Advance Search
Display Method:
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,
 doi: 10.11847/zgggws1133142
Abstract(897) HTML(466) PDF 641KB(165)
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.
Enlightenment of evolvement of health promotion policies for chronic disease control and prevention in China: a literature study
JIANG Ying-ying, MAO Fan, ZHANG Wei-wei,
 doi: 10.11847/zgggws1135055
Abstract(41) HTML(18) PDF 546KB(14)
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, developing personal skills, and reorienting health services) can effectively reduce the burden caused by NCDs. The implementation framework of health in all policies can promote governmental commitments on and implementation of maintaining population health, as well as provide a path for multi-sectoral cooperation to solve complex social determinants that affect health.
Establishment of and economic evaluation on health reporting system in China
LIU Shang-jun, LUO Ya-nan, GUO Shuai,
 doi: 10.11847/zgggws1134109
Abstract(27) HTML(12) PDF 923KB(9)
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
 doi: 10.11847/zgggws1134365
Abstract(23) HTML(15) PDF 785KB(3)
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.
Data mining and panoramic analysis on global Nipah virus-related patent applications
MA Li-li, HUA Yi-dan, HAN Xiu-cheng,
 doi: 10.11847/zgggws1132805
Abstract(19) HTML(10) PDF 590KB(3)
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 are constantly and relevant researches need to be promoted in China for Nipah virus-related biosafety and epidemic prevention.
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,
 doi: 10.11847/zgggws1133235
Abstract(22) HTML(9) PDF 568KB(5)
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 cases (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.
Heart disease mortality among residents in Hebei province, 2014 – 2019: an analysis on death registry data
ZHANG Fan, LIU Yu-huan, CAO Ya-jing,
 doi: 10.11847/zgggws1131826
Abstract(29) HTML(13) PDF 475KB(6)
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.
Risk assessment on crayfish eating-related cadmium exposure among consumers in Jiangsu province
XIE Wei, ZHU Qian-rang, ZHANG Jing-xian,
 doi: 10.11847/zgggws1133624
Abstract(25) HTML(9) PDF 523KB(3)
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.
Added effect of heat waves on mortality in residents of Beijing, 2007 – 2013
NIU Yan-lin, YANG Jun, LIN Hua-liang,
 doi: 10.11847/zgggws1134217
Abstract(24) HTML(5) PDF 680KB(2)
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.
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,
 doi: 10.11847/zgggws1133865
Abstract(39) HTML(11) PDF 582KB(11)
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.
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,
 doi: 10.11847/zgggws1132178
Abstract(26) HTML(11) PDF 533KB(8)
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 interviews with a self-designed questionnaire, physical examination and laboratory test 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.
Functional food for alleviation of nutritional amemia in China: an analysis on official registration data
HAN Xiao-qian, DU Yong, WU Guo-qing,
 doi: 10.11847/zgggws1133511
Abstract(11) HTML(6) PDF 765KB(0)
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 its 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.
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,
 doi: 10.11847/zgggws1133115
Abstract(15) HTML(8) PDF 841KB(2)
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.
Whole-genome sequencing-based genetic analysis of influenza A (H3N2) virus strains isolated in Guangzhou city
CAO Lan, LI Kui-biao, CHEN Yi-yun,
 doi: 10.11847/zgggws1131843
Abstract(13) HTML(8) PDF 811KB(1)
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.
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,
 doi: 10.11847/zgggws1133020
Abstract(17) HTML(9) PDF 509KB(4)
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.
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,
 doi: 10.11847/zgggws1131688
Abstract(19) HTML(10) PDF 540KB(5)
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,
 doi: 10.11847/zgggws1133313
Abstract(18) HTML(11) PDF 616KB(0)
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.
Status and population characteristics of knowledge, attitude and practice about foodborne disease prevention among Chinese public
ZHANG Na, LU Jiao, CHENG Jing-min
 doi: 10.11847/zgggws1132064
Abstract(15) HTML(7) PDF 517KB(3)
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.
Establishment of a microbial transplantation-induced dysbacteriosis model in rats with ischemic stroke
NIE Hui-fang, PENG Zhu-li, YOU Jian-kai,
 doi: 10.11847/zgggws1133778
Abstract(12) HTML(5) PDF 1131KB(1)
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
 doi: 10.11847/zgggws1133260
Abstract(11) HTML(8) PDF 1310KB(0)
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.
Changing trend in reported hepatitis B incidence among Chinese residents, 2004 – 2017
JIANG Wei, MAO Xian-hua, LIU Zhen-qiu,
 doi: 10.11847/zgggws1132715
Abstract(21) HTML(6) PDF 489KB(3)
Abstract:
  Objective  To analyze the trend of reported incidence of hepatitis B (HB) in 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 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.
Effect of comprehensive intervention on hepatitis B in Luohu district of Shenzhen city
ZHANG Shi-jie, CHEN Wei-hong, LIU Wei-min,
 doi: 10.11847/zgggws1134656
Abstract(18) HTML(12) PDF 497KB(1)
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.
Subclinical infection of hepatitis E and its influencing factors among community residents in Shanghai
XIAO Zheng-bin, CHEN Kai-yun, WANG Lin,
 doi: 10.11847/zgggws1133090
Abstract(18) HTML(10) PDF 531KB(1)
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.
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,
 doi: 10.11847/zgggws1121897
Abstract(8) HTML(4) PDF 475KB(1)
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.
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,
 doi: 10.11847/zgggws1133229
Abstract(15) HTML(10) PDF 538KB(1)
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.
Associations of waist circumference, waist-hip ratio, waist-height ratio, and body mass index with hypertension incidence among 35 – 74 years old residents in Jiangsu province: a prospective cohort study
CHEN Feng-mei, GUO Zhi-rong, HAI Bo,
 doi: 10.11847/zgggws1128795
Abstract(268) HTML(86) PDF 485KB(30)
Abstract:
  Objective  To explore effects of body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and waist to height ratio (WHtR) on hypertension incidence among adult community population.  Methods  During April 1999 in Jiangsu province, a baseline survey was conducted among 8 865 residents aged 35 – 74 years in three urban communities and nine natural villages and then two follow-up studies were carried out among 4 582 and 3 847 residents 2 and 5 years after the baseline survey. Finally, physical examination and questionnaire interview were performed among 2 531 residents being followed-up 2 or 5 years later and without hypertension, diabetes, cardiovascular diseases and high fasting blood glucose (≥ 5.6 mmol/L) at the baseline survey. Multivariate Cox proportional hazard regression analysis was adopted to analyze the effects of WC, BMI, WHR and WHtR on hypertension incidence.  Results  Among the 2 531 participants with a median follow-up interval of 3.8 years, 469 new hypertension were diagnosed by the end of follow-up and the hypertension incidence rate was 18.53%. After adjusting for gender, age, education, occupation, family annual income per capita, smoking and alcohol drinking, significantly higher hypertension risks were estimated for the participants with the third and the highest quartile value of BMI (hazard risk [HR] = 1.46 and 2.42), WC (HR = 1.63 and 2.51), WHR (HR = 1.70 and 2.62), and WHtR (HR = 1.63 and 2.62) compared to the participants with the lowest quartile value of the four indicators, respectively; furthermore, the hypertension risk was significantly higher for the participants with the highest tertile value of BMI and the second or the highest tertile values of WC (HR = 1.86 and 2.55) in comparison with the participants with the lowest tertile value of BMI and WC.  Conclusion  High somatotype indexes including WC, BMI, WHR and WHtR are associated with increased risk of hypertension incidence among adult community residents.
Effect of dietary restriction on manganese-induced neurotoxicity in mice
LANG Jing, GAO Liang, WANG Wen-bo,
 doi: 10.11847/zgggws1133241
Abstract(100) HTML(74) PDF 639KB(9)
Abstract:
  Objective  To explore the effect and mechanism of dietary restriction (DR) on manganese (Mn)-induced neurotoxicity.  Methods  Forty adult Kunming mice (male : female = 1 : 1) were randomly divided into four groups (10 in each group): control group (25.0 g feed/day and intraperitoneal injection of saline), DR control group (12.5 g feed/day and intraperitoneal injection of saline), Mn exposure group (25.0 g feed/day and intraperitoneal injection of Mn at dose of 200 μmol/kg) and DR intervention group (12.5 g feed/day and intraperitoneal injection of Mn at dose of 200 μmol/kg). The treatments were conducted once a day continuously for 6 weeks. The mice′s weight and blood glucose were measured and their behavioral changes were observed every week. By the end of the treatments, the brain specimens were collected for determinations of brain coefficient, cumulated Mn content, levels of inflammatory factors, and expressions of related proteins.  Results  In the Mn exposed mice, abnormal behavioral changes were observed; decreased brain coefficient and interleukin 4 (IL-4) but increased tumor necrosis factor-α (TNF-α), inducible nitric oxide synthase (iNOS), protein expression of nuclear factor kappa B (NF-κB), and caspase-8 were detected compared to those in the control mice (all P < 0.05). Decreased brain coefficient, TNF-α, iNOS, NF-κB, and caspase-8 were detected in the Mn exposed mice with DR in comparison with those in the Mn exposed mice with normal feeding (P < 0.05 for all).  Conclusion  Dietary restriction could play a protective role in Mn-induced neurotoxicity and the effect may be related to inflammation suppression, apoptosis reduction, and autophagy enhancement in mice.
Association of specific keywords index in Baidu website with influenza monitoring data during 2012 – 2020 and potential use of the index for influenza epidemic prediction
LI Le, ZHOU Zi-hao, WU Qun-hong,
 doi: 10.11847/zgggws1132684
Abstract(112) HTML(46) PDF 711KB(16)
Abstract:
  Objective  The analyze change trend in the correlation between specific keywords index in Baidu website (keyword Baidu index) and influenza monitoring data in China and to construct a Baidu index-based prediction model for influenza epidemics.   Methods   The data on weekly number of influenza virus-positive cases in China from the first week of 2012 through the 12th week of 2020 were collected from the Global Influenza Surveillance and Response Network (GISRS). Using influenza-related keywords of four domains (disease name, prevention, treatment, and symptom) screened out with literature studies, the daily Baidu indexes of those keywords during the same period were extracted from the Baidu index database (http://index.Baidu.com/). Using SPSS 22.0 software, the coefficients for the correlation between the keyword Baidu index and the number of influenza virus-positive cases were calculated for the two periods separated by a time node of 2017, when the scale of influenza epidemics in China changed significantly, and multivariate linear regression models for the correlation between the two variables were also constructed with Eviews 8 software.   Results   Totally 70 keywords were screened out. Before 2017, there were 18 keywords with the coefficients of greater than 0.5 for the correlation between keyword Baidu index and the weekly number of virus-positive influenza cases; while there were 30 such keywords after 2017, among which, 28 keywords were with the coefficients of march greater than 0.5. The top four keywords with the greatest coefficients were swine flu, influenza, influenza A, and fever before 2017; but after 2017, the top four keywords were swine flu symptom, influenza symptom, medicine for the treatment of influenza, and Tylenol (product name for paracetamol). The constructed regression model with the independent variables including a non-specific keyword of ‘high fever’ was of a better prediction outcome, and the prediction deviation of the model was reduced when the specific keyword was replaced.   Conclusion   In China, the scope of influenza-related keywords has been extending in network media based on big data monitoring and the correlation between the keywords with influenza epidemic has also been increased. The public tend to acquire more information on symptoms and treatment of influenza than on general knowledge about the infectious disease. The results suggest that the selected keywords should be updated timely and more specific keywords should be adopted in influenza epidemic surveillance with big data from network media.
Progress in researches on plasma homocysteine level and stroke: a review
ZHANG Ou, LIU Yang, MENG Hang-juan, CONG Shu-yan
 doi: 10.11847/zgggws1127767
Abstract(143) HTML(69) PDF 541KB(10)
Abstract:
Homocysteine, as an independent risk factor for stroke, is closely related to the incidence, recurrence rate and prognosis of stroke. Homocysteine level varied in different stroke subtypes, and the pathogenesis mainly involves vascular endothelial injury, hyperplasia of smooth muscle cells, coagulopathy, abnormal fat metabolism. Homocysteine level is affected by genotype, metabolism, age, gender, drugs and other factors. Supplementation with B vitamins and folic acid can significantly reduce homocysteine level, which is important for secondary prevention of cerebrovascular disease. In this study, the correlation between homocysteine level and stroke, subtype and severity, and the role of homocysteine in the pathogenesis of stroke, and the treatment status were reviewed to provide references for clinical prevention and treatment.
