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Monkeypox-related knowledge and influencing factors among men who have sex with men in China: an online cross-sectional survey
ZHENG Min, QIAN Xiao-han, YUAN Zhi,
 doi: 10.11847/zgggws1140253
Abstract(45) HTML(12) PDF 544KB(15)
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  Objective  To investigate monkeypox-related knowledge and influencing factors among men who have sex with men (MSM) in China.   Methods  Totally 3 889 MSM aged ≥ 16 years and having anal sex in past year were recruited in 20 provincial-level administrative divisions with the assistance of community-based AIDS prevention organizations. An expert-designed electronic questionnaire on demographics, residence history, sexual behavior, and monkeypox-related knowledge was administered online among the MSM during July 1 – 3, 2022.   Results  Of the 3 563 eligible respondents averagely aged 31.0 ± 9.0 years, 72.7% (2 592) reported homosexual orientation; 53.4% (1 903) reported having sex with men in the past month; 25.7% (916) were positive for human immunodeficiency virus (HIV); 2.7% (95) reported the history of travelling to foreign countries; and 47.2% (1 681) reported the awareness about monkeypox prevention. Multivariate logistic regression analysis showed that the respondents with following characteristics were more likely to have a higher knowledge about monkeypox prevention: at elder ages (35 – 44 years vs. 16 – 24 years: odds ratio [OR] = 1.54, 95% confidence interval [95% CI]: 1.18 – 1.99, 45 – 54 years vs. 16 – 24 years: OR = 1.90, 95% CI: 1.32 – 1.74), unmarried (versus married: OR = 1.49, 95% CI: 1.15 – 1.92 ) divorced/widowed (versus married: OR = 1.56, 95% CI: 1.12 – 2.18), with the education of master and above (versus primary school and lower: OR = 1.92, 95% CI: 1.02 – 3.60), being worry about imported monkeypox epidemic in China (yes vs. no: OR = 2.68, 95% CI: 2.29 – 3.15), the history of travelling to foreign countries (yes vs. no: OR = 1.73, 95% CI: 1.13 – 2.66 ), tested positive for HIV (versus never tested: OR = 1.69, 95% CI: 1.19 – 2.40), and tested negative for HIV (versus never tested: OR = 1.79, 95% CI: 1.28 – 2.50).   Conclusion  The MSM in China had paid a high attention to monkeypox epidemic, but were with a low knowledge about monkeypox epidemic prevention. The results suggest that the health education on monkeypox prevention should be strengthened among the MSM, especially among those at younger age, being married, with lower education, and never having HIV test.
Influenza-related burden in China: current situation, challenges and response strategies
CHEN Chen, LIU Guo-en, ZENG Guang
 doi: 10.11847/zgggws1140026
Abstract(53) HTML(10) PDF 565KB(18)
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Influenza and coronavirus disease 2019 (COVID-19) are both contagious respiratory illnesses. A co-infection of influenza and COVID-19 will prolong the illness, worsen the severity of COVID-19 symptoms and increase fatality, especially for senior citizens, children and people with chronic diseases; the co-infection condition could also bring heavy disease and economic burden to the sufferers, their families, and the society. Therefore, it is crucial to enhance influenza prevention strategies under the global COVID-19 pandemic. In this paper, we summarize the disease and economic burden of influenza and discuss current problems and challenges in influenza prevention and related researches in China. In the end, we put forward relevant strategies to achieve the goal of long-term influenza prevention.
Immunological and preventive effects of COVID-19 vaccine against Omicron variant – a review of research progress
CAO Zhi-qiang, LU Li, ZHANG Wei,
 doi: 10.11847/zgggws1139775
Abstract(259) HTML(75) PDF 520KB(81)
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Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant in November 2021, the coronavirus diseases 2019 (COVID-19) epidemics caused by the variant it has rapidly spread all over the world and the variant become the dominant strain in SARS-CoV-2 infections. Under the Omicron variant-induced pandemic, the effects of COVID-19 vaccine based on the ancestral strain has been brought to researches' attention around the world and many scholars have carried out researches on the immunological and preventive effects of different COVID-19 vaccines on the Omicron variant and immunization strategies. Reviewing literatures published from November 1st, 2021 to July 26th, 2022, the study systematically discussed immunological and preventive effects of COVID-19 vaccines on Omicron variant infections for providing a reference to public health decisions such as vaccination strategy optimization and research development.
Adverse events following immunization among the elderly having booster COVID-19 vaccine: an active surveillance in Guiyang city
YU Na, LIU Yu-na, BAI Xiao-ling,
 doi: 10.11847/zgggws1139515
Abstract(189) HTML(52) PDF 523KB(137)
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  Objective  To examine the incidence of adverse events following immunization (AEFI) among old people receiving booster dose of coronavirus disease 2019 (COVID-19) vaccine and to provide reference data for evaluating the safety of COVID-19 vaccine booster immunization in the population.   Methods  Using a self-designed questionnaire on AEFI, we conducted person-to-person telephone interviews among 1 157 vaccinees aged 60 years and above 7 – 14 days after receiving booster dose of COVID-19 vaccine at a community healthcare service station between October 2021 and March 2022.   Results  Of all the elderly interviewed, 122 (10.54%) reported AEFI. Local reaction was the most frequently reported AEFI (112 person times in 90 participants) and the majority (64.29%, 72/112 person times) of the local reactions was pain at the injection site. Of the 90 participants reporting AEFI, 58.89% (n = 53) had their adverse events spontaneously improved one or two days after the vaccination. Totally 46 person times of systemic reactions were reported by 38 participants, and 32.61% (15 person times) of the systemic reactions was fatigue; the reported systemic reactions also spontaneously improved in 21 (55.26%) of the sufferers one or two days after the vaccination. There were 6 participants reporting both local and systemic reaction. No significant association of hypertension, diabetes and hyperlipidemia with the occurrence of AEFI was observed. There was a significant difference in the incidence of AEFI among the participants having different booster immunization schedules (χ2 = 14.705, P < 0.05). Among the participants having inactivated vaccines, the incidence of AEFI was 12.59% (36/286) for those with the booster dose of homologous vaccine from the same manufacture as their routine vaccination and the incidence was 9.50% (67/705) for those with the booster dose of homologous vaccine but from different manufacture; among the participants having two doses recombinant novel coronavirus vaccine (type 5 adenovirus vector, abbreviated as adenovirus) the AEFI incidence was 13.33% (2/15); among the participants having non homologous vaccine booster dose, the AEFI incidence was 22.41% (13/58) or 4.30% (4/93) for those with the booster dose of adenovirus vaccine or recombinant novel coronavirus vaccine (CHO cell vaccine).   Conclusion  The incidence of AEFI was lower in the elderly after receiving booster dose of COVID-19 vaccine with different immunization schedules and most of the AEFI were transient, self-limiting reactions, indicating a good safety of booster immunization of COVID-19 vaccine .
Characteristics of local COVID-19 cases aged ≥ 60 years in Zhejiang province during epidemic period dominantly due to SARS-CoV-2 Omicron variant infection
LIU Bi-yao, WANG Zhen, QI Xiao-hua,
 doi: 10.11847/zgggws1139326
Abstract(187) HTML(49) PDF 741KB(135)
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  Objective   To analyze the characteristics of local coronavirus disease 2019(COVID-19)cases aged ≥ 60 years in Zhejiang province during the epidemic period dominantly due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection for providing evidences to the improvement of COVID-19 prevention and control among the elderly.   Methods  The information on all local COVID-19 cases aged ≥ 60 years at the diagnosis reported in Zhejiang province from March through April, 2022 were extracted from the National Information System for Disease Control and Prevention and from the reports field surveys on the cases. Descriptive statistics were conducted to analyze epidemiological characteristics of the cases.   Results  Of a total of 163 elderly local COVID-19 cases reported during the two months, 82 (50.31%) were confirmed cases and 81 (49.69%) were asymptomatic infections. Among the 82 confirmed cases, 69(84.15%)were mild type and 13(15.85%) were common type; no severe/critical case and mortality were reported.. For all the cases, the male to female ratio was 0.92 : 1; the age ranged from 60 to 95 years, with a median age of 68 years. The majority (69.33%, n = 113) of the cases occupations were non-social workers. Nearly a half (46.01%, n = 75) of the cases had underlying diseases. More than a half (57.06%, n = 93) of the cases had full-dose COVID-19 vaccination with booster injection. Of the cases, 69.94% (114) were identified among the people under centralized medical observation. Among the cases with cardio-cerebrovascular diseases, the proportion of common type patients was significantly higher than that of asymptomatic infection compared with the cases without the diseases (P = 0.008). The proportion of common type COVID-19 was significantly lower than that of asymptomatic infection (P = 0.015) and mild type COVID-19 (P = 0.012) for the cases with booster COVID-19 vaccination in comparison with those without the booster vaccination.   Conclusion  The clinical manifestation of local elderly COVID-19 cases was generally mild during the epidemic induced mainly by SARS-CoV-2 Omicron variant. The study results suggested that promoting COVID-19 vaccination and developing Omicron variant-specific vaccine are of significance for COVID-19 epidemic control and prevention in elderly population.
Epidemiological characteristics of two COVID-19 outbreaks caused by SARS-CoV-2 prototype and Omicron variant in border area of Yunnan province: a comparative analysis
QIU Yu-bing, JIA Man-hong, CHENG Jin-ou,
 doi: 10.11847/zgggws1139133
Abstract(161) HTML(65) PDF 581KB(127)
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  Objective  To examine the difference in epidemiological characteristics of coronavirus disease 2019 (COVID-19) epidemics caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prototype strain and Omicron variant in a border area of Yunnan province for providing references to real-time adjustment of regional measures on COVID-19 epidemic prevention and control.   Methods   Field surveys were conducted to collected relevant information on confirmed cases, asymptomatic infections, close contacts and secondary close contacts from two COVID-19 outbreaks in Ruili – a border city of Yunnan province: an epidemic during March 29 – April 19, 2021 caused by SARS-CoV-2 prototype strain based on whole gene sequencing (abbreviated as prototype-caused epidemic) and an another during February 16 – March 26, 2022 caused by SARS-CoV-2 Omicron variant BA.2 (variant-caused epidemic). Descriptive statistics were performed to compare epidemiological characteristics between the two COVID-19 outbreaks.   Results  Both the two outbreaks were induced by imported cases from abroad. The majority of sufferers were confirmed cases (93/117, 79.49%) for the prototype-caused epidemic and were asymptomatic infections (314/384, 81.77%) for the variant-caused epidemic, with a significant difference in the proportion between the two epidemics (χ2 = 177.254, P < 0.001). In nucleic acid tests at the time of diagnosis, the cycle threshold (Ct) values of ORF1ab gene and N gene for the cases infected with SARS-CoV-2 prototype strain were significantly higher than those for the cases with SARS-CoV-2 Omicron variant infection (Z = 6.089, 6.924, P < 0.001). The proportions of cases aged < 15 years and > 60 years in the variant-caused epidemic were significantly higher than those in the prototype-caused epidemic (χ2 = 33.236, P < 0.001). The incubation period (median [M], 25th percentile [P25], 75th percentile [P75]) for the secondary infections among close contacts was not significantly different between the two epidemics (3 [1,4.75] vs. 3 [2, 5], Z = – 1.54, P = 0.124), with 88.75% and 95.24% of the secondary infections having the incubation period less than 7 days for the prototype- and variant-caused epidemic. The secondary infection rate of close contacts was 1.17% (80/6 833) and 2.78% (145/5 223) and the rate of core close contact was 6.3% (58/920) and 6.23% (111/1782) for the prototype- and variant-caused epidemic. No secondary infection was detected among general close contacts and secondary close contacts and the secondary infection rate was the highest among the contacts living together with confirmed cases, followed by that among those having dinner with the confirmed cases. Totally 11 and 48 clustering epidemics were identified in the two COVID-19 outbreaks caused by SARS-CoV-2 prototype strain and Omicron variant, involving 76.07% and 33.85% of all diagnosed cases during the two outbreaks.   Conclusion  Compared to SARS-CoV-2 prototype strain, SARS-CoV-2 Omicron variant BA.2 exhibits higher infectivity and could result in more asymptomatic infections. The study results should be considered in developing measures on COVID-19 epidemic prevention and control.
Adverse effects of long COVID and its countermeasures: a review
HU Fang-fang, ZHAO Yan, LI Meng-hua,
 doi: 10.11847/zgggws1139286
Abstract(357) HTML(114) PDF 509KB(147)
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The coronavirus disease -19 (COVID - 19) pandemic is not only a major public health emergency of high global concern, but also has caused long - term adverse effects on physical and mental health of patients. The long - term sequelae of COVID - 19 has increasingly attracted the attention of the medical community and the whole society, and become a public health problem that cannot be ignored. An in - depth understanding of symptoms and harms of long coronavirus disease (long COVID) and strengthening health management on patients with long COVID are essential to reduce and avoid adverse effects of long COVID. This study reviews the latest research progress on long COVID at home and abroad, and on the basis of analyzing and summarizing adverse effects of long COVID on individuals, families and the society, puts forward corresponding countermeasures and suggestions to provide a reference for preventing and managing health hazards caused by long COVID in China.
