟时间、文化程度（大学及以上）及受教育年数与EAC发病风险之间有因果关联。.
Objective: To investigate the association between exposure to greenbelt in the vicinity of schools and non-suicidal self-injury (NSSI) in children and adolescents, and provide evidence for the improvement of adolescent mental health via environmental interventions. Methods: A prospective cohort study was conducted in 11 092 children and adolescents without NSSI at baseline surveys from 367 public schools in 13 prefectures in Jiangsu Province, with three follow-up surveys conducted between 2022 and 2024. Greenbelt exposure was assessed by using annual average normalized difference vegetation index (NDVI) within a 1 000-meter buffer zone around each school based on the satellite data from Moderate-Resolution Imaging Spectroradiometer of National Aeronautics and Space Administration, USA. Inverse probability weighting based on propensity scores was used to balance confounding factors, and Cox proportional hazards regression model was constructed to evaluate the association between NDVI and the risk of NSSI in adolescents. Following the Schoenfeld residual test, "duration of outdoor activities", a variable against the proportional hazards assumption, was treated as a stratification variable for stratified Cox proportional hazards regression analysis. Additionally, restricted cubic splines (RCS) were used to explore the non-linear dose-response relationship between NDVI and NSSI risk, while subgroup analysis and interaction test were conducted. Results: After weighting, baseline characteristics were similar between the exposure groups with high and low NDVI. The Cox proportional hazards regression analysis revealed that NDVI was a protective factor against NSSI (HR=0.75, 95%CI: 0.67-0.85, P<0.001), with robust findings from sensitivity analyses. Subgroup analyses demonstrated that this association was significant in boy students (HR=0.77,95%CI: 0.64-0.92, P=0.004), girl students (HR=0.74, 95%CI: 0.63-0.87, P<0.001), urban students (HR=0.73, 95%CI: 0.63-0.85,P<0.001), and rural students (HR=0.79, 95%CI: 0.65-0.97, P=0.026). RCS analysis indicated a significant non-linear negative correlation between NDVI and NSSI risk (non-linearity test P<0.001). Conclusions: Higher greenbelt exposure around schools was a protective factor for NSSI in adolescents, and this association was significant across subgroups defined by gender and urban-rural residence. Optimizing greenbelt environments in and around schools might serve as a potential public health strategy for prevention of NSSI in adolescents. 目的： 探讨学校周围绿地空间暴露与儿童青少年非自杀性自伤行为（NSSI）之间的关联，为通过环境干预促进儿童青少年心理健康提供科学依据。 方法： 采用前瞻性队列设计，于江苏省13个地级市的367所公立学校中选取基线无NSSI的儿童青少年11 092人，于2022-2024年进行3次随访调查。基于美国国家航空航天局中分辨率成像光谱仪卫星数据，以学校为中心1 000 m缓冲区内的年均归一化植被指数（NDVI）评估绿地暴露水平。采用倾向性评分逆概率加权平衡混杂因素，并构建Cox比例风险回归模型分析学校周边NDVI与儿童青少年NSSI风险的关联。通过Schoenfeld残差检验后，将违反比例风险假设的户外活动时长作为分层变量进行分层Cox比例风险回归分析。进一步采用限制性立方样条（RCS）探索NDVI与NSSI风险的非线性剂量-反应关系，并进行亚组分析及交互作用检验。 结果： 加权后NDVI高、低暴露组间基线特征均衡。Cox比例风险回归分析结果显示，学校周边NDVI是NSSI的保护因素（HR=0.75，95%CI：0.67~0.85，P<0.001），敏感性分析结果稳健。亚组分析表明，该关联在男生（HR=0.77，95%CI：0.64~0.92，P=0.004）、女生（HR=0.74，95%CI：0.63~0.87，P<0.001）、城区学生（HR=0.73，95%CI：0.63~0.85，P<0.001）和郊县学生（HR=0.79，95%CI：0.65~0.97，P=0.026）中均显著。RCS分析显示NDVI与NSSI风险呈显著非线性负相关（非线性检验P<0.001）。 结论： 学校周边较高的绿地暴露水平是儿童青少年NSSI的保护因素，这一关联在不同性别与城乡儿童青少年亚组中均有统计学意义。优化校园及周边绿地环境可作为预防儿童青少年NSSI的潜在公共卫生策略。.