Depressive symptoms, perceived social support and their correlation among adolescent lesbians
GUO Meng-lan, WANG Li-yin, DUAN Zhi-zhou,
 doi: 10.11847/zgggws1132758
Abstract(194) HTML(75) PDF 471KB(15)
Abstract:
  Objective  To examine the prevalence of depression symptoms and its association with perceived social support among adolescent lesbians for providing references to depression prevention in the population.  Methods  Totally 160 lesbians aged 15 – 25 years were recruited with the help of Beijing Lespark (a lesbian organization) for an online anonymous survey conducted during July – December 2018. The Centre for Epidemiologic Studies Depression Scale (CESD-10), Perceived Social Support Scale (PSSS) and a self-designed questionnaire were completed by the participants via Sojump platform.  Results  More than half (56.9%) of all participants reported depressive symptoms. The participants′ mean score for overall social support was 58.25 ± 13.39 and the mean score for family, friend, and other people support were 17.96 ± 5.64, 20.64 ± 4.86, and 19.65 ± 5.28, respectively; 45.6% of the participants reported a high level of perceived social support. Logistic regression analysis revealed that the perceived overall social support was significantly related to a decreased risk of depressive symptoms (odds ratio = 0.930, 95% confidence interval: 0.898 – 0.964).  Conclusion  Depressive symptoms are common and the prevalence of depressive symptoms is associated with perceived social support among adolescent lesbians.
Prevalence and influencing factors of chronic obstructive pulmonary disease among middle-aged and elderly residents in Sichuan province, 2015
DONG Ting, XU Xin-yin, DENG Ying,
 doi: 10.11847/zgggws1130083
Abstract(182) HTML(80) PDF 510KB(14)
Abstract:
  Objective  To explore the prevalence and risk factors of chronic obstructive pulmonary disease (COPD) among permanent residents aged 40 years and over in Sichuan province and to provide evidences for COPD prevention and control.  Methods  Using stratified multistage cluster sampling, we recruited 3 601 permanent residents aged ≥ 40 years in urban communities or rural villages in two districts and 4 counties covered by a national disease surveillance program in Sichuan province. Household questionnaire interview, physical examination and lung function test were carried out among the participants from December 2014 to December 2015.  Results  Among 3 391 participants with complete information, 813 were diagnosed as COPD and the COPD prevalence was 24.0%. The results of multi-level variance component model analysis revealed that being male, aged ≥ 50 years, living in rural region, being an ex-smoker, occasionally smoking, daily smoking, and underweight were risk factors of COPD; while, with the education of senior high school and above and exposed to second-hand smoke were protective factors against COPD.  Conclusion  The prevalence of COPD was high and mainly influenced by gender, age, education level, residence, smoking status, second-hand smoke exposure and body weight among middle aged and elderly permanent residents in Sichuan province.
Effect of different dietary carbohydrate/fat ratios on aging biomarkers under the same energy and protein in healthy people: a metabonomics study
ZHANG Dan-dan, ZHU Qiu-shuang, LIU Jin-xiao,
 doi: 10.11847/zgggws1131740
Abstract(140) HTML(82) PDF 780KB(7)
Abstract:
  Objective   To explore the relationship between different carbohydrate/fat intake ratio and aging biomarkers under normal energy and protein intake in healthy people.   Methods  Form 4 973 adult residents participating in Harbin Cohort Study on Diet, Nutrition and Non-Communicable Chronic Diseases conducted in 2015, we selected 90 healthy people reporting normal dietary protein and energy intake but without personal and family history of chronic disease and divided them into three groups (30 in each group): normal control (N), high fat (HF) and high carbonhydrate (HC) group. Ultrahigh performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-Q-Tof-MS) was used to detect metabolic fingerprints of plasma samples of the participants. Principal component analysis (PCA) and partial least squares analysis (PLS-DA) were employed to analyze differences in metabolites among the participants of different age group. Aging biomarkers were screened out according to the values of variable importance in the projection (VIP) and variation ratio obtained by PLS-DA model, and changes in the aging biomarkers in different dietary groups were analyzed.  Results  The results of UPLC-Q-Tof-MS showed that all the study groups could be distinguished accurately under PLS-DA mode and there were significant differences in plasma metabolic mode. Five aging biomarkers were identified; among which, 12 (s)-hpete, aminoadipic acid and 3-hydroxynonylcarnitine increased with age, while L-leucine and dehydroepiandrosterone sulfate decreased with age. In comparison with those of the N group, the concentrations of L-leucine and dehydroepiandrosterone sulfate of the HF and the HC group decreased, but the concentrations of 12 (s)-hpete, aminoadipic acid and 3-hydroxynonylcarnitine of the two groups increased. Compared with the HF group, the HC group had decreased L-leucine and dehydroepiandrosterone sulfate but increased 12 (s)-hpete, aminoadipic acid and 3-hydroxynonanoylcarnitine. The results suggested that both high-fat and high carbohydrate could promote aging to some extent, and the effect of high carbohydrate on aging is more obvious.  Conclusion  Under the same energy and protein intake, high-fat and high carbohydrate intake are not conducive to healthy life span; compared with high-fat intake, high carbohydrate intake is easier to promote aging process and shorten life expectancy.
Acquirement of health education on public health emergency and its associates among college students in Shandong province
WANG Na, ZHANG Wen, CAO Xiao-hua,
 doi: 10.11847/zgggws1131623
Abstract(1434) HTML(761) PDF 493KB(51)
Abstract:
  Objective   To examine the situation and influencing factors of acquirements of health education on public health emergency among college students in Shandong province and to provide references for developing education programs relevant to public health emergency among the students.   Methods  Using stratified random sampling, we recruited 8 000 students in 6 universities in Shandong province and conducted an online anonymous questionnaire survey during April – May 2020.   Results  Among the 7 719 students with valid responses, 4378 (56.7%) reported that there were on-campus education programs on infectious disease prevention and control; 4219 (54.7%) and 3238 (41.9%) reported there were on-campus education programs on sports safety and on prevention/first aid of accidental injury. In terms of college courses on health education, 3 090 (40.0%) and 3 889 (50.4%) of the students considered that the number of enrolment registration and class hour were not large enough; inflexible teaching, informal examination, and lectures′ professional deficit were reported by 3 543 (45.9%), 2 264 (29.3%), and 2345 (30.4%) of the students, respectively. Of the students, 4 602 (59.7%) and 4 995 (64.7%) reported being aware of and having received health education on public health emergency. The results of unconditional multivariate logistic regression analysis indicated that the girl students and the students entering colleges from regions other than in Shandong province were less likely to receive the education on public health emergency; while, the students with following characteristics were more likely to receive the education: being a sophomore, with a rural registered permanent residence, with health education courses in college, considering lectures with adequate professional quality for health education, being aware of public health emergency events, and being aware of college authorities′ usual or great concerns on health education.  Conclusion  Among college students in Shandong province, the acquirement of health education on public health emergency is at a relatively low level and mainly influenced by students′ gender, schooling grade, type of household registration, living region before college entrance, awareness on public health emergency events, and consideration on professional quality of health education lectures and colleges′ health education courses and concerns on health education.
Prevalence characteristics of cerebral infarction among residents in Hebei province, 2015 – 2018: a time series analysis
SHI Wei-wei, XUN Lu-ning, CAO Ya-jing,
 doi: 10.11847/zgggws1131022
Abstract(152) HTML(80) PDF 693KB(11)
Abstract:
  Objective   To examine prevalence characteristics of cerebral infarction (CI) among residents in Hebei province from 2015 to 2018, and to explore the application of time series model in the prediction of CI incidence for the prevention and control of the disease.   Methods   From National Chronic Non-Communicable Disease Surveillance System, we collected the data on registered cerebral infarction incidents in 18 surveillance points in Hebei province from January 1, 2015 through December 31, 2018. The prevalence characteristics of CI and its changing trend were analyzed and a time series model was established to predict annual and monthly incidence rate of CI in 2019.  Results  During the 4-year period in the province, the average annual CI incidence rate were 311.73/100 000, with the yearly incidence rate of 283.22, 296.36, 322.93, and 342.55 per 100 000 for the year from 2015 to 2018 and a significantly increasing trend (χ2 = 624.353, P < 0.001). The CI incidence rate in the male residents were significantly higher than that in the female residents (348.81/100 000 vs. 273.60/100 000, χ2 = 1 680.960; P < 0.05). The age-specific CI incidence rate was significantly different among various age groups, with the rate of 2.58, 48.96, 263.21, 650.61, 1 641.77, 2 083.59, and 3 000.88 per 100 000 for the residents aged < 35, 35 – 44, 45 – 54, 55 – 64, 65 – 74, 75 – 84, and ≥ 85 years, respectively (χ2 = 381 051.465, P < 0.001). The established best fitted model was ARIMA (autoregressive integrated moving average) (0, 1, 1)(2, 1, 0)12; the model's residual sequence was white noise sequence (P > 0.05); and the parameters for the established model were as following: Akaike information criterion (AIC) = 214.480, Bayesian information criterion (BIC) = 220.698, root mean square error (RMSE) = 2.97, mean absolute error (MAE) =1.62, and mean absolute percentage error (MAPE) = 7.55%. Based on the model, the predicted yearly CI incidence rate was 362.46/100 000 for the residents in 2019, which was higher than that in previous years; the predicted monthly CI incidence rates ranged between 23.62/100 000 and 33.33/100 000 and the variation of the rates for the year of 2019 was similar to that in previous years.   Conclusion   The incidence rate of cerebral infarction was at a high level and increased yearly during 2015 – 2018 among residents in Hebei province; the incidence rate was relatively higher in the male and the elderly residents. Time series model can be used to predicated the incidence rate for the prevention and control of cerebral infarction.
Prevalence and influencing factors of comorbidity of chronic diseases among community residents in Jiading district of Shanghai city
LI An-le, ZHAO Gen-ming, JIANG Feng,
 doi: 10.11847/zgggws1131982
Abstract(138) HTML(63) PDF 574KB(10)
Abstract:
  Objective  To examine the comorbidity of chronic diseases and its associates among community residents of Jiading district of Shanghai city and to provide evidences for comprehensive prevention of common chronic diseases in community populations.   Methods   Using multistage stratified cluster random sampling, we recruited 10 053 permanent residents aged 20 – 75 years in 12 committees/villages in Jiading district of Shanghai municipality and conducted face-to-face questionnaire survey and physical examination among the residents during July – September 2019.  Results  Among the participants, 4 920 (48.94%) were identified suffering from at least two chronic diseases; of all the sufferers of chronic disease comorbities, 1 988 (40.41%), 1 314 (26.71%), and 1 618 (32.89%) had two, three, and four or more chronic diseases. The results of unconditional multivariate logistic regression analysis demonstrated that male gender, aged ≥ 30 years, lack of physical exercise and with poor sleep quality were risk factors for chronic disease comorbidities; whereas, not smoking, having good sleep quality and without sweet food preference were protective factors against chronic disease comorbidities for the participants.  Conclusion  Among community residents of Jiading district of Shanghai municipality, the prevalence of chronic disease comorbidities is relatively high and mainly influenced by gender, age, smoking, physical exercise, sleep quality and sweet food preference.
Status quo of contracted family doctor services in China: a literature study
Mei-xuan LI, Xiu-xia LI, Xin XING,
 doi: 10.11847/zgggws1122093
Abstract(3880) HTML(2304) PDF 483KB(199)
Abstract:
  Objective  To examine the status of and research progress in contracted family doctor services in China and to summarize general problems existing in the implementation the services for providing references for the development of applicative mode of contracted family doctor services in China.  Methods  Studies on contracted family doctor services in China published till April 2018 were systematically searched through China National Knowledge Infrastructure (CNKI), Chinese Biomedicine Database (CBM), Wanfang and Chinese Science-Technology Periodical Database (VIP) database. EndNote X7 and Excel 2010 were used to manage and analyze the retrieved studies.  Results  All the 24 finally included articles were cross-sectional studies, of which 20 and 4 were conducted among urban and rural residents. Higher rates (36% – 96%) of awareness about contracted family doctor services were reported by studies conducted among residents in Guangdong province, followed by among those (16% – 90%) in Beijing. Higher proportions (42% – 100%) of participating in contracted family doctor services were reported by the studies conducted among the residents in Beijing, followed by those (30% – 74%) in Shanghai. A higher rate (86.33%) of satisfaction to contracted family doctor services was reported by the studies conducted among the residents in Beijing, followed that (56% – 80%) in Guangdong province. Major hindering factors for the implementation of contracted family doctor services indicated by the studies were shortage of family doctors, lack of awareness on the services among the public, low salary of family doctors, imperfect management, incentive, insurance, and information support for the services.  Conclusion  The rate of awareness about, participating in, and satisfaction to contracted family doctor services are higher among residents in economically developed provinces/municipalities and in urban area than among those in less developed regions and in rural areas in China. More researches on the issue need to be performed for effective implementation of contracted family doctor services.
