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2018 Vol. 34, No. 2

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Influence of intergenerational support on loneliness among older and oldest old persons in Tangshan city
Hao-yan ZHANG, Chang-xiang CHEN, Min ZHANG,
2018, 34(2): 12-16. doi: 10.11847/zgggws1114377
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Abstract:
  Objective  To examine the prevalence of loneliness and its correlation with parent-child support among older and oldest old persons and to provide evidences for implementing relevant interventions.  Methods  We recruited 3 448 residents aged ≥ 75 years from communities covered by 10 community health care centers in Tangshan city of Hebei province with stratified cluster random sampling; then we conducted a face-to-face household survey among the residents with the University of California, Los Angeles Loneliness Scale from July 2016 to January 2017.  Results  Of the 3 448 participants, 1 071 (21.9 %), 1 664 (50.2 %), and 713 (27.9 %) were assessed as having low, moderate, and high level of loneliness, with the mean overall loneliness scores of 28.33 ± 4.096, 41.86 ± 4.262, and 54.38 ± 3.360 for the participants with various level of loneliness and the mean overall score of 40.24 ± 10.225 for all the participants, respectively. Multivariate logistic regression demonstrated that the influencing factors of loneliness among the participants included age (80 – 85 years old vs. 75 – 79 years old: odds ratio [OR] = 1.212; 80 – 85 years old vs. 75 – 79 years old: OR = 1.365), education level (college and above vs. illiterate: OR = 0.478), relationship between the participants and their children (harmony vs. good relation: OR = 1.952; harmony vs. general relation: OR = 3.261) whether being visited alternately by their children (no vs. yes: OR = 1.318), whether being ignored by their children (no vs. yes: OR = 0.629), whether being helped in time by their children when needed (no vs. yes: OR = 1.828), and whether the children having been taken their advice (frequently vs. never: OR = 0.313).  Conclusion  Aloneness is prevalence among older and oldest old persons in Tangshan city of Hebei province and the promotion of family intergeneration support to the elderly populations may improve the situation.
Status quo of health literacy – basic knowledge and concept among Tibet residents, 2015
Suolangdeji, Ya-jie LI, Labazhuoma, Sheng GUO
2018, 34(2): 86-89. doi: 10.11847/zgggws1115505
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Abstract:
  Objective  To examine current situation and influencing factors of basic health knowledge and concept among adult Tibet residents and to provide references for promoting health literacy of the population.  Methods  Stratified cluster sampling and probability proportional sampling (PPS) were used to recruit 1 739 permanent residents aged 15 – 69 years for a questionnaire survey in Tibet Autonomous Region (Tibet). The status and relevant factors of basic health knowledge and concept of the participants were analyzed.  Results  Among the participants, the overall level of basic health knowledge and concept was 1.55 % and the average total score of health literacy was 11.01 ± 4.99. The participants showed the highest awareness rate (75.33%) for attentions required when a child receiving vaccination and the lowest awareness rate (14.20 %) for concerns while selecting packaged foods. The results of univariate analysis indicated that there were no significant gender and between ethnic group differences in health literacy scores among the participants (P = 0.190 and P = 0.650). The score of basic health knowledge and concept was significantly higher among the urban residents than among the rural residents (12.48 ± 4.80 vs. 10.74 ± 4.98, P < 0.001) and for all the residents the score increased with the increment of education level (P < 0.001). Significantly lower score of basic health knowledge and concept was observed among the participants aged 60 – 69 years, living in a family with 7 or more permanent members, being a farmer, and having an annual household income of < 10 000 RMB yuan (P < 0.01 for all).  Conclusion  The level of basic health knowledge and concept was low and differed by several characteristics among the adult residents in Tibet. Education on health literacy needs to be strengthened to promote the awareness of health knowledge in the population.
Frailty and its correlation with health status and lifestyle among oldest-old empty-nesters in Tangshan city
Xiao-kai LI, Chang-xiang CHEN, Min ZHANG,
2018, 34(2): 7-11. doi: 10.11847/zgggws1114805
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Abstract:
  Objective   To examine the prevalence of frailty and its association with health status and lifestyle among oldest-old empty-nesters in urban Tangshan of Hebei province.   Methods   We recruited 2 529 urban residents aged≥ 75 years and living alone with stratified random cluster sampling from 32 communities covered by 10 community health care centers in Tangshan city. Then we conducted household interviews among the participants between July 2016 and January 2017 with Comprehensive Frailty Assessment Instrument (CFAI), Health Promoting Lifestyle Profile (HPLP-Ⅱ), and Medical Outcomes Study 36-Item Short-Form Health (SF-36).   Results   Among the participants, the average overall score for frailty was 46.88 ± 11.879, indicating a serious frailty status; and for frailty domains, social breakdown was the most obvious, with a mean score of 3.67 ± 0.832. Multivariate analyses demonstrated that major frailty-related factors included marital status (married: β = – 0.385, widowed: – 0.391, separated or divorced:0.385), monthly income (501 – 1 000 RMB yuan: β = 0.004, 1 001 – 3 000:0.036, 3 001 – 4 999:0.018, ≥ 5 000:0.018), physiological function (β = 0.213), social function (β = 0.101), role-physical (β = 0.112), mental health (β = 0.152), emotional function (β = 0.053), vitality (β=0.203), and general health (β = 0.140) among the participants.   Conclusion   Severe frailty is prevalent among oldest-old empty-nesters in urban Tangshan and effective health promotion should be conducted to improve quality of life among the population.
Correlation between intake of food rich in phytoestrogens and pubertal development in junior high school girl students
Yuan-yuan XU, Li SUN, Xing-yong TAO,
2018, 34(2): 210-213. doi: 10.11847/zgggws1114424
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Abstract:
  Objective   To explore the association between intake frequency of food rich in phytoestrogens (PEs) and pubertal development in girls.   Methods   A questionnaire survey, physical examination, and pubertal development assessmentwere conducted among 1 601 girl students of grade one and two selected with cluster sampling in 8 high schoolsfrom November 2014 to May 2015 in Shenyang, Zhengzhou, Chongqing, and Guangzhou municipality.   Results   Therewere 232 (14.5 %) and 219 (13.7 %) girl students with early and delayed breast development. There were significant differences in breast development among the girl students at different age and with various parental education level, body mass index (BMI), and consumptions of bean products and cooking oil (P < 0.05 for all). Multivariate logistic regression analysis showed that relatively high intake frequency of bean products (odds ratio = 0.48, 95 % confidence interval: 0.31 – 0.74) was a protective factor for early breast development among the girl students.   Conclusion   A certain intake frequency of food richin PEs may be a protective factor for early breast development among girls. This may reflect that the traditional plant-baseddiets represent health dietary habits and lifestyle.
