中华疾病控制杂志

The intersection between biomarkers and the exposome in environmental health studies

LENG Shu-guang, ZHENG Yu-xin

2017, 21(11): 1079-1081,1095. doi: 10.16462/j.cnki.zhjbkz.2017.11.001

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This editorial introduced the definition of biomarkers and exposome, as well as their implication in environmental health studies. Four topics were introduced that include biomarkers and exposome, lifestage exposome snapshots, exposome wide association studies, and the role of biomarkers in studying the relationship between environmental exposures and diseases. Emphases of studies were suggested that include validity assessment of biomarkers, organ specificity of biomarkers, and bioinformatics for analyzing multi-level omics data.

Analysis on spatial distribution of diabetes and related factors among middle-aged and elderly population in China based on GIS

CHENG Wen-wei, YAN Xiao-fang, SHI Jing-cheng, LIU Xiao-li, LIU Xiao-fang

2017, 21(11): 1082-1087. doi: 10.16462/j.cnki.zhjbkz.2017.11.002

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Objective To explore the spatial distribution of diabetes and its main influencing factors among middle-aged and elderly population in China based on geographic information system(GIS) and to provide useful information for the improvement of regional prevention and control of diabetes. Methods Data came from the baseline survey of the China Health and Retirement Longitudinal Study in 2011, which included 11 538 participants in this study. A spatial analysis was conducted to analyze prevalence of diabetes and its main risk factors by Geoda and ArcGIS 10.2 software. Results The prevalence of diabetes and pre-diabetes among middle-aged and elderly population were 15.1% (range of prevalence of diabetes:7.9%-33.5%) and 40.0% (range of prevalence of pre-diabetes:17.6%-61.3%) in China except for Hong Kong, Macao, Taiwan, Hainan, Ningxia and Tibet in 2011. The local space analysis showed that the concentrated areas of prevalence were located in north of China including Tianjin and Hebei. The geographically weighted regression (GWR) revealed that the percentage of the highly educated population, the rate of overweight and high levels of c-reactive protein (CRP) were the main influencing factors for diabetes prevalence, and all the regression coefficients of these three factors showed spatial heterogeneity. Conclusions Over 50% of middle-aged and elderly Chinese are threatened by diabetes and pre-diabetes. Geographic visualization at the provincial level indicates widespread variation in diabetes prevalence and its main factors across China. The key areas for prevention and control are mainly located in northeast and north in China. Major measures should be regionalization.

The prevalence of diabetes among rural residents aged 15 and above in Hubei Province

LI Yu, LIU Jia-fa, HE Shou-jie, YAN Hong, LI Shi-yue, YU Li-ping

2017, 21(11): 1088-1091. doi: 10.16462/j.cnki.zhjbkz.2017.11.003

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Objective To investigate the prevalence and associated factors of diabetes among rural residents aged 15 and above in Hubei Province, and to provide evidences for diabetes control in rural areas. Methods A total of 12 003 households in 20 counties were sampled by multistage stratified cluster random sampling, and 16 739 rural residents aged 15 and above were interviewed. SPSS 20.0 was performed to analyze data. Results A total of 16 739 participants were included in the study, 306(1.83%) reported diabetes. And the prevalence in hypertension group and non hypertension group were 8.22% and 0.98% respectively. The multivariate Logistic regression analysis showed that compared with those who were currently working, it was more likely for the retired to develop diabetes in hypertension group(OR=2.186, 95% CI:1.454-3.289) and non hypertension group (OR=3.019, 95% CI:1.833-4.973) respectively. Overweight or obesity(OR=1.642, 95% CI:1.174-2.297;OR=2.532, 95% CI:1.788-3.586), negative emotions such as anxiety or depression (OR=1.655, 95% CI:1.102-2.486; OR=3.059, 95%CI:1.992-4.698) were both associated with diabetes in two groups. But age was an associated factor only in non hypertension group, the prevalence in those aged 35 and above was higher and it increased with age. Meanwhile, alcohol drinking(OR=0.425, 95% CI:0.246-0.734) was an associated factor of diabetes only in hypertension group. Conclusions The prevalence of diabetes among rural residents aged 15 and above in Hubei Province was at a relatively lower level, but the prevalence increased significantly. For diabetes prevention and control, those aged 35 and above, the retired, overweight or obese persons, or those having negative emotions need to be focused on.

