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Changes in online medicine purchases before and after the COVID-19 pandemic among urban young and middle-aged adults
CHENG Zhe-yu, SUN Wen-jun, ZHAO Zi-yin,
, Available online  , doi: 10.11847/zgggws1140533
Abstract:
  Objective  To examine the changes in online medicine purchases before and after the coronavirus disease 2019 (COVID-19) pandemic and its correlates among urban young and middle-aged adults.   Methods  Based on Wenjuanxing online survey platform, adults aged ≥ 18 years were randomly recruited for a electronic questionnaire survey during October 21 – 28, 2021. The collected information on 748 urban adults aged 18 – 59 years and ever purchasing medicine during the past year were finally included in the analysis. Multinomial logistic regression was adopted to examine the correlates of the changes in online medicine purchases.   Results  In the total sample, Of all the respondents, 178 (23.80%) reported no online medicine purchases before and after the COVID-19 pandemic; 477 (63.77%) reported ever purchasing medicine online before and after the pandemic; and 71 (9.49%) had purchased medicine online only after the pandemic. The results of regression analysis showed that, compared with those not ever purchasing medicine online before and after the COVID-19 pandemic, the respondents with the education of bachelor degree or above were more likely to purchase medicine online after the COVID-19 pandemic (relative risk ratio [RRR] = 3.64, 95% confidence interval [95% CI]: 1.37 – 9.68); the respondents purchasing medicine at medical facilities after the epidemic were less likely to purchase medicine online after the epidemic (RRR = 0.41, 95% CI = 0.22 – 0.75); the respondents with the education of bachelor degree or above and having chronic diseases were more likely to purchase medicine online both before and after the COVID-19 pandemic, with RRR (95% CI) of 2.06 (1.25 – 3.39) and 2.54 (1.65 – 3.92); the respondents living in central and western regions were less likely to purchase medicine online before and after the COVID-19 pandemic (RRR = 0.53, 95% CI: 0.33 – 0.84 and RRR = 0.58, 95% CI: 0.36 – 0.93).   Conclusion  Under the context of normalized COVID-19 pandemic control, online medicine purchases increased among urban young and middle-aged adults, especially among those with higher education, suffering from chronic disease, and not purchasing medicine at medical facilities.
Post-specific difference in mental health among medical staff in Beijing during COVID-19 epidemic: an online survey
LIU Yin-qi, WANG Zhe, ZHANG Chun-jie,
, Available online  , doi: 10.11847/zgggws1139423
Abstract:
  Objective  To analyze the difference in mental health status among medical staff working at different posts in Beijing city during coronavirus disease 2019 (COVID-19) epidemic.   Methods  An online questionnaire survey was conducted among 5 230 medical staff recruited with random cluster sampling at 22 public hospitals in Beijing city during October-November 2020. Psychological status of the stuff working at different posts during the COVID-19 epidemic was assessed with Patient Health Questionnaire (PHQ-9), 7-Item Generalized Anxiety Disorder Scale (GAD-7) and Insomnia Severity Index (ISI).Descriptive analysis and one-way analysis of variance were adopted in data analyses.   Results  Of the 4 931 staff with valid responses, 1 603 (32.51%) were assessed as having anxiety, 1 729 (35.06%) having depressive symptoms, 933 (18.92%) having insomnia during the epidemic period. The detection rate of anxiety, depression and insomnia differed significantly among the staff working at second-/front-line posts in their hospitals formerly belonged to and the staff dispatched to other medical institutions for anti-epidemic work (P < 0.05). The results of logistic regression analysis showed that the type of working post and age were influencing factors of anxiety and depression; while the type of working post, age and education were the influencing factors of insomnia.   Conclusion  The mental health status varied among medical staff working at different posts in Beijing city during COVID-19 epidemic and poor mental health could be detected most frequently among the staff working at front-line posts in their original hospitals.
Prevalence and influencing factors of pandemic fatigue during normalized COVID-19 containment among the public in China: an online cross cross-sectional sectional survey
LIU Yan-ni, HAO Yan-hua, WANG Zi-yu,
, Available online  , doi: 10.11847/zgggws1141011
Abstract(78) HTML (13) PDF 587KB(31)
Abstract:
  Objective  To investigate the prevalence of pandemic fatigue and its associates during the period of normalized containment of coronavirus diease 2019 (COVID-19) among the public in China.   Methods  Through an online survey platform ‘Wenjuanxing’ and with self-designed questionnaires on demographics, COVID-19-related risk perception, protective behaviors, negative emotion, and pandemic fatigue, we conducted a self-administered survey during February – March 2021 among web users aged 18 years and above in five provincial level administrative divisions across China. The collected data were analyzed with descriptive statistics, chi-square test and logistic regression analysis.   Results   Of 4 325 participants with eligible responses, 1 082 (25.0%) reported pandemic fatigue symptoms; 1 844 (42.6%) reported only having psychosomatic fatigue and 1 050 (24.3%) only having information fatigue. The results of logistic regression analysis revealed that the participants with following characteristics were more likely to have pandemic fatigue symptoms: with poor health status(odds ratio [OR] = 1.838, 95% confidence interval [ 95% CI]: 1.575 – 2.144), having a higher perceived susceptibility to COVID-19 (OR = 1.435, 95% CI: 1.236 – 1.667), having a lower perceived controllability of COVID-19 (OR = 1.760, 95% CI: 1.495 – 2.070), and with highly negative emotion (OR = 3.493, 95% CI: 2.987 – 4.086).   Conclusion   Pandemic fatigue symptoms were prevalent during the period of COVID-19 containment and the symptoms were associated with self-reported health status, perceived controllability and susceptibility of COVID-19, and negative emotion among adult web users in China.
