Email alert
RSSCurrent Issue
Display Method:
Abstract
PDF 4629KB
2023,
39(9):
1089-1095.
doi: 10.11847/zgggws1140772
HTML
Abstract:
Objective To evaluate the capacity for hypertension prevention and control and to identify strengths, shortcomings and key control points of the capacity-building in 31 provincial-level administrative divisions (PLADs) in China. Methods Policy documents, information reports, and research literature on hypertension prevention and control in 31 PLADs of China published from January 1995 through December 2019 were systemically collected via searching relevant websites and statistical yearbooks for evaluating on hypertension prevention and control capacity across the 31 PLADs according to the standards for appropriate public health system. Normative gap analysis was used to explore strengths and shortcomings of the capacity-building and multiple linear regression and sensitivity analysis were used to clarify key control points of the capacity-building. Results The average index for the appropriateness of hypertension prevention and control capacity-building was 47.10% among 31 PLADs of China in 2019, and the average annual increasing rate of the capacity-building was 18.75% from 2000 to 2019, showing a significant upward trend (Z = 6.067, P < 0.001). The strengths of hypertension prevention and control capacity-building for the PLADs include more complete organizational structure established, comprehensive coverage of medium- and long-term plans, and sound management and monitoring mechanisms; while the shortcomings are insufficient allocation of human and financial resources and low implementation of multi-dimensional management mechanisms such as management and coordination, medium- and long-term goals and evaluation criteria. The identified key control points for the five aspects in hypertension prevention and control capacity-building are effective motivation of personnel for resource allocation, the coordination for organizational framework, the coverage of incentive measures for management mechanism, practicable assessment criteria for management process evaluation, and the balance between supply and demand of medical service for service offering, with the estimated increment of 23.14%, 66.40%, 15.77%, 23.43% and 7.06%, respectively, in the indexes for the appropriateness of the capacity-building under the conditions of the five key control points being well managed. Conclusion The capacity for hypertension prevention and control has been improved continuously in 31 PLADs of China during 2000 – 2019 but several aspects in hypertension prevention and control capacity-building still need to be improved for the promotion of the capacity-building.
2023,
39(9):
1096-1101.
doi: 10.11847/zgggws1141021
Abstract:
Objective To investigate the correlation of waist circumference and its change with hypertension incidence among Chinese residents aged 18 – 65 years for providing evidence to the prevention and control of hypertension. Methods A prospective dynamic cohort was established among the participants of 7 waves of the China Health and Nutrition Survey (CHNS) conducted from 1993 to 2015 across the mainland of China. After screening out pregnant women and those with abnormal waist circumference (< 50 or >150 centimeters [cm]), the study enrolled 9 980 community residents aged 18 to 65 years who had participated in at least two waves of the survey and were not identified as having hypertension at the baseline survey. The study period was from 1997 through 2015. The individual period of follow-up was from the baseline survey to the last follow-up for non-hypertensives; but for hypertensives, the follow-up ended by the identification of hypertension incidence. Multivariate Cox proportional hazard regression model was used to analyze the influence of baseline waist circumference and its change on hypertension incidence. Results During the follow-up among 5 060 male and 4 920 female participants aged 36.88 ± 11.42 years and with a median follow-up of 7 years, totally 3 132 hypertension incidences were observed and the incidence density was 32.60/1 000 person-years; among the participants at the baseline survey with normal waist circumference (< 85 cm for males and < 80 cm for females), pre-obesity (85 – 89 cm for males and 80 – 84 cm for females), and central obesity ( ≥ 90 cm for males and ≥ 85 cm for females), the number (incidence density) of observed hypertension incidence were 1 983 (26.71/1 000 person-years), 496 (45.78/1 000 person-years), and 653 (59.45/1 000 person-years), respectively. After adjusting for sex, age, education, marital status, residence place, smoking, current alcohol consumption, total physical activity level, fat intake ratio, baseline chronic disease, baseline waist circumference, and the year at first and last follow-up, multivariate Cox proportional hazard regression showed that an increase of 1cm in waist circumference was associated with a 1.7% increased risk of hypertension (hazard risk [HR] = 1.017, 95% confidence interval [95%CI]: 1.011 – 1.024) and an increase of ≥ 5 cm in waist circumference was associated with a 29.5% increased risk of hypertension (HR = 1.295, 95%CI: 1.130 – 1.484) in comparison to normal waist circumference. The results of restricted cubic spline analysis revealed that the increase of 4.9 cm and higher in waist circumference was correlated with the increased risk of hypertension. In the same way after adjusting for confounding factors listed above, the results of multivariate Cox proportional hazard regression indicated that the risk of hypertension increased by 27.2% (HR = 1.272, 95%CI: 1.117 – 1.449) and 77.5% (HR = 1.775, 95%CI: 1.546-2.038) for all the participants with the waist circumference changed from normal to abnormal level and those with persistent abnormal waist circumference compared with the participants with persistent normal waist circumference; the increased risks were also significant for both male participants (HR = 1.191, 95%CI: 1.004 – 1.412 and HR = 1.485, 95%CI: 1.218 – 1.810) and female participants (HR = 1.374, 95%CI: 1.121 – 1.684 and HR = 2.061, 95%CI: 1.691 – 2.513). Conclusion Both baseline abnormal waist circumference and increased waist circumference over time can increase the risk of hypertension incidence. Keeping a waist circumference within the normal range with an increase of less than 5 cm is of great significance for the prevention and control of hypertension among adult population.
