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2023, 39(1)
Abstract:
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Contents
2023, 39(1): 1-136.
Abstract:
Special Report – Public Health Education and Course Setting
Improvement of public health and preventive medicine education in China from the perspective of “center-edge” theory
ZHANG Yue, LU Hui, YU Rong-bin,
2023, 39(1): 1-6. doi: 10.11847/zgggws1140732
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“Center edge” is a classical theory used to explain education and national development in comparative higher education research. The study analyzes the objective trend and the role of public health and preventive medicine education from the theory through multidimensional interpretation of policy requirements, epidemic demand, education supply and foreign experience, points out that public health education should become the communication center from university to society and disseminate public health education among the public actively. But there are practical bottlenecks in the development of public health and preventive medicine education in China, such as insufficient professional identity from the vague target positioning, existing gap between education and new medicine standard, and the weakness of public health knowledge and skills in the training of clinical medical talents. It is necessary to reform the mode of public health and general medicine talent training comprehensively and gradually, especially to promote the enrollment of large categories, separate track training and layered training. At the same time, we should pool the joint efforts of schools, governments, relevant institutions and society to establish a full chain development mechanism for public health talents under the system integrating the concept of “starting-process-result”.
Public health course in clinical medical education in China, Japan and the United States of America: a comparative analysis
FAN Jiang-bo, QIU Wu-qi, MAO A-yan,
2023, 39(1): 7-10. doi: 10.11847/zgggws1138752
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Public health course in clinical medical education is of great significance to strengthen the public health awareness of clinicians, improve public health skills, and cultivate medical talents with the combination of prevention and treatment. The medical education systems in the United States and Japan are relatively well developed. So understanding and analyzing public health course in clinical education in developed countries plays an important role in improving and developing China’s medical education training system. This study summarizes and analyzes the public health knowledge and skills in clinical medical education in China, Japan and the United States of America for providing references to China's medical education and training system.
Public health education and postgraduate education for public health physicians in China and the UK: a comparative analysis
WANG Xi, YAN Xiao-ling, LUO Lin-zhi,
2023, 39(1): 11-15. doi: 10.11847/zgggws1139638
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China's public health and clinical medical education were seriously separated. The outbreak of coronavirus disease 2019 (COVID - 19) and practices against the pandemic have all emphasized the importance of public health education and effective integration of treatment and prevention. In this paper, we compared the medical education system, the public health education and graduate medical education in China and the United Kingdom and provided suggestions for the reform and development of medical education in China through drawing on the experience of medical education in the UK according to actual domestic situation.
Characteristics of specialty and degree setting of public health discipline in the United States and its enlightenment
MO Wen-xi, ZHAO Hai-jing, CHEN Hao-yang,
2023, 39(1): 16-21. doi: 10.11847/zgggws1138384
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With rapid change of public health security needs in the post-epidemic era and the reality of national public health professional education reform, the current public health discipline system in China needs to be further improved urgently. In order to provide references for the construction of public health talent training, we describe the characteristics of post-secondary education system of public health in the United States from discipline classification, curriculum and occupational orientation of specialty, as well as the types, awarding conditions and knowledge/competencies requirements of degree by analyzing the open data on multiple public health education institutions. Combining actual situation of public health professional education in China, it is recommended to set up the classification of public health discipline accurately, play the intervention function of the classification catalogue correctly, promote career-oriented talent training, develop inter-disciplinary talent talents training based on multi-degree mode, and construct basic requirements and certification system of higher public health education.
Overview of United States Public Health Service Commissioned Corps and its enlightenment
BAI Jie, WANG Feng
2023, 39(1): 22-26. doi: 10.11847/zgggws1129636
Abstract(41) HTML (39) PDF 719KB(19)
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United States Public Health Service Commissioned Corps (Commissioned Corps), being under the leadership of the Department of Health and Human Services, is an elite team of more than 6 100 full-time, well-trained, highly qualified public health professionals who serve in 13 careers on 11 professions. Established with the concept of a cadre of mobile, the Commissioned Corps features full integration of disease control and prevention, health care and recover. The officers of the Commissioned Corps , in a wide range of specialties and remarkable leadership, work at federal agencies nationally under normal circumstances and can be deployed as fully-featured strike teams into epicenter of disaster if there is a public health emergency. We characterized the US Commissioned Corps as organizing task-oriented, function-modularized, and cadre-mobilized teams, and enhancing interdisciplinary excellence and leadership of crews.
Epidemiological Research
Prevalence and influencing factors of suboptimal health among urban middle-aged and elderly residents in China
ZHANG Zi-cheng, XUE Yun-lian, XU Jun,
2023, 39(1): 27-31. doi: 10.11847/zgggws1138024
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  Objective   To examine the prevalence and influencing factors of suboptimal health among urban middle-aged and elderly residents and to provide evidence for health promotion in the population.   Methods   Using stratified multistage random sampling, we recruited 3 600 urban permanent residents aged 45 years and above in five provinces across China and carried out a survey with Sub-Health Measurement Scale Version 1.0 and a self-designed questionnaire during December 2017 – October 2018. Unconditional multivariate logistic regression was adopted to explore influencing factors of suboptimal health status of the participants.   Results   Among 3476 participants completing the survey, the detection rate of general suboptimal health was 66.51% and the detection rate of physical, mental, and social suboptimal health status were 67.17%, 63.98%, and 69.45%, respectively. The results of unconditional multivariate logistic regression analysis revealed that with higher exposure to second-hand smoke, having unhealthy dietary behavior, and experiencing stress event during past six months were risk factors for suboptimal health; while, being married, with a monthly household income of 2 500 – 7 500 RMB yuan per capita, going to bed early and on time, with high adversity quotient, and paying a close attention to self-health were protective factors against suboptimal health.   Conclusion   Among urban permanent residents aged 45 years and above in China, the detection rate of suboptimal health status was relatively high, and mainly influenced by marital status, monthly household income per capita, second-hand smoke exposure, unhealthy eating habits, sleeping on time, adversity quotient, attention to self-health and recent stressful life event.
