Evaluation of Integrated Service Strategy Based on Diagnosis of Duct-Dependent Congenital Heart Disease and Neonatal Mortality Data Analysis — Beijing, China, 2021–2022

Wen Zhang¹; Zhengchao Chen¹; Xiaozheng Chen¹; Hongyan Xu¹; Yanchun Zhang¹; Kaibo Liu^1,#

1. Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China.

# Corresponding authors: Kaibo Liu, liukb@mail.ccmu.edu.cn.

Integrated congenital heart disease (CHD) services were implemented in Beijing in 2022. This study analyzed prenatal diagnosis patterns and neonatal mortality data for duct-dependent CHDs before and after implementation to provide insights for service optimization. We conducted a retrospective analysis of 487 cases of duct-dependent CHDs identified through the Beijing Birth Defects Monitoring System from January 2021 to December 2022. The study population included fetuses and infants from 13 weeks' gestation to one year postnatal. Cases underwent descriptive analysis focusing on disease occurrence, diagnostic timing, and mortality outcomes. The prenatal diagnosis rate for duct-dependent CHDs increased from 93.39% in 2021 to 93.91% in 2022, while delayed diagnosis rates decreased from 4.28% to 3.91%. Genetic diagnosis rates improved from 27.92% to 31.94%. Live birth rates following prenatal diagnosis increased substantially from 28.75% to 40.28%. Outcomes varied significantly by CHD subtype, with complete transposition of the great arteries with intact ventricular septum achieving an 82.14% live birth rate, while hypoplastic left heart syndrome cases resulted in no live births. Notably, neonatal mortality decreased markedly from 7.23% to 3.03%. Beijing's integrated service model for CHDs has effectively strengthened the connection between secondary and tertiary prevention strategies, reduced unnecessary pregnancy terminations, and improved neonatal survival outcomes.

基于导管依赖性先天性心脏病诊断与新生儿死亡资料的一体化服务策略评价 — 北京直辖市，中国，2021年–2022年

张雯¹；陈正超¹；陈笑征¹；徐宏燕¹；张彦春¹；刘凯波^1，#

1.首都医科大学附属北京妇产医院，北京妇幼保健院，北京，中国。

^# 通信作者: 刘凯波，liukb@mail.ccmu.edu.cn。

2022年北京市开展先天性心脏病一体化服务工作，本文对一体化服务开展前后北京市导管依赖性先天性心脏病的诊断时限、新生儿死亡资料进行分析，为进一步优化一体化服务提供线索。本研究2021年1月至2022年12月，北京市出生缺陷监测系统内监测对象（孕13周-生后1岁）中的487例导管依赖性CHD胎/婴儿作为研究对象，对发生、诊断、新生儿死亡资料进行描述性分析。 研究表明，2022年导管依赖性CHD产前诊断比例（93.91%）高于2021年（93.39%），延迟诊断比例（3.91%）低于2021年（4.28%）；遗传学诊断比例（31.94%）高于2021年（27.92%），产前诊断后活产比例（40.28%）高于2021年（28.75%），不同分型活产比例存在差异，室间隔完整的完全性大动脉转位活产比例为82.14%，左心发育不良活产0。2022年新生儿病死率（3.03%）低于2021年（7.23%）。结果表明北京市先天性心脏病一体化服务模式有效促进二级、三级预防有效衔接，避免不合理的终止妊娠，降低新生儿死亡率。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.025

Ningxia First Case of Orientia tsutsugamushi Infection — Ningxia Hui Autonomous Region, China, 2023

Xiuxiu Li^1,&; Dongyue Lyu^2,&; Jian Li^3,&; Jindong Zuo¹; Hanyu Sha²; Liping Wang¹; Xueping Ma⁴; Qun Duan²; Shuai Qin²; Ran Duan²; Rui Rao¹; Deming Tang⁵; Ziyi Bu⁶; Lianxu Xia²; Huaiqi Jing²; Xin Wang^2,#; Tao Zhang^4,#

1. People's Hospital of Yanchi County, Wuzhong City, Ningxia Hui Autonomous Region, China;

2. National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China;

3. Yanchi County Center for Disease Control and Prevention, Wuzhong City, Ningxia Hui Autonomous Region, China;

4. Ningxia Hui Autonomous Region Center for Disease Control and Prevention, Yinchuan City, Ningxia Hui Autonomous Region, China;

5. Dongcheng District Center for Disease Control and Prevention, Beijing, China;

6. Clinical college of Anhui medical university, Hefei City, Anhui Province, China.

& Joint first authors.

