Advance Search

2022 Vol. 38, No. 3

cover
cover
2022, 38(3): .
Abstract:
contents
contents
2022, 38(3): 1-6.
Abstract(170) HTML (160) PDF 2233KB(37)
Abstract:
Special Report – Enhancing Viral Hepatitis Control
Changing trend in reported hepatitis B incidence among residents of mainland China, 2004 – 2017
JIANG Wei, MAO Xian-hua, LIU Zhen-qiu,
2022, 38(3): 257-261. doi: 10.11847/zgggws1132715
Abstract(728) HTML (285) PDF 492KB(85)
Abstract:
  Objective  To analyze the trend of reported incidence of hepatitis B (HB) in mainland China from 2004 to 2017 to provide evidences for developing strategies on HB prevention and control.   Methods  From National Public Health Science Data Center, we extracted the data on HB incidence in 31 provincial-level administrative divisions (not including Chinese Taiwan, Hong Kong Special Administrative Region and Macao Special Administrative Region) reported from March 2004 through March 2017. The average annual percentage change (AAPC) in region-, gender- and age group-specific HB incidence were calculated to assess variation trend of HB incidence during the period.   Results  From 2004 to 2017, the average reported incidence (per 100 000 population) of HB for the 31 divisions were 70.50, 75.57, 84.82, 89.00, 88.52, 88.82, 79.46, 81.54, 80.68, 71.12, 69.05, 68.57, 68.74 and 72.61, with no significant variation in the reported incidence as a whole (AAPC = 0.2%, P > 0.05); while, the increased HB incidences were reported in 9 of the divisions, with the APPCs of 5.80% for Shanxi, 4.20% for Anhui, 1.50% for Jiangxi, 1.70% for Hubei, 11.30% for Hunan, 6.70% for Guangdong, 3.50% for Guangxi Zhuang Autonomous Region, 3.10% for Hainan, 14.50% for Tibet Autonomous Region, and 4.40% for Xinjiang Production and Construction Corps, respectively (all P < 0.05). The mean reported annual HB incidence (per 100 000 population) during the period was 97.03 for males and 57.38 for females and there was no significant variation in the incidence for both the males (AAPC = – 0.1%) and the females (AAPC = 0.5%) (both P > 0.05). The age group-specific HB incidences (per 100 000 population) were 12.78, 17.64, 80.21, 211.00, 181.62 and 163.11 for the population aged 0 – 4, 5 – 9, 10 – 19, 20 – 39, 40 – 59, and 60 years and above, respectively; the age group-specific HB incidence decreased for the groups less than 20 years (AAPC = – 7.7%, – 13.6%, and – 11.6% for groups of 0 – 4, 5 – 9, 10 – 19 years, all P < 0.001) but increased for the age groups 60 years old and above (AAPC = 5.0%, P < 0.001).   Conclusion  During 2004 – 2017 in mainland China, the reported incidence of hepatitis B was not significantly changed generally but the incidence showed an increasing trend in some regions and the residents aged 60 years and above is the key population for hepatitis B prevention.
Knowledge about anti-discrimination laws and regulations and assertion of rights among chronic hepatitis B patients in four provinces of China
HAN Bing-feng, YUAN Qian-li, LIU Jiang,
2022, 38(3): 262-265. doi: 10.11847/zgggws1121897
Abstract(504) HTML (221) PDF 475KB(43)
Abstract:
  Objective  To examine the knowledge about anti-discrimination regulations and awareness on patient rights protection and their associated factors among chronic hepatitis B (CHB) patients in China, and to provide evidences for enhancing the awareness of anti-discrimination actions.  Methods  We selected four province-level regions with different CHB prevalence as study sites and recruited 797 CHB patients in one or two hospitals in each of the four regions with convenient sampling for a face-to-face interview on the awareness of the three anti-discrimination laws and patient rights protection using a self-designed questionnaire during January – April 2017. Chi-square test was used to explore the relationship between the awareness and their associated factors.  Results  The proportions of the respondents reporting the awareness of one of the three anti-discrimination laws were 39.55% (297/751), 40.21% (302/751), and 56.99% (428/751), respectively; only 9.46% (73/772) of respondents reported being aware of patient rights protection and 0.91% (7/772) of the respondents reported asking for help from relevant organizations or agencies to solve discrimination-related issues. The respondents being aware of at least one of the three laws reported a 1.78 times higher ratio of having consciousness of assertion of rights compared to the respondents not being aware of all the laws (χ2 = 20.406, P < 0.001). The respondents living in Beijing city, aged 31 – 40 years, with higher education, being medical workers, students, teachers and researchers reported a significantly higher awareness rate of anti-discrimination laws and regulations than other respondents (all P < 0.05). The respondents with higher education had a significantly higher consciousness of assertion of rights (P = 0.006).  Conclusion  Although many chronic hepatitis B patients in China were aware of anti-discrimination laws, but a small number of them had the consciousness of assertion of rights and few of them took actions related to patient rights protection. The results suggest that educations on anti-discrimination protecting CHB patients should be promoted among the public.
Subclinical infection of hepatitis E and its influencing factors among community residents in Shanghai
XIAO Zheng-bin, CHEN Kai-yun, WANG Lin,
2022, 38(3): 266-270. doi: 10.11847/zgggws1133090
Abstract(714) HTML (292) PDF 533KB(37)
Abstract:
  Objective  To investigate the prevalence and influencing factors of subclinical infection of hepatitis E virus (HEV) in Shanghai community residents for providing evidences to comprehensive prevention and treatment of hepatitis E.  Methods  With multistage probability proportional-to-size random sampling, we conducted a seroepidemiological survey among 4 661 permanent residents (aged 1 – 69 years) in 32 urban communities/rural villages in 16 districts of Shanghai city during May – December 2018. The participants had face-to-face interviews with a self-designed questionnaire and detections of serum HEV immunoglobulin G (IgG) and immunoglobulin M (IgM) by enzyme-linked immunosorbent assay (ELISA). Binary multivariate logistic regression analysis was adopted to explore influencing factors of subclinical HEV infection.  Results  Of all the participants, 26.11% (1 217) were positive for HEV-IgG or HEV-IgM antibody. The results of regression analysis revealed that the risk factors of subclinical HEV infection included male gender, five years old and above, drinking unboiled water occasionally, being retired, having hepatitis related detection during past six months, and consuming fresh sashimi during past six months; the results also showed that with a non-local registered residence, being not sure about a history of having HEV vaccination, and washing hands before eating and after using bathroom were protective factors against HEV infection.  Conclusion  Among urban and rural community residents of Shanghai city, the prevalence of HEV subclinical infection was relatively high and influenced mainly by gender, age, occupation, registered residence, whether drinking unboiled water, history of HEV vaccination, and the status of having hepatitis-related test/consuming fresh sashimi during past six months.