Effect of smoking on estimated glomerular filtration rate in a male occupational population
ZHANG Ming, LIU Jie, WANG Jia-qi,
2023, 39(1): 32-35. doi: 10.11847/zgggws1137947
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  Objective  To investigate the effect of smoking on estimated glomerular filtration rate (eGFR) in a male occupational population for providing evidence to tobacco control and prevention of chronic kidney disease (CKD).   Methods  A face-to-face questionnaire survey, physical examination and laboratory testing were conducted from June 2018 to June 2019 among 1 760 male employees recruited with cluster random sampling in a large state-owned enterprise in Xuzhou city, Jiangsu province. The simplified diet in renal disease (MDRD) formula was used to calculate eGFR of the participants and logistic regression analysis was adopted to analyze the effect of smoking (pack years) on eGFR.   Results  For all the participants, the self-reported smoking rate was 62.67% and the detection rate of abnormal eGFR was 13.24%. The average eGFR (ml/min/1.73 m2) was 123.42 ± 26.27 for non-smokers and 119.05 ± 23.54, 113.72 ± 24.06, and 102.31 ± 24.86 for light, moderate, and heavy smokers, respectively; the eGFR decreased significantly with the increase of smoking quantity (F = 43.07, P < 0.001). The detection rate of abnormal eGFR was 8.37% in non-smokers and the rate was 10.53%, 15.06%, and 31.82% in light, moderate, and heavy smokers and there was a significant dose-effect relationship between smoking quantity and detection rate of abnormal eGFR (χ2 = 67.06, P < 0.001). After adjusting for age, waist circumference, hip circumference, alcohol drinking, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, and creatinine and in comparison with the non-smokers, the risk of eGFR abnormality increased significantly in the moderate smokers (odds ratio [OR] = 1.67, 95% confidence interval [95% CI]: 1.07 – 2.61) and in the heavy smokers (OR = 3.36, 95% CI: 2.14 – 5.28); when excluding the participants with newly diagnosed hypertension, the risk of abnormal eGFR was significantly higher for the moderate smokers (OR = 2.91, 95% CI: 1.50 – 5.64) and heavy smokers (OR = 4.38, 95% CI: 2.13 – 9.00) compared to the non-smokers; while, excluding the participants with newly diagnosed diabetes, the risk of abnormal eGFR was significantly higher for the moderate smokers (OR = 1.68, 95% CI: 1.04 – 2.72) and heavy smokers (OR = 3.78, 95% CI: 2.31 – 6.20) contrasting to the non-smokers.   Conclusion  Smoking can significantly reduce eGFR in dose-effect manner among male occupational people.
Species diversity and potential pathogenicity of bacteria carried by wild birds' claws in Yunnan province
JIANG Lin, DENG Wei, ZHANG Shu-xia,
2023, 39(1): 36-41. doi: 10.11847/zgggws1137091
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  Objective  To investigate species diversity and potential pathogenicity of bacteria carried by wild birds’ claws preliminarily for clarifying the necessity of monitoring pathogenic bacteria carried by wild birds.   Methods  Toe/claw swab specimens were collected from 12 kinds of wild forest/aquatic birds for isolation of bacteria. Amplicon sequence variants (ASV)-based high-throughput sequencing was used to analyze bacterial species composition and pathogenic bacteria isolated.   Results  A large number of bacteria dominant in the wild birds’ habitats were detected and the bacterial spectrum and its similarity for the bacteria detected in the wild birds of different species were associated with the birds’ living habitats. Of all the detected bacteria at genus and species levels, 81.25% and 75.00% were pathogenic bacteria, with more kinds of pathogenic bacteria detected in the forest birds and all as human pathogenic bacteria except for a small amount of plant pathogenic bacteria in the aquatic birds.   Conclusion  Wild birds’ toes/claws could carry pathogenic bacteria from their habitats and the detection of pathogenic microorganisms carried by different types of wild birds needs to be included in the scope of routine monitoring for public health.