Objective: To analyze the survival status and influencing factors among HIV-infected individuals in Henan Province during different confirmation periods from 1995 to 2023, and to provide a scientific basis for optimizing the "early detection, early treatment" strategy. Methods: The data were derived from the Chinese Information System for Disease Control and Prevention. HIV-infected individuals was divided into four periods based on confirmation period: 1995-2007, 2008-2013, 2014-2016, and 2017-2023. A retrospective cohort study was conducted. The life table method was used to calculate survival probability, the Kaplan-Meier method was used to estimate median survival time and to draw the survival curve; the log-rank test was used to compare differences between groups, and the Cox proportional hazards regression model was used to analyze the influencing factors of survival. Results: Among the 109 520 HIV-infected individuals, the all-cause mortality density was 3.83/100 person-years, the average survival time was 18.30 years, with a median of 22.57 years; the cumulative survival probabilities at 1, 5, 10, 20, and 30 years were 88.23%, 76.81%, 67.68%, 53.35%, and 40.99% respectively; the survival time of those who received antiretroviral therapy (ART) (27.22 years) was significantly more than that of those who did not receive ART (0.75 years, χ2=61 676.44, P<0.001). Multivariate Cox regression showed that male (aHR=1.31, 95%CI: 1.28-1.34), ≥45 years old (aHR=1.67, 95%CI: 1.48-1.88 for 45-59 years old; aHR=2.82, 95%CI: 2.49-3.19 for ≥60 years old), farmer or migrant worker (aHR=1.43, 95%CI: 1.38-1.48), blood transmission (aHR=1.19, 95%CI: 1.16-1.23), no CD4+ T lymphocytes (CD4) counts (aHR=3.49, 95%CI: 3.37-3.61), not receiving ART (aHR=5.22, 95%CI: 5.07-5.38) were risk factors for survival. The mortality risk of married individuals (aHR=0.85, 95%CI: 0.82-0.89) or divorced/widowed individuals (aHR=0.88, 95%CI: 0.84-0.91) was lower than that of unmarried individuals, and having junior high school (aHR=0.90, 95%CI: 0.88-0.93) or senior high school education (aHR=0.66, 95%CI: 0.63-0.69) was associated with lower mortality risk relative to primary school education. The detailed causes of death were mainly cardiovascular and cerebrovascular diseases (23.32%) and malignant tumors (13.04%). Conclusions: With the continuous optimization and popularization of ART strategies, the long-term survival status among HIV-infected individuals in Henan Province has significantly improved from 1995 to 2023. It is necessary to strengthen early detection and early treatment, focus on key populations such as the elderly, farmers, and migrant workers, promote the co-management of HIV infection and chronic non-communicable diseases like cardiovascular and cerebrovascular diseases, and further improve the quality of life. 目的： 分析1995-2023年河南省不同确证时期HIV感染者生存状况及影响因素，为优化“早发现、早治疗”策略提供依据。 方法： 资料来源于中国疾病预防控制信息系统，将HIV感染者按照确证时间分为4个时期（1995-2007年、2008-2013年、2014-2016年、2017-2023年），采用回顾性队列研究方法，运用寿命表法计算生存概率，Kaplan-Meier法分析中位生存时间并绘制生存曲线，log-rank检验比较组间差异，Cox比例风险回归模型分析HIV感染者生存时间的影响因素。 结果： 共有109 520例HIV感染者纳入分析，全死因死亡密度为3.83/100人年，平均生存时间为18.30年，中位生存时间为22.57年；1、5、10、20、30年累积生存概率分别为88.23%、76.81%、67.68%、53.35%、40.99%；接受抗病毒治疗（ART）者中位生存时间（27.22年）明显多于未接受ART者（0.75年，χ2=61 676.44，P<0.001）。多因素Cox比例风险回归模型分析结果显示，男性（aHR=1.31，95%CI：1.28~1.34）、年龄≥45岁（45~59岁：aHR=1.67，95%CI：1.48~1.88；≥60岁：aHR=2.82，95%CI：2.49~3.19）、农民/农民工（aHR=1.43，95%CI：1.38~1.48）、血液传播（aHR=1.19，95%CI：1.16~1.23）、无CD4+T淋巴细胞（CD4）计数检测结果（aHR=3.49，95%CI：3.37~3.61）、未接受ART（aHR=5.22，95%CI：5.07~5.38）是影响HIV感染者生存时间的危险因素，已婚（aHR=0.85，95%CI：0.82~0.89）、离异/丧偶者（aHR=0.88，95%CI：0.84~0.91）的死亡风险均低于未婚，与小学及以下文化程度者相比，初中（aHR=0.90，95%CI：0.88~0.93）、高中及以上（aHR=0.66，95%CI：0.63~0.69）死亡风险较低。死因以心脑血管疾病（23.32%）、恶性肿瘤（13.04%）为主。 结论： 随着ART策略的不断优化和普及，1995-2023年河南省HIV感染者的长期生存状况得到显著改善。需强化早发现、早治疗，关注老年人、农民/农民工等重点人群，推进HIV感染与心脑血管疾病等慢性病的共病管理，进一步提升生存质量。.
Objective: To investigate the prediction and mediating effects of triglyceride-glucose body mass index (TyG-BMI) on the incidence of stroke. Methods: A total of 18 062 residents free of stroke at baseline surveys of chronic disease cohort study in Pudong New District of Shanghai during 2013-2020 were followed until December 2024. Data were collected through questionnaires, physical examinations, and laboratory tests. Missing data were handled using multiple imputation. A Cox proportional hazards regression model was constructed to predict stroke risk and model performance was evaluated by using the concordance index (C-index), time-dependent receiver operating characteristic (ROC) curves, and the Brier score. Subsequently, the prediction and mediating effects of TyG-BMI were analyzed. Results: In the prediction model, the TyG-BMI index showed a HR of 1.00 (95%CI: 1.00-1.01), with a P=0.017. The model demonstrated a C-index of 0.71. Time-dependent area under ROC values were 0.770 (5-year), 0.717 (8-year), and 0.716 (10-year), while Brier scores were 0.005 3 (5-year), 0.043 7 (8-year), and 0.065 2 (10-year). Mediation analysis revealed hypertension mediated 51.9% of total effect of TyG-BMI on stroke (indirect effect: 0.028; total effect: 0.054), diabetes mediated 28.6% of total effect of TyG-BMI on stroke (indirect effect: 0.012; total effect: 0.042). Conclusions: The prediction model demonstrated reasonable accuracy and robustness, indicating that it could serve as a practical tool for screening the populations at high risk. TyG-BMI has both direct and indirect effects, mediated through hypertension or diabetes, on stroke incidence. 目的： 基于浦东新区慢性病危险因素研究队列，探讨甘油三酯葡萄糖体重指数（TyG-BMI）对脑卒中发病的预测效能及中介效应。 方法： 纳入2013-2020年上海市浦东新区18 062名基线无脑卒中居民，随访至2024年12月。通过问卷调查、体格检查和实验室检测收集数据，采用多重填补处理缺失值。使用Cox比例风险回归构建预测模型，通过C指数、时间依赖性受试者工作特征曲线、Brier分数评估模型性能，分析TyG-BMI的预测效能及中介效应。 结果： 预测模型中TyG-BMI的HR值（95%CI）为1.00（1.00~1.01）（P=0.017）。模型的一致性指数为0.71，5、8、10年受试者工作特征曲线下面积分别为0.770、0.717、0.716，Brier分数分别为0.005 3、0.043 7、0.065 2。中介分析结果显示，高血压介导的间接效应（0.028）占TyG-BMI对脑卒中发病总效应（0.054）的51.9%，糖尿病介导的间接效应（0.012）占TyG-BMI对脑卒中发病总效应（0.042）的28.6%。 结论： 本研究构建的脑卒中预测模型具有一定的准确性和稳健性，可为脑卒中高危人群筛查提供实用工具，TyG-BMI对脑卒中的发病存在直接和间接（通过高血压/糖尿病）的影响。.