Hepatitis B virus infection among 5 493 migrant workers in Shenzhen city′s Luohu Demonstration Zone for comprehensive hepatitis B prevention and treatment
ZHU Fang, YIN Xiang-dong, LIU Gang,
2022, 38(3): 271-275. doi: 10.11847/zgggws1133229
Abstract(531) HTML (301) PDF 541KB(30)
Abstract:
  Objective  To examine the prevalence of hepatitis B virus (HBV) infection among migrant workers in Luohu district of Shenzhen city for providing evidences to HBV infection prevention in the workers.   Methods   A questionnaire survey and serum hepatitis B surface antigen (HBsAg) and antibody (anti-HBs) detections with enzyme-linked immunosobent assay (ELISA) were conducted among 5 493 migrant workers in Shenzheng city′s Luohu demonstration zone for comprehensive prevention and control of hepatitis B (HB) when the workers had their physical examinations between April 2019 and June 2020.   Results   For all the workers, the positive rate was 6.54% and 60.37% for serum HBsAg and anti-HBs; the positive rate of both HBsAg and anti-HBs differed significantly by age, education, occupation, registered residence, and history of HBV vaccination. The results of binary logistic regression analysis on significant influencing factors of serum HBsAg and anti-HBs identified with univariate analysis demonstrated that inoculation of HBV vaccine is a protective factor against HBsAg positive; while, with the education of junior high school and lower and aged 30 – 49 years are risk factors for HBsAg positive; the results also indicated that the workers having received HBV vaccination, aged less than 30 years, and with a registered residence in East China were more likely to be serum anti-HBs positive compared to other migrant workers.   Conclusion  The prevalence of HBV infection decreased in comparison to that ten years ago among migrant workers in Shenzhen city′s Luohu demonstration zone for comprehensive HBV infection prevention and treatment but the prevention of HBV infection still needs to be strengthened in the unvaccinated migrant workers younger than 20 years and in those from southwest, northeast and northwest region of China.
Effect of comprehensive intervention on hepatitis B in Luohu district of Shenzhen city
ZHANG Shi-jie, CHEN Wei-hong, LIU Wei-min,
2022, 38(3): 276-279. doi: 10.11847/zgggws1134656
Abstract(455) HTML (240) PDF 500KB(45)
Abstract:
  Objective  To analyze carrier rate and infection incidence of hepatitis B virus (HBV) and HBV infection-related mortality rate among residents of Luohu district, Shenzhen city in 2010 and 2020 for evaluating the effect of comprehensive prevention and control of HBV infection in the region.   Methods  With stratified multistage cluster random sampling, HBV carrier was surveyed in 2010 and 2020 among residents in Luohu district (a designated demonstration region for viral hepatitis B [HB] prevention and control from 2006). Annual data for years of 2010 – 2020 on HBV infection incidence, HBV infection-related mortality, and demographics were collected simultaneously for Luohu district and Longgang district (a region in the same city but without implementation of comprehensive intervention on HB) for comparative study. Descriptive epidemiology was adopted in analyses on situations and changing trend of HBV carrier, infection and HBV infection-related mortality.   Results  Compared to those in 2010 (the early implementation stage of comprehensive intervention on HBV infection), the standardized serum positive rate of HBV surface antigen (HBsAg) declined significantly (8.74% vs. 6.91%, P < 0.01) and the incidence rate of HBV infection decreased by 96.88% (2.88/100 000 vs. 0.09/100 000), but the standardized mortality rate of HB-related diseases fluctuated not significantly (5.36/100 000 vs. 5.67/100 000, P = 0.561) among residents of Luohu district in 2020. For the years of 2010 – 2020, the annual incidence rate of HBV infection in Luohu district were all significantly lower than those in Longgang district (all P < 0.05). In comparison with that of Longgang district, the Luohu district's standardized mortality of HB-related diseases was higher during 2010 – 2015, basically the same in 2016 and 2017, but significantly lower for years of 2018 – 2020 (P < 0.05 for all).   Conclusion  Ten years after the implementation of the comprehensive prevention and treatment on viral hepatitis B in Luohu district, remarkable results have been achieved and the model for comprehensive intervention on viral hepatitis B in communities could be promoted in China.
Epidemiological Research
Status and population characteristics of knowledge, attitude and practice about foodborne disease prevention among Chinese public
ZHANG Na, LU Jiao, CHENG Jing-min
2022, 38(3): 280-284. doi: 10.11847/zgggws1132064
Abstract(685) HTML (213) PDF 517KB(82)
Abstract:
  Objective  To examine the status and population characteristics of knowledge, attitude and practice (KAP) about foodborne disease prevention among the public in China and to provide evidences for developing strategies on effective food safety education and health promotion in schools and communities.   Methods   With a self-designed questionnaire, we conducted an interview survey among 2 600 citizens recruited in 70 counties/prefectures of 7 geographical regions across China using stratified multistage random sampling during January – May of 2020. Four-quadrant analysis and multinominal logistic regression model were used to analyze the status quo and population characteristics of KAP about foodborne disease prevention in the participants.   Results  Among the 2 466 participants with valid responses, 62.20%, 59.26%, and 70.08% reported foodborne disease prevention-related awareness, correct attitude, and correct behaviors and the average scores for knowledge, attitude and practice about foodborne disease prevention were 4.98 ± 1.61, 4.74 ± 2.34 and 7.01 ± 2.20, respectively. Correlation analysis indicated significant positive correlations among participants′ foodborne disease prevention-related knowledge, attitude and practice (r = 0.228, 0.440, and 0.201, P < 0.01 for all). Of all the participants, 1 328 (54.29%) were classified into the first quadrant (the quadrant with a higher proportion of participants having better KAP about foodborne disease prevention) and 624 (25.51%), 281 (11.49%), and 213 (8.71%) into the second, third, and the fourth quadrant. The results of logistic regression analysis revealed that: the male participants were more likely to be classified into the third and the second quadrant; the participants aged 0 – 20 years were more likely to be classified into the fourth quadrant and those aged 21 – 40 years into the third quadrant, but those aged 41 – 60 years were less likely into the second quadrant; the participants with the education of college/university or below were more likely to be classified into the second quadrant, while those with the education of junior high school or below were more likely to be classified into the third quadrant; the married participants were less likely to be classified into the third quadrant; and the participants with an annual household income of less than 10 000 RMB yuan were more likely to be classified into the third quadrant.   Conclusion   The knowledge, attitude and practice about foodborne disease prevention is generally at a low level among the public in China and targeted education and intervention on food safety should be carried out in various populations.
