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Introduction: Previous studies had reported the impact of weight changes in middle age on the incidence of cardiovascular disease (CVD), but the results were inconsistent. In present study, we aimed to investigate the impact of a 4-year weight change on the risk of CVD in middle-aged and elderly Chinese individuals. Methods: Using nationally representative data from the China Health and Retirement Longitudinal Study, 7,530 participants (age: 58.2 ± 8.9 years) were included. Weight change was calculated by subtracting weight at baseline from that at 4-year follow-up. Weight change over 4 years was divided into 5 categories (loss ≥5 kg; loss 2–5 kg; stable (change ≤2 kg); gain 2–5 kg; and gain ≥5 kg). Results: During the follow-up period, a total of 758 respondents experienced CVD (including 319 stroke and 477 cardiac events). The multivariable ORs of CVD for gain ≥5 kg compared to stable weight (change ≤2 kg) was 1.50 (95% CI, 1.14–1.97) versus 1.41(1.09–1.83) for losing ≥5 kg. Multivariable-adjusted logistic regression model with restricted cubic splines showed a U-shaped association between weight change and the risk of CVD (p for nonlinearity <0.001). The significant associations did not change in subgroup and sensitivity analysis. Weight change was also associated with higher risk of stroke and cardiac events. Conclusion: Weight changes (weight gain or loss more than 5 kg) during middle age were associated with an increased risk of CVD in middle-aged and elderly Chinese individuals. [ABSTRACT FROM AUTHOR]

Squamous cell carcinoma (SCC) and adenocarcinoma (AC) of the uterine cervix have distinct biological behaviors and different treatment responses. Studies on immune features and genomic profiling of these two pathologic types were limited and mainly focused on small patient cohorts. From 2014 to 2021, 336 (254 SCC vs. 82 AC) cervical cancer patients who were diagnosed/treated in 7 medical centers in China were enrolled in the study. Next-generation sequencing of 425 cancer-relevant genes was performed on tumor tissues and liquid biopsies. Somatic alterations and immune response-related biomarkers were analyzed. Patient prognosis and immune infiltration were analyzed using data from The Cancer Genome Atlas (TCGA). AC tended to have more immunotherapy resistance-related STK11 alterations (P = 0.039), a higher proportion of microsatellite instability (P = 0.21), and more actionable mutations (P = 0.161). In contrast, higher tumor mutational burdens (TMB; P = 0.01), a higher proportion of TMB-high patients (P = 0.016), and more PD-L1-high patients (P = 0.0013) were observed in SCC. Multiple genetic alterations and aberrant signaling pathways were specifically enriched in AC (e.g., TP53, KRAS, ERBB2, and ARID1A alterations) or SCC (e.g., PIK3CA, FBXW7, EP300, and BAP1 mutations). Notably, AC-enriched genetic changes were significantly associated with decreased infiltrations of various B cells, T cells, and dendritic cells, whereas SCC-associated molecular features tended to be associated with increased CD4+ T cell infiltrations. This was the first multi-center study revealing the immunologic and genomic features between SCC and AC in Chinese patients with cervical cancer. Our findings have illustrated the difference in genetic profiles of those two cervical cancer subtypes, which may suggest the possibility of differential treatment regimens, with better immunotherapy efficacy in SCC and targeted therapy options more favorable in AC. • Squamous cell carcinoma (SCC) showed distinct immunologic and genomic features with adenocarcinoma (AC) in patients with cervical cancer. • SCC-enriched genetic changes were more associated with increased immune cell infiltration than AC-enriched genetic changes. • The genetic profile of SCC was more suggestive of sensitivity to immunotherapy and that AC might harbor more actionable mutations for targeted treatment options. [ABSTRACT FROM AUTHOR]