Helmet wearing and its influencing factors among E-bike drivers and passengers in Shanghai
YU Yan, PENG Juan-juan, LI Qing-feng,
2023, 39(1): 42-45. doi: 10.11847/zgggws1136164
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  Objective  To examine the prevalence and influencing factors of helmet wearing among E-bike drivers and passengers in Shanghai for providing evidence to road traffic injury prevention.   Methods  From October 2015 to April 2019, totally eight waves of observational survey were carried out at eight traffic intersections selected with stratified random sampling in Shanghai city. The number of E-bike drivers and passengers passing through the traffic intersections were counted and the frequency of helmet wearing among the passers was calculated.   Results  The ratio of helmet wearing was 14.12% among the 84 232 E-bike drivers and only 1.99% among the 10 540 E-bike passengers observed during the surveys. The results of the bivariate probit model analysis show that the helmet wearing is 0.14 probability unit lower in the female drivers than that in the male drivers; the helmet wearing in the E-bike drivers carrying adult passengers is 0.28 probability unit higher than that in the drivers carrying minor passengers; and the E-bike drivers′ helmet wearing in winter season is 0.52 probability unit higher than in summer season (all P < 0.01). The helmet wearing in the female E-bike passengers is 0.14 probability unit lower than in the male passengers and the E-bike passengers′ helmet wearing in winter season is 0.37 probability unit higher than in summer season (both P < 0.001). Marginal effect analyses reveal that the probability of E-bike drivers′ helmet wearing in winter season is 14% higher than that in summer season and 13% higher when carrying adult passengers than that when carrying minor passengers (both P < 0.001); when carrying passengers not wearing helmet, the probability of helmet wearing in the female E-bike drivers is 2% lower than that in the male drivers; all the E-bike drivers′ helmet wearing when carrying adult passengers is 4% higher than that when carrying minor passengers and is 6% higher in winter season than in summer season (all P < 0.05). The probability of helmet wearing in E-bike passengers carried by drivers not wearing helmet in winter season is 1% higher than that in summer season (Z = 3.24, P < 0.001).   Conclusion  The prevalence rate of helmet wearing among E-bike drivers and passengers in Shanghai is generally low and presents a seasonal fluctuation. The helmet wearing of E-bike drivers and passengers is lower in females that than that in the males and helmet wearing behavior of the drivers and passengers interact each other.
Stability of cadmium-induced renal injury biomarkers in adult residents with long-term environmental cadmium exposure: a 13-month follow up survey
WANG Mei, YAN Jun, ZHANG Chen-yang,
2023, 39(1): 46-49. doi: 10.11847/zgggws1138112
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  Objective  To investigate the stability of cadmium-induced renal injury biomarkers in community adults with low environmental exposure.   Methods  The participants of the survey were 80 permanent residents aged 40 – 69 years living in local areas at least 10 years (63 in an area with relatively heavy environmental cadmium pollution and 17 in an area with similar social and economic development to those of the contaminated area but with low environmental cadmium pollution) in Gansu province. Peripheral blood and morning urine samples of the participants were collected three times in November 2019, November 2020 and December 2020, for detections of blood cadmium, urinary cadmium, urinary β2-microglobulin (Uβ2-MG), urinary N-acetyl-β-D-glucosaminidase (UNAG), urinary retinol binding protein (URBP), urinary metallothionein (UMT) and urinary micro-albumin (UALB), respectively. Relevant information of the participants were collected simultaneously with questionnaire interviews. Descriptive statistics with variance analysis and Chi-square test were performed on the data collected.   Results  The main effects of time on blood cadmium, UALB, UMT and URBP were not statistically significant (all P > 0.05). The main effects of time on urinary cadmium, UNAG and Uβ2-MG were statistically significant (all P < 0.001). Pairwise comparison showed that there were no significant differences in blood cadmium, UALB, UMT and URBP levels among detections at the three time points (all P > 0.05); but the levels of urinary cadmium in the second and third detection were significantly higher than that in the first detection (both P < 0.001); the level of urinary cadmium in the third detection was significantly higher than that in the second detection (P < 0.01); the UNAG level of the second detection was significantly higher than that of the first detection and the third detection (both P < 0.001). There was no significant difference in UNAG level between the first test and the third test (P > 0.05). The Uβ2-MG level in the third detection was significantly higher than that in the first and the second detection (both P < 0.001). There was no significant difference in Uβ2-MG level between the first and second detection (P > 0.05).   Conclusion  Blood cadmium, UALB, UMT and URBP are less affected by time effect and of good stability; while urine cadmium, UNAG and Uβ2-MG are more affected by time effect and of poor stability.
Survey and Report
Epidemiological characteristics and hospitalization service utilization during pandemic of SARS-CoV-2 Omicron variant in China′s neighboring countries
WU Ke-ye, ZHU Bin, LI Xia,
2023, 39(1): 50-56. doi: 10.11847/zgggws1140782
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  Objective  To analyze epidemiological characteristics of coronavirus disease – 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant and hospitalization service utilization during the Omicron pandemic in China's neighboring countries including Japan, South Korea, Singapore, Malaysia, Vietnam, Thailand, Indonesia, Pakistan, India, and Russia.   Methods  Sourcing data from Our World in Data website, we compared vaccination rate, COVID-19 infection rate, case fatality rate and hospitalization rate before and during the pandemic caused by SARS-CoV-2 Omicron variant in the 10 countries neighboring China.   Results  Among the neighboring countries, the COVID-19 vaccination rate was higher but the case fatality rate of COVID-19 was lower for the developed countries such as Japan, South Korea, and Singapore with relatively higher average age of the population; in contrast, the vaccination rate was lower and the case fatality rate was higher in Pakistan, India and Indonesia. South Korea had the lowest median stringency index during the Omicron pandemic in the 10 neighboring countries, followed by Vietnam, Singapore, Russia, and India. For all the 10 countries, the COVID-19 case fatality rates were significantly lower during the Omicron pandemic than those during previous pandemic (P < 0.001), with all the case fatality rates of less than 0.8%. Only in South Korea and Japan, the number of COVID-19 deaths during Omicron pandemic accounted for more than 50% of total deaths due to COVID-19 pandemic. For the countries including Japan, South Korea and Malaysia with hospitalization data available, the proportion of COVID-19 cases admitted to intensive care units was significantly lower during Omicron pandemic than that during previous pandemic (P < 0.001).   Conclusion  The application of digital technology in monitoring and early warning of COVID-19 should be promoted and the coverage rate of COVID-19 vaccination needs to be increased continuously for rapid and effective response to Omicron pandemic.
