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2021 Vol. 37, No. 10

2021, 37(10): .
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2021, (10): 1-6.
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Special Report – Infectious Disease Control and Prevention
Verification on key issues in communicable disease control for urban primary health care institutions
WANG Quan, GUO Sha-sha, WANG Ting,
2021, 37(10): 1449-1453. doi: 10.11847/zgggws1132603
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  Objective   To verify key issues in the process of communicable disease control for urban primary health care institutions based on assessing the importance, seriousness, and priority of the issues.   Methods   We searched China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, the VIP database, and China Biomedical Literature Service System (SinoMed) for related studies published till August 21, 2020 and conducted literature researches and expert consultations to establish an overall list of the key issues. Then we calculated the index of importance (\begin{document}$ {I}_{i} $\end{document}), seriousness (\begin{document}$ {S}_{i} $\end{document}), and priority (\begin{document}$ {R}_{i} $\end{document}) for all issues listed for the determination of the items of the key issues.   Results  Totally 432 issues in the process of communicable disease control for urban primary health care institutions were identified based on literature studies on 126 finally included researches. We summarized the 432 issues into an issue system with 7 first-level issues and 22 second-level issues. Among all the issues in the constructed system, 3 were assessed as key issues, including the lack of public health doctors (\begin{document}$ {R}_{i} = 0.0765$\end{document}), the absence of institutional arrangement among urban primary health care institutions, upper-level hospitals and administrative agencies (\begin{document}$ {R}_{i} = 0.0741$\end{document}), and the incompetence of communicable disease diagnosis (\begin{document}$ {R}_{i} = 0.0566$\end{document}).   Conclusion   The structure of institutional system, human resource allocation and professional capability are key issues in the process of communicable disease control for urban primary health care institutions.
Progress in researches on methods for risk assessment of infectious diseases
KANG Liang-yu, LIU Jue, LIU Min
2021, 37(10): 1454-1458. doi: 10.11847/zgggws1132963
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In recent years, with the strengthening of prevention and control of infectious diseases and frequent occurrence of emerging infectious disease, risk assessment has been widely used in the prevention and control of different kinds of infectious diseases, and has achieved significant results. The methods frequently used in risk assessment of infectious disease include expert consultation method, Delphi method, the analytic hierarchy process, and risk level matrix analysis. World Health Organization and some relevant institutes have developed several risk assessment tools for major infectious diseases such as influenza, poliomyelitis, and measles. Recently, mathematical or probabilistic models, and geographic information systems, and big data have also been used to assess the risk of infectious diseases. The study reviewed various methods for risk assessment of infectious disease and assessment tools to provide enlightenments for risk assessment of infectious diseases.
Defining overall sentinel surveillance on emerging (major) infectious diseases – a literature study
JIAO Min, GAO Qian-qian, LIU Jin-mei,
2021, 37(10): 1459-1462. doi: 10.11847/zgggws1134198
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  Objective  To establish a general definition of overall sentinel surveillance (OSS) on emerging infectious diseases through reviewing relevant researches at home and abroad and clarifying dimensions of infectious disease sentinel surveillance to provide references to future studies on the issue.   Methods  Related literatures were retrieved through China National Knowledge Infrastructure (CNKI) and Web of Science. Content analysis and co-word clustering were used in sorting and categorizing the information about core definition of OSS on emerging infectious diseases; logical ‘deconstruction’ was used to explore dimensions of OSS for constructing the connotation and extension of OSS. The concept of OSS was defined based on formal logic definition method.   Results  Six dimensions of OSS were involved in 121 published studies (114 in Chinese and 7 in English), including ‘subject’, ‘essential attribution’, ‘monitoring purpose’, ‘monitoring content’, ‘classification’, and ‘grading’. Key people and at high risk people are principal populations of sentinel surveillance on infectious disease and the aim of the sentinel surveillance is to make early detection and warning of infectious disease epidemic for developing effective prevention and control strategies on the epidemic. The designated sentinel institutions or departments are responsible to conduct surveillance on factors relevant to potential emerging infectious disease epidemic; the factors include demographics, population behaviors, epidemiologic characteristics, medical intervention, symptoms/signs of disease cases, and auxiliary examination.   Conclusion   To make a clear definition of overall sentinel surveillance is of great significance for guiding contemporary practice in sentinel surveillance on emerging infectious disease epidemics.
Connotation and theoretical framework for three-dimensional decision-making of social control on emerging (major) infectious diseases: a literature study
LI Bing-hang, CHEN Miao-miao, LIU Jin-mei,
2021, 37(10): 1463-1467. doi: 10.11847/zgggws1134195
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  Objective  To explore the theoretical framework of social control on emerging (major) infectious diseases.   Methods  With the key words such as ‘social regulation/control’ and ‘formal/informal control’, we searched PubMed, China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-Text Database (Wanfang) and other academic databases for related literatures published from 1900 through 2020. Relevant elements of social regulation were analyzed and mined using content analysis and expert argumentation. Test-retest reliability was adopted to assess the analytic reliability of each element.   Results  Through logical analysis on the 45 full-text Chinese or English literatures retrieved, totally 11 elements were elaborated and the elements included the purpose, principle, scope of control, subject of control, means of control, process of control, object of control, value orientation and result. The indexes of test-retest reliability were between 0.800 – 1.000, indicating good reliability of the analyses. Two other elements – control time and control intensity were added to the element list based on expert argumentation and logical analysis. The relationship among the elements of social regulation were expounded in the light of the logical framework of global governance and the ‘structure-process-result’ model. Through the study and judgment on three dimensions (transmission route, infectivity and severity) of an infectious disease, a three-dimensional decision-making theoretical framework for social control on emerging (major) infectious diseases was constructed.   Conclusion  The theoretical framework, as an important basis for scientifically determining the region, intensity and time of different social control on a major infectious disease, will play a guiding role in effectively and timely controlling on an infectious disease epidemic.