Differential protein expressions in liver of mice exposed to light at night: a proteomics analysis
WANG Yue-fan, ZHANG Rong, HU Shuang,
, Available online  , doi: 10.11847/zgggws1138847
Abstract:
  Objective  To screen and analyze differentially expressed proteins and their biological significance in the liver of mice exposed to light at night.   Methods  Totally 16 healthy male C57BL/6J mice were randomly divided into an experimental group (n = 8) exposed to light 24 hours a day continuously for 10 days and a control group (n = 8) with lighting 12 hours a day also for 10 consecutive days. Tandem mass tag (TMT) technology was applied to detect differentially expressed proteins in liver tissues of the mice. The differential protein expressions were analyzed using Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway analysis.   Results  A total of 383 differentially expressed proteins were identified, of which 215 were expressed at an up-regulated level and 168 proteins were expressed at a down-regulated level. GO enrichment analysis and KEGG signaling pathway analysis revealed that the differentially expressed proteins were mainly distributed in the cytoplasm, and their major molecular functions were protein binding, mainly involved in protein and lipid biological metabolic processes, and their pathways involved in signaling pathways of oxidative phosphorylation, tumor necrosis factor (TNF), and retinoic acid-inducible gene-I (RIG-I)-like receptor. Protein molecules such as mitochondrial cytochrome C oxidase subunit 3 (MT-CO3), mitochondrial Fo complex subunit F2 (ATP5J2), Itchy E3 ubiquitin protein ligase (ITCH), nuclear factor kappa B p65 subunit (NF-κB p65), and inhibitor of nuclear factor Kappa-B kinase subunit Beta (IKBKB) may play a key role.   Conclusion  In terms of differentially expressed proteins and their functions in liver tissue, light exposure at night may lead to obesity and cancer in mice.
Association of perinatal depression with behavioral problems of children at 4 years of age: a cohort study
SUN Song-lin, XIE Zhen-zhen, LI Jin-can,
, Available online  , doi: 10.11847/zgggws1139296
Abstract:
  Objective   To evaluate the association between perinatal depression at multiple time points and behavioral problems of children at 4 years old.   Methods   A total of 653 mother-child pairs were included in the study from the Shanghai-Minhang Birth Cohort Study established in 2012. Follow-up interviews were conducted among the mothers at third trimester, childbirth in hospitals and at 6 and 12 months postpartum, 4 years of age of child at homes. Center for Epidemiological Studies-Depression scale was used to assess the depression of the mothers. Behavioral problems of children at 4 years were assessed with the Child Behavior Checklist scale. Log-binomial regression model was adopted to examine the association between perinatal depression and children′s behavioral problems.   Results  The detection rates of depressive symptoms among the mothers were 19.71% (121/614), 10.45% (56/536), 8.65% (45/520), and 4.65% (23/495) at the second and third trimester, 6 and 12 months postpartum, respectively. After adjusting for covariates, maternal depression symptoms at the four time points were associated with the increased risk of children′s behavioral problems, and the effects of maternal depression symptom in the second trimester and 12 months postpartum were stronger. Maternal depression in the second trimester was associated with children′s emotional reaction, somatic, aggressive behavior, and internal behavior abnormalities, with relative risk (RR) (95% confidence interval, 95% CI) of 2.01 (1.04 – 3.89), 2.29 (1.20 – 4.34), 1.97 (1.11 – 3.50), and 1.67(1.09 – 2.55), respectively. Besides, maternal depression at 12 months postpartum increased the risk of children′s anxiety/depression (RR, 95% CI: 3.27, 1.36 – 7.89), attention problems (2.76, 1.19 – 6.40), withdrawn (2.77, 1.30 – 5.90), aggressive behavior (2.65, 1.24 – 5.66), internal behavior disorders (2.64, 1.48 – 4.71), and external behavior disorders (2.76, 1.42 – 5.34). Similar to the results mentioned above, the maternal depression occurring only during pregnancy or only after childbirth was also associated with behavioral problems of the children.  Conclusion   Perinatal depression at multiple time points is associated with the increased risk of behavioral problems of children at 4 years of age and the effects of maternal depression in the second trimester and 12 months postpartum are stronger. In addition, maternal depression during pregnancy and postpartum both play independent adverse role on children′s neurobehavioral development.
Influencing factors of willingness to promote human papillomavirus vaccination in Chinese male university students
DAI Zhen-wei, SI Ming-yu, , SU Xiao-you
, Available online  , doi: 10.11847/zgggws1139013
Abstract(44) HTML (14) PDF 556KB(18)
Abstract:
  Objective  To describe the awareness of human papillomavirus (HPV) among male university students in China, and to explore potential influencing factors of the students' intention to encourage others to have HPV vaccination.   Methods   Using convenient sampling and a self-designed questionnaire on demographics, health and sexual behavior, and knowledge and attitude about HPV, we conducted an online voluntary survey among 3 570 male undergraduates of 7 universities in 7 provincial-level administrative divisions across China during February 21 – April 30, 2021.   Results  Of all the participants, 3 213 reported the willingness of promoting HPV vaccination in their friends. The results of logistic regression analysis showed that the students with following characteristics were more likely to promote HPV vaccination in their friends: agreeing with that HPV vaccination could prevent some diseases effectively (odds ratio [OR] = 2.011, P<0.001), ever receiving a self-paid category II vaccine (OR = 1.652, P<0.001), ever participating in education programs about sexual health (OR = 1.619, P<0.001), with positive attitude towards premarital sex (OR = 1.366, P = 0.012), having high knowledge about HPV (OR = 1.498, P = 0.002), and with a perceived benefit of HPV vaccination (OR = 3.225, P<0.005).   Conclusion  The survey results suggest that relative departments could conduct interventions on the awareness and attitude about HPV vaccination among male university students to promote HPV vaccination in China.
Impact of exercise on vascular health in postmenopausal women
YANG Yu-ting, ZHANG Pei-zhen
, Available online  , doi: 10.11847/zgggws1138798
Abstract:
Vascular aging is a major risk factor for cardiovascular disease in middle-aged and elderly people. In women, the vascular function appears to be accelerated decreased after menopause, and the risk of cardiovascular disease increased significantly. Exercise is an effective way to improve vascular function and reduce cardiovascular risk. It is of great significance to deeply investigate the impact of exercise on the vascular health of postmenopausal women for the prevention and control of cardiovascular diseases in the population. The study expounds features of vascular aging in postmenopausal women from two aspects of endothelial dysfunction and arterial stiffness, summarizes and analyzes the effect of exercise on vascular health of postmenopausal women and the related mechanisms, and influencing factors, systematically explores the characteristics of changes in vascular health among postmenopausal women and the regulation of exercise.