Analysis on influencing factors of type 2 diabetes based on multilevel model

ZHU Gao-pei, ZHU Le-le, WU Xue-sen

2017, 21(11): 1092-1095. doi: 10.16462/j.cnki.zhjbkz.2017.11.004

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Objective To discuss the construction of a multilevel model for binary outcome measure with hierarchical cluster data based on an example of type 2 diabetes. Methods Data was collected from a survey on chronic disease of Longzihu district of Bengbu city in 2015. One-level and multilevel Logistic regression models were conducted to investigate the influencing factors of type 2 diabetes using R software. Results The influencing factors of type 2 diabetes analyzed by one-level and multilevel Logistic regression were not exactly the same, including age, family history of diabetes, history of hypertension, frequency of fruit intake, glycosylated hemoglobin, body mass index (BMI). One-level Logistic regression showed that the prevalence of diabetes in non-overweight group was significantly different from that in overweight group (all P<0.05), which was not significant between non-overweight and overweight group in multilevel Logistic regression (all P>0.05). The Akaike information criterions of one-level and multilevel Logistic regression were 1 550.2 and 1 535.3, respectively. Conclusions The conclusions from one-level and multilevel Logistic regression model are not exactly the same, and the multilevel model has advantages in data analysis for hierarchical cluster data. Based on hierarchical cluster of type 2 diabetes, the prevention and control of type 2 diabetes should be carried out on the basis of community service center.

Analysis on prevalence of diabetes mellitus and personal characteristics of residents in 8 counties of Xinjiang

ZHANG Rong, LIAO Pei-hua, ZHE Wei, LIU Lai-xin, ZHANG Yun-jun, FUERHATI Wu-shou-er

2017, 21(11): 1096-1101. doi: 10.16462/j.cnki.zhjbkz.2017.11.005

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Objective To investigate the relationship between blood glucose and personal characteristics of residents in 8 counties of Xinjiang. Methods A total of 4 779 residents, who were 18 years old and above, were sampled by stratified cluster random sampling method in 8 counties of Xinjiang, 2013-2014. Personal characteristics, blood glucose, hypertension and dyslipidemia were collected by face to face investigation, physical measurements and laboratory testing. Results The prevalence of diabetes mellitus, impaired glucose tolerance (IGT), impaired fasting glucose (IFG) and normal blood glucose was 16.62%, 14.16%, 4.97% and 64.25%, respectively in 8 counties of Xinjiang. There was a significant difference of diabetes mellitus between Han and Uygur groups (χ²=116.893,P<0.001). The prevalence of diabetes mellitus of Han (21.14%) was higher than that of Uygur (8.81%). Age, over weight/obesity, central obesity, hypertension and dyslipidemia were related to diabetes mellitus in Han ethnic group. Age, region, over weigh/obesity, hypertension and dyslipidemia were related to diabetes mellitus in Uygur ethnic group by Logistic analysis. Conclusions The prevalence of diabetes was high in Xinjiang. The management of diabetes mellitus in basic public health services should be further strengthened.

The combined effect of obesity and family history of diabetes on the incidence of hyperglycemia

HONG Xin, LI Jie-quan, WANG Zhi-yong, LIANG Ya-qiong, YANG Hua-feng, XU Fei

2017, 21(11): 1102-1105,1110. doi: 10.16462/j.cnki.zhjbkz.2017.11.006

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Objective To investigate the combined effect of obesity and family history of diabetes on the incidence of hyperglycemia in Nanjing. Methods Population-based cross-sectional study was conducted on local residents aged 30 and above in Nanjing by a multi-stage stratified cluster sampling method. The subjects who were non-hyperglycemia in the baseline were selected for the three-year follow-up survey. Cox proportional hazards model was used to estimate the combined effect of obesity and family history of diabetes on the incidence of hyperglycemia. Results Of 2 900 subjects without hyperglycemia in baseline, 2 093 participated in the follow-up survey, and follow-up proportion was 72.2%. Three-year cumulative incidence of hyperglycemia was 7.5%, which was 6.4% in the subgroup without family history of diabetes/no obesity and 13.3% in the subgroup with family history of diabetes/obesity. By multivariable Cox regression model, the subgroup with family history of diabetes/no obesity (HR=1.63,95% CI:1.02-2.60,P=0.042) and with family history of diabetes/obesity (HR=2.37,95% CI:1.36-4.13,P=0.002) had a gradually increased risk of hyperglycemia, when compared to those without family history of diabetes/no obesity. The risk of hyperglycemia was the highest in the subgroup with family history of diabetes/obesity (all P<0.05). Conclusions In the Nanjing population, a family history of diabetes and coexistent obesity may increase the risk of hyperglycemia, suggesting that weight control is conducive to the prevention of hyperglycemia among the population with family history of diabetes.