# Corresponding author: Xin Wang, wangxin@icdc.cn.; Tao Zhang, melody68man@163.com.

This study aims to report the diagnostic process of the first documented case of scrub typhus identified in Ningxia Hui Autonomous Region, China, and to explore its public health significance. The patient was diagnosed through clinical symptoms, clinical examination, and serological tests. On July 10, 2023, a 58-year-old female farmer was bitten by an insect on her right ankle. Subsequently, she experienced acute onset of high fever (39.7℃) with accompanying headache, nausea, disseminated papular rash, eschar, and bilateral inguinal lymphadenopathy (right: 2.1cm×1.1cm; left: 2.7cm×1cm). Clinical examination revealed normal white blood cell counts, decreased eosinophil, and liver dysfunction (elevated aspartate aminotransferase and alanine aminotransferase). Serum sample collected from the patient (August 16, 2023) was tested for scrub typhus, which showed positive IgM but negative IgG. The case was confirmed as scrub typhus based on exposure history, clinical symptoms, and serological examination. The patient was treated with anti-infective treatment, anti-inflammatory effects and hepatoprotection, and significant clinical improvement. This study reports the first documented case of scrub typhus identified in Ningxia Hui Autonomous Region, China, indicating that improving the prevention and control of scrub typhus in this area and enhancing the detection and diagnostic capabilities of medical personnel is crucial.

宁夏首例恙虫病报告 — 宁夏回族自治区，中国， 2023年

李秀秀^1,&；吕东月^2,&；李剑^3,&；左进东¹；沙含雨²；王丽萍¹；马学平⁴；段群²；秦帅²；段然²；饶锐¹；汤德铭⁵；卜子弋⁶；夏连续²；景怀琦²；王鑫^2,#；张涛^4,#

1. 盐池县人民医院，吴忠市，宁夏回族自治区，中国；

2. 传染病预防控制所，中国疾病预防控制中心，北京，中国；

3. 盐池县疾病预防控制中心，吴忠市，宁夏回族自治区，中国；

4. 宁夏回族自治区疾病预防控制中心，银川市，宁夏回族自治区，中国；

5. 东城区预防控制中心，北京，中国；

6. 安徽医科大学，合肥市，安徽省，中国。

^& 共同第一作者。

^# 通信作者：王鑫, wangxin@icdc.cn.; 张涛, melody68man@163.com。

本研究旨在报道中国宁夏回族自治区1例恙虫病例的诊断过程，并探讨其公共卫生意义。

通过临床症状、临床检查及血清学检测对患者进行诊断。一位58岁女性农民，2023年7月10 日右踝被昆虫叮咬后出现高热（39.7℃）、头痛、恶心、皮疹、焦痂及腹股沟淋巴结肿大（右侧2.1cm×1.1cm，左侧2.7cm×1cm）。临床检查显示白细胞正常、嗜酸性粒细胞降低、肝肾功能异常（谷草转氨酶和谷丙转氨酶升高）。采集2023年8月16号血清检测恙虫病特异性抗体 IgM 阳性IgG阴性。该病例通过暴露史、临床症状、血清学检查，确诊为恙虫病。对患者采取抗感染、抗炎和保肝等治疗，症状好转。本研究报道了中国宁夏回族自治区首例恙虫病东方体感染病例，提示需要加强该地区恙虫病的监测与防控水平，并提升医务人员对恙虫病的诊断能力。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.026

Association of Childhood Trauma Subtypes and Substance Use Among Chinese College Students — Jilin Province, China, 2021

