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2022, 38(1): .
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Survey and Report
Influencing factors of medication seeking behaviors among adult migrant population with chronic diseases: a hierarchical model-based analysis
HE An-qi, YU Yan, ZHENG Si,
2022, 38(1): 75-79. doi: 10.11847/zgggws1127307
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  Objective  To examine the status and influencing factors of medication seeking behaviors among migrant population with chronic diseases for promoting reasonable medication seeking in the population.  Methods  The data on 5 657 migrant people with chronic diseases (aged 18 – 96 years, averagely 51.25 ± 12.02) were extracted from Dynamic Monitoring Survey among Migrant Population conducted in 2017 across China and that on population were from China Health Statistics Yearbook – 2019. Based on Anderson behavioral model for health services utilization, hierarchical model was used to analyze influencing factors of medication seeking behaviors among migrant people with chronic diseases.  Results  Of the patients surveyed, 88.51% reported seeking medication when being ill during previous one year and only 21.12% reported ever seeking medical services in primary medical institutions. The results of multi-level logistic regression analysis revealed following promoting factors for seeking medication during previous one year: ever receiving health education (odds ratio [OR] = 1.396), with their health records being established (OR = 1.273), with medical insurance (OR = 1.447), with a residence no more than 15 minutes away from a nearest medical institution (OR = 1.329), having poor self-rated health (OR = 1.611), and higher proportion of government health expenditure in total health expenditure (OR = 1.048); the results also indicated that ever receiving health education (OR = 1.407), with their health records being established (OR = 1.487), and with a residence no more than 15 minutes away from a nearest medical institution (OR = 1.273) were promoting factors for seeking medical service in primary medical institutions.  Conclusion  Among adult migrant people with chronic diseases, both personal factors and the proportion of government health expenditure in total health expenditure are associated with medication seeking behaviors.
Lag effect of humidex on bacillary dysentery and its regional heterogeneity in North China
WANG Shu-zi, LIU Zhi-dong, GAO Qi,
2022, 38(1): 80-84. doi: 10.11847/zgggws1131829
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  Objective   To study the association of humidex with bacillary dysentery (BD) incidence and its regional heterogeneity in North China.   Methods   The daily BD incidence and meteorological data from January 1, 2014 through December 31, 2016 in North China were collected from Chinese Center for Disease Control and Prevention and China Meteorological Science Data Sharing Service Network. Distributed lag non-linear model was used to assess associations of average ambient temperature, relative humidity and humidex with BD incidence. Multivariate meta-analysis was employed to pool region-specific analytic estimates and then meta-regression analysis was adopted to explore modifiers of the association between humidex and BD incidence.   Results   Approximately J-shaped relationships were observed between pooled BD risk and average ambient temperature, relative humidity and humidex. The humidex showed a promotion effect on BD incidence of the same day; the effect was the most obvious for the lag day 3 (relative risk [RR] = 1.07, 95% confidence interval [95% CI]: 1.05 – 1.09) and lasted until the lag day 7. Taking the median humidex as a reference, the humidex of 42.4 manifested a highest promotion effect on BD incidence, with the RR of 1.96 (95% CI: 1.52 – 2.53). The effect of humidex was more obvious in city-level regions at high latitude and longitude, with high natural population growth rate but low gross domestic production per capita.   Conclusion   The meteorological condition with high humidex may promote bacillary dysentery incidence in North China and the situation needs to be concerned in the control of the disease, especially in some vulnerable cities.
Influencing factors of health supervision and law enforcement capacity: a structural equation model analysis
GU Yu, MENG Qun
2022, 38(1): 85-89. doi: 10.11847/zgggws1132645
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  Objective  To explore influencing factors of supervision and law enforcement capacity of health administrative institutions and to provide references for improving institutional capacity of health supervision.   Methods   With a self-designed questionnaire and cluster sampling, we conducted a survey among 300 front-line staff in health supervision institutions in Hebi municipality of Henan province in December 2019. Structural equation model (SEM) was adopted in data analysis.   Results   The established SEM fits the data well (minimum chi-square/degree of freedom, [CMIN/DF] = 1.696, root mean square error of approximation [RMSEA] = 0.049, comparative-fit index [CFI] = 0.949). The SEM analysis revealed that law enforcement personnel, resource allocation, and right and responsibility assignment impose a direct positive effect on supervision capacity; the need for health supervision exerts a direct positive effect on government support, supervision mechanism, and resource allocation and an indirect effect on health law enforcement capability through the three factors being influenced; government support has a direct positive effect on right and responsibility assignment, supervision mechanism, and resource allocation and affects law enforcement capability through mediating effect of law enforcement personnel, resource allocation, and supervision mechanism.  Conclusion  Health supervision and law enforcement capacity are affected directly by supervision personnel, resource allocation, and right and responsibility assignment but indirectly by supervision mechanism, the need for supervision, and government support.
Incidence of crayfish-related rhabdomyolysis syndrome in some regions along Yangtze River, 2016
LI Shi-cong, MA Hui-lai, GUAN Xu-hua,
2022, 38(1): 90-93. doi: 10.11847/zgggws1122791
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  Objective  To investigate epidemiological characteristics of crayfish-related rhabdomyolysis (RM) syndrome in regions along Yangtze River in 2016.  Methods  We conducted a field epidemiologic survey on 811 RM cases reported in Anhui, Jiangsu and Hubei province along Yangtze River during 2016 to analyze clinical and prevalence characteristics of the disease.  Results  Of all the cases, 69.3% were female and 78.1% were aged between 20 and 49 years. Main symptoms of the cases were muscle ache, fatigue and digestive disorder-induced pain; five times increased serum creatine kinase (CK) was detected among 84.0% of the cases. Retrospective surveys found that consumption of crayfish, shrimp offal, and alcohol were risk factors for the incidence of the disease. The incidences occurred mainly at home and the crayfish consumed by the cases were mainly from wild fishing.  Conclusion  There is a causal correlation between the incidence of rhabdomyolysis syndrome and crayfish in some regions along Yangtze River in 2016, suggesting that monitoring on crayfish eating-related diseases should be strengthened.
