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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,
 doi: 10.11847/zgggws1140533
Abstract(0) HTML(0) PDF 576KB(0)
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  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,
 doi: 10.11847/zgggws1139423
Abstract(0) HTML(0) PDF 615KB(0)
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  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,
 doi: 10.11847/zgggws1141011
Abstract(67) HTML(12) PDF 587KB(28)
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  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,
 doi: 10.11847/zgggws1138847
Abstract(24) HTML(7) PDF 652KB(6)
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  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,
 doi: 10.11847/zgggws1139296
Abstract(26) HTML(9) PDF 542KB(7)
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  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
 doi: 10.11847/zgggws1139013
Abstract(36) HTML(7) PDF 556KB(17)
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  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
 doi: 10.11847/zgggws1138798
Abstract(17) HTML(3) PDF 739KB(2)
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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,
 doi: 10.11847/zgggws1139461
Abstract(42) HTML(5) PDF 548KB(8)
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  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,
 doi: 10.11847/zgggws1138304
Abstract(17) HTML(5) PDF 501KB(3)
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  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,
 doi: 10.11847/zgggws1138229
Abstract(17) HTML(3) PDF 535KB(5)
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  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
 doi: 10.11847/zgggws1139192
Abstract(31) HTML(2) PDF 664KB(7)
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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
 doi: 10.11847/zgggws1139392
Abstract(24) HTML(5) PDF 635KB(5)
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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,
 doi: 10.11847/zgggws1140656
Abstract(32) HTML(11) PDF 635KB(5)
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  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,
 doi: 10.11847/zgggws1138754
Abstract(48) HTML(6) PDF 545KB(9)
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  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,
 doi: 10.11847/zgggws1138641
Abstract(19) HTML(6) PDF 526KB(5)
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  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
 doi: 10.11847/zgggws1139677
Abstract(16) HTML(6) PDF 541KB(5)
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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,
 doi: 10.11847/zgggws1138625
Abstract(16) HTML(2) PDF 603KB(2)
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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,
 doi: 10.11847/zgggws1138613
Abstract(17) HTML(3) PDF 614KB(2)
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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,
 doi: 10.11847/zgggws1138751
Abstract(29) HTML(5) PDF 658KB(8)
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  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,
 doi: 10.11847/zgggws1140589
Abstract(128) HTML(71) PDF 1392KB(74)
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  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,
 doi: 10.11847/zgggws1139205
Abstract(23) HTML(5) PDF 603KB(6)
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  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,
 doi: 10.11847/zgggws1137624
Abstract(21) HTML(6) PDF 511KB(6)
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  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,
 doi: 10.11847/zgggws1139802
Abstract(16) HTML(5) PDF 608KB(3)
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  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,
 doi: 10.11847/zgggws1139039
Abstract(22) HTML(4) PDF 668KB(8)
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  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
 doi: 10.11847/zgggws1138700
Abstract(16) HTML(5) PDF 517KB(6)
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  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,
 doi: 10.11847/zgggws1139263
Abstract(27) HTML(9) PDF 524KB(1)
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  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,
 doi: 10.11847/zgggws1138312
Abstract(13) HTML(5) PDF 621KB(1)
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  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
 doi: 10.11847/zgggws1139851
Abstract(26) HTML(8) PDF 484KB(4)
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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,
 doi: 10.11847/zgggws1140113
Abstract(31) HTML(6) PDF 540KB(6)
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  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.
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2023, 39(1).  
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2023, 39(1): 1-136.  
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Special Report – Public Health Education and Course Setting
Improvement of public health and preventive medicine education in China from the perspective of “center-edge” theory
ZHANG Yue, LU Hui, YU Rong-bin,
2023, 39(1): 1-6.   doi: 10.11847/zgggws1140732
Abstract(51) HTML(24) PDF 1196KB(31)
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“Center edge” is a classical theory used to explain education and national development in comparative higher education research. The study analyzes the objective trend and the role of public health and preventive medicine education from the theory through multidimensional interpretation of policy requirements, epidemic demand, education supply and foreign experience, points out that public health education should become the communication center from university to society and disseminate public health education among the public actively. But there are practical bottlenecks in the development of public health and preventive medicine education in China, such as insufficient professional identity from the vague target positioning, existing gap between education and new medicine standard, and the weakness of public health knowledge and skills in the training of clinical medical talents. It is necessary to reform the mode of public health and general medicine talent training comprehensively and gradually, especially to promote the enrollment of large categories, separate track training and layered training. At the same time, we should pool the joint efforts of schools, governments, relevant institutions and society to establish a full chain development mechanism for public health talents under the system integrating the concept of “starting-process-result”.
Public health course in clinical medical education in China, Japan and the United States of America: a comparative analysis
FAN Jiang-bo, QIU Wu-qi, MAO A-yan,
2023, 39(1): 7-10.   doi: 10.11847/zgggws1138752
Abstract(39) HTML(26) PDF 532KB(31)
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Public health course in clinical medical education is of great significance to strengthen the public health awareness of clinicians, improve public health skills, and cultivate medical talents with the combination of prevention and treatment. The medical education systems in the United States and Japan are relatively well developed. So understanding and analyzing public health course in clinical education in developed countries plays an important role in improving and developing China’s medical education training system. This study summarizes and analyzes the public health knowledge and skills in clinical medical education in China, Japan and the United States of America for providing references to China's medical education and training system.
Public health education and postgraduate education for public health physicians in China and the UK: a comparative analysis
WANG Xi, YAN Xiao-ling, LUO Lin-zhi,
2023, 39(1): 11-15.   doi: 10.11847/zgggws1139638
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China's public health and clinical medical education were seriously separated. The outbreak of coronavirus disease 2019 (COVID - 19) and practices against the pandemic have all emphasized the importance of public health education and effective integration of treatment and prevention. In this paper, we compared the medical education system, the public health education and graduate medical education in China and the United Kingdom and provided suggestions for the reform and development of medical education in China through drawing on the experience of medical education in the UK according to actual domestic situation.