Study on the quality of life in diabetic patients from one rural area of Anhui Province based on EQ-5D-5L

WANG Jun, WANG Li-dan, JIANG Qi-cheng

2017, 21(11): 1106-1110. doi: 10.16462/j.cnki.zhjbkz.2017.11.007

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Objective To explore the quality of life (QOL) and its influencing factors in diabetic patients from rural areas in Anhui Province. Methods 325 diabetic patients were investigated with self-designed questionnaire and European quality of life-5 dimensions with 5 levels questionaire (EQ-5D-5L). Univariate analysis and multivariate analysis were used to explore factors influencing the QOL in diabetic patients. Results The results showed that pain/discomfort was the major health problem of diabetic patients (74.46%),VAS score was (71.94±18.24). 70 years old and over, primary school education and lower, lack-of-exercise, complications, side-effects, mental burdens and damaged relationship had more health problems in the five-dimensions. Exercise, complications, side-effects and relationship were the influencing factors for VAS score. Conclusion Relieving pain, prevention of side-effects, focusing on the psychological health and appropriate exercise would improve the QOL of diabetic patients.

Molecular epidemiological analysis of coxsackievirus A10 strains isolated in mainland China from 2004 to 2016

YAO Xue-jun, GUAN Shu-hui, LIU Xiu-lan, JIANG Ren-jie

2017, 21(11): 1111-1114,1127. doi: 10.16462/j.cnki.zhjbkz.2017.11.008

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Objective To analyze the genotype distribution and genetic evolution of coxsackievirus A10 (CA10) isolated in mainland China, 2004-2016, and to provide a scientific basis supporting for prevention and control of hand-foot-and -mouth disease. Method MEGA 6.0 software was used to analyze the VP1 gene sequence of CA10 isolates from mainland China through retrieving the GenBank nucleotide database. Besides, the phylogenetic tree was constructed and the homology of nucleotide and amino acids were calculated. Results A total of 218 Chinese CA10 isolates were included in this study. Most of Chinese CA10 isolates emerged from 2004 to 2016 belonged to genotype C. Comparing with the ptototype strain CA10-Kowalik, the homology of nucleotide sequences and amino acid sequences of VP1 gene of 218 Chinese isolates were 69.4%-73.9% and 90.6%-93.6%, respectively; Moreover, the nucleotide and the amino acid homology of VP1 gene of 218 Chinese CA10 isolates among themselves ranged from 76.4% to 100.0% and ranged from 92.9% to 100.0%, respectively. Conclusions This study suggests that effective measures should be taken to prevent hand-foot-and-mouth disease according to the tendency of molecular epidemiology and genotype distribution of CA10 strains isolated in China.

Serum cobalt concentrations in children with hand foot and mouth disease (HFMD)

WU Si-han, YAO Xiang-jie, ZHANG Hui-min, ZHANG Zhen, LI Ran, HONG Lie-cheng, HU Gang, ZHANG Jin, CHENG Jin-quan

2017, 21(11): 1115-1118. doi: 10.16462/j.cnki.zhjbkz.2017.11.009

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Objective To investigate the relationship between serum levels of cobalt (Co) in children with hand foot and mouth disease (HFMD) and the severity of the symptoms manifested. Methods The children with HFMD were recruited in Shenzhen Children's Hospital from 2013 to 2015, and they were divided into severe group (202 cases)、mild group (220 cases), and control group(208 cases)according to their severity of symptom.For each child,a rectabl swab, a saliva swab, and a blood sample were collected. The types of pathogens infected was analyzed by real-time quantitative polymerase chain reaction(qPCR), and the levels of serum Co were detected by inductively coupled plasma mass spectrometry (ICP-MS). Results The average concentrations of serum Co in the severe, mild and control groups were 0.36 μg/kg, 0.40 μg/kg and 0.31 μg/kg, respectively. The serum Co levels in the severe group were significantly lower than other groups(all P<0.05), while there was no significant difference in levels of serum Co between the mild group and the control group (Z=-0.821,P=0.412). There were moderate negative correlation between the levels of Co and the severity of HFMD (r=-0.298,P<0.001). No significant differences of serum Co levels were observed among different genders and different age groups(all P>0.05), while significant differences were observed among different enterovirus tenterovirus types.The level of serum Coin children infected by EV71 were significantly higher than those infected by CA16 in the mild group(Z=4.397,P<0.001), while this difference was not observed in the severe group (Z=-1.821,P=0.069). And the results of Logistic regression analysis showed that with a certain range increase,of serum cobalt concentration, the risk of infected by HFMD decreased. Conclusions The level of cobalt (Co) in serum of children may have an effect on children's hand foot and mouth disease.