Application of national Indoor Air Quality Standard and its obstacles in China: a cross-sectional survey
ZHANG Xia, XU Yi, GAO Jian-hui,
2022, 38(1): 94-98. doi: 10.11847/zgggws1130762
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  Objective  To examine the application of national Indoor Air Quality Standard – GB/T 18883 – 2002 (IAQS) and its obstacles and to provide references for revising the standard.  Methods  Using stratified multistage sampling, we conducted a questionnaire survey among 91 professional institutions in 26 cities across China during July – October 2019. The selected institutions included centers for disease control and prevention, health supervision institutes, housing and construction companies, detection agencies, industry associations, and universities. Information on IAQS-related awareness and concern among the public were also collected from 1 052 valid responses in all provincial-level regions of mainland China simultaneously.  Results  Valid information were collected from all the institutions selected. The IAQS was mainly applied by detection agencies and daily application of the IAQS was reported by 18.68% of institutions surveyed. In indoor air quality assessment performed by the institutions, the most commonly adopted indicators of the IAQS was formaldehyde (being adopted in 91.21% of the assessments reported), followed by benzene (68.13%), ammonia (62.64%), toluene (57.14%), and total volatility organic compounds (TVOC) (57.14%). There were 31% of the surveyed institutions reporting being able to conduct less than 10 of 19 indicators included in the IAQS. Of all the institutions, 91.21% were reported with the capability of detecting formaldehyde in routine monitoring, but only 28.57% with the capability of benzo(α)pyrene detection. Stratified indicator management, including the particulate matter less than 2.5 μm in aerodynamic diameter (PM2.5) as a quality index, and appropriate optimization of sampling and analyzing instrument were among the most frequent recommendations proposed by the institutions for the revision of the IAQS. Among the surveyed citizens, 43.82% reported the awareness about the IAQS and 73.8% reported the concern on indoor air.  Conclusion  The national Indoor Air Quality Standard – GB/T 18883 – 2002 is generally reasonable and mainly adopted by detection agencies in daily routine indoor air quality assessment. Improvements in indicator selection and analysis instrument were suggested by professional institutions for the revision of the standard
Continuity of health care for rural diabetic patients and its associates in Sanming city: an interpersonal relationship-based analysis
WU Shao-yan, DAI Yue, LI Yue-ping
2022, 38(1): 99-104. doi: 10.11847/zgggws1131796new
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  Objective  To examine characteristics and influencing factors of continuity of health care for rural diabetic patients in Sanming city of Fujian province from the perspective of interpersonal relationship for providing references to improve continuous health care for rural diabetic patients.   Methods  The data of 2016 on 2 606 rural diabetic patients in Sanming municipality of Fujian province were extracted from outpatient records registered in New Rural Cooperative Medical System. The interpersonal relationship-related continuity of health care for the diabetic patients was evaluated with following three indicators: usual provider of care (UPC), continuity of care index (COCI), and sequential continuity (SECON). Unconditional multivariate logistic regression analysis was performed to analyze influencing factors of the continuity of health care.  Results  The interpersonal relationship-related continuity of health care was generally good among the diabetic patients, with the same median value of 1 for UPC, COCI, and SECON. The proportions of the patients with high values of UPC (0.86 – 1), COCI (0.82 – 1), and SECON (0.81 – 1) were 84.80%, 85.61%, and 84.77%; while the proportions of the patients with low values of UPC (0 – 0.85), COCI (0 – 0.81), and SECON (0 – 0.80) were 15.20%, 14.39%, and 15.23%, respectively. The results of unconditional multivariate logistic regression analysis demonstrated that the patients in Shaxian region, visiting a doctor for 5 times or less during the year, without a complication, and seeking medical service mainly in county level or township institutions were more likely to have a high value of both UPC and COCI, while those in Youxi region were more likely to have a low value of both UPC and COCI; the patients being male, visiting a doctor for 5 times or less during the year, without a complication, and seeking medical service mainly in county level or township institutions were more likely to have a high value of SECON but those in Youxi region were more likely to have a low value of SECON.  Conclusion   The interpersonal relationship-related continuity of health care is generally good and mainly influenced by residential region, yearly frequency of visiting a doctor, situation of complication, and the grade of medical institution frequently being visited for medication among diabetic patients in rural region of Sanming municipality.
Genotyping analysis on foodborn Listeria monocytogenes starins isolated in Beijing region
CHANG Xiao-hui, WAN Xiao-nan, ZHANG Jie,
2022, 38(1): 105-109. doi: 10.11847/zgggws1132726
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  Objective  To examine genotype distribution of Listeria monocytogenes (Lm) strains isolated from meat product specimens in Beijing and genetic correlations among the strains with whole genome sequencing (WGS).   Methods  Totally 110 Lm strains were sequenced with WGS and analyzed with multilocus sequence typing (MLST). Gene assembly, prediction and function annotation for WGS results of the strains were performed using relevant softwares. The Comprehensive Antibiotic Research Database (CARD) and the Virulence Factors Database (VFDB) were used to screen drug resistance genes and pathogenic genes of the isolated Lm strains.   Results  The 110 Lm strains were classified into 17 sequence type (ST) types; among the 17 ST types, there was a unknown ST type (namely STnew1) and ST9 was the dominant ST type. The STnew1 has multiple drug resistance genes including genes against macrolides, aminoglycosides, oxazolidinones, chloramphenicols, tetracyclines, and trimethoprim and gene deletion of prfA, hpt, plcA, plcB, inlC, and hlyA. Of the 110 Lm strains, all carried the Listeria monocytogenes pathogenicity island (LIPI-1) gene, except for 6 non-pathogenic strains, and 20.9% carried drug resistance genes.   Conclusion  Multiple drug resistance genes are prevalence in Listeria monocytogenes strains isolated from meat products and LIPI-1 gene is dominant among the drug resistance genes. The results suggest that contamination of Listeria monocytogenes in meat products needs to be monitored and controlled to reduce the risk of foodborne diseases caused by the bacteria.