Characteristics of specialty and degree setting of public health discipline in the United States and its enlightenment
MO Wen-xi, ZHAO Hai-jing, CHEN Hao-yang,
2023, 39(1): 16-21.   doi: 10.11847/zgggws1138384
Abstract(37) HTML(32) PDF 788KB(26)
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With rapid change of public health security needs in the post-epidemic era and the reality of national public health professional education reform, the current public health discipline system in China needs to be further improved urgently. In order to provide references for the construction of public health talent training, we describe the characteristics of post-secondary education system of public health in the United States from discipline classification, curriculum and occupational orientation of specialty, as well as the types, awarding conditions and knowledge/competencies requirements of degree by analyzing the open data on multiple public health education institutions. Combining actual situation of public health professional education in China, it is recommended to set up the classification of public health discipline accurately, play the intervention function of the classification catalogue correctly, promote career-oriented talent training, develop inter-disciplinary talent talents training based on multi-degree mode, and construct basic requirements and certification system of higher public health education.
Overview of United States Public Health Service Commissioned Corps and its enlightenment
BAI Jie, WANG Feng
2023, 39(1): 22-26.   doi: 10.11847/zgggws1129636
Abstract(33) HTML(36) PDF 719KB(18)
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United States Public Health Service Commissioned Corps (Commissioned Corps), being under the leadership of the Department of Health and Human Services, is an elite team of more than 6 100 full-time, well-trained, highly qualified public health professionals who serve in 13 careers on 11 professions. Established with the concept of a cadre of mobile, the Commissioned Corps features full integration of disease control and prevention, health care and recover. The officers of the Commissioned Corps , in a wide range of specialties and remarkable leadership, work at federal agencies nationally under normal circumstances and can be deployed as fully-featured strike teams into epicenter of disaster if there is a public health emergency. We characterized the US Commissioned Corps as organizing task-oriented, function-modularized, and cadre-mobilized teams, and enhancing interdisciplinary excellence and leadership of crews.
Epidemiological Research
Prevalence and influencing factors of suboptimal health among urban middle-aged and elderly residents in China
ZHANG Zi-cheng, XUE Yun-lian, XU Jun,
2023, 39(1): 27-31.   doi: 10.11847/zgggws1138024
Abstract(23) HTML(18) PDF 530KB(16)
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  Objective   To examine the prevalence and influencing factors of suboptimal health among urban middle-aged and elderly residents and to provide evidence for health promotion in the population.   Methods   Using stratified multistage random sampling, we recruited 3 600 urban permanent residents aged 45 years and above in five provinces across China and carried out a survey with Sub-Health Measurement Scale Version 1.0 and a self-designed questionnaire during December 2017 – October 2018. Unconditional multivariate logistic regression was adopted to explore influencing factors of suboptimal health status of the participants.   Results   Among 3476 participants completing the survey, the detection rate of general suboptimal health was 66.51% and the detection rate of physical, mental, and social suboptimal health status were 67.17%, 63.98%, and 69.45%, respectively. The results of unconditional multivariate logistic regression analysis revealed that with higher exposure to second-hand smoke, having unhealthy dietary behavior, and experiencing stress event during past six months were risk factors for suboptimal health; while, being married, with a monthly household income of 2 500 – 7 500 RMB yuan per capita, going to bed early and on time, with high adversity quotient, and paying a close attention to self-health were protective factors against suboptimal health.   Conclusion   Among urban permanent residents aged 45 years and above in China, the detection rate of suboptimal health status was relatively high, and mainly influenced by marital status, monthly household income per capita, second-hand smoke exposure, unhealthy eating habits, sleeping on time, adversity quotient, attention to self-health and recent stressful life event.
Effect of smoking on estimated glomerular filtration rate in a male occupational population
ZHANG Ming, LIU Jie, WANG Jia-qi,
2023, 39(1): 32-35.   doi: 10.11847/zgggws1137947
Abstract(24) HTML(16) PDF 503KB(33)
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  Objective  To investigate the effect of smoking on estimated glomerular filtration rate (eGFR) in a male occupational population for providing evidence to tobacco control and prevention of chronic kidney disease (CKD).   Methods  A face-to-face questionnaire survey, physical examination and laboratory testing were conducted from June 2018 to June 2019 among 1 760 male employees recruited with cluster random sampling in a large state-owned enterprise in Xuzhou city, Jiangsu province. The simplified diet in renal disease (MDRD) formula was used to calculate eGFR of the participants and logistic regression analysis was adopted to analyze the effect of smoking (pack years) on eGFR.   Results  For all the participants, the self-reported smoking rate was 62.67% and the detection rate of abnormal eGFR was 13.24%. The average eGFR (ml/min/1.73 m2) was 123.42 ± 26.27 for non-smokers and 119.05 ± 23.54, 113.72 ± 24.06, and 102.31 ± 24.86 for light, moderate, and heavy smokers, respectively; the eGFR decreased significantly with the increase of smoking quantity (F = 43.07, P < 0.001). The detection rate of abnormal eGFR was 8.37% in non-smokers and the rate was 10.53%, 15.06%, and 31.82% in light, moderate, and heavy smokers and there was a significant dose-effect relationship between smoking quantity and detection rate of abnormal eGFR (χ2 = 67.06, P < 0.001). After adjusting for age, waist circumference, hip circumference, alcohol drinking, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, and creatinine and in comparison with the non-smokers, the risk of eGFR abnormality increased significantly in the moderate smokers (odds ratio [OR] = 1.67, 95% confidence interval [95% CI]: 1.07 – 2.61) and in the heavy smokers (OR = 3.36, 95% CI: 2.14 – 5.28); when excluding the participants with newly diagnosed hypertension, the risk of abnormal eGFR was significantly higher for the moderate smokers (OR = 2.91, 95% CI: 1.50 – 5.64) and heavy smokers (OR = 4.38, 95% CI: 2.13 – 9.00) compared to the non-smokers; while, excluding the participants with newly diagnosed diabetes, the risk of abnormal eGFR was significantly higher for the moderate smokers (OR = 1.68, 95% CI: 1.04 – 2.72) and heavy smokers (OR = 3.78, 95% CI: 2.31 – 6.20) contrasting to the non-smokers.   Conclusion  Smoking can significantly reduce eGFR in dose-effect manner among male occupational people.