Establishment of a full-coverage sentinel and multi-symptom surveillance system for new (major) infectious diseases – a literature study
LIU Jin-mei, GAO Qian-qian, JIAO min,
2021, 37(10): 1468-1472. doi: 10.11847/zgggws1134197
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  Objective  To explore main problems existing in current infectious disease surveillance system and to propose some primary considerations on the establishment of a full-coverage sentinel and multi-symptomatic infectious disease surveillance system in China to meet the growing demand for surveillance and prevention of infectious disease epidemic.   Methods  Literatures relevant to new (major) infectious disease surveillance and early warning published from 2000 through 2021 were systematically searched via China National Knowledge Infrastructure (CNKI), official websites of international organizations, and Baidu Scholar.   Results  Based on inductive generalization of 78 literatures retrieved, a theoretical infrastructure was proposed for the full-coverage sentinel and multi-symptomatic infectious disease surveillance system to be constructed. The suggested system should be operated effectively at five-regional level (country, province, municipality, county, and township); the system′s sentinels should include medical institutions, grassroots units, departments responsible for surveillance among migrant populations and a big data management center is also to be constructed for the system. Early clinical and social symptoms of new (major) infectious diseases should be monitored comprehensively across whole country.   Conclusion  The construction of full-coverage sentinel and multi-symptomatic surveillance system for new (major) infectious diseases should follow the principles of unified planning, nationwide networking, resource sharing, and effectively operating at ordinary times and in emergency.
Infectious disease surveillance system in Japan and its implication for China
CHEN Wan-li, DONG Lin-juan, WANG Ji-wei,
2021, 37(10): 1473-1477. doi: 10.11847/zgggws1131825
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Infectious disease surveillance is essential for early detection and timely control of infectious disease. This study introduced laws and regulations of the infectious disease surveillance system, classification standards of infectious diseases, surveillance methods and contents, quality control, and the surveillance on emerging infectious diseases in Japan. The study emphasized on case reports, pathogen reports and surveillance of emerging infectious diseases in Japan to provide a reference for improving infectious disease surveillance system in China.
Progress in researches on internet big data-based infectious disease prediction and early warning
LIN Meng-xuan, CHEN Hui, SONG Hong-bin,
2021, 37(10): 1478-1482. doi: 10.11847/zgggws1136289
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Infectious disease epidemics are a serious threat to human life and health. The prediction and early warning of infectious disease epidemics are the keys to the prevention of infectious diseases. The early warning of infectious disease epidemics based on traditional methods cannot meet the needs of current early warning of infectious disease epidemics. With the construction and application of big data, the researche on infectious disease epidemic prediction and early warning technology based on internet big data has become one of research hot spots. In this study, we reviewed internet big data based methods and models for the prediction and early warning of infectious disease epidemic from a technical point of view for providing references to researchers engaged in the field.
Epidemiological Research
Prevalence of high cardiovascular risk and preventive medication in residents aged 35 – 75 years in Northeastern China: an analysis on population screening data
YANG Yang, ZHU Zhi-hong, ZHANG Xing-yi,
2021, 37(10): 1483-1488. doi: 10.11847/zgggws1133293
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  Objective  To describe the characteristics of risk factors and the usage of prevention drugs for cardiovascular diseases (CVD) among adult residents in Northeastern China and to provide evidence data for developing strategies on precise prevention and control of cardiovascular diseases.  Methods   From the dataset of Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) conducted across China from 2014 to 2019, we extracted the data on 414 346 permanent residents aged 35 – 75 years in 26 county-level regions in 3 northeastern provinces of China. The overall and age-, sex-, geographic region-, and socioeconomic status-specific ratio of people at high of CVD risk were calculated for the participants. Multivariate mixed model was adopted to assess associations of individual characteristics with CVD risk factors. The usage of statins and aspirin recommended in China′s national guidelines for CVD prevention was also analyzed to evaluate CVD preventive medication among the participants at high CVD risk.   Results   Of all the participants, 8.9% were identified as individuals at high risk of CVD, and the ratio was relatively higher among the male and rural participants. Mixed model analysis revealed that the participants with higher education, being married and with medical insurance were less likely to be at high risk of CVD but those with an annual household income of 50 000 Yuan RMB were more likely to be at high risk of CVD. Of the participants with high CVD risk, only 0.4% reported taking both statins and aspirin currently.   Conclusion   Among the 35 – 75 years old permanent residents in Northern China, nearly 9% are individuals at high risk of cardiovascular diseases; whereas, less than 1% of the high risk individuals have current medication of statins and aspirin recommended by national guidelines for cardiovascular disease prevention, suggesting that relevant interventions should be promoted among the high risk population for the prevention of the diseases.
Mortalities and years of life lost correlated to alcohol use among residents in China: 2000 – 2019
HUANG Fu-lin, LI HUI, ZHAO Yan,
2021, 37(10): 1489-1494. doi: 10.11847/zgggws1134161
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  Objective  To examine the mortality and years of life lost (YLLs) induced by alcohol use in China from 2000 to 2019 and to provide evidences for making policy on the control of alcohol use.  Methods  The data on estimated age-, gender- and disease-specific mortalities and YLLs attributable to alcohol use during the years from 2000 to 2019 in China were extracted from the Global Burden of Disease (GBD) Study. Average annual change percentage (AAPC) and annual change percentage (APC) were used to analyze changing trend in the mortalities and YLL rate during the period.  Results  From 2000 to 2019, the standardized mortality rate (1/100 000) and YLL rate (1/100 000) attributable to alcohol drinking for Chinese residents decreased from 35.30 and 955.84 to 26.98 and 715.84, with a significant downward trend (both P < 0.001); for the male and female Chinese residents from 2000 to 2019, the standardized mortality rate decreased from 67.62 and 7.52 to 54.72 and 4.44 and the standardized rate of YLL decreased from 1 759.04 and 166.69 to 1 370.77 and 95.07, respectively; all the rates showed a significant downward trend (all P < 0.001). Among the residents aged 15 – 49 years, significant decreases from 2000 to 2019 were observed in alcohol use-related mortality rate (from 1.06 and 9.17 to 0.35 and 8.38) and YLL rate (from 53.15 and 438.82 to 17.02 and 395.73) of infectious and non-communicable diseases (all P < 0.001). Compared to those in 2000, significant decreases in 2019 were observed in alcohol use-related mortality rates (1.80 vs. 6.10, 52.61 vs. 73.75, and 3.96 vs. 5.49) and YLL rates (52.12 vs. 176.83, 1 545.58 vs. 2 190.40, and 122.00 vs. 171.03) of infectious diseases, non-communicable diseases, and injuries among the residents aged 50 – 69 years (P < 0.001 for all); while among the residents ≥ 70 years old, significant decreases were also observed in alcohol use-related mortality rates (10.48 vs. 23.03 and 174.27 vs. 195.45) and YLL rates (139.03 vs. 346.01 and 2 514.83 vs. 3 004.96) of communicable diseases and non-communicable diseases (all P < 0.001).  Conclusion  From 2000 to 2019, the alcohol drinking-related mortality rate and YLL rate decreased in Chinese residents 15 years old and above generally but there was no significant downward trend was observed in the alcohol drinking-related mortality rate and YLL of injuries among the residents aged 15 – 49 years and the residents aged 70 years and above.
