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  • Hong-jie MU, Yan ZHAI, Jie WANG, Li-peng MIAO, Ke-hao REN, Jun-cheng LV
    Modern Preventive Medicine. 2025, 52(3): 406-411.
    Objective

    To describe the changes in the burden of depression among Chinese residents from 1990 to 2021 and to forecast future trends, providing reference for the prevention and control of depression.

    Methods

    Based on the 2021 Global Burden of Disease data, indicators such as the number of cases, incidence rate, prevalence rate, and disability-adjusted life years (DALYs) along with DALYs rates were selected to calculate the rate of change. The Join point regression model was employed to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to analyze the trend of disease burden. Future trends were predicted using R software combined with the GM (1,1) model.

    Results

    In 2021, the total number of depression cases in China was approximately 42.36 million, with an incidence rate of 2 977.354 per 100 000 and a standardized incidence rate of 2 345.079 per 100 000. The total DALYs attributed to depression were 7.8659 million years, with a total DALYs rate of 552.87 per 100 000 and a standardized DALYs rate of 430.61 per 100 000. Compared to 1990, the standardized prevalence rates for the total population, males, and females decreased by 6.39%, 2.4%, and 9.17%, respectively; the standardized incidence rates decreased by 10.79%, 3.96%, and 14.93%; and the standardized DALYs rates decreased by 9.02%, 3.85%, and 12.43%. Join point regression analysis indicated that from 1990 to 1995 and from 2010 to 2015, the standardized incidence rate of depression among the total population in China showed an increasing trend (APC of 1.56% and 1.37%, respectively), while from 1995 to 2000 and 2005 to 2010, it exhibited a decreasing trend (APC of -2.74% and -1.45%,respectively). The standardized prevalence rates from 1990 to 1992, 1992 to 1995, and 2019 to 2021 all showed an upward trend (APC of 1.67%, 0.48%, and 0.96%, respectively), whereas from 1995 to 2000, 2000 to 2005, 2005 to 2010, and 2010 to 2019, they demonstrated a downward trend (APC of -1.06%, -0.22%, -1.02%, and -0.15%, respectively). The standardized DALYs rate increased from 1990 to 1994 (APC of 1.75%) and showed a decreasing trend from 1994 to 2000 and from 2000 to 2006 (APC of-1.55% and -0.46%, respectively).

    Conclusion

    The burden of depression among Chinese residents is increasing, with a higher burden observed in females. The risk of depression among the elderly should not be overlooked. Continued efforts are needed to enhance public awareness of depression-related health knowledge and implement preventive interventions.

  • Xue-ni JIA, Yu ZHOU, Jin-cai CAI, Feng-ling XIN, Bin HU, Hui ZHAO
    Modern Preventive Medicine. 2025, 52(3): 412-417.
    Objective

    To analyze the correlation between changes in uric acid trajectories in a male population undergoing health check-ups and the occurrence of hypertension, diabetes, and dyslipidemia.

    Methods

    This study selected 5 316 male subjects who met the inclusion and exclusion criteria from the Health Management Center of The Second Affiliated Hospital of Dalian Medical University over a ten-year period from 2012 to 2022. A group-based trajectory model (GBTM) was constructed based on uric acid levels, and the Cox proportional hazards regression model was utilized to analyze the risks of developing hypertension, diabetes, and dyslipidemia across different uric acid trajectory groups.

    Results

    The study participants were categorized into low stable, low increasing, moderate increasing, and high increasing groups. The incidence of hypertension in the high increasing group was significantly higher than that in the low stable group. After adjusting for confounding factors, the Cox proportional hazards regression analysis indicated that the risk of developing hypertension in the high increasing group was 1.51 times (95%CI: 1.20-1.91, P<0.001) compared to the low stable group. However, no significant correlation was found between changes in uric acid trajectories and the occurrence of diabetes. A significant correlation was observed between changes in uric acid trajectories and dyslipidemia; as uric acid levels increased, the incidence of dyslipidemia also rose. After adjusting for confounding factors, the Cox proportional hazards regression analysis revealed that the risk of developing dyslipidemia in the high increasing group was 1.75 times (95%CI: 1.44-2.12, P<0.001) compared to the low stable group.