Species diversity and potential pathogenicity of bacteria carried by wild birds' claws in Yunnan province
JIANG Lin, DENG Wei, ZHANG Shu-xia,
2023, 39(1): 36-41.   doi: 10.11847/zgggws1137091
Abstract(32) HTML(22) PDF 1398KB(12)
Abstract:
  Objective  To investigate species diversity and potential pathogenicity of bacteria carried by wild birds’ claws preliminarily for clarifying the necessity of monitoring pathogenic bacteria carried by wild birds.   Methods  Toe/claw swab specimens were collected from 12 kinds of wild forest/aquatic birds for isolation of bacteria. Amplicon sequence variants (ASV)-based high-throughput sequencing was used to analyze bacterial species composition and pathogenic bacteria isolated.   Results  A large number of bacteria dominant in the wild birds’ habitats were detected and the bacterial spectrum and its similarity for the bacteria detected in the wild birds of different species were associated with the birds’ living habitats. Of all the detected bacteria at genus and species levels, 81.25% and 75.00% were pathogenic bacteria, with more kinds of pathogenic bacteria detected in the forest birds and all as human pathogenic bacteria except for a small amount of plant pathogenic bacteria in the aquatic birds.   Conclusion  Wild birds’ toes/claws could carry pathogenic bacteria from their habitats and the detection of pathogenic microorganisms carried by different types of wild birds needs to be included in the scope of routine monitoring for public health.
Helmet wearing and its influencing factors among E-bike drivers and passengers in Shanghai
YU Yan, PENG Juan-juan, LI Qing-feng,
2023, 39(1): 42-45.   doi: 10.11847/zgggws1136164
Abstract(76) HTML(45) PDF 489KB(60)
Abstract:
  Objective  To examine the prevalence and influencing factors of helmet wearing among E-bike drivers and passengers in Shanghai for providing evidence to road traffic injury prevention.   Methods  From October 2015 to April 2019, totally eight waves of observational survey were carried out at eight traffic intersections selected with stratified random sampling in Shanghai city. The number of E-bike drivers and passengers passing through the traffic intersections were counted and the frequency of helmet wearing among the passers was calculated.   Results  The ratio of helmet wearing was 14.12% among the 84 232 E-bike drivers and only 1.99% among the 10 540 E-bike passengers observed during the surveys. The results of the bivariate probit model analysis show that the helmet wearing is 0.14 probability unit lower in the female drivers than that in the male drivers; the helmet wearing in the E-bike drivers carrying adult passengers is 0.28 probability unit higher than that in the drivers carrying minor passengers; and the E-bike drivers′ helmet wearing in winter season is 0.52 probability unit higher than in summer season (all P < 0.01). The helmet wearing in the female E-bike passengers is 0.14 probability unit lower than in the male passengers and the E-bike passengers′ helmet wearing in winter season is 0.37 probability unit higher than in summer season (both P < 0.001). Marginal effect analyses reveal that the probability of E-bike drivers′ helmet wearing in winter season is 14% higher than that in summer season and 13% higher when carrying adult passengers than that when carrying minor passengers (both P < 0.001); when carrying passengers not wearing helmet, the probability of helmet wearing in the female E-bike drivers is 2% lower than that in the male drivers; all the E-bike drivers′ helmet wearing when carrying adult passengers is 4% higher than that when carrying minor passengers and is 6% higher in winter season than in summer season (all P < 0.05). The probability of helmet wearing in E-bike passengers carried by drivers not wearing helmet in winter season is 1% higher than that in summer season (Z = 3.24, P < 0.001).   Conclusion  The prevalence rate of helmet wearing among E-bike drivers and passengers in Shanghai is generally low and presents a seasonal fluctuation. The helmet wearing of E-bike drivers and passengers is lower in females that than that in the males and helmet wearing behavior of the drivers and passengers interact each other.
Stability of cadmium-induced renal injury biomarkers in adult residents with long-term environmental cadmium exposure: a 13-month follow up survey
WANG Mei, YAN Jun, ZHANG Chen-yang,
2023, 39(1): 46-49.   doi: 10.11847/zgggws1138112
Abstract(19) HTML(16) PDF 554KB(22)
Abstract:
  Objective  To investigate the stability of cadmium-induced renal injury biomarkers in community adults with low environmental exposure.   Methods  The participants of the survey were 80 permanent residents aged 40 – 69 years living in local areas at least 10 years (63 in an area with relatively heavy environmental cadmium pollution and 17 in an area with similar social and economic development to those of the contaminated area but with low environmental cadmium pollution) in Gansu province. Peripheral blood and morning urine samples of the participants were collected three times in November 2019, November 2020 and December 2020, for detections of blood cadmium, urinary cadmium, urinary β2-microglobulin (Uβ2-MG), urinary N-acetyl-β-D-glucosaminidase (UNAG), urinary retinol binding protein (URBP), urinary metallothionein (UMT) and urinary micro-albumin (UALB), respectively. Relevant information of the participants were collected simultaneously with questionnaire interviews. Descriptive statistics with variance analysis and Chi-square test were performed on the data collected.   Results  The main effects of time on blood cadmium, UALB, UMT and URBP were not statistically significant (all P > 0.05). The main effects of time on urinary cadmium, UNAG and Uβ2-MG were statistically significant (all P < 0.001). Pairwise comparison showed that there were no significant differences in blood cadmium, UALB, UMT and URBP levels among detections at the three time points (all P > 0.05); but the levels of urinary cadmium in the second and third detection were significantly higher than that in the first detection (both P < 0.001); the level of urinary cadmium in the third detection was significantly higher than that in the second detection (P < 0.01); the UNAG level of the second detection was significantly higher than that of the first detection and the third detection (both P < 0.001). There was no significant difference in UNAG level between the first test and the third test (P > 0.05). The Uβ2-MG level in the third detection was significantly higher than that in the first and the second detection (both P < 0.001). There was no significant difference in Uβ2-MG level between the first and second detection (P > 0.05).   Conclusion  Blood cadmium, UALB, UMT and URBP are less affected by time effect and of good stability; while urine cadmium, UNAG and Uβ2-MG are more affected by time effect and of poor stability.