Articles in press have been peer-reviewed and accepted, which are not yet assigned to volumes /issues, but are citable by Digital Object Identifier (DOI).
Display Method:
Detection of plastic particles in environmental samples: status and perspective
GAO Hong-ying, SHEN He-qing
 doi: 10.11847/zgggws1128897
Abstract(256) HTML(108) PDF 583KB(69)
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.
Serum lipid profile and its associates in preschool children in Tianjin city
HU Tong-xin, LI Wei-qin, QIAO Yi-juan,
 doi: 10.11847/zgggws1132567
Abstract(19) HTML(7) PDF 582KB(6)
Abstract:
  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.
Practice and enlightenment of Child-Friendly City construction in health promotion in China
WANG Chen-ran, XU Tao
 doi: 10.11847/zgggws1134190
Abstract(136) HTML(13) PDF 652KB(15)
Abstract:
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 promote 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; and 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.
Completeness of maternal health care system in Beijing and Shanghai: a literature study
TIAN Zhuang, YU Fang, LI Bo-yang,
 doi: 10.11847/zgggws1122395
Abstract(144) HTML(64) PDF 599KB(16)
Abstract:
  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.
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,
 doi: 10.11847/zgggws1132290
Abstract(135) HTML(69) PDF 491KB(26)
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
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,
 doi: 10.11847/zgggws1134514
Abstract(18) HTML(7) PDF 680KB(3)
Abstract:
  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.
Government predominance in maternal health care financing in Beijing and Shanghai: a comparison analysis
MA Dong-ping, YIN Wen-qiang, SHI Lin-mei,
 doi: 10.11847/zgggws1122655
Abstract(14) HTML(8) PDF 615KB(5)
Abstract:
  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.
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,
 doi: 10.11847/zgggws1127792
Abstract(131) HTML(80) PDF 496KB(17)
Abstract:
  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 providing 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.
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
 doi: 10.11847/zgggws1131796new
Abstract(82) HTML(71) PDF 521KB(8)
Abstract:
  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,
 doi: 10.11847/zgggws1132726
Abstract(169) HTML(102) PDF 611KB(11)
Abstract:
  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.
Application of national Indoor Air Quality Standard and its obstacles in China: a cross-sectional survey
ZHANG Xia, XU Yi, GAO Jian-hui,
 doi: 10.11847/zgggws1130762
Abstract(114) HTML(38) PDF 846KB(15)
Abstract:
  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
Incidence of crayfish-related rhabdomyolysis syndrome in some regions along Yangtze River, 2016
LI Shi-cong, MA Hui-lai, GUAN Xu-hua,
 doi: 10.11847/zgggws1122791
Abstract(1818) HTML(2617) PDF 511KB(28)
Abstract:
  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.
Influencing factors of health supervision and law enforcement capacity: a structural equation model analysis
GU Yu, MENG Qun
 doi: 10.11847/zgggws1132645
Abstract(118) HTML(63) PDF 572KB(9)
Abstract:
  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.
Effect of bergenin on D-galactosamine-induced acute liver injury in rats
XU Jie, GAO Ya, JI Yan-ping,
 doi: 10.11847/zgggws1131528
Abstract(89) HTML(38) PDF 687KB(8)
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.
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,
 doi: 10.11847/zgggws1127307
Abstract(166) HTML(60) PDF 494KB(20)
Abstract:
  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,
 doi: 10.11847/zgggws1131829
Abstract(125) HTML(45) PDF 1173KB(13)
Abstract:
  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.
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,
 doi: 10.11847/zgggws1122014
Abstract(80) HTML(64) PDF 659KB(8)
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.
Smoking prevalence among 20 – 80 years old Han residents in urban and rural regions of Hebei province
YU Ji-gang, CUI Ze, Pan Li,
 doi: 10.11847/zgggws1131617
Abstract(164) HTML(63) PDF 482KB(19)
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 indicate that the male and rural residents are key populations for tobacco control in the province.
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,
 doi: 10.11847/zgggws1132939
Abstract(164) HTML(73) PDF 504KB(16)
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
 doi: 10.11847/zgggws1124619
Abstract(1441) HTML(789) PDF 558KB(59)
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.
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
 doi: 10.11847/zgggws1132699
Abstract(164) HTML(42) PDF 554KB(14)
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,
 doi: 10.11847/zgggws1131266
Abstract(196) HTML(69) PDF 593KB(16)
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.
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,
 doi: 10.11847/zgggws1132639
Abstract(16) HTML(12) PDF 532KB(2)
Abstract:
  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.
Clustering of oral health risk behaviors and its influencing factors among 12-year-old children in Beijing
YUN Qing-ping, LIU Min, CHANG Chun,
 doi: 10.11847/zgggws1134238
Abstract(20) HTML(10) PDF 507KB(5)
Abstract:
  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,
 doi: 10.11847/zgggws1132658
Abstract(15) HTML(7) PDF 564KB(8)
Abstract:
  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.
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
 doi: 10.11847/zgggws1131938
Abstract(130) HTML(64) PDF 533KB(10)
Abstract:
  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.
Prevalence and influencing factors of coronary heart disease among rural adult residents in Xinxiang county, Henan province
LI Hui-jun, LI Wen-long, WU Hui,
 doi: 10.11847/zgggws1125491
Abstract(60) HTML(81) PDF 530KB(12)
Abstract:
  Objective  To investigate the prevalence and influencing factors of coronary heart disease (CHD) among rural adult residents in Xinxiang county of Henan province for providing evidences to CHD prevention.  Methods  Using random cluster sampling, we recruited 10 691 adult residents (≥ 18 years old) in 17 villages of Xinxiang county and conducted face-to-face interview, physical examination and laboratory tests among the residents during April – June 2017.  Results  Among the 10 267 residents with complete data, 892 were identified with CHD; the crude and age-standardized prevalence rate of CHD was 8.69% and 6.65%. Unconditional multivariate logistic regression analysis indicated that aged ≥ 50 years, divorced or separated, smoking cessation, abstinence of alcohol, and suffering from hypertension/diabetes/stroke/central obesity were risk factors for CHD and current alcohol drinking was a protective factor against CHD.  Conclusion  The prevalence of CHD is relatively high and influenced by age, marital status, central obesity, history of smoking and alcohol drinking, and condition of hypertension, diabetes and stroke among adult rural residents in Xinxiang city, Henan province.
Indoor radon concentration and its influencing factors in newly decorated houses and offices in Shenyang city
WU Hao-lan, ZHAO Hang, LI Meng-ge,
 doi: 10.11847/zgggws1132296
Abstract(122) HTML(61) PDF 459KB(2)
Abstract:
  Objective  To examine indoor radon pollution and its associates in houses and offices with recent interior decoration in Shenyang city of Liaoning province and to provide evidences for developing targeted control measures against the pollution.   Methods  From Shenyang Construction Engineering Quality Testing Center, we collected the data on indoor radon detections for 581 houses and 151 offices after recent interior decoration in 25 buildings in Shenyang city during 2017. The concentrations of radon were described and the relationship between the indoor radon and decoration conditions was analyzed statistically.   Results   The mean indoor radon concentration of the offices was significantly higher than that of the houses (75.822 ± 4.090 vs. 69.285 ± 7.128 Bq/m3, P < 0.05). The most important influencing factor of room-specific radon concentration is the floor number of the room located on. The major influencing factors of indoor radon concentration for houses included whether the white powder (mainly consisted of calcium carbonate, cellulose and white latex) being used for interior wall decoration and the distance from a main road; in addition to whether the white powder being used for interior wall decoration, the indoor radon concentration of an office also influenced by the utilization of floor, marble tile, and polyvinyl chloride floor covering.   Conclusion  Decoration-related factors need to be concerned for the prevention and control of indoor radon pollution in houses and offices.
Health condition and its influencing factors among residents in mountainous regions of Ningxia Hui Autonomous Region
LI Xiang-rong, DANG Yuan-yuan, TANG Rong
 doi: 10.11847/zgggws1126760
Abstract(12) HTML(11) PDF 468KB(1)
Abstract:
  Objective  To examine the status and influencing factors of health among adult residents in mountainous regions of Ningxia Hui Autonomous Region (Ningxia) for developing strategies on health promotion in the population.  Methods  The participants of the survey were 1 500 residents of 18 years old and above randomly recruited with stratified sampling in 6 urban communities/rural villages in mountainous regions of Ningxia. Face-to-face interviews were conducted among the participants using a self-designed questionnaire during February 2016.  Results  Of the 1 298 participants with complete information, 287 (22.11%) reported having an illness during past two weeks (two-week prevalence) and 267 (20.57%) reported suffering from chronic diseases. Unconditional multivariate logistic regression analysis results revealed that for the participants, aged ≥ 40 years was a risk factor but with the education of senior high school/secondary school was a protective factor of two-week prevalence; whereas, aged ≥ 30 years was a risk factor but being married was a protective factor for suffering from chronic diseases.  Conclusion  In mountainous regions of Ningxia, the health status of urban and rural adult residents is mainly influenced by age, education and marital status and health promotion needs to be improved in the population.
Knowledge about donation of hematopoietic stem cells among registered volunteers of Shanghai Marrow Donor Program
LIU Bao-song, ZHANG Gang, LÜ Jun,
 doi: 10.11847/zgggws1132693
Abstract(132) HTML(43) PDF 566KB(4)
Abstract:
  Objective  To investigate the awareness on the knowledge about hematopoietic stem cell donation among the registered volunteers for improving volunteer recruitment and promoting donation willingness in the volunteers.  Methods  Using cluster sampling, we conducted a self administered survey among 2 361 volunteers with oral swab-based registration in Shanghai Marrow Donor Program during 2017. A self-designed questionnaire was used to collect participants′ information on the situation and acquisition of knowledge about hematopoietic stem cell donation and related factors.  Results  For the 2 240 participants with valid responses, the mean score for knowledge about hematopoietic stem cell donation was 3.94 ± 1.951 to a maximum score of 7, indicating a relatively low level. The results of multivariate linear regression analysis demonstrated that significant influencing factors for the knowledge status included academic background, blood donation experience, voluntary service experience, with relatives or friends ever registered in donation programs, ever having discussion on organ transplantation with family members, value judgment on donation behavior, and the pattern of registration in the donor program (P < 0.05 for all). The participant-reported main ways of acquiring knowledge on hematopoietic stem cell donation were internet media, television program, and on-site publicity campaign.  Conclusion  The level of knowledge about hematopoietic stem cell donation is relatively low among registered donation volunteers, indicating that comprehensive and continuous supporting measures are needed to effective operation of the marrow donation program.
Framework completeness of maternal health care system in Beijing and Shanghai: a comparison analysis
TIAN Zhuang, MA Dong-ping, YIN Wen-qiang,
 doi: 10.11847/zgggws1122393
Abstract(175) HTML(72) PDF 638KB(41)
Abstract:
  Objective  To compare the disparity in framework completeness of maternal health care (MHC) system between Beijing and Shanghai and to explore the feasibility of quantitative evaluation on the degree of framework completeness of MHC system.  Methods  We systematically and extensively collected documents on MHC issued by administrative agencies of Beijing and Shanghai municipality and relevant literatures published during 2000 – 2017. Then we extracted information on the MHC system′s department, institution and organizational structure from 649 retrieved documents and literatures (232 relevant to Beijing and 417 to Shanghai) and analyzed the information quantitatively to assess framework completeness of MHC system in the two municipalities. Spearman correlation and linear regression analysis were used to analyze the relationship between framework completeness of MHC system and maternal mortality rate (MMR).  Results  The relevant information-derived index for framework completeness of MHC system increased from 52.9% in 2000 to 78.0% in 2017 in Beijing municipality; while, the index increased from 68.5% to 85.8% in Shanghai, with a gradually increasing trend. There was an inverse correlation between the index for framework completeness of MHC system and MMR in the two municipalities.  Conclusion  The framework completeness of maternal health care system was improved and the improvement facilitated maternal health care practice in Beijing and Shanghai gradually during 2000 – 2017; but some supportive departments were not embedded into the MHC system′s framework and the completeness of subsystem need to be improved. The study verified the feasibility of quantitative assessment on framework completeness of maternal health care system.