Objective: The purpose of our study was to assess the knowledge and attitudes toward expanded carrier screening (ECS) between the medical staff and general population in China.Study Design: It was a survey-based cross-sectional study in Chinese. We provided an online survey for the general public nationwide. We classified the population into the medical staff and general population to evaluate the knowledge gap and provide a reference for ECS's education programs. Except for obstetrician-gynecologists and nurses in the department of Obstetrics and Gynecology, other medical staff were not included in our study. A total of 1947 questionnaires were collected from July 11, 2020 to February 10, 2021. Two hundred and eighty-four questionnaires were excluded from further analysis. The remaining 1663 cases were incorporated into the final analysis. Data were analyzed using IBM SPSS Statistics 26. Comparisons between categorical variables were tested by the use of crosstabs and χ2 test.Results: The total awareness rates of the knowledge about monogenic diseases and ECS in the respondents were low, with 35.7%, 26.1%, 3.3%, 23.3%, 24.1%, 55.2%, and 23.4% for questions Q1-Q7, respectively. Medical staff had more knowledge than general population. Knowledge about monogenic diseases and ECS was positively correlated with educational level. Most respondents showed a positive attitude toward ECS: 54.4% thought ECS was necessary, and 80.5% wanted to know more about monogenic diseases.Conclusion: Although the public had little knowledge about monogenic disease and ECS, most of them showed a positive attitude. Our cross-analysis showed that medical staff had more knowledge compared to general population. Pre-test education for ECS can be carried out by medical staff who are not qualified for genetic counseling. ECS training for medical staff, especially obstetrician-gynecologist and nurse in the department of Obstetrics and Gynecology, can reduce the workload of genetic counseling. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the association between trajectories of depressive symptoms and the subsequent risk of chronic kidney disease (CKD) by measuring depressive symptoms repeatedly in older adults with normal renal function., Methods: A total of 9650 participants, comprising community-dwelling middle-aged and older adults from the China Health and Retirement Longitudinal Study, were included. Depressive symptoms were assessed at three time points: Wave 1 (2011-2012), Wave 2 (2013-2014), and Wave 3 (2015-2016). Trajectories of depressive symptoms were determined using latent mixed models, and the association between these trajectories and CKD was verified using COX proportional hazards models., Results: Five trajectory patterns of depressive symptoms were identified: low CESD-10 score (Low-Stable, 3702 participants, 38.36 %), moderate CESD-10 score (Moderate-Stable, 3602 participants, 37.33 %), continuously increasing CESD-10 score from moderate initiation (Moderate-Increasing, 825 participants, 8.55 %), continuously decreasing CESD-10 score from high initiation (High-Decreasing, 1032 participants, 10.69 %), and stable high CESD-10 score (High-stable, 489 participants, 5.07 %). During the two-year follow-up period from Wave 3 to Wave 4 (2017-2018), 420 CKD events occurred. Participants in the Moderate-Stable, Moderate-Increasing, High-Decreasing, and High-Stable groups had an increased risk of developing CKD compared to those in the Low-Stable group, with multivariable-adjusted hazard ratios (95 % confidence interval) were 1.32 (1.02-1.71), 1.68 (1.15-2.45), 2.26 (1.63-3.13), and 3.73 (2.57-5.43), respectively, comparted to those with low-stable trajectory., Conclusion: Middle-aged and older adults with increasing (Moderate-Increasing) and persistent depressive symptoms (including Moderate-Stable, High-Decreasing, and High-Stable) face a higher risk of developing CKD over time., Competing Interests: Declaration of competing interest No competing interests have been declared., (Copyright © 2025 Elsevier Inc. All rights reserved.)

Objectives: Previous studies had reported the association between famine exposure in early life and subsequent non-communicable diseases risk. In current study, we aimed to evaluate the associations between famine exposure on multimorbidity prevalence and incidence in middle-aged and older Chinese population., Methods: A total of 13,254 participants from the China Health and Retirement Longitudinal Study 2011 were included in cross-sectional analyses. 5,780 participants were including in longitudinal analyses and were followed up in 2020. Based on the questionnaire, participants were divided into non-exposed, mild famine, moderate famine and severe famine subgroups., Results: In cross-sectional analyses, both mild, moderate and severe famine groups were significantly associated with higher multimorbidity prevalence. During the 9 years of follow-up, a total of 2,643(45.73%) participants with multimorbidity incident were identified. After adjusting for all covariates, individuals who experienced mild famine, moderate famine and severe famine were significantly associated with increased risk of multimorbidity incident, with the corresponding ORs (95%CI) being 1.32(1.14-1.52), 1.54(1.21-1.96) and 1.62(1.32-1.99), respectively., Discussion: Our findings indicate that famine exposure in mild, moderate and severe famine groups might be associated with an increased multimorbidity risk., Competing Interests: Declarations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Conflict of interest: All authors declare no conflict of interest. Ethical approval: The ethics application for collecting data on human subjects in CHARLS was approved by the Biomedical Ethics Review Committee of Peking University (IRB00001052-11015), and all CHARLS participants provided written informed consent. Clinical trial number: Not applicable., (© 2025. The Author(s).)

Background: Severe Fever with Thrombocytopenia Syndrome (SFTS) is a tick-borne disease caused by the SFTS virus (SFTSV) which has the potential to become a pandemic and is currently a major public health concern., Case Presentation: We present the case of a 74-year-old female from an urban area of Chongqing, with leukocytopenia, thrombocytopenia, organ function, inflammatory, blood coagulation, and immune abnormalities. SFTSV infection was confirmed through molecular detection and metagenomic next-generation sequencing (mNGS) analysis, indicating a diagnosis of SFTS due to the patient's history of tick bites. The patient received symptomatic and supportive therapy, including antibiotics, antiviral treatment, and antifungal therapy, and finally discharged from the hospital on day 18., Conclusions: This study highlights the need for increased awareness, early diagnosis, and prompt treatment for tick-borne SFTS. It also provides a comprehensive understanding of the disease's characteristics, pathogenesis, detection methods, and available treatments., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Rural solid waste management is an important method to improve rural living environments. Farmers' participation in rural solid waste management plays an essential role in sustainable waste management. Based on the micro-survey data of 592 farmers in Shaanxi province, a multinomial logit model was applied to explore farmers' preferences for participating in rural solid waste management. The empirical results show that both institutional and interpersonal trust have significant positive effects on farmers' payment participation, and labor and payment participation. Among environmental awareness, farmers with pro-environmental behavior prefer labor participation, and labor and payment participation; the more environmental knowledge farmers have, the stronger their preferences for payment participation, labor and payment participation, and labor participation; farmers concerned about environmental problems are more inclined to adopt labor and payment participation or payment participation. For socio-demographic characteristics, gender has no significant influence, while agricultural net income and education can significantly increase farmers' willingness to participate; farmers who have migrant work experience prefer to participate in payment; there are obvious intergenerational differences in the influence of social trust and environmental awareness on farmers' participation preference. Therefore, providing diversified participation modes, creating a good social trust environment, and enhancing farmers' awareness of environmental care are important in promoting rural solid waste management.