Survey and Report
Epidemiological characteristics and hospitalization service utilization during pandemic of SARS-CoV-2 Omicron variant in China′s neighboring countries
WU Ke-ye, ZHU Bin, LI Xia,
2023, 39(1): 50-56.   doi: 10.11847/zgggws1140782
Abstract(204) HTML(45) PDF 635KB(73)
Abstract:
  Objective  To analyze epidemiological characteristics of coronavirus disease – 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant and hospitalization service utilization during the Omicron pandemic in China's neighboring countries including Japan, South Korea, Singapore, Malaysia, Vietnam, Thailand, Indonesia, Pakistan, India, and Russia.   Methods  Sourcing data from Our World in Data website, we compared vaccination rate, COVID-19 infection rate, case fatality rate and hospitalization rate before and during the pandemic caused by SARS-CoV-2 Omicron variant in the 10 countries neighboring China.   Results  Among the neighboring countries, the COVID-19 vaccination rate was higher but the case fatality rate of COVID-19 was lower for the developed countries such as Japan, South Korea, and Singapore with relatively higher average age of the population; in contrast, the vaccination rate was lower and the case fatality rate was higher in Pakistan, India and Indonesia. South Korea had the lowest median stringency index during the Omicron pandemic in the 10 neighboring countries, followed by Vietnam, Singapore, Russia, and India. For all the 10 countries, the COVID-19 case fatality rates were significantly lower during the Omicron pandemic than those during previous pandemic (P < 0.001), with all the case fatality rates of less than 0.8%. Only in South Korea and Japan, the number of COVID-19 deaths during Omicron pandemic accounted for more than 50% of total deaths due to COVID-19 pandemic. For the countries including Japan, South Korea and Malaysia with hospitalization data available, the proportion of COVID-19 cases admitted to intensive care units was significantly lower during Omicron pandemic than that during previous pandemic (P < 0.001).   Conclusion  The application of digital technology in monitoring and early warning of COVID-19 should be promoted and the coverage rate of COVID-19 vaccination needs to be increased continuously for rapid and effective response to Omicron pandemic.
Disease burden of anxiety disorders in China in 1990 and 2019: a comparative analysis among global regions with different sociodemographic index
XIA Xiao-qing, ZHAO Yan, HAO Meng-xuan,
2023, 39(1): 57-61.   doi: 10.11847/zgggws1137708
Abstract(31) HTML(21) PDF 536KB(20)
Abstract:
  Objective  To compare the trend in disease burden of anxiety disorders between China and global regions with different socio-demographic index (SDI) in 1990 and 2019 for providing evidence to rational allocation of health resources and formulation of anxiety prevention and control strategies.   Methods  The study data were from the Global Burden of Disease Study (GBD 2019). Incidence, years lived with disability (YLDs), age-standardized incidence, age-standardized prevalence, and age-standardized YLDs rate were applied to compare the disease burden of anxiety disorders and its changing trend among residents in China to those of residents in global regions with different SDI in 1990 and 2019.   Results  Among Chinese residents, the incidence number and YLDs of anxiety disorders increased from 6 667 495 and 4 045 138 person-years in 1990 to 7 285 634 and 4 574 328 person-years in 2019, with the increase rates of 9.37% and 13.08%, respectively. Compared with those in the residents of global regions with different SDI, the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized YLDs rate of anxiety disorders in China in 1990 and 2019 were all at low levels and showed decreasing trend; the age-standardized incidence rate decreased from 556.56/100 000 to 522.97/100000, with a change rate of − 6.03%; the age-standardized prevalence rate decreased from 3507.31/100 000 to 3 164.18/ 100 000, with a change rate of − 9.78%; the age-standardized YLDs rate decreased from 337.47/100000 to 306.02 /100000, with a change rate of − 9.32%. In contrast, the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized YLDs rate of anxiety disorders among populations in the global regions with high SDI were all at high levels and increased from 679.46/100 000, 4637.21/100 000, and 441.19/100 000 in 1990 to 710.54/100 000, 4 806.55/100 000 and 456.89/100 000 in 2019, with the changing rates of 4.57%, 3.65%, and 3.56%. In 1990 and 2019, the burden of anxiety disorders in female residents in China and in global regions with different SDI were much higher than that in male residents. In comparison with those in the males, higher age-standardized rates (for 100 000 population) were observed in the females in China and in global regions with high SDI when examining anxiety disorders′ incidence (630.04 vs. 425.33 and 837.43 vs. 591.16), prevalence (3 912.33 vs. 2 453.91 and 6 168.67 vs. 3 482.78), and YLDs (377.20 vs. 238.88 and 582.82 vs. 334.80).   Conclusion  Compared with the residents in global regions with different SDI, the disease burden of anxiety disorders among Chinese residents decreased greatly from 1990 to 2019 and the disease burden was heavier in the female populations than in the male populations both in China and in global regions with different SDI.