2023,
39(9):
1102-1107.
doi: 10.11847/zgggws1141233
Abstract:
Objective To analyze correlations of modifiable risks with all-cause deaths and cardiovascular disease (CVD) deaths in hypertension patients. Methods Comprehensive data of 2015 on 51 438 community hypertensive patients aged 35 – 85 years were extracted from the management information system of Essential Public Health Services and were linked to individual records of mortality in the datasets of death registry system up to February 28, 2021 in Hangzhou municipality, Zhejiang province. Cox proportional regression model was used to estimate hazard risks of all-cause and CVD deaths associated with modifiable risk factors of the mortalities. Results By the end of study period, totally 2 365 all-cause and 842 CVD deaths were observed among the participants and the mortality ratios were 4.60% and 1.64%, respectively. Of the 51 438 hypertensives, 3 926 (7.63%), 20 392 (39.64%), 20 292 (39.45%), and 6 828 (13.28%) were assessed as having none, one, two, and three and more modifiable risk factors of CVD. The results of Cox proportional regression analysis showed that after adjusting for gender, age, living region, migration, and diabetes, the hypertensives being lack of good blood pressure control (systolic blood pressure [SBP] of ≥ 140 mmHg/diastolic blood pressure (DBP) of ≥ 90 mmHg at three measurements not in the same day) were at significantly increased risks of all-cause death (hazard risk [HR] = 1.39) and CVD death (HR = 1.52) compared to those under effective blood pressure control (SBP < 140 mmHg/DBP < 90 mmHg); the hypertensives being current smoker had significantly increased risks of all-cause death (HR = 1.21) and CVD death (HR = 1.24) contrasting to nonsmoking hypertensives; the hypertensives not having daily physical exercise were at significantly increased risks of all-cause death (HR = 1.52) and CVD death (HR = 1.73) in comparison to those reporting daily physical exercise; the results also revealed significantly increased risks of all-cause death (HR = 1.53, HR = 1.69, and HR = 1.97) and CVD death (HR = 2.32, HR = 2.35,and HR = 2.94) for the hypertensives with one, two, and three modifiable risk factors compared to those without any modifiable risk factor; while, the obese hepertensives had a significantly decreased risk of all-cause death (HR = 0.84) compared to the non-obese hypertensives. Conclusion The risks of all-cause and CVD death increased with the number of modifiable risk factors among adult community hypertension patients.
2023,
39(9):
1108-1113.
doi: 10.11847/zgggws1141912
Abstract:
Objective To explore critical indicators for identifying hypertension patients at high risk of hypertension-related complications for prevention and control of complications among community hypertension patients. Methods With boundary analyses, the checklists of major hypertension complications and their risk factors were established through systematic reviews on hypertension-related literatures published domestically and internationally up to April 2021, including 275 research articles, 36 entries on websites of professional institutions, 89 entries on official websites of organizations and associations, 529 entries on social medium websites, 10 guidelines and standards issued by professional institutions, and 7 professional books. Three rounds of expert consultations involving 34 experts were conducted to screen out critical indicators of hypertension complications in the checklist established. Using the screened-out critical indicators and electric health records of 62 150 community hypertension patients registered from January 2014 through January 2020 in Minhang district of Shanghai city, a subsequent empirical analysis was performed on the data on 37 483 hypertension patients without complications at the enrollment of community-based disease management. Results Totally 13 critical indicators for hypertension complications were identified, including poor blood pressure control, high salt diet, overweight/obesity (body mass index ≥ 24.0), irregular medication, aged ≥ 60 years, smoking, excessive drinking, family history of cardiovascular disease, abdominal obesity, long disease course, dyslipidemia, lack of physical exercise, and psychological pressure. The three rounds of expert consultation achieved positive coefficients of 100.0%, 100.0%, and 91.2% and authority coefficients of 0.86, 0.86, and 0.88, respectively; the expert opinion coordination coefficient was 0.281 for the first round (P < 0.05), indicating a good agreement among the experts. Resulted from the expert consultations, the hypertension patients with 5 or more of the 13 critical indicators could be assessed as being at high risk of hypertension-related complications. The assessment based on the analysis result indicated that 9.17% of the individuals were at high-risk of complications among 37 483 community hypertension patients without hypertension-related complications previously diagnosed. Conclusion The critical indicators established in this study could be adopted conveniently in rapid identification of individuals at high risk of complications among community hypertension patients.
2023,
39(9):
1114-1119.
doi: 10.11847/zgggws1140381
Abstract:
Objective To investigate the effect of blood pressure control its influencing factors in hypertensive patients under disease management of basic public health services (BPHS) in Yunnan province for improving the patients′ blood pressure control and BPHS′ community disease management. Methods The participants of the study were 1 521 previously diagnosed hypertension patients aged ≥ 35 years identified via questionnaire interview, physical examination, and laboratory tests conducted among 9 600 permanent adult residents recruited with multistage stratified random sampling in 8 counties/districts of Yunnan province during 2021. Of the participants, 1 011 (66.5%) were assigned into a management group (under the BPHS′s disease management confirmed by matching the participants′ identification card [ID] number with the records in the BPHS′s disease management information system) and 510 (33.5%) into a non management group (with the ID numbers not matched with the records of the information system). Demographic characteristics, disease management/blood pressure control (maintaining a systolic/diastolic blood pressure below 140/90 mmHg) and their associates of the participants were analyzed and compared between the two groups. Results The observed blood control rate was significantly higher among the participants of management group than that among those of non management group (33.2% vs. 22.0%, P < 0.05). Compared to those of the non management group, the participants of management group reported significant higher proportions of having received doctors′ lifestyle guidance on decreasing salt intake (89.5% vs. 81.7%), regular physical exercise (86.9% vs. 79.2%), body weight control (84.6% vs. 77.4%), smoking cessation (83.8% vs. 78.7%), restricting alcohol consumption (84.1% vs. 78.3%), and psychological counseling (81.3% vs. 72.9%) (all P < 0.05); for all the participants having accepted the six items of lifestyle guidance mentioned above, the observed blood pressure control rates of the management group′s participants were significantly higher than those of the non management group′s participants ( 33.6% vs. 22.8%, 33.5% vs. 22.0%, 34.3% vs. 22.3%, 33.7% vs. 22.4%, 34.0% vs. 22.5%, and 33.4% vs. 21.7%, all P < 0.05). The results of multivariate logistic regression analysis showed that the participants with higher education, being urban residents, having medication according to physician′s prescription, and receiving BPHS′s disease management were more likely to have their blood pressure under control. Conclusion In Yunnan province, the community hypertension patients under BPHS′ disease management have a better blood pressure control compared to the patients without the management, suggesting a good efficiency of the BPHS′ disease management in the province.