Prevalence and influencing factors of Chlamydia trachomatis, Neisseria gonorrhoeae and Treponema pallidum infection among men who have sex with men in Yunnan province, 2020: a cross-sectional survey
GUO Yan, ZHANG Xiao, YANG Chao-jun,
, Available online  , doi: 10.11847/zgggws1139461
Abstract:
  Objective  To investigate the prevalence and influencing factors of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Treponema pallidum (TP) among men who have sex with men (MSM) in Yunnan province for providing evidence to strategies on sexually transmitted infection prevention and control.   Methods  Totally 1 400 MSM aged 15 – 65 years and with insertive oral or anal sex during past one year were recruited with snowball sampling in 14 prefectures/cities of Yunnan province in 2020. Face-to-face questionnaire interview, sampling of b1ood, urine, and pharyngeal/rectal swab specimens for tests of CT, NG and TP infection were carried out among the MSM. Logistic regression model was adopted in analyses on influencing factors of the infections.   Results  Among the 1 298 MSM with valid information, the detection rates were 9.9% (number of positive cases: 129), 3.1% (40) and 3.2% (42) for CT, NG and TP infection, respectively, with the highest positive rate (6.0%, 61/1 023) of CT infection for rectal swab specimens and that (1.8%, 22/1 190) of NG infection for pharyngeal swab specimens. The results of multivariate logistic regression analysis showed that the MSM living in central region (odds ratio [OR] = 4.217, 95% confidence interval [95% CI]:1.611 – 11.04) or northwestern region (OR = 3.521, 95% CI: 1.357 – 9.136) compared to living in northeastern of the province and the MSM with the education of junior high school and below (versus college and above: OR = 2.333, 95% CI: 1.427 – 3.813) were more likely to have CT infection; the results also revealed that with the education of junior high school and below (versus college and above: OR = 2.935, 95% CI: 1.265 – 6.812) and seeking sexual partners via internet/dating applications (versus through other routes: OR = 2.64, 95% CI: 1.019 – 6.836) were risk factors for NG infection, and suffering from sexually transmitted diseases in past one year was a risk factor (OR = 43.983, 95% CI: 19.31 – 100.182) for TP infection.   Conclusion  Among MSM in Yunnan province, the prevalence of CT, NG and TP infection were relatively high, suggesting that comprehensive intervention measures, including screening on the infections among high-risk individuals, should be strengthened in the MSM.
Association of blood lipid levels with mild cognitive impairment in the elderly: community-based case-control study in Tianjin city
LIU Ke-shan, ZHU Li-ping, WU Xiao-min,
, Available online  , doi: 10.11847/zgggws1138304
Abstract:
  Objective  To explore the relationship between blood lipid and the risk of mild cognitive impairment (MCI) for providing evidence to MCI prevention in the population.   Methods  A case-control study was conducted among residents aged 65 years and above in four communities of Tianjin city during March 2016. The cases were 210 MCI patients diagnosed while attending physical examination at community healthcare centers; the controls were 1 : 1 gender- and age (± 1 year)-matched residents with normal cognitive ability. Face-to-face questionnaire interview, physical examination and laboratory detections were carried out among the participants. Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) was adopted in diagnosis and assessment of MCI. Multivariate conditional logistic regression analysis was used to explore the relationship between blood lipid and MCI in the elderly.   Results  No significant differences between the cases and controls were detected in total cholesterol (TC: 186.50 [25th, 75th percentile:160.75, 215.00] vs. 195.50 [168.00, 217.25] mg/dL), low density lipoprotein-cholesterol (LDL-C: 101.00 [77.75, 121.00] vs. 100.00 [79.75, 123.00] mg/dL), high density lipoprotein-cholesterol (HDL-C: 58.50 [46.75, 71.25] vs. 58.00 [47.00, 70.00] mg/dL), and LDL-C/HDL-C (1.71 [1.30, 2.35] vs. 1.66 [1.31, 2.26]) (P > 0.05 for all). The results of conditional multivariate logistic regression analysis showed that after adjusting for education, hypertension, diabetes, heart disease, and stroke, the LDL-C (mg/dL) of higher than 100 was associated with increased risk of MCI (100 – 130: odds ratio [OR] = 2.37, 95% confidence interval [CI]: 1.21 – 4.65; 130 – 160: OR = 3.22, 95% CI: 1.09 – 9.49; > 160: OR = 9.33, 95% CI: 1.59 – 54.61); while, following factors were correlated to decreased risk of MCI: higher TC (200 – 240 vs. < 200 mg/dL: OR = 0.52, 95% CI: 0.27 – 0.99), higher HDL-C (> 40 vs. ≤ 40 mg/dL: OR = 0.30, 95% CI: 0.14 – 0.67), and higher ratio of LDL-C/HDL-C (> 2.30 vs. < 1.31: OR = 0.37, 95% CI: 0.16 – 0.88).   Conclusion  Higher serum LDL-C is a risk factor of MCI but higher serum HDL-C, LDL-C/HDL-C ratio and moderate TC are protective factors against MCI for community elderly in Tianjin city.
Association of genetic variants of KIR2DL4 and its ligand HLA-G gene with HCV susceptibility and chronicity
FENG Ze-pei, CHEN Qiong, ZHANG Jin-wei,
, Available online  , doi: 10.11847/zgggws1138229
Abstract:
  Objective  To explore effects of single nucleotide polymorphism (SNP) in KIR2DL4 rs649216 and its ligand HLA-G rs1063320 on hepatitis C virus (HCV) infection susceptibility and chronicity and to provide evidences for screening, diagnosis and prevention of HCV infection.   Methods  Totally 1 854 high-risk adults (18 – 80 years old) of HCV infection without the history of anti-HCV therapy (interferon or antiviral drugs treatment) were recruited with cluster sampling in two compulsory drug rehabilitation centers and hemodialysis rooms of 9 hospitals in two cities of Jiangsu province from October 2011 to December 2015; all the participants (1 121 drug addicts and 733 hemodialysis patients) were assigned into three groups according to the results of two separate HCV antibody and HCV RNA detections during previous 6 months before the survey: 1 341 in an uninfected group (negative for both HCV antibody and HCV RNA), 301 in a spontaneous HCV clearance group (positive for HCV antibody but negative for HCV RNA), and 202 in a persistent HCV infection group (positive for both HCV antibody and HCV RNA). Face-to-face questionnaire interview was conducted among the participants and fasting venous blood samples of the participants were collected for detections of HCV antibody, HCV RNA, HCV genotype, and genotype of targeted genes with TaqMan probe-based real-time quantitative PCR. Multivariate logistic regression model was adopted in analyses on the associations of KIR2DL4 rs649216 and its ligand HLA-G rs1063320 locus with HCV susceptibility and chronicity.   Results  The proportions for carriers of genotype CC, CT and TT of KIR2DL4 rs649216 were 69.15%, 28.15% and 2.69% in the uninfected group; 73.90%, 23.05% and 3.05% in the spontaneous clearance group; and 62.25%, 33.82% and 3.92% in the persistent infection group; while, those for carriers of genotype GG, GC and CC of HLA-G rs1063320 were 32.89%, 51.25% and15.86% in the uninfected group; 34.29%, 45.36% and 20.36% in the spontaneous clearance group; and 33.15%, 47.28% and 19.57% in the persistent infection group, respectively. After adjusting for gender, age, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and infection route, unconditional multivariate logistic regression analyses showed that compared with the those with the genotype CC of KIR2DL4 rs649216, the participants with the genotype CT/TT of KIR2DL4 rs649216 were at a higher risk of chronic HCV infection (co-dominant model: odds ratio [OR] = 1.682, 95 % confidence interval [95% CI]: 1.109 – 2.551; dominant model: OR = 1.671, 95% CI: 1.121 – 2.493); the participants carrying allele T of KIR2DL4 rs649216 were at an increased risk of chronic HCV infection (additive model: OR = 1.508, 95% CI: 1.070 – 2.125) in comparison with those carrying allele C of KIR2DL4 rs649216; moreover, in comparison with those carrying genotype GG + GC of HLA-G rs1063320, the participants carrying genotype CC of HLA-G rs1063320 were more likely to have HCV infection (recessive model: OR = 1.361, 95% CI: 1.018 – 1.819).   Conclusion  The SNP of KIR2DL4 rs649216 is associated with the chronicity of HCV infection and the SNP of KIR2DL4’s ligand HLA-G rs1063320 is associated with the susceptibility to HCV infection.