Performance and support pattern of nonlocal medical relief personnel during containment of coronavirus disease 2019 epidemic in Hubei province
XUE Xiao-jing, LÜ Ru-qi, LI Wei,
 doi: 10.11847/zgggws1128317
Abstract(1198) HTML(2143) PDF 495KB(44)
Abstract:
  Objective  To examine the performance and support pattern of nonlocal medical relief personnel at designated hospitals during containment of coronavirus disease 2019 (COVID-19) epidemic in Hubei province for providing references to on-site support in the case of controlling similar respiratory infectious disease epidemic.  Methods  During 10 – 15 February 2020, we conducted a questionnaire survey and an interview among 279 medical relief personnel and 15 relief team leaders/managers from Sichuan province. Information on personnel structure, relief support pattern, relief work content and difficulties in relief work in the containment of COVID-19 in Hubei province were collected and analyzed.  Results  The patterns of relief support practice reported by the respondents included: (1) being in the charge of medication for all COVID-19 patients in a designated ward; (2) taking full responsibility for the medication of COVID-19 patients in a designated ward or department by a relief support team; (3) the same as the second pattern but by the relief support team and local medical professionals. The nonlocal medical relief personnel reported executing the relief work smoothly under local professional and social environment but reduced working performance due to the lack of medical equipments, without adequate accompanying articles for daily living, and overworking-induced low work efficiency.  Conclusion  The professional skill of relief personnel, material preparation and pre-service training are important for nonlocal medical relief personnel conducting efficient onsite support in public health emergency response.
Status and impact factors of self-reported health among migrant minority population in China, 2017
DU Jie, WANG Na, YU Li-ping,
 doi: 10.11847/zgggws1128065
Abstract(11) HTML(8) PDF 513KB(0)
Abstract:
  Objective  To examine self-reported health and its influencing factors among migrant ethnic minority people in China and to provide evidences for improving health of the population.  Methods  The data on 14 226 migrant ethnic minority people were extracted from the China Migrants Dynamic Survey conducted during 2017 across the country. Unconditional logistic regression model was used to analyze factors associated with self-reported health in the population.  Results  Of the people surveyed, 11 207 (79.2%) and 2 384 (16.8%) reported normal and basically normal self-rated health; 555 (3.9%) reported poor self-rated health but being able to take care of themselves; and only 17 (0.1%) reported poor self-rated health and being unable to take care of themselves, respectively. The results of logistic regression analysis demonstrated that the migrant ethnic minority people with following characteristics were more likely to reported good self-rated health: being male, aged 15 – 34 years, with the education of undergraduate and above, with migration experience of less than 10 years, having a stable employment, with a monthly income more than 6 000 yuan RMB, having their health records being established in immigration region, ever participating in at least one health education program, without chronic disease, and being aware of National Basic Public Health Service Project.  Conclusion  Health status in migrant ethnic minority population in China should be concerned, especially in those being female, with long migration experience, at elder age, without stable employment, and with low monthly income.
Status and influencing factors of mental health among veterans in China
MING Zhi-jun, CHEN Zhi-yan, LIU Ya-nan,
 doi: 10.11847/zgggws1130193
Abstract(218) HTML(136) PDF 514KB(27)
Abstract:
  Objective  To investigate the status and influencing factors of depression, anxiety and post-traumatic stress disorder (PTSD) among veterans in China and to provide references for promoting mental health of the population.  Methods  We conducted a questionnaire survey among 1 100 veterans under 80 years recruited from 30 provincial-level regions across China with cluster sampling during May – July 2019. Mental health status of the participants was assessed using the short version of the Center for Epidemiologic Studies Depression scale (CESD-9) Chinese version, the Generalized Anxiety Disorder scale (GAD-2), and PTSD risk scale.  Results  For all the valid respondents (1 045, 95.00% of the veterans recruite), the mean depression score was 9.73 ± 6.86 and the score differed significantly by education, military rank and income (all P < 0.001); the mean anxiety score was 2.09 ± 1.91 and the score differed significantly by age, education, military rank, and economic income (all P < 0.01). The proportion of the participants assessed as at high risk of PTSD risk was 42.58% and the proportion was significantly associated with education, military rank, economic income, and with major military action experience (all P < 0.01). The results of linear regression analysis indicated that significant influencing factors for depression score included income (β = – 0.13, P < 0.001), alcohol consumption (β = 0.12, P < 0.001), and sleep quality (β = – 0.59, P < 0.001) and significant impact factors for anxiety score included income (β = – 0.11, P < 0.01), alcohol consumption (β = 0.08, P < 0.01) and sleep quality (β = – 0.64, P < 0.001). The results of logistic regression analysis revealed that age (odds ratio [OR] = 1.04, 95% confidence interval [95% CI]: 1.02 – 1.06), with major military action experience (OR = 1.60, 95% CI: 1.11 – 2.30), alcohol consumption (OR = 1.18, 95% CI: 1.05 – 1.32) were significant risk factors for PTSD; while, and sleep quality (OR = 0.74, 95% CI: 0.68 – 0.80) was a protective factors against PTSD significantly.  Conclusion  Among Chinese veterans, the mental health was at a low level; alcohol consumption is a risk factor but income and sleep quality are protective factors against depression and anxiety; at older age, with major military action experience, and alcohol consumption are risk factors for PTSD risk, while, sleep quality is a protective factor against PTSD risk.
Prevalence and influencing factors of osteoporosis in Yugu adult women in Gansu province: a cross-sectional survey
REN Xiao-lan, LI Ming-yang, HU JI-hong,
 doi: 10.11847/zgggws1132721
Abstract(118) HTML(97) PDF 559KB(8)
Abstract:
  Objective  To explore the prevalence and influencing factors of osteoporosis and to analyze the relationship between biochemical indicators and bone mineral density among Yugur menopausal women and adult women (aged 20 – 80 years) in Gansu province.  Methods  Using stratified cluster sampling, we recruited 929 Yugu female residents aged 20 – 80 years in Su′nan Yugu Autonomous County, Gansu province and conducted a questionnaire survey, laboratory test and physical examination including calcaneal bone mineral density detection in the women during July – August 2016. Multivariate logistic regression was used to analyze associates of osteoporosis prevalence and multivariate linear regression was adopted to assess the relationship between biochemical indicators and bone density.  Results  For the 929 participants with complete information, the crude and standardized prevalence rate of osteoporosis was 27.64% and 23.53% and those were 13.99% and 12.78% for the menopausal participants, respectively. The prevalence rate of osteoporosis increased significantly with age among all the participants (χ2 = 114.576) and the menopausal participants (χ2 = 31.664) (both P < 0.05). The results of logistic regression analysis revealed that for menopausal women, the influencing factors of osteoporosis prevalence included marital status, menopause duration, and grip strength; while for adult women, the influencing factors included age, education, fracture history, and grip strength. Alkaline phosphatase was reversely correlated with bone mineral density significantly in menopausal women (β = – 0.003) and in the women aged 20 – 80 years (β = – 0.004) (both P < 0.05).  Conclusion  Among Yugur menopausal women and 20 – 80 years old women in Gansu province, the prevalence rate of osteoporosis is relatively low and increases with age; the main risk factors of osteoporosis prevalence include age, duration of menopause and fracture history; alkaline phosphatase is a predictor for bone density reduction in the women.
Impact of temperature on hand, foot and mouth disease and its attributable risk in Guangdong province
GAO Qi, LIU Zhi-dong, WANG Shu-zi,
 doi: 10.11847/zgggws1132059
Abstract(1145) HTML(481) PDF 1043KB(260)
Abstract:
  Objective  To study the impact of ambient temperature on hand, foot and mouth disease (HFMD) and to explore the source of heterogeneity in the impact and the HFMD burden attributable to ambient temperature in Guangdong province.   Methods  The data on daily reported HFMD cases and meteorological condition from 2009 through 2016 in Guangdong province were collected. The distributed lag nonlinear model (DLNM) was adopted to assess the effect of average daily ambient temperature on HFMD incidence at city level with the pooled effect estimates from multivariate meta-regression model analysis. Fraction and number of HFMD incidents attributable to variation in ambient temperature were estimated according to the results of DLNM analysis.   Results   Totally 2 279 647 HFMD cases were reported during the period. The risk of HFMD incidence increased with the increment of average daily ambient temperature. The cumulative relative risk (RR) of HFMD incidence reached the highest for the average daily ambient temperature of 30.5 ℃ versus that of 24 ℃ (RR = 1.24, 95% confidence interval [95% CI]: 1.12 – 1.37). The most obvious effect of low average daily ambient temperature on HFMD incidence was on the lag day 8 but that of high temperature was on the lag day zero. The disparity in the effect of average daily ambient temperature on HFMD incidence among various cities was derived from population density, growth rate of gross domestic production, location longitude, and average annual temperature/humidity/hours of sunshine. The estimated total number of HFMD incidents attributed to the exposure to high average daily temperature was 241 918, accounting for 10.61% (95% CI: 9.67% – 11.53%) of all the cases during the period. When exposed to high average daily ambient temperature, the elderly and the children less than 5 years old were at a higher risk of HFMD incidence than other populations.   Conclusion  High average daily ambient temperature could increase the risk of HFMD incidence and the impact of the high temperature may appear immediately or at lag days. The results suggest that specific measures should be taken in vulnerable populations during seasons with high temperature for the prevention of HFMD incidents.
Status and impact factors of social support for people with rare diseases in China
GAO Jia-min, MA Zheng
 doi: 10.11847/zgggws1126356
Abstract(12) HTML(8) PDF 515KB(2)
Abstract:
  Objective  To analyze the status and correlated factors of social support for people with rare diseases in China.  Methods  We conducted an internet- or telephone-based survey among 1 771 self-reported rare disease patients recruited with snow balling sampling during February 2016 in China. The Medical Outcomes Study Social Support Survey – Chinese Version(MOS-SSS)was applied to measure the social support for the patients. Descriptive statistics and linear regression were employed in data analysis.  Results  The total score of social support for the patients was 60.37 ± 18.23 and domain scores were 13.40 ± 4.12 for tangible support, 22.99 ± 7.89 for emotional/informational support, 8.42 ± 3.11 for positive social interaction, 8.87 ± 3.21 for affectionate support, and 6.69 ± 1.92 for additional items, respectively. The results of multivariate stepwise linear regression analysis demonstrated that the rare disease patients being married, retired, and being a student were more likely to have a strong social support; while, those at elder age, with the education of primary school and below, unemployed, living in rural regions, and with disease complication were more likely to have a weak social support.  Conclusion  In China, the social support for rare disease patients is at a low level and associated with the patients' age, education, marital status, occupation, residence, and whether having complicated disease.
Preventive medicine physician system in the United States and its implications for China
LI Gang, FENG Da, TANG Shang-feng,
 doi: 10.11847/zgggws1129364
Abstract(1854) HTML(2088) PDF 510KB(158)
Abstract:
Medical education system and licensed physician management system in the United States are two relatively mature institutions with successful operation. This study systematically reviewed the policy content of the preventive medicine physician system in the United States by establishing a theoretical analysis framework covering the education, employment admittance, deployment, professional title, and incentive pay system. This study discussed the identity crisis of public health physicians in China and considered that Chinese public health physicians are not preventive medicine physicians. The study suggested that for improving public health physician system in China, the connotation of public health physicians should be rectified; the criterion for admittance of public health physicians should be upgraded; and approaches for the transition between clinicians and public health physicians should be diversified.
Clarity of responsibilities for all parties in public health emergency response in Liaoning and Jilin province: a literature analysis
Jian-hua GONG, Cheng-yue LI, Ling-zhong XU,
 doi: 10.11847/zgggws1124622
Abstract(1877) HTML(1114) PDF 780KB(18)
Abstract:
  Objective  To analyze the clarity of responsibilities for all parties in public health emergency (PHE) response and the relationship between the clarity and the response efficacy in Liaoning and Jilin province for providing references for the improvement in public health organization system construction.  Methods  We searched literatures and documents referring to responsibility assignment for all parties in PHE response published by government agencies and professional institutions in the two provinces from 2000 through 2017 via public websites, China National Knowledge Infrastructure (CNKI), Wanfang Data and Web of Science. Cluster analysis and qualitative and quantitative methods were used to evaluate the clarity of the responsibility assignment for all parties of the two provinces. Spearman correlation and linear regression were used to analyze the relationship between the clarity and response efficacy.  Results  For the administration in Liaoning and Jilin province, the index for the clarity of the responsibilities assignment increased gradually from zero in 2000 to 20.60% and 21.95% in 2017; the index for response efficacy also gradually increased from 40.00% and zero to 53.33% and 60.00%, respectively. Significantly positive correlation between the clarity and the response efficacy was observed in Liaoning and Jilin province, with the correlation coefficients of 0.496 and 0.605, respectively (both P < 0.05).  Conclusion  The clarity of responsibilities for all parties in public health emergency response and the response efficacy have been improved in Liaoning and Jilin province since 2000, indicating an improvement in the construction of public health organization system of the two regions.