Changing trajectory of lung cancer mortality in Chinese residents 30 years old and above, 2013 – 2018
ZHAO Jian, LIU Li-qun, AI Fei-ling,
2021, 37(10): 1495-1500. doi: 10.11847/zgggws1132799
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  Objective   To analyze changing trajectory of lung cancer mortality among Chinese residents aged 30 years and above from 2013 to 2018 and to provide evidences for developing strategies on lung cancer treatment and prevention.  Methods   From cause-of-death data in the National Disease Surveillance Point system, we extracted the data on all lung cancer deaths at ages of 30 and above (n = 588 245) registered from 2013 through 2018 at 605 surveillance sites in 31 provincial level regions across China. The population census data of 2010 was used in calculation of standardized mortality rate (SMR). Latent variable growth model was adopted to analyze gender-, age-, and region-specific changing trajectory of lung cancer mortality.  Results   For years of 2013 – 2018, the annual crude mortality rates (1/100 000) of lung cancer were 40.2, 40.0, 44.8, 44.9, 45.4, and 46.5 for the Chinese residents aged 30 years and above, respectively and the corresponding SMRs (1/100 000) were 35.4, 37.2, 38.8, 36.5, 36.6, and 36.1, with an up-down trend (χ2trend = 3.42, P < 0.001). Four patterns of changing trajectory of lung cancer mortality in male residents could be identified, with a pattern of linearly downward trend and other three patterns of quadratic curving. Similar changing trajectories of lung cancer mortality over years were observed in the residents aged 30 – 70 years in eastern, central and western China; but in the residents at older age with higher lung cancer mortality, different patterns of changing trajectories were identified. For female residents, three patterns of lung cancer mortality trajectories changing over years were found and the trajectories showed a trend of rising first and then decreasing; the changing trajectory for female rural residents aged 45 – 49 years in eastern China differed from that for the residents of same ages in other regions and the trajectory was similar to that for the residents at elder age with higher lung cancer mortality rates.  Conclusion   There are different changing trajectories of lung cancer mortality between male and female residents in China. Identifying gender-, age-, and region-specific changing trajectory of lung cancer mortality is meaningful for developing targeted measures for lung cancer prevention and control.
Change trend in disease burden of stroke and its risk factors in China, 1990 – 2017
LIU Mi, WANG Chen-ran, LIANG Juan-juan,
2021, 37(10): 1501-1507. doi: 10.11847/zgggws1128349
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  Objective  To analyze change trend in disease burden of stroke and its risk factors in China from 1990 through 2017 and to provide evidences for rational allocation of health resources and the development of targeted stroke prevention and treatment strategies.   Methods  Data on disease burden of stroke during the period from 1990 through 2017 in China were extracted from the Global Burden of Disease (GBD) Study of 1990, 2000, 2010 and 2017. Years lived with disability (YLDs), years of life lost (YLLs), disability adjusted life years (DALYs) were used to evaluate the disease burden of stroke and population attributable fraction (PAF) was adopted to analyze risk factors of stroke-related disease burden. Disparities in disease burden of stroke between China and the world were compared.   Results  During the period of 1990 – 2017 in China, the YLLs rate and DALYs rate of stroke increased gradually; the YLLs rate also increased generally but with a temporary decline in 2010. In 2017 in China, the age-specific YLDs, YLLs, and DALYs rate of stroke increased with the increment of age and the highest rates were observed among the population aged ≥ 70 years (2 617.2/100 000 for YLDs, 16 789.4/100 000 for YLLs, and 16 773.4/100 000 for DALYs); the YLDs rate was lower for the males than that for the females (475.5/100 000 vs. 530.9/100 000) but the YLLs and DALYs rate were higher for the males than those for the females (3 181.7/100 000 vs. 2 060.9/100 000 and 3 657.1/100 000 vs. 2 591.8/100 000); the age-standardized YLDs, YLLs, and DALYs rate of stroke were higher than those in the world (374.5/100 000 vs. 235.0/100 000, 1 967.8/100 000 vs. 1 422.2/100 000, and 2 342.3/100 000 vs. 1 657.2/100 000). Compared to those in 1990 in China, the age-standardized YLDs rate of stroke increased by 30.9%; while, the age-standardized YLLs rate and DALYs rate decreased by 38.8% and 33.1%; the change trend of the three rates were consistent with the changes in global stroke burden (5.9% for YLDs, = – 34.5% for YLLs, and – 30.7% for DALYs). Among the 16 risk factors associated with DALYs (million person-years), PAF, and DALYs rate of stroke, the top five were hypertension (24.974, 56.4%, and 1 768.1/100 000), excessive sodium intake (17. 060, 38.5%, and 1 207.8/100 000), insufficient fruit intake (10.717, 24.2%, and 758.7/100000), insufficient cereal intake (10.690, 24.1%, and 756.8/100 000), and smoking (10.037, 22.7%, and 710.6/100 000) for the population in China in 2017; from 1990 to 2017, PAF for the 10 of the 16 stroke risk factors increased and the other 6 decreased, with the highest increase (90.0%) for high body mass index and the greatest decrease ( – 71.3%) for indoor air pollution.   Conclusion   In China, the disability caused by stroke is increasing gradually and although being effectively controlled, stroke-related premature death is still the main contribution of disease burden. Primary prevention strategies should be promoted to alleviate the disease burden of stroke.