Assessing health emergency response capacities of centers for disease control and prevention in China – research methods and results: a literature-based analysis
JIAO Min, MI Yu-qing, WANG Zhen-de,
2023, 39(1): 62-67.   doi: 10.11847/zgggws1138333
Abstract(27) HTML(31) PDF 630KB(49)
Abstract:
  Objective  To analyze current situation of assessment on health emergency response capacity of centers for disease control and prevention (CDCs) in China and to provide evidence for developing standards for the capability evaluation.   Methods  We retrieved relevant studies published in Chinese or English from January 1, 2003 to October 31, 2021 via searching Chinese National Knowledge Infrastructure (CNKI) and Web of Science database. Content analysis, co-word clustering and significance assessing were used in sorting and categorizing the information on evaluation indicators adopted and critical issues of the response capability mentioned in the studies.   Results  Of the 93 articles finally included in the analysis, 75 were studied using questionnaires and 70 were investigated by a regional CDC. Various index systems were used but no unified framework or standard was adopted in the studies. Based on co-word clustering analysis, four dimensions of the response capability of the CDCs were evaluated in the studies: emergency preparedness assessed by 8 indicators, monitoring/warning and risk assessment by 2 indicators, emergency response by 3 indicators, and organization by 2 indicators, respectively. As considered in the studies, the most important issue to be promoted in the CDCs′ response capability was the establishment of emergency workforce and rapid response team, followed by other main issues including standardized management on public health emergency, financial support, material reserve, staff training and simulation practice, related research, and development/improvement of preparedness plan and technical guidance.   Conclusion  The uniformed framework, standardized assessment criteria and index system are not yet established for the evaluation on CDCs public health emergency response capability nowadays in China and the situation needs to be concerned by national administrative departments.
Connotation of active health: a literature analysis
SUN Can, TANG Shang-feng, CHEN Chao-yi,
2023, 39(1): 68-72.   doi: 10.11847/zgggws1139565
Abstract(32) HTML(27) PDF 679KB(25)
Abstract:
  Objective  To explore contemporary connotation of active health for providing a theoretical basis to the development of scientific, efficient, and standard management model of active health.   Methods  Using active health, proactive health and protective health as preliminary key words, domestic and foreign literature and Web page contents relevant to the definition of active health were retrieved via searching databases of China National Knowledge Infrastructure, WanFang Data, VIP Data, and authoritative websites for the period from 2000 through 2022. A keyword matrix was established with co-term analysis and multidimensional scaling analysis was conducted with SPSS 25.0.   Results  Totally 51 literatures and web page contents of 8 authoritative websites were finally included in the analysis. Multidimensional scaling analysis on dissimilar matrix of 36 screened-out key words resulted in a stress value of 0.23279 and a regression squared value of 0.71918; based on the key words, the connotation of active health could be elucidated in four dimensions: practice theory, participation subject, implementation approach, and health result.   Conclusion  Current connotation of active health may implicate four dimensions of practice theory, participation subject, implementation approach, and health result. More studies are needed on active health theory-based medical model and practice.
Utilization of national health risk factors monitoring information system: a user log-based analysis
HAO Shu-xin, LIU Jie, LÜ Yi-ran,
2023, 39(1): 73-76.   doi: 10.11847/zgggws1136415
Abstract(19) HTML(19) PDF 571KB(17)
Abstract:
  Objective  To analyze user log data of a national health risk factors monitoring information system for providing technical support to the optimization and data quality improvement of the system.   Methods  Totally 522 638 user log records generated from 2018 through 2021 were derived from the health risk factors monitoring system – a subsystem of the China Information System for Disease Control and Prevention. The derived data were cleaned and analyzed to examine characteristics of user access and the operation/improvement of the information system.   Results  The frequency of user access to the health risk factors monitoring information system was higher in the first half of the year than that in the second half of the year during the 4-year period. The users of the information system were mainly staff of centers for disease control and prevention (CDCs) at municipal-level (26.5% of total access) and district/county-level (48.6%). The frequencies of access to the information system differed significantly among the staff users of CDCs at various administrative levels in provinces in eastern, central and western China (χ2 = 40.1, P < 0.001). Uploading and auditing data were predominant operations for the user access and the ratio of the two operations varied temporally in a year. Log analysis results revealed that user access to the information system for modification and deletion of population health-related data decreased obviously and the completeness of key variables increased yearly after the implementing optimization measures for the system.   Conclusion  The analysis on user log records of an information system records can explore operation characteristics and user behavior of the information system for operative optimization and data quality improvement of the information system.
Health Education and Health Promotion
Effect of informatization training in professional staff on First Aid by Your Side voluntary service: a web data-based evaluation
WEN Ying, ZHAO Jian-zhong
2023, 39(1): 77-81.   doi: 10.11847/zgggws1137798
Abstract(29) HTML(21) PDF 670KB(17)
Abstract:
  Objective  To evaluate the effect of an informatization training program in professional staff on the promotion of First Aid by Your Side voluntary service initiated by Red Cross Society of China for providing a reference to the management and improvement of on-site emergency first aid voluntary services.   Methods  Python web crawler technology was used to collect all information about the First Aid by Your Side voluntary service project released by the Chinese Red Cross Volunteer Website from January 11 through October 24, 2021. Considering one week training program partly on the utilization of National Red Cross Volunteer Service Information System (from May 17 to 23) as the intervention point and with the number of voluntary service projects released as the outcome variable, the changing trend in the number of voluntary service projects released within a total of 41 weeks before and after the informatization training program was analyzed with interrupted time series method.   Results  Totally 5 847 voluntary service projects were released nationwide during the 41-week period, of which 3 486, 529 and 1832 projects were released in the eastern, central, and western region. Before the training program, the number of voluntary service projects released per week in the whole country, the eastern region and the western region increased by 8, 4 and 3, respectively; while, after the training program, the number of voluntary service projects released per week in the western region in the short run decreased by 28 compared with that before the training, but the weekly number of voluntary service project released nationwide increased by 2 in the long run compared with that before the training (both P<0.05).   Conclusion  Informatization training plays a certain role in promoting the management of First Aid by Your Side voluntary services. While more attention should be paid to giving timely guidance after the training and to the training in central region in the future.