Frailty-related needs of daily care and spiritual comfort among oldest old persons in Tangshan city
Chang-xiang CHEN, Qiong SONG, Jian-min LI,
2018, 34(2): 23-27. doi: 10.11847/zgggws1114297
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Abstract:
  Objective   To examine frailty-related needs of daily care and spiritual comfort and to analyze the relationship between the degree of weakness and needs of daily care and spiritual comfort among oldest old residents.   Methods   We recruited 3 448 residents aged ≥ 75 years from communities covered by 10 community health care centers in Tangshan city of Hebei province with stratified cluster random sampling; then we conducted a face-to-face interview among the residents with the Comprehensive Frailty Assessment Instrument (CFAI), Activity of Daily Living Scale (ADL), and University of California, Los Angeles (UCLA) Loneliness Scale from July 2016 to January 2017.   Results   Among the 3 448 participants with valid information, the prevalence of frailty was 100 % and the frail condition tended to be severe with the increment of age (P < 0.05). Of the participants, 860 (24.9 %) and 804 (23.3 %) were evaluated with low and high demand for daily care according to their ADL scores; whereas, 61.0 % of the participants reported daily care demand by themselves and the ratio was higher than that of ADL assessment. More than a half (2 021, 58.6 %) of the participants selected their children to provide the daily care they required. There were 1 071 (31.06 %), 1 664 (48.26 %), and 713 (20.69 %) of the participants reporting low, moderate, and high demand for spiritual comfort. The proportion of the participants assessed with moderate and high demand for spiritual comfort was 68.94 %, much higher than that of those for demand of daily care; while, the number of the participants with the self-reported demand for spiritual comfort was 2 441 (70.17 %), similar to that for daily care. Of the participants requiring spiritual comfort, 1 906 (78.08 %) selected their children to provide the spiritual comfort. Multivariate analysis showed that age and the degree of frailty were the influencing factors of demand for daily care and spiritual comfort.   Conclusion   More daily care and spiritual comfort should be provided to community oldest old persons according to their frailty conditions.
Willingness to receive human papiilomavirus vaccination and its related factors among HIV-negative men who have sex with men
Tian TIAN, Guo-yao SANG, Fa-dong ZHANG,
2018, 34(2): 77-81. doi: 10.11847/zgggws1115544
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Abstract:
  Objective  To investigate the willingness to receive human papilloma virus (HPV) vaccination and its influencing factors among men who have sex with men (MSM) in Urumqi city.  Methods  Totally 500 MSM aged 18 years or older were recruited with snowballing sampling in Urumqi city between March and May, 2016. A questionnaire survey was conducted among the participants to collect information on demographics, sexual behavior, and the willingness to receive HPV vaccination.  Results  Of the participants, 95.2 % reported the willingness to receive HPV vaccine free of charge and 68.6 % were willing to have a self-paid HPV vaccine, with a significant difference between the two ratios (P < 0.01, χ2 = 31.556). Multivariate logistic regression analyses indicated that the major risk factors for the willingness to receive self-paid HPV vaccine were education level (senior high school and lower vs. college and higher: odds ratio [OR] = 0.375, 95 % confidence interval [95 % CI]: 0.229 – 0.616) and history of sexually transmitted infections [STIs] (yes vs. no: OR = 2.067, 95 % CI: 1.949 – 4.919).  Conclusion  The MSM in Urumqi city have a high willingness to receive self-paid HPV vaccine and charged HPV vaccination could be carried out in the population.
Daily life care need and its influential factors among oldest-old residents in Tangshan city
Ya-nan DU, Chang-xiang CHEN, Na DOU,
2018, 34(2): 191-195. doi: 10.11847/zgggws1114804
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Abstract:
  Objective   To explore daily life care need and its influential factors among the oldest elderly in Tangshan city.   Methods   We recruited 3 448 registered permanent urban residents aged ≥ 75 years with stratified random cluster sampling from 32 communities distributed across all urban areas and covered by 10 community health care centers in Tangshan city, and then conducted a household questionnaire survey among the participants between July 2016 and January 2017 with Activities of Daily Living (ADL), Comprehensive Frailty Assessment Instrument (CFAI), Loneliness Scale, and Social Support Rating Scale (SSRS).   Results   Of the participants, 1 784 (51.7 %) reported no need of daily life care; 860 (24.9 %) reported moderate need; 804 (23.3 %) reported severe need; and the general demand rate was 48.3 % . The top five needs reported by the participants were public transportation (reported by 38.7 % of the participants), cooking (32.4 %), shopping (31.8 %), doing housework (31.7 %), and laundry (28 %), respectively. Ordinal logistic regression analyses showed that main protective factors for daily care needs were at younger age (odds ratio [OR] = 0.263), being a empty-nester (OR = 0.591), high degree of frequent participation in community activities (OR = 0.366), high monthly income (OR = 0.324), low loneliness (OR = 0.022), low degree of frailty (OR = 0.179), with a good cognitive function (OR = 0.269), and not suffering from chronic disease (OR = 0.490); while major risk factors for the need included low frequency of receiving services supplied by neighborhood committees (OR = 1.631), with a poor self-rated health (OR = 14.850), less communication with their children (OR = 2.012), and having no health insurance (OR = 1.761).   Conclusion   About a half of urban oldest-old residents in urban Tangshan need daily life care; the situation needs to be concerned and a comprehensive care service system should be established to meet the demand of the population.
Progress in researches on effect of fine particulate pollution on stroke
De-hui KONG, Zhong-jie FAN
2018, 34(2): 161-164. doi: 10.11847/zgggws1115846
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Abstract:
The concerns on air pollution have been increasing among the public during recent years. Stroke is a cerebrovascular disease which occurs mainly in the elderly and is a major cause of death and disability. A large body of evidence supports the association between ambient air pollution exposure and increased stroke mortality and morbidity recently. We systematically review the studies examining the association between air pollution and admission to hospital for stroke or mortality from stroke.
Status and measurement of multidimensional poverty among small children in poor rural areas of Shanxi and Guizhou province
Qian-wei WEI, Xiao-li WANG, Bo HAO,
2018, 34(2): 204-209. doi: 10.11847/zgggws1115183
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Abstract:
  Objective  To explore the status of multidimensional poverty and a suitable method for its measurement among the children aged 0 – 35 months in poor rural areas of China.  Methods  The data on 1 754 less than 3 years old children and their caregivers were extracted from a cross-sectional survey conducted in poor rural areas of Shanxi and Guizhou province between July and September 2013. The 6 dimensions of multidimensional poverty included water and sanitation, nutrition, health, early education, protection, and participation. Multiple overlapping deprivation analysis (MODA) was adopted to evaluate multidimensional poverty and family income method was used in income poverty assessment.  Results  The rate of multi-dimensional child poverty (deprived in three or more dimensions) was 53.08 % and the rate of income poverty (annual per capita income of less than 2 300 RMB yuan) was 47.04 %. The rate of water and sanitation deprivation (90.25 %) was the highest and the rates of other deprivations were 52.96 % for early education, 46.69 % for protection, 35.58 % for health, 25.66 % for participation, and 15.30 % for nutrition. Water and sanitation and early education exhibited greater contribution to child poverty, accounting for 26.53 % and 22.06 % of the total poverty. The poverty rate was significantly higher among the small children in Guizhou province than among those in Shanxi province. The poverty rate was much higher among the children at younger age, being ethnic minority, with lower maternal education, with more family members, and with a poor household economic condition.  Conclusion  Multidimensional poverty is serious among small children in poor rural areas of Shanxi and Guizhou province and economic support alone could hardly improve the well-being of the children. Multidimensional measurement of poverty is helpful to identify and assess child poverty for making targeted strategies in promoting the well-being of the children.