Disease burden of anxiety disorders in China in 1990 and 2019: a comparative analysis among global regions with different sociodemographic index
XIA Xiao-qing, ZHAO Yan, HAO Meng-xuan,
2023, 39(1): 57-61. doi: 10.11847/zgggws1137708
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  Objective  To compare the trend in disease burden of anxiety disorders between China and global regions with different socio-demographic index (SDI) in 1990 and 2019 for providing evidence to rational allocation of health resources and formulation of anxiety prevention and control strategies.   Methods  The study data were from the Global Burden of Disease Study (GBD 2019). Incidence, years lived with disability (YLDs), age-standardized incidence, age-standardized prevalence, and age-standardized YLDs rate were applied to compare the disease burden of anxiety disorders and its changing trend among residents in China to those of residents in global regions with different SDI in 1990 and 2019.   Results  Among Chinese residents, the incidence number and YLDs of anxiety disorders increased from 6 667 495 and 4 045 138 person-years in 1990 to 7 285 634 and 4 574 328 person-years in 2019, with the increase rates of 9.37% and 13.08%, respectively. Compared with those in the residents of global regions with different SDI, the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized YLDs rate of anxiety disorders in China in 1990 and 2019 were all at low levels and showed decreasing trend; the age-standardized incidence rate decreased from 556.56/100 000 to 522.97/100000, with a change rate of − 6.03%; the age-standardized prevalence rate decreased from 3507.31/100 000 to 3 164.18/ 100 000, with a change rate of − 9.78%; the age-standardized YLDs rate decreased from 337.47/100000 to 306.02 /100000, with a change rate of − 9.32%. In contrast, the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized YLDs rate of anxiety disorders among populations in the global regions with high SDI were all at high levels and increased from 679.46/100 000, 4637.21/100 000, and 441.19/100 000 in 1990 to 710.54/100 000, 4 806.55/100 000 and 456.89/100 000 in 2019, with the changing rates of 4.57%, 3.65%, and 3.56%. In 1990 and 2019, the burden of anxiety disorders in female residents in China and in global regions with different SDI were much higher than that in male residents. In comparison with those in the males, higher age-standardized rates (for 100 000 population) were observed in the females in China and in global regions with high SDI when examining anxiety disorders′ incidence (630.04 vs. 425.33 and 837.43 vs. 591.16), prevalence (3 912.33 vs. 2 453.91 and 6 168.67 vs. 3 482.78), and YLDs (377.20 vs. 238.88 and 582.82 vs. 334.80).   Conclusion  Compared with the residents in global regions with different SDI, the disease burden of anxiety disorders among Chinese residents decreased greatly from 1990 to 2019 and the disease burden was heavier in the female populations than in the male populations both in China and in global regions with different SDI.
Assessing health emergency response capacities of centers for disease control and prevention in China – research methods and results: a literature-based analysis
JIAO Min, MI Yu-qing, WANG Zhen-de,
2023, 39(1): 62-67. doi: 10.11847/zgggws1138333
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  Objective  To analyze current situation of assessment on health emergency response capacity of centers for disease control and prevention (CDCs) in China and to provide evidence for developing standards for the capability evaluation.   Methods  We retrieved relevant studies published in Chinese or English from January 1, 2003 to October 31, 2021 via searching Chinese National Knowledge Infrastructure (CNKI) and Web of Science database. Content analysis, co-word clustering and significance assessing were used in sorting and categorizing the information on evaluation indicators adopted and critical issues of the response capability mentioned in the studies.   Results  Of the 93 articles finally included in the analysis, 75 were studied using questionnaires and 70 were investigated by a regional CDC. Various index systems were used but no unified framework or standard was adopted in the studies. Based on co-word clustering analysis, four dimensions of the response capability of the CDCs were evaluated in the studies: emergency preparedness assessed by 8 indicators, monitoring/warning and risk assessment by 2 indicators, emergency response by 3 indicators, and organization by 2 indicators, respectively. As considered in the studies, the most important issue to be promoted in the CDCs′ response capability was the establishment of emergency workforce and rapid response team, followed by other main issues including standardized management on public health emergency, financial support, material reserve, staff training and simulation practice, related research, and development/improvement of preparedness plan and technical guidance.   Conclusion  The uniformed framework, standardized assessment criteria and index system are not yet established for the evaluation on CDCs public health emergency response capability nowadays in China and the situation needs to be concerned by national administrative departments.