Epidemiological characteristics and influencing factors of scrub typhus in Jingjiang City of Jiangsu Province from 2011 to 2015

ZHAN Hai-yan, XU Zhen, HE Yi-lin

2017, 21(11): 1119-1122. doi: 10.16462/j.cnki.zhjbkz.2017.11.010

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Objective To study clinical features, epidemiological characteristics and influencing factors of scrub typhus in Jingjiang City, Jiangsu Province and to provide a basis for prevention and control work. Methods Clinical cases were collected and case study of scrub typhus was carried out in Jingjiang City from 2011 to 2015. The results were analyzed by descriptive analysis, chi-square test and other methods, which were combined with polymerase chain reaction (PCR) nucleic acid detection, IgG antibody detection and storage host, and media survey. Results A total of 962 scrub typhus cases were reported and average annual morbidity was 28.80/100 000. Western villages and towns were the high-prevalence areas and main duration of the disease was centered from October to November. There were 85.45% of peasants and male to female ratio was 1:1.35. There was a 72.70% of the positive rate for orientia tsutsugamushi nucleic acid with 9.64% of tsutsugamushi antigens IgG antibody positive rate among general population.The density of mice was 10.97% and main murine-like animal in epidemic region were flavipectus and skunks. Mites were leptotrombidium scutellares. Conclusions Scrub typhus epidemics in Jingjiang is increasing rapidly and has typical clinical symptoms, since epidemic situations are concentrated in autumns and winters. It is recommended to strengthen the surveillance of scrub typhus. Meanwhile, health educations and behavioral interventions for peasants over 40 years old should be carried out before autumn harvest season.

Epidemiological analysis of influenza surveillance in Changzhou from 2010 to 2016

QIAN Cheng, CHEN Cong, ZU Rong-qiang, ZHANG Yong-jie, ZHANG Jian-tao, HU Fei-fei, SHI Ping

2017, 21(11): 1123-1127. doi: 10.16462/j.cnki.zhjbkz.2017.11.011

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Objective To study the epidemiological characteristics of influenza in Changzhou during 2010-2016, and to provide references for developing strategies regarding the prevention and control of influenza. Methods Data concerning influenza like illness (ILI) and etiological detection were collected from the national influenza network surveillance system. Descriptive epidemiology was employed to analyze the epidemiological and etiological features of ILI in Changzhou during 2010-2016. Results There were altogether 97 400 ILI cases that were reported from 2010 to 2016 in Changzhou, with the average annual consultation rate of influenza like illness (ILI%) being 1.85%. The ILI% was significantly different among different years (χ²=16 461.59,P<0.001). The ILI% showed two peak seasons which distributed in winter-spring and summer. Instances with patients between 5 and 14 years old and patients under 5 years old were the most numerous in the sphere of ILI cases. Positive rate of pathogen detection was significantly different among different years (χ²=230.34,P<0.001). Type B and type A (H3) were the main types of flu strains and occasionally an epidemic of type A (H1N1) was present. Positive rate of etiological detection was positively correlated with ILI% (r_s=0.26,P=0.017). Conclusions The epidemic flu strains in winter-spring were type B and type A (H1N1), whereas the epidemic flu strain in summer switched to type A (H3). Vaccination is an important means to protect high-risk groups which are under 15 years old from influenza virus.