Dyslipidemia among 12 – 17 years children in western region of China: a cross-sectional analysis, 2016 – 2017
LI Yu-qian, JIA Shan-shan, LIU Bei-bei,
2021, 37(10): 1508-1513. doi: 10.11847/zgggws1131893
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  Objective  To examine the prevalence of dyslipidemia among 12 to 17 years old children in western region of China from 2016 to 2017.  Methods  The data on demographics, physical examination and blood lipid measurement for 11 474 children aged 12 – 17 years were extracted from ′ Nutrition and Health Surveillance for Children and Nursing Mothers′ conducted in 11 provinces and municipalities (not including Tibet Autonomous Region) across western region of China from 2016 through 2017. The prevalence of dyslipidemia among the children was statistically analyzed.  Results  For all the children surveyed, the overall detection rate of dyslipidemia was 21.12%, with the detection rates of 1.27% for hypercholesterolemia, 5.65% for hypertriglyceridemia, 1.39% for elevated low-density lipoprotein cholesterol, 16.21% for low high-density lipoprotein cholesterol, and 1.28% for elevated non-high-density lipoprotein cholesterol, respectively; the overall detection rate of dyslipidemia was 50.86% among obese children. Significant disparities in detection rate of dyslipidemia were observed among the children with different demographic and physique characteristics (P < 0.05).  Conclusion  Dyslipidemia was detected among more than one-fifth of the 12 to 17 years old children in western China; the dyslipidemia detection rate was different among the children with various characteristics and the detection rate was much more higher among the obese children.
Associations of altitude and ethnic groups with congenital heart disease prevalence in primary and secondary school students in five provinces of China: a screening data analysis
SONG Hong-lin, LU Jiang, ZHOU Ru-fang,
2021, 37(10): 1514-1516. doi: 10.11847/zgggws1130055
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  Objective   To investigate the prevalence of congenital heart disease (CHD) among primary and secondary school students of various ethnic groups and living in regions with different altitude in five provinces of China and to provide evidences for screening and prevention of CHD in communities.   Methods  Using cluster sampling, We recruited 1 952 919 primary and secondary school students aged 6 – 16 years in 16 municipalities and 6 prefectures of Tibet Autonomous Region (Tibet) and Yunnan, Hebei, Shanxi, Guizhou province and carried out community screenings on CHD among the students from April 2017 through December 2019. CHD cases were diagnosed based on oxyhemoglobin saturation detection and B-mode cardiac ultrasound examination.   Results   Totally 2 874 CHD cases were diagnosed and the CHD prevalence rate was 1.47‰ for all the students. The highest CHD prevalence rate of 7.64‰ was observed among the students in Tibet, followed by the rates among the students in Yunnan (1.49‰), Guizhou (1.02‰), Hebei (0.77‰), and Shanxi (0.69‰), with a significant difference (χ2 = 160.981, P < 0.001). The CHD prevalence rate differed significantly among the students living in regions at various altitude, with the rates of 0.69‰, 1.57‰, 1.45‰, and 1.37‰ for the students living in regions at the altitudes of < 1 000 m, 1 000 – 1 499 m, 1 500 – 1 999 m, and ≥ 2 000 m, respectively (χ2 = 26.081, P < 0.001). The CHD prevalence rate was also significantly different among the students of various ethnic groups and living in a same regions at a specific altitude; the CHD prevalence rates were 2.06‰, 1.93‰, and 1.34‰ for the students of Jingpo/Dai, Hani/Ni, and Han ethnics living in regions at the altitude of 1 000 – 1 499 m; the CHD prevalence rates were 1.68‰, 1.45‰, 1.00‰, and 0.62‰ for the students of Han, Ni, Bai, and Zhuang/Miao ethnics living in regions at the altitude of 1 500 – 1 999 m; and the CHD prevalence rates were 1.87‰, 1.54‰, and 0.69‰ for the students of Dong, Tibetan, and Lisu ethnics living in regions at the altitude of ≥ 2 000 m; all the differences were statistically significant (P < 0.05 for all).   Conclusion  In China, the prevalence rate of congenital heart disease is different among the primary and secondary school students living in various regions at different altitude; while for the students living in regions with the same altitude, the congenital heart disease prevalence rate differs by ethnic groups.
Experimental Study
Protective effect of proanthocyanidin on pancreatic iron metabolism disorder in diabetic rats
LIU Dan-dan, LI Xiao-xue, ZHOU Tong-tong,
2021, 37(10): 1517-1520. doi: 10.11847/zgggws1132021
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  Objective   To investigate protective effect of grape seed proanthocyanidin extract (GSPE) on pancreatic iron metabolism disorder and its mechanism in diabetic rats.   Methods   Healthy male Sprague-Dawley (SD) rats were randomly divided into a control group (n = 10) and diabetes group (30 rats with two intraperitoneal injections of 30 mg/kg streptozotocin); then the rats of diabetes group were further randomly assigned to a model group, a low and a high GSPE groups (by intragastric administration at dosages of 100 and 250 mg/kg once a day continuously for two weeks). By the end of the treatments, all rats′ blood samples were collected for determinations of glucose and insulin level; the specimens of the rats′ pancreatic tissues were also sampled for detections of transferrin (TF)/TF receptor (TFR)/iron, superoxide dismutase (SOD), reduced glutathione (GSH), malondialdehyde (MDA), and glutathione peroxidase (GSH-Px) with kit method.   Results   Significantly increases in blood glucose, pancreatic tissues′ TF, TFR, iron, MDA and decreases in blood insulin, pancreatic tissues′ SOD, GSH, GSH-PX activity were detected in the model rats compared to those in the control rats (P < 0.05 for all). The rats of GSPE dose groups had significantly higher blood insulin, pancreatic tissues′ SOD, GSH, GSH-PX activity but lower pancreatic tissues′ TF, TFR, iron in comparison to the model rats (all P < 0.05). Correlation analysis revealed that the pancreatic tissues′ TF, TFR, iron were positively associated with blood glucose and homeostatic model assessment for insulin resistance (HOMA-IR) in the rats.   Conclusion  Proanthocyanidin has a protective effect on pancreas and the effect may be related to the regulation of iron metabolism disorder and reduction of oxidative damage in diabetic rats.