Second-hand smoke exposure in in-door public places and satisfaction to tobacco control among residents in Hangzhou city: a cross-sectional survey
ZHANG Xin-yue, WANG Meng, YU Feng,
2023, 39(1): 82-85.   doi: 10.11847/zgggws1137983
Abstract(17) HTML(19) PDF 518KB(34)
Abstract:
  Objective  To examine the prevalence of second-hand smoke exposure (SHS) in indoor public places and the satisfaction to tobacco control in residents two years after the implementation of the Tobacco Control Regulation – 2019 in Hangzhou city of Zhejiang province, and to provide references for the promotion of the regulation.   Methods  Using stratified random sampling and a self-designed questionnaire, we conducted an on-site self-administered survey among 1 320 residents aged 15 – 75 years at 26 public places (administrative departments, hospitals, training centers, places of entertainment, restaurants, hotels and shopping malls) in two districts and one county of Hangzhou city during January 2021.   Results  Among the 1315 valid respondents, 1 101 were non-smokers; of the non-smokers, 27.52% (303) reported being exposed to SHS during the past week. For all the respondents, 67.76% reported an overall satisfaction to tobacco control in indoor public places and 64.49%, 59.54%, and 65.63% reported the satisfaction to tobacco control propaganda, supervision on tobacco control, and government agencies′ smoke-free demonstration, respectively. The results of unconditional multivariate logistic regression analysis showed that after adjusting for gender, age, education, marital status, occupation, place of residence, self-reported chronic disease, current smoking status, awareness of core knowledge about tobacco control regulations, awareness of tobacco hazards, and willingness to participate in tobacco control, the residents reporting the satisfaction to tobacco control propaganda, tobacco control supervision and law enforcement in public places, and government agencies′ smoke-free demonstration were more likely to report a higher overall satisfaction to tobacco control.   Conclusion  The prevalence of secondhand smoke exposure in indoor public places was relatively low and the satisfaction to tobacco control was high among residents in urban and rural Hangzhou after the implementation of updated tobacco control regulation.
Effect of health education on gallstone disease among Uygur rural residents in Xinjiang Production and Construction Corps: evaluation on a two years intervention program
QIN Xi-xi, MA Ru-lin, GUO Heng,
2023, 39(1): 86-91.   doi: 10.11847/zgggws1138099
Abstract(31) HTML(22) PDF 551KB(12)
Abstract:
  Objective   To evaluate intervention effect of health education on gallstone disease in Uygur rural residents of Xinjiang Production and Construction Corps (Xinjiang Corps) , and to provide a reference for the prevention and control of gallstone disease in the population.   Methods  The participants of the study were adult ( ≥ 18 years) Uygur people residing at least one year in four randomly-selected rural areas (two as intervention group and two as control group) under administrative of Xinjiang Corps. A 2-year gallstone disease-related health education program (including publicity of basic knowledge, on-site consultation, dissemination of propaganda materials in Uygur and Chinese, and lectures of 30-minutes long every 3 – 4 months) was conducted only among the participants in intervention group. With a self-designed questionnaire on gallstone disease related knowledge, attitude and practice (KAP), two waves of face-to-face interview were performed among 1 612 participants of intervention group and 744 controls before the intervention during June – July 2019 and 799 intervened participants and 580 controls by the end of intervention during July – September 2021. The status and changes of KAP about gallstone disease among the participants of intervention and control groups were analyzed and compared.   Results  Before the intervention, there were no significant differences in total score and dimensional scores of KAP between the intervention group and the control group (all P > 0.05). After the intervention, significantly higher total KAP score (3.02 ± 4.23 vs. 1.79 ± 2.89) and scores of knowledge (1.53 ± 2.21 vs. 0.88 ± 1.53), attitude (0.98 ± 1.35 vs. 0.61 ± 1.04) and practice (0.52 ± 1.08 vs. 0.30 ± 0.92) were observed among the intervened participants compared to those in the controls (all P < 0.01). After the intervention, significantly higher proportions of intervened participants reported being aware of general knowledge (12.6% vs. 7.4%), with appropriate attitude (14.0% vs. 8.6%) and adopting healthy behaviors (7.4% vs. 4.3%) about gallstone disease in comparison with the controls (all P < 0.05) but there were no significant differences in the proportions between the intervention group and control group before the intervention (all P > 0.05).   Conclusion   The health education program effectively improved the knowledge, attitude and practice about gallstone disease among rural Uygur residents in Xinjiang Corps.
Inspection technology
Establishment of an automatic detection method for Middle East respira-tory syndrome coronavirus with an integrated microfluidic chip
LIU Jian-li, GAO Jing, JIANG Peng-chong,
2023, 39(1): 92-97.   doi: 10.11847/zgggws1139190
Abstract(28) HTML(24) PDF 1189KB(21)
Abstract:
  Objective   To develop an automatic detection method for Middle East respiratory syndrome coronavirus (MERS-CoV) based on integrated microfluidic chip platform.   Methods  The pseudovirus particle of MERS-CoV was prepared as positive reference and primers and probe were designed for the ORF1b gene region of the virus. Integrated microfluidic chips were created in accordance with the whole procedure of real-time reverse transcription polymerase chain reaction (RT-PCR), including viral lysis, nucleic acid extraction, amplification and real-time fluorescence detection. The performance of the chip was monitored by the internal reference gene embedded on the chip. The sensitivity, specificity and repeatability of the chip were evaluated using the MERS-CoV pseudovirus.   Results  The internal reference gene on the microfluidic chip could be amplified and detected stably. The automated detection was sensitive enough to detect as few as 100 copies of MERS-CoV in the original sample, which was more sensitive than normal real-time RT-PCR with the detection limitation of 500 copies. A cycle threshold (Ct) value of 39.80 ± 0.53, with a coefficient variation of 1.34%, was obtained when the test was repeated six times with 100 copies of pseudovirus. No signal was observed in automated tests for other coronaviruses and human genes.   Conclusion  The established automatic detection method with microfluidic chip is of good stability, sensitivity, and specificity and the method is fast and easy to operate, and is not limited by experimental sites. The method could be used for rapid detection of MERS-CoV in field investigation.