Completeness of maternal health care system in Beijing and Shanghai: a literature study
TIAN Zhuang, YU Fang, LI Bo-yang,
2022, 38(1): 110-112. doi: 10.11847/zgggws1122395
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  Objective  To compare the disparity in the completeness of maternal health care (MHC) system between Beijing and Shanghai and to explore the feasibility of quantitative evaluation on the degree of the completeness.  Methods  We systematically and extensively collected documents and materials on MHC issued by administrative agencies of Beijing and Shanghai municipality published during 2000 – 2017. Then we extracted relevant information from 649 retrieved documents (232 relevant to Beijing and 417 to Shanghai) and analyzed the information quantitatively to assess the completeness of MHC system in the two municipalities. Spearman correlation and linear regression analysis were used to analyze the relationship between the completeness of MHC system and maternal mortality rate (MMR).  Results  The relevant information-derived index for the completeness of MHC system increased from 32.4% in 2000 to 50.6% in 2017 in Beijing municipality; while, the index increased from 41.1% to 64.6% in Shanghai, respectively. For the two municipal MHC systems, the framework completeness was at a high level but the coordination and responsibility assignment among various functional institutions of the system were at a low level. There was an inverse correlation between the index for the completeness of MHC system and MMR in the two municipalities.  Conclusion  The completeness of maternal health care system were improved and the improvement facilitated maternal health care practice in Beijing and Shanghai gradually during 2000 – 2017; but the coordination and responsibility assignment among various functional institutions of the system should be promoted. The study verified the feasibility of quantitative assessment on the completeness of maternal health care system.
Prevalence and risk factors of HIV infection among MSM having sexual activity at bathhouses in Urumqi city, 2016 – 2018
NI Ming-jian, HU Xiao-min, HU Xiao-yuan,
2022, 38(1): 113-117. doi: 10.11847/zgggws1127792
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  Objective  To examine the prevalence and risk factors of human immunodeficiency virus (HIV) infection among the men who have sex with men (MSM) ever having homosexual behaviors at bathhouses in Urumqi city of Xinjiang Uygur Autonomous Region for developing effective interventions on HIV transmission in the MSM.  Methods  Voluntary HIV counseling and testing service settings were established at selected bathhouses with MSM attendees in Urumqi city from 2016 through 2018 and on-site voluntary HIV counseling and testing, questionnaire interview and follow up services were carried out among 2 195 MSM during the 3 year period.  Results  Among all the MSM surveyed, totally 188 serum HIV antibody positives were detected, with an overall positive detection rate of 8.56%; the annual positive detection rate were 12.96% (77/594), 9.38%, (75/800) and 4.49% (36/801) for the three years, with a significant downward trend (χ2 = 32.01, P < 0.001). Significant decreasing trend was observed in the reported annual proportion of having homosexual behavior during previous 6 months (χ2 = 6.72, P = 0.01), inconsistent condom use (χ2 = 252.70, P < 0.001), having multiple sexual partners (χ2 = 15.25, P < 0.001), and drug use (χ2 = 5.77, P = 0.016); but the reported annual proportion of ever receiving peer education during previous one year (χ2 = 376.75, P < 0.001) and annual rate of awareness on relevant knowledge (χ2 = 115.14, P < 0.001) increased significantly. The results of logistic regression analysis revealed following risk factors for HIV infection among the MSM: suffering from sexually transmitted diseases during previous one year (adjusted odds ratio [aOR] = 2.93, 95% confidence interval [95% CI]: 1.85 – 4.63), inconsistent condom uses (aOR = 2.27, 95% CI: 1.62 – 3.17), having homosexual behavior with multiple partners (aOR = 1.80, 95% CI: 1.26 – 2.56), with multiple sexual partners (aOR = 1.62, 95% CI: 1.16 – 2.26), residing in local region less than one year (aOR = 1.592, 95% CI : 1.076 – 2.365), and at the age of under 35 years (aOR = 1.51, 95% CI: 1.10 – 2.08).  Conclusion  The prevalence of high-risk behaviors is relatively high among MSM having sexual activity at bathhouses in Urumqi city and onsite comprehensive intervention programs at the bathhouses may reduce high-risk behaviors and HIV infection among the MSM.
Government predominance in maternal health care financing in Beijing and Shanghai: a comparison analysis
MA Dong-ping, YIN Wen-qiang, SHI Lin-mei,
2022, 38(1): 118-121. doi: 10.11847/zgggws1122655
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  Objective  To examine changing trend and regional disparity in the insufficiency of government predominance in maternal health care financing and the maternal mortality ratio (MMR) in Beijing and Shanghai during 2000 to 2017 for exploring a rational government predominance in maternal health care financing.   Methods   Documents and literatures about maternal health care financing in Beijing and Shanghai published from 1995 through 2017 were searched; from which, the information on government predominance financing was extracted and the insufficiency of government predominance in maternal health care financing was evaluated with a severity score. Spearman correlation and linear regression analysis were used to analyze the relationship between the insufficiency of government predominance financing and MMR in the two municipalities.   Results   The severity score for the insufficiency of government predominance in maternal health care financing decreased from 3.58 in 2000 to 2.82 in 2017 in Beijing municipality; while in Shanghai the severity score decreased from 3.72 to 1.44. A significant correlation between the MMR and the severity score was observed in Shanghai municipality (r = 0.723, P < 0.01).   Conclusion   The government predominance in maternal health care financing increased during 2000 – 2017 in Beijing and Shanghai municipality and the government predominance financing has a more obvious influence on the reduction of maternal mortality ratio in Shanghai municipality.