Objective: To analyze the current status and changing trends of herpes zoster vaccination in Shandong Province from 2020 to 2024 and provide a reference for the prevention and control of herpes zoster in the population. Methods: The first dose of herpes zoster vaccine was collected from the Immunization Information System of Shandong Province from 2020 to 2024, and vaccination coverage was calculated based on population data. The temporal trend in vaccination coverage was analyzed using Joinpoint 5.3.0. Results: The vaccination coverage of the herpes zoster vaccine in Shandong Province showed an upward trend from 2021 to 2024 [average annual percentage change (AAPC)=46.48%, P=0.065], with the highest in 2023 (0.084%). The vaccination coverage of females was higher than that of males, but the growth rate of male vaccination coverage (AAPC=48.95%, P=0.057) was slightly higher than that of females (AAPC=45.11%, P=0.074). The vaccination coverage in regions with high gross domestic product (GDP) had a turning point in 2022, with rapid growth in 2021-2022 [annual percentage change (APC)=70.75%, P=0.028], and a flat growth rate in 2022-2024 (APC=4.91%, P=0.737), with the highest vaccination coverage in 2023 (0.094%). The growth rate of vaccination coverage in regions with medium GDP (AAPC=62.48%, P=0.039) and low GDP (AAPC=64.40%, P=0.040) was faster than that in regions with high GDP (AAPC=23.41%, P=0.037). The vaccination coverage was highest in the 50-59 age group, with the turning point in 2022. From 2021 to 2022, it increased rapidly (APC=128.03%, P=0.028), and from 2022 to 2024 (APC=5.68%, P=0.743), the growth rate tended to be flat. The growth trend in vaccination coverage in the 70-79 age group (AAPC=54.17%, P=0.024) and the 80- age group (AAPC=59.15%, P=0.028) was relatively fast. Conclusions: Herpes zoster vaccination coverage showed an upward trend in Shandong Province from 2020 to 2024, and vaccination coverage among the middle-aged population aged 50 to 69 has increased significantly. However, it is important to focus on increasing vaccination coverage in economically underdeveloped areas, among males, and older age groups. 目的： 分析2020-2024年山东省带状疱疹疫苗的接种现状和变化趋势，为带状疱疹的人群防控提供参考。 方法： 利用山东省预防接种信息系统中采集的2020-2024年带状疱疹疫苗首剂次接种数，结合人口数据计算疫苗接种率，并应用Joinpoint 5.3.0软件分析接种率的时间变化趋势。 结果： 2021-2024年山东省带状疱疹疫苗的接种率呈上升趋势［平均年变化百分比（AAPC）=46.48%，P=0.065］，2023年时最高（0.084%）。女性接种率高于男性，但男性接种率（AAPC=48.95%，P=0.057）的增速略高于女性（AAPC=45.11%，P=0.074）。高国内生产总值（GDP）地区接种率以2022年为转折点，2021-2022年快速增长［年变化百分比（APC）=70.75%，P=0.028］，2022-2024年增速平缓（APC=4.91%，P=0.737），2023年时接种率最高（0.094%）；中GDP地区（AAPC=62.48%，P=0.039）、低GDP地区（AAPC=64.40%，P=0.040）接种率增速快于高GDP地区（AAPC=23.41%，P=0.037）。50~59岁组的接种率最高，以2022年为转折点，2021-2022年上升较快（APC=128.03%，P=0.028），2022-2024年（APC=5.68%，P=0.743）增速趋于平缓；70~79岁组（AAPC=54.17%，P=0.024）、80~岁组（AAPC=59.15%，P=0.028）接种率的增速相对较快。 结论： 2020-2024年山东省带状疱疹疫苗接种率呈上升趋势，50~69岁人群接种率增速明显，需重点关注提高经济落后地区、男性和高年龄组人群的接种率。.
Objective: To explore the association between major chronic diseases and their cumulative number and the risk of hearing impairment in middle-aged and older adults in China. Methods: Based on data from the China Health and Retirement Longitudinal Study from 2011 to 2020, middle-aged and older adults without hearing impairment in 2011 were included as the baseline population. Follow-up for hearing impairment outcomes was conducted in 2013, 2015, 2018, and 2020. A multivariate Cox proportional hazards regression model was used to analyze the association between major chronic diseases, their cumulative number, and the risk of hearing impairment, with HRs and 95%CIs calculated. Subgroup analyses were performed by age (<65 years and ≥65 years) and sex. Results: Among the 8 144 middle-aged and older adults included in the study, with a mean follow-up of 7.78 person-years, 1 094 new cases of hearing impairment were identified, yielding an incidence density of 17.68 per 1 000 person-years. The multivariate Cox proportional hazards regression model analysis revealed that, for individual major chronic diseases, diabetes (HR=1.27, 95%CI: 1.01-1.60), heart disease (HR=1.66, 95%CI: 1.40-1.96), arthritis (HR=1.20, 95%CI: 1.06-1.37), and chronic kidney disease (HR=1.29, 95%CI: 1.02-1.62) were statistically significantly associated with hearing impairment risk. In contrast, hypertension, chronic lung disease, and stroke showed no statistically significant association with hearing impairment. Compared with middle-aged and older adults without any major chronic diseases, the HRs (95%CIs) for individuals with a cumulative number of 1, 2, and ≥3 major chronic diseases were 1.24 (1.07-1.43), 1.51 (1.27-1.79), and 1.86 (1.50-2.31), respectively, indicating a significant trend of increasing risk of hearing impairment with a greater number of chronic diseases (P<0.001). Subgroup analyses