    Conclusion

    Among male individuals undergoing health check-ups, there is a correlation between uric acid trajectories and hypertension as well as dyslipidemia, yet no significant correlation with the occurrence of diabetes.

  • Jie TAN, Yu-ping CAO, Si CHEN
    Modern Preventive Medicine. 2025, 52(3): 418-423.
    Objective

    To explore the relationship between uric acid and the risk of hepatic steatosis and non-alcoholic fatty liver disease (NAFLD), providing new insights for the prevention of NAFLD.

    Methods

    Utilizing data from the 2017-2018 NHANES population and summary data from genome-wide association studies (GWAS), the association between uric acid and the risk of hepatic steatosis and NAFLD was analyzed using restricted cubic spline models, generalized linear models, and binary logistic regression models. The inverse variance weighted method was employed as the primary approach for Mendelian randomization (MR) analysis to assess the causal relationship between uric acid and NAFLD. Additional verification of results was conducted using MR Egger regression, weighted median methods, simple models, and weighted models, followed by sensitivity testing.

    Results

    After adjusting for all covariates, a linear relationship was observed between uric acid and the risks of hepatic steatosis and NAFLD (Pnon-linear > 0.05). Populations with higher uric acid levels exhibited increased risks of hepatic steatosis (β=3.559,95%CI: 1.722-5.395, P < 0.001) and NAFLD (OR=1.151, 95%CI: 1.048-1.265, P=0.003). The MR analysis using the inverse variance weighted method indicated a causal relationship between uric acid and NAFLD (OR=1.68, 95%CI: 1.01-2.81, P=0.049),with the other four analytical methods providing similar directional causal inferences. Sensitivity tests suggested no significant heterogeneity or horizontal pleiotropy among instrumental variables (P > 0.05), and the results were not influenced by individual genetic variations.

    Conclusion

    Uric acid is positively linearly correlated with the risk of hepatic steatosis and NAFLD, indicating that controlling uric acid levels may play a crucial role in the prevention and management of NAFLD.

  • Jie-fa ZHONG, Man WANG, Le LUO, Zong-jie HUANG
    Modern Preventive Medicine. 2025, 52(3): 424-429.
    Objective

    To analyze and assess the characteristics of the infected population and the disease burden of clonorchiosis in a city of the Pearl River Delta, providing a scientific basis for future prevention and control strategies.

    Methods

    Based on population monitoring and medical institution data from 2019 to 2023 regarding clonorchiosis in the city, infection rates and prevalence proportions were calculated for different genders and age groups. The characteristics of patients seeking medical attention were described, and the disease burden was evaluated using Disability-adjusted Life Years (DALYs).

    Results

    The overall infection rate for clonorchiosis in the surveyed population from 2019 to 2023 was 8.32%, with a male infection rate of 12.50% and a female infection rate of 4.84%, showing a statistically significant difference (χ2=98.54, P<0.001). The weighted infection rate was 7.87% [95% Confidence Interval (CI): 5.67%-10.06%]. The weighted infection rates across various age groups ranged from 0.09% to 16.18%, with higher rates observed in individuals over 40 years of age. The majority of infections were mild (97.00%), while moderate and severe infections were less common. The annual DALYs lost due to clonorchiosis were 14 399.10 for males and 4 606.71 for females, totaling 19 005.81, equating to a loss of 4.76 DALYs per 1 000 people per year.From 2019 to 2023, a total of 3 193 cases of clonorchiosis sought medical attention, primarily through outpatient services (95.49%). The proportions of complications such as cholelithiasis, cholecystitis, cholangitis, liver cysts, gallbladder polyps, cholecystectomy, gallbladder hypertrophy, and cholangiocarcinoma were 1.16%, 0.60%, 0.53%, 0.22%, 0.06%, 0.06%, 0.00%,and 0.00%, respectively. The average outpatient medical cost was 155.62 yuan, while the average inpatient medical cost was 6 545.97 yuan.