Special Report – Promoting Healthy Development in Children
Practice and enlightenment of Child-Friendly City construction in health promotion in China
WANG Chen-ran, XU Tao
2022, 38(1): 1-5. doi: 10.11847/zgggws1134190
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In “Healthy China” 2030 Plan, the construction of healthy cities is considered as a critical strategy to build healthy China. The constructed Child-Friendly Cities (CFC) may provide children with a prioritized environment for survival and development, which promotes children′s well-beings. In this study, the definition of CFC and the significance of health promotion in the construction of CFC were briefly introduced; CFC construction-related practices in five main aspects of children′s health promotion (nutrition, mental health, early development, health behaviors, and injuries) in 29 cities of 12 foreign countries were reviewed; the experiences and limitations in CFC construction in several cities of China were also summarized. The study intends to provide a reference for CFC construction in China during the 14th FiveYear Plan period.
Prevalence and indoor environment risk factors of pneumonia among preschool children in Urumqi city: a cross-sectional survey
WANG Ting-ting, YONG Xian-ting, YAO Jian, SHI Hao-nan, , ZHU Jia
2022, 38(1): 6-10. doi: 10.11847/zgggws1131938
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  Objective  To explore the prevalence and indoor environment risk factors of pneumonia among preschool children in Urumqi city of Xinjiang Uygur Autonomous Region for providing evidences to the prevention of the disease.  Methods  Using stratified random cluster sampling, we recruited 10 000 children aged 2 – 7 years in 60 kindergartens in 6 districts of Urumqi city. Then we conducted a self-administered survey among the parents of the selected children during August 2019 using a self-designed questionnaire based on the International Study of Asthma and Allergies in Childhood (ISAAC) and Dampness in Buildings and Health (DBH).  Results  Among 8 153 children with valid information provided by their parents, the prevalence of doctor-diagnosed pneumonia was 29.5%. Multivariate logistic regression results revealed that the children exposed to following indoor conditions were more likely to have pneumonia: home decoration or installation of new furniture during the period from maternal pregnancy to age of one year (odds ratio [OR] = 1.18, 95% confidence interval [95% CI]: 1.04 – 1.35), emergence of cockroaches, flies or mosquitoes at home (OR = 1.69, 95% CI: 1.49 – 1.91), plantation of flowering plants in the house since children′s birth (OR = 1.19, 95% CI: 1.07 – 1.32), keeping pets at home since children′s birth (OR = 1.31, 95% CI: 1.15 – 1.49), and exposed to passive smoking at home (OR = 1.31, 95% CI: 1.19 – 1.45).  Conclusion  Pneumonia prevalence is relatively high and influenced by several indoor environment risk factors among preschool children in Urumqi city. The results suggest that some indoor conditions need to be improved for pneumonia prevention in the children.
Clustering of oral health risk behaviors and its influencing factors among 12-year-old children in Beijing
YUN Qing-ping, LIU Min, CHANG Chun,
2022, 38(1): 11-14. doi: 10.11847/zgggws1134238
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  Objective   To investigate the clustering of oral risk behaviors and its influencing factors among children and to provide evidences for promoting oral health in children.   Methods   The data on 2 158 children aged 12 years in 18 middle schools were extracted from the Fourth Oral Health Survey conducted during 2015 in Beijing city. The prevalence and the clustering of oral health risk behaviors among subgroups of the children were compared and factors affecting the clustering of oral health risk behaviors were explored.   Results   Of all the children surveyed, 45.92% reported having at least two oral risk behaviors, indicating a clustering trend in oral risk behaviors among the children. The proportion of the children with clustering of oral risk behaviors were 52.36% and 39.48% for the boys and the girls, respectively. The results of logistic regression analysis showed that the children with following characteristic were less likely to have clustering of oral risk behaviors: being female (odds ratio [OR] = 0.58, P < 0.001), with a maternal education of undergraduate and above (OR = 0.45, P < 0.001), and with a higher oral health knowledge (OR = 0.64, P < 0.001); while, the children being non-only child were more likely to have clustering of oral risk behaviors (OR = 1.41, P < 0.01).   Conclusion   The clustering of oral health risk behaviors is prevalent among 12 years old school children in Beijing, particularly among the children being non-only child and with lower maternal education.
Influencing factors of hand, foot, and mouth disease among children in Guangdong province: a case-control study
CHEN Si-yi, WU Wei, PENG Jie-wen,
2022, 38(1): 15-19. doi: 10.11847/zgggws1132658
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  Objective  To explore influencing factors of hand, foot, and mouth disease (HFMD) among children in Guangdong province and to provide evidences for developing comprehensive measures on HFMD prevention and control and mechanism.   Methods  With a self-designed questionnaire and face-to-face interview with the participants′ legal guardians, we conducted a case-control study during May – July 2017. The cases were 339 children (177 boys and 162 girls aged 3.54 ± 1.17 years) initially diagnosed with HFMD at two hospitals in a prefecture and a county of Guangdong province; the controls were 339 hospital/community-matched children without diarrhea, gastroenteritis, history of suffering from HFMD, herpangina or other related diseases.   Results  Compared to the controls, the cases were reported with significantly higher proportions of with 3 or more children under the age of 14 years in the family (12.09% vs. 5.90%), taking Chinese patent medicine in the past month (13.57% vs.9.73%), sucking fingers frequently (18.29% vs. 10.06%), playing on the ground occasionally (55.46% vs. 44.97) or frequently (24.78% vs. 21.30%), spending 40 – 59 minutes in every physical activity (14.75% vs. 8.88%), and having a contact with someone suffering from HFMD in the past month (20.35% vs. 0.59%) but lower proportions of with paternal education of college and above (23.01% vs. 34.91%), with maternal education of college and above (20.65% vs. 31.86%), washing hands frequently before eating and after using toilet (70.50% vs. 84.91%), washing hands frequently after going out (60.18% vs. 76.33%), consuming food supplemented with prebiotics in the past month occasionally (18.88% vs. 23.96%) or frequently (2.65% vs. 12.43%), and drinking herbal tea occasionally (52.51% vs. 60.36%) or frequently (9.14% vs. 12.13%) (P < 0.05 for all). Unconditional multivariate logistic regression analysis revealed that significant risk factors of HFMD incidence included taking Chinese patent medicine in the past month, sucking fingers frequently, spending 20 – 59 minutes in every physical activity, and contacting with HFMD cases in the past month; while, consuming prebiotics frequently in the past month and drinking herbal tea occasionally were protective factors against HFMD incidence.   Conclusion  HFMD incidence is affected by many factors such as exposure to HFMD cases, hygiene habits, prebiotics consumption, and taking medicine among children in Guangdong province.