Optimization of COVID-19 prevention and control measures based on prevalence characteristics of SARS-CoV-2 Delta and Omicron variants: an analysis on surveillance data of Ningbo city
CHU Yan-ru, ZHANG Dong-liang, CHEN Yi,
 doi: 10.11847/zgggws1139538
Abstract(148) HTML(52) PDF 517KB(122)
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  Objective  To analyze and compare prevalence characteristics of coronavirus disease 2019 (COVID-19) cluster epidemic-related secondary infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta and Omicron variant in Ningbo city, and to provide a basis for optimizing and adjusting measures on COVID-19 prevention and control.   Methods  From the National Information System for Disease Control and Prevention and the reports of field surveys, we extracted the information on 171 COVID-19 cases with SARS-CoV-2 Delta and Omicron variant infection identified among close contacts of 37 local COVID-19 outbreaks in Ningbo city from December 1, 2021 to May 31, 2022. Descriptive analysis was performed to analyze prevalence characteristics of the cases and the incubation period of secondary infection was calculated for the cases with definite exposure time to index cases.   Results  Of all the cases, 80.70% (n = 138) and 19.30% (n = 33) were confirmed patients and asymptomatic infections; 64.33% (n = 110) and 35.67% (n = 61) were infected with SARS-CoV-2 Delta and Omicron variant, respectively. The proportion of asymptomatic infection was significantly higher in the cases infected with Omicron variant than that in the cases with Delta variant (54.10% vs. 0, P < 0.05). The mean incubation period was 3.45 ± 0.44 days for the 22 confirmed cases (15 and 7 with Delta and Omicron variant infection) after a definite exposure to the index case. The longest incubation period of Delta and Omicron variant infection were 8 and 6 days. The mean incubation period was 3.60 ± 0.58 and 3.14 ± 0.63 days for Delta and Omicron variant infection, with no significant difference (P > 0.05). The interval time between the last exposure and the first positive detection of nucleic acid was ≤ 7 days for the cases with Omicron variant infection. The Ct value of N gene at the first positive nucleic acid detection was significantly higher in the patients with Omicron variant infection than that in those with Delta variant infection (P < 0.05), but the average hospitalization days of the cases with Omicron variant infection was significantly lower than that of cases infected with Delta variant (P < 0.05).   Conclusion  The incubation period of SARS-CoV-2 Omicron variant infection is less than 7 days and Omicron variant infection is less pathogenic than Delta variant infection. The results suggest that the recommended managent and control measures for close contacts are 7 days′ centralized isolation and 3 days′ home-based health monitoring.
A discussion on rapid response decision-making mechanism for public health emergency in port cities in China
HUANG Li-qun, FANG Peng-qian, CHEN Dan,
 doi: 10.11847/zgggws1137412
Abstract(254) HTML(67) PDF 672KB(133)
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Severe circumstance of global public health has posed higher requirements for rapid response to public health emergencies in port cities, especially at border ports, and it is urgent to construct a rapid decision-making mechanism for the response to public health emergency in port city in China. In this paper, the basic elements of public health emergency management decision-making, the structure of decision-making system, as well as the experience of port cities in responding to public health emergencies, are summarized. Specific problems in decision-making mechanism for the response to public health emergency in port city were also discussed in the paper, including the risk identification and screening of infectious diseases, novel model for comprehensive risk management of public health event, the application of artificial intelligence technology to construct rapid response infrastructure, and the structure and operation mode of the early-warning decision-making system.
Status quo of contracted family doctor services in China: a literature study
Mei-xuan LI, Xiu-xia LI, Xin XING,
 doi: 10.11847/zgggws1122093
Abstract(4820) HTML(2583) PDF 483KB(390)
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  Objective  To examine the status of and research progress in contracted family doctor services in China and to summarize general problems existing in the implementation the services for providing references for the development of applicative mode of contracted family doctor services in China.  Methods  Studies on contracted family doctor services in China published till April 2018 were systematically searched through China National Knowledge Infrastructure (CNKI), Chinese Biomedicine Database (CBM), Wanfang and Chinese Science-Technology Periodical Database (VIP) database. EndNote X7 and Excel 2010 were used to manage and analyze the retrieved studies.  Results  All the 24 finally included articles were cross-sectional studies, of which 20 and 4 were conducted among urban and rural residents. Higher rates (36% – 96%) of awareness about contracted family doctor services were reported by studies conducted among residents in Guangdong province, followed by among those (16% – 90%) in Beijing. Higher proportions (42% – 100%) of participating in contracted family doctor services were reported by the studies conducted among the residents in Beijing, followed by those (30% – 74%) in Shanghai. A higher rate (86.33%) of satisfaction to contracted family doctor services was reported by the studies conducted among the residents in Beijing, followed that (56% – 80%) in Guangdong province. Major hindering factors for the implementation of contracted family doctor services indicated by the studies were shortage of family doctors, lack of awareness on the services among the public, low salary of family doctors, imperfect management, incentive, insurance, and information support for the services.  Conclusion  The rate of awareness about, participating in, and satisfaction to contracted family doctor services are higher among residents in economically developed provinces/municipalities and in urban area than among those in less developed regions and in rural areas in China. More researches on the issue need to be performed for effective implementation of contracted family doctor services.
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Application of standardized patients in health service quality assessment: a review on research progress
LI Qin-nan, WU Jian-xiong, WANG Jing,
 doi: 10.11847/zgggws1137819
Abstract(19) HTML(5) PDF 606KB(5)
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Assessment of health service quality is an important prerequisite for improving health service quality, and the use of standardized patients (SPs) is considered to be the gold standard for evaluating health service quality, which can effectively capture the real performance of health service providers. Application of SPs in health service quality assessment is mainly focused on primary health care, doctor - patient communication, and pharmaceutical practice. SPs method is more comprehensive, direct and accurate than the information collected from medical records, but it needs a lot of human, material and financial resources and involves complex ethical issues. Therefore, it is suggested that moral hazard should be fully considered when conducting SPs surveys, and case scripts should be designed scientifically and the standardization of SPs training should be strengthened. In addition, the effectiveness of standardized patients should be validated.
Association of antibiotic exposure with obesity: a review on research progress
CHU Lei, SU De-qi, DAI Jiang-hong
 doi: 10.11847/zgggws1137759
Abstract(9) HTML(5) PDF 567KB(3)
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Antibiotics are used to treat diseases in humans and animals. Antibiotic residues in the environment and food can be ingested into human body through exposure via food and drinking water. As a new environmental pollutant, antibiotics residue is closely associated with obesity, which in turn affects human health and poses a threat to public safety. The purpose of the study is to review the progress in researches on antibiotic exposure and its pathways, the relationship between antibiotics and obesity and thus the impact on population health for providing evidences to early intervention on antibiotic exposure among populations.
Construction and application of an electronic health record-based hospitalized injury surveillance system
PENG Juan-juan, XU Nai-ting, SHI Yan,
 doi: 10.11847/zgggws1137531
Abstract(11) HTML(0) PDF 835KB(3)
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Injury surveillance is an important part of a comprehensive disease surveillance system to be established. To analyze the occurrence and changing trends of severe injuries related to different causes and to provide evidence for formulating injury prevention and control strategies and evaluating the effects of intervention measures, a hospital electronic health record (EHR)-based injury surveillance system was constructed and applied in Shanghai. Under the development of the EHR-based surveillance system, the definition of injury cases to be reported, contents, data standards and the function and standard document of the system were formulated. The system greatly improved the quality and efficiency of injury registration by data sharing between hospital information system (HIS) and HER and between centers for disease control and prevention (CDCs) at district level and Shanghai municipal CDC, and promoted the issue of the Regulation for Shanghai Municipal Inpatient Department-based Injury Registration and Reporting.
Methods of economic evaluation on child nutrition interventions: a research progress review
XIAN Meng-yao, XU Hai-quan
 doi: 10.11847/zgggws1136739
Abstract(8) HTML(2) PDF 646KB(0)
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With methodological development of assessment on child nutrition interventions, relevant evaluation indicators have been developed from merely for simple health outcomes to for comprehensive economic benefits. The cost accounting on child nutrition interventions has been subdivided into various items and the indicators for cost-effectiveness is no longer limited to a single indicator. A more complete analytical framework for evaluating child nutrition interventions is established with probability method-based cost-utility analysis. In cost-benefit analysis, the income, medical expenses and assigning a value to the life year are all taken into account, which also makes the estimation of intervention benefits more comprehensive. In order to estimate the improvement of human capital for child nutrition interventions, sociological and econometric methods have also been used, and prediction model of human capital is constructed from the changes in height, years of schooling and cognitive ability due to the nutrition improvement. A trend in deep integration of multiple disciplines has been shown in economic evaluation on child nutrition interventions.
Paracancerous tissue microbiota in esophageal squamous carcinoma patients from different regions of Fujian province - a comparison study
CHEN Si-ting, RAO Wen-qing, LIN Zheng,
 doi: 10.11847/zgggws1135963
Abstract(9) HTML(0) PDF 998KB(1)
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  Objective  To investigate the characteristics and diversity of paracancerous tissue microbiota among esophageal squamous cell carcinoma (ESCC) patients from different regions of Fujian province for providing evidences to ESCC prevention.   Methods   Totally 120 ESCC patients were recruited after radical surgery at two municipal hospitals in two cities of Fujian province from February 2013 through October 2017. All the participants were pathologically diagnosed primary ESCC cases with local residential history of more than 10 years and with intact para-cancerous tissue/exact tumor stage/complete medical records and but without infectious disease/other primary malignant, without antimicrobial therapy/radiotherapy/ chemotherapy during two months before the surgery and without specific medicine use during one month before the surgery. A face-to-face questionnaire interview was conducted in the participants. Double-ended sequencing with 16S rRNA V3-V4 variable region was performed for para-cancerous tissue specimens. The paracancerous tissue microbiota diversity and composition were analyzed with QIIME2019.4. Multivariate unconditional logistic regression was used to assess the association of residential region with patients' paracancerous tissue microbiota.   Results   Of the 120 participants, 105 were from 4 prefectures (Zhangzhou,Fuzhou, Putian and Quanzhou prefecture) and only 15 participants from other 5 prefectures of the province. There were no significantly differences in gender, age, smoking, alcohol and tea consumption, sampling season and tumor site among the participants from various regions (all P > 0.05); while the alpha- and beta-diversity in paracancerous tissue microbiota were significantly different among the participants from various regions (both P < 0.05). The abundance of para-cancerous esophageal microbiota of 15 phyla, 22 classes, 28 orders, 48 families, 71 genera, and 85 species were calculated with QIIME 2019.4.After adjusting for confounding factors including gender, age, smoking, alcohol consumption, tea consumption, sampling seasons and tumor location, the multivariate unconditional logistic regression analysis of dominant microbiota showed that the abundance of order Rickettsiales and family mitochondria detected in the participants from Fuzhou were higher than those in the participants from Zhangzhou; while the abundance of order Sphingomonadales, family Ruminococcaceae and Sphingomonadaceae, genus Faecalibacterium and Sphingomonas detected in the participants from Fuzhou were lower than those in the participants from Zhangzhou; the abundance of class Actinobacteria,order Caulobacterales and Sphingomonadales, family Ruminococcaceae, Caulobacteraceae and Sphingomonadaceae,and genus Sphingomonas in detected in the participants from Putian were lower than those in the participants from Zhangzhou; the abundance of phylum OD1, order Rickettsiales and family mitochondria in the participants from Quanzhou were higher than those in the participants from Zhangzhou; the abundance of order Coriobacteriales, Caulobacterales and Sphingomonadales, family Ruminococcaceae, Caulobacteraceae, Sphingomonadaceae, and Coriobacteriaceae, and genus Faecalibacterium in the participants from Quanzhou were lower than those in the participants from Zhangzhou; the abundance of class Coriobacteriia,order Coriobacteriales and Caulobacterales, family Ruminococcaceae, Caulobacteraceae and Coriobacteriaceae,and genus Faecalibacterium in the participants from other regions were lower than those in the participants from Zhangzhou. After adjusting for gender, age, smoking, alcohol consumption, tea consumption, sampling season and tumor site, the multivariate unconditional logistic regression analysis on rare microbiota showed that the abundance of phylum Verrucomicrobia, class Verrucomicrobiae, order Verrucomicrobiales, family Verrucomicrobiaceae, genus Roseburia, Mycoplana and Akkermansia, and species muciniphila were more likely to be lower in the participants from Fuzhou in comparison with the participants from Zhangzhou; the abundance of phylum Verrucomicrobia, class Verrucomicrobiae, order Verrucomicrobiales, family Verrucomicrobiaceae, genus Blautia, Roseburia, Mycoplana and Akkermansia, and species Longicatena and Muciniphila were more likely to be lower in the participants from Putian, Quzhou and other regions compared to the participants from Zhangzhou.   Conclusion   Residential region is an influencing factor for paracancerous tissue microbiota among ESCC patients.
Attitude and approach to acquiring health knowledge and their influencing factors among employees in public places: a cross-sectional survey in Zhejiang province
XING Ming-luan, LI Xue-qing, WU Li-zhi,
 doi: 10.11847/zgggws1138093
Abstract(17) HTML(6) PDF 547KB(1)
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  Objective  To explore the status and influencing factors of attitudes and approaches to acquiring health knowledge among employees in public places in Zhejiang province.   Methods  A face-to-face survey was conducted among 1 296 employees working in hotels, public baths/swimming pools, hair/beauty salons, and waiting rooms for buses/trains in 4 prefectures/municipalities of Zhejiang province in 2019. Participants′ information on attitude and approach to acquiring health knowledge were collected with a questionnaire compiled by researchers of Chinese Center for Disease Control and Prevention. Logistic regression was used to analyze main factors influencing the approach for health knowledge acquisition.   Results  Of the 1 290 valid respondents, 986 (76.43%) reported objective need to acquire health knowledge, 1 092 (84.65%) reported the willingness to acquire the knowledge, and 1 085 (84.11%) reported ever obtaining the knowledge actively. The respondents′ attitude towards health knowledge acquisition differed significantly by age, gender, education attainment, and work type (P < 0.05 for all). Among all the respondents, the top three approaches to acquiring health knowledge were through internet surfing (reported by 89.77% of the respondents), from administrators' publicities (89.38%), and via watching television programs (87.29%). The results of logistic regression analysis revealed that higher education (college and above vs. primary school or lower) and higher annual household income (more than 200 000 vs. less than 50 000 RMB yuan) are promoting factors for acquiring health knowledge through internet surfing, with the odds ratio [OR] (95% confidence interval [CI]) of 6.819 (3.005 – 15.471) and 5.268 (1.235 – 22.465); compared to those being cleaners, the respondents being engaged in technical tasks were less likely to acquire health knowledge from administrators′ publicities (OR = 0.367, 95% CI: 0.187 – 0.720); and female gender (versus male: OR = 1.720, 95% CI: 1.209 – 2.446) and higher education (college and above vs. primary school or lower: OR = 3.438, 95% CI: 1.608 – 7.352) are promoting factors for acquiring health knowledge via watching television programs.   Conclusion  Among employees working in public places in Zhejiang province, the attitude towards health knowledge acquisition needs to be improved and special attention should be paid to the approach for health knowledge acquisition and the employees′ characteristics when developing related projects.