Progress in economic evaluation of human papillomavirus vaccines
WANG Xiao-xuan, ZHANG Liang-wen, FANG Ya
, Available online  , doi: 10.11847/zgggws1139192
Abstract:
Human papilloma virus (HPV) infection is the main cause of cervical cancer, which seriously endangers the life and health of women around the world. HPV vaccine can effectively prevent HPV infection and reduce the incidence of cervical cancer, and has been widely used in countries around the world. In recent years, many countries have carried out studies on economic evaluation of HPV vaccines, focusing on evaluating the cost and social benefits of HPV vaccination. In this paper, we reviewed current situation and economic evaluation of HPV vaccination based on relevant literature published in recent years at home and abroad; we also described the application of mathematical models in the economic evaluation of HPV vaccine, which is helpful for the formulation of HPV vaccination strategies and elimination of cervical cancer.
Decision making for government-funded HPV vaccination programs in China: a multiple streams framework-based analysis
LIU Shu-jun, QIAO You-lin, ZHOU Cai-hong
, Available online  , doi: 10.11847/zgggws1139392
Abstract:
Persistent infection of human papillomavirus (HPV) can cause a variety of diseases including cervical cancer, which affects human health and leads to a huge socio-economic burden. Although it has shown that HPV vaccines could effectively prevent HPV infection and reduce cervical cancer incidence, China hasn′t introduced HPV vaccination into the national immunization program. The multiple streams framework proposed by Kindon is an essential theoretical tool for analyzing the public policy agendas and is suitable for analyzing the decision-making processes of immunization programs. In this study, we adopted multiple streams framework to assess the main influencing factors of introducing HPV vaccination into the immunization programs by examining the problem stream, policy stream, politics stream, the policy spillover effect of pilot cities, and the role of policy entrepreneurs. And we also give some suggestions to promote the inclusion of HPV vaccines in the immunization programs at regional and national levels, and finally achieve the purpose of ‘eliminating cervical cancer′.
Mediating role of blood pressure on the association of body mass index with cardiovascular disease risk
ZHANG Zeng-hang, GUO Xiao-lei, YIN Zhao-xue,
, Available online  , doi: 10.11847/zgggws1140656
Abstract:
  Objective  To investigate mediating role of blood pressure on the association of body mass index (BMI) with cardiovascular disease (CVD) risk and to provide evidence for control of CVD risk.   Methods  Using stratified multistage random sampling and a self-designed questionnaire, a baseline survey including face-to-face interview, physical examination and laboratory tests were conducted among 15 600 permanent urban/rural residents aged 18 – 69 years during June – September 2021 in Shandong province; then the residents were followed up to October 11, 2021 through the Cardiovascular Diseases and Mortality Surveillance System to collect the information on their prevalence of CVD. Univariate and multivariate Cox proportional risk regression model was used to analyze the association of body mass index (BMI) with the risk of CVD. The dose-response relationship between BMI and CVD risk was described with restricted cubic splines (RCS). The mediating role of blood pressure on the association of BMI with CVD risk was assessed with sequential test.   Results  Of all the residents at the baseline survey, 89.17% (13 688) were followed up; after excluding those with previous history of coronary heart disease (n = 254) and stroke (n = 115) and those without valid outcome information, 13 268 participants were finally included in the analysis, with a total follow-up of 133 733.79 person years and a median follow-up period of 10.25 years. By the end of the follow-up among the participants, totally 492 CVD incidences were identified and the CVD incidence density was 367.90/100 000 person-years. The number of CVD incidence was 22, 173, 183, and 114 among the participants with low-weight, normal-weight, overweight, and obesity, with the corresponding CVD incidence densities (1/100 000 person-years) of 380.08, 285.84, 410.42, and 499.25, respectively. After adjusting for age, gender, education, marital status, annual household income, living area (urban/rural), geographical region of residence (central/southeast/northwest) , smoking, alcohol drinking, physical activity, daily salt intake, daily oil intake, and disease history of hypertension, diabetes or dyslipidemia, multivariate Cox proportional risk regression model analysis showed that the participants with overweight were at an increased risk of CVD incidence (hazard risk [HR] = 1.253, 95% confidence interval [95% CI]: 1.014 – 1.548) compared to those with normal weight. Dose-response analysis revealed a J-shaped relationship between BMI and the risk of CVD (χ2overall = 29.87, P overall = 0.004; χ2nonlinear = 7.08, Pnonlinear = 0.069). Mediating effect analysis demonstrated that the direct effect of BMI on CVD incidence risk was 0.038 (Z = 11.644, P < 0.001) and the mediating effect of systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension was 0.022 (Z = 12.354, P < 0.001), 0.041 (Z = 10.589, P < 0.001) and 0.133 (Z = 11.506, P < 0.001). The mediating effect percentages of SBP, DBP pressure and hypertension were 36.67%, 51.90% and 77.78%, respectively.   Conclusion  Blood pressure has a strong mediating effect on the association of BMI with CVD risk. The results suggested that more attention and intervention on the changes of blood pressure need to be promoted among overweight and obesity populations.