Neonatal genetic metabolic disease entities ought to be included in tandem mass spectrometry screening in China
GONG Yi-xiao, SONG Xiao-hong, XU Juan, DU Jia-yue, XIE Li-chun,
2022, 38(1): 20-24. doi: 10.11847/zgggws1134514
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  Objective   To systematically retrieve and sort out the information on neonatal genetic metabolic disease entities included in tandem mass spectrometry (MS/MS) screening in some countries and to provide a reference for entity expansion in the screening on neonatal genetic metabolic diseases with MS/MS in China.   Methods   With literature analysis and expert consultation, we assessed the priority order of the neonatal genetic metabolic diseases to be included in screening with MS/MS using a comprehensive score.   Results   Totally 53 neonatal genetic metabolic diseases were identified with the practicability of to be screened with MS/MS; of which, 23, 16, and 14 were aminoacidopathies, organic acidemias and fatty amino acid metabolic diseases, respectively. The diseases with top ten comprehensive scores in descending order are isovaleric acidemia, glutaric acidemia type Ⅰ, medium-chain acyl-CoA dehydrogenase deficiency, maple syrup urine disease, homocystinuria, propionic acidemia, methyl malonic acidemia, phenylketonuria, citrullinemia type Ⅰ, and very long-chain acyl-CoA dehydrogenase deficiency.   Conclusion   Based on the study results, we recommend that the ten neonatal genetic metabolic diseases with higher comprehensive scores ought to be included in MS/MS screening and the subsequent disease entities for the screening could be adjusted timely according to screening detection outcomes and the incidences of neonatal genetic metabolic diseases.
Serum lipid profile and its associates in preschool children in Tianjin city
HU Tong-xin, LI Wei-qin, QIAO Yi-juan,
2022, 38(1): 25-28. doi: 10.11847/zgggws1132567
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  Objective   To investigate serum lipid level and its related factors among kindergarten children in Tianjin city.   Methods   Using cluster sampling, we recruited 5 943 children aged 5 – 6 years in 49 kindergartens for a cross-sectional survey in Tianjin city from March to June, 2018. Fasting serum total cholesterol (TC) and triglyceride (TG) were detected and physical measurements were performed among the children. Student t-test, analysis of variance (ANOVA), and Chi-square test were adopted in data analysis.   Results   For all the children, the overall abnormal rate of serum lipids was 10.3% and the abnormal rate was 9.0% and 1.7% for serum TC and TG. Compared to those among the boys, significantly higher mean value (4.29 ± 0.71 vs. 4.18 ± 0.66 mmol/L) and abnormal rate (10.5% vs. 7.6%) of serum TC were detected among the girls (both P < 0.05); the overall dyslipidemia (abnormal TC or TG) rate was also significantly higher in the girls than in the boys (11.9% vs. 9.0%, P < 0.05). The abnormal rates of TG were 7.9%, 2.1%, 1.9%, and 0.8% for the children with obesity, overweight, underweight, and normal weight assessed by body mass index (BMI), with a significant difference among the groups (P < 0.05). The overall dyslipidemia rate differed significantly among the children with different BMI; the overall dyslipidemia rate of obesity/underweight children were significantly higher those of normal weight/overweight children (14.7%/14.6% vs. 9.8%/9.8%) (P < 0.01 for all). In comparison to the children in suburban regions, the urban children had significantly higher abnormal rate of TC (10.2% vs. 7.9%) and overall dyslipidemia (11.6% vs. 9.3%) (both P < 0.05).   Conclusion   Among pre-school children in Tianjin city, the prevalence of dyslipidemia is relatively high and special attention should be paid to dyslipidmia prevention and control among the pre-school children with obesity and living in urban regions.
Co-occurrence and intercorelation of health risk behaviors among rural primary and middle school students in Jiangxi province
JIA Zhi-hui, CHEN Fei-yu, LI Xu-yang,
2022, 38(1): 29-32. doi: 10.11847/zgggws1132639
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  Objective   To explore the co-occurrence and intercorelation of health risk behaviors among rural primary and middle school students in Jiangxi province.   Methods  Using stratified cluster random sampling, we recruited 2 284 students at 12 rural primary and middle school students in 6 counties across Jiangxi province for an on-site questionnaire survey during September 2018. Modified Youth Risk Behavior Surveillance System (YRBSS) in Chinese was adopted in the study.   Results   Among all the students, the self-reported rate was 29.60% for physical violence, 90.96% for physical inactivity, and 24.96% for poor hygiene habits; of the students, 2.41%, 30.99%, and 7.67% reported ever having one, three, and five or more health risk behaviors. The reported rate of single and multiple risk behaviors differed significantly by gender (χ2 = 42.65), schooling grade (χ2 = 33.42) and family structure (χ2 = 30.21) (P < 0.01 for all). There were positive correlations among the reported rates of various health risk behaviors (P < 0.05 for all).   Conclusion  The co-existence of health risk behaviors is prevalent and various health risk behaviors are intercorrelated among rural primary and middle school students in Jiangxi province.