2021, 37(11): .  
Abstract(21) HTML(10) PDF 4367KB(5)
Abstract:
2021, (11): 1-6.  
Abstract(16) HTML(12) PDF 609KB(5)
Abstract:
Comment
Design and implementation of a project – Prevention and Intervention on Neurodegenerative Disease in the Elderly
WANG Zhi-hui, QI Shi-ge, ZHANG Han, Li Zhixin, Guo Haoyan, Wang Linhong
2021, 37(11): 1585-1589.   doi: 10.11847/zgggws1133281
Abstract(106) HTML(76) PDF 608KB(26)
Abstract:
Alzheimer′s disease (AD) and Parkinson′s disease (PD) are major neurodegenerative diseases, which seriously affect the health and quality of life of the elderly and bring heavy burden of care and health services to families and the society. The project – Prevention and Intervention on Neurodegenerative Disease in the Elderly in China has been implemented since 2015 with the aims of investigating the prevalence and related risk factors of AD and PD among elderly people to improve the awareness about the diseases in the public and to strengthen primary medical and health institutions′ capacity for prevention and intervention of the diseases. In this paper, we briefly introduce the contents and methods of the project.
Special Report – Promoting Elderly Health for Active Coping to Population Aging
Prevalence of falls and fall-related injuries among Chinese community-dwelling older adults: a one-year retrospective follow-up data analysis
ZHANG Han, QI Shi-ge, CUI Lu,
2021, 37(11): 1590-1593.   doi: 10.11847/zgggws1133277
Abstract(239) HTML(76) PDF 475KB(21)
Abstract:
  Objective   To examine the prevalence of falls and fall-related injuries in Chinese community elderly populations and to provide references for developing relevant intervention measures.   Methods   The information on demographics and falls/fall-related injuries during past one year for 21 084 urban and rural residents aged 60 years and above were extracted from the database of Prevention and Intervention on Neurodegenerative Disease for Elderly in China (PINDEC) project, which was conducted in 6 provincial level regions (Beijing, Shanghai, Hubei, Sichuan, Yunnan and Guangxi) across China from July through October 2018. Statistical analyses were carried out on the data using SAS 9.3.   Results   Among all the elderly, 2 979 reported falls during past one year and the falls prevalence rate was 14.7% after complex weighting; the falls prevalence rate differed significantly by gender, age, education, marital status, occupation, employment, and residential region (P < 0.001 for all). Of the elderly with falls during past one year, 2 252 had fall-related injuries, with a complex weighted ratio of 79.5%; the injury ratio varied significantly among the elderly of different gender, age, education, occupation, employment, and residential region (all P < 0.01). In the 2 252 self-reported fall-related injuries, the number (complex weighted proportion) was 1 472 (70.1%) for bruise, 242 (10.0%) for hand/arm fracture, 101 (4.6%) for femoral head fracture, 89 (2.4%) for hip fracture, 167 (7.0%) for head injury, and 416 (15.3%) for other types of injuries, respectively.   Conclusion   Among community elderly in China, both the prevalence of falls and the occurrence of fall-related injuries are relatively high and bruise is a major type of fall-related injuries.
Effect of chronic disease multimorbidity on self-rated health among rural elderly in Shandong province
HU Fang-fang, ZHANG Jiao, JIANG Fan,
2021, 37(11): 1594-1596.   doi: 10.11847/zgggws1132246
Abstract(884) HTML(515) PDF 463KB(23)
Abstract:
  Objective  To examine the effect of chronic disease multimorbidity on self-rated health among rural elderly, and to provide references for chronic disease prevention and treatment in aging populations.  Methods  Using stratified multistage random sampling, we recruited 7 070 permanent residents aged ≥ 60 years in 108 villages of three prefectures across Shandong province. A face-to-face questionnaire survey was conducted among all the residents during August – September 2017 and the data on 5 514 residents were analyzed to explore the effect of multimorbidity on self-rated health.  Results  Of the 5 514 participants, 2 878 (52.19%) reported a self-rated good health and 1 902 reported suffering from more than one chronic disease, with a multimorbidity prevalence rate of 34.5%. The results of unconditional multivariate logistic regression analysis demonstrated that compared to the residents without chronic disease, the residents suffering from a chronic disease were more likely to report a self-rated poor health (odds ratio [OR] = 2.947, 95% confidence interval 95% CI: 2.547 – 3.404) and the residents with chronic disease multimorbidity were much more likely to report a self-rated poor health (OR = 6.675, 95% CI: 5.735 – 7.746) after adjusting for gender, age, education, family annual income, residence region, smoking, and alcohol drinking.  Conclusion  The prevalence of chronic disease multimorbidity was high and the multimorbidity had a negative impact on self-rated health among the rural elderly in Shandong province.
Association of central obesity with prevalence of chronic obstructive pulmonary disease among middle-aged and elderly residents in Jiangsu province
CHEN Lu-lu, SU Jian, TAO Ran,
2021, 37(11): 1597-1601.   doi: 10.11847/zgggws1132223
Abstract(194) HTML(86) PDF 534KB(22)
Abstract:
  Objective  To investigate the association between central obesity and chronic obstructive pulmonary disease (COPD) among middle-aged and elderly residents in Jiangsu province, and to provide references for early detection of COPD high-risk groups and the development of COPD prevention and control strategies and measures.  Methods  With multistage cluster random sampling, we recruited 3 600 permanent residents aged 40 years and above in 6 surveillance areas of Jiangsu province. Face-to-face questionnaire interview, physical examination and pulmonary function test were carried out among the selected residents during July – December 2015.  Results  Of the 3 365 residents with complete information, 1 545 (45.9%) were identified with central obesity and 428 (12.7%) were diagnosed with COPD. The results of unconditional multivariate logistic regression analysis revealed that the residents with central obesity were at a significantly increased risk of COPD (odds ratio = 1.41, 95% confidence interval: 1.05 – 1.89) compared to those without central obesity after adjusting for sex, age, education, smoking status, history of passive smoking exposure, history of biomass and lampblack for cooking exposure, history of biomass for heating exposure, history of occupational harmful gas or dust exposure, body mass index, and hypertension. Stratified analysis demonstrated that the residents being female, aged ≥ 60 years, with the education of elementary school and below, being farmer/forestry worker/stock farmer/fisherman, without the history of heating fuel exposure, ever exposed to occupational dust or harmful gas, and with central obesity but without hypertension had a significantly higher risk of COPD (all P < 0.05).  Conclusion  The risk of COPD is higher among the middle-aged and elderly residents with central obesity in Jiangsu province.
Prevalence and influencing factors of depression symptoms among disabled elderly in Henan province: a cross-sectional study
ZHANG Lu-yu, LU Di, CHEN Xue-jiao,
2021, 37(11): 1602-1606.   doi: 10.11847/zgggws1130653
Abstract(18) HTML(6) PDF 594KB(4)
Abstract:
  Objective   To examine prevalence and influencing factors of depression symptoms among disabled elderly in Henan province and to provide references for promoting the integration of medical and elderly care.   Methods   Using stratified multistage cluster sampling, we conducted a household face-to-face survey among 6 667 urban and rural residents aged 60 years and above in 18 municipalities/prefectures of Henan province during 2019. The Ability Assessment Criteria for the Elderly issued by Ministry of Civil Affairs of China was adopted in the study; the prevalence of depression symptoms among the elderly with disabilities were analyzed and binary logistic regression was used to explore influencing factors of depression symptoms.   Results  Among the 5 570 elderly residents with valid information, 3 615 were identified with disabilities and of the disabled elderly, 9.13% (330) were assessed with depression symptoms. The results of multivariate logistic regression analysis demonstrated that with an education of college and above, with moderate or severe disability, with moderate or severe disability in daily life, with different levels of impaired mental state, with moderate or severe impaired perception and communication, and severe impaired social participation were significant risk factors for depression symptoms (P < 0.05 for all) and aged ≥ 90 years and being married or divorced were protective factors against depression symptoms (both P < 0.05).   Conclusion   Among the disabled elderly residents in Henan province, the prevalence of depression symptom was at a relatively low level and mainly influenced by age, marital status, education, daily life ability, mental state, ability of perception/communication/social participation, and the extent of disability.
Association of dietary patterns with cognitive impairment among community elderly people in Taiyuan city
CHENG Le, DONG Rui-rui, SONG Chen-meng,
2021, 37(11): 1607-1610.   doi: 10.11847/zgggws1132682
Abstract(174) HTML(66) PDF 509KB(12)
Abstract:
  Objective   To explore the correlation between dietary patterns and cognitive impairment among elderly residents in communities of Taiyuan city, Shanxi province and to provide evidences for the prevention and control of cognitive dysfunction.   Methods   Using stratified cluster random sampling, we recruited 600 community residents aged 65 years and older in 6 districts of Taiyuan city for a survey conducted from June 2016 to July 2017. A self-designed questionnaire, Food Frequency Questionnaire and Mini-Mental State Examination were used to collect relevant information of the elderly. Dietary patterns of the elderly were discriminated with factor analysis and multivariate logistic regression analysis was adopted to assess associations of dietary patterns with cognitive impairment of the elderly.   Results   Of the 565 participants with valid information, 230 (40.71%) were identified having cognitive impairment. Factor analyses revealed four dietary patterns (namely patterns of plant, meat, fruit egg-milk, and sweet food) for the participants and the cumulative variance contribution rate of the four dietary patterns was 51.84%. After adjusting for gender, age, education, smoking, alcohol drinking, physical exercise, hypertension, diabetes, and hyperlipidemia, the results of unconditional multivariate logistic regression analysis demonstrated that compared to those with lower scores (in the lowest quartile, Q1) of meat and fruit egg-milk dietary patterns, the participants with higher scores (in the highest quartile [Q4] or in the higher quartile [Q3]) of the two dietary patterns were at a decreased risk of cognitive impairment (meat pattern score of Q4 vs. Q1: odds ratio [OR] = 0.570, 95% confidence interval [CI]: 0.336 – 0.967; fruit egg-milk pattern of Q3 vs. Q1: OR = 0.847, 95% CI: 0.712 – 0.992 and Q4 vs. Q1: OR = 0.527, 95% CI: 0.319 – 0.872).   Conclusion   Higher dietary intake of fruits, eggs, milk and meat are related to a decreased risk of cognitive impairment among community elderly residents in Taiyuan city.
Health status and its influencing factors among the elderly dwelling in pension institutions providing integrated medication in Qingdao city
SI Ming-shu, SHAO Mei-ying, GE Dan-dan,
2021, 37(11): 1611-1615.   doi: 10.11847/zgggws1126966
Abstract(15) HTML(10) PDF 506KB(2)
Abstract:
  Objective  To explore self-rated health and its influencing factors among the elderly in pension institutions providing integrated medication in Qingdao city, Shandong province, and to provide evidences for improving health status of the elderly.  Methods  With stratified random sampling, totally 2 040 dwellers aged ≥ 60 years were recruited in 43 pension institutions providing integrated medication in 7 districts of Qingdao city and a face-to-face interview was conducted among the elderly with a self-designed questionnaire and Activity of Daily Living (ADL) Scale from June 2017 to August 2018.  Results  Good self-rated health was reported by 687 (36.03%) of the 1 907 respondents with valid information. The results of unconditional multivariate logistic regression analysis demonstrated that the elderly without an extremely poor economic condition, with rural household registration, having the medical insurance other than medical insurance for urban/rural residents and for urban workers, and being capable to pay medical expenses were more likely to report a good self-rated health; however, the elderly with the education of high school and above, being professionals, participating in medical insurance for urban residents, and with impaired ADL were less likely to report a good self-rated health.  Conclusion  Among the elderly dwelling in pension institutions providing integrated medication in Qingdao city, the self-rated health is at a low level and mainly influenced by education, occupation, economic condition, type of household registration, type of medical insurance, affordability of medical expenses, and ADL level.