Quality of life and its influencing factors among diabetic patients two years after a self-management intervention in six provinces and cities in China: a follow-up study
XIA Zhang, JIANG Ying-ying, MAO Fan,
2022, 38(3): 285-290. doi: 10.11847/zgggws1131688
Abstract(567) HTML (220) PDF 540KB(51)
Abstract:
  Objective  To analyze the quality of life (QoL) and its influencing factors among diabetes mellitus patients two years after undergoing a community-based diabetes self-management and to provide references for improving medical service to diabetes.   Methods  From August to October of 2013, 1 653 diabetic patients were recruited in 84 communities in three cities (Beijing, Shanghai and Chongqing) and three provinces (Jiangsu, Guangdong and Zhejiang) to carry out a 2-month diabetes self-management group intervention. A follow-up survey was conducted during September – December 2015 to analyze changes in QoL and its influencing factors before and after the self-management intervention. The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) was used in QoL evaluation.   Results  Among the 1 653 diabetic patients recruited in 2013, 1 603 (96.98%) completed a baseline survey, of which, 1 299 patients were followed up and 304 (18.96%) were lost to follow-up in 2015. Compared to those before the intervention, the patients′ median (quartile range, QR) of SF-36 physical health score increased significantly two years after the self-management intervention (76.50 [23.75] vs. 75.00 [25.00], Z = – 2.53; P = 0.011), but the patients′ median (QR) of SF-36 mental health score was not significantly different (78.44 [25.03] vs. 78.44 [23.31], P > 0.05). The results of unconditional multivariate logistic regression analysis demonstrated that two years after receiving the diabetes self-management intervention, the patients suffering from diabetes 5 years or more and smoking were less likely to have an increased physical health score, while those with an improved self-efficacy were more likely to have an increased physical health score; the patients with following characteristics were less likely to have an increased mental health score: female, with medication reimbursement by medical insurance for urban workers, having complication of other chronic disease, smoking, and being capable of self-injection of insulin or not needing insulin injection.   Conclusion  The quality of life was improved to a certain extent among a group of community diabetic patients in China two years after a self-management intervention and the improvement was influenced by the patients′ gender, major payer of the medication cost, disease course, comorbidity of other chronic diseases, self-efficacy, smoking, and self-injection of insulin.
Utilization of health-related WeChat official accounts and its influencing factors among urban occupational population in China: a path analysis
WANG Xiao-qi, ZHU He, LIU Mei,
2022, 38(3): 291-296. doi: 10.11847/zgggws1133313
Abstract(599) HTML (242) PDF 620KB(54)
Abstract:
  Objective  To assess the utilization of health WeChat official accounts and its related factors among urban occupational population in China.   Methods   Using multistage cluster sampling, we recruited 7 699 employees aged 18 – 60 years working in enterprises or institutions in 6 provinces across China and conducted an online survey during October – December, 2018. A self-designed questionnaire was used to collect information on the utilization of health WeChat official accounts; multivariate linear regression and path analysis were adopted to explore major factors affecting the utilization.  Results  Of the 6 821 employees with valid responses, 5 688 (83.39%) reported the utilization of health WeChat official accounts. The results of path analysis indicated that behavioral intention, eHealth literacy and perceived susceptibility affected the frequency of health WeChat official account use directly, with direct effect value of 0.073, 0.090, and 0.088; while effort expectancy, hedonic motivation and social influence indirectly affected the frequency through behavioral intention with the path coefficients of 0.450, 0.447, and 0.447, respectively. In addition, habit, perceived barriers, perceived severity, and self-reported health were directly and indirectly related to the frequency with the total effect values of 0.450, – 0.247, – 0.061, and 0.133, respectively.   Conclusion  Habit and effort expectancy are the most critical factors affecting the frequency of health WeChat official accounts utilization among occupational population in China. The results suggest that guidance for utilization and improvements of interfaces of health WeChat official accounts could promote health education through the utilization of health WeChat official accounts.