2023,
39(9):
1120-1129.
doi: 10.11847/zgggws1141964
Abstract:
Objective To explore the prevalence and determinants of hyperuricemia (HUA) among hypertensive patients registered at community health service centers in suburb of Shanghai for promoting prevention and management of HUA in primary health institutions. Methods The participants of the study were 3 600 hypertensive patients randomly recruited from chronic disease patients registered at two community health service centers in a suburban district of Shanghai city. Face-to-face interview with a self-designed questionnaire and the International Physical Activity Questionnaire, physical examination, laboratory tests were conducted among the participants during October − December 2021. The prevalence of HUA was described and unconditional multivariate logistic regression analysis was used to analyze determinants of HUA. Results Among the 2 899 eligible participants, 882 were identified as having HUA, with an overall prevalence of 30.42% and not significantly different gender-specific prevalence of 31.96% for the males and 29.15% for the females (P > 0.05). The results of unconditional multivariate logistic regression analysis indicated that hyperlipidemia, chronic kidney disease, overweight, and obesity were risk factors for HUA but suffering from diabetes, medication with angiotensin receptor blockers (ARBs) or with calcium channel blockers (CCBs) were protective factors against HUA for all the participants; while for the male participants, hyperlipidemia, chronic kidney disease, overweight, obesity were risk factors and suffering from diabetes was a protective factor; for the female participants, aged 80 years and above, hyperlipidemia, chronic kidney disease, overweight, obesity were risk factors but medication with ARBs or with CCBs were protective factors. Conclusion The prevalence of HUA was relatively high in hypertensive patients at community health service centers in suburb of Shanghai. The result suggests that uric acid should be monitored among the hypertensive patients with chronic kidney disease, hyperlipidemia, overweight or obesity and antihypertensive drugs should be selected carefully for hypertensive patients complicated with HUA.
2023,
39(9):
1130-1134.
doi: 10.11847/zgggws1140949
Abstract:
Objective To investigate the relationship between sleep duration and blood pressure control among community adult hypertension patients for providing evidence to blood pressure control in the population. Methods The participants of the study were 15 686 hypertension patients identified from 61 098 adult residents (aged ≥ 18 years) recruited with stratified multi-stage cluster sampling for the Nanjing Chronic Disease and Risk Factor Surveillance in communities of 5 districts of Nanjing city. Face-to-face interview with a self-designed questionnaire and International Physical Activity Questionnaire (IPAQ), physical examination and laboratory tests were conducted among all the residents during January 2017 – June 2018. Multiple logistic regression model was used to analyze the association of sleep duration with blood pressure control of the hypertension patients. Results Of all the hypertension patients, 45.1% (7 082) were assessed as having effective blood pressure control (systolic blood pressure <140 mm Hg and/or diastolic pressure <90 mm Hg) and the proportions of effective blood pressure control were 43.8%, 45.6%, 47.2%, 43.7%, and 40.2% for the patients reporting the night sleep duration of < 6.0 , 6.0 – 6.9 , 7.0 – 7.9 , 8.0 – 8.9, and ≥ 9.0 hours per day (h/d), respectively, with a significant difference (χ2 = 23.354, P < 0.001). After adjusting for gender, age, residential area, education, smoking, alcohol consumption, physical activity, body mass index, diabetes, dyslipidemia, and anti-hypertensive medication, the results of multivariate logistic regression analysis for all hypertension patients revealed that compared to the patients with the sleep duration of 7.0 – 7.9 h/d, those with a shorter or longer sleep duration were less likely to have an effective blood pressure control (for sleep duration of < 6 h/d: odds ratio [OR] = 0.88, 95% confidence interval [95%CI]: 0.77 – 0.99; for sleep duration of ≥ 9 h/d: OR = 0.75, 95%CI: 0.65 – 0.87); further analysis using the comparison groups with the sleep duration of 7.0 – 7.9 h/d also showed that some subgroups with a shorter or longer sleep duration were also less likely to have an effective blood pressure control: (1) the male patients with the sleep duration of < 6 h/d (OR = 0.74, 95%CI: 0.62 – 0.89), 8.0 – 8.9 h/d (OR = 0.86, 95%CI: 0.76 – 0.95) or ≥ 9 h/d (OR = 0.75, 95%CI: 0.65 – 0.87); (2) the female patients with sleep duration of ≥ 9 h/d (OR = 0.73 95%CI: 0.59 – 0.91); (3) the elderly patients (aged ≥ 60 years) with the sleep duration of < 6 h/d (OR = 0.80, 95%CI: 0.68 – 0.94) or ≥ 9 h/d (OR = 0.68, 95%CI: 0.56 – 0.83). Conclusion The study results suggest that night sleep duration is associated with effective blood pressure control among community adult hypertension patients, especially among those being male and those aged 60 years and above.