You Wu^1,2,&; Bowen Liu^3,4,&; Leiyu Shi¹; Dongyang Chen³; Yunhe Wang⁵; Dake Wei⁶; Diyang Qu³; Shicun Xu^7,8,9; Yingjie Zhang^10,#; Xiaoqian Zhang^4,#

1. Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA;

2. Institute for Hospital Management, Tsinghua University, Shenzhen City, Guangdong Province, China;

3. Vanke School of Public Health, Tsinghua University, Beijing, China;

4. Wulituo Hospital of Beijing Shijingshan District, Beijing, China;

5. Nuffield Department of Population Health, University of Oxford, Oxford, UK;

6. School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China;

7. Northeast Asian Research Center, Jilin University, Changchun City, Jilin Province, China;

8. Department of Population, Resources and Environment, Northeast Asian Studies College, Jilin University, Changchun City, Jilin Province, China;

9. China Center for Aging Studies and Social-Economic Development, Jilin University, Changchun City, Jilin Province, China;

10. Tsinghua University Hospital, Beijing, China.

& Joint first authors.

# Corresponding author: Xiaoqian Zhang, xiaoqian1211@tsinghua.edu.cn; Yingjie Zhang, yingjiezhang@tsinghua.edu.cn.

Childhood trauma represents a critical determinant in the rising prevalence of substance use among young populations globally, constituting a significant public health challenge. This study examined the relationship between substance use and trauma in a large cohort of Chinese college students, investigating how distinct trauma categories and cumulative exposure patterns influence substance use behaviors. This investigation constitutes part of a comprehensive cross-sectional study utilizing convenience sampling across 63 universities in Jilin Province, China. The study encompassed 96,151 participants (male=40,039, 41.64%; mean age=19.59 years). We employed logistic regression analyses to calculate adjusted odds ratios for various childhood trauma types on different aspects of substance use, accounting for relevant confounding variables. To elucidate distinct influences on substance use patterns among Chinese college students, we categorized cumulative abuse experiences on a spectrum ranging from no childhood trauma to multiple types of abuse experiences. Participants who experienced severe emotional abuse, sexual abuse, and physical neglect during childhood demonstrated significantly elevated risks of substance use: emotional abuse [adjusted odds ratio (aOR): 1.22, 95% confidence interval (CI): 1.04 to 1.42], sexual abuse (aOR: 1.54, 95% CI: 1.32, 1.80), and physical neglect (aOR: 1.11, 95% CI: 1.04, 1.19). Cumulative trauma experiences exhibited a consistent dose-response relationship, with increased exposure to traumatic events corresponding to substantially higher odds of substance use. Compared to individuals without childhood trauma, those who experienced all five types of abuse showed approximately doubled risks for any substance use (aOR: 2.16, 95% CI: 1.94, 2.41), smoking (aOR: 1.82, 95% CI: 1.62, 2.05), e-cigarette use (aOR: 2.48, 95% CI: 2.12, 2.89), and alcohol use (aOR: 2.03, 95% CI: 1.82, 2.26). This investigation demonstrates a robust association between childhood trauma and substance use among the youth population. The findings reveal markedly elevated risks of smoking, e-cigarette use, and alcohol consumption, particularly among individuals with severe and cumulative childhood trauma experiences. These results underscore the critical need for targeted interventions and support strategies specifically designed to address the cumulative burden of childhood trauma within this vulnerable population.