Role of hedgehog signaling pathway on cartilage tissue damage in chronic fluorosis rats
Zhi-jian ZHU, Yan-ni YU, Rong CHEN,
2018, 34(2): 241-245. doi: 10.11847/zgggws1115085
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Abstract:
  Objective  To investigate the role of hedgehog (Hh) signaling pathway on cartilage tissue damage in rats with chronic fluorosis.  Methods  Thirty-six healthy Sprague-Dawley (SD) rats were randomly divided into three groups (6 males and 6 females in each group): a control group (supplied with drinking water containing sodium fluoride [NaF] of < 1 mg/L) and two fluorosis groups (supplied with drinking water containing NaF of 5 and 50 mg/L). By the end of 6 months’ treatment, fluorine content in urine and bone of the rats were detected with fluorin-ion electrode method. Histological changes in cartilage tissues were observed with light microscope using hematoxylin and eosin (HE) staining. Protein components of the Hh signaling pathway, including sonic hedgehog (Shh), smoothened (Smo) and bone morphogenetic protein-2 (BMP-2), as well as apoptosis-regulating proteins B cell lymphoma/leukemia-2 (Bcl-2) and B cell lymphoma/leukemia gene associated x protein (Bax), were detected using immunohistochemistry staining and Western blot.  Results  The fluorine contents in the urine (3.66 ± 0.43 and 8.05 ± 0.60 mg/L) and bone (402.38 ± 33.77 and 935.12 ± 49.60 mg/kg) of the rats of low and high-dose fluoride groups were higher than those of the rats of control group (P < 0.05 for all). Thinned metaphysic cartilage of stifles, decreased count of chondrocytes, and signs of sclerotic skeletal fluorosis were observed in the rats with fluorine treatment. Compared with those of the control rats, significantly increased protein expression of Shh (0.86 ± 0.09 and 1.11 ± 0.15), Smo (0.92 ± 0.11 and 1.17 ± 0.14), BMP-2 (1.02 ± 0.14 and 1.13 ± 0.12), Bax (0.91 ± 0.14 and 0.92 ± 0.11) and decreased protein expression of Bcl-2 (0.78 ± 0.03 and 0.57 ± 0.09) were detected in the rats treated with low and high dose fluorine (P < 0.05 for all).  Conclusion  The activation of Hh signaling pathway and excessive expression of the downstream target genes may become pathogenesis of chondrocyte damage in chronic fluorosis in rats.
Demands and support system for economic and safety care among home-living oldest-old people in Tangshan city
Chang-xiang CHEN, Si-qi AN, Xi-jun HAO,
2018, 34(2): 186-190. doi: 10.11847/zgggws1114803
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Abstract:
  Objective  To examine the need and related family,community and society factors of economic and safety care among home-living oldest-old people and to provide evidences for taking supportive measures.  Methods  We recruited 3 448 home-living residents aged ≥ 75 years with stratified random cluster sampling from communities covered by 10 community health care centers in Tangshan city; then we conducted a household questionnaire survey on falling risk and economic status among the participants between July 2016 and January 2017 with Modified Falls Risk for Older People in the Community Assessment (FROP-Com) and the Economic Support Scale.  Results  Of all the participants, 13.92 % (480/3 448) and 25.93 % (894/3 448) reported high demand for economic and safety care and most of the demanders considered their children as the providers for the two types of care. Multivariate analyses showed that significant impact factors for economic care included helps from children (t = 3.141), neighborhood committee (t = – 3.560), siblings (t = 6.455), and volunteers (t = – 3.076) and age (t = – 4.165) (P < 0.05 for all); while those for safety care were age (t = 10.012) and helps from neighborhood (t = 7.636), spouse (t = – 5.109), children (t = – 3.587), brothers and sisters (t = 1.996), and other family members (t = – 2.112), respectively (all P < 0.05).  Conclusion  Family members,community and social support are the strong guarantees for economic and security care for the oldest-old people. We should enhance the ability of individuals,perfect the construction of support system and promote the overall level of cares for improving life quality of the population.
Demands and support system for daily life and mental care among oldest-old people in Tangshan city
Chang-xiang CHEN, Si-qi AN, Xi-jun HAO,
2018, 34(2): 1-6. doi: 10.11847/zgggws1114802
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Abstract:
  Objective  To examine the need and related family, community and society factors of frailty-related daily life and mental care among oldest-old people and to provide evidences for taking supportive measures.  Methods  We recruited 3 448 home-living residents aged ≥ 75 years with stratified random cluster sampling from communities covered by 10 community health care centers in Tangshan city; then we conducted a household questionnaire survey among the participants between July 2016 and January 2017 with Comprehensive Frailty Assessment Instrument (CFAI), Activities of Daily Living (ADL), and University of California, Los Angeles (UCLA) Loneliness Scale.  Results  Various degrees of frailty were identified among all the participants; 23.32 % (804/3 448) and 68.9 % (2 377/3 448) of the participants reported strong demands for daily life care and spiritual comfort and most of the demanders considered children and spouse as the providers for the two types of care. Multivariate analyses showed that significant impact factors for daily life care included frailty degree (t = 21.876), age (t = 11.673), and helps from siblings (t = 2.676), neighbours (t = 3.871), children (3.812), spouse (t = – 2.806), volunteers (t = – 2.735) and other family members(t = – 2.573) among the home-living oldest-old people (P < 0.05 for all); while those for spiritual comfort were frailty degree (26.572) and helps from neighbours (t = 13.060), children (t = – 6.995), spouse (t = – 4.607), neighborhood committee (t = 2.729), siblings (t = – 2.165), and education level (t = – 3.057) (all P < 0.05).  Conclusion  Family function, community and social support are the basis of daily life and mental care for oldest-old people; we should strengthen the construction of support system and improve the level of overall care for the oldest-old people.
Associations of life attitude and personality type with degree of frailty in disabled oldest-old people
Si-qi AN, Chang-xiang CHEN, Jian-min LI,
2018, 34(2): 17-22. doi: 10.11847/zgggws1114801
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Abstract:
  Objective  To examine the status of frailty and to explore impacts of life attitude and personality pattern on frailty among disabled oldest-old people.  Methods  We recruited 1 664 disabled oldest-old residents aged ≥ 75 years with stratified random cluster sampling from communities covered by 10 community health care centers in Tangshan city and then conducted a household survey among the participants between July 2016 and January 2017 with a self-designed general questionnaire, Comprehensive Frailty Assessment Instrument (CFAI), and Activities of Daily Living (ADL).  Results  Among all the participants, the prevalence rate of frailty was 100 %, with the prevalence rates of 15.81 % (263/1 664), 32.99 % (549/1 664), and 51.20 % (852/1 664) for mild, moderate, and severe frailty. Logistic regression analyses revealed following significant impact factors of frailty among the participants: extrovert personality (odds ratio [OR] = 0.655), attitude towards life (without positive attitude towards life: OR = 2.440, without perceived happiness in life at all: OR = 21.025, confiding in others frequently: OR = 0.477, not participating in community activities: OR = 2.547), and personality type (no perceived life enrichment: OR = 0.183, no perceived boredom: OR = 0.554, having no harmonious relationship with others: OR = 1.585, no perceived depression: OR = 0.457, feeling lonely at all the time: OR = 4.130, with perceived neglect at all the time: OR = 2.986) (P < 0.05 for all).  Conclusion  Frailty condition differs by attitude towards life and personality type among disabled oldest-old people and education on human life cycle should be promoted to retard frailty progress among the population.