Connotation of active health: a literature analysis
SUN Can, TANG Shang-feng, CHEN Chao-yi,
2023, 39(1): 68-72. doi: 10.11847/zgggws1139565
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  Objective  To explore contemporary connotation of active health for providing a theoretical basis to the development of scientific, efficient, and standard management model of active health.   Methods  Using active health, proactive health and protective health as preliminary key words, domestic and foreign literature and Web page contents relevant to the definition of active health were retrieved via searching databases of China National Knowledge Infrastructure, WanFang Data, VIP Data, and authoritative websites for the period from 2000 through 2022. A keyword matrix was established with co-term analysis and multidimensional scaling analysis was conducted with SPSS 25.0.   Results  Totally 51 literatures and web page contents of 8 authoritative websites were finally included in the analysis. Multidimensional scaling analysis on dissimilar matrix of 36 screened-out key words resulted in a stress value of 0.23279 and a regression squared value of 0.71918; based on the key words, the connotation of active health could be elucidated in four dimensions: practice theory, participation subject, implementation approach, and health result.   Conclusion  Current connotation of active health may implicate four dimensions of practice theory, participation subject, implementation approach, and health result. More studies are needed on active health theory-based medical model and practice.
Utilization of national health risk factors monitoring information system: a user log-based analysis
HAO Shu-xin, LIU Jie, LÜ Yi-ran,
2023, 39(1): 73-76. doi: 10.11847/zgggws1136415
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  Objective  To analyze user log data of a national health risk factors monitoring information system for providing technical support to the optimization and data quality improvement of the system.   Methods  Totally 522 638 user log records generated from 2018 through 2021 were derived from the health risk factors monitoring system – a subsystem of the China Information System for Disease Control and Prevention. The derived data were cleaned and analyzed to examine characteristics of user access and the operation/improvement of the information system.   Results  The frequency of user access to the health risk factors monitoring information system was higher in the first half of the year than that in the second half of the year during the 4-year period. The users of the information system were mainly staff of centers for disease control and prevention (CDCs) at municipal-level (26.5% of total access) and district/county-level (48.6%). The frequencies of access to the information system differed significantly among the staff users of CDCs at various administrative levels in provinces in eastern, central and western China (χ2 = 40.1, P < 0.001). Uploading and auditing data were predominant operations for the user access and the ratio of the two operations varied temporally in a year. Log analysis results revealed that user access to the information system for modification and deletion of population health-related data decreased obviously and the completeness of key variables increased yearly after the implementing optimization measures for the system.   Conclusion  The analysis on user log records of an information system records can explore operation characteristics and user behavior of the information system for operative optimization and data quality improvement of the information system.
Health Education and Health Promotion
Effect of informatization training in professional staff on First Aid by Your Side voluntary service: a web data-based evaluation
WEN Ying, ZHAO Jian-zhong
2023, 39(1): 77-81. doi: 10.11847/zgggws1137798
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  Objective  To evaluate the effect of an informatization training program in professional staff on the promotion of First Aid by Your Side voluntary service initiated by Red Cross Society of China for providing a reference to the management and improvement of on-site emergency first aid voluntary services.   Methods  Python web crawler technology was used to collect all information about the First Aid by Your Side voluntary service project released by the Chinese Red Cross Volunteer Website from January 11 through October 24, 2021. Considering one week training program partly on the utilization of National Red Cross Volunteer Service Information System (from May 17 to 23) as the intervention point and with the number of voluntary service projects released as the outcome variable, the changing trend in the number of voluntary service projects released within a total of 41 weeks before and after the informatization training program was analyzed with interrupted time series method.   Results  Totally 5 847 voluntary service projects were released nationwide during the 41-week period, of which 3 486, 529 and 1832 projects were released in the eastern, central, and western region. Before the training program, the number of voluntary service projects released per week in the whole country, the eastern region and the western region increased by 8, 4 and 3, respectively; while, after the training program, the number of voluntary service projects released per week in the western region in the short run decreased by 28 compared with that before the training, but the weekly number of voluntary service project released nationwide increased by 2 in the long run compared with that before the training (both P<0.05).   Conclusion  Informatization training plays a certain role in promoting the management of First Aid by Your Side voluntary services. While more attention should be paid to giving timely guidance after the training and to the training in central region in the future.
Second-hand smoke exposure in in-door public places and satisfaction to tobacco control among residents in Hangzhou city: a cross-sectional survey
ZHANG Xin-yue, WANG Meng, YU Feng,
2023, 39(1): 82-85. doi: 10.11847/zgggws1137983
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  Objective  To examine the prevalence of second-hand smoke exposure (SHS) in indoor public places and the satisfaction to tobacco control in residents two years after the implementation of the Tobacco Control Regulation – 2019 in Hangzhou city of Zhejiang province, and to provide references for the promotion of the regulation.   Methods  Using stratified random sampling and a self-designed questionnaire, we conducted an on-site self-administered survey among 1 320 residents aged 15 – 75 years at 26 public places (administrative departments, hospitals, training centers, places of entertainment, restaurants, hotels and shopping malls) in two districts and one county of Hangzhou city during January 2021.   Results  Among the 1315 valid respondents, 1 101 were non-smokers; of the non-smokers, 27.52% (303) reported being exposed to SHS during the past week. For all the respondents, 67.76% reported an overall satisfaction to tobacco control in indoor public places and 64.49%, 59.54%, and 65.63% reported the satisfaction to tobacco control propaganda, supervision on tobacco control, and government agencies′ smoke-free demonstration, respectively. The results of unconditional multivariate logistic regression analysis showed that after adjusting for gender, age, education, marital status, occupation, place of residence, self-reported chronic disease, current smoking status, awareness of core knowledge about tobacco control regulations, awareness of tobacco hazards, and willingness to participate in tobacco control, the residents reporting the satisfaction to tobacco control propaganda, tobacco control supervision and law enforcement in public places, and government agencies′ smoke-free demonstration were more likely to report a higher overall satisfaction to tobacco control.   Conclusion  The prevalence of secondhand smoke exposure in indoor public places was relatively low and the satisfaction to tobacco control was high among residents in urban and rural Hangzhou after the implementation of updated tobacco control regulation.