童年创伤亚型与物质使用的关联 — 吉林省，中国，2021年

吴优^1,2,&；刘博文^3,4,&；石磊玉¹；陈东阳³；王云鹤⁵；魏大可⁶；屈笛扬³；许世存^7,8,9；张莹洁^10,#；张小芊^4,#

1. 健康政策与管理系，布隆伯格公共卫生学院，约翰霍普金斯大学，巴尔的摩，马里兰州，美国；

2. 医院管理研究院，清华大学，深圳市，广东省，中国；

3. 万科公共卫生与健康学院，清华大学，北京，中国；

4. 北京石景山区五里坨医院，北京，中国；

5. 纳菲尔德人群健康研究所，牛津大学，牛津，英国；

6. 公共卫生学院，香港大学，香港特别行政区，中国；

7. 东北亚研究中心，吉林大学，长春市，吉林省，中国； 

8. 人口、资源与环境系，东北亚研究学院，吉林大学，长春市，吉林省，中国；

9.中国老龄化研究中心与社会经济发展研究院，吉林大学，长春市，吉林省，中国；

10. 清华大学医院，北京，中国。

^& 共同第一作者。

^# 通信作者: 张小芊, xiaoqian1211@tsinghua.edu.cn; 张莹洁, yingjiezhang@tsinghua.edu.cn。

既往研究表明，童年创伤是物质使用的关键风险因素，但不同童年创伤亚型对物质使用的影响仍需探索。本研究旨在评估中国大学生群体中物质使用与童年创伤之间的关联，明确五种童年创伤亚型和累积暴露如何增加物质使用行为的风险。本研究基于一项大型横断面研究，涵盖了中国吉林省的63所大学。共计96,151名参与者完成了调查（男性=40,039，41.64%；平均年龄=19.59岁）。采用Logisitic回归评估不同童年创伤亚型对三种物质使用（饮酒、吸烟、电子烟使用）的影响，并将累计的童年创伤进行分类，重新编码为无创伤经历到五种创伤经历，从而明确童年创伤对中国大学生物质使用模式的累积风险影响。经历严重情感虐待、性虐待和身体忽视的参与者，其物质使用风险显著增加，具体风险情况为：情感虐待（aOR：1.22, 95% CI：1.04, 1.42），性虐待（aOR：1.54, 95% CI：1.32, 1.80）和身体忽视（aOR：1.11, 95% CI：1.04, 1.19）。累积创伤经历表现出一致的趋势，经历更多创伤类型的参与者其物质使用风险显著增加。经历五种虐待的个体在任何物质使用（aOR：2.16, 95% CI：1.94, 2.41）、吸烟（aOR：1.82, 95% CI：1.62, 2.05）、电子烟使用（aOR：2.48, 95% CI：2.12, 2.89）和饮酒（aOR：2.03, 95% CI：1.82, 2.26）的风险大约是没有童年创伤者的两倍。本研究突出了童年创伤与大学生物质使用之间的关联。特别是经历严重和累积童年创伤的个体，其吸烟、电子烟使用和饮酒的风险明显增加，这表明需要对这一群体实施针对创伤累积负担的干预和支持策略。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.027

Suicide Risk and Its Associations with Psychiatric Symptoms and Sleep Disturbances in Schizophrenia Inpatients — Henan, Hebei, and Shandong Provinces and Beijing Municipality, China, 2019–2022

Chaowei Li¹; Yun Chen¹; Lyufeng Zhang²; Hongle Zhang³; Shun Zhang⁴; Qianqian Chen⁵; Meihua Yang²; Na Liang²; Sifan Hu¹; Zhaojun Ni¹; Lin Lu¹; Xinyu Sun^1,#; Hongqiang Sun¹

1. Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China

2. Zhumadian Second People's Hospital, Zhumadian Psychiatric Hospital, Zhumadian City, Henan Province, China

3. Liaocheng Fourth People's Hospital, Liaocheng City, Shandong Province, China

4. Kailuan Mental Health Centre, Tangshan City, Hebei Province, China

5.  Fifth Hospital of Qinhuangdao, Qinhuangdao City, Hebei Province, China.

^# Corresponding author: Xinyu Sun, sunxinyu@bjmu.edu.cn.