Internet sentiment to public health emergencies – current situation and response strategies in China: a literature-based analysis
MI Yu-qing, JIAO Min, WANG Zhen-de,
 doi: 10.11847/zgggws1138468
Abstract(21) HTML(9) PDF 657KB(8)
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  Objective  To examine current situation of internet sentiment on public health emergencies and strategies for coping with the situation in China to provide evidence for administrative agencies′ effective response to the public sentiment.   Methods  Published studies relevant to internet sentiment on public health emergency published in Chinese or English up to October 30th, 2021 were retrieved through comprehensively searching Chinese National Knowledge Infrastructure (CNKI), Wanfang Database and PubMed. Content analysis, co-word clustering and significance assessing were used to sort out and categorize the characteristics of internet sentiment on public health emergencies and strategies and problems in administrative agencies′ response to the sentiment. Ordinal ranking was adopted to evaluate the importance and severity of the strategies and problems in the agencies′ responses.   Results   Based on content analysis on 116 literatures included into the study, 29 features were identified in terms of public health emergency-related internet sentiment′s ontology, subject, content, development, communication, society, space and time. Also according to the analysis, 25 problems and 26 strategies in the responses to the internet sentiments were revealed at four stages of prevention, preparation, response and recovery in dealing with a public health emergency. The ordinal ranking for the importance/severity of the 25 problems and 26 response strategies were basically consistent in the 4 stages of public health emergency management; the top four serious problems were delayed management and prevalence of rumors due to the lack of initiative in response stage, without theoretical guidance owing to imperfect laws and regulations in preparation stage, lacking post-event evaluation and accountability as a result of imperfect systemic infrastructure in recovery stage, and too much information noise due to the absence of serial theme propaganda in prevention stage, with the severity/importance index score of 0.1263, 0.0982, 0.0355, and 0.0305; the top four important strategies included dispelling rumors actively in mass media in response state, establishing a mechanism to deal with the internet sentiment in preparation stage, establishing regulations for rapid evaluation and accountability about the internet sentiment in recovery stage, and constructing a media-wide communication system for carrying out positive publicity actively in preparation stage, with the severity/importance index score of 0.1062, 0.1016, 0.0360, and 0.0257, respectively.   Conclusion   The response to public health emergency-related internet sentiment should be integrated into the whole process responding to public health emergencies and should be addressed in each of the four stages: prevention, preparation, response and recovery. Such considerations should be aligned with risk communication strategies for public health emergency response, for better resolving of social contradictions and satisfying of public needs.
Association between Yingyangbao intervention and nutritional and health status among infants and young children in poverty-stricken areas of Hunan province
LI Hui-xia, YUAN Shan, ZHENG Jian-fei,
 doi: 10.11847/zgggws1137868
Abstract(5) HTML(2) PDF 534KB(1)
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  Objective  To analyze effects of Yingyangbao (YYB) intervention-a community-based complementary food supplement program on nutritional and health status of infants and young children aged 6 – 23 months in poverty-stricken regions.   Methods  A combination of multistage sampling and random isometric sampling was used to recruit 12 619 infants and young children aged 6 – 23 months in 42 poverty-stricken counties of Hunan province. Questionnaire survey, body length and weight measurement, and hemoglobin detection were conducted among the participants between August and October 2020. According to the consumption of YYB, all participants were divided into three groups of non-consumption (n = 3 438), non-effective consumption (n = 3 119) and effective consumption (n = 6 062). The prevalence rate of protein-energy malnutrition, anemia, two-week fever and diarrhea among the three groups were compared. Multivariate logistic regression was used to analyze effects of effective and non-effective consumption of YYB on nutritional and health status of participants.   Results  Among the participants with non-consumption, non-effective consumption, and effective consumption of YYB, the prevalence rates were 4.5% ,5.4% , and 4.3% for stunting, 3.4%, 3.9%, and 3.0% for underweight, 3.1%, 3.6%, and 2.7% for wasting, 29.6% , 20.8%, and 15.3% for anemia, 14.3% , 14.5% , and 11.5% for having fever in the two weeks, and 12.0% , 12.1%, and 9.2% for having diarrhea in the two weeks, respectively. Multivariate logistic regression analysis showed that among the participants, effective consumption of YYB was a protective factor against anemia (adjusted odds ratio [aOR] = 0.43, 95% confidence interval [95% CI]: 0.39 – 0.48), two-week fever (aOR = 0.79, 95% CI: 0.70 – 0.90), and two-week diarrhea (aOR = 0.75, 95% CI: 0.65 – 0.86); non-effective consumption of YYB also was also a protective factor against anemia (aOR = 0.61, 95% CI = 0.54 – 0.58). There was no significant association of YYB consumption with stunting (aOR = 0.95, 95% CI = 0.77 – 1.17), underweight (aOR = 0.89, 95% CI = 0.70 – 1.13), and wasting (aOR = 0.91, 95% CI = 0.71 – 1.17) among the participants.   Conclusion  For the infants and young children in in poverty-stricken regions, effective consumption of Yingyangbao could improve anemia and reduce the two-week prevalence rate of fever and diarrhea; but non-effective consumption of Yingyangbao is less effective than effective consumption in reducing anemia.
Effect and mechanism of CagA on miR-142-3p expression regulation in gastric cancer cells
WU Lei-lei, JIANG Fei, CHEN Xiao-wei,
 doi: 10.11847/zgggws1135771
Abstract(49) HTML(20) PDF 1603KB(9)
Abstract:
  Objective   Cytotoxin associated protein A (CagA), the main virulence factor of Helicobacter pylori (Hp), plays an important role in the occurrence and development of gastric cancer. Micro RNA (miRNA) can promote or inhibit cancer by affecting the expression of downstream mRNA molecules. The aim of the study is to explore CagA-related miRNAs and effects of the miRNAs on gastric cancer for providing evidences to the diagnosis and treatment of gastric cancer correlated with Hp-CagA infection.   Methods  MiRNAs related to both Hp infection and gastric cancer were screened in the Gene Expression Omnibus (GEO) database and relevant clinicopathological data were analyzed based on the Cancer Genome Atlas (TCGA) dataset. The prokaryotic expression system of CagA was constructed and AGS cells were transfected with different concentrations of CagA. Real-time reverse transcription-PCR (qRT-PCR) was used to detect the expression of the targeted miRNAs after transfection. Finally, the upstream and downstream related genes of miRNAs were predicted and analyzed with DIANA mirPath3.0, ENCORI and other websites and online databases.   Results  MiR-142-3p was confirmed being related Hp- CagA infection based on GEO database, TCGA dataset and cell experiment. In clinical studies, mir-142 expression was associated with the prognosis of male patients with stage I gastric cancer and female patients aged 45 – 54 and 55 – 64 years (all P < 0.05). In cytological studies, the expression of miR-142-3p was up-regulated in gastric cancer cells (P < 0.01) and the level of mir-142-3p expression was affected by Hp- CagA infection (P < 0.01). Other study results suggested that as downstream targets, phosphoinositide-3-kinase regulatory subunit 2 (PIK3R2), PIK3R5 and phosphoinositide-3 kinase, catalytic subunit delta (PIK3CD) may be closely related to the effect of miR-142-3p in progressing course of gastric cancer.   Conclusion  MiR-142-3p may promote gastric cancer progressing through pathways of PIK3R2/PIK3R5/PIK3CD and may be a potential therapeutic target.
Patterns of multimorbidity in middle-aged and elderly type 2 diabetes patients: an electronic outpatient medical record- based analysis
YAN Ze-yu, GAO Rui, SUN Ming-yue,
 doi: 10.11847/zgggws1138135
Abstract(8) HTML(3) PDF 1029KB(2)
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  Objective  To identify multimorbidity patterns and major comorbidities in middle aged and elderly patients with type 2 diabetes mellitus (T2DM) for providing evidence to the improvement of traditional Chinese health management and clinical guidelines on multimorbidity.   Methods  We extracted electronic medical records of 21 425 middle-aged and elderly T2DM patients seeking medication from January 1, 2015 to December 31, 2019 in Xiyuan Hospital of the Chinese Academy of Chinese Medical Sciences. Association rule mining was used to identify common binary patterns of multimorbidity in the patients and the multimorbidity network for the T2DM patients was constructed. The major comorbidities were identified according to the network topological index.   Results  Of all the T2DM patients, 83.3% (17 843) were diagnosed with 16 other chronic diseases. Among the 16 chronic diseases (including coronary heart disease, congestive heart failure, atrial fibrillation, ischemic stroke, hypertension, dyslipidemia, atherosclerosis, chronic obstructive pulmonary disease, asthma, chronic nephritis, chronic hepatitis, rheumatoid arthritis, osteoarthritis, osteoporosis, depression, and anxiety), totally 76 types of binary patterns of multimorbidity were found, with the most common comorbidity of coronary heart disease and hypertension (support index = 0.45, lift index = 1.31) according the rank of support index and hypertension and coronary heart disease being one of the diseases in 15 binary comorbidities. For the T2DM patients treated with traditional Chinese medicine, the multimorbidity network plot suggested higher multimorbidity rates among hypertension, coronary heart disease, dyslipidemia, osteoporosis and osteoarthritis diseases, indicating a complex multimorbidity relationship. In the multimorbidity network constructed, coronary heart disease and hypertension were identified with the greatest node and closeness degree (nodes = 15, closeness index = 0.45). Based on the degrees of node, strength, closeness and eigenvector centrality, hypertension, coronary heart disease, dyslipidemia, osteoarthritis and osteoporosis were at the key positions in the multimorbidity network constructed and were the major comorbidities among the T2DM patients.   Conclusion  Among middle-aged and elderly patients with type 2 diabetes mellitus, hypertension, coronary heart disease, dyslipidemia, osteoarthritis and osteoporosis are the major comorbidities and the comorbities need to be concerned for effective prevention and management on multimorbidity in the patients.
Economic burden of chronic obstructive pulmonary disease patients and its influencing factors in rural Yunnan province: a population-based study
LIU Lan, WANG Xu-ming, MO Yi,
 doi: 10.11847/zgggws1137807
Abstract(11) HTML(0) PDF 572KB(4)
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  Objective  To analyze the economic burden of patients with chronic obstructive pulmonary disease, (COPD) and its influencing factors in rural regions of Yunnan province and to provide evidence for formulating health policies and measures to reduce the economic burden.   Methods  Face-to-face interview with a self designed questionnaire and lung function test were conducted among 7 572 permanent residents at ages of 35 years and above recruited using stratified multistage random sampling in rural regions of Yunnan province from November 2020 to November 2021. The COPD patients among the residents were identified based on results of lung function test and self reported symptoms of COPD. Both direct and indirect cost of COPD patients were estimated and the influencing factors of the cost were analyzed with structural equation modeling.   Results  Among the 7 572 participants with complete information, 954 COPD patients were diagnosed, with a prevalence rate of 12.6%. The estimated average annual COPD-related expenditure per patient was 5 787.2 Yuan (Renminbi); in which, 98.50% (5 700.5 Yuan) and 1.50% (87.2 Yuan) was direct and indirect cost. For the direct expenditure, the cost of hospitalization, outpatient service, medication, and accommodation/transportation were 3 020.7, 1 189.1, 141 8.6, and 72.1 Yuan. The results of structural equation model analysis indicated that the COPD patients′ economic burden was associated with the condition of hospitalization, frequency of outpatient visits within one year and the impact of the disease on patients’ life and work, with the standardized regression coefficient of 0.43, 0.36 and 0.27. The standardized regression coefficient for the length of hospital stay and the type of medical institution were 0.41 and 0.40; while the standardized regression coefficient for the impact of the disease on daily work, housework and daily life was 0.26, 0.23 and 0.23, respectively.   Conclusion  The economic burden of rural COPD patients is relatively high in Yunnan province. The study results suggest that early diagnosis and treatment of the disease, reducing duration of hospitalization and the level of medical institution providing hospitalization service could alleviate the economic burden of the rural COPD patients.
Association between sedentary time and semen quality in adult men: a hospital-based cross-sectional survey
ZHANG Li, YUAN Guan-xiang, LIU Pei-yi,
 doi: 10.11847/zgggws1137843
Abstract(62) HTML(2) PDF 564KB(7)
Abstract:
  Objective   To investigate the relationship between semen quality and sedentary time.   Methods   A cross-sectional survey was conducted among 4 532 men (aged 18 – 60 years) seeking fertility consultation at a reproductive center of a hospital in Shenzhen city from March 2017 through May 2019. Questionnaire interview and semen sampling were carried out among the participants. Routine indicators of semen quality were determined with a computer assisted semen analysis system (CASA) and the relationship between sedentary time and semen quality indicators was assessed with binary logistic regression analysis.   Results  In comparison to those in the participants reporting the sedentary time of less than 4 hours per day, significantly lower sperm progressive motility rate (53.18 ± 19.59% vs. 55.29±19.15%, F = 2.96; P < 0.05) and total sperm motility rate (64.30 ± 20.16% vs. 66.57 ± 19.50%, F = 3.19; P < 0.05) were detected in the men reporting the sedentary time of 8 hours and above per day. The results of logistic regression analysis showed that compared to those with the sedentary time of less than 4 hours per day, the participants with the sedentary time of 8 hours and above per day were at a significantly increased risk of having a reduced sperm progressive motility (odds ratio = 1.29, 95% confidence interval: 1.03 – 1.62) after adjusting for age, body mass index, days of abstinence, smoking, alcohol drinking, and time of physical activity.   Conclusion  Prolonged sedentary time (≥ 8 h/day) is a risk factor for decreased sperm progressive motility in adult men.
Helmet wearing and its influencing factors among E-bike drivers and passengers in Shanghai
YU Yan, PENG Juan-juan, LI Qing-fen,
 doi: 10.11847/zgggws1136164
Abstract(11) HTML(1) PDF 491KB(5)
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  Objective  To examine the prevalence and influencing factors of helmet wearing among E-bike drivers and passengers in Shanghai for providing evidences 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 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 seasons is 0.52 probability unit higher than in summer seasons (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 seasons is 0.37 probability unit higher than in summer seasons (both P < 0.001). Marginal effect analyses reveal that the probability of E-bike drivers' helmet wearing in winter seasons is 14 % higher than that in summer seasons 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 seasons than in summer seasons (all P < 0.05). The probability of helmet wearing in E-bike passengers carried by drivers not wearing helmet in winter seasons is 1 % higher than that in summer seasons (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.