Effect of health education on gallstone disease among Uygur rural residents in Xinjiang Production and Construction Corps: evaluation on a two years intervention program
QIN Xi-xi, MA Ru-lin, GUO Heng,
2023, 39(1): 86-91. doi: 10.11847/zgggws1138099
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  Objective   To evaluate intervention effect of health education on gallstone disease in Uygur rural residents of Xinjiang Production and Construction Corps (Xinjiang Corps) , and to provide a reference for the prevention and control of gallstone disease in the population.   Methods  The participants of the study were adult ( ≥ 18 years) Uygur people residing at least one year in four randomly-selected rural areas (two as intervention group and two as control group) under administrative of Xinjiang Corps. A 2-year gallstone disease-related health education program (including publicity of basic knowledge, on-site consultation, dissemination of propaganda materials in Uygur and Chinese, and lectures of 30-minutes long every 3 – 4 months) was conducted only among the participants in intervention group. With a self-designed questionnaire on gallstone disease related knowledge, attitude and practice (KAP), two waves of face-to-face interview were performed among 1 612 participants of intervention group and 744 controls before the intervention during June – July 2019 and 799 intervened participants and 580 controls by the end of intervention during July – September 2021. The status and changes of KAP about gallstone disease among the participants of intervention and control groups were analyzed and compared.   Results  Before the intervention, there were no significant differences in total score and dimensional scores of KAP between the intervention group and the control group (all P > 0.05). After the intervention, significantly higher total KAP score (3.02 ± 4.23 vs. 1.79 ± 2.89) and scores of knowledge (1.53 ± 2.21 vs. 0.88 ± 1.53), attitude (0.98 ± 1.35 vs. 0.61 ± 1.04) and practice (0.52 ± 1.08 vs. 0.30 ± 0.92) were observed among the intervened participants compared to those in the controls (all P < 0.01). After the intervention, significantly higher proportions of intervened participants reported being aware of general knowledge (12.6% vs. 7.4%), with appropriate attitude (14.0% vs. 8.6%) and adopting healthy behaviors (7.4% vs. 4.3%) about gallstone disease in comparison with the controls (all P < 0.05) but there were no significant differences in the proportions between the intervention group and control group before the intervention (all P > 0.05).   Conclusion   The health education program effectively improved the knowledge, attitude and practice about gallstone disease among rural Uygur residents in Xinjiang Corps.
Inspection technology
Establishment of an automatic detection method for Middle East respira-tory syndrome coronavirus with an integrated microfluidic chip
LIU Jian-li, GAO Jing, JIANG Peng-chong,
2023, 39(1): 92-97. doi: 10.11847/zgggws1139190
Abstract:
  Objective   To develop an automatic detection method for Middle East respiratory syndrome coronavirus (MERS-CoV) based on integrated microfluidic chip platform.   Methods  The pseudovirus particle of MERS-CoV was prepared as positive reference and primers and probe were designed for the ORF1b gene region of the virus. Integrated microfluidic chips were created in accordance with the whole procedure of real-time reverse transcription polymerase chain reaction (RT-PCR), including viral lysis, nucleic acid extraction, amplification and real-time fluorescence detection. The performance of the chip was monitored by the internal reference gene embedded on the chip. The sensitivity, specificity and repeatability of the chip were evaluated using the MERS-CoV pseudovirus.   Results  The internal reference gene on the microfluidic chip could be amplified and detected stably. The automated detection was sensitive enough to detect as few as 100 copies of MERS-CoV in the original sample, which was more sensitive than normal real-time RT-PCR with the detection limitation of 500 copies. A cycle threshold (Ct) value of 39.80 ± 0.53, with a coefficient variation of 1.34%, was obtained when the test was repeated six times with 100 copies of pseudovirus. No signal was observed in automated tests for other coronaviruses and human genes.   Conclusion  The established automatic detection method with microfluidic chip is of good stability, sensitivity, and specificity and the method is fast and easy to operate, and is not limited by experimental sites. The method could be used for rapid detection of MERS-CoV in field investigation.
Reverse osmosis-based enrichment of virus in water samples: an experiment study
LIU Chao, LI Ping, PANG Yan,
2023, 39(1): 98-101. doi: 10.11847/zgggws1138988
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Abstract:
  Objective  To establish a reverse osmosis technology-based method for enrichment of virus in water samples.   Methods  Two inactivated virus vaccines and two viral nucleic acid plasmids were added into simulated water samples and detected with real-time quantitative reverse transcriptase PCR (qRT-PCR) after reverse osmosis-based enrichment. Reverse osmosis membrane material, membrane pore size, and filtration time were optimized in the enrichments.   Results  The enrichment efficiency increased with the decrease of pore size of the reverse osmosis membrane. The average virus enrichment efficiency of reverse osmosis membrane with the pore size of 0.10 μm was 22.86 ± 0.84% for 2 simulated water samples. The virus enrichment efficiency of nylon, cellulose acetate and polyethersulfone membranes were similar between each other. The enrichment efficiency goes up with the increase of filtration times, but the difference in the efficiency was not significant between two and three times of filtration.   Conclusion  The efficiency can be up to 32.64% for the enrichment of polio virus in water samples using cellulose acetate filter membrane with 0.10 μm aperture and two times of filtration.