Prevalence, associates and stage-specific preventive behaviors of myopia among junior high school students in Guangdong province: health action process approach- and theory of planned behavior-based analysis
ZHONG Miao, XU Shao-min, SUN Cai-jun
2022, 38(1): 33-38. doi: 10.11847/zgggws1132699
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Abstract:
  Objective  To examine the prevalence of myopia and its related personal eye habits among junior high school students and to explore stage-specific myopia prevention behaviors of the students based on health action process approach (HAPA) and theory of planned behavior (TBA).  Methods  Using stratified random cluster sampling, we recruited 4 894 students at 6 junior high schools in 5 prefectures of Guangdong province. An anonymous questionnaire survey was conducted among 2 289 students online and 2 570 students on-site during July 2020.  Results  Of the 4 859 students with valid responses, 3 013 (62.0%) reported being myopic and 994 (20.5%) reported suffering from myopia during past 6 months. The students being female, in higher schooling grade, and with parental myopia reported a significantly higher myopia prevalence rate than other students (P < 0.001 for all). The students′ myopia prevalence differed significantly by sleeping time during school days, proper reading/writing time during school days or weekends, daily outdoor activity, outdoor activity in school days, outdoor activity with parents/friends during free days, posture while reading/writing, and rest time after continuous reading for 40 minutes (all P < 0.05). The results of multivariate logistic regression analysis revealed following risk factors of myopia for the students: being female, in higher schooling grade, with parental myopia, low frequency of outdoor activity for 2 hours per day, and low frequently of having a rest of 10 minutes after reading/writing for 40 minutes. Based on reported frequencies of having daily outdoor activity for at least 2 hours and having a rest of 10 minutes after reading/writing for 40 minutes, we classified 1 543 (31.8%), 1 433 (29.5%), and 1 883 (38.3%) of the students as at the pre-intention, intention, and action stage of developing eye habits for myopia prevention; high proportions of the boy students and the students in low schooling grade were assessed in the action stage. The students at the action stage reported a higher social cognition and better eye habits related to myopia prevention than the students at both pre-intention and intention stage (P < 0.01 for all) but no difference in risk cognition was observed among the students at different stages. The results of hierarchical regression analysis showed that for the students at pre-intention stage, the attitude towards and self-efficacy of action were major predictors for myopia prevention behaviors, jointly explaining 15% of total variance of behavior change; for the students at intention stage, risk perception, subjective norm, and action self-efficacy were major predictors, altogether explaining for 12% of total variance of behavior change; whereas, attitude towards action, subjective norm, action and coping self-efficacy, and behavioral planning and coping were major predictors, explaining 20% of total variance of behavior change, for the students at action stage.  Conclusion  Among junior high school students, the prevalence of myopia varies with individual characteristic and eye habits; the influence of social cognition variables on myopia prevention behaviors is different among the students at various stages of developing eye habits for myopia prevention.
Association of traditional bullying and cyberbullying victimization with suicide-related psychological behaviors in high school students in Chongqing municipality
JIN Feng, DIAO Hua, PU Yang,
2022, 38(1): 39-46. doi: 10.11847/zgggws1131266
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Abstract:
  Objective  To investigate the prevalence of bullying victimization and suicidal psychological behavior and to explore the correlation between different bullying victimization and suicidal behaviors among high school students in Chongqing municipality.   Methods   Using stratified cluster random sampling and a self-designed questionnaire, we conducted a survey among 8 276 junior and senior high school students in 4 districts and counties in Chongqing municipality during November – December 2019.  Results  The participants reported an incidence rate of 9.63% for total bullying victimization during past 30 days and the reported incidence rates were 5.10%, 2.04%, 2.67%, 4.10%, and 0.57% for verbal, physical, relational, sexual, and cyber bullying victimization, respectively. The reported prevalence rates were 23.90%, 10.58% and 2.68% for suicide ideation, plan and attempt during previous 12 months. After controlling for potential confounding variables, multivariate logistic regression analysis revealed that following victimizations were significant risk factors for different suicidal psychological behaviors: verbal bullying for suicidal ideation/plan/attempt (odds ratio [OR] = 1.777/1.714/2.256, all P < 0.05); physical bullying for suicidal ideation/attempt (OR = 1.484/1.995, both P < 0.05); relational bullying for suicidal ideation/plan (OR = 1.802/1.970, both P < 0.05); sexual bullying for suicidal ideation/plan (OR = 1.676/1.724 both P < 0.05); and cyber bullying for suicide attempt (OR = 3.190, P < 0.05).   Conclusion  School bullying victimization is an important factor for suicide-related psychological behaviors and should be actively managed among high school students.
Association of dietary behaviors with health-related quality of life among primary and high school students in urban and rural Nanjing, China
ZHAO Ping, QIN Zhen-zhen, WANG Na,
2022, 38(1): 47-51. doi: 10.11847/zgggws1132290
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Abstract:
  Objective  To explore the correlation between dietary behaviors and health-related quality of life (HRQoL) among primary and high school students in urban and rural regions of Nanjing municipality, China.   Methods  Using multistage random cluster sampling, we recruited 4 498 students of grade 4 – 12 in 108 classes of 36 primary and junior/senior high schools in all administrative districts of Nanjing. On-site self-administered questionnaire survey and anthropometric measurement were conducted among the students during May – June 2018. Child Health Utility 9D – Chinese Version (CHU9D-CHN), Item-Specific Physical Activity Scale for Chinese Children and Adolescents (I-PASCA), and the Food Frequency Questionnaire were adopted in the survey. Multivariate linear regression model was used to analyze the association of dietary behavior with HRQoL among the students.  Results  For the 4388 participants completed the survey (response rate = 97.6%), the mean value of HRQoL was 0.78 (standard deviation = 0.17). After adjusting for confounders and potential class-level clustering effects, the score of CHU9D decreased for the students with low frequency of vegetable intakes (mean difference [MD] = – 0.022, 95% confidence interval [95% CI]: – 0.043 – – 0.001) and fruit intakes (MD = – 0.015, 95% CI: – 0.034 – 0.004) compared to those with high frequency of vegetable and fruit intakes; decreased CHU9D scores were also measured in the students with high consumption frequency of snack (MD = – 0.030, 95% CI: – 0.041 – – 0.020) and soft-drink (MD = – 0.024, 95% CI: – 0.034 – – 0.013) in comparison to those with low frequency of snack and soft-drink consumption; moreover, the results of multivariate analysis demonstrated that a – 0.22 (95% CI: – 0.03 – – 0.01) increment in the CHU9D score was correlated with each of the four unhealthy dilatory behaviors additively (low intake of vegetable and fruit and high consumption of snack and soft-drink) after adjusting for other variables.  Conclusion  The intake frequency of vegetables and fruits are inversely associated with HRQoL, but the frequency of snack and soft-drink consumption are positively correlated to HRQoL; the four dietary behaviors are of synergistic effect on HRQoL among primary and high school students in Nanjing, China