Hepatitis E virus:a serological study among HIV-infected people in Xiaogan City

SHU Yi-lin, ZHANG Shou-de, GONG Han-ying, ZHOU Sheng, WAN Qin, XIN Yu-xuan, XIE Jin-wei, FANG Shen-ying, ZHANG Ling

2017, 21(11): 1128-1131. doi: 10.16462/j.cnki.zhjbkz.2017.11.012

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Objective To determinate the seroprevalence associated with hepatitis E virus(HEV)exposition among HIV-infected people in Xiaogan City, which could provide the basic data better to prevent and control the epidemiology of HIV and hepatitis E virus. Methods 203 serum samples of HIV-infected people from May 2015 to September 2016 were collected. Demographic data, other disease histories and laboratory data for these subjects were collected from Chinese disease control information system. Serum samples were performed for anti-HEV IgG, anti-HEV IgM and HEV-Ag screening, in which liver function were screened among positive anti-HEV IgM subjects. Results For the 203 HIV-infected people, anti-HEV IgM positive ratio was 2.46%, anti-HEV IgG positive ratio was 43.31%(94/203). There was no significant difference in anti-HEV IgG positive rate between different gender(χ²=0,P=0.996). The anti-HEV IgG positive rate of subjects was as high as 80% in divorced group, but showed significant difference compared with another marital status groups(all P<0.05). Anti-HEV IgG positive rate for the crowd with CD4 value ≤ 200 cell/μl was higher than that of > 200 cell/μl, but showed no significant difference(χ²=0.286,P=0.593), and CD4 indexs of two positive anti-HEV IgM patients were 189 and 199 in cell/μl, respectively, followed with abnormal liver function in one patient. In addition, anti-HEV IgG positive rate in seven counties showed similar without difference(χ²=5.906,P=0.551). Conclusions There were higher HEV infection rate among HIV-infected people in Xiaogan City, thus, it is essential to positively carry out double-way screening for these two diseases at the same time, and take several targeted measures to prevent and treat them.

The impacting factor of peer education among MSM

SONG Li-ping, ZHANG Zhen-kai, ZHANG Yun-lian, LAN Guang-hua, TANG Jie, LIU Yue-long, GENG Wen-kui

2017, 21(11): 1132-1135,1144. doi: 10.16462/j.cnki.zhjbkz.2017.11.013

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Objective To understand the prevalence of utilization of peer education and the correlates of peer education among MSM. Methods Structured questionnaire was used to collect data such as demographic characteristics, behavior factors, self-rating anxiety score, self-rating depression score and peer education. Univariate and multivariate Logistic analyses were used to determine the correlates of peer education. Results The age was (32.5±9.2) years old. The score of social support was (25.75±3.87). 35.0% of participants never utilized peer education. Self-rating anxiety score was positively associated with never utilized peer education(OR=2.44,95% CI=1.22-4.90, P=0.012). Age was negatively connected with never utilized peer education. Regarding aged 18-25 group as reference, the OR value of aged 26-35 years old and aged 36-67 years old was 0.51 and 0.38, respectively. Resident time was positively linked to never utilized peer education. Other factors didn't influence peer education(OR=2.18, 95% CI=1.01-4.69, P=0.046). Conclusions There is a need for us to improve the situation of peer education among MSM through strengthening mental health, and subsequently prevent MSM away from HIV infection.

Characteristics and associated factors of commercial sexual contacts among attendees at the STD clinics in Guangdong Province

LIN Wei, SHEN Hong-cheng, HUANG Shu-jie, LIU Jian, DENG Zhou, LI Zheng-tian, WANG Cheng, ZHENG He-ping, YANG Bin

2017, 21(11): 1136-1140. doi: 10.16462/j.cnki.zhjbkz.2017.11.014

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Objective To investigate the characteristics and associated factors of commercial sexual contacts among attendees at the sexually transmitted disease (STD) clinics in Guangdong Province. Methods We recruited attendees at the STD clinics in Dongguan and Zhongshan cities, and collected the information on demographic characteristics, history of commercial sex behavior, and STDs testing. The Logistic regression model was applied to analyze possible associated factors. Results In total, 259 (13.1%) attendees reported a history of commercial sex in the past six months. The prevalence of commercial sex in men was higher than that among women (χ²=129.173,P<0.001). The proportions of condom use at last sex intercourse, the rates of testing for human immunodeficiency virus (HIV) and syphilis separately and simultaneously, and the rate of HIV tested positive for people who pay for sex were all higher than those among people without commercial sex (all P<0.05). Gender, monthly income, habitation status, and STD history were associated with commercial sex behavior. Conclusions The prevalence of commercial sex behavior among attendees at the STD clinics in Guangdong Province was high. Males, especially those with lower income, or without a STD history, or live alone, may tend to have commercial sexual contacts.