Associations of different degrees and types of obesity with cardiovascular disease incidence among rural Kazakh residents in Xinjiang Uygur Autonomous Region
HE Jia, QI Hao-yue, LI Yu,
2022, 38(3): 297-301. doi: 10.11847/zgggws1133020
Abstract(596) HTML (208) PDF 513KB(46)
Abstract:
  Objective   To analyze associations of different degrees and types of obesity with cardiovascular disease (CVD) incidence among rural Kazakh residents in Xinjiang Uygur Autonomous Region (Xinjiang) and to provide evidences for the prevention and control of CVD in Kazakh residents.  Methods   Prospective cohort design was adopted in the study including face-to-face interview with a self-designed questionnaire, physical examination and laboratory tests. A baseline survey was first conducted among 2 644 permanent rural Kazakh residents aged 18 years and above from April 2010 to December 2012 in a town of Xinjiang; a follow-up survey was then carried out among 2 286 participants during April – December 2016.   Results  The follow-up survey was completed among a total of 2 004 participants (796 males and 1 208 females averagely aged 40.72 ± 12.35), with an accumulated follow-up of 11 001.96 person-years and a median follow-up of 5.49 years. Of the participants followed-up, 495 (24.7%), 259 (12.9%) and 881 (44.0%) were identified with overweight, obesity and central obesity. During the follow-up period, totally 278 CVD incidents were observed and the cumulative incidence rate of CVD was 13.9% among all the participants; the cumulative incidence rate of CVD was 10.2%, 17.6%, and 24.7% among the participants with normal weight, overweight, and obesity; while among the participants with and without central obesity, the cumulative incidence rate of CVD was 20.0% and 9.1%, respectively. After adjusting for confounders such as gender, age, education, occupation, smoking, alcohol drinking, hypertension, metabolic syndrome, blood glucose, blood lipid, consumption frequency of light-colored vegetables/milk and milk products/animal viscera/fresh meat, Cox proportional hazard regression analysis revealed that the risk of CVD incidence increased significantly among the participants with overweight (relative risk [RR] = 1.76, 95% confidence interval [CI]: 1.34 – 2.31) and obesity (RR = 2.36, 95% CI: 1.74 – 3.20) compared to that among those with normal weight; the risk of CVD incidence also increased among the participants with central obesity (RR = 2.23, 95% CI: 1.75 – 2.85) in comparison with that among those without central obesity.   Conclusion  Among rural Kazakh residents in Xinjiang, the incidence rate of CVD is relatively high and overweight, obesity and central obesity could increase the risk of CVD incidence.
Whole-genome sequencing-based genetic analysis of influenza A (H3N2) virus strains isolated in Guangzhou city
CAO Lan, LI Kui-biao, CHEN Yi-yun,
2022, 38(3): 302-308. doi: 10.11847/zgggws1131843
Abstract(1156) HTML (698) PDF 812KB(111)
Abstract:
  Objective  To analyze the characteristics of whole genome sequences of H3N2 influenza virus strains isolated in Guangzhou city for providing reference data to the prevention and control of H3N2 influenza.  Methods  Whole-genome sequencing was performed for 13 strains of H3N2 influenza virus isolated in Guangzhou city in 2019 and the sequencing results were analyzed with bioinformatics software. Gene segments of H3N2 influenza vaccine strains recommended by World Health Organization for the northern hemisphere population over the years were extracted from the Global Initiative on Sharing Avian Influenza Data (GISAID) as the reference sequences.  Results  For the 13 virus strains sequenced, the lowest nucleotide homology was 94% and the highest was 100%. Compared to the reference sequences, the gene with the greatest difference was NA (94% – 100%) and that with the least difference was PA (98.9% – 100%). The nucleotide variation rate of was the highest for NA gene (8.37%) and the lowest for PA gene (2.14%). All genes of the isolated strains, including both from out-patients under surveillance and from outbreak cases, belong to those of the same evolutionary branch of the vaccine strain (A/Hong Kong/2671/2019 H3N2). The HA, PB2, PB1, NP, M and NS genes of the strains could be further divided into three small branches (group 1 – 3) based on their epidemic time. Group 1, 2, and 3 were prevalent during periods of January – August, November – December, and January – August/November – December of 2019, respectively.  Conclusion  The H3N2 influenza virus strains isolated in Guangzhou in 2019 were on the same evolutionary branch to the vaccine strain. The isolated strains had the same evolutionary origin but there were diversities in evolutionary characteristics, homologies and the variation rates of the whole genome among the strains.
Status and influencing factors of blood pressure control among 35 – 74 years old community hypertensive patients in Luohu district of Shenzhen, 2019
LUO Qi, WANG Jian, CHENG Rui-rong,
2022, 38(3): 309-313. doi: 10.11847/zgggws1132178
Abstract(566) HTML (138) PDF 537KB(61)
Abstract:
  Objective   To investigate the condition and impact factors of blood pressure control among 35 – 74 years old hypertension patients in Luohu district, Shenzhen city of Guangdong province and to provide evidences to improve health management of the patients.   Methods  Using stratified random sampling, we recruited 1 205 hypertension patients aged 35 – 74 years at 10 community health service centres affiliated to Shenzhen Luohu Hospital Group. Face-to-face surveys with a self-designed questionnaire, physical examination and laboratory tests were conducted among the patients during February 2019.   Results  Of all the patients, 618 (51.3%) had their blood pressure well-controlled. The results of unconditional multivariate logistic regression analysis showed that the patients with following characteristics were more likely to have well-controlled blood pressure: with locally registered permanent residence (odds ratio [OR] = 1.379, 95% confidence interval [95% CI]: 1.088 – 1.748), taking antihypertensive medication regularly (OR = 1.598, 95% CI: 1.173 – 2.177), and having a physical examination every year (OR = 1.578, 95% CI: 1.221 – 2.040); the results also revealed that male patients were less likely to have well-controlled blood pressure (OR = 0.762, 95% CI: 0.603 – 0.963) compared to female patients.   Conclusion  Among 35 to 74 years old community hypertension patients in Luohu district of Shenzhen city, the blood pressure control rate was relatively high and was mainly influenced by gender, whether having local household registration, whether having antihypertensive medication regularly and whether taking a physical examination every year.