Internet use and its impact on depression among elderly people in China, 2018: a CFPS data-based analysis
ZHAI Ya, YIN Wen-qiang, LI Wan-peng,
, Available online  , doi: 10.11847/zgggws1138754
Abstract:
  Objective  To examine the prevalence of Internet use and its impact on depression symptoms among community elderly in China and to provide evidence for improving mental health of the elderly.   Methods  The data on 6 302 community elderly ( ≥ 60 years old) were extracted from one round of China Family Panel Studies (CFPS) conducted in 2018 across China. The depression symptoms of the elderly were assessed with Center for Epidemiological Studies Depression Scale (CES-D) in the studies.   Results  Of all the elderly, 789 (12.52%) reported Internet use and 537 (8.52%) were identified as having depression symptoms. Unconditional multivariate logistic regression analysis showed that the elderly being Internet users were less likely to have depression symptoms (odds ratio = 0.444, 95% confidence interval: 0.268 – 0.735) compared to the elderly not surfing the Internet after adjusting for gender, age, education level, marital status, type of household registration, medical insurance, pension insurance, smoking, alcohol drinking, physical exercise, chronic disease status, self-care capability, frequency of contacting with children, relationship with children, and self-rated health.   Conclusion   Among community elderly in China, the prevalence rate of Internet use was low and the elderly Internet users could be at a reduced risk of having symptoms of depression.
Association of alcohol consumption with serum soluble corin: a cross-sectional study among community adults
PANG Xiao-dong, ZOU Zhao-yang, HE Jia-chen,
, Available online  , doi: 10.11847/zgggws1138641
Abstract:
  Objective  To examine the association of alcohol consumption with serum soluble corin, a key protease of natriuretic peptides system, for providing evidence to researches on the role of natriuretic peptides system in the incidence of cardiovascular diseases.   Methods  Questionnaire survey, blood pressure measurement and laboratory tests were conducted among 3 061 permanent residents aged 30 years and above recruited in a district of Suzhou city, Jiangsu province durig May - August 2010. Median linear regression model was adopted to examine the association between alcohol consumption and serum corin in the residents.   Results  Among the 2 498 participants completing the survey, the sex-specific medians of serum corin (pg/mL) in the non-, light, moderate, and heavy drinkers were 2238.10, 2220.93, 2070.50, and 1966.49 for the males and 1514.58, 1477.28, 1707.43, and 1490.48 for the females, respectively. In the male participants, the median of serum corin decreased significantly in moderate and heavy drinkers (both P < 0.01) but not in light drinkers (P > 0.05) compared with the non-drinkers. After adjusting for age, education, smoking, and the preference for salty food, the result of median linear regression analysis showed that compared to the non-drinkers, the heavy drinkers still had a lower serum corin (215.26 pg/mL, β = − 215.26; P = 0.002). While in the female participants, the serum corin median of the three drinker groups were all not significantly different from that of non-drinkers (all P > 0.05).   Conclusion  Alcohol consumption is associated significantly with a decreased level of serum corin in male community adults. The result suggests that alcohol consumption may affect the function of natriuretic peptides system, and thereby have impact on cardiovascular system.
Role and mechanism of extracellular vesicles in smoking-induced chronic obstructive pulmonary disease: a review on research progress
LU Lu, SHI Ai-min, LIU Qi-zhan
, Available online  , doi: 10.11847/zgggws1139677
Abstract(27) HTML (12) PDF 541KB(12)
Abstract:
Chronic obstructive pulmonary disease (COPD) is a complex, heterogeneous respiratory disease that is characterized by functional and structural alterations mainly caused by long - term inhalation of harmful particles. Cigarette smoke (CS) is a major risk factor for COPD. Inflammation, cellular stress, and tissue damage caused by cigarette smoke play key roles in COPD progression. Extracellular vesicles (EVs) are functional nanoscale membrane - bound vesicles. Recently, EVs have attracted more and more attention due to their roles in the diagnosis and treatment of many diseases. However, the research on the roles and mechanism of EVs in smoking - induced COPD is still in its infancy. In this paper, we provided an overview of national and international research on the roles and mechanisms of EVs in the pathogenesis of CS - induced COPD.
Medical ethics principle-based quality control techniques for population health survey: a brief discussion
HAN Hui-nan, WANG Xiao-yu, HAN Li-ping,
, Available online  , doi: 10.11847/zgggws1138625
Abstract:
With the rapid and in-depth development of medical practice and medical research, medical ethics issues are receiving more and more attention; at the same time, population-related health surveys are also facing more and more medical ethics issues. How to deal with the medical ethics in population health investigation is the focus and difficulty of on-site quality control in population health investigations. On the basis of expounding the four basic principles of medical ethics (beneficial principle, non-harm principle, respect principle, and fairness principle) and their interrelationships, we summarize the application of the basic principles of medical ethics in the quality control of field survey on population health from three aspects: the basic principles of medical ethics and the presentation of population health questionnaire, the recruitment of participants, and the process of inquiry, aimed to promote cross-integration and innovative development of medical ethics and public health and other related disciplines.
Advances in early diagnosis of Alzheimer′s disease: an overview
LUO Qiang, LUO Ya-nan, FENG Na-na,
, Available online  , doi: 10.11847/zgggws1138613
Abstract:
Alzheimer′s disease (AD) is one of the diseases which cause disability and mortality in older adults. Early diagnosis is of great significance for delaying the development of Alzheimer′s disease and its related function decline, which can help to achieve the aim of healthy aging. This study reviewed current research about the prediction and early diagnosis of AD, which included literature review on the fields of the development and frontiers of early diagnosis technology in humoral markers, blood markers, cognitive markers detection and digital markers. The study provides the conceptual ideas to help accurately identify the high - risk groups, accurately deliver interventions, and provides important reference for early diagnosis of the disease in older adults.