Suicide behaviors are prevalent among inpatients with schizophrenia. However, the associations between psychiatric symptoms, sleep disturbances, and suicide risk remain unclear in these high-risk populations. In this cross-sectional study conducted across nine hospitals in four Chinese provinces, suicide risk was assessed by uniformly trained psychiatrists using the suicide module of the Mini-International Neuropsychiatric Interview. Among 672 inpatients with schizophrenia, the prevalence of suicide risk was 22.3% (95% CI: 19.3, 25.6%). Multivariable logistic regression revealed that suicide risk was associated with poor sleep quality, depressive symptoms, anxiety symptoms, and other psychiatric manifestations including thinking disorder and activation. Identifying the common sleep and psychiatric factors associated with suicide risk in hospitalized schizophrenia patients will help clinicians and policymakers recognize clinical characteristics and enhance the quality of treatment and control programs for suicide prevention.

精神分裂症住院患者的自杀风险及其与精神症状和睡眠紊乱的关联 —河南、河北、山东省和北京直辖市，中国，2019–2022年

李朝伟¹；陈云¹；张绿凤²；张洪乐³；张顺⁴；陈倩倩⁵；杨美华²；梁娜²；胡思帆¹；倪照军¹；陆林¹；孙新宇^1,#；孙洪强¹

1. 北京大学第六医院，北京大学精神卫生研究所，国家卫生健康委精神卫生学重点实验室（北京大学），国家精神心理疾病临床医学研究中心（北京大学第六医院），北京，中国；

2. 驻马店市第二人民医院，驻马店精神病医院，驻马店市，河南省，中国；

3. 聊城市第四人民医院，聊城市，山东省，中国；

4. 开滦精神卫生中心，唐山市，河北省，中国；

5. 秦皇岛市第五医院，秦皇岛市，河北省，中国。

^# 通信作者：孙新宇，sunxinyu@bjmu.edu.cn。

自杀行为在精神分裂症住院患者中常见。然而，在这些自杀高危人群中，精神症状、睡眠紊乱与自杀之间的关联尚不明确。在中国四省九家医院进行的横断面研究中，由经过统一培训的精神科医生使用简易国际精神访谈的自杀模块进行自杀风险的评估。结果显示，在672例精神分裂症住院患者中，自杀风险率为22.3% （95% CI：19.3, 25.6%）。多因素逻辑回归分析显示，自杀风险与睡眠质量差、抑郁、焦虑以及其他精神症状（如思维障碍和激活性）有关。了解与精神分裂症住院患者自杀风险相关的常见睡眠和精神因素将有助于临床医生和公共卫生决策者识别临床特征，并提高自杀治疗和预防控制的质量。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.028

Temporal Trends in Cardiovascular Disease Mortality Attributable to Ambient Particulate Matter Pollution — China, 1990–2021

Yunning Liu¹; Wu Yan²; Lijun Wang¹; Jing Wu^1,#

1. National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China;

2. Clinical Research Center, Children's Hospital of Nanjing Medical University, Nanjing City, Jiangsu Province, China.

^# Corresponding authors: Jing Wu, wujing@ncncd.chinacdc.cn.

Cardiovascular disease (CVD) represents a leading cause of mortality and disability in China. This study evaluates the temporal trends of cardiovascular disease mortality attributable to ambient particulate matter pollution (APMP) across China. Using data from Global Burden of Disease 2021 and age-period-cohort analysis, we found that APMP-attributable CVD mortality increased by 100.6% from 1990 to 2021 (101.8% increase in males, 100.0% in females). The mortality risk associated with APMP-attributable CVD showed a decline for both sexes after 2017. Birth cohort analysis revealed continuing risk increases in males while demonstrating decreases among females born after 1971. These findings underscore the need for more effective interventions to mitigate rising APMP-attributable CVD mortality, particularly among males.