Epidemiological Research
Prevalence and influencing factors of female sexual dysfunction in Chinese women: a cross-sectional analysis
JIN Zong-lan, CHEN Ping-ping, CHEN Mei-xia,
2021, 37(11): 1616-1620.   doi: 10.11847/zgggws1131555
Abstract(174) HTML(82) PDF 551KB(48)
Abstract:
  Objective  To investigate prevalence and influencing factors of female sexual dysfunction (FSD) among Chinese women.   Methods   During February – May 2019, a random online survey was conducted among 14 306 women aged 18 – 69 from 23 provinces, 4 municipalities directly under the central government, 2 special administrative regions and 5 autonomous regions in China by using the FSFI and the related factors questionnaire. Logistic regression analysis, analysis of variance and chi square test were adopted in data analyses.  Results  Of the 14 306 participants with valid information, 53.17% (7 606) reported FSD symptoms; 46.17% (6 605) and 46.97% (6 720) reported having sexual desire and satisfaction disorder, respectively. The results of logistic regression analysis revealed following significant influencing factors of FSD: age (≥ 30 vs. 18 – 29: odds ratio (OR) = 1.875, 95% confidence interval (95% CI: 1.553 – 2.265), education level (senior high school and above vs. junior high school and below: OR = 0.737, 95% CI: 0.587 – 0.924), occupation (non-manual worker vs. manual worker: OR = 1.189, 95% CI: 1.030 – 1.373), monthly household income per capita (≥ 3 000 vs. < 3 000 RMB yuan: OR = 1.247, 95% CI: 1.081 – 1.438), history of gynecological diseases (yes vs. no: OR = 1.301, 95% CI: 1.136 – 1.490), menopause (yes vs. no: OR = 2.354, 95% CI: 1.712 – 3.238); no significant impact of pregnant and childbirth history on FSD were observed.   Conclusion  The incidence rate of FSD in China is high, which affects the quality of life and mental health of women. It is of great significance to promote the health of women in groups and reproductive health according to the cause of disease and intervention.
Calcaneal bone mineral density and its impact factors among 20 – 80 years old Han residents in Hebei province
ZHANG Fang-yu, CUI Ze, PAN Li,
2021, 37(11): 1621-1625.   doi: 10.11847/zgggws1131866
Abstract(204) HTML(68) PDF 504KB(10)
Abstract:
  Objective   To investigate calcaneal bone mineral density and its impact factors among Han residents aged 20 – 80 years in Hebei province and to provide references for bone health promotion and osteoporosis prevention.  Methods   Using stratified multistage cluster sampling, we conducted face-to-face questionnaire interview, physical examination, and calcaneal bone mineral density detection among 3 707 Han residents aged 20 – 80 years in urban communities and rural villages of Hebei province during July – August, 2017.  Results   Of all the participants, 40.95% (1 518) were male and 59.05% (2 189) were female. The calcaneal broadband ultrasound attenuation (BUA) was significantly higher in the male participants than in the female participants (74.42 ± 20.30 dB/MHz vs. 71.91 ± 22.28 dB/MHz, P < 0.001) and the difference was still significant after adjusting for age, body mass index, residence (urban or rural region) (74.32 ± 0.53 dB/MHz vs. 72.00 ± 0.44 dB/MHz, P < 0.001). The results of multivariate linear regression demonstrated that for male participants, aged 30 – 80 years and current smoking are risk factors of decreased calcaneal bone mineral density; while for female participants, aged 50 – 80 years, alcohol abstinence, and being postmenopausal are risk factors of decreased calcaneal bone mineral density, but overweight, obesity, with high school education, and current alcohol drinking are protective factors against decreased calcaneal bone mineral density.   Conclusion   The calcaneal bone mineral density is affected by physiological factors such as age, menopause and lifestyles including smoking and alcohol drinking among 20 – 80 years old Han residents in Hebei province.
Prevalence and influencing factors of chronic obstructive pulmonary disease among residents aged 40 and above in Jiangsu province
SU Jian, TAO Ran, LIU Jian-nan,
2021, 37(11): 1626-1630.   doi: 10.11847/zgggws1129731
Abstract(284) HTML(87) PDF 504KB(69)
Abstract:
  Objective  To investigate the prevalence and influencing factors of chronic obstructive pulmonary disease (COPD) among residents aged 40 and above in Jiangsu province and to provide evidences for prevention and control of the disease.  Methods  With multistage cluster random sampling, we recruited 3 600 residents aged 40 and above in 6 surveillance areas of Jiangsu province and carried out a questionnaire interview, physical examination and lung function test among the residents during July – December 2015. Patients with COPD were diagnosed according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD). The prevalence of COPD was estimated with complicated sampling weights. Influencing factors of COPD were analyzed with multivariate logistic regression model.  Results  Among the 3 365 participants completing the survey, totally 428 were diagnosed with COPD and the estimated prevalence of COPD was 11.9%. Of the 428 COPD patients, 68.7%, 27.1%, 3.7% and 0.5% were classified into GOLD stage Ⅰ, Ⅱ, Ⅲ and Ⅳ, respectively. Multivariate logistic regression analysis indicated that male gender, aged 50 years and older, with the education of junior high school and below, being a former smoker, being a current smoker, with the history of serious respiratory disease during childhood, with the history of exposure to occupational hazards, and lower body weight were risk factors for COPD and obesity was protective factor for COPD among the participants.  Conclusion  The prevalence of COPD was relatively high and influenced mainly by gender, age, education, smoking, body mass index, history of serious respiratory disease during childhood and exposure to occupational hazards among residents aged 40 and above in Jiangsu province.
Rubella antibody level and immunity strategy among Chinese residents and Burmese entering China in border regions of Yunnan province: a cross-sectional survey
YU Wen, YUAN Shu-yi, LI Li-qun,
2021, 37(11): 1631-1634.   doi: 10.11847/zgggws1133234
Abstract(125) HTML(42) PDF 473KB(7)
Abstract:
  Objective  To examine rubella antibody level and the effect of immunization among healthy Chinese residents and Burmese entering China in border regions of Yunnan province for providing evidences to rubella prevention and control in the populations.   Methods  During 2018 in Yunnan province, we conducted a study including questionnaire survey and blood specimen collection. The participants of the study were 891 residents aged elder than 8 months recruited with multistage random sampling in 27 villages/towns of 3 counties in border regions and 981 people recruited among Burmese entering China for seeking medical service at hospitals in the regions with convenient sampling. The collected blood specimens were detected for rubella immunoglobulin G (IgG) antibody with enzyme-linked immunosorbent assay (ELISA). SPSS 21 software was adopted in data process and analysis.   Results  Between the Chinese residents and the Burmese entering China, there were significant differences in positive rate of rubella antibody (79.35% [95% confidence interval: 72.03%, 84.94%] vs. 84.40% [95% confidence interval: 79.98%, 88.97%], χ2 = 6.72, P < 0.05) and geometric mean concentration of IgG (31.37 IU/ml vs. 33.00 IU/ml, U = 2.38; P < 0.05) of rubella. The rubella antibody level differed significantly among the Chinese residents of various age groups, with a lower antibody positive rate in the residents aged 3 – 19 years (χ2 = 25.91, P < 0.05) and a lower geometric mean concentration of IgG in the residents aged 3 – 29 years (H = 21.96, P < 0.05). For the childbearing women in the Chinese residents, the rubella antibody positive rate was 82.14% and the geometric mean concentration of IgG was 34.30 IU/ml and reversely correlated with the age of the women.   Conclusion   The blood rubella antibody is at a relatively low level among healthy populations in China-Myanmar border region of Yunnan province, suggesting that there is a risk of rubella epidemic in Chinese residents due to the infected Burmese entering China, especially in the residents aged 3 – 29 years and in the childbearing women.
Turnover intention and its influencing factors among general practitioners in the Eastern, Central and Western China
FENG Jing, SHEN Xin, GAN Yong
2021, 37(11): 1635-1640.   doi: 10.11847/zgggws1131685
Abstract(123) HTML(75) PDF 526KB(24)
Abstract:
  Objective   To investigate the prevalence of turnover intention and its influencing factors among general practitioners (GPs) in the Eastern, Central and Western China and to provide evidences for policymaking on the improvement of GPs system.   Methods   With stratified multistage random sampling, we recruited 3 244 GPs from 360 community health service institutions in 12 provinces, cities or autonomous regions in the Eastern, Central and Western China; then we conducted an online questionnaire survey among the GPs via WeChat between October 2017 and February 2018.   Results   For the 3 236 GPs with valid responses, the total turnover intention score was 15.07 ± 4.33 assessed by a scale with marks from 6 to 24; for the GPs in Eastern, Central and Western China, the total turnover intention score was 15.11 ± 4.10, 15.26 ± 4.52, and 14.83 ± 4.40, respectively. The number (percentage) of GPs assessed with the highest, higher, lower, and the lowest turnover intention was 667 (20.61%), 1 633 (50.46%), 728 (22.50%), and 208 (6.43%), respectively. The results of multivariate linear stepwise regression analysis demonstrated that: (1) among all the GPs, those with a bachelor degree or higher education, employed under a temporal work contract, with heavy work stress, with a higher emotional exhaustion score, with a higher depersonalization score, and with higher personal accomplishment score were more likely to have a higher turnover intention, while those being female, at elder age, without an administrative responsibility, with a higher score for material satisfaction, and with a higher score for career development satisfaction were more likely to have a lower turnover intention; (2) among the GPs in Eastern China, those with a higher emotional exhaustion score were more likely to have a higher turnover intention and those at elder age, without an administrative responsibility, having an average annual personal income of ≥ 50 000 RMB yuan, with a higher score for material satisfaction, and with a higher score for career development satisfaction were more likely to have a lower turnover intention; (3) among the GPs in Central China, those with a bachelor education, employed under a temporal work contract, with a higher emotional exhaustion score, with a higher depersonalization score, and with a higher personal accomplishment score were more likely to have a higher turnover intention; but those with a higher score for material satisfaction and with a higher score for career development satisfaction were more likely to have a lower turnover intention; and (4) among the GPs in Western China, those with a bachelor degree or higher education, employed under a temporal work contract, with heavy work stress, and with a higher emotional exhaustion score were more likely to have a higher turnover intention, but those being female, at elder age, with a higher score for material satisfaction, and with a higher score for career development satisfaction were more likely to have a lower turnover intention.   Conclusion   The turnover intention is relatively high and mainly influenced by gender, age, education, employment contract, administrative responsibility, work stress, material satisfaction, career development satisfaction, emotional exhaustion, depersonalization, and personal accomplishment among GPs in Eastern, Central and Western China.
Antibiotic resistance of Burkholderia pseudomallei isolates from Guangdong province: a molecular epidemiology study
HUANG Jing-min, KE Bi-xia, HE Dong-mei,
2021, 37(11): 1641-1646.   doi: 10.11847/zgggws1132874
Abstract(141) HTML(69) PDF 690KB(18)
Abstract:
  Objective   To study drug resistance and molecular epidemiological characteristics of Burkholderia pseudomallei (Bp) strains isolated in Guangdong province and to provide evidences for surveillance, diagnosis and treatment, and prevention of melioidosis.   Methods   Broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) of antimicrobial susceptibility for 8 Bp strains clinically isolated in Guangdong province from 2018 through 2019. Whole genome sequencing was used to identify drug-resistant genes and to conduct molecular typing and phylogenetic tree construction for the Bp strains.   Results   All the Bp stains were sensitive to tetracycline, ceftazidime, imipenem, amoxicillin-clavulanic acid, doxycycline and sulfamethoxazole. Drug-resistance gene blaOXA-59 was detected in 7 of the 8 strains and the drug-resistance gene blaOXA-57 was detected in 3 strains. Multilocus sequence typing (MLST) analysis showed that the 8 strains belonged to different sequence types (ST271, ST562, ST10, ST46, ST1325, ST830, ST1774, and ST1775), and 2 of them were novel types. Whole-genome single nucleotide polymorphism (wgS-NPs) phylogenetic evolution analysis demonstrated that the 8 Bp stains belonged to different clusters and closely related to several strains isolated in different geographical regions.   Conclusion   Burkholderia pseudostellariae stains isolated in Guangdong province were not resistant to antibacterials commonly used in clinic treatment and the genomes of the strains have high genetic diversities with rapid mutation and high probability of genome recombination.