Correlation between age at natural menopause and postmenopausal obesity: a population-based cross-sectional study in Guangzhou city
WU Yong-jun, ZHANG Wei-sen, ZHOU Bai-jing,
 doi: 10.11847/zgggws1138576
Abstract(10) HTML(1) PDF 676KB(2)
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  Objective  To analyze the correlation between early or late age at natural menopause and obesity among postmenopausal women, and to provide reference for health care of postmenopausal women.   Methods  From November 2017 through January 2020, totally 5 646 natural menopausal women aged ≥ 50 years were recruited from the voluntary participants of a prospective cohort study on chronic diseases in middle-aged and elderly residents of Guangzhou city. The women's information on demographic characteristics and physical indicators (including body mass index [BMI], waist circumference [WC], and waist-hip ratio [WHR]) were collected from the baseline survey of the cohort study. Generalized linear model, multivariate logistic regression model and restricted cubic spline analysis model were adopted in data analysis using SPSS 25.0 and STATA 16.0.   Results  For all the women aged 60.0 ± 5.8 years, the mean age at menopause was 50.3 ± 3.1 years and the age at natural menopause was u-shaped associated with obesity. After adjusting for possible confounders, the results of multivariate logistic regression analysis showed that compared with the women with a normal age at natural menopause (46 – 53 years), the women with an early age at natural menopause (< 46) were more likely to have an increased the risk of central obesity determined by WC (odds ratio [OR] = 1.32, 95% confidence interval [95% CI]: 1.03 – 1.69) or WHR (OR = 1.32, 95% CI: 1.06 – 1.64) and overweight/obesity determined by BMI (OR = 1.39, 95% CI: 1.13 – 1.71); while, the women with a late age at natural menopause (> 53) were also more likely to have an increased the risk of central obesity determined by WC ( OR = 1.34, 95% CI: 1.11 – 1.63) or WHR (OR = 1.41, 95% CI: 1.19 – 1.68) and overweight/obesity determined by BMI (OR = 1.49, 95% CI: 1.26 – 1.76).   Conclusion  Early or late age at natural menopause are associated with an increased risk of postmenopausal obesity for middle-aged and elderly women. The results suggest that the women with early or late age at natural menopause should pay more attention to muscle training and balanced diet and appropriately control the intake of food mainly providing energy.
Effect of short-term intensive brisk walking prescription on obesity in Chinese occupational population: a pair matched-control study
GUO Kai-ming, ZHAO Yi-fan, ZHAO Ping-ping, , LIN Yong-qing
 doi: 10.11847/zgggws1139360
Abstract(12) HTML(3) PDF 503KB(1)
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  Objective  To evaluate intervention effect of intensive brisk walking prescription on obesity in Chinese occupational population and to provide a reference for popularizing appropriate weight control program among occupational population in China.   Methods  All the participants of the study were from a 100-day vigorous walking program conducted among 31 528 in service employees in 12 provincial-level administrative divisions of China during May – August 2021 and the participants were divided into an intervention group required to complete a 4 sets of walking schedule in a day (10, 10, 15, 15 minutes of walking continuously at the speed of 100 – 150 steps per minute) and a positive control group with the same requirement as the intervention group but only 3 sets of waling schedule (10, 10, 15 minutes); the body weight in kg (BW) of the participants were measured at least once a week during the program period. From the 28 285 participants with complete information on baseline questionnaire survey and data on physical examination and vigorous waling, 5 208 pairs of intervention and control individuals were matched by tendency scores. The changes in BW, body mass index (BMI), waist circumference in cm (WC), hip circumference in cm (HC) and body fat rate in % (BFR) of the intervention and control individuals before and after the intervention were compared to evaluate the effect of intensive brisk walking prescription on the obesity indicators.   Results  For both the intervention and positive control group, the percentages and the 25th percentiles of the proportions of individuals having 10 000 steps walking per day, group walking, completing 4/3 sets of walking schedule, and BW measuring once a week were all more than 85%, indicating a good compliance with the program of the participants. Compared t o those at the beginning of the intervention program, there were significant differences at the end of the intervention for both the intervention and the positive control groups in the average values of BW (64.18 ± 11.50 vs. 65.98 ± 11.86 and 63.86 ± 11.58 vs. 65.23 ± 11.87), BMI (23.18 ± 3.16 vs. 23.77 ± 3.29 and 23.31 ± 3.19 vs. 23.78 ± 3.30), WC (81.33 ± 10.05 vs. 82.75 ± 10.25 and 81.09 ± 9.99 vs. 82.54 ± 10.14), HC (95.16 ± 6.88 vs. 96.15 ± 7.37 and 94.97 ± 6.70 vs. 96.06 ± 7.17), and BFR (26.89 ± 6.11 vs. 27.92 ± 6.18 and 27.00 ± 6.29 vs. 27.75 ± 6.37), respectively (all P < 0.01). The BW of the intensive intervention group was significantly higher than that of positive control group at the beginning of the intervention (t = – 3.25, P = 0.0012). The results of covariance analysis showed that the BW, BMI and BFR of the intensive intervention group were significantly lower than those of positive control group by the end of intervention (all P < 0.01). After adjusting confounding factors such as sex, age, residence, education, occupation, chronic disease, score for knowledge about chronic disease, psychological scale score and sleeping time, the results of multilevel model combined with multiple difference method revealed a higher decline of 0.29% in BFR of intensive intervention group compared to that of positive control group at the end of intensive intervention (t = – 2.05, P = 0.04). Further subgroup analysis demonstrated that the intensive intervention promoted the decrease of BW, BMI and BFR for the individuals with the BMI indicating overweight status, the decrease of BMI and BFR for the individuals with the BMI indicating obesity status, and the decrease of BFR for the individuals with the BMI indicating both overweight or obesity at the beginning of the intervention.   Conclusion  The short-term intensive intervention with four sets of vigorous walking schedule could reduce obesity indicators among overweight and obese in service employees in China, especially for the decline of body fat rate.
Re-hospitalization and its impact factors among depression patients in Chengdu city, 2013 − 2017
LIAO Shi-yi, WANG Yang-yang, CAI Yan,
 doi: 10.11847/zgggws1137561
Abstract(6) HTML(1) PDF 662KB(2)
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  Objective  To study the status and influencing factors of readmission in depression patients.   Methods  From Chengdu Municipal Medical Insurance Administration, Sichuan province, we collected 25 043 medical and reimbursement records for 16 556 depression patients having hospitalizations during the period from 2013 through 2017; the hospitalization status of the patients was analyzed. Rank-sum test and Chi-square test were used in analysis on hospitalization-related difference among subgroups of the patients; logistic regression model was used to analyze influencing factors of some patients′ readmission.   Results  The person-times of depression patient's hospitalization for 10 000 population increased from 1.92 in 2013 to 5.35 in 2017 and the person-times was higher for female population than for male population. Among all depression patients studied, the number of readmission within 30 days of discharge was 1 519 and 30-day readmission rate was 9.17%; the total number of readmission during the 5-year period was 3 854 and the 5-year readmission rate was 23.28%. The readmission rate was lower in the patients with medical insurance for urban and rural residents than that in the patients with medical insurance for urban workers. For all the re-hospitalizations recorded, the top three diagnosis at the readmission were mental and behavioural disorders (coded with F00-F99 in International Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10], accounting for 28.35% of total re-hospitalization), circulatory diseases (I00-I99, 20.17%), and respiratory diseases (J00-J99, 16.27%), respectively. Logistic regression analysis showed that female gender, aged ≥20 years, covered by medical insurance for urban workers, having the hospital stay of ≥ 8 days, and being diagnosed as recurrent depression (ICD-10 code: F33) were significant risk factors for re-hospitalization of depression patients; while, having comorbidity disease and being hospitalized in primary/secondary/tertiary hospital were significant protective factors against readmission.   Conclusion  The ratio of readmission was high among depression patients ever being hospitalized in Chengdu city and the re-hospitalization is mainly influenced by gender, age, medical insurance type, length of stay, depression type, comorbidity, and the grade of hospital providing hospitalization.
Evaluation on effectiveness and operation mechanism of management system for severe mental disorders: a literature study
YU Qin-wen, SHI Pei-wu, SHEN Qun-hong, et al (, Research Institute, of Health, Development Strategies, Fudan University, Shanghai 200032, China),
 doi: 10.11847/zgggws1136865
Abstract(5) HTML(0) PDF 572KB(1)
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  Objective  To analyze operational effectiveness and mechanism of management system for severe mental disorder (SMD) prevention and control in China for providing references to subsequent policy formulation.   Methods  Through searching official websites, we retrieved policy documents relevant to management on SMDs issued by governmental departments and professional institutions as of December 31, 2018 in 31 provincial-level administrative divisions (PLADs) across mainland China and analyzed the completeness and operation mechanism of the management scheme from four perspectives: management and monitoring, planning and evaluation, financing and compensation, and coordination and motivation based on evaluation standards for effectiveness of a public health system. The indicator data on management of SMD from 2014 through 2018 were also collected from National Severe Mental Disorder Information System and research literatures. The relationships between management implementation and effectiveness were analyzed using fixed effects model.   Results  For 31 PLADs in 2018, the average appropriate degree of SMD management scheme was 43.87%, with an increment of 22.08% to that in 2014 and a gap of 48.39% to the appropriate standard (85%). The dimensional appropriate degree of the SMD management scheme was the highest (64.96%) for financing and compensation mechanism but the lowest (23.69%) for coordination and motivation mechanism. For the dimension of management and monitoring in 2018 at national level, the completeness degree of content and form was relatively high (89.29%) but the degree of clarity for responsibility assignment was relatively low (24.91%), and the degree of management procedure feasibility was only 6.48%; for the dimension of planning and evaluation, the coverage of long-term planning was as high as 96.24%. The results of fixed effect model analysis showed that after adjusting for gross domestic product, significant increase of 1.00 % for completeness of regional SMD scheme, 1.54% for average standardized management rate, and 0.28% for average regular medication of SMD patients were observed (all P < 0.05).   Conclusion  The management mechanism of severe mental disorders has been steadily improved in China from 2014 to 2018; for the management scheme, the coverage of management standards and medium and long-term planning were relatively high , but the coordination and motivation mechanism and t responsibility assignment need to be improved.
Association of interaction between mental health literacy and non-suicidal self-injury with suicidal behaviors among middle school students: a cross- sectional survey in three China cities
ZHANG Zhixian, HUANG Xuexue, HU Jie,
 doi: 10.11847/zgggws1138596
Abstract(11) HTML(1) PDF 587KB(6)
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  Objective   To investigate the association of interaction between mental health literacy (MHL) and non-suicidal self-injury (NSSI) with suicidal behaviors among middle school students in China.   Methods  With multistage cluster sampling, totally 17 000 students were recruited from 39 middle schools in three China cities (Beijing, Zhengzhou of Henan province, and Yangjiang of Guangdong province) for self-administered anonymous survey during October 2020 – June 2021. Two scales compiled by Chinese researchers (Adolescent Mental Health Literacy Assessment Questionnaire [AMHLAQ] and Adolescent Non-suicidal Self-injury Assessment Questionnaire [ANSAQ] and a self- designed questionnaire were adopted in the survey. Multivariate logistic regression model was used to explore the association of interaction between MHL and NNSI with suicidal behavior in the students.   Results  Among the 16 853 students with valid responses, 31.3%, 16.3% and 7.5% reported ever having suicidal ideation, plan and attempt during past one year and the overall self-reported rate of NSSI was 28.9%. Multivariate logistic regression analyses revealed that inadequate MHL and NSSI are risk factors for suicidal ideation, plan and attempt. Furthermore, MHL and NSSI could exert an additive or multiplicative interactive effect on suicidal-related behaviors.   Conclusion  Among middle school students in China, suicidal-related behaviors is relatively prevalent and inadequate MHL and NSSI are risk factors for suicidal ideation, suicidal plan and suicidal attempt; the interaction between the two risk factors could increase the risk of suicide-related behaviors.
Association of mental health with myopia among children and adolescents: a cross sectional survey in Shandong province
WU Hui, XIE Long-tang, HU Yuan-yuan,
 doi: 10.11847/zgggws1136667
Abstract(14) HTML(0) PDF 555KB(3)
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  Objective  To explore the correlation between mental health and myopia in children and adolescents and to provide evidences for developing strategies on myopia prevention.  Methods  Using stratified cluster sampling, we recruited 10 720 students of grade 3 – 8 from 52 primary/junior high schools in 13 urban districts and 13 counties across Shandong province. The students' visual acuity was examined with Standard Logarithm Eyesight Table and computer refractometer during September – December 2020 and their mental health status were assessed simultaneously online with the Mental Health Scale for Child and Adolescent (MHS-CA) developed previously by domestic researchers.   Results  Complete information were collected from a total of 8 672 students (53.9% boys and 46.1% girls, 79.5% primary and 20.5% junior high school students). Compared to the non-myopic students, the myopic students had significantly higher MHS-CA dimension scores for thinking (17.25 ± 2.87 vs. 17.12 ± 2.86, t = – 1.97) and emotion (10.69 ± 1.93 vs. 10.57 ± 1.96, t = – 2.67) (both P < 0.05). The differences in MHS-CA dimension scores for thinking, emotion and volitional behavior between myopic students and non-myopic students became significant with the age increase of the students. There was a significant difference in MHS-CA score among the students in different geographical regions. The occurrence and development of myopia in the students differed significantly by gender (t = – 38.85), schooling grade (t = – 6.75), residence region (t = 4.26), and MHS-CA score for emotional dimension (t = – 2.63) (all P <0.05).   Conclusion  The incidence of myopia in children and adolescents of Shandong province is related to gender, age, residence region, and mental status and the impact factors need to be concerned in myopia prevention in the younger population.