Experimental Study
Establishment of a microbial transplantation-induced dysbacteriosis model in rats with ischemic stroke
NIE Hui-fang, PENG Zhu-li, YOU Jian-kai,
2022, 38(3): 314-319. doi: 10.11847/zgggws1133778
Abstract(607) HTML (246) PDF 1152KB(22)
Abstract:
  Objective  To establish a rat model of intestinal dysbacteriosis and provide methodological support for the study of intestinal dysbacteriosis after cerebral ischemia.   Methods  Totally 19 male specific pathogen free (SPF) Sprague-Dawley (SD) rats were divided into a normal group (n = 5), a donor group (n = 9) and a recipient group (n = 5). The rats of donor group were subsequently assigned into 3 groups and middle cerebral artery occlusion (MCAO) was performed in the rats on the first, second and third day after a 3-day adaptive feeding and cecal flora were taken as grafts 72 hours after the MCAO operation. After gavage administration of streptomycin sulfate for exhausting intestinal microbes, the rats of the recipient group were administered with the grafts by gavage once a day continually for three days. The cecal specimens of all the rats of the three groups were examined with gram staining microscopy. The contents of ileum, cecum and transverse colon of normal and recipient rats and cecum contents of donor rats were sampled for 16S rDNA high-throughput sequencing and the microbial structure and characteristics of the contents were detected and analyzed with bioinformatics.   Results  Compared with that of the ileum, the species diversity of cecum and transverse colon flora in normal rats increased significantly (P < 0.01) and the flora in the three intestinal segments were mainly composed of thick-walled bacteria. Compared with that of the normal rats, the species diversity of cecal flora in the donor rats decreased significantly; the species composition analysis at phylum level showed that the Firmicutes decreased significantly and the Proteobacteria increased significantly (both P < 0.01). Compared with that of the normal rats, the species diversity of cecum and transverse colon flora in the recipient rats decreased significantly (P < 0.01). The cecal flora of the recipient rats was similar to that of the transverse colon, mainly composed of Bacteroides. There were no significant differences in α diversity ACE index and β diversity among the ileum, cecum and transverse colon flora of the recipient rats and the cecum flora of the donor rats (P > 0.05 for all), but the flora structure of the rats of the two groups were similar.   Conclusion   Gavage administration of cecal flora 72 hours after MCAO operation could be used to establish a rat model of intestinal flora imbalance similar to the structure and characteristics of microorganisms of the rats with ischemic stroke.
Inhibitory effect of D-penicillamine stabilized silver cluster on Escherichia coli and Staphylococcus aureus
HAN Yi, KONG Ling-can, LI Geng-wei
2022, 38(3): 320-324. doi: 10.11847/zgggws1133260
Abstract(824) HTML (253) PDF 1313KB(22)
Abstract:
  Objective   To observe inhibitory effect of silver cluster assemblies capped by D-penicillamine on Escherichia coli (E.coli) and Staphylococcus aureus (S.aureus).   Methods  The structure of D-penicillamine stabilized silver cluster assemblies was examined with infrared spectroscopy, X-ray photoelectron spectroscopy and Auger electron spectroscopy. Then, the E.coli and S.aureus strains were cultivated with various doses of D-penicillamine stabilized silver cluster assemblies. Scanning electron microscope was used to observe the proliferation of the cultivated bacteria.   Results  The minimum inhibitory concentration (MIC) and the half maximal inhibitory concentration of silver cluster assemblies for E. coli were 1 μg/mL and 0.86 μg/mL; no inhibition effect of silver cluster assemblies on S.aureus at the concentration of 200 times higher than the MIC for E. coli. Observations with scanning electron microscope revealed obvious rupture of the cell membranes of E. coli cultivated with silver cluster assemblies, which may be contributed to the bacterial death.   Conclusion  Silver cluster assemblies has obvious inhibition effect on E. coli but no such effect on S.aureus.
Survey and Report
Establishment of an integrated index for family socioeconomic gradients based on the Birth Cohort Study in Guangzhou
WEI Xue-ling, LIN Shan-shan, TU Si,
2022, 38(3): 325-329. doi: 10.11847/zgggws1133115
Abstract(537) HTML (261) PDF 842KB(29)
Abstract:
  Objective  To construct an integrated index of family socioeconomic gradient for providing a valid assessment of socioeconomic status (SES) of the mother and her child/children in a family.  Methods  The participants of the study were 16 175 pregnant women and their children enrolled between February 2012 and June 2016 from the Birth Cohort Study in Guangzhou. Information on social and economic condition of the children′s parents were collected. Principal components analysis (PCA) and standard score (Z-score) summative method were used to construct a family SES score. The consistency among different combinations of socioeconomic variables in the evaluation on families′ socio-economic gradient were compared.   Results  Significant pairwise correlations were observed among 9 parental socioeconomic variables (maternal education, paternal education, average maternal monthly income, average paternal monthly income, maternal employment, family real estate ownership, private car ownership, per capita living space, and residential floor), except for the associations of maternal employment with per capita living space and residential floor; the coefficients for the correlations ranged from – 0.036 to 0.585 (P < 0.01 for all). The SES grouping of the pregnant women by the integrated index established using PCA method on account of the nine variables was consistent well with that using Z-score summative method, with a weighted Kappa coefficient of 0.737 (95% confidence interval [95% CI]: 0.730 – 0.743); both of the indexes could accurately reflect the mothers′ and children′s family socioeconomic gradients. An integrated index established using the Z-score summative method based on 8 parental socioeconomic variables showed the best consistence with that using PCA method on account of the 9 parental socioeconomic variables, with a weighted Kappa coefficient of 0.774 (95% CI: 0.768 – 0.780).  Conclusion  The integrated index established in the study using PCA method and Z-score summative method based on 9 parental socioeconomic variables could be used to conduct valid assessment on family socioeconomic gradients of Chinese women and children.