    Conclusion

    The burden of clonorchiosis in the city of the Pearl River Delta is significant, characterized by a high population infection rate, primarily among males, middle-aged and elderly individuals, and mild infections. Future efforts should focus on public education, screening, and treatment for at-risk populations.

  • Kai LIN, Ya-wen LIU, Ren-zhan HUANG, Chen-huan ZHANG, Zhen-dong XU, Li-si GU, Xue-mei LI
    Modern Preventive Medicine. 2025, 52(3): 430-435.
    Objective

    To analyze the current status and trends of the burden of respiratory syncytial virus (RSV) lower respiratory tract infections in China from 1992 to 2021, providing a reference for the prevention and control of RSV infections in the country.

    Methods

    The burden of disease was assessed using disability-adjusted life years (DALYs). Data on DALYs for RSV lower respiratory tract infections in China from 1992 to 2021 were extracted from the 2021 Global Burden of Disease Study database. Join point regression analysis was employed to evaluate trends in disease burden, and an age-period-cohort (APC) model was constructed to explore the impacts of age, period, and birth cohort on disease burden.

    Results

    In 2021, the DALYs rate for RSV lower respiratory tract infections in China was 3.08 per 100 000, with the highest DALYs number (35 400 person-years) and rate (45.63 per 100 000) observed in the 0-4 age group, followed by those aged 65 and older (5 300 person-years, 2.68 per 100 000). From 1992 to 2021, the DALYs rate for RSV lower respiratory tract infections in China showed a declining trend (AAPC=-12.96%, P<0.001), with the DALYs rate remaining relatively stable from 2012 to 2016 (AAPC=-1.61%, P=0.198), while other intervals exhibited a downward trend, particularly from 2019 to 2021, which had the most significant decline (AAPC=-57.90%, P<0.001). Among different age groups, the 0-4 age group experienced the largest decrease in DALYs rate (AAPC=-12.02%, P<0.001), whereas the decline was the smallest in those aged 65 and older (AAPC=-5.19%, P<0.001). The APC model indicated that age, period, and birth cohort effects influenced the changes in DALYs rates for RSV lower respiratory tract infections in China, with DALYs rates initially decreasing and then increasing with age, while declining with advancing periods and shifting birth cohorts.

    Conclusion

    The burden of RSV lower respiratory tract infections in China showed a downward trend from 1992 to 2021, predominantly affecting children and the elderly.

  • Jin-xu HUANG, Jing JIANG, Xue-dan XU, Qiu-xia CHEN, Wen-yang LI, Dao-qin WANG, Xi CHEN, Hong-wei TU
    Modern Preventive Medicine. 2025, 52(3): 436-440.
    Objective

    To analyze the external exposure levels of nitrate in rural drinking water in Guangdong Province and provide technical support for the safety management of rural water supply.

    Methods

    Monitoring was conducted on the finished water and terminal water from rural drinking water supply units in Guangdong Province from 2018 to 2022. The compliance of nitrate levels in water quality was evaluated according to the Standards for Drinking Water Quality (GB 5749-2022). The Kolmogorov-Smirnov test was used to determine the normality of the data. For non-normally distributed data, the median was used for description. The chisquare test or Fisher’s exact test was employed to analyze differences in rates between groups. The Mann-Whitney U test was used to compare nitrate exposure levels between two groups, and the Kruskal-Wallis H test was applied for comparisons among multiple groups.

    Results

    A total of 62 998 water samples were monitored, with an overall compliance rate of 99.52%. The nitrate exposure levels ranged from 0.001 to 63.80 mg/L. Significant differences in nitrate exposure levels were observed across different years (H=445.586, P<0.01), regions (H=2 050.151, P<0.01), water source types (Z=-5.268, P<0.01), sample types (Z=-11.888, P<0.05), water supply capacities (Z=-33.794, P<0.01), water treatment methods (H=27.750, P<0.01), and the presence or absence of advanced treatment (Z=-2.121, P<0.05).