Investigation on exposure risk for human infection with avian influenza A(H7N9) among urban residents in Xi'an,Shaanxi

LI Guang-zhi, ZHANG Yi, WANG Lin-jiang, SUN Ye, CAO Lei

2017, 21(11): 1141-1144. doi: 10.16462/j.cnki.zhjbkz.2017.11.015

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Objective To understand the exposure risk of human infection with avian influenza A (H7N9) among urban residents in Xi'an, Shaanxi. Methods A cross-sectional study was conducted in urban areas of Xi'an. Participants were selected by multistage sampling. We collected information on human exposure to poultry, related knowledge of human infection with avian influenza A (H7N9) and treatment after influenza-like symptoms occurred. Results Among 624 participants investigated, 192(30.77%) purchased live poultry during the past year. 86(13.78%) touched directly live poultry or poultry cage. We estimated that the mean number of live poultry purchased per year was 1.1 among urban residents in Xi'an. The exposure frequency was 0.15 per person. The overall awareness rate of knowledge on influenza A(H7N9) was 70.38% (2 635/3 744). The awareness of "Early symptoms" was the lowest (60.90%). Among 75(12.02%) participants who had influenza-like symptoms, only 22(29.33%) choosed to see the doctor directly. Conclusions The urban residents in Xi'an had exposure risk of human infection with avian influenza A (H7N9) in certain degree. Health education for the residents should be strengthened.

The relationship between demographic characteristics and personality traits of the accident prone drivers

WANG Xiao-min, ZUO Yu-kun, JIANG Hu, SU Jing, YANG Li

2017, 21(11): 1145-1148. doi: 10.16462/j.cnki.zhjbkz.2017.11.016

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Objective To explore the relationship between demographic characteristics and personality traits of the accident prone drivers. Methods A cross-sectional study was conducted. A total of 263 accident prone drivers were investigated by the demographic questionnaire and eysenck personality questionnaire(EPQ) scale. Results The accident prone drivers' personality traits were correlated with their demographic characteristics such as education level, marital status, monthly income levels, smoking and alcohol consumption (all P<0.05). The different age groups had different E,P,N scores, and E,P,N scores of the accident prone drivers with age ≥ 40 years were significantly lower than in the other groups (all P<0.05). The different education level had different E score, and E score of the accident prone drivers with primary school and junior middle school education was significantly higher than the other two groups (all P<0.05).The different marital status groups had different E,P,N scores, and E,P,N scores of the accident prone drivers with divorce or bereft of one's spouse were significantly higher than the other two groups (all P<0.05).The different monthly income groups had different E,P,N scores, and E,P,N scores of the accident prone drivers with RMB ≤ 2 500 yuan were significantly higher than the other two groups (all P<0.05). The E score of smoking group was significantly higher compared with the nonsmoking group (t=2.516,P=0.012). The E,P score of drinking group were higher than nondrinking group (all P<0.05). Conclusions Our results suggest that the accident prone drivers' demographic characteristics are associated with their personality traits.The accident prone drivers with younger, low education level, divorce or bereft of one's spouse, lower average month income, smoking and alcohol consumption have an higher E,P,N scores which indicate the personality characteristic such as extroversion, psychoticism and neuroticism.

Risk factors for adult burn patients:a qualitative study based on the Haddon's matrix

LI Lin, PAN Qiong, XU Le, LIN Ren-qin, DAI Jia-xi, CHEN Zhao-hong

2017, 21(11): 1149-1151,1160. doi: 10.16462/j.cnki.zhjbkz.2017.11.017

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Objective To explore the risk factors of adult burn patients. Methods A semi-structured interview was conducted with 22 hospitalized adult burn patients. Data was analyzed using the Colaizzi phenomenological research method and Haddon's matrix. Results Human factors:the lack of safety awareness in the pre-event,strong psychological shock leading to panic coping in the event,and improper management of the wound in the post-event. The aspect of appliances:a great deal of unanticipated issues with equipment combined with less protective appliances in the pre-event, neglect and failing to remember to make use of firefighting equipment in the event, and lack of basic first aid supplies in the post-event. The physical environment:more accidents in the high temperature season, closed environment in the event, and sheer distance from the specialized hospitals in the post-event. The social environment:safety education is imperfect in the pre-event, improper fire-fighting of people in the event, many times to transport in the post-event. Conclusions Haddon's matrix is used to analyze the risk factors of adult burn patients through four dimensions including human, appliance, environment and time so as to provide the scientific basis for formulating feasible burn prevention and response measures and provided new ideas for the domestic burns epidemiological studies.

