To explore a suitable research design for evaluating the long-term effects of vaccines, taking into account the heterogeneity caused by individual susceptibility, vaccination status, vaccination timing, and the confounding effects of healthcare-seeking behavior.

This study employed a Monte Carlo simulation method to extend the Test-Negative Design (TND),considering constant vaccine efficacy and two types of time-dependent vaccine efficacy under a fixed study duration model. A multivariable logistic regression model and a semi-parametric generalized additive model based on restricted cubic splines were constructed to evaluate the long-term effects of vaccines.

When only considering changes in vaccine efficacy, the estimated vaccine effectiveness (VE) curves from both models accurately fit the actual decay trend of VE, being only slightly higher than the true VE (approximately 1%-3%). The VE curves were minimally affected by vaccination rates, the mean probability of influenza-like illness in the entire population, and the probability of influenza-like illness in the vaccinated population.

The extended TND under a fixed study duration model provides a feasible new approach for evaluating long-term vaccine effectiveness, with the potential for application to other types of vaccines. Both models demonstrated good fitting performance over time with no significant differences. However, further exploration is needed to comprehensively consider other heterogeneous influencing factors and to conduct simulation experiments with the extended TND after group assignment.

To understand the species composition, density, seasonal fluctuation of mosquitoes and the virus-carrying situation in Tianjin from 2019 to 2023, and to provide a reference for reducing mosquito density and controlling mosquito-borne diseases.

According to the “Monitoring Work Plan for Vector Control in Tianjin”, from April to November each year, the number of adult mosquitoes was monitored in 16 districts of Tianjin using the mosquito-attracting lamp method. Habitats such as residential areas, parks, hospitals, livestock sheds, and rural households were selected as monitoring sites. In addition, from June to October, adult mosquitoes or mosquito larvae were captured using methods such as the mosquito-attracting lamp method and the mosquito-and-egg trap method. Reverse transcription polymerase chain reaction (RT-PCR) technology was used to detect the presence of Japanese encephalitis virus and dengue virus in the samples.

From 2019 to 2023, a total of 12 641 mosquito-attracting lamps were deployed in Tianjin, and 54 870 female mosquitoes were captured, with an average mosquito density of 0.72 mosquitoes/(lamp·h). Among them, 52 569 were Culex pipiens pollens (accounting for 95.81%),followed by 1 402 Aedes albopictus (accounting for 2.56%). From 2019 to 2023, the overall mosquito density showed a downward trend. The mosquito density was the highest in July each year, showing a single-peak distribution. Among different habitats, the mosquito density was the highest in livestock sheds, reaching 1.45 mosquitoes/(lamp·h), followed by rural households at 0.96 mosquitoes/(lamp·h), and the lowest in hospitals at 0.42 mosquitoes/(lamp·h). Culex pipiens pollens was the dominant mosquito species in all habitats. Neither Japanese encephalitis virus nor dengue virus was detected in Culex pipiens pollens or Aedes albopictus.

The dominant mosquito species in Tianjin is Culex pipiens pollens, and the key period for mosquito density control is from June to September. Priority should be given to improving the environmental conditions of livestock sheds, and targeted mosquito- vector control strategies should be implemented according to the mosquito population distribution, density changes, and seasonal fluctuation patterns.

To analyze the influencing factors of carotid artery plaque occurrence based on a prospective dynamic cohort.

A nested case-control study was adopted. A total of 1 150 newly-diagnosed patients with carotid artery plaques from March 2018 to November 2023 were selected as the case group. According to the principles of the same gender, age ± 3 years, and the same year and month of the initial examination, 1 150 individuals without carotid artery plaques were individually matched at a ratio of 1:1 as the control group. Finally, 2 300 subjects were included in the study. A conditional Logistic regression model was used to analyze the influencing factors of carotid artery plaque occurrence. Meanwhile, the dose-response relationship between different exposure factors and the risk of carotid artery plaque was analyzed by using tertile stratification and restricted cubic spline (RCS).

The results of multivariate conditional Logistic regression analysis showed that abnormal serum high-density lipoprotein-cholesterol (HDL-C) (OR=1.370, 95%CI: 1.073-1.748), blood urea nitrogen/creatinine (OR=1.024, 95%CI: 1.004-1.044), and red blood cell distribution width-SD (OR=1.037, 95%CI: 1.003-1.072) were risk factors for carotid artery plaques, while total protein (OR=0.966, 95%CI: 0.944-0.988) was a protective factor.The RCS results showed that there was a negative linear dose-response relationship between HDL-C, total protein and the risk of carotid artery plaque, and a positive linear dose-response relationship between blood urea nitrogen/creatinine and the risk of carotid artery plaque (P _overall < 0.05, P _non-linear > 0.05). No dose-response relationship was found between red blood cell distribution width-SD and the risk of carotid artery plaque.

HDL-C, total protein, blood urea nitrogen/creatinine, and red blood cell distribution width-SD are associated with the occurrence of carotid artery plaques, and there is a linear dose-response relationship between HDL-C, blood urea nitrogen/creatinine, total protein and the risk of carotid artery plaque.

