中华预防医学杂志最新文献

The main health problems faced by children and adolescents in China are constantly changing. Myopia, overweight and obesity, abnormal spinal curvature, and mental health issues have become the main health problems for children and adolescents. However, multidimensional health problems such as infectious diseases, chronic non-communicable diseases and injuries still coexist and present regional imbalances. Since these coexisting health problems usually have common behavioral and environmental factors, implementing joint prevention works for children and adolescents could improve the efficiency of monitoring and intervention of multimorbidity among students. School health standards are an important component of China's school health regulations and a crucial technical basis for implementing various school health laws and regulations. Carrying out high-quality revision, preliminary research, implementation evaluation, and promotion of school health standards could provide important technical support for monitoring, comprehensive intervention, and evaluation of common diseases among students, implementing the policy of joint prevention of multimorbidity of common diseases among students, and promoting the high-quality development of disease prevention and control in the field of school health in the new era.

Multimorbidity of common diseases in children and adolescents refers to the coexistence of two or more common diseases or chronic health problems in the same individual. In recent years, the multimorbidity of common diseases in children and adolescents has become increasingly serious, which has enormously increased disease burden and socio-economic losses. These diseases typically share similar influencing factors, such as adverse environmental factors, unhealthy diets, lack of outdoor activities and physical exercise, sedentary lifestyle, excessive use of electronic devices, and disturbed sleep rhythms. Multidimensional interventions targeting these factors are effective methods of preventing and controlling multimorbidity of common diseases in children and adolescents. This review summarizes the public health burden, epidemiological data, risk factors, and interventions for multimorbidity of common diseases in children and adolescents to strengthen relevant research, develop effective intervention strategies, reduce the disease burden of children and adolescents, and promote their healthy growth.

In recent decades, the global community has encountered several significant viral outbreaks, including the Ebola epidemic in West Africa, the Zika virus epidemic in South America, and the recent worldwide COVID-19 pandemic. In these instances, the deployment of effective vaccines has been instrumental in protecting public health. Nevertheless, as new challenges emerge in the prevention and management of infectious diseases, the traditional model of global vaccine development confronts both unprecedented opportunities and challenges. These circumstances underscore the limitations inherent in conventional vaccine development, particularly the protracted timelines and substantial costs involved. This article examines innovative approaches in contemporary vaccine clinical trials, investigates randomization techniques specific to vaccine studies, and delineates essential statistical considerations pertinent to vaccine trial design. The objective is to provide scientific support for vaccine development and to foster ongoing innovation and optimization within the realm of vaccine research and development.

Objective: To understand the occurrence of different patterns of multimorbidity among children and adolescents aged 9-18 in Tianjin City and analyze the cumulative effects of lifestyle on these patterns of multimorbidity. Methods: From September to November 2022, a stratified cluster random sampling method was used to select students from primary schools, junior high schools, general high schools, and vocational schools in 16 districts of Tianjin to screen for height, weight, blood pressure, distant vision, and diopter. One year later, a follow-up measurement and questionnaire survey were conducted. The log-binomial model was used to analyze the strength of the association between lifestyle factors and different patterns of multimorbidity. Results: The age of 9 488 students was (12.37±2.49) years old, including 4 999 boys and 4 489 girls. The detection rates of three patterns of multimorbidity of overweight obesity and high blood pressure, overweight obesity and myopia, and overweight obesity with high blood pressure and myopia were 6.63%, 9.32%, and 4.21%, respectively. The detection rates of the three types of multimorbidity in boys were higher than those in girls (all P<0.001). The detection rate of overweight obesity and high blood pressure in suburban areas was higher than that in urban areas (P=0.002). The detection rate of overweight obesity and myopia in suburban areas was lower than that in urban areas (P=0.034). The detection rate of overweight obesity and myopia among those aged 9-12 years old was higher than other age groups (all P<0.001). The ARR (95%CI) for the association between favorable physical activity and the occurrence of overweight obesity and high blood pressure was 0.79 (0.68-0.92). The ARR (95%CI) for the association between favorable physical activity and the occurrence of overweight obesity with high blood pressure and myopia was 0.82 (0.67-0.99). Compared with children and adolescents with 0-2 favorable lifestyle factors, those with 4-5 favorable lifestyle factors had a lower risk of overweight obesity and high blood pressure (ARR=0.84, 95%CI: 0.59-0.92). Conclusion: Boys aged 9-18 in Tianjin City are more prone to multimorbidity of overweight obesity and high blood pressure, overweight obesity and myopia, and overweight obesity with high blood pressure and myopia. Children and adolescents with 4-5 favorable lifestyle factors have a reduced risk of occurrence of overweight obesity and high blood pressure. Lifestyle has cumulative effects on multimorbidity of overweight obesity and high blood pressure.