Simultaneous and rapid determination of 6 primary bile acids in plasma by high-performance liquid chromatography-tandem mass spectrometry
MU Yan, WU Ying-xia, ZHANG Yi-tian, ZENG Ying-xuan, ZHOU Zhi-feng
2023, 39(1): 102-106. doi: 10.11847/zgggws1138567
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Abstract:
  Objective  To develop a rapid and accurate high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method for the simultaneous determination of 6 primary bile acids in plasma.   Methods  Plasma was separated on a Thermo Accucore C18 column (100 mm × 4.6 mm; 2.6 μm) after being extracted by protein precipitation using methanol. The 6 primary bile acids were separated by using the mobile phase of methanol-water (0.1% formic acid + 5 mmol/L ammonium acetate) running in gradient elution. The mass spectrometer was operated on an electrospray ionization source in negative ion mode for the multiple reaction monitoring analysis. Plasma from 6 healthy adults and 6 adult Sprague-Dawley (SD) rats was detected.   Results  Baseline separation of 6 primary bile acids was achieved within 6 min. The linearity of the calibration curves of the 6 primary bile acids was excellent in the range of 5 – 2000 μg/L with a correlation coefficient higher than 0.995. The limits of detection and limits of quantitation were in the range of 0.25 – 0.45 μg/L and 0.84 – 1.49 μg/L, respectively. The recoveries of intra-day and inter-day were 86.3% – 111.5% and 87.7% – 104.9%, with relative standard deviations of 5.2% – 11.9% and 6.6% – 14.3%, respectively. The concentrations of primary bile acids in plasma of healthy adults and adult SD rats were significantly different.   Conclusion  This method is simple, rapid, sensitive, and accurate, and can meet the needs for rapid detection of primary bile acids in clinical tests and animal experiments.
Simultaneous determination of antibiotics in tap water with automatic solid phase extraction-UHPLC-MS/MS
ZANG Jin-xin, YANG Qi-fan, WANG Ying-ying,
2023, 39(1): 107-112. doi: 10.11847/zgggws1136471
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Abstract:
  Objective  To establish a rapid method for simultaneous determination of 27 antibiotics in tap water with ultra high performance liquid chromatography with tandem mass spectrometry (UHPLC-MS/MS) combined with automatic solid phase extraction.   Methods   After added internal standard solutions of 27 antibiotics within 24 hours, the tap water sample (200 mL) was filtered with glass fiber filters and adjusted for pH value of 7.5 – 8.5. The reference antibiotics in the tap water samples were concentrated with extraction column in the automated solid phase extraction instrument and then eluted with methanol solution. The reference antibiotics in the eluate was reconstituted into constant solution with 20% methanol and separated gradiently with T3 chromatography column using 40% acetonitrile methanol and 0.2% formic acid solution as mobile phase; and finally detected with UHPLC-MS/MS and quantified with internal standard method. Thereafter, 70 tap water samples were collected in rural areas of Zhejiang province and 27 antibiotics in the samples were detected simultaneously using the established method.   Results  A good linearity was observed for detections of the 27 antibiotics at the concentration of 1 to 100 ng/mL, with the correlation coefficient ranging from 0.9963 to 1.0000. For the established method, the detection limits were between 0.004 – 0.296 ng/L; the quantification limits were from 0.013 to 0.998 ng/L; and the mean recoveries ranged from 70.0% – 120.8%. For the 70 rural tap water samples, only four macrolide antibiotics were detected, including roxithromycin, clarithromycin, erythromycin, and tilmicosin, with the concentration ranges (ng/L) of 0.162 – 2.858, 0.063 – 0.849, 0.100 – 1.804, and 0.100 – 1.804, respectively.  Conclusion   The established method is simple to operate, time- and labor-saving; the method is also of high sensitivity, accuracy and reliability; and the method could be applied to rapid determination of 27 antibiotics in tap water.
Whole-genome sequencing of SARS-CoV-2 Omicron variant strains isolated from pharyngeal swab samples in Shandong province
LIU Zan-zan, XIE Cui-hua, JIANG Ya-juan,
2023, 39(1): 113-116. doi: 10.11847/zgggws1140061
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Abstract:
  Objective   To conduct whole genome sequencing of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) Omicron variant strains isolated from patients of a coronavirus disease 2019 (COVID-19) epidemic in Shandong province for effective control of COVID-19 epidemic.   Methods  High-throughput sequencing technology was used to sequence the whole genome of SARS-CoV-2 Omicron variant strains isolated from pharyngeal swab samples collected from four COVID-19 cases in a prefecture of Shandong province in April 2022. MEGA 7.0.14 software was adopted in homology and mutation analysis and evolutionary tree construction of the viral strains.   Results  The whole genome sequences of the four SARS-CoV-2 variants have 99.76% – 99.77% homology with the reference strain Wuhan-hu-1, and they are all located in the BA.2 clade of Omicron variant on the evolutionary tree. The 4 sequences all had multiple genetic loci variations and deletions; of which, A28271T mutation caused the -3 nucleotide of N gene translation initiation region changing from A to T and the deletion of amino acid from 24 to 26 of S protein resulted in the loss of the potential binding motif PPAY25-28 of the WW domain.   Conclusion   Several gene site mutants occurred in SARS-CoV-2 Omicron variants and the mutants may associate with highly infectious and camouflage of the variants and mild clinical symptoms of the viral infection.