Effect and mechanism of Yinchen Wuling Powder on liver function in young rats with cholestasis
WANG Xin-fang, HU Chen-min, ZHAO Zhen,
2021, 37(10): 1521-1526. doi: 10.11847/zgggws1132576
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  Objective  To examine protective effect and mechanism of Yinchen Wuling Powder (composed of Chinese medicinal herbs including Artemisia capillaris, Poria cocos, Rhizoma alismatis, Polyporus umbellatus, Ramulus cinnamomi, and Rhizoma atractylodis) on liver function in young rats with cholestasis.  Methods  Totally 72 young Sprague-Dawley (SD) rats were randomly divided into 6 groups (6 males and 6 females in each group): a blank control and a model group with normal saline, an ursodeoxycholic acid (UDCA, at the dose of 0.10 g/kg) group, and low, moderate, high dose (100, 200, 400 g/kg) Yinchen Wuling Powder groups. The administrations were conducted by gavage once a day continuously for 6 days before and 2 day after the establishment of cholestasis model induced by intragastric administration of 0.5% α-naphthalene isothiocyanate (ANIT) at the dosage of 50 mg/kg in all rats except for those of control group. Twelve hours after the last administration, all rats′ bile were collected and blood specimens were sampled for detections of serum alkaline phosphatase (ALP), γ-glutamyltransferase (γ-GT), total bile acid (TBA), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) with biochemical method; the rats′ liver tissue specimens were also sampled for detections of superoxide dismutase (SOD), malondialdehyde (MDA), catalase (CAT), and glutathione peroxidase (GSH-Px) in liver homogenate with biochemical method, the observation of pathological changes in liver tissues with hematoxylin-eosin (HE) staining; and determinations of protein expression of Kelch-like ECH-associated protein 1(Keap1), nuclear factor erythroid-2-related factor-2 (Nrf2), reduced coenzyme/quinone oxidoreductase (NQO1), and heme oxygenase 1 (HO-1) with Western blot.  Results  Compared with those in the blank control rats, significantly higher serum ALP, γ-GT, TBA, ALT and AST and lower bile secretion, SOD, CAT and GSH-Px in liver tissues were detected in the model rats (P < 0.05 for all); disordered arrangement of hepatocyte cords, enlargement/spotty necrosis/vacuolar change of the hepatocytes, and a large number of inflammatory cell infiltration were observed in the model rats′ liver tissues; significantly higher expression of Keap1 but lower expressions of Nrf2, NQO1 and HO-1 in liver tissue were also detected (all P < 0.05). In comparison with the model rats, the rats of UDCA group and high/moderate dose Yinchen Wuling Powder groups had significantly lower serum ALP, γ-GT, TBA, ALT, AST and MDA in liver homogenate but higher bile secretion, SOD, CAT and GSH-Px in liver homogenate (all P < 0.05); the rats of the three groups also had significantly higher protein expressions of Nrf2, NQO1 and HO-1 but lower expression of Keap1 (P < 0.05 for all) and obviously alleviated pathological damage in liver tissues.  Conclusion  Yinchen Wuling Powder is of protective effect on liver injury induced by ANIT in young rats with cholestasis, and the mechanism of the effect may be related to inhibited expression of Keap1, up-regulated expression of Nrf2, improved antioxidant capacity, and alleviated oxidative stress injury in liver.
Survey and Report
Impact of COVID-19 epidemic on reported incidence of infectious diseases among children in Guangdong province: a hospital-based study
HUANG Jian-ying, LI Jing-jing, LIU Miao-ling,
2021, 37(10): 1527-1530. doi: 10.11847/zgggws1132777
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  Objective  To explore incidence features of notifiable infectious diseases among children seeking medication at a tertiary women and children′s hospital during the outbreak of coronavirus disease-2019 (COVID-19) for providing evidences to the prevention and control of childhood infectious disease.  Methods  From China Information System for Disease Control and Prevention, we extracted the data on all notifiable infectious disease cases aged 0 – 14 years reported from January 2017 through June 2020 by a tertiary women and children′s hospital. The data on all l0 – 14 years old non-infectious disease outpatients and hospitalizations of the hospital during the same period were collected simultaneously. The features of childhood infectious diseases before and during the COVID-19 epidemic (February – June, 2020) were analyzed and compared statistically.  Results  During the period, totally 56 609 childhood infectious disease cases were reported, accounting for 1.75% of all child patients (outpatients and inpatients) of the hospital. The proportion of reported infectious disease cases (0.30%) against all child patients of the hospital in the epidemic period was obviously low compared to that in the same period in 2017, 2018 and 2019, with the decreased ratios of 75.82%, 85.10% and 89.20% for the child patients aged 0 – 2, 3 – 5 and 6 – 14 years, respectively. Among all reported infectious disease cases, the top three diseases were influenza (n = 25 355, 44.79%), hand-foot-mouth disease (n = 20 936, 36.98%) and other infectious diarrhea disease (n = 7 180, 12.63%). A significant disparity in the composition of reported infectious diseases was observed between the epidemic period and the same duration of previous three years (χ2 = 539.938, P < 0.001). Hand-foot-mouth disease, influenza, other infectious diarrhea disease, chickenpox and scarlatina were among the diseases with a decreased proportion to some extent reported during the epidemic period (P < 0.001).  Conclusion  The COVID-19 epidemic exerts a certain impact on reported infectious diseases in children and the influence may be associated with the changes in medication seeking behaviors and implemented measures on the epidemic containment among the public.