Prevalence and influencing factors of hazardous drinking among residents in northern China, 2010: a cross sectional survey
ZHANG Hui, LI Xue, LI Ya-chao,
, Available online  , doi: 10.11847/zgggws1138751
Abstract:
  Objective   To examine the prevalence and risk factors of hazardous drinking behavior among residents in northern China for providing evidence to the implementation of mental health care in populations with hazardous drinking behavior.   Methods   An on-site self-administered questionnaire survey was conducted among 6 087 community residents at ages of 16 years and above recruited in northern China (Beijing municipality, Harbin city of Heilongjiang province, and Karamay city of Xinjiang Uygur Autonomous Region) using probability proportionate to size sampling during October 2010. In addition to a self designed questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), Self-Rated Health Measurement Scale (SRHMS), Patient Health Questionnaire (PHQ), Ways of Coping Questionnaire (WCQ), and other relevant scales were adopted in the survey.   Results   Of the 5 972 participants completing the survey effectively, 1 886 (31.58%) reported alcohol drinking; 785 (13.14%) were assessed as with hazardous drinking, accounting for 41.62% of all alcohol drinkers identified. Unconditional multivariate logistic regression analysis revealed following risk factors of hazardous drinking for the participants: at ages of 31 – 50 years, living in Harbin or Karamay city, being administrative personnel or personnel other than technician/ salesman, with family monthly income ≥ 1 500 yuan (RMB) per capita, positive for depression symptoms, positive for anxiety symptoms, and with a high score of negative coping style; while, female gender and with a high score of mental health were protective factors against hazardous drinking.   Conclusion  The prevalence of hazardous drinking was high and mainly influenced gender, age, region, occupation, family monthly income per capita, mental health score, depressive symptom, anxiety symptom and negative coping style among community residents in the northern China.
Preparation of nanobody against N protein of SARS-CoV-2 and assembly of colloidal gold immunochromatography card
WU Fang-hui, YIN Yi-feng, LIU Yan-li,
, Available online  , doi: 10.11847/zgggws1140589
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Abstract:
  Objective  To prepare nanobodies against N protein of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and apply them to the detection of N protein antigen of SARS-COV-2.   Methods  The alpaca was immunized with N protein to construct a gene library of nanobody to N protein. The nanobody with affinity to N protein was screened with phage display technology; nanobody genes were cloned to yeast plasmids; positive clone strains were picked to induce expression; the secreted proteins were purified with affinity chromatography, desalted with dialysis and concentrated, then screened with enzyme-linked immunosorbent assay (ELISA) for the collection of high affinity nanobodies to N protein. A pair of nanobodies was screened with cross pairing experiment for the preparation of colloidal gold immunochromatography detection cards, and N-protein solution was dropwise added to the sample wells to observe the detection line and quality control line.   Results  Totally 46 nanobodies with different sequences were screened out and 6 of them were selected to express nanobodies with the concentration > 1.0 mg/ml and high affinity to N protein after purification, desalting and enrichment. Finally, the selected pair of antibodies was assembled into colloidal gold N protein immunodetection card to detect N protein with sandwich method. Obvious detection line and quality control line were observed in the test of SARS-CoV-2 N protein antigen using the detection card and the detection limit was ≥ 10 μg/mL for the test.   Conclusion  The prepared nanobody can be used in the colloidal gold nanobody immunochromatography detection card to detect SARS-CoV-2 N protein.
Willingness to participate in time bank mutual assistance program and its influencing factors among rural elderly in Xuzhou city
HU Bin, HAN Xin, WEN Zong-liang,
, Available online  , doi: 10.11847/zgggws1139205
Abstract:
  Objective  To explore the willingness to participate in time bank mutual care program and its influencing factors among rural elderly in Xuzhou city for providing evidence to the improvement of mutual elderly care service system by relevant departments.   Methods  An onsite self-administered or interviewer-assisted questionnaire survey was conducted among 950 elderly residents (60 years old and over) recruited with multistage random sampling from 38 rural villages in 5 prefectures/counties of Xuzhou municipality, Jiangsu province during July – September 2021. Unconditional multivariate logistic regression model and the random forest model were adopted in analyses on factors influencing the participants′ willingness to participate in the time bank mutual care.   Results  Of the 925 participants with valid responses, 599 (64.8%) reported the wiliness to participate in the time bank mutual pension. The results of logistic regression analysis showed that the participants with following characteristics were more likely to have a higher willingness of the participation: being usually visited by their children once per month, being aware of the time bank mutual support for the elderly, with the preference for mutual elderly care system, and considering the time bank mutual pension having a good prospect or being worth to have the service; while, living with a cohabitant, being not optimistic about the prospect of the mutual assistant program, and being visited by their children once per week and more were factors against the participants′ willingness. The results of random forest model analysis demonstrated that the frequency of children's visit, the satisfaction to economic conditions and the living conditions were the top three important influential factors for the participants′ participation willingness, followed by the preference for mutual pension system, the awareness on the time bank mutual assistance program, and the prospect for the development of the mutual assistance elderly care system.   Conclusion  The willingness to participate in the time bank mutual pension is high among rural elderly in Jiangsu province, especially among those living alone, being visited by their children not frequently, and with positive attitude towards the time bank mutual pension system.
Disability prevalence and long-term care of the disabled among poor elderly in China: a cross-sectional analysis
LI Cheng-fu, WANG Yi-ran, LIU Yun-duo,
, Available online  , doi: 10.11847/zgggws1137624
Abstract:
  Objective  To examine the prevalence of disability and the situation of long-term care of the disabled among poor elderly in China.   Methods  The information up to December 31, 2020 on 11.4955 million poor residents aged 60 years and over in 25 provincial-level administrative divisions across China were extracted from the National Health Poverty Alleviation Dynamic Management System. The Self-Care Ability Scale for the Elderly in the National Basic Public Health Service Specification – 3rd Edition was adopted to assess disability of the poor elderly. The prevalence of disability and long-term care of the disabled among the poor elderly were analyzed.   Results  Of all poor elderly (50.17% males aged 72.72 years averagely and 49.83% females with a mean age of 73.66 years), 6.50% were assessed as having different degrees of disability; the proportion of disability was 5.97% in the males and 7.03% in the females. Among the poor elderly, the proportion of disability increased with the age; the proportion was 4.08%, 6.20%, 11.78%, 21.88%, and 30.57% for the poor elderly aged 60 – 69, 70 – 79, 80 – 89, 90 – 99, and ≥ 100 years, respectively. Among the poor disabled elderly, 18.70% were living alone and 70.90% were under home-based care.   Conclusion   Among the poor elderly in China, the disability prevalence increased with age; for the disabled poor elderly, the proportion of living alone was high and the majority had home-based care, indicating that the burden of long-term care of the disabled poor elderly was heavy and home-based care of the elderly needs to be improved.
