Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and infection is one of the most common complications and death causes of SLE. Vaccination is an effective tool for prevention of infections among SLE patients. This expert consensus was achieved by the Rheumatic Disease Prevention and Control Committee, Zhejiang Preventive Medical Association on the prevention of infections with vaccines, types of vaccines, vaccination timing, efficacy and safety of vaccines and impact of therapeutic agents for SLE on vaccinations to guide the rheumatologists and vaccination professionals for scientific and standardized vaccinations among SLE patients, so as to prevent infection and improve quality of life among SLE patients.

Objective To investigate epidemiological characteristics of notifiable infectious diseases in Zhejiang Province in 2023, so as to provide the evidence for strengthening prevention and control of infectious diseases. Methods Data pertaining to notifiable infectious diseases reported in Zhejiang Province in 2023 were retrieved from the Infectious Disease Surveillance System of Chinese Disease Prevention and Control Information System. The incidence and mortality were analyzed according to the classification of notifiable infectious diseases and transmission routes, and epidemiological characteristics of infectious diseases were descriptively analyzed. Results Thirty types of notifiable infectious diseases with 2 955 699 cases and 427 deaths were reported in Zhejiang Province in 2023, with a reported incidence rate of 4 493.93/10⁵ and a reported mortality rate of 0.649 2/10⁵. A total of 679 notifiable infectious disease emergencies were reported, with 26 514 cases and 1 case death (rabies). The emergencies mainly occurred in schools and preschool institutions, with 621 cases accounting for 91.46%. There were 1 case of cholera reported in class A notifiable infectious diseases and no death, 22 types of class B notifiable infectious diseases, with a reported incidence rate of 552.46/10⁵ and a reported mortality rate of 0.644 7/10⁵, and 8 types of class C notifiable infectious diseases, with a reported incidence rate of 3 941.48/10⁵ and a reported mortality rate of 0.004 6/10⁵. The incidence rates of respiratory, intestinal, blood-borne and sexually transmitted, natural and insect-borne infectious diseases were 4 028.67/10⁵, 381.59/10⁵, 81.15/10⁵ and 1.35/10⁵, respectively, according to transmission routes. Influenza (3 561.78/10⁵) and COVID-19 (423.77/10⁵) reported the highest incidence, and AIDS (0.477 4/10⁵) and tuberculosis (0.130 8/10⁵) reported the highest mortality. Conclusion The incidence rates of respiratory and intestinal infectious diseases were high in Zhejiang Province in 2023, and schools and preschool institutions were the main places of diseases occurred.

Chronic kidney disease (CKD) is characterized by long course, poor prognosis, multiple complications and high cost of treatment, thus it has become a major public health problem. Based on review of publications pertaining to the epidemiological study of CKD from February 2002 to March 2023, this article summarizes the epidemiological characteristics, risk factors, prevention and control strategies of CKD. It is found that China has the largest number of adult patients with CKD in Asia, and the prevalence of CKD is higher among females and elderly people. The influencing factors for CKD include cardiovascular diseases, diabetes, hypertension and coronavirus disease 2019. Henceforth, it is of vital importance to emphasize three levels of prevention and optimize the CKD management, so as to support for prevention and control of CKD.

Human adenovirus (HAdV), which is characterized by infectivity, complex pathogenesis and multiple target organs, causes multiple organ infections in the respiratory system, gastrointestinal system and eyes, which seriously endangers human health. Various subspecies of HAdV has different tissue tropism, which presents diverse clinical symptoms and epidemiological characteristics. Based on the molecule biological characteristics of HAdV, this review summarizes the clinical symptoms and epidemiological characteristics of HAdV infections depending on tissue tropism, and describes the trends in HAdV epidemiology, so as to provide insights into prevention and control of HAdV infections.

Objective To evaluate the association of smoking with the risk of ankylosing spondylitis (AS) using a Mendelian randomization (MR) approach. Methods A total of 16 383 186 AS-associated single nucleotide polymorphisms (SNPs), 378 smoking initiation associated SNPs and 126 lifetime smoking score-associated SNPs were collected from three large-scale genome-wide association studies (GWAS). The association of smoking phenotypes with the risk of AS was examined using inverse-variance weighted (IVW) with AS as a outcome variable, smoking initiation and lifetime smoking score as exposure factors and SNPs with strong associations with smoking as instrumental variables, and sensitivity analyses were performed with maximum likelihood-based method, MR pleiotropy residual sum and outlier (MR-PRESSO) test and MR-Egger regression analysis. Results A 33.5% increased risk of AS was found among genetically predicted smokers relative to non-smokers (OR=1.335, 95%CI: 1.059-1.682), and an increase in predicted lifetime smoking by per standard deviation resulted in a 101.4% increased risk of AS (OR=2.014, 95%CI: 1.341-3.024). The maximum likelihood-based method and MR-PRESSO test showed consistent correlated effect estimations and MR-Egger regression analysis identified no evidence of pleiotropy. Conclusion It is genetically predicted that smoking is associated with an increased risk of AS.