    Conclusion

    The overall compliance rate of nitrate levels in rural drinking water in Guangdong Province is relatively high. However, special attention should be paid to nitrate pollution in certain areas of western and eastern Guangdong, groundwater sources, decentralized and small-scale centralized water supplies, as well as the high exposure risks for infants and young children.

  • Lei CHEN, Yue-ming XU, Mei ZHAO
    Modern Preventive Medicine. 2025, 52(3): 441-446.
    Objective

    To investigate the association between blood ethylene oxide exposure levels and sleep disorders.

    Methods

    Utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2015-2018, this study selected adults aged 18 and older. The relationship between blood ethylene oxide exposure levels and sleep disorders was analyzed using multivariable logistic regression, subgroup analysis, interaction analysis, and restricted cubic spline analysis.

    Results

    A total of 2 579 participants were included, with a median blood ethylene oxide exposure concentration of 21.76 pmol/g Hb, and 753 (29.2%) individuals reported sleep disorders. Multivariable logistic regression indicated that compared to the lowest quartile, the risk of sleep disorders increased by 94% in the highest quartile of blood ethylene oxide exposure (OR=1.94, 95%CI: 1.27-2.95, P=0.012). Subgroup analysis revealed a significant association between ethylene oxide exposure and sleep disorders among women, individuals aged 40 to 59, those of other races, individuals with a poverty ratio of 1.3 to 3.5, those with an education level of high school or below or possessing a college degree, individuals engaging in moderate physical activity, and the unmarried population.Interaction analysis showed that these factors did not exhibit interaction effects on sleep. Restricted cubic spline analysis indicated no nonlinear association between ethylene oxide exposure levels and the occurrence of sleep disorders (Pnon-linear=0.09).

    Conclusion

    There is a significant positive correlation between high blood ethylene oxide exposure levels and sleep disorders.

  • Heng-yu SU, Gao-feng SUN, Hui-fang XIE
    Modern Preventive Medicine. 2025, 52(3): 447-454.
    Objective

    To explore the influence and lag effects of different groups of relative humidity, temperature, atmospheric pollutants and their interactions on respiratory disease mortality in a basin city in southwest China under a subtropical humid climate.

    Methods

    Daily meteorological, air pollutant and respiratory-related mortality data of residents in a city in southwest China from 2018 to 2022 were collected, and time-series analysis was carried out using the distributed lag-wise nonlinear model (DLNM) with quasi-Poisson distribution and the generalized additive model (GAM).

    Results

    A total of 11 779 people died of respiratory diseases in this city. At lag15, when the SO2 concentration increased by 10 μg/m3, the impact on the respiratory disease mortality of the population was the greatest, with RR=1.055 (95%CI: 0.993-1.120). In the single-factor grouped lag model, in the extremely high-temperature group (≥P95), when the temperature increased by 1 °C, the impact on respiratory disease mortality was the greatest at lag0, which was 1.710(95%CI: 1.209-2.418). In the multi-factor model, when SO2 and NO2 were taken as synergistic factors, the impact of relative humidity on respiratory mortality was the greatest at lag18, which was 1.026 (95%CI: 1.000-1.053), and the RR of temperature on mortality was the greatest at lag0, which was 1.024 (95%CI: 1.010-1.038). Interaction analysis showed that there were interactions among relative humidity, temperature and various pollutants, and the mortality risk generated by the interaction between 60%-80% humidity level and SO2 and NO2 was the greatest.

    Conclusion

    Each factor has an independent influence and lag effect on respiratory disease mortality.The interactions between different humidity levels and pollutants have different impacts on respiratory disease mortality and may have synergistic or antagonistic effects. Among them, the mortality risk generated by the interaction between medium humidity level and pollutants is the greatest, while the impact generated by the interaction between high humidity and pollutants is instead reduced.