indicated that having 1, 2, and ≥3 major chronic diseases increased the risk of hearing impairment in both middle-aged adults (<65 years) and older adults (≥65 years). However, the trend was more pronounced in the <65 years age group compared to the ≥65 years group. Additionally, males were more susceptible to the effects in the early stages, whereas females exhibited a cumulative increase in risk. Conclusions: Major chronic diseases and their cumulative number are risk factors for hearing impairment. In the prevention and control of hearing impairment, focused attention should be given to middle-aged and older adults with major chronic diseases. Furthermore, in clinical practice, emphasis should be placed on gender-specific considerations, which will be of significant importance for the early prevention and intervention of hearing impairment. 目的： 探讨中国中老年人重大慢性病及其累计数量与听力障碍发病风险之间的关联。 方法： 基于中国健康与养老追踪调查2011-2020年数据，以2011年未发生听力障碍的中老年人群作为基线，于2013、2015、2018和2020年随访听力障碍结局。采用多因素Cox比例风险回归模型分析重大慢性病及其累计数量与听力障碍风险的关联，计算HR值及其95%CI，并进行分年龄（<65岁和≥65岁）和性别的亚组分析。 结果： 在8 144名中老年人中，平均随访7.78人年，新发听力障碍1 094名，发病密度为17.68/1 000人年。多因素Cox比例风险回归模型分析显示，对单一重大慢性病的研究结果显示，糖尿病（HR=1.27，95%CI：1.01~1.60）、心脏病（HR=1.66，95%CI：1.40~1.96）、关节炎（HR=1.20，95%CI：1.06~1.37）和慢性肾脏病（HR=1.29，95%CI：1.02~1.62）差异有统计学意义，而高血压、慢性肺病和脑卒中与听力障碍无统计学关联。与无重大慢性病中老年人比较，累计患1、2和≥3种重大慢性病中老年人的HR值（95%CI）分别为1.24（1.07~1.43）、1.51（1.27~1.79）和1.86（1.50~2.31），随重大慢性病数量增加，听力障碍风险显著上升（P<0.001）。亚组分析表明，<65岁中老年人和≥65岁老年人累计患1、2和≥3种重大慢性病均升高听力障碍风险，但<65岁中老年人增长趋势较≥65岁老年人显著。男性更易在早期受到影响，而女性则会出现累积暴发。 结论： 重大慢性病及其累计数量是听力障碍的危险因素，在听力障碍的防控中应重点关注患有重大慢性病的中老年人，并且在临床实践中应重视性别差异，将对听力障碍的早期预防和干预具有重要意义。.
Objective: To analyze factors associated with life quality of HIV-infected individuals receiving antiretroviral therapy by using three models and compare the prediction performance of different models in Wuxi. Methods: Using a cross-sectional study design, a questionnaire survey was conducted in HIV-infected individuals receiving antiretroviral therapy recruited through convenience sampling in Wuxi from June to September 2025 with a sample size of 346. The Chinese version of the World Health Organization Quality of Life Questionnaire for HIV was used to evaluate the life quality of HIV-infected individuals. The logistic regression model, decision tree model and random forest model were used to analyze factors associated with the life quality of HIV-infected individuals. The prediction performance of different models was compared by using confusion matrix and the area under receiver operating characteristic curve. Results: A total of 460 HIV-infected individuals were involved, with a total life quality score (79.49±8.46) lower than that in general population of national norm (80.28±17.46)(t=-2.01, P=0.045). The logistic regression analysis showed that risk factors associated with the life quality of HIV-infected individuals included informing no others of HIV infection status (aOR=1.72, 95%CI: 1.04-2.85), anxiety (aOR=2.23, 95%CI: 1.26-4.00), and depression (aOR=4.05, 95%CI: 2.42-6.87), while protective factor was better social support (aOR=0.60, 95%CI: 0.37-0.97). The decision tree model showed that depression, social support, and education level were factors associated with life quality of HIV-infected individuals. The random forest model indicated that main factors associated with life quality of HIV-infected individuals were depression and anxiety, followed by other chronic diseases, education level, and marital status. The accuracy rates of logistic regression, decision tree, and random forest models for the prediction of the life quality of HIV-infected individuals were 0.723, 0.715, and 0.752, respectively. Conclusions: The overall life quality of HIV-infected individuals was lower than that of general population, which was mainly associated with factors, such as depression, social support and education level. All the three models exhibited good accuracy in prediction of the life quality of HIV-infected individuals, but random forest model showed the better overall prediction performance. 目的： 运用3种模型分析无锡市抗病毒治疗HIV感染者生存质量的相关因素，并比较不同模型的预测性能。 方法： 采用横断面研究设计，2025年6-9月通过方便抽样方法在无锡市招募抗病毒治疗的HIV感染者开展问卷调查，样本量为346例。使用中文版WHO艾滋病生存质量简表评估调查对象的生存质量。采用logistic回归模型、决策树模型和随机森林模型分析HIV感染者生存质量的相关因素。通过混淆矩阵与受试者工作特征曲线下面积比较不同模型的预测性能。 结果： 共调查HIV感染者460例，生存质量总分（79.49±8.46）分低于全国常模的一般人群（80.28±17.46）分（t=-2.01，P=0.045）。Logistic回归模型分析结果显示，HIV感染者生存质量的风险因素包括HIV感染状况未告知他人（aOR=1.72，95%CI：1.04~2.85）、焦虑（aOR=2.23，95%CI：1.26~4.00）、抑郁（aOR=4.05，95%CI：2.42~6.87），保护因素为社会支持较好（aOR=0.60，95%CI：0.37~0.97）。决策树模型分析结果显示，抑郁、社会支持和文化程度是HIV感染者生存质量的相关因素；随机森林模型分析结果显示，HIV感染者生存质量的主要相关因素为抑郁和焦虑，次要相关因素为其他慢性病、文化程度和婚姻状况。Logistic回归模型、决策树模型和随机森林模型对HIV感染者生存质量预测的准确率分别为0.723、0.715和0.752。 结论： HIV感染者的整体生存质量低于一般人群，且主要与抑郁、社会支持和文化程度等因素有关。Logistic回归模型、决策树模型和随机森林模型在预测HIV感染者生存质量方面均有良好的准确性，但随机森林模型的综合预测性能较佳。.