Willingness to seek sexual health service and its associates in 15 – 24 years young people with online sex-seeking experience: a web-based survey in China
PAN Ling, ZHANG Da-peng, CAI Ling-ping,
 doi: 10.11847/zgggws1138309
Abstract(19) HTML(5) PDF 593KB(2)
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  Objective   To examine the attitude towards sexually transmitted disease and acquired immunodeficiency syndrome (STD/AIDS) and the willingness to seek STD/AIDS-related health service in Chinese young people having sexual behavior through online dating.  Methods   Using snowball sampling and 4 online social network platforms, we recruited 15 – 24 years young people with online sex-seeking experience and conducted a voluntary survey via Sojum application from September to November, 2017. A self-designed questionnaire was adopted to collected respondents′ information about demographic characteristic, sexual high-risk behaviors and willingness to seek STD/AIDS-related health service. Descriptive statistics, univariate and multivariate logistic regression were used to analyze the profile of willingness and its impact factors.  Results   Valid information were collected from 730 respondents. Of the 1 119 person-times of responses about intended options for seeking STD/AIDS-related health service, 45.9% (n = 514) reported the intention to visit public hospitals or Center for Disease Control (CDC), followed by the intention to conduct self-testing or treatment (23.6%, n = 264) and to visit private clinic or to have online consultation (19.4%, n = 217); while, 11.1% (n = 124) of the responses reported the disregarding of related healthcare seeking or even the possibility of STD/AIDS infections. Multiple logistic regression analysis revealed that the male respondents were more likely to report the disregarding of related healthcare seeking or even the possibility of STD/AIDS infections compared to the female respondents (P < 0.05) and the respondents having homosexual partners were more likely to report the intention to visit public hospitals or CDC for seeking STD/AIDS-related healthcare (P < 0.05).  Conclusion   Young people with online dating experience have a high demand for STD/AIDS-related healthcare service and different willingness/ approach to seek the healthcare, suggesting that targeted health education on STD/AIDS prevention and treatment needs to be promoted among young populations and strategies of multi-sectoral cooperation are necessary to increase the access to youth-friendly STD/AIDS service.
Prevalence and influencing factors of depression symptoms among emergency nurses in China: a nationwide cross-sectional survey
LEI Zi-hui, FENG Jing, SHEN Xin,
 doi: 10.11847/zgggws1138660
Abstract(8) HTML(1) PDF 618KB(2)
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  Objective  To examine the prevalence and influencing factors of depressive symptoms among emergency nurses in China.   Methods  Totally 20 136 nurses working in emergency departments at least for 6 months were recruited with stratified multistage random sampling in 31 provincial level administrative regions across China for a self-administered questionnaire survey conducted during July – September, 2019. The Center for Epidemiological Studies Depression Scale (CES-D), two scales designed by domestic experts on lifestyle and workplace violence, and a self designed questionnaire were used to collect relevant information of the participants. Descriptive statistics, chi-square test and multivariate binary logistic regression analysis were performed in data analyses with SPSS 22.0.   Results  Of 20 316 participants with valid responses, 26.82% were assessed as with depressive symptom based on the total CES-D score of 20 and above. The results of logistic regression analysis demonstrated that the participants with following characteristics were more likely to have depression symptoms: alcohol drinking (odds ratio [OR] = 1.425), abstaining from alcohol consumption (OR = 1.391), averagely working 10 hours or more per work day (OR = 1.272), perceiving a higher working pressure (OR = 2.358) or very high working pressure (OR = 5.731), and ever experiencing workplace violence (OR = 1.675/3.290/5.982 for low/moderate/high severity); while, the participants elder than 44 years (OR = 0.710), being married (OR = 0.707), having a senior professional title (OR = 0.677), with a good or fair self-assessed health (OR = 0.276 or 0.506), and with good or fair sleep quality (OR = 0.358 or 0.575) were less likely to have depression symptoms.   Conclusion  Among emergency nurses in China, depression symptom is associated with working stress, unhealthy behavioral lifestyle, and workplace violence. Working framework and management strategies for emergency departments should be improved to reduce depression symptoms in emergency nurses.
Evolution of whole society participation in AIDS prevention and control in China: a brief discussion
SUN Quan, CHENG Jun-qi, XU Xiao-jun
 doi: 10.11847/zgggws1138899
Abstract(7) HTML(3) PDF 925KB(1)
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Recognizing AIDS epidemic as a social problem, the article reviews the development process of society participation in AIDS prevention in China during the past 40 years from a panoramic perspective. During the period in China, the concept of AIDS prevention changed from prevention and treatment to prevention and control with a passivity to initiative transformation occurring in the development of whole society participation in AIDS containment. From a long - term consideration, the initiative of whole society participation in AIDS prevention and control needs to be promoted continuously for the construction of a prevention community for effective control of AIDS epidemic.
Survival time and related factors among child HIV/AIDS patients in Anhui province
DAI Se-ying, LIU Ai-wen, JIN Lin,
 doi: 10.11847/zgggws1137822
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  Objective  To examine the survival time of child human immunodeficiency virus (HIV)/AIDS patients and its influencing factors in Anhui province.   Methods  Follow-up and medication information on all laboratory confirmed AIDS patients aged ≤ 15 years at the diagnosis and being permanent residents of Anhui province were collected from National Comprehensive HIV/AIDS Information Management System up to the end of 2020 and analyzed retrospectively. The survival rate was calculated with life table method and impact factors of survival were assessed using Cox regression model.   Results  Among a total of 329 child HIV/AIDS patients being followed-up during the period, 54 died of AIDS-related diseases and the mortality rate was 2.2/100 person-years. The results of Cox proportional hazards regression analysis showed that for all the child patients, the children with AIDS at the time of first diagnosis and not receiving antiretroviral therapy were at a significantly higher risk of AIDS-related disease mortality, with the hazard ratio (HR) of 5.32 (95% confidence interval [95% CI] : 2.70 – 10.47) and 28.29 (95% CI : 14.63 – 54.70) compared to those not having AIDS at the first diagnosis and to those receiving antiretroviral therapy; among the child patients with antiretroviral therapy, the risk of AIDS-related disease mortality were significantly higher for those aged < 5 years at the first diagnosis (versus aged 11 – 15 years: HR = 6.18, 95% CI : 14.63 – 54.70 ), having AIDS at the first diagnosis (versus having HIV infection: HR = 5.07, 95% CI : 1.27 – 20.29), and with the baseline CD4 + T lymphocyte count of < 50 cells/μL (HR = 10.99, 95% CI : 2.04 – 59.20) or 50 – 200 cells/μL (HR = 8.40, 95% CI : 1.35 – 52.26) compared to the child patients with the baseline count of > 200 cells/μL, respectively.   Conclusion  Among child HIV/AIDS patients in Anhui province, antiretroviral therapy is an important factor for survival and the baseline CD4 + T lymphocyte count is the key factor affecting the effect of antiretroviral therapy.
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2022, 38(8).  
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2022, 38(8): 1-1.  
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All for People′s Health – All-Out Response to COVID-19 Epidemic
Effectiveness of centralized quarantine for close contacts′ close contacts: an evaluation on a Delta variant-induced local COVID-19 outbreak
PAN Jin-ren, CHEN En-fu
2022, 38(8): 961-964.   doi: 10.11847/zgggws1139183
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  Objective  To evaluate the effectiveness of centralized quarantine for close contacts′ close contacts (sub-contacts) in coronavirus disease 2019 (COVID-19) epidemic.   Methods  The definition of sub-contacts for this study is based on the State Council′s Joint Prevention and Control Protocol for Prevention and Control of COVID-19 (Edition 8). The information on 8 192 sub-contacts were extracted from the dataset of a COVID-19 epidemic caused by a Delta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a district of Shaoxing city, Zhejiang province in December 2021. All the sub-contacts were followed retrospectively; the epidemiologic survey reports of all sub-contacts with subsequent SARS-CoV-2 infection and the infected sub-contacts′ related cases/close contacts were reviewed and analyzed. The effect of the centralized quarantine for the sub-contacts was assessed as effective, ineffective, adverse effect, and uncertain, respectively based on outcomes (SARS-CoV-2 infection incidence) of follow ups on both the close contacts and the sub-contacts.   Results  Totally 387 confirmed SARS-CoV-2 infections were reported in the epidemic and averagely 21 sub-contacts were associated with one confirmed infection in the epidemic. Of all the sub-contacts, 99.8% were negative for SARS-CoV-2 nucleic acid in multiple successive PCR tests, suggesting an unnecessity of the centralized quarantine. By the end of the retrospective follow-up period, 18 (0.2%) of the sub-contacts were with positive result of SARS-CoV-2 nucleic acid test and all the positive sub-contacts were associated close contacts′ familial cohabitants. Among the 18 SARS-CoV-2 nucleic acid positive sub-contacts, 9 were identified being with the associated close contacts never being positive for SARS-CoV-2 nucleic acid test throughout the retrospective follow-up period, indicating that the sub-contacts might be infected during the transfer or centralized quarantine period. The analysis results suggest that among the 18 SARS-CoV-2 nucleic acid positive sub-contacts, the centralized quarantine is not necessary for all the sub-contacts, ineffective for 3 (16.7%) sub-contacts, with an adverse effect for 9 (50.0%) sub-contacts, and with uncertain effect for 6 (33.3%) sub-contacts, respectively.   Conclusion  The analysis showed no evidence of positive control effect of centralized quarantine for sub-contacts in a Delta variant induced COVID-19 epidemic but that a few sub-contacts could be infected in the process of transfer and centralized quarantine. The analysis results suggest that centralized quarantine for close contacts′ close contacts could be suspended and more studies are needed for effective management on sub-contacts, such as home quarantine in containment of COVID-19 epidemic.
Efficiency of dual test of SARS-CoV-2 antigen and nucleic acid among freight truck drivers and workers passing through expressway toll gates
HONG Hang, FANG Ting, DING Ke-qin,
2022, 38(8): 965-967.   doi: 10.11847/zgggws1139218
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  Objective  To evaluate the efficiency of dual test of severe acute respiratory disease coronavirus 2 (SARS-CoV-2) antigen and nucleic acid among freight truck drivers and workers passing through expressway toll gates.   Methods  Dual tests of SARS-CoV-2 antigen and nucleic acid were conducted among 48 734 freight truck drivers and workers passing through 8 expressway toll gates in Ningbo city from provinces other than Zhejiang province during the period of March 20 – April 17, 2022. The test results were statistically analyzed.   Results  Totally 9 infections of SARS-CoV-2 Omicron variant were detected; of which, 6 were diagnosed clinically as mild coronavirus disease 2019 (COVID-19) case and 3 as asymptomatic infection. No subsequent COVID-19 case was confirmed. For the SARS-CoV-2 antigen test, the sensitivity and specificity were 55.5% (5/9) and 99.9% (48 717/48 725); the positive and negative predictive value were 38.5% (5/13) and 99.9% (48 717/48 721), respectively. For multiplex fluorescence PCR test of SARS-CoV-2 nucleic acid among the participants with positive SARS-CoV-2 antigen result, the Ct values of ORF1ab and N gene M (25th percentile, 75th percentile) were 19.0 (17.1, 21.5) and 19.0 (16.6, 22.5); while, the Ct values of the participants with negative result was significantly higher than those of the participants with positive SARS-CoV-2 antigen result (P < 0.05).   Conclusion  In this study, the sensitivity of SARS-CoV-2 antigen test is low but the specificity of the test is high for the detection of SARS-CoV-2 infection. The results suggest that dual test of SARS-CoV-2 antigen and nucleic acid should be implemented to reduce the risk of imported case-induced local COVID-19 epidemic.
Clinical symptoms and severity of elderly COVID-19 patients infected with different SARS-CoV-2 variants
WANG Hai-feng, LI Ya-fei, PAN Jing-jing, You Aiguo, Wang RuoLin, Fan Wei, Wang Wenhua, Wang Yingying, Ye Ying, Huang Xueyong, Guo Wanshen
2022, 38(8): 968-974.   doi: 10.11847/zgggws1138940
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  Objective   To analyze differences in clinical symptoms and severity of elderly coronvirus disease 2019 (COVID-19) patients infected with Delta, Omicron BA.1 and Omicron BA.2 variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).   Methods  From China′s Infectious Disease Information System, provincial center for disease control and prevention, and local designated hospitals, we collected socio-demographic and clinical information on 60 years and older COVID-19 patients reported in the four large-scale COVID-19 epidemics in Henan province during 2022 and the SARS-CoV-2 variants for the patients′ infections were identified based on gene sequencing in combination with epidemi-ological investigation. Chi-square and Fisher′s precision probability test were used to compare the differences in the incidence of patients infected with different variants and multivariate logistic regression was adopted analyze the influencing factors of disease severity.   Results  The total number of elderly cases for the four local COVID-19 epidemics was 234, including 118, 36, and 80 cases infected with SARS-CoV-2 Delta, Omicron BA.1, and Omicron BA.2 variant. Of all the cases, 56.8% were female; 47.6% suffered from underlying diseases; and 88.0% had COVID-19 vaccination. The main clinical manifestations for all the cases were fever, fatigue and upper respiratory symptoms such as cough, sore and dry throat. The symptomatic proportion in the cases with Delta variant infection was significantly higher than that in the cases with Omicron variant infection (34.7% vs. 19.0%, P = 0.007). The proportion of severe or critical conditions was significantly higher in the cases with Delta variant infection than that in the cases with Omicron variant infection (12.7% vs. 1.7%, P = 0.002). The results of multivariate logistic regression analysis revealed following risk factors for the occurrence of severe or critical conditions among the elderly cases: infected with Delta variant (odds ratio [OR] = 5.7, 95% confidence interval [95% CI]: 1.1 – 31.2), aged ≥ 80 years (OR = 8.4, 95% CI = 2.0 – 34.4), suffering from dyskinesia (OR = 5.3, 95% CI: 1.5 – 18.3), and suffering from diabetes (OR = 5.7, 95% CI: 1.1 – 31.3).   Conclusion  In COVID-19 patients aged 60 years and above, clinical symptoms and the occurrence of server or critical conditions differ by different SARS-CoV-2 variants and the patients with Delta variant infection, at older age, and with underlying diseases are at a higher risk of having severe or critical conditions.