Correlation between parent-child relationship and degree of frailty among community oldest-old people in Tangshan city
Si-qi AN, Chang-xiang CHEN, Jian-min LI,
2018, 34(2): 28-32. doi: 10.11847/zgggws1114410
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Abstract:
  Objective  To examine the status of frailty and to explore impacts of parent-child relationship on frailty among oldest-old people.  Methods  We recruited 3 448 oldest-old residents aged ≥ 75 years with stratified random cluster sampling from communities covered by 10 community health care centers in Tangshan city of Hebei province and then conducted a household survey among the participants between July 2016 and January 2017 with a self-designed general questionnaire and Comprehensive Frailty Assessment Instrument (CFAI).  Results  Among all the participants, the prevalence rate of frailty was 100 %, with 1 093 (31.70%), 1 230 (35.67 %), and 1 125 (32.63 %) participants having mild, moderate, and severe frailty, respectively. Multivariate regression analyses revealed that among the participants, significant risk factors of frailty included female gender (odds ratio [OR]=1.220, 95% confidence interval [95 % CI]: 1.020 – 1.461), aged 80 years and older (OR = 2.030, 95 % CI: 1.596 – 2.581), with children living in a same city as the parents' home town (OR = 2.376, 95 % CI: 1.257 – 4.490), having inharmonious relationship with children (OR = 6.314, 95 % CI: 4.561 – 8.741), without alternate visits of children (OR = 1.309, 95 % CI: 1.078 – 1.589), not communicating with children frequently (OR = 1.869, 95% CI: 1.103 – 3.168), and having no frequent telephone calls with children (OR = 1.366, 95 % CI: 1.106 – 1.686) (all P < 0.05); whereas, the protective factors against frailty were the education of senior high school and above (OR = 0.607, 95 % CI: 0.375 – 0.980) and frequent acceptance of participants' advise by their children (OR = 0.506, 95 % CI: 0.374 – 0.685) (both P < 0.05).  Conclusion  Poor parent-child relationship could aggravate frailty condition of middle-old and oldest-old persons and communication between oldest-old people and their children should be promoted for the implementation of healthy aging.
Impact of rural doctors′ signing service on health literacy among rural residents in Dafeng district of Jiangsu province
Chun-lin PAN, Jin-xia YANG, Cai-hong XU
2018, 34(2): 214-217. doi: 10.11847/zgggws1114274
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Abstract:
  Objective  To examine changes in health literacy after the implementation of singing service of village doctors and to explore the impact of the singing service on health literacy among rural residents.  Methods  We conducted a questionnaire survey among 2 240 permanent residents in rural regions covered by signing service of village doctors in Jiangsu province in March 2015 using health literacy questionnaire. T test and nonparametric test were adopted to analyze differences in overall and dimensional score of health literacy among the participants from various populations.  Results  The average overall health literacy score of the residents receiving signing service of village doctors was higher than that of residents not receiving the service (72.33 ± 10.10 vs. 71.41 ± 10.67). The residents with village doctors’ signing service showed higher scores for health knowledge and concept (42.27 ± 6.56 vs. 41.64 ± 7.08) and health behavior (13.80 ± 2.93 vs. 13.38 ± 2.87), but a lower score for health skill (16.25 ± 3.84 vs. 16.39 ± 3.96) compared to the residents without the service. Among the residents receiving village doctors’ signing service, those with the education of high school and lower and with the monthly income of less than 2 000 RMB yuan had lower overall health literacy score (72.45 ± 2.95 and 71.03 ± 5.46); among the residents not receiving village doctors’ signing service, those divorced had a higher overall health literacy score (74.67 ± 2.88).  Conclusion  Rural doctors’ signing service is helpful to enhance health literacy level among rural residents, suggesting the utilization of village doctors’ signing service should be promoted among rural populations.
Research progress on development of multivalent vaccine against hand, foot and mouth disease
Yi-sheng SUN, Han-ping ZHU, Zhang-nü YANG,
2018, 34(2): 148-152. doi: 10.11847/zgggws1117833
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Abstract:
Hand, foot and mouth disease (HFMD) is a common contagious disease in children under 5 years old, and caused by a variety of different enterovirus infection. There were several large-scale outbreaks of the disease in China and other Asia-Pacific region. The first inactive EV71 vaccine was approved in China in December 2015. The univalent vaccine prevents a part of the epidemics. However, there is no multivalent vaccines for HFMD. This article reviews the progresses in the development of multivalent HFMD vaccines as well as animal models.
Formaldehyde decreases learning and memory ability through BDNF pathways in ICR mice
Shi-ming GAN, Xue-ying CHEN, Li-qian ZHANG,
2018, 34(2): 246-248. doi: 10.11847/zgggws1114753
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Abstract:
  Objective  To investigate the influence of formaldehyde on learning and memory ability in ICR mice.  Methods  The ICR mice were assigned into a control group and high, moderate, and low (200, 150, 100 mg/kg) formaldehyde groups with consecutive administration of formaldehyde for 8 weeks. The learning and memory abilities of the mice were evaluated with novel object recognition test and Morris water maze. The expression of neurotrophic factor was detected with enzyme-linked immunosorbent assay.  Results  Compared with those of the control group, the priority index (0.49 ± 0.11, 0.48 ± 0.08) was significantly decreased in high and moderate formaldehyde groups; the avoidance latency of the third-day Morris water maze test (56.51 ± 8.01, 53.46 ± 10.64 seconds) was significantly prolonged (both P < 0.01). The levels of brain derived neurotrophic factor (BDNF) (121.19 ± 3.07, 101.87 ± 2.95 pg/mL) and nerve growth factor (NGF) (54.44 ± 2.64, 33.93 ± 4.06 pg/mL) in hippocampus of high and moderate formaldehyde groups were significantly lower than those in the control group.  Conclusion  The administration of formaldehyde could result in learning and memory impairments in ICR mice and the effect may be related to the decrease of neurotrophic factors in the brain of the mice.
Time and associated factors of survival among HIV/AIDS patients with HAART in Hubei province: 2006 – 2015
Wu ZHENG, Qin DA, Guo-ping PENG
2018, 34(2): 255-259. doi: 10.11847/zgggws1114552
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Abstract:
  Objective   To investigate survival time and its influencing factors among human immunodeficiency virus (HIV)/AIDS patients who received highly active antiretroviral therapy (HAART) in Hubei province.   Methods   A retrospective cohort study was carried out among HIV/AIDS patients aged 15 years and older who received HAART from January 1, 2006 to December 31, 2015 in Hubei province. Life table was adopted to calculate survival rate, mortality rate, and cumulative survival rate. Log-rank test was used to compare differences in survival time among the patients of various age groups. Univariate analysis and Cox proportional hazard model were utilized to evaluate influencing factors of survival time among the patients.   Results   Among a total of 10 065 patients (7 449 [74.01 %] males, 2 616 [25.99 %] females) retrospectively followed-up during the 10-year period, 1 048 (10.41 %) died. Of the died cases, 646 (61.64 %) died from HIV/AIDS related diseases; 471 (72.91 %) died within the first 6 months of the treatment and 497 (76.93 %) died in the first year of treatment. For all the patients followed-up, the cumulative survival rate was 95.03 % for the first year and was 86.97 % by the end of follow-up. The patients engaged in home service industry were at a higher risk of death (hazard risk [HR] = 1.33, 95 % confidence interval [95 % CI]: 1.09 – 1.62); the patients with the education of high school/secondary school were at a higher risk of death (HR = 3.26, 95 % CI: 1.72 – 6.18) compared to those with junior high school education or lower. Higher risks of death after receiving HAART were observed among the patients with more types of opportunistic infection at the baseline checkup (HR = 0.73, 95 % CI: 0.58 – 0.93 for having three or more types of opportunistic infection), the patients categorized as a higher clinical stage according to the criterion of World Health Organization (WHO) (HR = 0.59, 95 % CI = 0.49 – 0.70), having a CD4+T lymphocyte count of ≥ 351/μL at the baseline checkup (HR = 5.83, 95 % CI = 1.84 – 18.54), and aged ≥ 50 years when beginning HAART (HR = 0.70, 95 % CI = 0.58 – 0.85).   Conclusion   The cumulative survival rate is relatively high and the survival is correlated positively with the number of opportunistic infection at baseline checkup, WHO clinical stage, and age of the patients and reverse with CD4+T lymphocyte count at baseline checkup among HAART treated HIV/AIDS patients in Hubei province during the period from 2006 to 2015.