2023,
39(9):
1135-1140.
doi: 10.11847/zgggws1140715
Abstract:
Objective To examine the impact of extreme apparent temperature (AT) on daily emergency visits for hypertension in Shenzhen city, Guangdong province for providing evidence to revision of public health policies relevant to hypertension management and ambulances allocation. Methods The data on daily emergency visits for hypertension from January 2013 to December 2020 were collected from the Shenzhen First-Aid Service Platform and daily meteorological data of Shenzhen city over the same period were collected simultaneously for the estimation of daily average AT. Distributed lag nonlinear model (DLNM) was used to analyze the lag day and lag period effects of extreme AT on daily emergency visits for hypertension. Relative risk (RR) and population attributable risk percent (PARP%) were adopted in estimating the effects. Results During the 8-year period in the city, totally 14 491 outpatient emergency visits for hypertension occurred based on the records of the platform; the daily number of visits ranged from 1 to 28 and the average number of daily visits was 9.28 ± 0.90. During the same period for the city, the lowest daily average AT was – 4 ℃ and the highest was 39.4 ℃, with an average AT of 25.62 ± 7.95 ℃. A nonlinear effect of extreme AT on daily emergency visits for hypertension was observed; the number of the daily visits decreased with daily average AT but increased with daily average AT when the daily average AT being 30 ℃ and above. The results of DNLM analysis showed that in comparison to appropriate AT (30 ℃), both extreme low AT (9 ℃) and extreme high AT (36 ℃) were associated with an increased risk of daily emergency visit for hypertension during the lag period of 0 – 21 day, with the relative risk (RR) (95% confidence interval [95%CI]) of 1.783 (1.303 – 2.433) and 1.315 (0.994 – 1.747); the lag effect of the extreme low AT was much stronger on the daily emergency visits of male hypertension patients and those aged under 65 years, with the RR (95%CI) of 1.721 (1.050 – 2.811) and 1.872 (1.184 – 2.982), respectively. The PARP of extreme low AT-related daily emergency visits for hypertension was 13.64% generally for the study period. Conclusion The extreme AT is of significant impact on daily emergency visit of hypertension patients in Shenzhen city, especially for the male patients and the patients aged under 65 years.
2023,
39(9):
1141-1146.
doi: 10.11847/zgggws1139640
Abstract:
Objective To compare the prevalence of asthma and the impact of socioeconomic position (SEP) on economic burden of asthma among rural residents in Yunnan province in 2011 and 2021, and to provide evidence for the prevention and treatment of asthma in the population. Methods Using stratified multistage random sampling, we conducted face-to-face surveys during 2011 and 2021 among 8 187 and 7 572 rural residents aged ≥ 35 years in Yunnan province. A self-designed questionnaire was used to collect information on demographics, SEP, asthma clinically diagnosed at township and upper level hospitals, and asthma-related economic burden for analyses on asthma prevalence and the influence of SEP on asthma-induced economic burden among the participants. Results Among the rural adults surveyed in 2011 and 2021, totally 111 and 122 asthma cases were identified, with the asthma prevalence rate of 1.36% and 1.61% and without significant difference between the two prevalence rates. Compared to those reported by the adults with asthma incidence in 2011, significantly higher per capita asthma-related direct cost (4 230.11 vs. 2 776.85 Chinese Yuan), indirect cost (69.57 vs. 49.86), and total cost (4 299.68 vs. 2826.71) were reported by the adults with asthma incidence in 2021 (all P < 0.05). Contrasting to that in 2011, the per capita asthma-related total cost increased significantly in 2021 for the asthma sufferers of various SEP groups (P < 0.05 for all) and the total cost increment varied in a descending order for the asthma sufferers with high, low, lower-middle, and upper-middle SEP. Conclusion Among the rural adult residents in Yunnan province, the prevalence of asthma was not significantly different but the economic burden of asthma sufferers increased substantially between 2011 and 2022 and the sufferers' economic burden varied with their socioeconomic position.
2023,
39(9):
1147-1151.
doi: 10.11847/zgggws1140880
Abstract:
Objective To explore the prevalence of chronic obstructive pulmonary disease (COPD), knowledge about antibiotics and their influences on self-medication with antibiotics (SMA) among middle-aged and elderly adults in communities of Songjiang district, Shanghai city. Methods The participants of the survey were 3 500 residents aged 40 years and over recruited using random sampling at four communities in Songjiang district of Shanghai city. Face-to-face interview with a self-designed questionnaire and Pittsburgh Sleep Quality Index (PSQI), physical examination and spirometry test were conducted among the participants during June – December 2021. Unconditional multivariate logistic regression model was adopted to analyze the influences of COPD, knowledge and awareness about antibiotics on SMA. Results Of the 3 184 participants ultimately included in the analysis, 259 (8.1%) were identified as having COPD. The number (proportion) of the participants with the antibiotic awareness score of 0, 1, 2, and 3 – 4 (indicating complete awareness) were 969 (30.4%), 461 (14.5%), 1462 (45.9%), and 292 (9.2%), respectively. The number (proportion) of the participants reporting SMA was 537 (16.9%). The results of unconditional multivariate logistic regression analysis showed that compared to the participants without COPD, the COPD sufferers aged under 60 years had a significantly increased risk of SMA (odds ratio [OR] = 3.31, 95% confidence interval [95% CI]: 1.11 – 9.90) after adjusting for sex, education level, marital status, place of residence, smoking, exercise, sleeping status, digestive system disease, other respiratory system diseases, cough and sputum symptoms, shortness of breath symptoms, and body mass index; but the increased risk was not significant for the COPD sufferers aged ≥ 60 years (OR = 1.09, 95% CI: 0.74 – 1.60); the results also revealed that in comparison to those with the antibiotic knowledge and awareness score of 0, the participants with the knowledge and awareness scores of 1, 2, and 3 – 4 were less likely to conduct SMA, with the ORs (95% CI) of 0.26 (0.18 – 0.36), 0.17 (0.13 – 0.22), and 0.17 (0.10 to 0.26) after adjusting for age and the confounding factors mentioned above. Conclusion The prevalence of SMA was high and the prevalence might be associated positively with suffering with COPD and reversely with the awareness about antibiotics among middle-aged and elderly community adults in Songjiang district, Shanghai.