Epidemiological characteristics of a local COVID-19 outbreak caused by Omicron (BA.2.2) variant in Henan province
PAN Jing-jing, WANG Ying-ying, WANG Wen-hua,
2022, 38(8): 975-979.   doi: 10.11847/zgggws1138726
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  Objective  To analyze epidemiological characteristic and transmission process of a local coronavirus disease 2019 (COVID-19) outbreak induced by imported cases from other provinces in Henan province.   Methods  The data on all local COVID-19 cases in Xiuwu county, Henan province reported during March 18 – 28, 2022 were extracted from National Notifiable Disease Report System. The results of field investigations on the cases were also collected simultaneously. Descriptive statistics was performed on the data collected with SPSS 22.0.   Results  Totally 45 cases (16 males and 29 females, 14 minor or common patients and 31 asymptomatic infections) were reported during the 11-day outbreak period. The median age (25th percentile [P25], 75 percentile [P75]) of the cases was 23.02 (18.57, 28.64) years. The median (P25, P75) of cycle threshold (Ct) value for Orf1ab gene and N gene for positive cases in primary screening were 23.02 (18.57, 28.64) and 23.10 (18.63, 28.03), respectively. A case clustering involving 18 cases was identified in a local textile factory, with an incidence rate of 6.6%; seven family clusters were also identified, with a family secondary attack rate of 20.78% and a secondary attack rate of 3.79% among close contacts. Of all the cases, 12.5% could attributed the infection to the exposure to the asymptomatic infections being negative for nucleic acid test at that time. The results of genome second generation sequencing for the isolates from 29 infections indicated that the pathogen of the outbreak was severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant Omicron (BA.2.2) and the local transmission of the virus variant was traced back to the 2 first generation cases returning home from other epidemic area. The median (P25, P75) of incubation period was 3 (2, 4.25) days and that of generation interval was 3 (2, 3) days. Five generations of transmission were identified for the outbreak . The estimated basic reproductive number (R0) of this epidemic was 6.14, and the effective reproduction number (Rt) decreased 2 days after the control measures were taken and declined to less than 1 in 8 days after the implementa-tion of control measures.   Conclusion  The reported COVID-19 outbreak in Henan province was caused by imported cases from other epidemic area and spread mainly in factories, families and schools. The control measures on the outbreak were effective and subsequent transmission was prevented.
Spatial-temporal clustering of cases in a COVID-19 outbreak in Guangzhou city
ZHANG Qian, CHEN Xu-guang, HU Jian-xiong,
2022, 38(8): 980-984.   doi: 10.11847/zgggws1137165
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  Objective   To explore spatial-temporal clustering of coronavirus disease 2019 (COVID-19) cases in an outbreak epidemic in Guangzhou city, Guangdong province and to provide evidences for developing COVID-19 prevention and control measures.   Methods  The data on 215 local COVID-19 cases reported in Guangzhou city from April 4 to May 2, 2020 were collected and the cases′ demographics and spatial-temporal distribution were described statistically. Knox test was used to identify possible spatial-temporal clustering of the cases by given specific critical thresholds. The spatial thresholds for the distance between the two cases′ residential address were set varying from 0 to 1000 meters (m) with an interval of 100 m; the temporal thresholds for the time interval between the two cases′ incident time were set varying from 1 to 15 days with an interval of 1 day. The strength of clustering (S-value) and relative risk (RR) of clustering for each gender- and age-group-specific case pair were calculated to analyze temporal-spatial clustering of case pairs.   Results  The S-value and RR of the COVID-19 case pairs decreased with the increment in pairs′ spatial distance and time interval. The RR value was the highest for a pair with the nearest spatial distance under the interval time of 1 day. For a case pair with the time interval of 1 day, the RR was 2.4 when the spatial distance between the pair′s two cases being 100 m, while the RR was only 1.2 when the spatial distance being 3 kilometers (km). For male-male pairs, the S-value was higher under the time interval of 1 – 5 days with a spatial distance less than 300 m; for female-female pairs, the S-value was higher under the time interval of 1 – 7 days with a spatial distance less than 400 m; and for male-female pairs, the S-value was higher under the time interval of 1 – 4 days with a spatial distance less than 500 m. A stronger trend of spatial-temporal clustering was observed among female-female case pairs than among male-male case pairs. For age-group-specific case pairs, the S-value of child-child pairs with the time interval of 1 day was significantly higher than that of other age-group pairs and the S-value of middle-aged-youth pairs was higher under the time interval of 1 – 5 days with a spatial distance of less than 300 m.   Conclusion  Spatial-temporal clustering with between gender and age group differences was observed among the COVID-19 cases of an outbreak epidemic in Guangzhou city.
Safety of inactivated COVID-19 vaccine in 3 – 17 years old healthy children
LI Min-jie, WANG Lei, WU Zhi-wei,
2022, 38(8): 985-989.   doi: 10.11847/zgggws1138965
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  Objective  To evaluate the safety of an inactivated coronavirus disease 2019 (COVID-19) vaccine in healthy children and adolescents aged 3 – 17 years.   Methods  Totally 500 healthy children and adolescents aged 3 – 17 years were recruited in Zanhuang county of Hebei province and randomly assigned into a vaccination group (n = 375) and a placebo group (n = 125) during May 2021. Two doses of inactivated COVID-19 vaccine (Sinovac Life Sciences Co., Ltd, Beijing) or placebo (day 0 and day 28) were administered to the participants. The participants were observed for adverse reactions within 30 minutes after each vaccination. The participants′ information on local and systemic solicited adverse events from day 0 to day 7, and unsolicited adverse events from day 0 to day 28 were collected after the vaccination. Serious adverse events were recorded from the beginning of vaccination to 6 months after the second dose vaccination to evaluate the safety of the vaccine.  Results  The incidence of adverse reactions was 19.2% (72/375) in the vaccination group and 15.2% (19/125) in the placebo group, without significant difference between the incidence of the two groups (P > 0.05). The most common adverse reactions were injection site pain and fever. There was no significant statistical difference in the incidence of other adverse reactions between the two groups except for pain at the injection site. Most observed adverse reactions were grade 1 and 2 in severity, only 3 participants reported grade 3 adverse reactions. The vaccination group′s incidences of adverse reactions of grade 1 (14.93% vs. 12.8%), grade 2 (7.73% vs. 4%), and grade 3 (0.53% vs. 0.8%) were not significantly different from those of the placebo group. No serious vaccination-related adverse event was reported in either group. The incidence of adverse reactions was higher (28%) in the 3 – 5 years old participants than those in the participants aged 6 – 11 and 12 – 17 years (16% and 15.5%) and the age-group-specific adverse reaction incidences were not significantly different between vaccination group and placebo group. The incidence of adverse reactions for the first dose vaccination was significantly higher than that for the second dose (14.6% vs. 5.69%, P < 0.05) and there was no significant difference in the dose order-specific adverse reaction incidence between the vaccination group and the placebo group.  Conclusion  The inactivated COVID-19 vaccine is of good safety when administered in 3 to 17 years old healthy children.
Characteristics of SARS-CoV-2 vaccine breakthrough infections among Chinese travelers entering China via Chengdu city
LONG Lu, LIU Zhu, MAO Yi,
2022, 38(8): 990-995.   doi: 10.11847/zgggws1137924
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  Objective  To investigate the characteristics and prognosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine breakthrough infections for providing a reference for coronavirus disease 19 (COVID-19) epidemic prevention and control.   Methods  We collected the information on 38 SARS-CoV-2 infections laboratory-confirmed among Chinese travelers entering China via Chengdu city, Sichuan province during the period from December 10, 2020 to July 7, 2021 and divided the infections into a vaccine breakthrough group (14 male cases ever receiving domestic inactivated COVID-19 vaccine and with confirmed genotype of SARS-CoV-2 strains inducing the infections) and a natural infection group (18 male and 6 female cases reporting no COVID-19 vaccination history). Comparison analyses were conducted to examine differences between the two groups in epidemiological characteristics, clinical/laboratory indicators and treatment outcomes.   Results  The participants arrived at Chengdu from 15 foreign countries during December 10, 2020 – July 7, 2021 and were diagnosed with SARS-CoV-2 infection within the period of December 11, 2020 – July 12, 2021; all the participants reported no history of SARS-CoV-2 infection/nucleic acid positive before entering China. In the vaccine breakthrough group, 9 participants had two doses of COVID-19 vaccine by separate inoculations with the interval of 56 days, 3 had two doses in one inoculation and only 2 had one dose; the interval from the last vaccination to the confirmation of SARS-CoV-2 infection ranged 8 – 173 days, with a median of 100 days. No statistically significant between-group differences were observed in the distribution of age (35.0 ± 7.7 vs. 35.8 ± 10.9 years), Pangolin-based genotyping of SARS-CoV-2 strains isolated, and the time of nucleic acid negative conversion from the first positive detection (t = 1.106, P > 0.05). Compared to the participants of natural infection, the participants with vaccine breakthrough infection had following significantly higher indicators: Ct value for N gene (26.8 ± 4.1 vs. 22.4 ± 7.4) and ORF1ab gene (29.4 ± 4.5 vs. 24.8 ± 6.9) of SARS-CoV-2 (t = 2.376 and t = 2.228, both P < 0.05); 50th percentile (P50), (25th percentile [P25], 75th percentile [P75]) of immunoglobulin M (IgM) antibody titer (0.9 [0.3, 11.6] vs. 0.040 [0.027, 0.096]); P50 (P25, P75) of immunoglobulin G (IgG) antibody titer (4.5 [1.7, 7.6] vs. 0.006 [0.003, 0.052]); total antibody titer (31.9 [4.6, 916.4] vs. 0.015 [0.010, 0.038]) (P < 0.05 for all); and the counts of lymphocyte, CD3+ T lymphocyte, CD3+/CD4+ T lymphocyte, CD3+/CD8+T lymphocyte detected at the time of hospital admission (all P < 0.05). While the participants of vaccine breakthrough infection had significantly lower peripheral blood eosinophil count and neutrophil percentage than those of the participants with natural infection (both P < 0.05). Although there was no significant between-group difference in the duration of hospitalization (t = 1.889, P > 0.05), the proportion of the participants being hospitalized less than 20 days was significantly higher for the vaccine breakthrough group than that for the natural infection group.   Conclusion  For COVID-19 vaccine breakthrough infections, the vaccination helps to reduce viral load and may enhance the vaccinees′ T-cell immune response and exert a positive impact on vaccinees′ outcome of the infection treatment.
Vaccination-related contamination-induced false positive SARS-CoV-2 specimen from a suspected COVID-19 case in Chengdu city: a gene tracing-based analysis
XIE Wen-jun, CHEN Heng, FENG Jing,
2022, 38(8): 996-1000.   doi: 10.11847/zgggws1137810
Abstract(247) HTML(71) PDF 641KB(61)
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  Objective  To conduct a gene tracing-based analysis on a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive oropharyngeal swab specimen from a suspected coronavirus disease 2019 (COVID-19) case without epidemiologically-confirmed exposure history and with negative results in confirmation tests in Chengdu city, Sichuan province for providing evidence to the operation of clinics engaged in COVID-19 vaccination.  Methods  An epidemiological investigation was conducted on a suspected COVID-19 case reported by a medical institution providing both COVID-19 vaccination and SARS-CoV-2 nucleic acid screening services in a district of Chengdu city, Sichuan province on February 24, 2021. The information on case′s onset and treatment, travel and close contacts within 14 days before the onset were collected and analyzed. Specimen collection and laboratory nucleic acid testing were conducted for the case, the case′s close contacts and living environment, and the environment and work clothes of medical staff of the reporting medical institution. Second generation gene sequencing and gene tracing analysis were performed for the case′s positive specimen collected for the screening test.   Results  The suspected case was a 57-year old man seeking medication for cough, throat discomfort, and runny nose at a medical institution provided both COVID-19 vaccination and SARS-CoV-2 nucleic acid screening services and having a oropharyngeal swab test for screening SARS-CoV-2 infection at the medical institution on February 23, 2021. The case reported no history of travelling abroad himself and his close contacts, contacting with confirmed/suspected COVID-19 patients, potential exposure to SARS-CoV-2, and COVID-19 vaccination. No positive results of SARS-CoV-2 nucleic acid were detected for case′s oropharyngeal/nasal and anal swab specimens, close contacts′ oropharyngeal swab specimens, swab specimens of living/working/relevant public place environment, swab specimens of environment and working clothes of the staff of the medical institution for retests performed one day after the case′s screening test. The results of gene sequencing for the case′s positive specimen at the screening test showed a 99.99% sequence homology with the sample of COVID-19 vaccine for inoculation service at the medical institution. The Pangolin type was B for both the case′s specimen and the vaccine sample.   Conclusion  The clinical manifestation and laboratory test of the suspected case were not consistent with the diagnosis criterion for COVID-19 patient and asymptomatic SARS-CoV-2 infection. The case′s false SARS-CoV-2 positivity of the suspected specimen at the screening test probably results from vaccination related contamination of the case′s oropharyngeal swab specimen at the medical institution proving both COVID-19 vaccination and SARS-CoV-2 nucleic acid screening services. The result needs to be concerned when conducting SARS-CoV-2 nucleic acid screening.
Construction of grounded theory-based vaccination decision-making process model for the public: a empirical study in college students
FAN Kai-sheng, HAO Yan-hua, GUAN Han-wen,
2022, 38(8): 1001-1006.   doi: 10.11847/zgggws1136354
Abstract(604) HTML(195) PDF 661KB(163)
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  Objective  To construct a decision-making process model on vaccination of coronavirus disease 2019 (COVID-19) vaccine and to explore reasons of unwilling to have the vaccination from public perspective for providing theoretical evidences to COVID-19 vaccination promotion.   Methods  Using a self-designed open-ended questionnaire on COVID-19 vaccine hesitancy, we conducted a survey among 347 students in a medical university during March 27 – 29, 2021 – one week after the students′ applying voluntarily for COVID-19 vaccination. Word frequency and text node analysis on collected information were carried out and word cloud maps were generated with NVivo 12 software. A theoretical framework for vaccination decision-making process model was constructed based on grounded theory.   Results  Valid information were collected from all the participants. In the respondents′ responses in writing about reasons for having COVID-19 vaccination, the words with high frequency included COVID-19, prevention, vaccination, and free of charge; while, safety, vaccine, effectiveness and adverse reaction were among the high frequency words in the writings on COVID-19 vaccine hesitancy. In the respondents′ writing texts, 3 parent nodes and 9 child nodes were identified. According to theoretical models of bio-psycho-social medicine, protective behavior decision, and vaccine hesitation/vaccination willingness and considering the results of previous studies, the public motivation for COVID-19 vaccination could be summarized into three aspects with nine causal factors as following: objective biological determination (factors relevant to virology/pharmacology and physiology/pathology), subjective psychological determination (personal risk and benefit judgment, vaccine safety, vaccine efficacy, and perceived social responsibility), and social determination (service accessibility, information accessibility). The three determinant aspects with nine relevant factors ought to be concerned in the construction of theoretical framework of vaccination decision-making process model for the public.   Conclusion  A vaccination decision-making process model for the public was preliminarily constructed for the promotion of COVID-19 vaccination willingness and behavior in Chinese population.