Cognition on adverse drug reaction among residents in Henan province
Yong-jian HU, Shi-min LIANG, Meng-di SHEN,
2018, 34(2): 82-85. doi: 10.11847/zgggws1114558
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Abstract:
  Objective   To examine the status and influencing factors of cognition on adverse drug reaction (ADR) among community residents in Henan province and to provide a basis for promoting safe medication in the population.   Methods   Using a self-designed anonymous questionnaire and simple random sampling, we conducted a across-sectional survey among 2 146 urban and rural residents in 15 municipalities of Henan province between July and September 2016. We adopted descriptive statistics, chi-square test, and logistic regression analysis in data analyses.   Results   The awareness rate of ADR was 74.00% (1 588/2 146) and the rate rose with the upgrade of education level (P < 0.05) among the respondents. Compared to the respondents with other occupations and other ages, the medical workers and those aged 20 – 39 years showed highest awareness rate (98/110, P < 0.05; 878/1 150, P < 0.05). The correct definition of ADR was recognized by 57.83 % (1 241/2 146) of all the respondents and 63.66 % (1 011/1 588) of the respondents being aware of ADR. Logistic regression analyses showed that significant factors affecting the way of ADR management were gender, with the education of technical secondary school, being a medical worker, working as civil servant or a company staff, and being retired.   Conclusion   The awareness of ADR is at a general level but the awareness of the necessity of ADR reporting and the procedure of ADR reporting are poor among community residents in Henan province, suggesting that education on ADR needs to be promoted among the population for safe medication.
Differences and their influencing factors in cognition and attitude on antibiotics use between breeding farmers and crop farmers
Yao LIU, Qiang SUN
2018, 34(2): 273-276. doi: 10.11847/zgggws1113117
Abstract(1778) HTML (436) PDF 485KB(53)
Abstract:
  Objective  To investigate the differences in knowledge and attitude about antibiotics use between breeding farmers and crop farmers and to explore factors related to the differences.  Methods  A total of 780 residents from 12 villages were selected with probability-proportional-to-size sampling in a county of Shandong province. A face-to-face interview was conducted with a questionnaire to collect information about cognition and attitude on antibiotics use among breeding farmers and crop famers; then the differences in the cognition and attitude between the two groups and their influencing were analyzed.  Results  Compared to those in the crop farmers, higher rates for antibiotics related overall awareness (35.6 % vs. 22.5 %), recognition (33.7 % vs. 16.8 %), basic knowledge (30.7 % vs. 18.5 %) and a higher proportion of expectation for large amount of antibiotics use (31.6 % vs. 18.2 %) were observed in the breeding farmers; the differences were of statistical significance after adjusting for age and education level (P < 0.05 for all), with the odds ratio values of 1.553, 2.199, 1.622, and 1.869, respectively (all P < 0.05).  Conclusion  The cognition of antibiotics and expectation for large amount of antibiotics usage are higher among breeding farmers than among crop farmers in Shandong province and breeding practice is one of factors influencing the differences between the two groups.
Occupational stress and its influencing factors among working populations in four cities, China
Yang SHEN, Ying JIANG, He-ya NA,
2018, 34(2): 199-203. doi: 10.11847/zgggws1115139
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Abstract:
  Objective  To analyze occupational stress and its influencing factors among working populations in urban China.  Methods  Employees aged 18 – 65 years were selected from 5 types of workplaces in Beijing, Xiamen, Quanzhou and Hohhot using stratified cluster sampling and surveyed with a questionnaire between March and October 2015.  Results  For the 3 553 employees with valid responses, the average age was 34.2 ± 9.7 years; 62.3 % (2 213/3 553) of the participants had high degree of occupational stress, and there was a significant difference in the proportions of the occupational stress among the participants from the 5 types of workplace (χ2 = 100.19, P < 0.01). The results of analysis of variance (ANOVA) showed that there were significant differences in job demand scores among the employees categorized by gender, age, education, job type, income, household registration, occupational group, type of contract, work shift, and working condition (all P < 0.05); there were significant differences in job control scores among employees categorized by age, education, job type, marital status, household registration, occupational group, and working condition (all P < 0.05); and there were significant differences in social support scores among employees categorized by age, education, job type, income, household registration, occupational group, type of contract, working hours, and working condition (all P < 0.05). Logistic regression analysis indicated that employees who were female (odds ratio [OR] = 1.20, 95 % confidence interval [95 % CI]:1.03 – 1.38), with education of college and above (OR = 2.14, 95 % CI:1.73 – 2.65), being a administrator (OR = 1.37, 95 % CI:1.09 – 1.71), having working hours of > 8 hours/per day (OR = 1.24, 95 % CI:1.06 – 1.47), and experiencing unfavorable working condition (OR = 1.48, 95 % CI:1.28 – 1.71) were more likely to have occupational stress.  Conclusion  The occupational stress is high and mainly influenced by gender, education, occupational group, working hours, and unfavorable working condition among urban working population in China. Interventions should be taken on individual and organizational level to reduce the occupational stress.
Positive rate and associated factors of anxiety and depressive symptoms among community-dwelling hypertension and diabetes patients
Ju GAO, Qing-zhi ZENG, Yan-ling HE,
2018, 34(2): 70-76. doi: 10.11847/zgggws1113306
Abstract(2139) HTML (456) PDF 648KB(33)
Abstract:
  Objective   To examine the positive rate and influential factors of anxiety and depressive symptoms among community patients with hypertension or diabetes and to provide evidences for future interventions.   Methods   Patients with type-2 diabetes or hypertension registered in 3 community health service centers in 2 districts of Shanghai were recruited with cluster random sampling for a self-administered questionnaire survey during the period from August 2012 to February 2013. We identified participants with depressive or anxiety symptoms using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale-7 (GAD-7) and explored the factors related to these symptoms.   Results   A total of 8 813 diabetes or hypertension patients completed the survey. The proportion of patients with depressive symptoms (score of PHQ-9≥ 5) and anxiety symptoms (score of GAD-7≥ 5) were 14.7 % and 7 %, respectively, and 16.0 % of the patients had either depressive or anxiety symptoms. The positive rates were the highest among the patients with both diabetes and hypertension (19.7 % for depression, 9.4 % for anxiety, and 21.3 % for depression or anxiety), followed by those among the patients with only hypertension (16.3 % for depression, 7.4 %, for anxiety, and 17.7 % for depression or anxiety); and the positive rates were lowest among the patients with only diabetes (12.3 % for depression, 5.9 % for anxiety, and 13.4 % for depression or anxiety) . Multivariate regression analyses indicated that depressive or anxiety symptoms were more prevalent in patients with lower education, divorced or widowed, with more complications, having more general hospital visits within previous six months, and with comorbided diabetes and hypertension.   Conclusion   Depressive and anxiety symptoms are common in community-dwelling patients with hypertension or diabetes. Screening and intervention on these symptoms should be gradually incorporated into community health services to improve the health status of the patients.