Functional food for alleviation of nutritional amemia in China: an analysis on official registration data
HAN Xiao-qian, DU Yong, WU Guo-qing,
2022, 38(3): 330-334. doi: 10.11847/zgggws1133511
Abstract(532) HTML (152) PDF 766KB(20)
Abstract:
  Objective   To analyze the status quo of functional food for improving nutritional anemia officially registered in China for providing evidences to relevant research and development of enterprises and governmental supervision.   Methods   From the website of China Food and Drug Administration (CFDA) and State Administration for Market Regulation (SAMR), we extracted the information on 228 functional food products (FFPs) for improving nutritional anemia officially registered in China from March 1996 through February 2010. Dosage form, function claim, composition of traditional Chinese medicine, content of iron-compound, and content measurement of functional/marker components of the FFPs were analyze with general descriptive analysis, visual data analysis, factor analysis and principal component analysis using Ucinet 6 and SPSS 22.0. Social network mapping was performed to display the utilization frequency of the 73 traditional Chinese medicine and their extracts and other bioactive compounds which were included in the ingredients of the three or more of the FFPs.   Results   Of the 228 FFPs in 7 dosage forms, 117 (51.3%) are oral liquids. The main raw materials were listed the ingredients of 197 (86.4%) of the FFPs. Angelica sinensis and its extract, Astragalus membranaceus and its extract, donkey-hide gelatin, Chinese-date and its extract, and iron and its compound are among the components locating in central region of the social network map constructed. Traditional Chinese medicine raw material and medicine food homology raw material were listed in the ingredients of 157 FFPs. Among 14 top traditional Chinese medicine raw material most frequently used in the FFPs, seven common factors (Angelica sinensis and Astragalus mongholicus, Poria cocos and Chinese yam, prepared rehmannia root and Codonopsis pilosula, Paeonia Lactiflora, mulberry, longan, Lycium chinensis and black-bone chicken) were identified, contributing a cumulative variance of 72.378. Among the 165 FFPs with iron-compound in the ingredients, 130 (78.8%) contain traditional Chinese medicine raw material. The top 5 iron-compounds utilized in the 165 FFPs are ferrous lactate (in 46 FFPs), ferrous gluconate (43), heme chloride (30), ferrous fumarate (9), and ehylenediaminetetraacetic acid ferric sodium (8), respectively. Of the 70 FFPs approved by the Ministry of Health of the People′s Republic of China, 42 (60.0%) indicated the contents of functional/marker components in the products′ registration information; all the 158 FFPs approved by CFDA and SAMR indicated the contents of functional/marker components in the products′ registration information, with the top 3 most frequently listed functional/marker components of iron (in the ingredients of 76% of the 158 FFPs), polysaccharide (29.5%), and total saponins (22%).   Conclusion   For the officially registered FFPs for improving nutritional anemia, the combination and types of utilized traditional Chinese medicine raw material is relatively identical and there is lack of known specific correlation between the utilized traditional Chinese medicine raw material and the implied effect of functional/marker components.
Risk assessment on crayfish eating-related cadmium exposure among consumers in Jiangsu province
XIE Wei, ZHU Qian-rang, ZHANG Jing-xian,
2022, 38(3): 335-338. doi: 10.11847/zgggws1133624
Abstract(416) HTML (215) PDF 525KB(26)
Abstract:
  Objective   To investigate crayfish eating-related cadmium exposure risk among consumers in Jiangsu province for providing evidences to food safety risk assessment by relevant departments.   Methods   Cadmium contents were detected for a total of 408 crayfish samples (20, 220, and 168 samples of juvenile, adult, and precooked crayfish) randomly collected from farmers′ markets, supermarkets, wholesale markets and catering units in four municipalities/prefectures of Jiangsu province from June 2011 to September 2014. An on-site questionnaire survey was conducted among 377 crayfish consumers selected with multistage random sampling in 25 restaurants providing crayfish dishes in five municipalities/prefectures of Jiangsu province during July – September, 2014 to establish an intake assessment model for estimating crayfish eating-related cadmium exposure among the consumers.   Results   The average cadmium content of the crayfish was 0.23 ± 0.72 mg/kg, with significantly higher content of head specimens than that of tail specimens (0.45 ± 0.97 vs. 0.01 ± 0.02 mg/kg) and higher content of juvenile crayfish specimens than that of adult/precooked crayfish specimens (1.11 ± 1.91 vs. 0.19 ± 0.68/0.18 ± 0.38 mg/kg) (all P < 0.05). For the consumers, the monthly amount of crayfish consumed was 0.56 ± 1.01 kg/month; the average monthly crayfish eating-related cadmium intake was 1.76 ± 3.56 μg/kg, with the 90th percentile of 4.71 μg/kg and upper limit of 8.57 μg/kg; and the cadmium intake accounted for 7.04%, 18.84% and 34.29% of the monthly tolerated intake (PTMI) and the margin of safety (MOS) values corresponding to the intakes were 14.20, 5.31 and 2.92, respectively. The average monthly crayfish eating-related cadmium intake could differ significantly by different eating behaviors, with estimated intakes of 0.09 ± 1.73, 2.44 ± 3.56, and 6.64 ± 3.26 μg/kg for the consumers eating only tail, both tail and head, and only head of crayfish, respectively (F = 33.718, P < 0.001). There was no significant difference in the monthly crayfish eating-related intake of cadmium among consumers at various ages (P > 0.05). The monthly MOS value of cadmium intake due to crayfish consumption was > 1 for the consumers of different ages and eating different body parts of crayfish, indicating that the risk of cadmium exposure for crayfish consumers in Jiangsu province was acceptable.   Conclusion  The risk of crayfish eating-related cadmium exposure for crayfish consumers in Jiangsu province is within an acceptable range, but the cadmium content of the head and juvenile crayfish is high, and long-term consumption of large amounts of crayfish may cause health hazards. The results suggest that it is better for consumers not to eat head of crayfish and juvenile crayfish to decrease cadmium exposure.
Human resources in China′s disease prevention and control institu-tions – allocation equity in 2014 and 2019
ZHANG Tian-tian, YIN Wen-qiang, MENG Cui-xiang,
2022, 38(3): 339-343. doi: 10.11847/zgggws1133865
Abstract(792) HTML (226) PDF 583KB(84)
Abstract:
  Objective  To examine the equity in human resources allocation in centers for disease prevention and control (CDCs) and to provide evidences for optimizing resource allocation.   Methods   The data on human resources among CDCs in all administrative regions across China in 2014 and 2019 were collected from China′s Statistical Yearbook of Health and Family Planning – 2015 and China′s Statistical Yearbook of Health – 2020. Then, health resource agglomeration degree (HRAD) was used to evaluate the equity in human resources allocation according to population and geographical area.   Results   The total number of personnel in CDCs across China decreased by 2.51% from 192 397 in 2014 to 187 564 in 2019. The number of CDCs′ personnel per 10 000 population also showed a shrinking trend at all provincial levels and the number for most provincial level regions did not meet the national standard. In 2019, the proportions of CDC personnel at young age (< 35 years) and middle-aged (35 – 54 years) decreased by 3.8% and 2.4% compared with those in 2014, but the proportion of elderly personnel (≥ 55 years) increased by 6.0% contrasting to that in 2014. The number of personnel with high school/technical secondary school education or below in all CDCs in China decreased from 28.8% in 2014 to 19.4% in 2019, while the number of those with junior college education or above increased from 71.1% in 2014 to 80.6% in 2019. The results of analysis on the equity in human resources allocation showed that the spatial distribution of human resource was unbalanced. The geographical region-specific HRAD index was the highest (indicating a better equity in human resources allocation) for eastern region, followed by that for central and western region; while, the population distribution-specific HRAD index was higher for western region than that for central and eastern region.   Conclusion   Insufficient total number, serious turnover and unbalanced allocation are main problems in health resources allocation for CDCs in China and the situation needs to be improved for CDCs′ capability construction in China.