Epidemic analysis of serious traffic accidents and casualties in Shanghai from 2013 to 2015

YU Yan, HOU Xin-yi, GAO Ning, PENG Juan-juan, REN Hong

2017, 21(11): 1152-1156. doi: 10.16462/j.cnki.zhjbkz.2017.11.018

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Objective To identify the epidemic characteristics of serious road traffic accidents and road traffic injuries in Shanghai from 2013 to 2015 and provide the evidence for road traffic injury intervention. Methods A representative sample of serious road traffic accidents was randomly obtained through a systematic sampling of data from the Shanghai municipal traffic police department to analyze the main cause of serious road traffic injury and clinic feature of injuries. ArcMap 10.1 was used to describe the global spatial autocorrelation and local spatial autocorrelation and spatial clustering in a community scale. Results According to data road traffic in Shanghai from 2013 to 2015, there were a total 224 accidents, 258 casualties (injury and death), and 1.96 million dollars in direct property loss. Most injuries (43.41%) occurred between 6:00 to 12:00. The leading reason was motor vehicle illegal behavior, which accounted for 56.98% of all accidents. In addition, the largest group of victims(33.33%) were E-bike riders and passengers, with the most prevalent clinical characteristic in each age group being brain trauma, accounting for 65.89%. The Getis-OrdGi index of local spatial autocorrelation indicated that the clusters of serious accidents and casualties were detected in the relatively small populated districtsin the east along with the western districts of Shanghai where roads are overlapped with the main channels that connect other cities to Shanghai. Conclusions The influences of road traffic injury include people, vehicle, environment and road. To explorer hotspot, high risk population and develop appropriate intervention program would promote to decrease the serious traffic accidents and casualties.

Study on the influencing factors of interferon/ribavirin in patients with chronic hepatitis C

ZANG Feng, YAO Yi-nan, LIU Mei, CHEN Hong-bo, HUANG Peng, YU Rong-bin

2017, 21(11): 1157-1160. doi: 10.16462/j.cnki.zhjbkz.2017.11.019

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Objective To analyze the baseline influencing factors of pegylated interferon plus ribavirin (pegIFN-α/RVB) in the treatment of chronic hepatitis C (CHC) in order to help to judge the therapeutic effect and the reasonable treatment plan. Methods The baseline data of CHC patients in Jurong People's Hospital of Jiangsu Province were collected and analyzed by univariate and multivariate Logistic regression. Results A total of 371 patients with hepatitis C was surveyed. The total SVR rate was 64.7%. Multivariate logistic regression analysis showed that high baseline viral load of HCV RNA (OR=0.95, 95% CI:0.91-0.99, P=0.012), abnormal alpha fetoprotein (AFP) level (OR=0.87, 95% CI:0.78-0.97,P=0.014) and abnormal fasting blood glucose (GLU) level (OR=0.86, 95% CI:0.78-0.95,P=0.004) were less likely to get SVR. Conclusions The SVR rate was higher in the treatment of pegIFN-α/RVB with CHC patients. Baseline viral load, AFP and GLU are the factors affecting the sustained virological response after treatment.

A study on the association of life satisfaction with resilience and coping style among medical students

PAN Li-li

2017, 21(11): 1161-1164. doi: 10.16462/j.cnki.zhjbkz.2017.11.020

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Objective To investigate the current situation of life satisfaction among medical students, and to explore its association with resilience or coping style. Methods Life satisfaction, resilience, and coping styles of 1 300 medical students were evaluated with the multidimensional student's life satisfaction scale, Connor-Davidson resilience scale and trait coping style questionnaire. t-test or ANOVA was conducted to compare the scores of different groups. The correlation of variables was analyzed with Pearson correlation analysis. Results The average score of life satisfaction among medical students was (4.38±0.61). Univariate analysis showed that gender, paternal and maternal educational levels were determinants for life satisfaction. Correlation analysis showed that life satisfaction was positively associated with resilience and positive coping, but was negatively associated with negative coping. After adjusting gender and/or paternal education, it was shown that resilience and positive coping were independent factors for overall and each dimensional life satisfaction. Meanwhile, negative coping was an independent factor for all life satisfactions except family satisfaction. Conclusions Resilience and coping style are associated with life satisfaction among medical students.