Prevalence and influencing factors of frailty among community elderly people in Shijiazhuang city
Kun WANG, Chang-xiang CHEN, Shu-xing LI
2018, 34(2): 196-198. doi: 10.11847/zgggws1114001
Abstract(2279) HTML (522) PDF 482KB(84)
Abstract:
  Objective   To explore the prevalence and influencing factors of frailty among elderly residents in communities of Shjiazhuang city and to provide evidences for making plans on elderly frailty intervention.   Methods   We conducted a face-to-face questionnaire survey among 3 125 residents aged 60 years and above in two communities of Shijiazhuang city between July 2015 and July 2016. We used Comprehensive Frailty Assessment Instrument (CFAI) to assess frailty condition among the elderly.   Results   The mean frailty score of the participants was 41.01 ± 10.64. Multivariate analysis revealed that significant influencing factors of frailty for the participants included age (β′ = 0.074), marital status (β′ = 0.138), education level (β′ = 0.153), individual balance for income and expenditure (β′ = 0.108), loss of teeth (β′ = – 0.045), tooth function (β′ = 0.188), teeth brushing habit (β′ = 0.037), sleep quality (β′ = 0.057), activities of daily living (β′ = 0.165), pattern of health promotion (β ′= – 0.182), relationship with family members (β′ = 0.129), and role in the family (β′ = 0.096) (P < 0.05 for all).   Conclusion   Elderly frail is affected by a variety of factors and effective measures need to be taken to reduce the occurrence of the condition.
Child-parent discrepancy in body image perception among pupils in urban Guangzhou
Wei LIU, Rong LIN, Li-hua XIONG,
2018, 34(2): 218-222. doi: 10.11847/zgggws1113675
Abstract(1403) HTML (460) PDF 543KB(12)
Abstract:
  Objective  To study the body image perception among pupils and their parents in Guangzhou city of Guangdong province, and to provide evidences for effective intervention on childhood obesity.  Methods  A questionnaire survey on body image perception and on-site height and weight measurement were conducted among 6 068 pupils of grade 3 to 5 and their parents from April to October 2014.  Results  Among the pupils, the proportion of thin, overweight, and obesity were 14.49 %, 9.54 %, and 5.37 %; 77.85 % of the pupils were not satisfied with their body image, which was higher than their parents’ perception (72.98 %). The body dissatisfaction (BD) score of the pupils was 0.19 but the BD score of the parents for their children was – 0.30. Regardless of gender and grade, the BD score of the pupils was positive, while the BD score of the parents for their children was negative. Of the parents not satisfied with the body image of their children with normal weight, 70.01 % reported the expectation for their children to gain weight; whereas, of the pupils with normal weight but not satisfied with body image, only 46.07% reported the expectation to gain weight. Compared to the pupils of grade 3, more students of grade 4 and 5 expected to become thinner. More parents of senior grade pupils expected their children to gain weight than the parents of junior grade pupils. The pupils in public schools and their parents showed higher accuracy for body image perception than the pupils in private schools and their parents.  Conclusion  Obvious bias exists in body image perception of grade 3 to 5 pupils and their parents and how to improve the accuracy of body image perception among pupils and their parents may be worthy of research for intervention on childhood obesity.
Effect of perinatal exposure to 4-nonylphenol on adipogenesis in offspring rats
Hong-yu ZHANG, Zhi-guo LIU, Xiao-yu KE
2018, 34(2): 249-254. doi: 10.11847/zgggws1113793
Abstract(1307) HTML (459) PDF 942KB(14)
Abstract:
  Objective  To investigate the effect of 4-nonylphenol (4-NP) exposure of maternal rats during and after gestation period on adipogenesis and the expression of estrogen receptor alpha (ERα) in offspring rats.   Methods   The female Wistar rats were exposed to 4-NP at the dosages of 5, 25, and 125 μg/kg by gavage once a day from the 6th gestation day to 21th postnatal day (PND). The serum samples of some of the offspring rats were collected at the 21th PND and the blood and adipose tissues adjacent to kidney and gonads of the other offspring rats were collected 23 weeks after their births. A control group with 16 rats treated the same as the exposed rats but without 4-NP was established simultaneously.   Results  The body weight of the offspring rats with maternal exposure to 5, 25, and 125 μg/kg 4-NP were all significantly higher than those of the control rats (male offspring rats: 453 ± 51, 475 ± 57, and 509 ± 29 g vs. 384 ± 43 g, female offspring rats: 260 ± 13, 260 ± 12, and 284 ± 3 g vs. 231 ± 8 g) (P < 0.05 for all). The serum total cholesterol and leptin of the offspring rats with maternal 4-NP exposure were significantly higher than those of the control rats (P < 0.05 for all). Compared to those of the control rats, the areas of adipose tissues of the offspring rats with 5, 25, and 125 μg/kg maternal 4-NP exposure significantly increased (male offspring rats: 10 142 ± 9 209, 17 465 ± 9 830, and 33 854 ± 2 620 μm2 vs. 6 307 ± 312 μm2, female offspring rats: 10 100 ± 9 095, 15 134 ± 965, and 31 280 ± 4 654 μm2 vs. 5 915 ± 287 μm2) (all P < 0.05). Compared with those of the control rats, the expressions of the genes related to the differentiation and proliferation of adipocytes significantly increased (P < 0.05 for all), while the expressions of ERα mRNA and protein were down-regulated for the offspring rats with 4-NP exposure of various dosages.   Conclusion   Maternal exposure to 4-NP during and after gestation period can affect adipogenesis of both male and female offspring rats and down-regulated expressions of ERα gene and protein may related to the effects.
Development of public health emergency response framework in China: a cross-sectional study
Chao-nan WANG, Kai-ju LIAO, Bing LI,
2018, 34(2): 1-5. doi: 10.11847/zgggws1118023
Abstract(1799) HTML (514) PDF 581KB(172)
Abstract:
  Objective  To describe current situation of the development of public health emergency response framework at provincial, municipal and county level in China and to provide evidences for promoting the development of the framework.  Methods  A questionnaire-based cross-sectional survey was conducted in 2013 to collect the information on the development of public health emergency response framework (policy, preparedness planning, legislation, organizational structure, mechanism and decision making system) in health related facilities at provincial, municipal, and county levels in China.  Results  The average scoring percentage in the evaluation on overall development of health emergency response framework was 83.1 %, 72.0 %, and 65.8 % for health related facilities at provincial, municipal, and county level; the average scoring percentages for evaluating the overall development in eastern, central, and western region of China were as following: 84.8 %, 84.8 %, and 80.1 % for the health related facilities at provincial level; 77.1 %, 73.0 %, and 66.9 % for the facilities at municipal level; and 68.6 %, 65.4 %, and 60.5 % for the facilities at county level.  Conclusion  The development of health emergency response framework at the provincial, municipal and county level in China has been improved in recent years but the development differs obviously by administration level and geographical region. Special concern should be paid to the development in grass roots health related facilities and the facilities in western China.