Epidemiological Research
Correlation between dietary patterns and impaired fasting glucose in adults aged 30 – 79 years in Chongqing city
YUAN Xin-yü, XIAO Meng, CHEN Li-ling,
2022, 38(1): 52-56. doi: 10.11847/zgggws1132939
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Abstract:
  Objective  To analyze the relationship between dietary patterns and impaired fasting glucose (IFG) in adults of Chongqing city and to provide evidences for adopting reasonable dietary patterns to prevent diabetes in the population.   Methods   Using stratified multistage random cluster sampling, we recruited 19 862 permanent residents aged 30 – 79 years in Chongqing municipality. Face-to-face interviews with a general questionnaire and Food Frequency Questionnaire, physical examination, and laboratory test were conducted among the residents from September 2018 through February 2019. Data process and analysis were performed with SPSS 25.0. Chi-square test was used to assess between group differences. Factor analysis was adopted to distinguish dietary patterns and logistic regression models were used to analyze associations of dietary patterns with IFG.   Results  Of the residents, 1 496 (7.53%) individuals with IFG were detected. Factor analysis revealed four dietary patterns among the residents, including patterns of egg and milk, animal foodstuff, cereal/potato and vegetable, and pasta and pickles. After adjusting for potential confounding factors, the results of logistic regression analysis showed that in terms of animal foodstuff pattern, the residents with lower scores were at a decreased risk of IFG (odds ratio [OR] = 0.841, 95% confidence interval [95% CI]: 0.716 – 0.989) compared to those with the highest scores; while in regard to pasta and pickles pattern, the residents with the lowest and lower scores were at a decreased risk of IFG (for those with the lowest scores: OR = 0.853 [95% CI: 0.730 – 0.998]; for those with lower scores: OR = 0.839 [95% CI: 0.721 – 0.977]) in comparison with those with the highest scores.   Conclusion  Among 30 – 79 years old residents in Chongqing city, dietary factors are related closely to the prevalence of impaired fasting glucose and the influence of animal foodstuff pattern and pasta and pickles pattern are more significant in the prevention of the disorder.
Evaluation on influencing factors of doctor-patient information communication in China: a grounded theory-based cross-sectional survey
ZHANG Yue, YU Rong-bin, WANG Jin-fan
2022, 38(1): 57-60. doi: 10.11847/zgggws1124619
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Abstract:
  Objective  To explore influencing factors of doctor-patient information communication (DPIC) and to provide evidences for improving the situation of DPIC in China.  Methods  To screen influencing factors of DPIC based on grounded theory, we conducted an expert fractal analysis and semi-structured interviews among 8 schoolors engaged in medical humanities education and research, 20 senior doctors and 20 patients in three tertiary hospitals in Nanjing city using purposive sampling. With the coded influencing factors prelimilarily determined, we compiled a questionnaire. Then we conducted an on-site self-administered questionnaire survey among 2 727 medical professionals and 1 781 patients and their relatives recruited using cluster random sampling at tertiary hospitals in 23 municipalities/provinces across China during March – May 2016. We analyzed the data collected for weighting and ranking all influencing factor of DPIC by comprehensive and average impact scores calculated for each of the factors.  Results  Of the surveyed medical professionals and patients and their relatives, 45.9% and 44.1% reported a strong willingness to conduct DPIC; 75.9% and 71.4% affirmed the necessity of governmental agencies' role in DPIC; 49.0% and 53.9% evaluated the role of media and network in DPIC as very necessary; 21.6% and 18.0% approved representative role of medical associations in the process of DPIC but only 14.5% and 26.7% approved the representative role of consumers associations. There were significant disparities between medical professionals and patients and their relatives in attitudes towards DPIC and its relevant dimensions mentioned above (all P < 0.01). The rank order from high to low for impact scores of DPIC influencing factors was governmental administration (score = 3.69), demand for the communication (3.34), media and network (3.18), medical association (2.56), and consumer association (2.21) among the medical professionals; while among the patients and their relatives, the rank order was government administration (3.61), media and network (3.32), demand for the communication (3.25), consumer association (2.71), and medical association (2.47).  Conclusion  A good doctor-patient information communication comes from the joint efforts among medical staff, patients, government agencies, media and network, and relevant social organizations. The study result suggests that a comprehensive platform needs to be established to promote the communication.
Smoking prevalence among 20 – 80 years old Han residents in urban and rural regions of Hebei province
YU Ji-gang, CUI Ze, Pan Li,
2022, 38(1): 61-64. doi: 10.11847/zgggws1131617
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Abstract:
  Objective   To examine smoking prevalence among urban and rural Han residents aged 20 – 80 years in Hebei province and to provide evidences for developing tobacco control measures.   Methods  Using stratified multistage cluster sampling, we recruited 3 835 permanent residents aged 20 – 80 years in urban and rural regions of three municipalities of Hebei province and conducted a face-to-face survey with a self-designed questionnaire during July – September 2017.  Results   Among the 3 828 participants with valid responses, 894 (23.35%) were current smokers and the current smoking rate differed significantly by gender, age, education, and living region (all P < 0.01). Of the 1 206 former smokers, 312 (25.88%) quitted smoking for 6 months or more and the smoking cessation rate was significantly different among the former smokers of diverse age and with different education (both P < 0.01). The average daily smoking amount for the current smokers was 16.36 ± 10.42 cigarettes and the amount varied significantly by the smokers′ gender, age, education, and living region (all P < 0.01); the average age of smoking initiation of the current smokers was 21.12 ± 6.57 years and the average age was significantly different among the current smokers of different gender and age (both P < 0.01).   Conclusion   Among adult permanent residents in urban and rural regions of Hebei province, the smoking rate was high but the smoking cessation rate for former smokers was low and the age of smoking initiation was young for current smokers. The study also indicates that the male and rural residents are key populations for tobacco control in the province.