Objective: To investigate the impact of High Alcohol-Producing Klebsiella pneumoniae (HiAlc Kpn) on hepatocyte function and explore its regulatory mechanism from the perspective of epigenetic modifications. Methods: Using the HepG2 cell line as the research model, the study involved exposing the cells to alcohol and three different HiAlc Kpn strains in vitro, dividing them into a control group, alcohol-treated group, W8 group, 3-24 group, and 4-26 group. The effect of HiAlc Kpn on liver cell proliferation was investigated using the Incucyte live cell imaging system, and the apoptotic level of liver cells was determined using flow cytometry. The fluorescence confocal microscopy combined with live cell probes was used to detect lipid accumulation and intracellular ROS levels in liver cells. The amount of mitochondrial damage was determined using flow cytometry combined with the seahorse cell metabolism analyzer, and changes in protein levels undergoing global lactylation modification were investigated using Western blotting. Results: Compared with the control group, HiAlc Kpn strains W8, 3-24 and 4-26 could decrease the proliferation rate and increase the ratio of apoptosis of hepatocyte HepG2 cells. The results of high-content cell imaging showed that the fluorescence points of ROS enrichment in HepG2 cells were increased after HiAlc Kpn treatment. The lipid accumulation was significantly increased by oil red O and BODIPY staining. The number of oil droplets and fluorescence points was higher than those in the control group and alcohol treatment group. The results of flow cytometry showed that the ratio of JC-1 monomer/polymer was significantly increased after alcohol and three kinds of HiAlc Kpn were treated and the W8 treatment group was about six times higher than the control group (P<0.05). Seahorse Energy Metabolism System's mitochondrial pressure test results showed that the extracellular acidification degree and oxygen consumption rate were significantly reduced by the HiAlc Kpn 4-26 strain. Western blot analysis showed that the pan-lactylation modification level increased after high-concentration alcohol treatment and the increased rate of pan-lactylation modification in the 1 000 mmol/L alcohol group was about three times that of the control group. HiAlc Kpn W8 and 3-24 strains resulted in four or two-times pan-lactylation modification increases compared with the control group, and the differences were statistically significant (P<0.05). Conclusion: HiAlc Kpn can induce lipid peroxidation in hepatic cells by regulating the increase in histone pan-lactylation modification levels, leading to mitochondrial damage, impaired cell proliferation capacity and increased apoptosis levels.

Acute lower respiratory infections in infants and young children, caused by respiratory syncytial virus (RSV), represent a significant global public health challenge, characterized by a substantial disease burden. During the winter and spring seasons, various respiratory viruses tend to co-circulate, leading to increased pressure on pediatric healthcare services due to heightened rates of visits and hospitalizations. Currently, there is no approved RSV vaccine available for children worldwide; however, the development and application of long-acting monoclonal antibodies present a promising avenue for the prevention of RSV in this vulnerable population. In June 2024, Tianjin released"Guidelines for the monoclonal antibody of respiratory syncytial virus in Tianjin (2024 version)", which outlines the promotion of monoclonal antibody administration in vaccination clinics throughout the region. The objective of this paper is to provide reference information that may assist in the formulation and implementation of a national RSV immunization strategy.