Impact of inclusion of rubella attenuated live vaccine into National Expanded Program for Immunization on rubella incidence in Liaoning province: an interrupted time series analysis
Xiao-hui AN, Wen-qing YAO, Xing FANG
2018, 34(2): 114-117. doi: 10.11847/zgggws1116119
Abstract(1168) HTML (423) PDF 617KB(62)
Abstract:
  Objective  To assess the impact of rubella attenuated live vaccine (RV) administration on the trend of rubella incidence after the inclusion of RV into National Expanded Program for Immunization (NEPI).  Methods  We extracted data on rubella incidence rates from 2004 through 2016 in Liaoning province and then explore the trend of incidence before and after the RV administration using interrupted time series analysis and segmented regression model.  Results  Before the inclusion of RV into NEPI, the average monthly rubella incidence was 1.22 per 100 000 population and the incidence rate showed a significant ascending trend with an increment of 0.018 per 100 000 population per month (P = 0.01). After the inclusion of RV into NEPI, the average monthly rubella incidence was 0.176 2 per 100 000 population, with a significant immediate decrease (β2 = 1.702 9, P = 0.006 8). Although, there was a 0.024 1 decrease in the slope of monthly rubella incidence ( – 0.006 1) after the inclusion of RV into the NEPI, but the slope did not differ significantly compared to that before the inclusion (P = 0.124).  Conclusion  The inclusion of RV into the National Expanded Program for Immunization has decreased rubella incidence but its long-term effect needs to be observed in Liaoning province.
Short-term cumulative lag impacts of PM10 exposure on mortality at various air temperature among residents aged 65 years and over in Chengdu city
Ke-xing ZHANG, Qiang WANG, Ning XU,
2018, 34(2): 268-272. doi: 10.11847/zgggws1116894
Abstract(1947) HTML (467) PDF 817KB(101)
Abstract:
  Objective   To explore the difference in cumulative lag impacts of particulate matter less than 10 μm in aerodynamic diameter (PM10) exposure on daily mortality in relation to various air temperature among residents aged 65 years and over in Chengdu city.  Methods   The scales of air temperature were defined by interquartile range (IQR) of annual mean temperature during 2013 – 2016. We estimated cumulative lag impacts of PM10 on mortality and the duration of the cumulative lag impacts with distributed lag nonlinear quasipoisson regression model by temperature scale stratum.   Results   After controlling for daily mean temperature, a significant cumulative lag impact of PM10 (excess mortality risk [ER] = 0.2 %, 95 % confidence interval [95 % CI]: 0.0 % – 0.3 %) for a 10 μg/m3 increase on non-accidental mortality was observed. The lag impacts were postponed two to five days and the lag impacts lasted for three to five days. Stratified by IQR of temperature, the associations between PM10 and cumulative lag impacts of PM10 on the mortality were quite different in different temperature ranges. The impacts were significant at high and medium temperature ranges. However, significant impacts were not observed at low temperature range. As for high temperature range, significant cumulative lag impacts of PM10 (for a 10 μg/m3 increase) on non-accidental mortality (ER = 3.5 %, 95 % CI: 0.1 % – 7.0 %) and cardiovascular mortality (ER = 3.3 %, 95 % CI: 0.2 % – 6.4 %) were observed. As for medium temperature range, significant cumulative lag impacts of PM10 (for a 10 μg/m3 increase) on non-accidental mortality (ER = 0.3 %, 95 % CI: 0.1 % – 0.5 %), cardiovascular mortality (ER = 0.3%, 95 % CI: 0.1 % – 0.6 %), and cancer mortality (ER = 0.5%, 95 % CI: 0.2 % – 0.9%) were observed. No significant cumulative lag impacts of PM10 (for a 10 μg/m3 increase) on respiratory mortality were observed on whole temperature range.  Conclusion   Cumulative lag impacts of PM10 on mortality of residents aged 65 years and over in Chengdu city are influenced significantly by ambient air temperature.
Discrimination against viral hepatitis B patients among rural adults in Shandong province
An-li LENG, Zhen WANG, Da-wei ZHU,
2018, 34(2): 277-281. doi: 10.11847/zgggws1110596
Abstract(1555) HTML (627) PDF 505KB(44)
Abstract:
  Objective  To analyze the situation and influencing factors of discrimination against hepatitis B patients among rural adults in Shandong province.  Methods  Using probability-proportionate-to-size sampling, we recruited a total of 2 894 rural adults more than 18 years old in 14 villages of 4 counties in Shandong province between 2011 and 2012. We conducted a survey among the adults with a self-designed questionnaire to collect information relevant to discrimination against hepatitis B patients among the adults. We adopted logistic regression model in data analyses.  Results  Of all the participants, 23.67 %, 10.19 %, 7.64 %, and 7.84 % had no knowledge about symptoms, consequences of without treatment, effective therapy, and route of transmission of viral hepatitis B. More than a half (53.84 %) of the participants reported being afraid of contact with hepatitis B patients or hepatitis B virus carriers for the viral infection of themselves. More than two thirds (71.73 %) of the participants demonstrated serious discrimination against hepatitis B patients and only 3.14 % showed no discrimination. The discrimination against hepatitis B patients and hepatitis B virus carriers was influenced mainly by income and fear towards the disease, and the cognition on the transmission route of hepatitis B virus. The majority (61.47 %) of the participants acquired hepatitis B related knowledge via public media and only 3.42 % of them obtained the knowledge via communication with hepatitis B patients.  Conclusion  Discrimination against hepatitis B patients is prevalent among rural adults in Shandong province and intervention on the discrimination needs to be promoted urgently in the population.
Human resources for family doctor service at district level in Shenyang city: current status and countermeasures
Lei ZHANG, Han FU, Yue-e LI
2018, 34(2): 282-284. doi: 10.11847/zgggws1117448
Abstract(1406) HTML (371) PDF 493KB(32)
Abstract:
  Objective  To analyze current situation of human resources for assigned family doctor service in a district of Shenyang city for improving quality of medical service provided by family doctor system.  Methods  We conducted a questionnaire survey among 312 personnel of 65 groups engaged in assigned family doctor service in community health care centers in a district of Shenyang city.  Results  There were 5 family doctor groups in each community health care center and 5 to 6 staff in each group averagely. For all the staff surveyed, the proportion of practicing physicians, associated physicians, nurses, and public health workers were 35.90 %, 3.85 %, 40.71 %, and 19.55 %, respectively. About a half (48.08 %) of the staff were less than 30 years old and all most all the staff were female, with a male to female ratio of 8 : 92. Of the staff, 38.14% were employed by governmental institutions; 94.87 % were with the education of university or below; 80.13 % achieved certification for medical practice; and 98.72 % had a monthly income of less than 5 000 RMB yuan. There were 81.73 % of the staff reporting great or general satisfaction with the work they engaged in.  Conclusion  The structure of medical staff providing community family doctor service is generally reasonable in Shenyang city; but the deficit in number and quality and high personal mobility of the family doctors are problems need to be improved for the promotion of assigned community medical service.
Clinical application of carbapenem antibiotics in tertiary general hospitals: a cross-sectional study
Ying-bo ZHAO, Xiao-yuan QU, Chang YIN,
2018, 34(2): 285-289. doi: 10.11847/zgggws1116616
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Abstract:
  Objective  To analyze the status and trend of clinical application of carbapenem antibiotics in grade A tertiary general hospitals in China between 2011 – 2014 for promoting rational clinical drug usage and the control of drug-resistant bacteria.  Methods  We collected relevant data from the national surveillance network for clinical application of antibacterial drugs and all the clinically applied antibiotics were categorized according to Anatomical Therapeutic Chemical (ATC) classification codes recommended by World Health Organization (WHO). We examined clinical application of carbapenem antibiotics and economic burden in relation to the antibiotics usage.  Results  The amount of carbapenem antibiotics clinically used and cost related to the usages increased by 17.67 % and 18.66 % in 151 grade A tertiary general hospitals across China during the period, with the highest increased rate for meropenem (> 50 %/per year). The clinically used carbapenem antibiotics with the largest amount and the highest cost is meropenem, followed by imipenem and cilastain. The carbapenem antibiotics with highest cost for defined daily dose is biapenem, followed by panipenem/betamipron. During the period, the clinically applied carbapenem antibiotics with the highest antimicrobial use density is meropenem for the hospitals in eastern and central regions of China, followed by imipenem and cilastain. The seasons with higher carbapenem antibiotics application are the first and the fourth quarter of a year for the hospitals in eastern, central and western regions and are the first and the third quarter of a year for hospitals in northeastern regions of China.  Conclusions  The risk for the occurrence of drug resistance exists to some extent for tertiary general hospitals and hospitals in some key regions in China and supervision and management on clinical usage of carbapenem antibiotics should be strengthened for these hospitals.