Association of rearing model with health inequality among 0 – 3 years old children
MAN Xiao-ou, YANG Yang, LI He-yun
2021, 37(10): 1531-1534. doi: 10.11847/zgggws1132465
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Abstract:
  Objective   To examine the association between child rearing model and health inequality among 0 – 3 years old children and to provide references for health promotion of the children.  Methods  The data on 1 837 children aged 0 – 3 years and with valid information and the height-for-age Z-scores (HAZ) were extracted from the China Family Panel Studies (CFPS) conducted in 2018 across China. HAZ value was used to assess health status of the children. The concentration index (CI) and decomposition method were adopted to explore the children′s health inequality and its related contributing factors, especially on the contribution of child rearing model.   Results  The value of health equality CI for all the children was 0.039, indicating a minor health inequality related to socio-economic status in the children and the children from higher-income families being of better health. The decomposition analysis on health equality CI revealed that the contribution ratio of inter-generational rearing to health inequality of the children was 4.99% and that of mixed rearing was 8.04%. The family size, annual household income, and paternal health are the top three contributors to the children′s health inequality, with the contribution ratio of 53.98%, 38.81%, and 23.63%; medical insurance and breastfeeding duration are the two contributors against the health inequality, with the contribution ratio of – 6.36% and – 7.56%, respectively.   Conclusion  Child rearing model and related family factors have an important influence on the health of children aged 0 – 3 years in China, and may cause health inequality among the children.
Genome-wide characterization of a salivirus strain isolated in Fujian province
HE Weng-xiang, WU Bing-shan, LIN Qi,
2021, 37(10): 1535-1539. doi: 10.11847/zgggws1133181
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Abstract:
  Objective  To analyze whole genome characteristics and genetic background of a salivirus strain isolated in Fujian province.  Methods  Next-generation sequencing was performed on a salivirus-positive specimen detected from 342 feces samples from the children with diarrhea in Fujian province in 2018 to obtain the whole genome sequence of the virus strain named FUAN-01. The FUAN-01' s genetic evolution in nucleotide sequence and the nucleotide and amino acid of VP1 region were analyzed.  Results  The full-length nucleotide of FUAN-01 is 7907 bp. The nucleotide homology between the whole genome of the virus strain and that of the reference strain is 81.86% – 98.21%, and the homology is the highest with KT182636 strain. There are differences in 14 amino acid sites of the open reading frame (ORF) region coding protein between the two strains. The nucleotide acid homology between VP1 of FUAN-01 and the reference strain was 76.83% – 97.81%, and the homology is the highest with KT182636 strain. The homology of amino acids between the FUAN-01 and that of reference strain is 85.27% – 99.22% and the homology is also the highest with that of KT182636 strains. The FUAN-01 belongs to salivirus A1 (SAV-A1) genotype.  Conclusion  A salivirus strain was first isolated in feces specimens from the children with diarrhea in Fujian province. The domestic SAV-A1 strain may be introduced from the same source and may be epidemiologically associated with the viruses of European origin. A reliable screening strategy should be established to further study the etiology and epidemiology of salivirus infection in Fujian.
Disparity in health service utilization between residents with and without contracted family doctor services in Jiangsu province
WU Yao-qin, XU Ai-jun, CHEN An-qi,
2021, 37(10): 1540-1542. doi: 10.11847/zgggws1126983
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Abstract:
  Objective  To compare the disparity in health service utilization between the residents with and without contracted family doctor services and to provide evidences for improving family doctor service system.  Methods  The data of the study were from the Sixth National Health Service Survey conducted in 2008. Valid information on health service demand and utilization were collected via questionnaire interviews from a total 4 398 urban and rural residents living in 6 prefectures/counties/districts acorss Jiangsu province in 2008.  Results  The proportion of the residents with and without contracted family doctor services were 42.81% (n = 1 883) and 57.19% (n = 2 515), respectively. Compared to those without contracted family doctor services, the residents with the services reported significantly higher rate of two-week prevalence, the prevalence rates of chronic disease, hypertension and diabetes, and the rates of hospitalization, self medication and buying medicine by themselves (P < 0.05 for all).  Conclusion  In Jiangsu province, the urban and rural residents with contracted family doctor service have both higher health care demands and medical services utilization and the residents are more likely to visit doctors in grassroots medical institutions in comparison with the residents without contracted family doctor services. The effect of contracted family doctor services on reducing medical expenses is not yet observed.
Job satisfaction and its associates among staff providing combined medical and nursing care services in Henan province
GUO Qing, ZHU Chun-yan, CAO Meng,
2021, 37(10): 1543-1545. doi: 10.11847/zgggws1132455
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Abstract:
  Objective  To examine the status and influencing factors of job satisfaction among staff in institutions affording combined service of medication and nursing care to elderly people in Henan province for providing evidences to improve integration of medical and nursing care services to the elderly.   Methods  Using stratified multistage cluster sampling, we recruited 2 500 staff working for one year or more in 265 institutions with combined medical and nursing care services to elderly people in 72 urban districts/rural towns across Henan province. Face-to-face interviews were conducted among the staff with a self-designed questionnaire during July – September 2018.   Results  Of the 2 432 staff with valid responses, 58.3% (1 418) reported the satisfaction with their jobs. The results of unconditional multivariate logistic regression analysis indicated that the staff aged 30 – 39 years and those having an average monthly income of 2 000 – 3 000 RMB yuan were more likely to have job satisfaction; while those working for five years and longer and those working in nursing homes were less likely to be satisfied to their jobs.   Conclusion  In Henan province, the level of job satisfaction is not high generally and mainly influenced by age, working years, and whether working in nursing homes among the staff in the institutions providing combined service of medication and nursing care to elderly people.