An active health behavior scale for hypertensive patients: development and reliability and validity evaluation
WEI Yi-lin, ZHANG Li, CHEN Fang-fei,
, Available online  , doi: 10.11847/zgggws1139802
Abstract:
  Objective  To develop an active health behavior scale (AHBS) for hypertensive patients and to evaluate reliability and validity of the AHBS.   Methods  The initial AHBS for hypertensive patients was developed by means of literature research and focus group discussion. Then, the initial scale was tested with two rounds of interview survey among 120 and 720 community hypertensive patients recruited with simple random sampling at 18 towns in 2 prefectures and one county of 3 provinces (Sichuan, Hunan and Hubei) during October – December 2021. After preliminarily screening with dispersion degree, discrimination, and correlation coefficient analysis and Cronbach′s alpha coefficient, the items of the initial scale were randomly divided into two parts using random number generator: the one for exploratory factor analysis of further item screening and factor model construction and the other for validity evaluation with confirmatory factor analysis and reliability evaluation based on Cronbach′s alpha coefficients. Chi-square value/degree of freedom (χ2/df), root mean square error of approximation (RMSEA), comparative fit index (CFI), incremental fit index (IFI), normed fit index (NFI), and Tucker-Lewis index (TLI) were adopted in the analyses.   Results  Valid responses were collected from 84 participants (aged 67.54 ± 10.26 years) in the first round of survey and 525 participants (67.42 ± 8.99) in the second round of survey. The finally developed health behavior scale for hypertensive patients consists of 30 items in 5 dimensions of health responsibility and diet, physical exercise, labor and emotion, and illness management, explaining 73.72% of the total variance. Confirmatory factor analysis shows that the established model fits the data well (χ2/df = 2.279, NFI = 0.866, CFI = 0.919, IFI = 0.920, TLI = 0.909, RMSEA = 0.052). The Cronbach′s α coefficient for the total scale is 0.948 and the Cronbach′s α coefficients for each subscale of the AHBS are between 0.724 – 0.975, indicating a good reliability of the scale developed.   Conclusion  The developed AHBS for hypertensive patients covers five dimensions of health responsibility and diet, physical exercise, labor and emotion, and illness management and is of good reliability and validity; the scale could be used to assess active health behaviors of hypertensive patients in China.
Construction of an index system for evaluation on regional health emergency response capability in digital environment
HU Ling-xia, LIU Zhi-yong, YAN Feng,
, Available online  , doi: 10.11847/zgggws1139039
Abstract:
  Objective   To establish an index system for the evaluation on regional health emergency response capability in digital environment and to provide a reference to decision makers in relevant management practice.   Methods  An index system for evaluating regional health emergency response capacity in digital environment was preliminarily established through literature research. Two rounds of Delphi expert consultation were conducted among 15 professionals to assess the 16, 61, and 138 first, second, and third level indexes covering 3 dimensions of process, structure and outcome. All the indexes were screened with boundary value method based on the experts′ assessments and the weight of each index was calculated with analytic hierarchy process (AHP) and proportional distribution method.   Results  For the two rounds of consultation, the positive coefficients of experts reached 100%; the authority coefficients of the experts were 0.823 and 0.840 and the coordination coefficients of expert opinions were 0.141 and 0.303 (all P < 0.05). The finally established index system includes 8 first, 32 second, and 172 third level indicators, with the highest weight of 0.1961 for ‘emergency support′, 0.5903 for ‘training′, and 1.0000 for ‘local health administrative department′s timely report of information on rapid manipulation of a regional health emergency to local government and to superior health administrative department among the first, second, third level indicators, respectively.   Conclusion  The established index system for the evaluation on regional health emergency response capability in digital environment is of clear hierarchy, indicators with reasonable weights, and practicability and the index system could be used in the evaluation-related survey, management and decision-making.
Resuming of purchase behavior and its associates after food safety incidents among adult residents in Shanxi province: a cross-sectional survey
CHENG Jing-min, WU Yuan-yuan, HU Xian-ming
, Available online  , doi: 10.11847/zgggws1138700
Abstract:
  Objective  To examine the resumption of purchase behavior and its influencing factors after food safety incidents among the residents in Shanxi province, and for providing evidence to the improvement of food safety risk management.   Methods  A self-administered questionnaire survey was conducted among 2 275 adult residents ( ≥ 18 years) recruited in 70 districts/counties of 11 municipalities of Shanxi province using stratified random sampling from December 2020 through March 2021.   Results  Of the 1 991 participants with valid responses, 1 045 (52.5%) reported the unwillingness to resume purchase behavior after a food safety crisis in comparison to 946 (47.5%) reporting the willingness to resume purchase behavior. The results of unconditional multivariate logistic regression analysis results showed that the participants with following characteristics are more likely to resume purchase behavior after a food safety incident: male gender, with a family annual income of more than 5 000 yuan (RMB) per capita per month, suffering from chronic disease, being generally concerned about food safety, and having confidence in enterprises′ capability on food safety management; in contrast, the participants being female, with a food safety knowledge score of equal to or higher than the average score, considering a generally higher domestic food safety risk, and believing in government management on food safety were less likely to resume purchase behavior after a food safety accidents.   Conclusion  Slightly more than a half of adult residents in Shanxi province would resume purchase behavior after a food safety incident and the residents′ willingness to resume purchase behavior after food safety incident is mainly influenced by the consideration on domestic overall risk of unsafe food, concerns about food safety, household annual income per capita, and the confidence in government management on food safety.