Objective To estimate the burden of disease (BOD) attributable to main risk factors of chronic diseases in Zhejiang Province in 2017, so as to provide the evidence for formulating the control strategy for chronic diseases and reducing BOD. Methods The results of the Global Burden of Disease Study 2017 ( GBD 2017 ) were extracted to evaluate years of life lost due to premature mortality ( YLL ), years lived with disability ( YLD ) and disability-adjusted life years ( DALY ). The gender- and age-specific BOD attributable to main risk factors of chronic diseases, including the environment, metabolism and behaviors, in Zhejiang Province in 2017 was estimated and compared with those in 1990. Results High DALY rates of chronic diseases were estimated attributable to tobacco use ( 2 807.08/10⁵ ), unreasonable diet ( 2 724.72/10⁵ ) and hypertension ( 1 878.69/10⁵ ) in Zhejiang Province in 2017, and high DALY rates of chronic diseases were estimated in men attributable to tobacco use ( 4 764.77/10⁵ ), unreasonable diet ( 3 297.00/10⁵ ) and hypertension ( 2 076.92/10⁵ ), while high DALY rates of chronic diseases were estimated in women attributable to unreasonable diet ( 2 117.16/10⁵ ), hypertension ( 1 668.24/10⁵ ) and hyperglycemia ( 1 100.53/10⁵ ), respectively. Among individuals at ages of 15 to 49 years, high DALY rates of chronic diseases were estimated attributable to unreasonable diet ( 759.29/10⁵ ), drug abuse ( 611.71/10⁵ ) and tobacco use ( 605.37/10⁵ ); among individuals at ages of 50 to 69 years, high DALY rates of chronic diseases were estimated attributable to tobacco use ( 5 528.37/10⁵ ), unreasonable diet ( 4 628.18/10⁵ ) and hypertension ( 2 757.78/10⁵ ); and among individuals at ages of 70 years and older, high DALY rates of chronic diseases were estimated attributable to unreasonable diet ( 16 370.09/10⁵ ), tobacco use ( 15 551.40/10⁵ ) and hypertension ( 14 408.63/10⁵ ). As compared to those in 1990, the DALY rates of chronic diseases attributable to high body mass index, alcohol use, hyperglycemia, high low-density lipoprotein cholesterol and drug abuse increased by 108.23%, 48.59%, 23.17%, 17.64% and 6.06%, and the DALY rates of chronic diseases attributable to air pollution, occupational risks, unreasonable diet and impaired renal function reduced by 51.11%, 44.81%, 22.49% and 19.83%, and no significant alterations were detected in DALY rates of chronic diseases attributable to tobacco use or hypertension in 2017. Conclusions There was a high BOD of chronic diseases attributable to tobacco use, unreasonable diet and hypertension in Zhejiang Province in 2017, and the BOD of chronic diseases attributable to high body mass index, alcohol use and hyperglycemia appeared a tendency towards a rise in Zhejiang Province in 2017 relative to in 1990.