Study and application of dengue fever risk assessment system based on spatial information technology and big data technology

QU Yu-bing, LI Ren-dong, ZHUANG Da-fang, WANG Yong

2017, 21(11): 1165-1169,1174. doi: 10.16462/j.cnki.zhjbkz.2017.11.021

Abstract(520)

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Abstract:
Objective The application of spatial information technology and big data technology in the construction of dengue risk assessment system provides an information platform and scientific basis for the rapid assessment of disease risk. Methods The risk assessment system was developed by secondary development method, based on the hybrid programming language, and the software functions such as SaTScan, ENVI and ArcGIS. Results We successfully developed a set of risk assessment system of dengue fever based on spatial information technology and big data technology, and the overall design, function modules and key technologies of the system were introduced in detail. The main functions of the system included spatio-temporal aggregation detection, influencing factor extraction, risk assessment, big data analysis and visualization. Taking the outbreak of dengue fever in mainland China in 2014 as an application case, the risk assessment of dengue fever epidemic and the production of corresponding thematic products were realized from three levels of China, Guangdong and Guangzhou. Conclusions The establishment of the system provided a new information platform for the rapid assessment of dengue fever risk in typical areas of China, and improved the automation level of dengue fever monitoring and assessment.

Application of Serfling cyclical regression model in the estimation of influenza-associated excess mortality in Shenzhen

HUANG Zhi-feng, LIU Xiao-jian, WU Yong-sheng, YANG Lian-peng, ZOU Yu-hua, LI Ye, CAI Yun-peng

2017, 21(11): 1170-1174. doi: 10.16462/j.cnki.zhjbkz.2017.11.022

Abstract(574)

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Abstract:
Objective To estimate the excess mortality caused by influenza in Shenzhen from 2013 to 2015, in order to provide scientific reference for understanding the epidemic characteristics of influenza and formulating the strategy of vaccination. Methods All reported influenza deaths in Shenzhen from 2013 to 2015 were collected and divided into three groups, including all-age, < 65years old and ≥ 65 years old groups. Based on the data of all cause deaths (AC),respiratory and circulatory deaths (R&C) and pneumonia and influenza deaths (P&I), age-specific Serfling cyclical regression model was established to estimate the influenza-associated excess mortality and death numbers for three groups. Results From 2013 to 2015, the AC-based estimates of the annually averaged excess death and mortality due to influenza were 652.80 and 6.11 per 100 000 person years respectively. The R&C-based estimates excess death and mortality due to influenza were 449.78 and 4.21 per 100 000 person years respectively. The P&I-based estimates excess death and mortality due to influenza were 44.94 and 0.42 per 100 000 person years respectively. Conclusions Serfling cyclical regression model shows that the elderly, especially those already suffer from respiratory and circulatory system diseases are the high-risk groups of excess death due to influenza.

A study on measles and rubella antibody level in 492 pairs of mothers and infants in Fuzhou

CHEN Ling-ling, YAO Xu, LI Hong, BIAN Xiao-jun

2017, 21(11): 1175-1177. doi: 10.16462/j.cnki.zhjbkz.2017.11.023

Abstract(305)

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A sero-epidemiological study on measles, rubella and mumps among the community-based populations aged 0 to 40 years in Yangzhong City, Jiangsu of China

QIU Jia-jun, CHEN Pei-qiao, WANG Jian-ming

2017, 21(11): 1178-1180. doi: 10.16462/j.cnki.zhjbkz.2017.11.024

Abstract(468)

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Carriage and antibiotic resistance of group B streptococcus among pregnant women in Shenzhen

WEN Guo-ming, CAO Xue-lian, LIU Jiang-ling, WU Chuan-an, LI Shun-ming, YE Xiao-Hua

2017, 21(11): 1181-1183. doi: 10.16462/j.cnki.zhjbkz.2017.11.025

Abstract(426)

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Survey of the knowledge, attitude and practice (KAP) for the reproductive health of undergraduate students in a college of Nanjing

DAI Bing-yuan, ZHANG Kai

2017, 21(11): 1184-1186. doi: 10.16462/j.cnki.zhjbkz.2017.11.026

Abstract(229)

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Editor

Editor-in-Chief Ye Dongqing M.D.

Assistant editor Fan Yinguang M.D.

Assistant editor Pan Haifeng M.D.

Assistant editor