Awareness, treatment and control of hypertension and their influencing factors among 40 years old and above hypertensive patients in rural regions of Liaoning province
GUO Wei, TIAN Yuan-meng, JING Li,
2021, 37(10): 1546-1551. doi: 10.11847/zgggws1126424
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Abstract:
  Objective  To examine the awareness, treatment and control of hypertension and their influencing factors among hypertensive patients aged ≥ 40 years in rural regions of Liaoning province and to provide references for the prevention and control of hypertension.  Methods  Using stratified random cluster sampling, we carried out a survey including questionnaire interview, physical examination and laboratory test among 10 926 permanent residents aged ≥ 40 years in 19 administrative villages of 4 counties, Liaoning province from September 2017 to May 2018. The awareness, treatment and control of hypertension and their correlates in 6 623 hypertensive patients identified from the participants of the survey were analyzed.  Results  Among the 6 623 hypertensive patients, the crude and standardized rate were 47.50% and 44.25% for hypertension awareness, 35.41% and 31.34% for hypertension treatment, and 3.59% and 3.18% for hypertension control, respectively. Unconditional multivariate logistic regression analysis revealed that the patients with following characteristics were more likely to have higher hypertension awareness and treatment rate: female gender, aged ≥ 50 years, overweight/obesity, lack of physical exercise, family history of hypertension, history of diabetes, and high triglyceridemia; the patients with an average annual household income of 5 000 to 9 999 yuan RMB were more likely to have a high hypertension awareness rate; the patients with low serum high-density lipoprotein cholesterol were more likely to have a high hypertension treatment rate; the patients aged 50 – 69 years, lack of exercise, with family hypertension history were more likely to have a high hypertension control rate; whereas, the patients being current alcohol drinkers and with high serum total cholesterol were more likely to have low hypertension awareness, treatment and control rate; the patients with an average annual income of ≥ 20 000 yuan RMB were more likely to have a low hypertension control rate.  Conclusion  The rate of hypertension awareness, treatment and control are low and the rates are associated with gender, age, average annual household income, current alcohol drinking, physical exercise, family history of hypertension, history of diabetes, overweight/obesity, high total cholesterol, high triglyceridemia, and low high-density lipoprotein cholesterol among hypertension patients aged 40 years and above in rural regions of Liaoning province.
Effect of keeping pets behavior on physical activity and depression in community elderly
CUI Zhao-yi, ZHENG Fang, CHEN Chang-xiang
2021, 37(10): 1552-1555. doi: 10.11847/zgggws1129409
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Abstract:
  Objective   To examine the status and effects of keeping pets on physical activity and depression among the elderly in communities.   Methods   A household interview was conducted among 528 permanent residents ≥ 60 years and without severe diseases registered in a community health service center in Nanyang city of Henan province from August 2019 to January 2020. International Physical Activity Questionnaire – Short Form (IPAQ-s), the Center for Epidemiologic Studies Depression Scale (CES-D) and a self-designed questionnaire were used in the survey.   Results   Of all the elderly, 38.07% kept pets in home and 63.7% were assessed as having depression symptoms. The IPAQ-s scores ranged 0 – 5 664 for all the elderly. The results of multivariate linear regression analysis revealed following pet-keeping-related factors for physical activity in the elderly: feeling while walking pets (β = – 375.244), perceived attitude of neighbors and friends towards keeping pets (β = – 373.867), whether the kept pet ever attacking other pedestrians (β = 732.816), whether having their pets bathed in home (β = – 166.877), and the daily time being accompanied by their pets (β = – 343.849); the results also demonstrated that ever having pet-keeping-related conflicts with others (β = 3.139), feeling while walking pets (β = 1.476), ever being hurt by pets (β = – 4.391), the frequency of walking pets per day (β = 2.038), family members′ attitude towards pet-keeping (β = 1.989), and the daily time being accompanied by their pets (β = 2.937) were significant influencing factors for depression symptoms in the elderly.   Conclusion   Good pet-keeping behaviors could promote physical activities, alleviate depression symptoms, and improve health status among community elderly.
Influence of family sports environment on physical activity among urban adolescents in China
LIU Jing-min, HOU Xiao, GUAN Jian,
2021, 37(10): 1556-1561. doi: 10.11847/zgggws1132062
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Abstract:
  Objective  To explore effects of different dimensions of family sports environment on physical activity (PA) among Chinese adolescents and to provide evidences for developing family-based PA promotion strategies in the future.   Methods   Using randomly sampling at 4 urban high schools in two municipalities (Beijing and Shanghai) and two provinces (Shandong and Shaanxi), we recruited 320 healthy adolescents aged 14 – 18 years and in two-parent families. The students′ time for physical activity of various intensity during previous one week were determined with ActiGraph WGT3X-BT three-axis accelerometer and the information on students′ family sports environment were collected with a questionnaire survey self-administrated by the students′ parents.   Results   For the 314 adolescents with complete information, the weekly time (minutes) of sedentary behavior (SB), light-intensity physical activity (LPA), and moderate-vigorous intensity physical activity (MVPA) were 5 016.33 ± 1 872.00, 338.03 ± 215.60, and 1 585.24 ± 896.22. The adolescents′ scores for family-based PA availability and accessibility were 12.62 ± 3.65 and 7.83 ± 3.52; the adolescents′ scores for parental PA modeling and encouragement were 15.69 ± 5.28 and 22.29 ± 6.62 and those for maternal PA modeling and encouragement were 16.74 ± 4.11 and 8.64 ± 3.17, respectively. Compared to the adolescent girls, the adolescent boys had significantly higher weekly time of LPA and MLPA, higher scores for family-based PA availability and accessibility, and higher scores for parental and maternal PA modeling and encouragement (all P < 0.01) but lower score for SB. The results of the multivariate linear regression analysis demonstrated that: the major influential factors of SB included (1) family-based PA availability, maternal PA modeling and encouragement for all adolescents, (2) family-based PA availability, parental and maternal PA modeling, and maternal PA encouragement for adolescent boys, and (3) family-based PA availability and maternal PA encouragement for adolescent girls; the major influential factors of LPA were family-based PA availability and maternal PA encouragement for all adolescents and adolescent boys, and family-based PA availability and parental PA encouragement for adolescent girls; and major influential factors of MVPA included (1) family-based PA availability and maternal PA encouragement for all adolescents, (2) family-based PA availability and maternal PA modeling for adolescent boys, and (3) parental PA encouragement for adolescent girls, respectively.   Conclusion   The PA of urban adolescents is closely related to family-based PA environment and the social environment and the results should be concerned in promoting PA among adolescents.