2023,
39(9):
1152-1158.
doi: 10.11847/zgggws1140023
Abstract:
Objective To estimate the incidence of all-cause otitis media (OM) in children under 5 years old (under-5) in Suzhou city, Jiangsu province. Methods From the Health Information System (HIS) of Soochow University Affiliated Children′s Hospital (SCH), we extracted outpatient visit and hospitalization records of local under-5 children (born from 2017 to the end of 2020) during the period from January 2017 through June 2021 for a retrospective cohort analysis. The children with the diagnosis of all-cause otitis media were followed up for the estimation of overall and age specific all-cause otitis media incidence among the children. Results Among the 507 678 children followed-up during the 4-year period, 9 378 otitis media incidents of 7 903 children were identified, including 8 979 outpatient incidents and 399 hospitalizations. The overall incidence rate of otitis media was 6.37/1 000 person-years and the incidence rate was 6.10/1 000 person-years for outpatient children and 0.27/1 000 person-years for inpatient children, respectively. The incidence rate of otitis media was higher among the children aged 3 – 4.5 years and the highest incidence rate of 24.59/1 000 person-years was observed in the children aged 4 – 4.5 years. Higher otitis media incidence rate of 21.45/1 000 person-years was also observed for the children with allergic rhinitis and recurrent acute upper respiratory infections. Conclusion The incidence rate of all-cause otitis media was low and influenced by age and other diseases among under-5 children in Suzhou city.
2023,
39(9):
1159-1164.
doi: 10.11847/zgggws1139954
Abstract:
Objective To examine time-dependent variations in serum antibodies of severe acute respiratory disease coronavirus 2 (SARS-CoV-2) among confirmed coronavirus disease 2019 (COVID-19) cases at different stages and inactivated COVID-19 vaccine recipients after inoculation. Methods The study was conducted in a city of Henan province. Totally 86 serum samples were collected from 43 confirmed COVID-19 cases at acute stage (1th – 23rd day of onset) and recovery state (25th – 58th day of onset) during January 2020 – October 2021; other 184 serum samples from 46 healthy recipients of inactivated COVID-19 vaccine at 4/8/12/31 weeks after inoculations and 50 serum samples from 50 residents without confirmed SARS-CoV-2 infections were also collected during March – October 2021. Anti-SARS-CoV-2 immunoglobulin A/G/M (IgA/G/M) were detected with magnetic particle chemiluminescence method and enzyme-linked immunosorbent assay for all the serum samples. The levels of the serum antibodies among the three groups′ participants were analyzed statistically. Results Among the confirmed COVID-19 cases, the positivity rates of anti-SARS-CoV-2 IgA, IgM and IgG of the serum samples collected at recovery stage were significantly higher than those at acute stage (all P < 0.05) ; while, the concentrations of anti-SARS-CoV-2 IgM and IgG of the serum samples collected at recovery stage were significantly higher than those at acute stage (both P < 0.05). Among the healthy COVID-19 vaccine recipients 31 weeks after the inoculations, the positivity rate was 63.04% (29/46) for anti-SARS-CoV-2 IgG and 36.96% (17/46) for anti-SARS-CoV-2 IgA, but all samples were negative for anti-SARS-CoV-2 IgM. No significant differences were observed in the absorbance ratios anti-SARS-CoV-2 IgA among the samples collected 4, 8, 12, and 31weeks after the inoculation (F = 2.365, P = 0.073), but there were significant differences in the concentrations of anti-SARS-CoV-2 IgM and IgG (both P < 0.05) among the samples. Both the positivity rate of anti-SARS-CoV-2 IgA and IgM and the concentrations of anti-SARS-CoV-2 IgG and IgM were significantly higher among the confirmed COVID-19 cases than those among the inactivated COVID-19 vaccine recipients during a comparable period of time (P < 0.05 for all). Conclusion The positivity rate of serum anti-SARS-CoV-2 IgG is the highest during early stage and recovery stage among COVID-19 cases. The positivity of serum anti-SARS-CoV-2 IgA and IgG occur earlier than that of IgM and could maintain till 31 weeks after the inoculation among inactivated COVID-19 vaccine recipients. The concentration of serum anti-SARS-CoV-2 IgG and IgM are higher among COVID-19 cases than those among inactivated COVID-19 vaccine recipients during a comparable period of time.
2023,
39(9):
1165-1170.
doi: 10.11847/zgggws1141819
Abstract:
Objective To investigate the protective effect and mechanism of fucoidan on intestinal mucosal barrier function in hyperuricemic mice. Methods Forty specific pathogen-free (SPF) C57BL/6J mice were randomly assigned into a control, hyperuricemia model, fucoidan treatment (by gavage administration at the dosage of 200 mg/kg/day continuously for 10 weeks) , and allopurinol positive control group (10 in each group). By the end of the treatments for the mice of the four groups, serum uric acid (UA) was measured with colorimetric method; serum lipopolysaccharides (LPS), diamine oxidase (DAO), tumor necrosis factor (TNF-α) and interleukin-1β (IL-1β) were measured with enzyme-linked immunosorbent assay (ELISA). Histopathological changes in ileum mucosa were observed with hematoxylin-eosin (HE) staining; the expressions of tight junction proteins in ileum mucosa and autophagy-related proteins in small intestine were determined with Western blot. Results Significant decreases in serum UA (52.45%), TNF-α (29.18%), IL-1β (25.36%), LPS (27.24%), and DAO (21.78%) were detected in the hyperuricemic mice with fucoidan treatment ( P < 0.05 for all ); in addition, the fucoidan-treated hyperuricemic mice had significantly improved intestinal cell junctions and permeability, increased expressions of zonula occludens-1 (ZO-l), occludin and autophagy-related proteins (all P < 0.05). Compared to those in model mice, significantly increased ratio of autophagy-related proteins light chain 3B II/I (LC3BII/I), beclin-1, and phosphorylated p38 mitogen-activated protein kinase (p-p38 MAPK) but significantly decreased phosphorylated mammalian target of rapamycin (p-mTOR) were observed in the hyperuricemic mice with fucoidan treatment. Conclusion Oral administration of fucoidan could effectively reduce serum uric acid and improve intestinal mucosal barrier damage by increasing autophagy via p38 MAPK/mTOR pathway in hyperuricemic mice.