Objective: To analyze the changes in the prevalence characteristics of multimorbidity among adolescents aged 13-18 in Inner Mongolia Autonomous Region from 2019 to 2022 and to explore the association between multimorbidity and moderate to high-intensity physical activity among them. Methods: A stratified random cluster sampling method was used to select students aged 13-18 in Inner Mongolia Autonomous Region every September from 2019 to 2022. Physical examinations, demographic characteristics, and depression-related surveys were conducted to analyze the multimorbidity of overweight, obesity, high blood pressure, myopia, spinal curvature abnormality, and depression. A logistic regression model was used to analyze the association between multimorbidity and moderate to high-intensity physical activity. Results: From 2019 to 2022, 70 972, 62 923, 80 254, and 78 288 study subjects were included, with the rates of multimorbidity being 56.4%, 55.4%, 57.2%, and 55.8%, respectively. The rates of multimorbidity remained relatively stable from 2019 to 2022 (χ²=0.06, P=0.950). The incidence of multimorbidity among girls was significantly higher than that among boys (P<0.001). The incidence of multimorbidity among urban students was significantly higher than that among suburban students (P<0.001). The incidence of multimorbidity among high school students was higher than that among middle school students (P<0.001). The top three multimorbidity combinations were myopia and overweight/obesity (26.4%), myopia and high blood pressure (24.4%), and myopia and depression (19.8%), while the least common combination was depression and spinal curvature abnormality (1.1%). The multimorbidity patterns showed no significant differences between years (χ²=0.03, P=0.999). The multimorbidity status was significantly associated with the status of meeting the standard of moderate to high-intensity physical activity (OR=0.83, 95%CI: 0.80-0.86). The association was stronger in boys (OR=0.77, 95%CI: 0.73-0.81) compared with girls (OR=0.90, 95%CI: 0.85-0.96), with a significant interaction term (P<0.001). Conclusion: From 2019 to 2022, the incidence of multimorbidity among adolescents aged 13 to 18 in Inner Mongolia Autonomous Region is relatively high, mainly due to the co-occurrence of myopia and other health problems. Adequate physical activity is an important factor in reducing multimorbidity.

Objective: To analyze the respiratory virus infection status and epidemiological characteristics of influenza-like illness (ILI) cases in Shandong Province during the 2020-2021 influenza surveillance year. Methods: According to the National Influenza Surveillance Plan (2017 version), throat swab samples of ILI cases were collected from 14 surveillance sentinel hospitals in Shandong Province. Nucleic acid was extracted from all samples. Real-time fluorescence quantitative PCR (RT-PCR) was utilized to detect six common viruses, including human metapneumovirus (HMPV), human parainfluenza virus (HPIV) types 1, 2 and 3, respiratory syncytial virus (RSV), and adenovirus (ADV). Subsequently, the obtained detection results were analyzed. Results: A total of 2 386 specimens were collected, with a detection rate of 24.22% (578). Six viruses were detected, with detection rates of 6.75% (162 cases) for HMPV, 5.87% (140 cases) for RSV, 3.56% (85 cases) for HPIV3, 3.14% (75 cases) for HPIV2, 2.98% (71 cases) for HPIV1, and 2.77% (66 cases) for ADV. There was no significant difference in detection rates between genders, but a notable variation among different age groups (P<0.001). The highest detection rate was observed in individuals aged 0-4 years (31.94%), followed by those aged≥60 years (26.06%). The prevalence of six viruses showed a monthly variation, with the detection rate of HMPV being higher in December and HPIV1 being higher in February. HPIV2, HPIV3, RSV, and ADV had higher detection rates in November. The co-detection rate of multiple viruses was 0.80%, with RSV being the most common pathogen involved in co-detection, primarily in individuals aged 0-4 years. Conclusion: The detection of six multiple pathogens in ILI cases in Shandong Province is dominated by HMPV, RSV and HPIV3. The prevalence of respiratory viruses varies by age and time.