Evidence-Based Medicine
Behavioral intervention effect of social norm feedback on reducing clinicians′ antibiotic prescribing: a meta-analysis
SHI Lin, ZENG Ying-chao, LI Wei-bin,
2023, 39(1): 117-121. doi: 10.11847/zgggws1137911
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Abstract:
  Objective  To evaluate intervention effect of social norm feedback (SNF) on reducing antibiotic prescribing behavior of clinicians and to provide a reference for decreasing irrational use of antibiotics.   Methods  Literatures published relevant to intervention effect of SNF on doctors′ antibiotic prescribing behavior were retrieved through searching publications up to October 31, 2021 from China Journal Full-Text Database, VIP Journal Full-Text Database, WanFang Database, PubMed Database, Web of Science Database, Scopus Database, and EMBASE Database; the searching was supplemented using literature retrospective method. Stata 16.0 statistical software was adopted to perform meta-analysis.   Results  Totally 9 English literatures with 19 528 pooled participants were included in the analysis. The results of meta-analysis showed that SNF intervention can reduce the number of clinicians′ antibiotic prescriptions by 4% (rate difference, [RD] = – 0.04, 95% confidence interval [95% CI]: – 0.06 – – 0.03). Further subgroup analysis indicated that all SNF interventions being carried out through following approaches could significantly reduce antibiotic prescription rate of clinicians: with short interval (< 3 months) or long interval ( ≥ 3 months), targeted at doctors or medical institutions, disseminating intervening information by letters and emails/electronic pop-up windows, and adopting fuzzy ranking evaluation (all P < 0.001). Sensitivity analysis and publication bias test demonstrated that the literatures included in the analysis had less publication bias and the results were relatively stable.   Conclusion   SNF intervention could restrain clinicians′ antibiotic prescribing behavior.
Overview
Evaluation on implementation effect of long-term care insurance: research progress at home and abroad
LI Si-cheng, ZHANG Liang-wen, FANG Ya
2023, 39(1): 122-126. doi: 10.11847/zgggws1138845
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Abstract:
As an important measure to deal with population aging, long - term care insurance (LTCI) has played a significant role in relieving the pressure of long - term care for the elders. Through six years′ practice since 2016, each pilot city in China has basically established the LTCI system that conforms to its own reality. In order to verify the implementation effect of the LTCI system, scholars at home and abroad mainly focused on the three dimensions of government, markets and individuals. The implementation of LTCI has effectively reduced government and personal pressure, improved health status of beneficiaries and promoted the development of nursing and insurance market. However, the implementation effect of the LTCI is affected by many factors such as social demography and social economics. Due to the lack of a corresponding comprehensive evaluation index system, it is difficult to compare the implementation effect of the LTCI in different regions with a single index. Future researches should comprehensively consider the government, the market and individuals, and establish a systematic evaluation system for the implementation effect of the LTCI.
Progress in researches on effects of heavy rainfall and flood on bacillary dysentery incidence
LIU Yu-chen, LI Wei-bin, LIU Li,
2023, 39(1): 127-131. doi: 10.11847/zgggws1138144
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Abstract:
Under the background of climate change, frequent heavy rainfall and floods have a great influence on the developing countries in the monsoon region in Southeast Asia, which may change the incidence pattern or regional difference of bacillary dysentery. In the review, we summarize the progress in researches on associations of rainstorm and flood on bacillary dysentery, mechanism and path of the influence, related environmental-social factors, and main models in the studies. Many studies have shown that rainstorm and flooding significantly increase the risk of bacillary dysentery; a number of studies also have dealt with relevant environmental-social factors such as infrastructure overload, geographic landscape pattern, economic development, urban and rural difference, and medical staff allocation. The results of the studies indicated that the heavy rainfall and floods-induced risk of bacillary dysentery incidence varied among populations of different gender, age, occupation, and living regions. The analytical models adopted by the studies include generalized additive model, distributed lag nonlinear model, and Poisson regression model. Further studies are warrented to explore the mechanism path of the influece of heavy rainfall and floods on bacillary dysentery incidence.
Public Health Forum
Convention on Biological Diversity and Nagoya Protocol: historical development and public health implications
ZHOU Wei-yu, GUAN Bai-chu, LU Yi-han
2023, 39(1): 132-136. doi: 10.11847/zgggws1138724
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Abstract:
Convention on Biological Diversity of the United Nations came into force in 1993. In order to further achieve the goal of access and benefit - sharing (ABS) in the area of microbial resources, Conference of the Parties to the Convention on Biological Diversity in 2014 adopted the Nagoya Protocol. We attempt to sort out historical process of the Convention and the Protocol and to analyze ABS issue of pathogen in infectious disease prevention and control in detail for conducting public global health cooperation based on biodiversity and improving domestic laws and regulations on the sharing of microbial resources.