2023,
39(9):
1171-1179.
doi: 10.11847/zgggws1141631
Abstract:
Objective To investigate potential inflammatory effect of polystyrene microplastics (PS-MPs) in small intestine of mice and its molecular mechanisms. Methods Thirty-five male BABL/c mice were randomly assigned into five groups and gavaged daily with H2O and PS-MPs of 50 nm, 500 nm, 5 μm, 50 μm in diameter at the dosage of 1mg/day continuously for 42 days. Body weight of the mice were measured during the administration and pathological changes in ileum of the mice were observed using hematoxylin and eosin (HE) staining at the end of the treatments. Murine intestinal epithelial MODE-K cells were cultured with fluorescent PS-MPs of 50 nm, 5 μm, 50 μm in diameter at concentration of 10 μg/ml. The internalization of the PS-MPs in the cultured MODE-K cells was examined with flow cetometry after the treatments of 10 mins, 30 mins, 1 h, 2 hs, and 4 hs and the viability of the MODE-K cells treated with PS-MPs at various concentrations was assessed with 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. The expressions of cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) pathway-related mRNAs and proteins in the in small intestine tissues and the MODE-K cells after PS-MPs treatment were determined with real-time PCR and Western blot test. Results Pathological changes of different severity were observed in small intestinal tissues of the mice exposed to PS-MPs. PS-MPs of 50 nm was internalized more rapidly and efficiently into the cytoplasm of MODE-K cells than 5 μm and 50 μm PS-MPs, and the PS-MPs significantly affected the viability of the MODE-K cells. Compared with those of the control mice, significant upregulations of the mRNAs of pro-inflammatory cytokines IL-6 (increased by 589%), IL-10 (573%), IL-22 (475%) and TNF-β (177%) were detected in small intestinal tissues of the mice treated with 50 nm PS-MP (P < 0.01 for all); meanwhile, protein expressions of IL-1β, IL-6 and IL-10 also increased significantly in the tissues of the mice (P < 0.05 for all). In MODE-K cells treated with PS-MPs of 50 nm at high dosage (20μg/mL), the expressions of IL-6, IL-10, IL-22, TNF-α, and TNF-β were significantly higher than those in the control cells, with the increases of 74%, 85%, 83%, 75% and 69%, respectively (P < 0.05 for all). Then, compared with those of the control mice, the mRNA expressions of cGAS and STING increased by 485% and 136% in small intestinal tissues of mice treated with PS-MPs of 50 nm ( both P < 0.05), and the protein expressions of STING and p-NF-κB also increased by 61% and 54%, respectively (both P < 0.05). In addition, the protein expressions of STING and p-NF-κB increased by 96% and 178% in the MODE-K cells treated with high-dose (20 μg/mL) 50 nm PS-MPs, respectively. Conclusion PS-MPs exposure could trigger small intestinal inflammation in mouse and exposure to PS-MPs of 50 nm in diameter could activate cGAS-STING signaling pathway through cellular internalization and then act on related downstream inflammatory factors, finally contributing to chronic inflammation in small intestine.
2023,
39(9):
1180-1184.
doi: 10.11847/zgggws1141479
Abstract:
Objective To establish a set of indicators for assessing the public health emergency response capacity at county/district level in China. Methods An indicator system for evaluating public health emergency response capacity at county/district level was initially formulated based on theoretical research and literature review. Three rounds of Delphi consultation were conducted among 18 senior professionals to determine the indicators and their weights of the system using hierarchical analysis method. Results For the 3 rounds of expert consultation, the positive coefficients of the were 100.0%, 88.9%, and 88.9%; the expert authority coefficients were 0.87, 0.84, and 0.87; and the coordination coefficients of expert opinions were 0.207, 0.210, and 0.295 (all P < 0.001), indicating a good coordination of the experts′ opinions. The finally established indicator system for assessing public health emergency response capacity at county/district level included 5 first-, 19 second-, and 61 third-level indicators. For the third round of Delphi consultation, the experts′ mean scores and ranges of coefficients of variance for importance/feasibility of all the indicators were 4.83 ± 0.13/4.48 ± 0.21 and 0.00 – 0.18/0.07 – 0.22, respectively. The weights for the first-, second-, and third-level indicators ranged from 0.094 to 0.290, 0.011 to 0.119, and 0.001 to 0.087, respectively. Conclusion The established indicator system could be used to develop tools for evaluating public health emergency response capacities at county/district level, while the reliability and validity of the indicator system need to be assessed further.
2023,
39(9):
1185-1190.
doi: 10.11847/zgggws1141646
Abstract:
Objective To examine the implementation of diabetes health management project and its influence on knowledge awareness, health behavior, medication, and blood glucose control among the diabetes patients with the standardized management for the improvement of the project. Methods Using multistage random sampling, we recruited 3 995 diabetes patients aged 35 years and over and being followed-up in the Survey for Assessment on Chronic Disease Patients Management in the National Primary Public Health Services in 8 provincial level administrative divisions. A questionnaire survey and peripheral blood glucose test were conducted among the participants during August – October 2018. Binary logistic regression model was used to analyze the impact of standardized management on diabetes patients′ knowledge awareness, health behavior, medication and blood glucose control. Results Of the 3 938 participants with complete information, 71.28%, 88.69%, 51.98% reported having standardized management (receiving 4 times and more health care follow-ups per year), medication for diabetes, and effective blood glucose control (fasting and postprandial blood glucose < 7.0 and < 10.0 mmol/L), respectively. Compared with those without standardized management, the participants with the management reported significantly higher ratios of relevant knowledge awareness (56.11% vs. 41.54%), better dietary diversity score (48.79% vs.43.26%), and effective blood glucose control (53.16% vs. 47.96%) (all P < 0.05) but significantly lower ratios of current smoking (10.17% vs. 12.49%) and alcohol consumption during past one year (13.34% vs. 18.78%) (both P < 0.05 ). Binary logistic regression analysis showed that the standardized management on diabetes patients was significantly correlated positively with the patients′ better knowledge awareness and better dietary diversity, and negatively with the patients′ current smoking and alcohol drinking (all P < 0.05). Conclusion The standardized management on diabetes patients was positively related to the patients′ better knowledge awareness and dietary diversity but negatively related to the patients′ current smoking and alcohol drinking, suggesting that the management achieved good primary outcomes in China.