  • Hao-min XIE, Jing-hua HUANG, Qin HE, Kai-ling TANG, Jie MA, Ning-ye FANG, Shu-jia LIANG, Xian-wu PANG
    Modern Preventive Medicine. 2025, 52(3): 455-459.
    Objective

    To analyze the status of antiretroviral therapy (ART), survival outcomes, and influencing factors among HIV-infected children in Guangxi.

    Methods

    A retrospective cohort study was conducted, incorporating data from HIV-infected children aged ≤14 years in Guangxi, including treatment status, survival time, and influencing factors. Logistic regression and Cox proportional hazards regression models were employed for statistical analysis.

    Results

    A total of 472 HIV-infected children were included, with 27 deaths reported. All children received ART. Factors such as age and clinical stage at diagnosis influenced the risk of delayed initiation of treatment. Survival analysis revealed that baseline CD4+ T-cell levels, clinical stage, and treatment regimen were key determinants of survival time. Children with baseline CD4+ T-cell counts >350 cells/μL had longer survival time compared to those with counts <200 cells/μL (aHR=0.31, 95%CI: 0.13-0.74). Children in WHO clinical stage IV had shorter survival times than those in stage I (aHR=3.22, 95%CI: 1.24-12.2). Additionally, children treated with the 3TC+ABC+LPV/r regimen had shorter survival time than those treated with the 3TC+AZT+EFV regimen (aHR=4.26, 95%CI: 1.16-15.61).

    Conclusion

    The coverage of ART among HIV-infected children in Guangxi is high, with relatively favorable survival rates. However, efforts should be intensified to educate caregivers and initiate treatment early, optimize treatment regimens, and improve quality of life.

  • Ping ZHOU, Qing-qun JIANG, Zhi-qian HU
    Modern Preventive Medicine. 2025, 52(3): 460-464.
    Objective

    To explore the mediating role of self-efficacy between social support and coping styles in female patients with stress urinary incontinence (SUI) and to provide a reference for clinical interventions.

    Methods

    A total of 128 female SUI patients admitted to the People’s Hospital of Xinjiang Uygur Autonomous Region from January 2022 to January 2024 were selected. General information was collected using a self-designed questionnaire. The Perceived Social Support Scale (PSSS) was used to assess social support, the General Self-Efficacy Scale (GSES) to evaluate self-efficacy, and the Simplified Coping Style Questionnaire (SCSQ) to measure coping styles. Correlation analysis and structural equation modeling were employed to analyze the mediating effect of self-efficacy.

    Results

    Patients aged ≤60 years had higher GSES scores, positive SCSQ scores, total PSSS scores, and scores on its three subscales compared to those aged >60 years, while their negative SCSQ scores were lower (P < 0.05). Correlation analysis revealed that GSES scores were positively correlated with PSSS scores and positive SCSQ scores but negatively correlated with negative SCSQ scores in both age groups (r=-0.601, P < 0.05). PSSS scores were positively correlated with positive SCSQ scores (r=0.650, P < 0.05) and negatively correlated with negative SCSQ scores in both age groups. The Amos 24.0 maximum likelihood estimation method was used to construct a mediation model, showing that self-efficacy had a positive effect on positive coping styles (effect values: 0.62 and 0.56 for ≤60 and >60 years, respectively) and a negative effect on negative coping styles (effect values: -0.50 and -0.45, respectively). Social support positively influenced self-efficacy (effect values: 0.59 and 0.65, respectively), while positive coping styles positively influenced social support (effect values: 0.57 and 0.60, respectively), and negative coping styles negatively influenced social support (effect values: -0.40 and-0.51, respectively).

    Conclusion

    Self-efficacy mediates the relationship between social support and coping styles in female SUI patients, and age significantly affects self-efficacy and coping styles. Enhancing patients’ social support and self-efficacy can promote the adoption of positive coping styles, thereby improving clinical outcomes.