归因于环境颗粒物污染的心血管疾病死亡率趋势分析 — 中国，1990–2021年

刘韫宁¹；燕武²；王黎君¹；吴静^1,#

1. 中国疾病预防控制中心慢性非传染性疾病预防控制中心, 北京, 中国；

2. 南京医科大学附属儿童医院临床研究中心, 南京市，江苏省, 中国。

^# 通信作者：吴静, wujing@ncncd.chinacdc.cn。

心血管疾病（CVD）是中国死亡和残疾的重要原因。本研究旨在评估中国环境颗粒物污染（APMP）导致的CVD死亡率长期趋势。数据来自于全球疾病负担研究2021，年龄-时期-队列模型用于数据分析。1990年至2021年，中国归因于APMP的CVD死亡率增加了100.6%（其中男性增加了101.8%，女性增加了100.0%）。2017年以后，归因于APMP的CVD死亡风险在男性与女性中均有所下降。对于不同的出生队列而言，男性死亡风险持续增加，但是1971年之后的女性出生队列死亡风险有所下降。需要更多的努力来缓解APMP导致的CVD死亡率上升趋势，尤其对于男性。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.029

The Cohort Study on Association Between Prolonged Sleep Latency and Hypertension — 4 PLADs of the Southern China, 2018–2020

Li Xiang¹; Jialu Yang²; Siqi Li²; Wanlan Chen²; Jiaqi Zhao²; Wanying Zhao²; Qi Zhang²; Min Xia²; Yan Liu^2,#

1. Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou City, Guangdong Province, China;

2. Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition, School of Public Health, Sun Yat-sen University, China.

^# Corresponding author: Yan Liu, liuyan215@mail.sysu.edu.cn.

To understand the prevalence of hypertension among adults aged 25–89 in the southern China and to explore the impact of prolonged sleep latency on the prevalence of hypertension. This study utilized baseline survey data from the South China Cohort (SCC), including a total of 72,476 subjects. Hypertension was defined as self-reported diagnosis of hypertension, the use of antihypertensive medication, or blood pressure ≥ 140/90 mmHg. Sleep latency was defined based on the Pittsburgh Sleep Quality Index (PSQI) questionnaire. A multivariable logistic regression model was used to investigate the impact of normal sleep latency, occasional prolonged sleep latency, and habitual prolonged sleep latency on the prevalence of hypertension. The prevalence of hypertension among adults aged 25–89 in the southern China was 24.03%. The prevalence of hypertension increased with longer sleep latency. After adjusting for potential confounding factors, the logistic regression model showed that subjects with habitual prolonged sleep latency had a 21% higher prevalence of hypertension compared to those with normal sleep latency. The findings suggest that the public should be encouraged to raise awareness of prolonged sleep latency and adopt targeted strategies to curb the rise in the prevalence of hypertension.

睡眠潜伏期延长与高血压相关性的队列研究 — 华南四省份，中国，2018–2020年

向丽¹；杨嘉璐²；李思琪²；陈婉兰²；赵嘉琪²；赵婉滢²；张琪²；夏敏²；柳雁^2,#

1. 广东省食品营养与健康重点实验室，流行病与卫生统计学系，公共卫生学院，中山大学，广州市，广东省，中国；

2. 广东省食品营养与健康重点实验室，营养学系，公共卫生学院，中山大学，广州市，广东省，中国。

^# 通信作者：柳雁, liuyan215@mail.sysu.edu.cn。

了解华南区域25-89岁成年人高血压患病情况，探索睡眠潜伏期延长对高血压患病率的影响。本研究利用了华南区域自然人群慢性病前瞻性队列研究(SCC)的基线调查数据，共纳入了72,476名研究对象，高血压定义为自我报告曾被诊断为高血压或服用降压药、连续测量的血压在140/90 mmHg及以上。睡眠潜伏期根据匹兹堡睡眠质量指数(PSQI)问卷定义。利用多因素Logistic回归模型探究正常睡眠潜伏期、偶发性睡眠潜伏期延长、习惯性睡眠潜伏期延长对高血压患病率的影响。华南区域25-89岁成年人高血压患病率为24.03%。高血压患病率随着睡眠潜伏期的延长而增加。调整了潜在混杂因素后的Logistic回归模型显示，伴有习惯性睡眠潜伏期延长的受试者高血压患病率比正常睡眠潜伏期的受试者高21%。研究结果表明，应鼓励公众提高对睡眠潜伏期延长的认识和采取针对性策略，以遏制高血压患病率的攀升。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.030