Correlation between HLA-DRB1 and DQB1 gene polymorphism and hemorrhagic fever with renal syndrome
Yan LI, Qin WANG, Jie ZHANG
2018, 34(2): 290-292. doi: 10.11847/zgggws1115749
Abstract(1042) HTML (361) PDF 472KB(60)
Abstract:
  Objective  To investigate the relationship between HLA-DRB1, DQB1 gene polymorphism and hemorrhagic fever with renal syndrome(HFRS).  Methods  We recruited 300 HFRS patients taking medical services and 300 healthy persons having physical examinations as the controls at hospitals in Tieling municipality of Liaoning province between 2007 and 2016. PCR amplification with sequence-specific primers (PCR-SSP) was used to detect genotypes of HLA-DRB1 and HLA-DQB1 gene of the participants in two groups. Gene frequencies (GF) of HLA-DRB1 and HLA-DQB1 were compared between the two groups and genotype-related relative risk (RR) of HFRS was calculated. Pearson linear correlation analysis was adopted to explore correlation between HLA-DRB1 and DQB1 gene polymorphism and HFRS.  Results  Totally 12 and 13 allele locus of HLA-DRB1 gene were detected in the HFRS patients and the controls. The GF of HLA-DRB1*16 allele of the HFRS patients was significantly higher than that of the control group (8.0 % vs. 1.0 %, RR = 6.60, χ2 = 4.39; P < 0.05); no significant between-group differences were observed in the GF of other HLA-DRB1 allele and in the GF of DQB1 allele (P > 0.05 for all). Pearson linear correlation analyses revealed that HLA-DRB1*16 gene was positively correlated with HFRS (odds ratio [OR] = 2.014, 95 % confidence interval [95 % CI]: 0.373 – 10.132; P < 0.05) and HLA-DRB1*10 gene was also positively correlated with HFRS (OR = 2.273, 95 % CI: 0.254 – 9.252; P < 0.05).  Conclusion  HLA-DRB1*16 and HLA-DRB1*10 gene are positively correlated with HFRS and may be susceptibility gene loci for HFRS.
Association of dietary pattern and greenhouse gas emission with human health
Ru-xi LIU, Yang LIU, Bo WU
2018, 34(2): 293-297. doi: 10.11847/zgggws1118214
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Abstract:
The impact of changes in human dietary patterns on the environment and human health is becoming more obvious. The changes in human dietary patterns not only exacerbate climate change, but also lead to an increase in global incidence of chronic diseases. In comparison to plant-based foods, animal-based foods could result in higher green house gas emissions (GHGE). The animal-based foods inducing the highest GHGE is ruminant meats (beef and lamb). The western dietary pattern was found to be associated with an increased risk of dyslipidaemia, diabetes, metabolic syndrome (MetS), high body mass index (BMI), and hypertension. Compared to those in the populations with conventional omnivorous diet, a 16 % – 41 % decreased incidence of type II diabetes, 7 % – 13 % decreased incidence of cancer, 20 % – 26 % decreased mortality of coronary heart diseases, and 0 % – 18 % decreased overall mortality were observed in the populations with vegetarian diet, the Mediterranean diet, and the fish-vegetarian diet. Contrasted to current diet pattern, the healthy diet pattern might be associated with a 15 % average decrease in GHGE; while the sustainable diet pattern might be associated with a 27 % average decrease in GHGE. Therefore, focusing only on healthy diet pattern could not reduce diet pattern-related average GHGE substantially, suggesting that new dietary guideline needs to be established in the view of the impact of dietary pattern on environment. Reducing meat products consumption is an efficient strategy to cope with climate change for both developed countries and the transitional countries, including China, with rapidly expanding of the consumption. But the demand for meat products has been increased continuously due to population growth in developing countries and restrictive or monotonous plant-based dietary pattern may result in nutrient deficiencies with deleterious effects on health, which would make it below the internationally-agreed limit of 2 ℃ for climate warming in Paris Agreement.
Prevalence characteristics of measles in Yinzhou district of Tieling municipality: 2007 – 2016
Ying ZHAO, Xin ZHENG
2018, 34(2): 153-155. doi: 10.11847/zgggws1117857
Abstract(1192) HTML (364) PDF 478KB(26)
Abstract:
  Objective  To examine epidemiological characteristics of measles prevalence in Yinzhou district of Tieling municipality and to provide evidences for developing measles prevention and control strategy.  Methods  Data on measles incidences form 2007 to 2016 in the district were collected via Information Management System for Notable Infectious Disease Registry and Measles Surveillance and then analyzed with descriptive epidemiological methods.  Results  A total of 161 measles cases were reported and the average annual incidence was 4.42/100 000 in the district during the 10-year period. The highest annual incidence (29.89/100 000) was in the year of 2014, and no case was reported in the year of 2011, 2012, 2015, and 2016. More measles incidents were reported from April to June during a year. The majority of the reported cases were children under ages of 15 years, accounting for 80.75 % of all the reported cases; only 9 (5.59 %) of the reported cases were infants less than 8 months old. Among the 152 reported cases aged more than 8 months, 9 (5.92 %) were confirmed with the history of immunization; 15 (9.87 %) had no history of immunization; and 128 (84.21 %) were with unknown history of immunization.  Conclusion  Planned and supplemental immunization for measles should be strengthened among the children at the appropriate age, especially among migrant children, for the prevention of measles epidemic in the district.
Effect of fixed combination of valsartan-amlodipine on primary hypertension: a systematic review and meta-analysis
Dan LI, Ling-jian ZHANG, Mei LIU,
2018, 34(2): 156-160. doi: 10.11847/zgggws1118367
Abstract(1994) HTML (508) PDF 634KB(99)
Abstract:
  Objective  To evaluate the effect of fixed combination of valsartan-amlodipine on primary hypertension for providing reference for the rational drug use.  Method  Comprehensive searches published from 1997 through 2017 were performed via Web of Science, Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure, WanFang Database, and VIP Database with the key words of hypertension, fixed-dose combination, fixed combination, valsartan, and amlodipine. Trials of fixed combination of valsartan-amlodipine selection, data extraction, quality assessment were conducted according to Cochrane review standards and data analyses were conducted using RevMan 5.3 software.  Findings  Totally 25 studies involving 23761 patients on the effect of fixed combination of valsartan-amlodipine on primary hypertension were finally included. The effect of fixed combination of valsartan-amlodipine was better than that of the control group (90.62% vs. 75.58%, pooled odds ratio [OR] = 2.98, 95 % confidence interval (2.02 – 4.40), P < 0.001), but the incidence of adverse drug reactions was higher than that of the control group [17.58 % vs. 16.50 %, pooled OR = 0.66, 95 % CI (0.50 – 0.87, P = 0.003)  Conclusions  The fixed combination of valsartan-amlodipine is more effective than other medication for the treatment of primary hypertension but education on adverse drug reactions should be promoted in its clinical application. The study provides evidences for rational drug use and drug policy development.