Reverse osmosis-based enrichment of virus in water samples: an experiment study
LIU Chao, LI Ping, PANG Yan,
2023, 39(1): 98-101.   doi: 10.11847/zgggws1138988
Abstract(21) HTML(25) PDF 548KB(28)
Abstract:
  Objective  To establish a reverse osmosis technology-based method for enrichment of virus in water samples.   Methods  Two inactivated virus vaccines and two viral nucleic acid plasmids were added into simulated water samples and detected with real-time quantitative reverse transcriptase PCR (qRT-PCR) after reverse osmosis-based enrichment. Reverse osmosis membrane material, membrane pore size, and filtration time were optimized in the enrichments.   Results  The enrichment efficiency increased with the decrease of pore size of the reverse osmosis membrane. The average virus enrichment efficiency of reverse osmosis membrane with the pore size of 0.10 μm was 22.86 ± 0.84% for 2 simulated water samples. The virus enrichment efficiency of nylon, cellulose acetate and polyethersulfone membranes were similar between each other. The enrichment efficiency goes up with the increase of filtration times, but the difference in the efficiency was not significant between two and three times of filtration.   Conclusion  The efficiency can be up to 32.64% for the enrichment of polio virus in water samples using cellulose acetate filter membrane with 0.10 μm aperture and two times of filtration.
Simultaneous and rapid determination of 6 primary bile acids in plasma by high-performance liquid chromatography-tandem mass spectrometry
MU Yan, WU Ying-xia, ZHANG Yi-tian, ZENG Ying-xuan, ZHOU Zhi-feng
2023, 39(1): 102-106.   doi: 10.11847/zgggws1138567
Abstract(19) HTML(18) PDF 704KB(20)
Abstract:
  Objective  To develop a rapid and accurate high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method for the simultaneous determination of 6 primary bile acids in plasma.   Methods  Plasma was separated on a Thermo Accucore C18 column (100 mm × 4.6 mm; 2.6 μm) after being extracted by protein precipitation using methanol. The 6 primary bile acids were separated by using the mobile phase of methanol-water (0.1% formic acid + 5 mmol/L ammonium acetate) running in gradient elution. The mass spectrometer was operated on an electrospray ionization source in negative ion mode for the multiple reaction monitoring analysis. Plasma from 6 healthy adults and 6 adult Sprague-Dawley (SD) rats was detected.   Results  Baseline separation of 6 primary bile acids was achieved within 6 min. The linearity of the calibration curves of the 6 primary bile acids was excellent in the range of 5 – 2000 μg/L with a correlation coefficient higher than 0.995. The limits of detection and limits of quantitation were in the range of 0.25 – 0.45 μg/L and 0.84 – 1.49 μg/L, respectively. The recoveries of intra-day and inter-day were 86.3% – 111.5% and 87.7% – 104.9%, with relative standard deviations of 5.2% – 11.9% and 6.6% – 14.3%, respectively. The concentrations of primary bile acids in plasma of healthy adults and adult SD rats were significantly different.   Conclusion  This method is simple, rapid, sensitive, and accurate, and can meet the needs for rapid detection of primary bile acids in clinical tests and animal experiments.
Simultaneous determination of antibiotics in tap water with automatic solid phase extraction-UHPLC-MS/MS
ZANG Jin-xin, YANG Qi-fan, WANG Ying-ying,
2023, 39(1): 107-112.   doi: 10.11847/zgggws1136471
Abstract(21) HTML(27) PDF 550KB(19)
Abstract:
  Objective  To establish a rapid method for simultaneous determination of 27 antibiotics in tap water with ultra high performance liquid chromatography with tandem mass spectrometry (UHPLC-MS/MS) combined with automatic solid phase extraction.   Methods   After added internal standard solutions of 27 antibiotics within 24 hours, the tap water sample (200 mL) was filtered with glass fiber filters and adjusted for pH value of 7.5 – 8.5. The reference antibiotics in the tap water samples were concentrated with extraction column in the automated solid phase extraction instrument and then eluted with methanol solution. The reference antibiotics in the eluate was reconstituted into constant solution with 20% methanol and separated gradiently with T3 chromatography column using 40% acetonitrile methanol and 0.2% formic acid solution as mobile phase; and finally detected with UHPLC-MS/MS and quantified with internal standard method. Thereafter, 70 tap water samples were collected in rural areas of Zhejiang province and 27 antibiotics in the samples were detected simultaneously using the established method.   Results  A good linearity was observed for detections of the 27 antibiotics at the concentration of 1 to 100 ng/mL, with the correlation coefficient ranging from 0.9963 to 1.0000. For the established method, the detection limits were between 0.004 – 0.296 ng/L; the quantification limits were from 0.013 to 0.998 ng/L; and the mean recoveries ranged from 70.0% – 120.8%. For the 70 rural tap water samples, only four macrolide antibiotics were detected, including roxithromycin, clarithromycin, erythromycin, and tilmicosin, with the concentration ranges (ng/L) of 0.162 – 2.858, 0.063 – 0.849, 0.100 – 1.804, and 0.100 – 1.804, respectively.  Conclusion   The established method is simple to operate, time- and labor-saving; the method is also of high sensitivity, accuracy and reliability; and the method could be applied to rapid determination of 27 antibiotics in tap water.