Hotspots and trends in frontier researches on vaccine and vaccination: a literature study with CiteSpace
CHEN Ruo-hui, JIA Hao-nan, YIN Hang,
2021, 37(10): 1562-1565. doi: 10.11847/zgggws1123817
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Abstract:
  Objective  To examine hotspots and trends in frontier researches on vaccine and vaccination for the improvement of planned immunization policies in China.  Methods  Through the database of Web of Science, we searched relevant literatures published during 2009 – 2019 using the boolean phrase "vaccine* AND attitude". After excluding duplications, we conducted analyses on country- and institution-specific number of studies published, journal-specific number of citations, author-specific impact factors, frequency of key words, and weight of mutated key words for the 2 537 studies finally included using CiteSpace software.  Results  The top three countries with high number (n) and centrality index (CI) of the studies published were United States (n = 1 096, CI = 0.44), Australia (n = 198, CI = 0.21), and the United Kingdom (n = 197, CI = 0.21). The institution with the highest number and centrality index of the published studies was United State Centers for Disease Control and Prevention (n = 135, CI = 0.30). The most of the institutions with higher CI of the published studies were universities. The journal with the highest number of citations and CI was Vaccine (n = 2 037, CI = 0.43). The researcher with the highest number of citations (309) for the published studies was Brewer NT and the author with the highest CI (0.23) for the published studies was Dempsey AF. The researcher with the highest number of studies published during the 10 years was Zimet GD. The high-frequency key words for the published literatures were attitude, vaccine, human papillomavirus vaccination and vaccine hesitancy was the mutant word with the highest weight.  Conclusion  Independent and collaborative studies on vaccine and vaccination need to be promoted in China.
Demand and influencing factors of community health services among urban residents in Liaoning province
LI Yue-e, YU Hai-di, FU Han
2021, 37(10): 1566-1570. doi: 10.11847/zgggws1133633
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Abstract:
  Objective  To investigate the status of demand for community health services and its influencing factors among urban residents in Liaoning province for providing references to the development of community health service.   Methods  Using quota convenient sampling and a self-designed questionnaire, we conducted a face-to-face/telephone interviews among 1 351 adult residents (≥ 18 years) from July 1 to November 20, 2020 in 14 municipalities across Liaoning province. Descriptive statistics and logistic regression analysis were adopted in data analyses.   Results   Of the 1 284 residents with valid responses, 59.8% (768) reported the demand for community physical health service, higher than that (53.1%, 682) reporting the demand for community mental health service. Among the respondents, the reported demand for community physical and mental health service differed significantly by age, time of living in a community and the supply of health services in communities (P < 0.05 for all); and education level was a significant impact factor for demand of community mental health service (P < 0.05).   Conclusion  In Liaoning province, community health service could be promoted through improving grass-roots public health system and relevant facilities and developing differentiated community service items.
Overview
Global prevalence of e-cigarette and coping strategies: a review
XIE Chen-chen, JIA Xiao-xian, GONG Zheng-yang,
2021, 37(10): 1571-1574. doi: 10.11847/zgggws1132212
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Abstract:
Studies have demonstrated that the awareness rate of e-cigarettes is high, but the rate of e-cigarettes-related health knowledge is low among the public; social network is one of main ways for the public to know about e-cigarettes. Data from all over the world indicated that e-cigarettes is widely consumed currently among young populations and main reasons for the use of e-cigarettes are to quit smoking, to reduce tobacco hazards, to prevent re-smoking, being curious, and fashion design of e-cigarettes products. Strategies proposed by the researchers to cope with the prevalence of e-cigarettes consumption included promoting education on e-cigarettes-related health knowledge, strengthening supervision on e-cigarettes, and implementing effective interventions to reduce e-cigarettes consumption in key populations.
Progress in researches on contamination of antibiotic resistance genes in drinking water and its detection techniques in China
YANG Yi-di, LIANG Yong-bin, LI Jun-wen,
2021, 37(10): 1575-1579. doi: 10.11847/zgggws1132173
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The bio-safety of drinking water is related to the national economy and the people′s livelihood. As an emerging pollutant with potential risk for human health and threat to public safety, antibiotic resistance genes (ARGs) contamination in drinking water has attracting increasing attention around the world. To provide references for accurate assessment on ARGs contamination-related health risk and effective prevention of the contamination, the study reviews researches on characteristics and mechanism of ARGs contamination in drinking water in China and on techniques for enrichment and detection of ARGs in drinking water.
Progress in researches on antiviral effect of selenium: a review
WANG Yi-long, YANG Zhi-hua, ZHU Mao-xiang
2021, 37(10): 1580-1584. doi: 10.11847/zgggws1132823
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Abstract:
Selenium is an essential trace element of human body, which encodes and synthesizes selenoprotein in the form of selenocysteine. Selenium and selenoprotein have a wide range of physiological functions such as antioxidation and immune regulation. Selenium deficiency is related to more than 40 human diseases such as cardiovascular and cerebrovascular diseases, cancer, diabetes, nervous system diseases, autoimmune diseases and infectious diseases. Selenium nutritional status is closely related to viral diseases. Selenium deficiency leads to the imbalance of redox and immune regulation, promoting virus infection and replication. Oxidative stress caused by selenium deficiency increases mutation rate of virus genome. A large amount of selenium is consumed by the host of infected virus to initiate antioxidant and immune response. The virus itself expresses selenoprotein to compete with the host with viral infection, while inhibiting virus replication by negative feedback regulation. The safe dose and toxicity of different selenium compounds used as therapeutic drug should be considered comprehensively. Recent studies suggest that selenium status is related to infection and pathogenicity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and more clinical and basic research is needed to explore the effect of selenium on viral infection diseases including coronavirus disease-2019 (COVID-19) in the future.