Risk factors of acute hepatitis B virus infection in Tianjin city: a case-control study
WU Wei-shen, ZHANG Guo-ping, WEI Zhao-fei,
2021, 37(11): 1647-1651.   doi: 10.11847/zgggws1131441
Abstract(179) HTML(49) PDF 591KB(29)
Abstract:
  Objective  To investigate risk factors of acute hepatitis B virus (HBV) infection in Tianjin city and to provide evidences for developing strategies on acute HBV infection prevention and control.  Methods  We conducted a 1 : 2 matched case-control study in Tianjin city. The 322 acute HBV infection cases diagnosed from 2017 through 2019 were recruited from the Information System for Infectious Disease Surveillance. The 644 controls were gender-, age (± 3 years)-, residence (in a same community/town or village)-, and HBV vaccination history-matched healthy residents in Tianjin city. Face-to-face or telephone interview were performed to collected relevant information with a self-designed questionnaire. Paired univariate and multivariate logistic regression analysis were used to explore risk factors of acute HBV infection.  Results  The results of paired multivariate logistic regression analysis revealed following risk factors of acute HBV infection: ever contacting closely with someone being hepatitis B surface antigen positive (odds ratio [OR] = 4.587, 95% confidence interval [95% CI]: 2.546, 8.265), ever having shave in barber′s shops (OR = 4.107, 95% CI: 1.746, 9.660), ever receiving pedicure service (OR = 3.748, 95% CI: 2.116, 6.637), with the history of accident injury (OR = 2.391, 95% CI: 1.051, 5.441), having a history of liver disease (OR = 3.027, 95% CI: 1.061, 8.638), and being divorced (OR = 5.350, 95% CI: 1.647, 17.383); the results also demonstrated that with a higher education background was a protective factor against acute HBV infection, with an OR of 0.777 (95% CI: 0.657, 0.920).  Conclusion  Close contact with someone being HBsAg positive, having shave in barber′s shop, receiving pedicure service, having accident injury history, ever suffering from a liver disease, and being divorced are risk factors of acute hepatitis B virus infection, but with high education is a protective factor for the infection among residents in Tianjin city.
Self-reported respiratory symptoms and their associates among rural women in Huaihe River Basin: an Answer Tree analysis
ZHANG Jin-liang, LÜ Zhan-lu, ZOU Tian-sen,
2021, 37(11): 1652-1658.   doi: 10.11847/zgggws1134446
Abstract(13) HTML(7) PDF 827KB(3)
Abstract:
  Objective  To examine the prevalences of respiratory symptoms and their impact factors among rural female residents in Huaihe River Basin for providing evidences to prevention and control of chronic respiratory diseases in the women.   Methods  The data on 1 394 adult (20 – 75 years) female non-smokers living 3 years and longer in local rural areas were extracted from a sampling survey on respiratory symptom-related exposures and environmental factors conducted in 6 counties/districts of 4 provinces in Huaihe River Basin between November 2015 and October 2018. The prevalences of self-reported respiratory symptoms were examined statistically and impact factors of the symptoms were explored with Answer Tree analysis.   Results  Respiratory symptoms were reported by 34.7% (484) of the all women and the self-reported prevalences of cough/expectoration and wheezing/shortening were 18.1% (253) and 27.2% (379), respectively. The results of Answer Tree analysis showed that the self-reported prevalence of cough/expectoration was significantly lower (14.1%) among the women using gas as the fuel when cooking at home than that (23.2%) among those using other fuels (χ2 = 19.061, P < 0.001); the self-reported prevalence of wheezing/shortness of breath was significantly higher in the elder women (≥ 50 years) than that in the women less than 50 years (23.2% vs. 30.9%, χ2 = 19.588; P < 0.001); and in the women with the education of 9 years and above, the overall prevalence of self-reported respiratory symptoms was significantly lower than that in the women with the education less than 9 years (27.6% vs. 39.2%, χ2 = 19.416; P < 0.001).   Conclusion  The prevalence of self-reported respiratory symptoms is relatively higher among non-smoking rural women in Huaihe River Basin and the self-reported prevalence of cough/expectoration is associated with cooking fuel and that of wheezing/shortness of breath is correlated with age among the women.
Experimental Study
Effect of maternal coal-burning fluorosis on neuronal nicotinic acetylcholine receptor protein and mRNA expression in brain tissue of offspring rats
WANG Jin-yu, YU Mao-juan, HE Juan
2021, 37(11): 1659-1662.   doi: 10.11847/zgggws1132174
Abstract(112) HTML(68) PDF 630KB(8)
Abstract:
  Objective  To study the effect of coal-burning fluorosis on protein and mRNA expression of neuronal nicotinic acetylcholine receptor (nAChR) in brain tissue of offspring rats.   Methods   Forty eight Sprague-Dawley (SD) rats (32 females and 16 males) were used in the study. The female rats were randomly divided into a control group and three (low, moderate, and high) fluoride treatment groups supplied with the feed containing fluoride at concentrations of 5.2, 24.4, 47.8, and 106.0 mg/kg continuously from puberty to lactation period. After 3-months′ fluoride treatment, the female rats of each groups were cohabited with 4 male rats. The females' offspring were fed with normal diet after weaning. Morris water maze test was performed for 30-day old offspring rats for evaluations of their learning and memory ability and the offspring rats′ brain tissues were collected for the determinations of nAChR protein with Western blot and nAChR mRNA with real-time fluorescent quantitative PCR.   Results  The brain tissue fluoride content of the offspring rats in moderate and high fluoride groups increased significantly compared to the offspring rats of the control group (both P < 0.05). On the 3rd and 4th day of Morris water maze test, the average escape latency of offspring rats of high fluoride group was significantly longer than that of the control offspring rats (P < 0.05). Significantly decreased expressions of nAChR a7, a4 and β2 mRNA in the offspring rats with moderate and high maternal fluoride exposure and nAChR a7, a4 and β2 protein in all the offspring rats with maternal fluoride exposure were detected in comparison with the offspring rats of control group (all P < 0.05).  Conclusion  Maternal fluoride exposure could reduce the expression of neural nicotine receptor protein and mRNA in brain tissue of offspring rats and the decreases may contribute to impacted learning and memory ability of the offspring rats.
Role of γδT cells in lethal Plasmodium yoelii infection in BALB/c mice
BAI Pai-hui, LI Dan-ni, LIU Jun,
2021, 37(11): 1663-1666.   doi: 10.11847/zgggws1132941
Abstract(125) HTML(44) PDF 493KB(10)
Abstract:
  Objective  To explore the role and mechanism of γδ T cells in immune response of BALB/c mice infected with the lethal Plasmodium yoelii 17XL (P.y 17XL).  Methods  Female BALB/c mice at 6 – 8 weeks of age were randomly divided into a normal control, P.y 17XL infection, and P.y 17XL infection and γδ T cell elimination group. The mice were intraperitoneally injected with P.y 17XL to infect 1×106 red blood cells per mouse. The mice of γδ T cell elimination group were intraperitoneally injected with anti-mouse TCR γ/δ monoclonal antibody (150 μg/mouse) for two consecutive days before P.y 17XL infection, while the mice of normal control and P.y 17XL infection group were injected with the same volume of isotype control antibody. The infection rate of red blood cells and survival rate of mice were monitored dynamically. The number of γδ T cells, dendritic cells (DCs), and type 1 helper (Th1) cells in spleen cell suspension were detected with flow cytometry at the third and fifth day after P.y 17XL infection. After 48 hours′ cultivation in vitro, the supernatant specimens of spleen cell culture in vitro were collected for detections of interferon-γ (IFN-γ) and tumor necrosis factor α (TNF-α) with enzyme-linked immunosorbent assay (ELISA).  Results  Compared with those of the normal control mice, the number of γδ T cells in spleen tissue of P.y 17XL infected mice increased significantly at the third and fifth day after the infection (both P < 0.05); while, the number of γδ T cells in spleen tissue of the mice with γδ T cell elimination decreased significantly (both P < 0.01). At the fifth day after the P.y 17XL infection, the number and activation of spleen DCs, the number of splenic Th1 cells, and the contents of IFN-γ and TNF-α in spleen cell culture supernatants increased significantly in mice with γδ T cell elimination in comparison with those in mice of P.y 17XL infection group.  Conclusion  γδ T cells are involved in acute phase infection of P.y 17XL in erythrocytic stage. After γδ T cell elimination, the Th1 immune response increases as a compensation.
Survey and Report
Classics connotation of public health: a content analysis-based literature study
CAI Wei-qin, LI Cheng-yue, MA An-ning,
2021, 37(11): 1667-1671.   doi: 10.11847/zgggws1127898
Abstract(19) HTML(7) PDF 556KB(10)
Abstract:
  Objective  To explore classical connotation of public health concept at home and abroad for developing a contemporary definition of public health.  Methods  Through online searching on websites such as China National Knowledge Infrastructure, Institute of Science Information (ISI) Web of Science and manual retrieval, we retrieved relevant studies in journals, books and government/professional institution documents published up to the end of January 2018 and then concluded 28 national and 31 international definitions of public health. Retest reliability was used to evaluate the reliability of the definitions; content analysis was adopted to analyze classical connotations of the definitions and an impact indicator was established to assess the significance of the classical connotations.  Results  Through the analysis on the 59 definitions, 257 connotations were initially generalized and 12 domains of classical connotations were derived with stepwise classifying and clustering analysis. The retest reliability of the classical connotations ranged 0.800 – 1.000, indicating that the analytical results were reliable and stable. The top five classical connotations with great significance were ensuring and promoting public health, organizing the society to work together, preventing and controlling various diseases and disabilities, being a field of science and art, and exerting interventions at population.  Conclusion  Ensuring and promoting the health of general population is the key connotation for the definition of public health and to develop a contemporary definition of public health is important for guiding theoretical research and practice of public health in all societies.
Incidence and mortality of atrial fibrillation in China, 1993 – 2017: an age-period-cohort analysis
ZHOU Li-hui, PENG Qin, WANG Yuan,
2021, 37(11): 1672-1676.   doi: 10.11847/zgggws1131433
Abstract(155) HTML(85) PDF 790KB(14)
Abstract:
  Objective   To examine long-time trend in incidence and mortality of atrial fibrillation (AF) and influences of age, period and birth cohort on the incidence and mortality among Chinese population and to provide evidences for developing AF prevention and control strategies.   Methods   The data on AF incidence and mortality from 1993 through 2017 in China were collected from the results of the Global Burden of Diseases Study 2017 (GBD 2017). An R-based web tool from the United States National Cancer Institute for age-period-cohort (APC) analysis was used in this study. The data were arranged to conduct APC analysis for assessing effects of age, period and cohort on AF incidence and mortality.   Results  Increasing trend in the crude and age standardized AF incidence and mortality were observed during the 25-year period in China. The increments during the period of 1993 – 2017 for the crude rate (1/100 000) and age-standardized rate (1/100 000) of AF incidence and mortality for male and female populations were as following: (1) crude AF incidence: 20.61 vs. 42.30 and 24.90 vs. 42.30; (2) age-standardized AF incidence: 30.35 vs. 32.67 and 31.95 vs. 34.18; (3) crude AF mortality: 0.79 vs. 2.32 and 1.89 vs. 4.64; and (4) age-standardized AF mortality: 2.46 vs. 2.78 and 3.78 vs. 3.86. The results of APC analysis demonstrated that the net drift of AF incidence and mortality for male and female populations were all above 0 (AF incidence: 16.595% and 16.527%, AF mortality: 28.570% and 29.026%). Both the incidence and mortality risk of AF increased sharply with the increment of age in a 'J' shaped pattern and the highest AF incidence and mortality risk were observed in populations aged 80 – 89 years. Compared to those during the period of 2003 – 2007, the risk of AF incidence was higher for the periods of 1993 – 2002 and 2008 – 2012 but lower for the period of 2013 – 2017. The risk of AF mortality increased yearly during the 25-year period, and the increase was more dramatic for the years of 2008 – 2017. The risk of AF incidence and mortality for people born between 1976 and 1985 increase with their year of birth in a 'J' shaped exponential pattern.   Conclusion  The incidence and mortality of atrial fibrillation increased persistently during 1993 – 2017 for Chinese population due to impacts of age, period and birth cohort effect.