Whole-genome sequencing of SARS-CoV-2 Omicron variant strains isolated from pharyngeal swab samples in Shandong province
LIU Zan-zan, XIE Cui-hua, JIANG Ya-juan,
2023, 39(1): 113-116.   doi: 10.11847/zgggws1140061
Abstract(59) HTML(24) PDF 651KB(26)
Abstract:
  Objective   To conduct whole genome sequencing of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) Omicron variant strains isolated from patients of a coronavirus disease 2019 (COVID-19) epidemic in Shandong province for effective control of COVID-19 epidemic.   Methods  High-throughput sequencing technology was used to sequence the whole genome of SARS-CoV-2 Omicron variant strains isolated from pharyngeal swab samples collected from four COVID-19 cases in a prefecture of Shandong province in April 2022. MEGA 7.0.14 software was adopted in homology and mutation analysis and evolutionary tree construction of the viral strains.   Results  The whole genome sequences of the four SARS-CoV-2 variants have 99.76% – 99.77% homology with the reference strain Wuhan-hu-1, and they are all located in the BA.2 clade of Omicron variant on the evolutionary tree. The 4 sequences all had multiple genetic loci variations and deletions; of which, A28271T mutation caused the -3 nucleotide of N gene translation initiation region changing from A to T and the deletion of amino acid from 24 to 26 of S protein resulted in the loss of the potential binding motif PPAY25-28 of the WW domain.   Conclusion   Several gene site mutants occurred in SARS-CoV-2 Omicron variants and the mutants may associate with highly infectious and camouflage of the variants and mild clinical symptoms of the viral infection.
Evidence-Based Medicine
Behavioral intervention effect of social norm feedback on reducing clinicians′ antibiotic prescribing: a meta-analysis
SHI Lin, ZENG Ying-chao, LI Wei-bin,
2023, 39(1): 117-121.   doi: 10.11847/zgggws1137911
Abstract(33) HTML(18) PDF 831KB(14)
Abstract:
  Objective  To evaluate intervention effect of social norm feedback (SNF) on reducing antibiotic prescribing behavior of clinicians and to provide a reference for decreasing irrational use of antibiotics.   Methods  Literatures published relevant to intervention effect of SNF on doctors′ antibiotic prescribing behavior were retrieved through searching publications up to October 31, 2021 from China Journal Full-Text Database, VIP Journal Full-Text Database, WanFang Database, PubMed Database, Web of Science Database, Scopus Database, and EMBASE Database; the searching was supplemented using literature retrospective method. Stata 16.0 statistical software was adopted to perform meta-analysis.   Results  Totally 9 English literatures with 19 528 pooled participants were included in the analysis. The results of meta-analysis showed that SNF intervention can reduce the number of clinicians′ antibiotic prescriptions by 4% (rate difference, [RD] = – 0.04, 95% confidence interval [95% CI]: – 0.06 – – 0.03). Further subgroup analysis indicated that all SNF interventions being carried out through following approaches could significantly reduce antibiotic prescription rate of clinicians: with short interval (< 3 months) or long interval ( ≥ 3 months), targeted at doctors or medical institutions, disseminating intervening information by letters and emails/electronic pop-up windows, and adopting fuzzy ranking evaluation (all P < 0.001). Sensitivity analysis and publication bias test demonstrated that the literatures included in the analysis had less publication bias and the results were relatively stable.   Conclusion   SNF intervention could restrain clinicians′ antibiotic prescribing behavior.
Overview
Evaluation on implementation effect of long-term care insurance: research progress at home and abroad
LI Si-cheng, ZHANG Liang-wen, FANG Ya
2023, 39(1): 122-126.   doi: 10.11847/zgggws1138845
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Abstract:
As an important measure to deal with population aging, long - term care insurance (LTCI) has played a significant role in relieving the pressure of long - term care for the elders. Through six years′ practice since 2016, each pilot city in China has basically established the LTCI system that conforms to its own reality. In order to verify the implementation effect of the LTCI system, scholars at home and abroad mainly focused on the three dimensions of government, markets and individuals. The implementation of LTCI has effectively reduced government and personal pressure, improved health status of beneficiaries and promoted the development of nursing and insurance market. However, the implementation effect of the LTCI is affected by many factors such as social demography and social economics. Due to the lack of a corresponding comprehensive evaluation index system, it is difficult to compare the implementation effect of the LTCI in different regions with a single index. Future researches should comprehensively consider the government, the market and individuals, and establish a systematic evaluation system for the implementation effect of the LTCI.
Progress in researches on effects of heavy rainfall and flood on bacillary dysentery incidence
LIU Yu-chen, LI Wei-bin, LIU Li,
2023, 39(1): 127-131.   doi: 10.11847/zgggws1138144
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Abstract:
Under the background of climate change, frequent heavy rainfall and floods have a great influence on the developing countries in the monsoon region in Southeast Asia, which may change the incidence pattern or regional difference of bacillary dysentery. In the review, we summarize the progress in researches on associations of rainstorm and flood on bacillary dysentery, mechanism and path of the influence, related environmental-social factors, and main models in the studies. Many studies have shown that rainstorm and flooding significantly increase the risk of bacillary dysentery; a number of studies also have dealt with relevant environmental-social factors such as infrastructure overload, geographic landscape pattern, economic development, urban and rural difference, and medical staff allocation. The results of the studies indicated that the heavy rainfall and floods-induced risk of bacillary dysentery incidence varied among populations of different gender, age, occupation, and living regions. The analytical models adopted by the studies include generalized additive model, distributed lag nonlinear model, and Poisson regression model. Further studies are warrented to explore the mechanism path of the influece of heavy rainfall and floods on bacillary dysentery incidence.
Public Health Forum
Convention on Biological Diversity and Nagoya Protocol: historical development and public health implications
ZHOU Wei-yu, GUAN Bai-chu, LU Yi-han
2023, 39(1): 132-136.   doi: 10.11847/zgggws1138724
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Abstract:
Convention on Biological Diversity of the United Nations came into force in 1993. In order to further achieve the goal of access and benefit - sharing (ABS) in the area of microbial resources, Conference of the Parties to the Convention on Biological Diversity in 2014 adopted the Nagoya Protocol. We attempt to sort out historical process of the Convention and the Protocol and to analyze ABS issue of pathogen in infectious disease prevention and control in detail for conducting public global health cooperation based on biodiversity and improving domestic laws and regulations on the sharing of microbial resources.