Objective: To explore the association between urinary arsenic and neurological mortality among Chinese older adults aged ≥60 years. Methods: A total of 9 826 participants from the China National Human Biomonitoring and the Healthy Ageing and Biomarkers Cohort Study who were aged ≥60 years were enrolled as the study population. Inductively coupled plasma-mass spectrometry was utilized to quantify the urinary arsenic concentration. Detailed profiles of death cases from 2017 to 2024 were obtained from the national Death Surveillance Points system, along with the death questionnaires specified for the respective cohorts. The Cox proportional hazards models were applied to assess the association between the urinary arsenic concentration and neurological mortality. Results: A total of 46 607.42 person-years of follow-up was conducted, with a median of 4.03 years per person. The age at baseline was (77.89±13.11) years. A total of 4 630 (47.1%) participants were male. The median urinary arsenic concentration was 21.66 μg/L. A total of 165 (1.7%) participants died from neurological causes during follow-up. After adjusting for confounders, compared with the Q1 group of the urinary arsenic concentration, the risk of neurological mortality increased by 23.9% (HR=1.239, 95%CI: 0.719-2.135), 81.4% (HR=1.814, 95%CI: 1.100-2.991), and 65.5% (HR=1.655, 95%CI: 1.039-2.636) in the Q2, Q3 and Q4 group, respectively. Restricted cubic spline analysis revealed a significant nonlinear dose-response association between the urinary arsenic concentration and the risk of neurological mortality: as the urinary arsenic concentration increased, the risk of neurological mortality initially increased and tended to plateau at higher doses. Subgroup analyses indicated that the association between the urinary arsenic concentration and the risk of neurological mortality was stronger among women (HR=2.101, 95%CI: 1.179-3.743) and participants with hypertension (HR=2.542, 95%CI: 1.452-4.449). Conclusion: The urinary arsenic concentration was positively associated with the risk of neurological mortality in Chinese older adults aged ≥60 years. 目的： 探讨中国≥60岁老年人尿砷与神经系统疾病死亡之间的关联。 方法： 纳入国家人体生物监测队列和中国老年健康生物标志物队列研究9 826名≥60岁的老年人，采用电感耦合等离子体-质谱法获取研究对象尿砷水平，基于死因监测系统并结合死亡问卷调查，2017-2024年随访获取研究对象神经系统疾病死亡信息。采用Cox比例风险回归模型探索尿砷与神经系统疾病死亡风险之间的关联。 结果： 共随访46 607.42人年（中位随访时长4.03年）。基线年龄为（77.89±13.11）岁，其中男性4 630名（47.1%），尿砷水平的中位数为21.66 μg/L。随访期间，发生神经系统疾病死亡人数为165名（1.7%）。Cox比例风险回归模型分析结果显示，调整混杂因素后，与尿砷水平Q1组相比，Q2、Q3及Q4组神经系统疾病死亡的风险分别升高23.9%（HR=1.239，95%CI：0.719~2.135）、81.4%（HR=1.814，95%CI：1.100~2.991）及65.5%（HR=1.655，95%CI：1.039~2.636）。限制性立方样条分析结果显示，尿砷水平与神经系统疾病死亡风险之间存在显著的非线性剂量-反应关联，随着尿砷水平升高，神经系统疾病死亡风险呈上升趋势，后趋于平缓。亚组分析结果显示，尿砷水平与神经系统疾病死亡风险之间的关联在女性（HR=2.101，95%CI：1.179~3.743）及高血压患者（HR=2.542，95%CI：1.452~4.449）中更为显著。 结论： 中国≥60岁老年人尿砷与神经系统疾病死亡风险呈正向关联。.
As a core course in preventive medicine, epidemiology contains abundant resources for ideological and political education. However, current teaching practices still face challenges such as fragmented exploration of ideological and political elements and awkward integration methods. Grounded in the fundamental mission of moral education and talent cultivation, this study focused on the distinctive characteristics of epidemiology and developed the "One Core, Two Integrations" teaching model for ideological and political education for preventive medicine students. This model crystallized the distinctive core educational philosophy: "Tracing Etiologies, Pursuing Truth; Safeguarding Health, Being Pioneers". It promoted the deep integration of professional knowledge instruction with scientific worldviews and methodologies, as well as of professional case analysis with professional ethics and social responsibility. Complementary efforts included five systematic teaching resource developments: syllabus optimization, case database construction, online course development, expanded resource integration, and standardized lesson plan compilation. A three-stage teaching implementation process-"pre-class guidance, in-class deepening, and post-class extension"-was established and put into practice. The research culminated in a systematic, actionable teaching framework for integrating ideological and political education into epidemiology courses. Its practical application has effectively promoted the coordinated development of students' professional competencies and ethical standards, thus achieving a mutually reinforcing relationship between curriculum development and disciplinary advancement. This framework provides a referenceable model for deepening the integration of ideological education with specialized instruction in epidemiology and related medical disciplines. It holds significant practical value for strengthening the value orientation in public health talent cultivation and advancing the implementation of the Healthy China strategy. 流行病学作为预防医学的主干课程，蕴含着丰富的思政教育资源，但现有教学实践中仍存在思政元素挖掘零散、融入方式生硬等问题。本研究立足“立德树人”根本任务，以预防医学专业学生为对象，基于流行病学学科特质，构建并实施“一核心、两融合”课程思政教学模式，凝练“追溯病因、探索寻真，健康守护、我为先锋”特色核心育人理念，推动专业知识讲授与科学世界观、方法论深度融合，专业案例分析与职业伦理、社会责任深度融合；配套开展教学大纲优化、案例库建设、在线课程搭建、拓展资源整合及标准化教案编制五大教学资源系统化建设，构建并落地“课前引导-课中深化-课后拓展”三阶段教学实施流程。研究最终形成一套系统化、可操作的流行病学课程思政教学体系，实践应用中有效促进了学生专业能力与职业素养的协同发展，实现了课程建设与学科发展的良性互促，为流行病学及医学类相关专业推进思政教育与专业教学深度融合提供了可借鉴的实践框架，对强化公共卫生人才培养的价值引领、助力健康中国战略实施具有重要实践意义。.