Objective To investigate the migration characteristics and follow-up treatment among HIV/AIDS patients after HIV confirmation in Yiwu City, Zhejiang Province from 2016 to 2020, so as to provide insights into the optimization of the HIV/AIDS control strategy among floating populations. Methods The reported HIV/AIDS patients' demographics, follow-up and treatment data in Yiwu City from 2016 to 2020 were captured from the HIV/AIDS Prevention and Control Information System of Chinese Disease Control and Prevention Information System. The migration characteristics, antiretroviral therapy and outcomes of HIV/AIDS patients were analyzed after HIV confirmation, and the factors affecting the migration of HIV/AIDS patients after HIV confirmation were identified using a Cox proportional hazard regression model. Results A total of 1 189 HIV/AIDS patients were enrolled, including 988 men (83.10%) and 806 cases without Zhejiang provincial household registration (67.79%). There were 441 patients (37.09%) migrating out of Yiwu City after HIV confirmation, with a migration rate of 17.73/100 person-years, and there were 366 patients migrating out of Zhejiang Province, with a cross-province migration rate of 30.78%. Among participants without Zhejiang provincial household registration, 395 patients (49.01%) migrated out of Yiwu City, including 337 patients (85.32%) returning to their household registration provinces, which mainly included Yunnan, Sichuan, Guizhou and Hunan. Cox proportional hazard regression analysis showed a high risk of migration among minority ethnic populations (HR=1.375, 95%CI: 1.044-1.811), retires (HR=3.605, 95%CI: 1.771-7.335), students (HR=8.969, 95%CI: 4.095-19.645), patients without Zhejiang provincial household registration (HR=4.545, 95%CI: 3.164-6.529) and patients identified through physical examination of floating populations or employees (HR=1.318, 95%CI: 1.006-1.727), and a low risk among married patients with spouses (HR=0.721, 95%CI: 0.569-0.913) and with an educational level of junior high school and above (HR: 0.428~0.753, 95%CI: 0.280-0.952). Among all floating HIV/AIDS patients, there were 26 cases lost to follow-up (5.90%) and 49 deaths (11.11%). In addition, the proportion of absence of antiretroviral therapy, HIV infection progressing into AIDS patients and failure in HIV inhibition were all greater among floating HIV/AIDS patients than among non-floating patients (P<0.05). Conclusions A high risk of migration was found among HIV/AIDS patients without Zhejiang provincial household registration, unmarried patients, patients with a low education level, retirees, students, and patients identified through physical examination of floating populations or employees in Yiwu City from 2016 to 2020, and migration does not facilitate the sustainability of antiretroviral therapy and follow-up, which may affect the prognosis of HIV/AIDS.

Objective To investigate the factors influencing the development of gastric cancer in Chinese populations, so as provide insights into creating a model for predicting gastric cancer incidence among Chinese populations. Methods The case-control and cohort studies pertaining to factors affecting the development of gastric cancer were retrieved in electronic Chinese and English databases, including CNKI, Wanfang Data, VIP, PubMed, Web of Science and Embase from their inception until September 30, 2021. A meta-analysis was performed using R package version 4.1.0. Sensitivity analysis was performed using the “leave-one-out” evaluation procedure, and the publication bias was evaluated using the Egger regression test and the trim-and-fill procedure. Results A total of 5 301 publications were screened and 116 eligible studies were included in the final analysis, including 103 case-control studies and 13 cohort studies, which covered approximately 3.23 million study subjects. A total of 45 factors affecting the development of gastric cancer were collected, and there were less than 4 publications reporting 7 factors, which were only qualitatively described. There were 38 factors included in the final meta-analysis. A total of 21 factors were identified as risk factors of gastric cancer, including a history of gastrointestinal diseases (pooled OR=4.85, 95%CI: 3.74-6.29), H. pylori infection (pooled OR=3.18, 95%CI: 2.35-4.32), binge eating and drinking (pooled OR=2.88, 95%CI: 2.09-3.97) and a family history of tumors (pooled OR=2.78, 95%CI: 2.17-3.56), and 10 factors as protective factors, including vegetable intake (pooled OR=0.48, 95%CI: 0.38-0.61), tea consumption (pooled OR=0.55, 95%CI: 0.47-0.64), administration of aspirin (pooled OR=0.53, 95%CI: 0.31-0.92) and administration of statins (pooled OR=0.59, 95%CI: 0.44-0.80). Sensitivity analyses of eating moldy food frequently, white meat intake, favoring spicy food and administration of sulfonylureas were not robust. Following correction with the trim-and-fill procedure, there was still a publication bias pertaining to high income, diabetes, administration of stains, alcohol consumption, tea consumption and white meat intake. Conclusions The development of gastric cancer is associated with a medical history of gastrointestinal disease, H. pylori infection, family history of tumors and poor dietary habits. Risk and protective factors of gastric cancer are recommended to be included in models used to predict gastric cancer incidence among Chinese populations.

The diabetic complications involve blood vessels, eye, kidney and foot, and cause high disability and mortality, which severely endanger human health and quality of life. Epidemiological data have shown that the mortality of diabetes appears a tendency towards a rise in China, which results in a high burden of disease, and early screening and interventions are urgently needed to reduce the risk of mortality. Based on the publications of mortality due to diabetes in China from 2010 to 2021, this review summarizes the epidemiological characteristics of diabetes mortality and the main causes of deaths due to diabetes in China, so as to provide insights into management of diabetes epidemics and reduction in risk of diabetes mortality.