Positivity of SARS-CoV-2 nucleic acid and antibody of different biological specimens from COVID-19 cases in Dongguan city – a comparative analysis
XU Lin, CHEN Rong, HONG Yun,
2022, 38(8): 1007-1010.   doi: 10.11847/zgggws1136175
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  Objective  To investigate positive rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid and antibody of different biological samples from diagnosed coronavirus disease 2019 (COVID-19) patients.   Methods  A variety of biological samples were collected from 101 confirmed COVID-19 cases and 35 asymptomatic infected persons in Dongguan city, Guangdong province from January 23 to October 9, 2020. SARS-CoV-2 nucleic acid was detected with real-time fluorescence quantitative reverse transcriptase polymerase chain reaction (RT-PCR); serum immunoglobulin M (IgM) and IgG antibodies against SARS-CoV-2 were measured with colloidal gold method. The detection results were analyzed statistically.   Results  The median duration of persistent positivity of SARS-CoV-2 nucleic acid the was 7.00 days (interquartile range: 0.00 – 27.00 days) for all the patients. Within 0 – 7 days after the onset of COVID-19, the positive rates were 48.21% (121/251), 36.00% (9/25), and 31.82% (7/22) for pharyngeal, anal, and nasopharyngeal swab specimens, respectively. No SARS-CoV-2 nucleic acid positive urine samples were detected during whole course of the disease for all the patients. SARS-CoV-2 nucleic acid positive pharyngeal, anal, and nasopharyngeal swab specimens were detected but no positive sputum and feces samples were detected among the asymptomatic patients.   Conclusion  With the progress of disease, the positive rate of SARS-CoV-2 nucleic acid decreases for pharyngeal, anal, and nasopharyngeal swab specimens from COVID-19 patients but that of serum IgG antibody against SARS-CoV-2 increases.
Transmission route of SARS-CoV-2 and personal health intervention: a review on research advances
TU Hong-wei, GAN Ping, ZHONG Ruo-xi,
2022, 38(8): 1011-1017.   doi: 10.11847/zgggws1138953
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The conronavirus disease 2019 (COVID-19) pandemic exerts a major impact on the world. Understanding the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can help public health personnel to define the prevention and control priorities in practical work. This study summarized the existing literature (update to May 2, 2022) and analyzed and classified the main transmission routes of SARS-CoV-2 based on typical cases and laboratory studies, and proposed relevant prevention and personal protection strategies to provide a basis for more accurate and effective control of SARS-CoV-2 transmission.
Epidemiological Research
Revision and an empirical evaluation of the Chinese Patient Health Literacy Scale
CHEN Ying, DONG Jian, TIAN Xiang-yang,
2022, 38(8): 1018-1023.   doi: 10.11847/zgggws1136236
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  Objective   To modify the Chinese Patient Health Literacy Scale (CPHLS) for improving the reliability and validity of the scale.   Methods   From January to May 2021, t he CPHLS was preliminarily revised by expert consultation and the revised electronic scale was employed to measure the health literacy of 2 808 outpatients randomly selected at 14 hospitals in eastern, central and western China. SPSS 23.0 was utilized for Cronbach′s α calculation and exploratory factor analysis (EFA) to further improve the revised scale; AMOS 23.0 was applied to build a structural equation model (SEM) to test the validity of the scale.   Results   The Cronbach′s α coefficient of the preliminarily revised CPHLS was 0.841 and the α coefficients of the scale′s five dimensions were 0.751 for concept of medical science, 0.787 for disease self-management skills, 0.568 for medical common sense, 0.725 for self-efficacy , and 0.412 for medical information cognition, respectively, with an overall cumulative proportion of variance of 62.538%. Three common factors of the revised scale (e.g. self-efficacy, disease self-management skills and medical common sense) were extracted according to the results of EFA. After deleting four original items, the α coefficient of the revised scale was raised to 0.845, the α coefficients of the three dimensions were 0.926, 0.831, and 0.753 and the cumulative proportion of variance was 67.228%. The SEM analysis on the revised scale demonstrated that the dimension-specific factor load capability ranged 0.53 – 0.90 and the constructed SEM is of good overall goodness of fit, with the root mean square residual (RMR) of 0.083, root mean square error of approximation (RMSEA) of 0.086, goodness-of-fit index (GFI) of 0.926, adjusted goodness-of-fit index (AGFI) of 0.891, normed fit index (NFI) of 0.928, relative fit index (RFI) of 0.909, incremental fit index (IFI) of 0.931, the Tacker-Lewis index/non-normed fit index (TLI/NNFI) of 0.913, comparative fit index (CFI) of 0.931, parsimony goodness-of-fit index (PGFI) of 0.631, parsimony-adjusted normed fit index (PNFI) of 0.737, parsimony-adjusted comparative fit index (PCFI) of 0.740, and the critical number (CN) of 171, respectively.   Conclusion   The revised Chinese Patient Health Literacy Scale is of good internal consistency reliability and construct validity, indicating a potential application in the evaluation on patients' health literacy.
Knowledge on contraception and safe sex among college students in Shanghai: a network-based cross-sectional survey
XIA Wen-rong, ZHAN Chun-lin, ZHOU Hai-wang,
2022, 38(8): 1024-1029.   doi: 10.11847/zgggws1136687
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Abstract:
  Objective   To examine the knowledge on contraception and safe sex among college students in Shanghai for providing evidences to promote reproductive health of college students in China.   Methods  An onsite/online network-based anonymous survey was conducted among 16 235 students of various degrees in 62 colleges and universities during June – November, 2019. A self-designed questionnaire on knowledge, attitude and behaviors about safe sex and contraception was used in the survey.   Results  Of the 14 612 students (4 829 males and 9 783 females averagely aged 21.63 years) with valid replies, 24.93% reported ever having sexual behavior. Among the respondents with sex experiences, 66.80% reported adopting contraceptive measures every time but 3.46% stated never taking contraceptive measures when having sex; and unintended pregnancy was reported by 7.24% of the respondents. For all the respondents in terms of contraceptive measures, the knowledge rate was 82.90% for condom, 26.51% for spermicide, 17.72% for contraceptive injections, and 15.30% for contraceptive subcutaneous implant. The reported knowledge about induced abortion was higher among the female respondents than among the males. There were 47.16% of all the respondents not having sufficient knowledge about sexually transmitted disease and AIDS and the ratio was lower among male respondents than among the females.   Conclusion  In colleges or universities of Shanghai, the students are open in their attitude about sex and active in sexual relationships but the students are lack of knowledge about contraception and avoidance of unintended pregnancy. The results suggest that specific education on safe sex and a better reproductive health services should be promoted among the students.
Physical activity parenting practice and its influencing factors among parents of preschool children in southern cities, China
WU Hua, RUAN Hui, WANG Shan-shan,
2022, 38(8): 1030-1034.   doi: 10.11847/zgggws1137782
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Abstract:
  Objective  To examine the prevalence and influencing factors of physical activity (PA) parenting practice among urban parents of preschool children for providing evidences to develop strategies on promoting PA of the children in China.   Methods  Using non-probabilistic sampling and a self-designed questionnaire, we conducted an online survey among 4 074 parents of healthy kindergarten children at 9 large and medium-sized cities in southern regions of China during February 2021. Contingency table chi-square test was adopted to explore the influence of different PA parenting practices on young children′s PA.   Results  Of the 3 959 participants with valid responses, 39.28% and 27.12% reported having a at least 30 minutes′ leisure-time physical activity (LTPA) 2 – 3 times and once a week; while, 20.86% reported not having LTPA every week. Among all the participants, 58.59% reported the PA parenting practice at the frequency of 1 – 2 times/week and aerobic exercise and chasing/role-playing game were the most popular parent-child PA, being reported by 55.83% and 52.68% of the participants having the practice. In terms of family support to children′s PA, the top three considerations of the parents were allowing a child to play in parks or other outdoor places frequently (selected by 87.82% of all the participants), buying sports equipment to meet children′s PA needs (69.87%), and encouraging children to play freely (69.21%); only 26.02% of the participants chose financially supporting children to take program in sports training facilities. Significant impact factors for PA parenting practice included parental role disparity (χ2 = 23.31, P < 0.001), gender stereotype-related differences in parents′ cognition on required PA time (χ2 = 9.91,P = 0.042) and intensity (χ2 = 17.14, P = 0.001) for the boys or girls.   Conclusion  Physical activity parental practice may be more effective in family-based support to young children′s physical exercise if the parents could have correct cognition about parental role and gender stereotype.
Effectiveness and operability of different screening methods for diabetes in community populations: a comparative analysis
LI Yan-yun, WANG Si-yuan, YANG Qin-ping,
2022, 38(8): 1035-1038.   doi: 10.11847/zgggws1135267
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Abstract:
  Objective  To evaluate the efficiency and practical significance of different diabetes screening methods in community population and to provide evidences for the establishment of community diabetes screening process.   Methods  Using multistage cluster random sampling, we recruited 23 940 permanent residents aged ≥ 35 years and without acute or serious chronic diseases/type I diabetes in urban communities and rural villages of 7 districts of Shanghai for a questionnaire survey, physical examination and blood glucose measurement during October – December, 2017. The effectiveness and operability of an early-detecting process, risk score assessment and fast plasma glucose (FPG) screening for type 2 diabetes (T2DM) were evaluated by comparing the three methods′ sensitivity, specificity, Youden index , area under the receiver operating characteristic curve (AUROC), the proportion of abnormal FPG and oral glucose tolerance test (OGTT).   Results  Of the 17 981 previously undiagnosed diabetics identified among the residents and included in the analysis, 4 129 prediabetics and 2 213 diabetes were detected, with the prevalence rates of 22.96% and 12.31%, respectively. For the three methods (early-detecting process vs. risk score assessment vs. FPG screening) in detections of diabetes/prediabetic in previously undiagnosed diabetic population, the sensitivities (%) were 87.3/61.0 vs. 96.7/93.3 vs. 82.5/47.8; the specificities (%) were 60.2/58.9 vs. 15.2/15.8 vs. 87.5/86.0; the Youden indexes were 0.479/0.199 vs. 0.119/0.091 vs. 0.700/0.338, and the values of AUROC were 0.858/0.620 vs. 0.680/0.602 vs. 0.922/0.708; also for the three methods, the proportions (%) of the examinees requiring FPG/2-hour plasma glucose detection of OGTT were 45.7/42.6 vs. 86.3/86.3 vs. 100/21.1, respectively.   Conclusion  In diabetes screening among community residents, early-detecting process could achieve a higher detection rate of abnormal glucose metabolism with a minimum number of venous blood glucose detection and simplified on-site implementation procedures and the process could be adopted effectively in large-scale prediabetics and diabetes screening in community populations.
Experimental Study
Expression and significance of inflammatory markers in rats with arsenic-induced lung injury
WANG Wen-juan, ZHENG Fan-yan, WANG Qing-ling,
2022, 38(8): 1039-1042.   doi: 10.11847/zgggws1136963
Abstract(53) HTML(16) PDF 1237KB(13)
Abstract:
  Objective  To investigate lung injury effect of sodium arsenite (NaAsO2) in rats and the expression and significance of inflammatory markers associated with the injury.   Methods  Thirty-two Wistar rats were randomly divided into four groups according to body weight: a control group and three groups with 4-month gavage administration of NaAsO2 at dosages of 2.5, 5, and 10 mg/kg per day. The expression of Clara cell secretory protein (CC16), matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinases-1 (TIMP-1) in lung tissue and serum were detected with immunofluorescence assay and enzyme-linked immunosorbent assay (ELISA). Pearson correlation analysis was adopted to assess the association between expressions of the markers in lung tissues and serum.   Results  After 90 days′ treatment, the body weight of the rats exposed to moderate- and high-dose NaAsO2 decreased significantly (P < 0.05). For the rats with NaAsO2 treatment, the expression of CC16 in lung tissue and serum of reduced significantly (P < 0.05) and the expression of CC16 in lung tissue was positively correlated with that in serum (r = 0.89, P < 0.05); while, the expression of MMP-9 in lung tissue and serum increased significantly (P < 0.05) and MMP-9 expression in lung tissue was positively correlated with that in serum (r = 0.50, P < 0.05); the ratio of MMP-9/TIMP-1 expression in lung tissue was positively correlated with the ratio of the expressions in serum (r = 0.38, P < 0.05).   Conclusion  Arsenic exposure can induce lung injury in rats and expressions of inflammatory markers in lung tissue and serum are associated with the development of arsenic-induced lung injury.
Survey and Report
Effective utilization of infectious disease surveillance system in China: a literature study-based analysis
HU Yi-ming, SHI Pei-wu, SHEN Qun-hong,
2022, 38(8): 1043-1047.   doi: 10.11847/zgggws1138155
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Abstract:
  Objective  To analyze current situation, development trend and regional disparity about effective utilization of infectious disease surveillance system and the effect of the utilization on infectious disease prevention and control in China.   Methods  Relevant literatures and reports on infectious disease risk monitoring and early warning issued during 2004 – 2019 by infectious disease surveillance system in 31 provincial-level administrative divisions in China were systemically retrieved through searching websites of governmental agencies, professional organizations, China National Knowledge Infrastructure and Web of Science. The data on infectious disease incidence were extracted from China Health Statistics Yearbook for years from 2005 to 2020. The information collected were quantitatively analyzed to assess effective utilization of the infectious disease monitoring system. Spearman correlation and linear regression were adopted to explore the association of effective utilization of surveillance systems and infectious disease morbidity.   Results  The average index for countrywide effective utilization of infectious disease surveillance system was 9.64% in 2019, with an increment of 1 338.81% compared with that in 2004; the average index for eastern region was relatively higher (11.73%) than that for other regions of China. Correlation and regression analysis showed that there was a reverse correlation between the effective utilization of infectious disease surveillance system and the incidence of infectious diseases at regional and national level, with the nationwide correlation coefficient of − 0.88 (P < 0.01) and standardized regression coefficient of − 6.87 (P < 0.001).   Conclusion  The utilization of infectious disease surveillance system has been improved steadily during 2004 – 2019 in China, but regional difference for the utilization still exists and continuous efforts should be made for effective utilization of the surveillance system.