Objective: By establishing a quality evaluation index system for final report of public health emergency caused by infectious disease, and provide reference for standardizing the report format and enhancing the report quality. Methods: The initial draft of the indicators was formed through a combination of literature research and expert consultation. The index system was constructed through 2 rounds of expert consultation using the modified Delphi method, and the weights were determined by the weighted average method. The corresponding evaluation form was used to evaluate 30 final reports. Meanwhile, experts were invited for qualitative evaluations of the same reports, and the reliability was verified through comparison. Results: A total of 587 indicators were extracted and they were classified as 85 initial indicators. Two rounds of expert consultation was conducted involving 26 experts from 12 provinces (municipalities). The expert positive coefficients were 96.30% and 100.00% respectively, and the expert authority coefficients were 0.93 and 0.95 respectively; the Kendall's W concordance coefficients were 0.250 and 0.333 respectively (P<0.001). The degree of concordance in the second round of expert consultation was higher than that in the first round one, the expert opinions seemed consistent. The index system consists of 3 first-level indicators (standardization, completeness and scientificity, with weights of 0.314 6, 0.338 4 and 0.347 0), 25 second-level indicators, 55 third-level indicators. The internal consistency was good (Cronbach's α=0.737). The results of quality evaluation of final reports of this index system showed moderate consistency with the independent evaluation results by experts (Kappa=0.434, P<0.001). Conclusion: The quality evaluation index system constructed in this study can provide reference for the development of quality standards of final reports. 目的： 通过构建传染病类突发公共卫生事件结案报告质量评价指标体系，为规范报告格式、提升报告质量提供相关参考。 方法： 采用文献研究结合专家会商法形成指标初稿，2轮改良德尔菲专家咨询法构建指标体系，加权平均法确定权重。使用对应编制的评价表对30份结案报告进行评价，同步邀请专家根据自身经验对相同报告定性评价，对比验证信度。 结果： 共提取587条指标，归纳为85个初始指标。12个省（市）26名专家参与2轮专家咨询，专家积极系数分别为96.30%、100.00%，专家权威系数分别为0.93、0.95，Kendall's W值分别为0.250、0.333（P<0.001），第二轮协调程度高于第一轮，专家意见趋同。指标体系含3个一级指标（规范性、完整性、科学性，权重分别为0.314 6、0.338 4、0.347 0）、25个二级指标、55个三级指标。指标体系内部一致性良好（Cronbach's α=0.737），利用该指标体系评价结案报告质量的结果与专家自主评价结果一致性中等（Kappa=0.434，P<0.001）。 结论： 本研究构建的质量评价指标体系可为结案报告的质量规范提供参考。.
Objective: To investigate the association between recurrent childhood and adolescent antibiotic exposure and the risk of adult-onset pneumonia in individuals aged 40 and over, using data from the United Kingdom Biobank (UKB). Methods: A total of 170 496 UKB participants without a history of pneumonia at baseline were included. Based on a baseline questionnaire, participants were categorized into an exposed group (recurrent early-life antibiotic use), a non-exposed group, or an unknown-exposure group. Cox proportional hazards regression models were applied to calculate HRs and their 95%CIs for pneumonia incidence, with the non-exposed group as the reference. Subgroup analyses were conducted to test for effect modification and heterogeneity, and the robustness of the findings was assessed through multiple sensitivity analyses. Results: During a median follow-up of 13.8 years, 6 041 incident pneumonia cases were recorded. After adjusting for major sociodemographic and lifestyle factors, a significantly increased risk of pneumonia was observed in both the exposed group (HR=1.42, 95%CI: 1.32-1.52) and the unknown-exposure group (HR=1.21, 95%CI: 1.11-1.31) compared with the non-exposed group. Subgroup analysis revealed that this association was stronger in individuals with baseline cancer but weaker in those with chronic obstructive pulmonary disease (COPD) (both P for interaction <0.05). The results remained robust across multiple sensitivity analyses, and the association varied with increasing age at pneumonia onset. Conclusions: Recurrent childhood and adolescent antibiotic exposure is associated with a significantly increased risk of adult-onset pneumonia in individuals aged 40 and older. Baseline health status, such as the presence of cancer or COPD, may act as an effect modifier for this association, and its strength appears to be influenced by age of onset. 目的： 基于英国生物银行（UKB）数据，探讨儿童期和青少年期反复抗生素暴露与≥40岁人群成年期肺炎发病风险之间的关联。 方法： 共纳入170 496名基线无肺炎史的UKB参与者。根据基线问卷调查结果，将参与者分为儿童期和青少年期反复抗生素暴露组、非暴露组和暴露未知组。采用Cox比例风险回归模型计算不同暴露分组与非暴露组相比的肺炎发病HR值及其95%CI。通过亚组分析检验效应异质性来评估潜在的交互作用，并通过多重敏感性分析评估结果的稳健性。 结果： 在中位随访13.8年期间，共发生新发肺炎6 041名。调整主要社会人口学和生活方式因素后，与无暴露组相比，暴露组与暴露未知组的肺炎发病风险均显著升高（HR=1.42，95%CI：1.32~1.52；HR=1.21，95%CI：1.11~1.31）。亚组分析提示，该关联在基线癌症患者中增强，而在慢性阻塞性肺疾病（COPD）患者中减弱（均交互作用P<0.05）。结果在多项敏感性分析中保持稳健，且发现该关联强度随发病年龄增长而变化。 结论： 儿童期和青少年期反复抗生素暴露会显著增加≥40岁人群成年期肺炎的发病风险。基线健康状况（如是否合并癌症或COPD）可能是该关联的效应修饰因素，且该风险关联的强度可能受发病年龄影响。.