2023,
39(9):
1191-1196.
doi: 10.11847/zgggws1140926
Abstract:
Objective To examine the financial toxicity (FT) of cancer care among cancer patients covered by urban customized supplementary medical insurance (customized insurance) and its influencing factors for providing evidence to the optimization of customized insurance and the development of FT-related intervention measures. Methods Using random sampling and a self-designed questionnaire, we conducted telephone interviews among 600 registered cancer patients with customized insurance and ever attending local public hospitals for medication after December 2020 during July – August 2021 in a city. The Comprehensive Scores for Financial Toxicity (COST) scale was adopted to assess FT of cancer treatment. The influencing factors of FT were analyzed with stepwise multivariate linear regression model. Results For the 560 participants finally included in the analysis, the COST score was 17.90 ± 8.01 and the number (proportion) of the participants with the scores indicating mild, moderate, and severe FT were 89 (15.89%), 307 (54.82%), and 164 (29.29%), respectively. The results of regression analysis showed that the participants with following characteristics were more likely to have a lower COST score indicating severe FT: with agricultural residence registration, aged 45 – 59 years, having an out-of-pocket medication expenditure of 10 000 Chinese Yuan (CNY) and more in the past year, ever borrowing money for cancer treatment in the past year, and abandoning treatment due to financial difficulties in the past year; while, the participants with other commercial health insurance in addition to customized insurance, having a total household income of 100 000 CNY and more in the past year, having a total household consumption expenditure of 100 000 CNY and more in the past year, and having been hospitalized 1 – 4 times for cancer treatment in the past year were more likely to have a higher COST score indicating mild FT. Conclusion FT of cancer is common among cancer patients covered by customized insurance in a Chinese city and the prevalence of FT is impacted by sociodemographic factors and family financial factors, suggesting that effective intervention on FT needs to be carried out in various ways.
2023,
39(9):
1197-1200.
doi: 10.11847/zgggws1141219
Abstract:
Objective To examine the awareness of and responding to a nationwide road traffic safety campaign named “One Helmet, One Seatbelt” among motor vihicle riders/passengers in China. Methods An online questionnaire survey was conducted among e-bike or motorcycle riders/passengers and automobile drivers/passengers recruited with snowball sampling in 18 provinces, 5 autonomous regions, and 3 municipalities across China between July and August 2021 – one year after the initiation of the program. We analyzed the awareness of the campaign and the increase of helmet-wearing and seatbelt usage after the campaign among the participants. Results Eligible responses were collected from a total of 564 participants including 314 (55.68% of the participants) e-bike/motorcycle riders, 17 (3.01%) e-bike/motorcycle passengers, 137 (24.29%) automobile drivers, and 96 (17.02%) automobile passengers. Of the 451 e-bike/motorcycle riders and automobile drivers, 91.13% (411) reported the awareness of the road traffic safety campaign and there was no significant difference in the awareness rate between the e-bike/motorcycle riders and automobile drivers (92.04% vs. 89.05%, χ2 = 1.053; P > 0.05). Among the 331 e-bike/motorcycle riders/passengers, 245 (74.02%) reported increased helmet-wearing after the implementation of the campaign and significantly more e-bike/motorcycle riders reporting increased helmet-wearing compared to e-bike/motorcycle passengers (76.11% vs. 35.29%, χ2 = 13.973; P < 0.001). Of the automobile drivers/passengers, 43.78% reported increased seatbelt usage after the campaign and the proportion of reporting increased seatbelt usage was not significantly different between the drivers and the passengers (43.07% vs. 44.79%, χ2 = 0.068; P > 0.05). Conclusion The awareness rate of the nationwide “One Helmet, One Seatbelt” road traffic safety campaign was high among e-bike/motorcycle riders and automobile drivers; meanwhile, helmet-wearing increased in e-bike/motorcycle riders/passengers and seatbelt usage increased in automobile drivers/passengers one year after the initiation of the campaign.
2023,
39(9):
1201-1206.
doi: 10.11847/zgggws1138076
Abstract:
Objective To examine annual number of first registered human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) cases aged ≥ 50 years and its changing trend in Hubei province during 2011 – 2020 for providing evidence to the development of targeted strategies on HIV/AIDS epidemic prevention. Methods The data on 9 224 HIV/AIDS cases aged ≥ 50 years first registered in Hubei province during 2011 – 2020 were extracted from the Information System for AIDS Prevention and Control of China′s Disease Prevention and Control Information System and analyzed using descriptive statistics. The changing trend of annual number of the HIV/AIDS cases was analyzed with joinpoint regression model. Results The 9 224 cases aged ≥ 50 years accounted for 35.04% of all the HIV/AIDS cases (n = 26 324) first registered in the province during the 10-year period. The annual number of the cases ≥ 50 years showed a significant increasing trend in the period (Z = 21.01, P < 0.001). The results of joinpoint regression analysis revealed gender- and infection route-different changing trajectories for the annual number of first registered cases aged ≥ 50 years during the period: (1) increasing from 2011 to 2017 for all the male and the female cases, with the annual percentage change (APC) of 24.68 and 23.91; (2) decreasing from 2017 to 2020 for the male cases (APC = – 1.93); (3) increasing slowly from 2017 to 2022 for the female cases (APC = 2.25); (4) increasing rapidly from 2011 to 2016 (APC = 29.31) but slowly from 2016 to 2020 (APC = 2.76) for the male cases sexually infected; (5) increasing from 2011 to 2017 (APC = 26.12) but decreasing from 2017 to 2022 (APC = – 6.34) for the male cases infected homosexually; (6) increasing obviously from 2011 to 2016 (APC = 28.77) and the increase slowing down from 2016 to 2022 (APC = 3.73) for the male cases infected heterosexually; (7) increasing from 2011 to 2017 (APC = 26.01) and the increase slowing down from 2017 to 2020 (APC = 1.47) for the female cases with sexually transmitted infection; and (8) decreasing from 2011 to 2020 for the cases with non sexually transmitted infection or unknown transmission routes (APC = – 25.66). Conclusion The annual number of first registered HIV/AIDS cases aged ≥ 50 years increased from 2011 to 2020 in Hubei province and the majority of the cases were infected due to heterosexual transmission. The results suggest that targeted interventions should be developed for the prevention and control of HIV/AIDS epidemic in the elderly population.