Correlative factors of multiple induced abortions among migrant female workers in Shenzhen city: a hospital-based survey with decision tree analysis
ZHANG Dong-mei, ZHENG Jie-nan, LI Rou-rou,
2022, 38(1): 65-69. doi: 10.11847/zgggws1122014
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Abstract:
  Objective  To examine the knowledge about reproductive health, reasons and impact factors of induced abortion among migrant female workers in Baoan district of Shenzhen city for providing evidences to develop strategies on reducing unintended pregnancy-related induced abortion in the population.  Methods  Using convenient sampling, we selected two grade A tertiary hospitals in Shenzhen city of Guangdong province as study sites and conducted a face-to-face interview among 3 737 migrant female workers having induced abortion from March 2016 through March 2017 at the two hospitals. Information on demographics, abortion behaviors and knowledge about reproductive health were collected and decision tree analysis was adopted to analyze correlative factors of multiple induced abortions among the participants.  Results  Valid responses were collected from 3 363 participants averagely aged 26.3 ± 5.4 years. Among the participants, the frequency of induced abortion differed significantly by marital status, whether living with family members, the number of sexual partners, and the perception of health risk related to induced abortion (all P < 0.001). Univariate analysis indicated that significant influencing factors of induced abortion incidence included marital status, with whom living together, the number of sexual partners, and the knowledge about induced abortion related health risk/infertility/reproductive tract inflammation/obstruction of fallopian tubes/backache/perforation of uterus. The results of decision tree analysis revealed that the participants with following characteristics were more likely to have multiple induced abortions: with more unmarried sexual partners, with more than 4 unmarried sexual partners and having correct perception on the risk of induced abortion, being divorced or widowed but having more sexual partners and living together with a spouse or family members, and being married and with fewer sexual partners but having a positive attitude towards unmarried pregnancy.  Conclusion  The migrant female workers in Shenzhen city are lack of the consciousness on contraception and the knowledge about reproductive health and education programs for reproductive health in the population need to be promoted by relevant social departments.
Experimental Study
Effect of bergenin on D-galactosamine-induced acute liver injury in rats
XU Jie, GAO Ya, JI Yan-ping,
2022, 38(1): 70-74. doi: 10.11847/zgggws1131528
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Abstract:
  Objective  To study protective effect and mechanism of bergenin on D-galactosamine (D-GalN)-induced acute liver injury in rats.  Methods  Totally 60 Sprague-Dawley (SD) rats were randomly assigned into 6 groups (10 in each group): a control and a model group with saline, a silymarin group (120 mg/kg), and low, moderate and high bergenin groups (20, 40, 80 mg/kg). All the treatments were carried out by intragastric administration (10 mL/kg) once a day consecutively for 7 days. Two hours after the last administration, D-GalN (700 mg/kg) was intraperitoneally administered for all the rats to establish acute liver injury model, excepted for the control rats. Sixteen hours after the D-GalN injections, all rats′ blood and liver tissue specimens were collected. Biochemical methods were used to detect serum content or activity of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total antioxidant capacity (T-AOC), total bilirubin (TBIL), total superoxide dismutase (T-SOD), malondialdehyde (MDA), and glutathione peroxidase (GSH-Px); enzyme-linked immunosorbent assay (ELISA) was adopted to measure contents of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) in liver tissues; and Western blot analysis was performed to determine phosphorylated c-Jun N-terminal kinase (p-JNK), JNK, c-Jun, phospharylated adenosine monophosphate-activated protein kinase (p-AMPK), and AMPK protein expressions in liver tissues, respectively. Pathological changes of liver tissues were observed with hematoxillin-eosin (HE) staining.  Results  Compared with those in the control rats, serum activity of AST, ALT, TBIL and MDA were significantly increased in the model rats (all P < 0.01). In contrast to those in the model rats, serum AST, ALT, TBIL, and MDA were significantly reduced in the rats of the three bergenin groups (all P < 0.05) and the activity of serum T-AOC, T-SOD, and GSH-Px were significantly increased in the rats of moderate and high bergenin groups (all P < 0.01); in addition, significantly decreased TNF-α, IL-1β, IL-6 and increased IFN-γ (all P < 0.01), down-regulated p-JNK and c-Jun expressions (both P < 0.05) but up-regulated p-AMPK expression (P < 0.01) were detected in liver tissues of the rats of moderate and high bergenin groups.  Conclusion  Bergenin possesses a protective effect on D-GalN-induced acute liver injury in rats and the mechanism of the effect may be related to the inhibition of oxidative stress and the regulation of AMPK/JNK signaling pathway.
Overview
Detection of plastic particles in environmental samples: status and perspective
GAO Hong-ying, SHEN He-qing
2022, 38(1): 122-128. doi: 10.11847/zgggws1128897
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Abstract:
To summarize studies on detections of microplastic particles in environmental and biological samples. The reported methods′ theory, methodology, technical characteristics, and application were described and their main advantages/disadvantages and research directions were discussed. Major technologies for detections of microplastic particles in environmental and biological samples include microscope- and imaging-based particle morphological characterization, light spectrum-based plastic molecular and atomic analysis, pyrolysis-based reaction characteristics and products analysis and other analytical methods. There are great disparities in detection results of microplastic particles in various types samples using different methods; as yet there is no a method which could meet simultaneous analysis on morphology, composition, and trace concentration of micro- and nano-plastic particles in complex samples. While, pyrolysis-based gas chromatography-mass spectrometry could be employed as a general analysis on particles with specific size in prepared samples; combined with pyrolytic condition optimization and utilization of high-throughput mass spectrometry detector, the method could be applied to detections of trace plastic in various environmental and biological samples.