Chronic kidney disease (CKD) is an irreversible progressive disease accompanied by multiple complications, and a cluster of chronic diseases caused by various complex factors such as hypertension and diabetes. Characterized by high prevalence and disability rates, it has been recognized as one of the important public health issues endangering human life and health worldwide. The etiology of CKD is complex and diverse; in addition to genetic factors, environmental factors also play a significant role in its development. With rapid industrialization and economic development in China, large amounts of metals are released into the environment, causing environmental pollution. After entering the human body, these metals are mainly excreted through the kidneys, where they tend to accumulate and exert adverse effects on renal structure and function. Among them, metals such as cadmium, arsenic, lead, and lithium can cause kidney damage. Therefore, this article summarizes the relationships between cadmium, arsenic, lead, lithium, other metals, and CKD, aiming to provide new insights for the prevention and control of CKD induced by metal exposure. 慢性肾脏病（CKD）是一种伴随多种并发症的不可逆进行性疾病，由高血压、糖尿病等多种复杂因素引起的一系列慢性疾病群。其具有高患病率和高致残率的特点，已被认为是在全球范围内危害人类生命健康的重要公共卫生问题之一。CKD的病因复杂多样，除遗传因素外，环境因素也是CKD的重要原因。随着工业化和经济的高速发展，大量金属被释放到环境中造成环境污染，而金属进入人体后主要经肾脏排泄，易在肾脏蓄积并对肾结构与功能产生影响，而镉、砷、铅、锂等金属会对肾脏造成损害。本文总结镉、砷、铅、锂和其他金属与CKD的关系，为预防和控制金属导致的CKD提供新思路。.
Objective: To analyze the epidemiological characteristics of hand, foot and mouth disease (HFMD) in Hebei Province from 2008 to 2024, and quantitatively evaluate the impacts of enterovirus A71 (EV-A71) vaccination and non-pharmaceutical interventions (NPIs) during the COVID-19 pandemic period on the incidence trend of HFMD by using the interrupted time series (ITS) method. Methods: The incidence data of HFMD in Hebei from 2008 to 2024 were collected for a descriptive analysis to understand the temporal, population, and regional distributions of HFMD. ITS model was used to quantitatively evaluate the impact of EV-A71 vaccination and the NPIs during the COVID-19 pandemic period on HFMD incidence. Additionally, the children under five years old were divided into two age groups (<2 years and ≥2 years) for subgroup ITS analyses to compare the differential responses of age groups to these interventions. Results: A total of 822 740 HFMD cases were reported in Hebei during the study period, the reported cases increased firstly, then-declined, showing an obvious seasonality, with an uneven geographic distribution. The majority of cases were children aged 0-5 years, especially the scattered children, and the incidence rate was higher in boys than in girls. ITS analysis showed that following the introduction of EV-A71 vaccination in 2016, the annual decline in overall HFMD incidence accelerated from 2.00 per 100 000 (P=0.735) to 10.67 per 100 000 (P=0.186). Age-stratified analysis indicated that in children under 2 years old, HFMD incidence trend reversed from increase to decrease (P=0.014). In children aged ≥2 years, the incidence remained generally stable before and after the vaccination, with no significant immediate or long-term changes observed. In 2020, when COVID-19 control measures were taken, HFMD incidence significantly decreased in both overall population and the two age groups, with a greater decline observed in children aged ≥2 years compared with those aged <2 years. Subsequently, the incidences in both groups showed rebounds. Conclusions: From 2008 to 2024, the HFMD incidence in Hebei exhibited distinct phase-specific changes, resulting from the synergistic effects of pathogen spectrum shifts, vaccine interventions, and public health measures. Following the introduction of the EV-A71 vaccine, the incidence of HFMD showed a decreasing trend, but the intervention effect exhibited age heterogeneity, being more significant in children under 2 years old. The NPIs during the COVID-19 pandemic period significantly suppressed HFMD transmission for a short time. These findings suggest that relying solely on overall incidence is insufficient to fully evaluate type-specific vaccine effects; integrating pathogen type surveillance and age-stratified analyses can provide a more accurate evaluation of HFMD control and inform the optimization of comprehensive prevention strategies. 目的： 分析河北省2008-2024年手足口病（HFMD）的流行特征，并通过中断时间序列（ITS）方法定量评估肠道病毒A组71型（EV-A71）疫苗接种和新型冠状病毒感染（COVID-19）疫情期间非药物干预（NPIs）对发病趋势的影响。 方法： 收集2008-2024年河北省HFMD发病数据，使用描述性方法分析HFMD的发病时间、人群及地区分布特征，采用ITS模型，定量评估EV-A71疫苗推广接种和COVID-19疫情期间NPIs的实施对HFMD发病率的影响；并进一步将年龄<5岁儿童分为<2岁和≥2岁两个亚组，开展分层ITS分析比较不同年龄人群对干预措施的响应差异。 结果： 研究期间共报告HFMD病例822 740例，整体呈先升后降的趋势，地区分布不均匀；主要发病人群为0~5岁儿童，尤其是散居儿童，男性发病率高于女性。ITS分析显示，2016年EV-A71疫苗接种后，总体HFMD发病率年下降幅度由2.00/10万（P=0.735）增至10.67/10万（P=0.186）；年龄分层分析发现，<2岁儿童HFMD发病趋势由上升转为下降（P=0.014），而≥2岁儿童发病率变化总体平稳，未观察到显著的即时效应或长期趋势变化。COVID-19疫情防控措施实施当年总体及2个年龄组HFMD发病率均显著下降，其中≥2岁降幅高于<2岁儿童；随后出现回升现象。 结论： 2008-2024年河北省HFMD发病趋势呈明显阶段性变化，该变化是病原谱演替、疫苗干预及公共卫生措施等多因素的协同作用。EV-A71疫苗推广后发病率呈下降趋势，但干预效应具有年龄异质性，在<2岁儿童中更为显著。COVID-19疫情期间实施的NPIs在短期内显著抑制了 HFMD 传播。研究结果表明，仅依赖总体发病率难以全面评估型别特异性疫苗效应，结合病原分型监测与分人群分析有助于更准确地认识 HFMD 的防控效果，并为优化综合防控策略提供依据。.