2023,
39(9):
1207-1211.
doi: 10.11847/zgggws1141655
Abstract:
The phenomenon of "information islands" in medical studies is becoming increasingly prevalent since healthcare information resources are generally characterized by multiple sources, multiple types, and non - standardization. The data from large cohort studies in China have complex sources and multiple types and it is difficult for the data from different cohorts to be integrated, shared and utilized. For promoting the standardized integration of healthcare resource data in China, we conduct an in - depth literature analysis on the research on common medical data models (CDM) at home and abroad and patterns of CDM establishment for cross - cohort studies. The study also proposes some recommendations regarding the problems of medical data integration and sharing in the context of precision medicine in China for effective integration, consolidation, sharing, and utilization of cross - cohorts data.
The phenomenon of "information islands" in medical studies is becoming increasingly prevalent since healthcare information resources are generally characterized by multiple sources, multiple types, and non - standardization. The data from large cohort studies in China have complex sources and multiple types and it is difficult for the data from different cohorts to be integrated, shared and utilized. For promoting the standardized integration of healthcare resource data in China, we conduct an in - depth literature analysis on the research on common medical data models (CDM) at home and abroad and patterns of CDM establishment for cross - cohort studies. The study also proposes some recommendations regarding the problems of medical data integration and sharing in the context of precision medicine in China for effective integration, consolidation, sharing, and utilization of cross - cohorts data.
2023,
39(9):
1212-1216.
doi: 10.11847/zgggws1141818
Abstract:
Population medicine is a medical discipline that uses and integrates the knowledge, technology, art and academic of contemporary medicine and related disciplines as the basis of public health practice to maximize the overall and long - term health benefits of the population. The construction of population medicine talent teams is in line with the strategy of reinvigorating China through human resource development, and the practice of population medicine tends to be consistent with the construction of Healthy China. In this paper, we discussed the necessity and reality of the construction of talent teams in population medicine and putted forward some considerations on the construction of talent teams in China by summarizing and drawing lessons from the relevant experience and practice of foreign countries in medical talent training.
Population medicine is a medical discipline that uses and integrates the knowledge, technology, art and academic of contemporary medicine and related disciplines as the basis of public health practice to maximize the overall and long - term health benefits of the population. The construction of population medicine talent teams is in line with the strategy of reinvigorating China through human resource development, and the practice of population medicine tends to be consistent with the construction of Healthy China. In this paper, we discussed the necessity and reality of the construction of talent teams in population medicine and putted forward some considerations on the construction of talent teams in China by summarizing and drawing lessons from the relevant experience and practice of foreign countries in medical talent training.
2023,
39(9):
1217-1220.
doi: 10.11847/zgggws1141632
Abstract:
Information technology is one of effective means to promote school health implementation. However, the existing school health information systems are fragmented, isolated, and lack of integration and suffer from serious information barrier. Additionally, some of the existing systems have incomplete functions, low level of intelligence, and slow update and iteration, witch seriously restricting the development of school health informatization. To break through the information barrier and promote the development of school health informationization, as well as to provide scientific means to improve the level of school health management and student health, it is imperative to build a smart and integrated school health management system platform. In this article, we briefly presented construction goal, technical framework, application, and utilization effects of the Shenzhen Intelligent Campus School Health Management System.
Information technology is one of effective means to promote school health implementation. However, the existing school health information systems are fragmented, isolated, and lack of integration and suffer from serious information barrier. Additionally, some of the existing systems have incomplete functions, low level of intelligence, and slow update and iteration, witch seriously restricting the development of school health informatization. To break through the information barrier and promote the development of school health informationization, as well as to provide scientific means to improve the level of school health management and student health, it is imperative to build a smart and integrated school health management system platform. In this article, we briefly presented construction goal, technical framework, application, and utilization effects of the Shenzhen Intelligent Campus School Health Management System.
2023,
39(9):
1221-1224.
doi: 10.11847/zgggws1138879
Abstract:
We established a government cloud platform-based epidemiological survey information management system to improve the capability of response to public health emergencies in Liaoning province. By using big data, cloud computing, image recognition, speech recognition, fifth generation (5G), geographic information systems (GIS) and other technologies, the system takes the advantages of government cloud platform including strong computing power, safe and reliable data exchange, flexible server deployment, and efficient data collection. The system could be used to construct multi-dimensional transmission model of epidemics, to conduct big data analysis, to link the data collected at provincial/municipal and district levels, to assist real-time cross-provincial collaborative investigation, and to carry out closed-loop management on the information of joint prevention and control of epidemic. The established system came into operation in August 2021 in Liaoning province and played an important role in regional epidemic control and prevention.
We established a government cloud platform-based epidemiological survey information management system to improve the capability of response to public health emergencies in Liaoning province. By using big data, cloud computing, image recognition, speech recognition, fifth generation (5G), geographic information systems (GIS) and other technologies, the system takes the advantages of government cloud platform including strong computing power, safe and reliable data exchange, flexible server deployment, and efficient data collection. The system could be used to construct multi-dimensional transmission model of epidemics, to conduct big data analysis, to link the data collected at provincial/municipal and district levels, to assist real-time cross-provincial collaborative investigation, and to carry out closed-loop management on the information of joint prevention and control of epidemic. The established system came into operation in August 2021 in Liaoning province and played an important role in regional epidemic control and prevention.