Added effect of heat waves on mortality in residents of Beijing, 2007 – 2013
NIU Yan-lin, YANG Jun, LIN Hua-liang,
2022, 38(3): 344-350. doi: 10.11847/zgggws1134217
Abstract(733) HTML (291) PDF 682KB(61)
Abstract:
  Objective  To explore the added effect of heat wave on mortality in residents of Beijing and to provide evidences for developing public health strategies related to extreme weather events.  Methods  The data on daily mortality, meteorological factors and air pollution during 2007 – 2013 in Beijing were collected. A distributed lag nonlinear model was applied to establish exposure-response relationships among air temperature, heat wave and mortality. The added effects of heat waves with nine different definitions were evaluated by comparing the mortality risk during heatwave days to that during non-heatwave days. Step function and quadratic spline function were used to evaluate the added effects associated with different heat wave durations, respectively.  Results  With the increase of threshold and duration of heat waves with specific definitions, the total number of heat wave days in Beijing decreased gradually. The added effects of heat waves varied under different definitions. When the threshold was in the 95th quantile (27.62 ℃) and the duration was ≥ 4 days, the added effect of heat wave on non-accidental death was the greatest, with an increased mortality risk of 11% (95% confidence interval [95% CI]: 4% – 18%). The added effect appeared when a heat wave lasting for more than two days and the added effect intensified sharply when a heat wave lasting for more than six days. The added effects of heat waves were associated with the increased mortality risk of respiratory diseases (34%, 95% CI: 12% – 60%) and circulatory diseases (14%, 95% CI: 4% – 24%). The populations vulnerable to the added effect of heatwave include the females, middle-aged people and the elderly; the most vulnerable people is those with less education.  Conclusion  Heat wave could significantly increase the mortality risk of residents in Beijing and there existed an added effect due to continuous days with high temperature. The persons with respiratory or circulatory diseases, the female, the middle-aged people and the elderly, especially those with less education, are particularly vulnerable to adverse effect of heat waves.
Heart disease mortality among residents in Hebei province, 2014 – 2019: an analysis on death registry data
ZHANG Fan, LIU Yu-huan, CAO Ya-jing,
2022, 38(3): 351-355. doi: 10.11847/zgggws1131826
Abstract(529) HTML (183) PDF 476KB(43)
Abstract:
  Objective  To examine the trend in heart disease mortality among the residents in mortality surveillance points in Hebei province from 2014 to 2019, and to provide references for developing relevant intervention measures.   Methods  From Hebei Province Death Registration Management System, we extracted all records of heart disease death from January 1, 2014 to December 31, 2019 among residents living in regions covered by the Mortality Surveillance System. The collected data were analyzed using descriptive statistics methods.   Results  Among the population in 30 mortality surveillance points across the province, totally 173 521 heart disease deaths were registered during the 6-year period. The annual heart disease mortality rate (1/100 000) for the years of 2014 – 2019 were 186.85, 180.18, 184.17, 192.98, 214.01, and 207.06 and the standardized mortality rate were 191.26, 185.50, 172.31, 173.83, 178.89, and 170.56, respectively. For the 6-year period, there was a significant downward trend in overall and gender-specific standardized heart disease mortality rate (for total population: χ2trend = 171.553, P < 0.001; for males and females: χ2trend = 51.327 and 119.630, both P < 0.01); the age-specific heart disease mortality rate presented an upward trend for the residents aged 35 – 39, and ≥ 85 years (all P < 0.05) but a downward trend for the residents aged 20 – 40, 40 – 44, 60 – 64, 65 – 69, 70 – 74, 75 – 79 and 80 – 84 years (all P < 0.01). For all the heart disease mortalities, the constituent ratio was 69.17% for ischemic heart disease, 19.79% for hypertensive heart disease, 1.66% rheumatic heart disease, 8.95% for other heart diseases, and 0.44% for inflammatory heart disease, respectively.   Conclusion  From 2014 to 2019, the heart disease mortality showed a downward trend generally among the residents in mortality surveillance points in Hebei province and ischemic heart disease was a main contributor to the mortalities.
Pathogens of patients with fever with rash syndrome in Gansu province, 2009 – 2019: a multiple correspondence analysis
ZHOU Jian-hui, MENG Lei, WANG Li-juan,
2022, 38(3): 356-359. doi: 10.11847/zgggws1133235
Abstract(569) HTML (240) PDF 570KB(39)
Abstract:
  Objective  To examine characteristics of pathogens identified among patients with fever and rash syndrome (RFIs) in Gansu province from 2009 to 2019, and to provide a reference for implementing targeted prevention measures and conducting pathogen surveillance.   Methods   Sentinel surveillance data on 5 822 RFIs cases reported in Gansu province from 2009 through 2019 were extracted from the Information Management System for Prevention and Treatment of AIDS and Viral Hepatitis and other Major Infectious Diseases. Multiple correspondence analysis was adopted to analyze characteristics of pathogens isolated from the RFIs patients.   Results   Enterovirus infection was confirmed in 1 653 (28.39%) of the all RFIs patients reported during the period and the number (proportion) of the patients confirmed with other pathogen infections were 548 (9.41%) for measles virus, 201 (3.45%) for rubella virus, and 495 (8.50%) for varicella-zoster virus, respectively. No pathogen infection was confirmed in 2 925 (50.24%) RFIs patients. The results of multiple correspondence analysis showed that enteroviruses infection was more frequently diagnosed in hospitalized cases in western and central Gansu province, during summer/autumn season, among scattered children aged ≤ 5 years and kindergarten children, among patients hospitalized in provincial and county-level hospitals; measles virus infection was more frequently confirmed among the patients in eastern and southern areas of Gansu province, during winter/spring season, in the adults (≥ 18 years) with some specific occupations, and among patients seeking medication at municipal hospitals; and more varicella-zoster virus and rubella virus infections were detected among the students aged 6 to 17 years. No pathogen infection was identified among the majority of the RFIs patients visiting doctors in outpatient/emergency departments.   Conclusion   The main pathogens inducing RFIs incidents in Gansu province from 2009 to 2019 include enterovirus, measles virus, varicella-zoster virus and rubella virus, and there were disparities in the detection rate of the pathogens among various populations, in different seasons and in various geographical areas.