Population life expectancy and mortality in main countries along the "Belt and Road": a comparison analysis
LONG Zheng, LIU Wei, WANG Li-jun,
2022, 38(8): 1048-1053.   doi: 10.11847/zgggws1136718
Abstract(38) HTML(22) PDF 1027KB(8)
Abstract:
  Objective  To compare life expectancy and mortality among populations in main countries along "Belt and Road" between 2009 and 2019 for providing evidences to promote sustained health cooperation with the countries and active participation in global health governance.   Methods  Data on life expectancy and mortality of residents in 13 major countries along the “Belt and Road” were collected from the Global Burden of Disease Study 2019 (GBD 2019). Life expectancy and mortality of infectious diseases, maternal and infant diseases, nutritional deficiencies, chronic diseases, and injury in 2009 and 2019 were compared among these countries.   Results  The life expectancy of residents in all the 13 major countries along the “Belt and Road” in 2019 increased compared with those in 2009, with the highest increment in Myanmar (5.5 years), and the lowest in Vietnam and the Philippines (both 1.4 years). Compared with those in 2009, the age standardized mortality rate of infectious diseases, maternal and infant diseases, nutritional deficiencies, chronic diseases, and injury among residents of 13 major countries along the “Belt and Road” have decreased in 2019, and the highest decline in the age standardized mortality rate of infectious diseases, maternal and infant diseases and nutritional deficiencies was seen in Myanmar (47.1%) and the lowest decline was seen in Thailand (10.5%). The highest decline in the age standardized mortality rate of chronic diseases was in Russia (21.5%), and the lowest decline was in Indonesia (2.9%). Russia had the highest decrease (33.0%) in age standardized mortality rate for injury, and the lowest decrease was seen in Turkey (4.7%). Compared with those in 2009, among the 13 major countries along the “Belt and Road” in 2019, Iran had the highest increase in the mortality rate of residents aged 70 and older (5.5%), and Bangladesh had the highest decrease (13.4%). In 2009 and 2019, the proportion of causes of death from infectious diseases, maternal and infant diseases, and nutritional deficiencies were the lowest in Russia (4.3%) and in China (3.3%), and the highest were both in Pakistan (47.5% and 39.0%); for chronic diseases, the proportion was the lowest in Pakistan (46.8% and 55.3%), and the highest was in Turkey (88.1%) and in China (90.1%); the lowest proportion of deaths caused by injury was seen in Turkey (5.0% and 4.9%), and the highest was in Iran (14.9% and 10.5%). There were differences in the ranking of causes of death among different populations and countries. Stroke and ischemic heart disease were the leading two causes in 10 major countries along the “Belt and Road” in 2009 and 2019 except for in Egypt, India, and Pakistan.   Conclusion  The life expectancy and mortality varied substantially for residents in 13 major countries along the “Belt and Road”. Health cooperation should be strengthened among the countries.
Screening, early diagnosis and treatment of liver cancer in Zherong county of Fujian province: 2012 – 2019
LIN Yong-tian, WEI Qing-song, YANG Sheng-yun,
2022, 38(8): 1054-1057.   doi: 10.11847/zgggws1135840
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Abstract:
  Objective  To examine outcomes of screening, early diagnosis and treatment of liver cancer in Fujian province and to provide evidences for the evaluation on population-based liver cancer screening.   Methods   Zherong county in a mountainous rural region of the province was selected with cluster sampling for the analysis. Serum hepatitis B virus surface antigen (HBsAg) was tested among all male residents aged 35 – 64 years and female residents aged 45 – 64 years in diagnostic screenings on liver cancer carried out from July 2012. Then serum alpha-fetoprotein (AFP) detection and B-mode ultrasonography (BU) of liver were performed in all HBsAg-positive residents every 6 months after the screening. All diagnosed liver cancer patients were followed up till April 30th, 2021 and observed survival of the patients were calculated with life table method. The efficiency of the screening, early diagnosis and treatment were assessed using rate of task completion, detection, early diagnosis, and early treatment.   Results  Of 51 486 residents having HBsAg screening from July 2012 through December 2019, 4 412 (8.72%) were positive. Among the HBsAg-positive participants, 10 653 person-times of AFP detection and BU of liver were carried out, with an overall task completion rate of 94.16%, and totally 49 liver cancer cases were detected, with the detection rate of 0.32%. For all the diagnosed liver cancer cases, the rate of early detection was 40.81% and that of early treatment was 79.59%. The calculated 1-, 3-, 5-year survival of the liver cancer cases were 75.51%, 43.28%, and 34.96% and the survivals were significantly higher than those of 36.18%, 16.56%, and 11.60% for the liver cancer patients registered from 2012 through 2014 in Fujian Provincial Cancer Registry System (P < 0.05 for all).   Conclusion  The study findings suggest that semiannual serum AFP detection and BU of liver could detect liver cancer cases more effectively in HBsAg-positive population and the survival of the detected liver cases may be increased due to early diagnosis and treatment.
Changes in erythrocyte methylmercury among women during pregnancy: a monocentric survey and comparison study
CHEN Xing, LUO Jia-yao, CHEN Huan, CHEN Xi,
2022, 38(8): 1058-1061.   doi: 10.11847/zgggws1136158
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Abstract:
  Objective   To investigate changes in peripheral erythrocyte methylmercury among pregnant women during different gestational periods and the methylmercury in neonatal umbilical cord blood erythrocyte.   Methods  Totally 79 pregnant women having prenatal examination were recruited at a women′s and children′s health care center in Wuhan city during January – April, 2019. The women′s peripheral blood samples were collected at the first trimester (12 ± 2 weeks of gestation) and the third trimester (37 ± 2 weeks of gestation) and neonatal umbilical cord blood samples were also collected. Red blood cells of the samples were separated and concentrations of methylmercury in the cells were detected with high performance liquid chromatography-inductively coupled plasma mass spectrometry (HPLC-ICP-MS).   Results   The geometric means of erythrocyte methylmercury of all the women were 0.322 μg/g (interquartile range [IRQ]: 0.188 – 0.728 μg/g) for the samples of first trimester, 0.238 μg/g (IRQ: 0.120 – 0.549 μg/g ) for those of third trimester, and 0.515 μg/g (IRQ: 0.322 – 1.099 μg/g) for neonatal umbilical cord samples. The erythrocyte methylmercury of the first trimester samples was significantly higher than that of the third trimester samples (P < 0.05); while, the erythrocyte methylmercury of both the first trimester and the third trimester samples were significantly lower than that of neonatal umbilical cord samples (both P < 0.05). The erythrocyte methylmercury of the umbilical cord blood samples, the first trimester samples and the third trimester samples were closely correlated with each other, with the correlation coefficients of 0.763, 0.866, and 0.854, respectively.   Conclusion   The erythrocyte methylmercury of pregnant women during first and third trimester and that of neonatal umbilical cord blood are significantly correlated with each other. Higher erythrocyte methylmercury of neonatal umbilical cord blood than that of women during pregnancy suggests a possible enrichment of methyl mercury.
Rapid pathogen detection and molecular tracing: a laboratory analysis on a cholera epidemic
XIONG Chang-hui, YANG Meng, XU Xiao-qian,
2022, 38(8): 1062-1065.   doi: 10.11847/zgggws1136896
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Abstract:
  Objective  To report rapid pathogen isolation and identification, virulence gene detection and pathogen tracing for a suspected cholera epidemic.   Methods  Four stool and four anal swab specimens were collected from 8 diarrhea patients in an overseas tour group and 13 anal swab specimens were also collected from 13 other members of the tour group on October 21, 2018. Rapid detections of the specimens were conducted with Filmarray system and real-time PCR rapid identification and culture methods were used, respectively, for the specimens. VITEK-2 automatic microbial identification instrument and pulsed field gel electrophoresis (PFGE) typing were used for bio-identification of the isolated strains. Virulence genes were analyzed with real-time PCR.   Results  Vibrio parahemolyticus (VP) was isolated from 11 of the specimens. Molecular typing of PFGE showed that the 11 VP stains were highly homologous, indicating that the epidemic was resulted from the infection of a same VP strain.   Conclusion  Combined utilization of multiple laboratory detections is of important value for rapid diagnosis, pathogen identification and tracing in epidemiological investigation on cholera epidemics.
Evidence-Based Medicine
Lipid level and risk of Alzheimer′s disease: a systematic review and meta-analysis
LÜ Xuan-rui, XU Jing, LIN Xiao-nan, SONG Jing,
2022, 38(8): 1066-1069.   doi: 10.11847/zgggws1138716
Abstract(45) HTML(11) PDF 608KB(17)
Abstract:
  Objective  To systematically evaluate the role of blood lipid level in predicting the risk of Alzheimer′s disease (AD).   Methods  We searched Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database for Chinese Technical Periodicals (VIP), Pubmed, Web of Science, Springer, and Cocharne Library for literatures on the correlation between AD incidence and blood lipid level published in Chinese or English till June 2021 and supplementary manual tracing for some of the references was also conducted. Newcastle-Ottawa-Scale literature quality evaluation scale was adopted to evaluate the quality of the included studies. Statistical analyses were performed with RevMan5.3 software.   Results  A total of 15 eligible studies were selected according to the inclusion and exclusion criteria, and the data on blood lipid level were collected from 1 435 healthy elderly people and 2 162 elderly people with AD. Meta-analysis showed that there was no significant difference in total cholesterol (TC) and triglyceride (TG) level between the AD sufferers and the healthy controls; low-density lipoprotein cholesterol (LDL-C) was significantly higher in the AD sufferers than that in the healthy controls (mean difference [MD] = 3.59, 95% confidence interval [95% CI]: 0.98 – 6.21); while, high-density lipoprotein cholesterol (HDL-C) was significantly lower in the AD sufferers than that in the healthy controls (MD = – 3.47, 95% CI: – 5.94 – – 0.99).   Conclusion  Higher LDL-C level but lower HDL-C level may indicate a higher risk of AD in older adults.
Overview
Salt reduction in the world – intervention strategies and measures: a progress review
FAN Fang, LI Ying-hua
2022, 38(8): 1070-1078.   doi: 10.11847/zgggws1137783
Abstract(89) HTML(22) PDF 620KB(13)
Abstract:
Non-communicable diseases (NCDs) is the main cause of deaths around the world and salt reduction is considered as one of the most cost-effective priority actions to reduce the risk of NCDs. In order to reduce salt intake among residents, many countries in the world have implemented a series of salt reduction strategies and measures, such as establishing salt reduction policies, enhancing consumer health education, improving food formulations in the food industry, and implementing front-of-package labeling programs. This paper summarizes researches on source of salt, salt and health, as well as the strategies, measures and achievements of salt reduction intervention in some countries and regions, in order to provide references for carrying out relevant salt reduction actions in China.
Progress in researches on health risk types in designated drivers
ZHANG Meng, WANG Qi-qi, YAO Hong-yan, , LIU Jian-jun
2022, 38(8): 1079-1081.   doi: 10.11847/zgggws1135792
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Abstract:
Designated driving service provides new ideas for reducing drunk driving. As the core of designated driving industry, the health status of designated drivers is closely related to the safety of driving. Current researches are mainly about the utility evaluation of the designated driving service, and few about the designated drivers. This study summarizes the definition of designated drivers, the types, research methods and intervention measures of health risks, and provides references for exploring the health risk management measures for designated drivers.
Long-term effects of pregnancy exposure to natural disasters on physical health: a review
ZHAO Yi-hao, HU Xi-yuan, GUO Chao
2022, 38(8): 1082-1087.   doi: 10.11847/zgggws1136302
Abstract(30) HTML(14) PDF 670KB(6)
Abstract:
Based on the theory of developmental origins of health and disease (DOhaD), adult diseases are related to adverse factors experienced in early life. In this study, we reviewed relevant literatures and studied the effects of pregnancy exposure to disasters such as earthquakes, floods, famines, hurricanes, tropical cyclone, and ice storms on physical health of infants, children, adolescents, and adults. Published researches demonstrated that exposure to catastrophic events during fetus period could exert adverse effects on physical health from newborn to adulthood, and the exposure at different periods could have different effects on physical health. At present, there are a few studies on the long - term effects of fetal exposure to catastrophic events on physical health in China, and it is necessary to establish a long - term monitoring cohort of exposed people. In addition, further study is needed to explore the impact of catastrophic exposure at different stages of fetal period on physiological health in order to provide evidences for developing effective intervention programs.
Development of group B meningococcal vaccine: a progress review
ZHAO Wei, BAI Shuang, KANG Yan-li,
2022, 38(8): 1088-1092.   doi: 10.11847/zgggws1137414
Abstract(82) HTML(29) PDF 555KB(15)
Abstract:
Epidemic cerebrospinal meningitis is a respiratory infectious disease caused by Neisseria meningitidis, most commonly manifesting as meningitis and septicaemia. Due to the lack of effective prevention measures, serogroup B Neisseria meningitidis (MenB) has become one of dominant epidemic bacterial groups. In recent years, the emergence of reverse vaccinology has greatly promoted the research on serogroup B meningococcal vaccine, and researches on the vaccine have also made a breakthrough. In order to develop a more effective meningococcal vaccine, this article reviews the research progress on new protein antigen vaccine, outer membrane vesicle vaccine and recombinant protein vaccine in the field of MenB vaccine.
Public Health Forum
Social attributes and social prevention and control of disease: a comment
WANG Chao, LU Zu-xun
2022, 38(8): 1093-1096.   doi: 10.11847/zgggws1138138
Abstract(312) HTML(102) PDF 579KB(89)
Abstract:
The social attribute of people determines that illness is not only a medical problem, but also a social disease. The illness has a wide range of social attributes from its occurrence and development, diagnosis and treatment to its social impacts. The prevention and control of disease require a full participation of the whole society, including the government, medical institutions, social organizations, and individuals. However, a healthy social environment urgently requires further innovations in disease prevention and control concepts and strategies to strengthen social foundations against to various diseases.