Background and Aims: The association between visceral adiposity index (VAI) and chronic kidney disease (CKD) remains debatable. We aimed to prospectively investigate the relationship between VAI and CKD., Methods and Results: A total of 8808 participants from the China Health and Retirement Longitudinal Study were included. Males and females were divided into four groups according to gender-specific quartiles of VAI scores. CKD was based on self-reported physicians' diagnosis or personal eGFR level. A logistic regression model was established to analyze the correlation between VAI and CKD. A meta-analysis was conducted to incorporate the results of the current study and previous studies on the association of VAI with CKD. During 7 years of follow-up, a total of 826 participants (9.38%) experienced CKD. In multivariable-adjusted analyses, the adjusted odds ratios (95% confidence intervals) for the highest versus lowest quartile of VAI was 1.33 (1.03-1.77) for male, and 1.10 (0.81-1.48) for female, respectively. The meta-analysis found the significant associations between VAI and CKD in total, male and female participants (pooled relative risk for highest vs lowest VAI quartile were 2.24(1.70-2.95), 2.36(1.54-3.61) and 2.57 (1.57-4.22), respectively)., Conclusions: Higher VAI score was associated with increased risk of CKD, independently of established risk factors. The VAI may be a predictor of incident CKD, but only among male participants based on present study., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Objectives: To investigate the knowledge, attitudes, and practices of healthcare professionals (HCPs) working in prenatal diagnosis toward expanded non-invasive prenatal testing (NIPT) in China., Methods: We conducted a national online survey among HCPs working in prenatal diagnosis, including specialists in prenatal diagnosis and foetal medicine, obstetricians and gynaecologists, nurses in obstetrics and gynaecology, obstetric ultrasound doctors, and technicians in prenatal diagnosis laboratories. A total of 1882 questionnaires were collected, among which 1822 questionnaires met the research criteria and were included in the analysis., Results: More than 99% of all participants opted for NIPT for trisomies 21, 18, and 13. The rates of support for expanded NIPT for sex chromosome aneuploidies, rare autosomal trisomies, microdeletions and microduplications, and single-gene disorders were 93.9%, 88.6%, 89.4%, and 86.8%, respectively. Specialists in prenatal diagnosis and foetal medicine had greater knowledge but were less likely to support expanded NIPT compared to other participants. Knowledge increased with educational level, whereas support for expanded NIPT decreased with educational level., Conclusions: More than 80% of HCPs working in prenatal diagnosis in China expressed support for expanding NIPT to conditions other than common trisomies. The degree of knowledge was negatively associated with the rate of support., (© 2021 John Wiley & Sons Ltd.)

Purpose: The study aim was to investigate the risk factors for the progression of oral leukoplakia (OLK) to malignancy., Patients and Methods: The data from 2,628 patients with OLK were retrospectively reviewed. Of these 2,628 patients, 192 had undergone sequential biopsies and were separated into 4 groups according to their final diagnosis. The risk factors were analyzed using Kaplan-Meier univariate survival analysis and Cox multivariate analysis., Results: In 41 of the 2,628 patients (1.7%), the OLK had progressed to cancer, with a mean interval to malignancy of 26.7 months. Of the 192 patients with sequential biopsies, OLK was maintained or had progressed to mild, moderate, or severe dysplasia or carcinoma in 50, 66, 35, and 41 patients, respectively. The 3- and 5-year oral cancer-free survival (OCFS) was 78.9 and 72.5%, respectively. The factors associated with worse overall survival were lesions located in the ventral tongue (P = .04), alcohol use (P = .025), nonhomogeneous lesions (P < .01), and high-risk dysplasia (P < .01). Cox regression analyses indicated that nonhomogeneous lesions (P = .03) and high-risk dysplasia (P < .01) were independent prognostic factors for the progression of OLK to malignancy., Conclusions: High-risk dysplasia and nonhomogeneous lesions were shown to be important factors for progression to malignancy in patients with OLK. Thus, such patients should receive close follow-up and undergo sequential biopsies in the first 2 to 3 years for early screening of OLK evolving into a malignancy., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)