Data mining and panoramic analysis on global Nipah virus-related patent applications
MA Li-li, HUA Yi-dan, HAN Xiu-cheng,
2022, 38(3): 360-363. doi: 10.11847/zgggws1132805
Abstract(692) HTML (211) PDF 598KB(41)
Abstract:
  Objective   To describe the status of Nipah virus-related patent application around the world and to provide references for relevant patent application and researches in China.   Methods  Global data on Nipah virus-related patent applications from 2002 up to August 18, 2020 were searched through Derwent Innovations Index of Web of Science. Derwent Data Analyzer 9.0 was adopted to conduct data mining and panoramic analysis on overall trend, technology field and layout, countries of registration, and protection intensity of the declared patents.  Results  From the year of 2002, the annual number of Nipah virus-related patent applications increased generally. The United States, China and Canada are among the major registration countries of those patent applications. The filed patent applications were mainly for antiviral agent, viral antigen or antibody products, DNA recombination technology, vaccine development, and virus detection method. The number of patent applications for antiviral agents/antivirals and viral antigen/antibody is relatively small in China compared to that in major registration countries.   Conclusion   The increase in annual number of Nipah virus-related patent applications indicates that technology research and development on the pathogen of biosafety level 4 are enhanced continuously in the United States and other countries and relevant researches need to be promoted in China for Nipah virus-related biosafety and epidemic prevention.
Overview
Establishment of and economic evaluation on health reporting system in China
LIU Shang-jun, LUO Ya-nan, GUO Shuai,
2022, 38(3): 364-370. doi: 10.11847/zgggws1134109
Abstract(509) HTML (164) PDF 926KB(63)
Abstract:
China is on the stage of rapid population aging while still in the process of health transition, with the morbidity and mortality spectrum harboring great and complex population health and safety risks; the situation poses a huge challenge for public health. This study proposed to establish a health reporting system adapted to national context and needs in the perspective of system optimization. Population economics-based cost-benefit analyses were conducted to evaluate the benefits of this new system. The results indicate that health reporting system is a further development of health surveillance system; current development of public health system and service system is in the turn of “system balance” to “system imbalance” and an important manifestation of institutional innovations and optimization. The direct benefits of the health reporting system include economic cost savings and data and information resources generated by population coverage; the indirect benefits of the system contain health gains contributed to the utilization of the health reporting system.
Risk factors, early detection and effective surveillance of outbreaks or epidemics of typhoid and paratyphoid fevers: a review
MENG Yin-ping, WANG Shu-kun
2022, 38(3): 371-375. doi: 10.11847/zgggws1134365
Abstract(547) HTML (234) PDF 784KB(42)
Abstract:
Typhoid and paratyphoid fevers, one of major infectious diseases with global transmission potentiality and high incidence, still imposes pressing disease burden and major global-health concern in low- and middle-income countries. In endemic areas, the disease is characterized by high incidence, limited effect of prevention and control, and more cases caused by water contamination, food contamination and close contact. In addition, the remarkable characteristics of the disease in developed countries and regions are the low incidence rate and the relatively large proportion of tourism-related cases, and there are still difficulties in the sustainable reduction of the incidence rate. Detection and surveillance on typhoid and paratyphoid fevers in a timely and accurate manner is an important scientific and technological problem to prevent the outbreak and reduce the hazard. In the study, we summarized researches on risk factors, early detection and effective surveillance of typhoid and paratyphoid fevers, and paid attention to multispace-time node triggering and multi-disciplinary channel monitoring and etiological results in the process of outbreak and epidemic for providing a basis to the construction of an innovative technical system with sensitive specificity, staging measurement of typhoid and paratyphoid fevers.
Public Health Forum
Research/development, approval and marketing of medicine and test reagents for major public health events: a comparison between China and foreign countries
YAN Zi-qi, FENG Zhan-chun, CHEN Chao-yi,
2022, 38(3): 376-380. doi: 10.11847/zgggws1133142
Abstract(1761) HTML (793) PDF 646KB(206)
Abstract:
The epidemic of coronavirus disease 2019 is a severe test for China′s response to major public health emergencies. Through literature reviews, we summarized approval system and process for research/development and marketing of medicine and test reagents related to responses to major public health emergencies in many foreign countries and conducted comparative studies on the system and process at home and abroad for providing references to relevant system construction and administrative management China.
Reflections on evolvement of health promotion policies for chronic disease control and prevention in China: a literature study
JIANG Ying-ying, MAO Fan, ZHANG Wei-wei,
2022, 38(3): 381-384. doi: 10.11847/zgggws1135055
Abstract(837) HTML (286) PDF 547KB(109)
Abstract:
It is estimated that 89% of mortalities could be attributed to chronic and non-communicable diseases (NCDs) currently in China and NCDs are the most serious diseases which cause the disease burden in Chinese population. Since 1980s, World Health Organization has been advocating the application of health promotion strategies to improve population health. Recapitulating the evolution of health promotion policies, we can find that comprehensive actions (such as developing healthy public policy, creating supportive environments for health, strengthening community action, building up personal skills, and reorienting health services) can effectively reduce the burden caused by NCDs. The implementation framework of health in all policies is in favor of the government commitments on maintaining population health, by which it can lead to a path for multi-sectoral cooperation to solve complex social determinants that affect health.