To investigate the correlation between the platelet-to-lymphocyte ratio (PLR) and the risk of cardiovascular disease mortality in elderly patients with diabetes mellitus (DM) based on samples from a public database in the United States.

Data on demographic characteristics and laboratory indicators of participants from the National Health and Nutrition Examination Survey (NHANES) database from 2009 to 2018 were collected, along with mortality data from the National Death Index as of December 31, 2019. A weighted Cox regression model, subgroup analysis, and restricted cubic spline (RCS) were used to explore and visualize the correlation between Log₂PLR values and cardiovascular disease mortality in elderly DM patients. The accuracy of Log₂PLR in predicting survival outcomes was assessed using receiver operating characteristic (ROC) analysis.

A total of 1 323 elderly DM patients were included in this study, with an average follow-up of 4.86 years. Ninety-one patients died from cardiovascular disease, resulting in a mortality rate of 6.88%. Both univariate and adjusted Cox regression model results indicated that a high Log₂PLR (≥7.08) was associated with cardiovascular disease mortality (HR1=2.71, 95%CI: 1.61-4.56; aHR3=2.75, 95%CI: 1.60-4.72). RCS analysis showed a linear positive correlation between Log₂PLR and cardiovascular mortality (P_non-linear=0.141). There were no significant interactions between age, sex, BMI,history of hypertension, ethnicity, education level, and Log₂PLR (P>0.05). The ROC curve demonstrated that the area under the curve (AUC) for Log₂PLR predicting cardiovascular disease mortality at 1, 3, 5, and 7 years were 0.68, 0.69, 0.67, and 0.63,respectively. When combined with age, the AUC for predicting cardiovascular disease mortality at these time points was greater than 0.70.

PLR is associated with a high risk of cardiovascular disease mortality in elderly DM patients and has certain predictive value regarding the risk of mortality from cardiovascular disease.

To evaluate the clinical value of maternal liver function indicators combined with umbilical artery blood flow parameters in diagnosing fetal growth restriction (FGR).

This study employed a case-control design, including pregnant women who underwent prenatal examinations and delivered at Southern Hospital of Southern Medical University from December 2017 to July 2022. The case group consisted of 172 pregnant women clinically diagnosed with FGR, while the control group included 292 pregnant women with normal pregnancies who were examined at the same hospital during the same period. Maternal late-pregnancy liver function indicators and umbilical artery blood flow parameters were collected. Multivariate logistic regression analysis was conducted to assess the association of these indicators with the risk of FGR. The performance of each indicator and the combined model was evaluated using receiver operating characteristic curves, net reclassification improvement index, and integrated discrimination improvement index.

In this study, pregnant women in the FGR group had significantly higher levels of ALT, ALB, and S/D ratio of umbilical artery blood flow compared to the control group. Multivariate logistic regression analysis indicated that ALT (OR=1.744, 95%CI: 1.332-2.283), ALB (OR=1.290, 95%CI: 1.002-1.661), and S/D ratio (OR=1.778,95%CI: 1.324-2.387) were significant risk factors for FGR, and the combined model of these three indicators exhibited high diagnostic value for fetal growth restriction.

Maternal liver function indicators (ALT, ALB) and umbilical artery blood flow parameters (S/D ratio) are associated with the risk of FGR, and the combined analysis of these factors can significantly enhance the diagnostic efficiency for FGR.

To investigate the causal relationship between serum liver enzymes and cardiovascular diseases in the East Asian population through Mendelian randomization (MR) analyses.

A two-sample Mendelian randomization study was conducted using the hitherto largest genome-wide association study summary datasets in the East Asian population. The inverse-variance weighted method (IVW) and MR PRESSO were used as primary univariable MR analyses, whereas the weighted median method, MR Egger, removing palindromic and pleiotropic instrumental variables were used as sensitivity analyses. Multivariable MR analyses used the multivariable IVW method to evaluate the independent causal effects of multiple serum liver enzymes on coronary artery disease (CAD) and stroke.

Genetically predicted serum alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) were causally associated with CAD (ALT→CAD: OR=0.546, 95% CI: 0.403-0.739; GGT→CAD: OR=0.618, 95% CI: 0.555-0.689). Additionally, GGT directly affected CAD independent of ALT (OR=0.662, 95% CI: 0.586-0.747). Genetically predicted serum aspartate aminotransferase (AST) and GGT had direct causal effects on stroke that were independent of each other (AST→stroke: OR=1.137, 95% CI: 1.054-1.226; GGT→stroke: OR=1.166, 95% CI: 1.110-1.225).

Serum liver enzymes have causal effects on cardiovascular diseases in the East Asian population.

To analyze the epidemiological characteristics of hepatitis C in Nanchang from 2005 to 2023 and evaluate the application value of the Bayesian structural time series (BSTS) model in predicting hepatitis C incidence trends, providing a scientific basis for the prevention and control of hepatitis C in the city.