With the rapid aging of the population in China, the number of adults aged 80 years and above is increasing rapidly, and their nutritional status and weight management have drawn increasing attention. Body mass index (BMI) is a commonly used indicator for assessing body weight and nutritional status. However, the existing BMI standards were mainly developed for the general adult population, and their applicability to the oldest old remains uncertain. To provide guidance for BMI evaluation and weight management among the oldest old population in China, the National Health Commission issued the standard Appropriate body mass index range and weight management standards for the oldest old (WS/T 868-2025). Based on evidence from prospective cohort studies including the Chinese Longitudinal Healthy Longevity Survey and the Healthy Aging and Biomarkers Cohort Study, the standard recommends an appropriate BMI range of 22.0-26.9 kg/m² for adults aged ≥80 years, and provides recommendations on BMI measurement, weight monitoring, and individualized weight management. The implementation of this standard provides scientific evidence for weight evaluation and health management in the oldest old population and contributes to promoting healthy aging. 随着我国人口老龄化程度不断加深，80岁及以上高龄老年人群快速增长，其体重管理和营养状况逐渐受到关注。体质指数（BMI）是评价体重状况和营养水平的关键指标，但现有BMI指南主要针对一般成年人制定，是否适用于高龄老年人群仍存在争议。为制定适用于我国高龄老年人群的BMI适宜范围与体重管理规范，国家卫生健康委发布了WS/T 868-2025《高龄老年人体质指数适宜范围与体重管理指南》。该标准基于中国老年健康影响因素跟踪调查和老年健康生物标志物研究等前瞻性队列研究证据，提出高龄老年人（80岁及以上）的BMI适宜范围为22.0~26.9 kg/m²，并对BMI测量方法、体重监测频率及个体化体重管理策略提出指导建议。本标准的制定为高龄老年人体重管理和健康评估提供了循证依据，对促进健康老龄化具有重要意义。.
The digital information environment has deeply integrated into the learning, living, and social scenarios of children and adolescents, and has had a profound impact on their physical and mental health. This article systematically reviews research from both domestic and international sources, clarifies the connotations and characteristics of the digital information environment, and analyzes its multi-dimensional impacts on the health of children and adolescents from four domains:physical health, mental health, cognitive function, and social adaptation. It also analyzes the internal mechanisms and key regulatory factors to provide a scientific basis for promoting the health of children and adolescents in the digital era. 数字信息环境已成为儿童青少年学习生活场景中的重要组成部分，并影响着他们的身心健康。本文系统回顾国内外研究成果，厘清数字信息环境的内涵与特征，从身体、心理、认知及社会适应4个方面阐明数字信息对儿童青少年健康的影响，并分析其中的作用机制与关键调节因素，以期为数字时代的儿童青少年健康促进提供科学依据。.
Objective: To evaluate the impact of the official front-end software for intelligent surveillance and early warning of infectious diseases on the reporting of other infectious diarrheal disease, hand foot and mouth disease (HFMD), and bacillary dysentery in 113 medical institutions at or above grade Ⅱ in Beijing, China. Methods: Based on monthly incidence data from 2012 to 2023, we constructed multiple prediction models, including seasonal autoregressive integrated moving average (SARIMA) model, error-trend-seasonality model, neural network auto regressive (NNAR) model, Prophet model, Bayesian structural time series model and hybrid model. The data in 2024 were used as the test set for the model evaluation, and the optimal prediction models were used to predict the case count from January to August 2025 without the intervention of front-end software use. Changes in reporting case count were analyzed by comparing actual reporting with prediction from January to August 2025 and actual reporting during the same period in 2024 by using paired t-test or Wilcoxon signed-rank test. Results: The optimal prediction models for other infectious diarrheal diseases and HFMD were SARIMA (1,0,1)(1,1,1)12 and SARIMA (3,0,0)(0,1,1)12 respectively, while the optimal prediction model for bacillary dysentery was NNAR (3,1,2)12. After the use of front-end software, the actual reported case count of other infectious diarrheal diseases increased by 1 625.75 cases compared with the prediction from January to August 2025, an increase of 168.71% (P<0.001) and by 1 500.25 cases compared with the actual case count during the same period in 2024, an increase of 152.61% (P<0.001). The actual reported case count of HFMD increase by 103.38 cases compared with prediction from January to August 2025, an increase of 75.80% (P=0.008), but showed no significant difference compared with the same period in 2024 (P=0.461). No significant changes were observed in the reporting bacillary dysentery before and after the front-end software use in the two comparisons (P=0.895 and P=0.239). Conclusion: The application of the official front-end software significantly improved the reporting sensitivity for other infectious diarrheal diseases and HFMD, but no significant effect was observed in the reporting of bacillary dysentery. 目的： 评估国家传染病智能监测预警前置软件（前置软件）在北京市113家二级及以上医疗机构正式部署后，对其他感染性腹泻病、手足口病、痢疾报卡量的影响。 方法： 基于2012-2023年月度发病数据构建季节性自回归综合移动平均模型（SARIMA）、误差-趋势-季节性模型、神经网络自回归模型（NNAR）、先知模型、贝叶斯结构时间序列模型及混合模型。以2024年数据作为测试集进行模型评价，选取最优预测模型，进而预测2025年1-8月在无前置软件部署干预情况下的预期发病数。通过比较2025年1-8月实际报告数与模型同期预测值及2024年同期实际值，采用配对t检验或Wilcoxon符号秩检验分析报卡量的变化。 结果： 其他感染性腹泻病和手足口病的最优模型分别为SARIMA（1，0，1）（1，1，1）12和SARIMA（3，0，0）（0，1，1）12，痢疾的最优模型为NNAR（3，1，2）12。前置软件应用后，2025年1-8月其他感染性腹泻病的实际报卡量显著高于预测值（平均增加1 625.75例，增幅168.71%，P<0.001）和2024年同期水平（平均增加1 500.25例，增幅152.61%，P<0.001）。手足口病的实际报卡量显著高于预测值（平均增加103.38例，增幅75.80%，P=0.008），但与2024年同期相比无显著差异（P=0.461）。痢疾的报卡量在前置软件应用前后与2个对照基准相比均无显著变化（P值分别为0.895和0.239）。 结论： 前置软件的部署与应用显著提升了其他感染性腹泻病和手足口病的报告敏感度，但对痢疾的报卡量未见明显影响。.