Characteristics and risk factors of bike-sharing related road traffic accidents in Nanning city
WANG Ke, CHEN Ri-ming, WANG Xiao-min,
2021, 37(11): 1677-1680.   doi: 10.11847/zgggws1131889
Abstract(476) HTML(111) PDF 527KB(184)
Abstract:
  Objective   To investigate the characteristics and risk factors of bike-sharing related road traffic accidents in Nanning city, and to provide a theoretical basis for the adoption and formulation of prevention and control measures.   Methods   We conducted a self-administered online questionnaire survey to collect information on the occurrence of road traffic accident, cycling behavior and cycling environment among 458 Nanning citizens who had cycling experience in the past three months.   Results   Of the 430 valid respondents, 33.7% (145) reported that they had experienced cycling-related road traffic accidents. There was no significant gender difference in the reported incidence rate but the respondents aged > 30 years and with lower education reported a significantly higher incidence of traffic accidents; the respondents being employed reported a significantly higher traffic accidents than the respondents being student; the respondents with more experiences of minor injury or risky riding behaviors reported a significantly higher traffic accidents than those without the experiences. Heavy traffic and high speed of the vehicles on roads of cycling and bike lane being occupied by motor vehicles were major problems for cycling environment reported by the respondents.   Conclusion   The incidents of bike-sharing related traffic accidents are influenced by multiple factors and comprehensive measures such as formulating bicycle traffic safety regulations, improving riding environment, carrying out safety education, and promoting helmet use, should be taken for the prevention of bike-sharing traffic accidents.
Comorbidities and their risk factors among hypertension patients from Jinchang Cohort
LUO Yan, ZHENG Shan, MIAO Qian,
2021, 37(11): 1681-1686.   doi: 10.11847/zgggws1129604
Abstract(165) HTML(75) PDF 614KB(32)
Abstract:
  Objective  To investigate the incidence and influencing factors of comorbidities among hypertension patients in a cohort established among workers in an enterprise – Jinchang Cohort, and to provide references for prevention and management of comorbidities in hypertension patients.   Methods  The data on 4 551 primary hypertension patients were collected in a baseline survey and subsequent follow-ups were carried out during the period from June 2011 to December 2015 among the participants of Jinchang Cohort with on-the-job and retired workers in a large nonferrous metals and chemical enterprise located in Northwestern China. The incidence of comorbidities in the hypertension patients and their influencing factors were analyzed.   Results  Among the 4 551 hypertension patients, 325 developed comorbidities during the follow-up of 10 174.90 person-years and the comorbidity incidence density was 31.94/1 000 person years. Of the hypertension patients with comorbidities, 92.00% (299) and 8.00% (26) were detected with only one and two or more hypertension comorbidites. The top three comorbidities of the hypertension patients were stroke, coronary heart disease and diabetes, with the incidence densities of 12.87/1 000 person years, 10.91/1 000 person years and 10.61/1 000 person years, respectively. The results of unconditional multivariate logistic regression analysis demonstrated that aged ≥ 45 years was a risk factor for comorbidities of stroke and coronary heart disease, while with the education of college and above was a protective factor against stroke; aged ≥ 65 years, obesity, abnormal total cholesterol and abnormal triglyceride were risk factors for concurrent diabetes.   Conclusion  Stroke, coronary heart disease and diabetes are high-risk comorbidities of hypertension and older age is a common risk factor for the three comorbidities among the hypertension patients in the workers of Jinchang Cohort.
Relationship between physical activity and complications in patients with chronic obstructive pulmonary disease: a hospital-based survey
CHEN Jia, BAI Juan
2021, 37(11): 1687-1690.   doi: 10.11847/zgggws1121310
Abstract(6) HTML(4) PDF 479KB(1)
Abstract:
  Objective  To investigate the association of physical activity intensity with complication prevalence among patients with chronic obstructive pulmonary disease (COPD).   Methods  From September 2016 to September 2017, we conducted a survey among 330 COPD inpatients recruited with stratified random sampling in Guiyang public health treatment center. A self-designed questionnaire, International Physical Activity Questionnaire (IPAQ), Fatigue Severity Scale-9 (FSS-9), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) were used in the survey. The inpatients′ lung function were assessed based on the criteria in Global Initiative for Chronic Obstructive Lung Disease (GOLD).   Results  Of the 315 inpatients completing the survey, 49 (15.56%), 178 (56.51%), and 88 (27.94%) were assessed having low, moderate, and high intensity of physical activity. Among the inpatients, 204 (64.76%) were diagnosed with various complications, and the complication prevalence was 28.25% for infection, 11.75% for cardiovascular disease, 11.11% for chronic renal failure, 11.11% for cognitive dysfunction, 11.11% for metabolic syndrome, 7.30% for osteoporosis, 6.03% for skeletal muscle disorders, and 3.49% for lung cancer, respectively. For all the inpatients with complications, 56 (27.45%), 61 (29.90%), and 87 (42.65%) had one, two, and three or more complications. Unconditional multivariate logistic regression analyses showed that compared to those with low physical activity intensity, the inpatients with moderate and high physical activity intensity were at a significantly decreased risk of having complications, with the odds ratios of 0.486 (95% confidence interval [95% CI]: 0.243 – 0.973) and 0.368 (95% CI: 0.151 – 0.897) after adjusting for potential confounding factors as gender, age, education, marital status, employment, residence, smoking, alcohol drinking, course of disease, lung function, fatigue, anxiety, and depression.   Conclusion  Multiple complications, especially infections and cardiovascular diseases, are prevalent among patients with chronic obstructive pulmonary disease and the intensity of physical activity may inversely correlates with complication prevalence in the patients.
Overview
Progress in researches on association of ultra-processed foods with adult overweight and obesity
LÜ Jia-le, LIU Fang-hua, WU Qi-jun,
2021, 37(11): 1691-1694.   doi: 10.11847/zgggws1130449
Abstract(107) HTML(45) PDF 528KB(12)
Abstract:
According to the NOVA classification system based on the extent and purpose of food processing, ultra-processed foods (UPF), modified by a series of complex industrial processing, refer to a group of convenient, ready-to-eat, hyper-palatable foods that add varieties of food additives and generally contain high dose of sugar, salt and fat, and low dose of protein, dietary fiber and micronutrients. In recent years, the global consumption of UPF has increased rapidly; at the same time, the prevalence of overweight and obesity is also growing continuously. Most studies have shown that the increased UPF intake is closely related to adult overweight and obesity; however, the results remain controversial. The purpose of this study is to review the epidemiological studies on the relationship between UPF intake and adult overweight and obesity for providing reference for further research.
Overseas and domestic progress in researches on financing mechanism for long-term care insurance
FU Si-jia, ZHANG Liang-wen, FANG Ya
2021, 37(11): 1695-1697.   doi: 10.11847/zgggws1131142
Abstract(164) HTML(79) PDF 483KB(23)
Abstract:
With the increased population aging in China, the demand on long-term care for disabled elderly is increasing rapidly. To deal with the situation, it is critical to establish a long-term care insurance (LTCI) system suitable for the Chinese context and financing is the core for both the development of the LTCI system and the foundation of the insurance funds. How to construct a fair, reasonable and sustainable financing mechanism is the primary problem for the establishment of an LTCI system. Compared with those in foreign countries, the domestic researches are with more traditional methods and lack of systematic evaluation on the LTCI financing model and quantitative research, such as policy simulation, on financing level in terms of security level. Future researches in China should focus on the fairness, efficiency and sustainability of LTCI to provide evidences for the establishment of a sustainable financing mechanism. This study summarizes the progress in overseas and domestic researches on the LTCI financing mechanism.
Progress in researches on novel tuberculosis vaccine for different populations: a review
ZHANG Xiao-meng, XU Cai-hong, PANG Xue-wen,
2021, 37(11): 1698-1703.   doi: 10.11847/zgggws1133162
Abstract(139) HTML(83) PDF 540KB(13)
Abstract:
Tuberculosis (TB) is a serious contagious disease caused by a single infectious pathogen, which brings serious social and economic problems. Bacillus Calmette-Guérin (BCG) vaccine is currently the only licensed vaccine for preventing TB. However, considering the limited protective duration of the BCG vaccine, low protection ability against TB in latent TB infection, and the vaccination risk of newborns with immunodeficiency, it is imperative to study a new anti-tuberculosis vaccine. The purpose of this review is to summarize current progress in researches on new tuberculosis vaccine for different populations and to provide references for accelerating the research and development of new vaccines.
Detection and influencing factors of peripheral blood mitochondrial DNA copy number: a review
LI Meng-ying, GUO Huan
2021, 37(11): 1704-1708.   doi: 10.11847/zgggws1132373
Abstract(159) HTML(95) PDF 505KB(14)
Abstract:
Peripheral blood mitochondrial DNA copy number (mtDNAcn) is a novel biomarker reflecting oxidative stress status in body. Emerging epidemiological evidences have reported associations of peripheral blood mtDNAcn with major chronic diseases such as cardiovascular diseases, Parkinson's disease, and cancer. It is of great importance to develop methods for measuring peripheral blood mtDNAcn and to identify their risk factors, which could help to promote prevention of chronic diseases. In this study, we introduce detection methods of mtDNAcn and give an outline review on the potential influencing factors of peripheral blood mtDNAcn, aiming to present evidences for identification of peripheral blood mtDNAcn as an early biomarker and to provide technical support for the prevention of chronic diseases.
Public Health Forum
Characteristics, dissemination features and suppression mechanisms of rumors related to nutrition for chronic disease prevention and control
LIU Zhen, LIU Kai-qi, GUO Cang,
2021, 37(11): 1709-1712.   doi: 10.11847/zgggws1132973
Abstract(11) HTML(7) PDF 524KB(2)
Abstract:
  Objective   To explore the characteristics of involved illnesses, disseminators, communication routes, and victims of rumors about nutrition and nutients intakes related to chronic diseases prevention and control and to provide policy and strategy recommendations for establishing rumor suppression mechanism.   Methods  With online searching in China National Knowledge Infrastructure, Wanfang Data, and National Newspaper and Magazines Index Database, we retrieved relevant literatures, reports and articles published between January 1, 2015 and November 31, 2019. Expert interviews and consultations were also conducted among 18 senior professionals in various relevant fields during September to December 2019.   Results  In all the disseminated nutrition rumors, the most involved chronic disease was cancer (being remarked in 25.13% of the rumors). Of the nutrition rumors, 40.91% were disseminated by means of self-media. Based on the estimation made by 55.56% (10/18) of senior professionals consulted, the ratio of online versus offline dissemination of the nutrition rumors was 8 : 2, indicating online dissemination as a major transmission way of the rumors. The majority (66.67%) of the victims of the disseminated nutrition rumors were the elderly people (38.9%) and chronic disease patients (27.8%).   Conclusion   The rumors about nutrition and nutients intakes related to chronic diseases prevention and control were mainly disseminated by online media and the potential adverse impact of the rumor is huge. Therefore, online rumor suppression and a long-term mechanism for cooperation among multiple social organizations in the rumor suppression should be promoted.
Implications of health technology assessment practice in eight countries for Healthy China Initiative
WANG Yi, CHEN Jia-heng, HU Xiu-jing,
2021, 37(11): 1713-1717.   doi: 10.11847/zgggws1127261
Abstract(183) HTML(12) PDF 506KB(14)
Abstract:
Health technology assessment (HTA) is an applied discipline that provides research evidences to improve health and decision-making. With the emergence of new technologies and the growing health-care demand in disease prevention and control, the need for HTA becomes crucial in the implementation of Healthy China Initiative. The study presented a brief introduction on application of HTA and its main characteristics in eight countries including Australia, Canada, Germany, France, Spain, United Kingdom, Thailand, and South Korea. The implications of HTA practices in the eight countries for Healthy China Initiative and the significance of HTA application in China were also discussed.
Effect of Healthy China Initiative on teaching mode of professional master degree in clinical pharmacy
GONG Jian, ZHANG Ling-jian, DING Xuan-sheng,
2021, 37(11): 1718-1720.   doi: 10.11847/zgggws1137078
Abstract(15) HTML(10) PDF 397KB(2)
Abstract:
The education on professional degree master in clinical pharmacy is mainly intended to train high-level applied professionals in clinical pharmacy. ‘Healthy China Initiative’ aims to promote national health and provide comprehensive health service for the whole people in China and the initiative also presents some novel requirements and enlightenments for the training of professional master degree in clinical pharmacy. Considering special competence of clinical pharmacy, the influence of ‘Healthy China Initiative’ on teaching reform in the education on professional master degree in clinical pharmacy was discussed briefly in this article for providing references to the improvement of high-level applied professionals training system.