Data on hepatitis C incidence in Nanchang from January 2005 to December 2023 were collected. The trend and seasonal components of the monthly incidence data were analyzed using time series decomposition. The BSTS model was constructed using R software, with data from January 2005 to December 2022 used as the training set to fit the model, and data from January to December 2023 used as the test set to evaluate the model's predictive performance. The prediction accuracy of the BSTS model was compared with that of the autoregressive integrated moving average (ARIMA) model using mean absolute error (MAE), mean absolute percentage error (MAPE), root mean square error (RMSE), and root mean square percentage error (RMSPE) as evaluation metrics.

The overall incidence of hepatitis C in Nanchang has been on an upward trend, though the rate of increase has slowed since 2017. The data reveals significant cyclical and seasonal fluctuations, with a peak incidence in the spring months from March to May and a trough from January to February.The prediction performance indicators of the BSTS model (MAE=9.67, MAPE=17.61%, RMSE=11.99 and RMSPE=17.84) were all lower than those of the ARIMA model (MAE=12.12, MAPE=29.03%, RMSE=15.30, RMSPE=33.62). Based on the BSTS model, the total predicted number of hepatitis C cases in Nanchang from January 2024 to December 2024 is 308 (95% CI: 68-583), with an average monthly incidence of 26 cases (95% CI: 6-48).

Hepatitis C incidence in Nanchang exhibits periodic and seasonal fluctuations. The BSTS model outperforms the ARIMA model in prediction performance and can provide technical support for the precise prevention and control of hepatitis C.

To analyze the mortality trend of ischemic stroke in China from 1982 to 2021, and to explore the effects of age, period and cohort on the mortality rate, so as to provide reference for the scientific prevention and treatment of ischemic stroke.

The study data were derived from the Global Health Data Exchange Platform. Residents aged 5-94 years were used as the study subjects, and a Joinpoint regression model was used to analyze the trend of ischemic stroke deaths over time, and the age-period-cohort model was used to assess the age-, period-, and cohort-specific effects on the mortality rate.

The national ischemic stroke mortality rate fluctuated from 80.70/100 000 in 1982 to 64.47/100 000 in 2021, with a mean annual percentage change of -0.505%. The mortality rate of ischemic stroke for men and women fluctuated from 91.56/100 000 and 74.26/100 000 in 1982 to 88.32/100 000 and 48.58/100 000 in 2021, with an average annual percentage change of -0.054% and -0.993%, respectively; the mortality rate of ischemic stroke showed an upward trend with increasing age. With regard to the age effect, the mortality risk of ischemic stroke for male and female residents in the age group of 90-94 years increased by 6 032.91 and 4 754.90 times, respectively, compared with that of the age group of 10-14 years. For the period effect, the risk of death from ischemic stroke in 2017—2021 was 3.17 and 1.94 times higher than that in 1982—1986 for men and women, respectively. For cohort effect, the risk of ischemic stroke death for men and women born in 1892—1896 was 135.15 and 109.51 times higher than that born in 2012—2016, respectively.

The mortality rate of ischemic stroke in China generally showed a fluctuating and decreasing trend, in which the mortality rate of male residents was more prominent compared with that of females. The mortality risk of ischemic stroke is higher with increasing age and period.

To understand the prevalence and spatial clustering characteristics of tuberculosis in Guizhou Province, and provide scientific basis for further reducing the prevalence of tuberculosis.

Based on the incidence monitoring data of tuberculosis in Guizhou Province in the tuberculosis information management system from 2016 to 2023, this study described and analyzed the distribution characteristics of tuberculosis incidence in the whole province in time, population and region, and used spatial clustering to analyze the key regions and types of incidence rate clustering in the province.

From 2016 to 2023, the annual average reported incidence rate of tuberculosis in Guizhou Province was 100.28/100 000, and the reported incidence rate declined at an average annual rate of 6.82%, from 130.66/100 000 in 2016 to 82.90/100 000 (trend χ²=9 647.38, P<0.001). From 2016 to 2023, the reported incidence rate of men and women will decrease from 165.18/100 000, 93.89/100 000 to 102.32/100 000 and 62.58/100 000 respectively (trend χ²=6 968.96, 2 828.21,all P<0.001). The reported incidence rates in the age groups of <20 years old, 20-39 years old, 40-59 years old and ≥60 years old all showed a downward trend (trend χ²=3 021.42, 3 563.78, 2 477.46, 1 184.20,all P<0.001). The average annual reported incidence rate of men and age groups ≥60 years old were higher than others (χ²=18 845.45, 65 957.05, all P<0.001) and the proportion of farmers was 69.46% higher than that of other occupations (χ²=732 538.16, P<0.001). At the same time, the proportion of medical staff and teachers increased (trend χ²=61.54, 45.87, all P<0.001). Spatial clustering analysis showed that tuberculosis in the province presented a clustered distribution (Moran I=0.293, Z=4.607, P<0.001), with high-high clustered areas mainly concentrated in Wangmo County, Ceheng County and other areas in Qiannan Prefecture.

In recent years, the prevention and control of tuberculosis in Guizhou Province has achieved certain results, but the current situation of prevention and control is still quite severe. Males, age groups ≥60 years old, farmers, medical personnel and teachers are the key population affected by the disease. Areas with relatively backward economic and living standards, such as Wangmo and Ceheng in Qiannan Prefecture, are the key areas affected by the disease.