Association of age at menarche with age at first sexual behavior among unmarried women in Anhui province
YANG Xin-liu, LIAO Tie-rong, GAO Jin,
, Available online  , doi: 10.11847/zgggws1139263
Abstract:
  Objective  To explore the correlation between age at menarche and age at first sexual behaviors among unmarried women in Anhui province.   Methods  From the participants of a cohort study (Reproductive Health of Couples of Childbearing Age – Anhui Cohort) conducted during April 2019 – June 2021 in 16 districts of Anhui province, we recruited 28 899 women (aged 18 – 49 years) taking premarital examination for their first marriage. Relevant information of the unmarried women were collected with an on-site self-administered questionnaire survey under the help of interviewers. Chi-square test and multivariate logistic regression model were adopted to explore the correlation between age at menarche and age at first sexual behaviors.   Results  Earlier menarche (at ages of ≤ 12 years) and later menarche (at ages of ≥ 15 years) were reported by 37.2% and 14.0% of the unmarried women. The reported proportions of the women having their first sex at ages ≤ 14 age, 15 – 17, 18 – 20, and ≥ 21 years were 0.2%, 4.5%, 26.8%, and 68.4%, respectively. Multivariate logistic regression analysis showed that, after adjusting for potential confounding factors, the women with earlier age at menarche were more likely to have first sexual behavior at ages of ≤ 14 (odd ratio [OR] = 2.721, 95% confidence interval [95% CI]: 1.626 – 4.533), of 15 – 17 years (OR = 1.645, 95% CI = 1.456 – 1.860), and of 18 – 20 years (OR = 1.155, 95% CI: 1.088 – 1.227) compared to the women with normal age at menarche; while, the women with later age at menarche were less likely to have first sexual behavior at ages of ≤ 14 (OR = 0.230, 95% CI: 0.054 – 0.979), of 15 – 17 (OR = 0.573, 95% CI: 0.465 – 0.707), and 18 – 20 years (OR = 0.812, 95% CI: 0.745 – 0.885) compared to the women with normal age at menarche, respectively.   Conclusion  The age at menarche is significantly associated with the age at first sexual behavior among unmarried women in Anhui province.
Association of interpregnancy weight change with adverse birth outcome: an analysis based on delivery records of Guangdong province
WU Li, LIU Qing, FAN Gao-jie,
, Available online  , doi: 10.11847/zgggws1138312
Abstract:
  Objective  To investigate associations of interpregnancy weight change with preterm birth, low birth weight, macrosomia, small for gestational age (SGA), and large for gestational age (LGA).   Methods  The data on 6 589 pregnant women having two or more singleton live births during 2015 – 2020 and their newborns were extracted from the Maternal and Child Health Information System of Guangdong Province. The pregnant women were assigned into four groups according to the changes in their interpregnancy body mass index (BMI) of <−1, −1 – <1 , 1 – <3, and ≥ 3 kg/m2. Logistic regression model was used to assess the associations of interpregnancy BMI change with adverse birth outcomes.   Results  In all the newborns, the proportion was 5.5% for preterm birth, 4.7% for low birth weight, 2.4% for macrosomia, 11.4% for SGA, and 5.4% for LGA, respectively. The results of logistic regression analysis showed that compared to those with the interpregnancy BMI change of −1 – < 1, the pregnant women having the change of 1 – < 3 have an increased risk of giving a birth to a macrosomia (odds ratio [OR] = 1.66, 95% confidence interval [95% CI]: 1.13 – 2.24); the women with the interpregnancy BMI change of 3 and more have an increased risk of giving a birth to a macrosomia (OR = 2.31, 95% CI: 1.42 – 3.70) and to a LGA infant (OR = 1.87, 95% CI: 1.33 – 2.60); while, each increase of 1 kg/m2 in interpregnancy BMI is associated with a 7% decreased risk of SGA (OR = 0.93, 95% CI: 0.89 – 0.97). No significant association of interpregnancy BMI change with preterm birth or low birth weight were observed (P > 0.05).   Conclusion  Pregnant women′s interpregnancy weight gain is associated with increased risks of macrosomia and LGA of their newborns. The results suggest that body weight control during pregnancy and after delivery need to be promoted among pregnant women.
Protection efficiency and vaccination strategy of single-dose HPV vaccine: opportunity and challenges
ZHANG Meng, WU Dan, LIANG Xiao-feng
, Available online  , doi: 10.11847/zgggws1139851
Abstract:
Vaccination against human papilloma virus (HPV) prevents HPV infections and HPV - related cancers. Most countries currently use a two - dose HPV vaccination schedules, but a growing number of studies have found potential effectiveness of single - dose HPV vaccine, sparking a debate about the feasibility of switching from a two - dose regimen to a single - dose regimen in the global vaccine community. Given the large global disease burden of cervical cancer and inequality between countries and regions due to the tight HPV vaccine supply, World Health Organization Strategic Advisory Group of Experts on Immunization (SAGE) stated that single - dose schedules provide comparable protection to the two - or three - dose schedules at a relevant meeting in April 2022. In this article, we review current status of HPV vaccination and researches on the single - dose HPV vaccine protection, and analyze the opportunity and challenges for single - dose HPV vaccination strategy in the future.
Willingness to pay for human papillomavirus vaccines among Chinese female health care workers
LU Xin-yue, SHAO Xiao-ping, HUANG Wei-feng,
, Available online  , doi: 10.11847/zgggws1140113
Abstract:
  Objective  To investigate the willingness to pay (WTP) for human papillomavirus (HPV) vaccine and its influencing factors among Chinese female health care workers for improving HPV vaccination strategies in China.   Methods  An online survey was conducted among 18 – 45 years old female health care workers from 310 hospitals in 31 provincial level administrative divisions across China during November – December 2021. A self-designed questionnaire was used to collect information on demographics, HPV vaccination status, HPV-related knowledge, protective motivation theory (PMT)-based HPV vaccination-related cognition and attitude, and the amount of WTP for HPV vaccination. Structural equation model was adopted to analyze influencing factors of WTP.   Results  Of the 15 969 valid respondents aged 30.6 ± 6.2 years, 43.4%, 33.2%, and 23.4% reported the highest amount (CNY) of WTP for HPV vaccine ranging 0 – 1 600, 1 601 – 3 200, and 3 201 – 5 000, respectively; higher amount of WTP was reported by the respondents aged 18 – 26 years, being Han ethnic, unmarried/divorced/widowed, having the education of master or above, without professional title, with a monthly income more than 8 000 CNY, working in a tertiary hospital, and already receiving HPV vaccination or having an appointment for the vaccination. The scores for multidimensional PMT-based cognition and attitude about HPV vaccination were significantly correlated with HPV vaccine acceptance and the WTP for HPV vaccine (P < 0.001 for all). The structural equation model analysis showed that perceived susceptibility (β = 0.046), perceived severity (β = 0.012), response efficacy (β = 0.027), self-efficacy (β = 0.155), HPV-related knowledge (β = 0.151) and vaccination behavior (β = 0.154) were positively associated with the WTP for HPV vaccination; whereas response cost was negatively associated with the WTP for HPV vaccination (β = – 0.183).   Conclusion  Chinese female health care workers have relatively higher WTP for HPV vaccination. Price of HPV vaccine, convenience of vaccination/ appointment services, and safety of vaccines remain the main influencing factors of the WTP.