中华疾病控制杂志

Progress of HIV care cascade from HIV infection to viral suppression

XIA Xiao-liang, WU Zun-you, MA Ye

2017, 21(4): 323-326. doi: 10.16462/j.cnki.zhjbkz.2017.04.001

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The HIV care continuum from diagnosis of HIV infection, to the initiation of antiretroviral therapy, and to the achievement of viral suppression is called HIV care cascade. The number of HIV infected individuals shrinks along each steps of the HIV care continuum. Maximizing the proportion of HIV infected individuals to achieve viral suppression is an effective strategy to control the HIV epidemic. We reviewed progress of HIV care cascade in international and domestic settings, and provide our recommendations for achieving the 90-90-90 targets in China by 2020.

Association between F protein and the methylation of APC gene in chronic HCV infection

JI Xiao-wei, XIAO Wen, PEI Jia-ping, SHI Li-ping, JIANG Long-feng, WANG Chang-jun, DENG Xiao-zhao, ZHANG Qi, HAN Yi-fang, ZHANG Jin-hai, ZHU Dan-yan, XU Xiao-dong

2017, 21(4): 327-331. doi: 10.16462/j.cnki.zhjbkz.2017.04.002

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Objective To investigate the relationship between F protein and the methylation of adenomatous polyposis coli (APC) gene in chronic hepatitis C virus (HCV) infection. Methods Blood samples collected from chronic HCV patients (CHP) were divided into F-Ab(+) CHP group and F-Ab(-) CHP group, blood samples from healthy persons were used as control. Isolated peripheral blood mononuclear cells (PBMCs) were stimulated by Core protein and F protein for 72 hours, and then cell DNA was etracted to detect the methylation level of APC gene. Results The methylation level of APC gene in three groups was significantly different (F=185.185,P<0.001). The methylation level of APC gene in F-Ab(+) CHP group was significantly higher than that in F-Ab (-) CHP group, the healthy control group was the lowest (all P<0.05). There was significant difference in methylation level of APC gene by Core/F protein stimulated in vitro in all subgroups(all P<0.05). The methylation of APC gene in cells stimulated by Core protein and F protein was higher than that in cells stimulated by F protein, which was higher than that in cells stimulated by Core protein. Conclusions HCV F protein can affect the methylation of APC gene in chronic HCV infection.

Epidemiological characteristics of the spontaneous reactivation of HBV carriers in community population in Wuwei City

SUN Guo-dong, WANG An-hui, WANG Yu-fei, PU Zhong-shu, FU Ting, Wang Yang, YAN Yong-ping

2017, 21(4): 332-335. doi: 10.16462/j.cnki.zhjbkz.2017.04.003

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Objective To analyze the epidemiological characteristics of the spontaneous reactivation of hepatitis B surface antigen (HBsAg) carriers in the community, and to provide a scientific management for the chronic hepatitis B virus (HBV) carriers. Methods A serum epidemiological cross-sectional study was conducted in September 2010, and the HBsAg carriers cohort was established. Then the cohort was followed in 2012 and 2014 to clarify the HBV reactivation rate and epidemiological characteristics. Results After the follow-up, there were 72 carriers developed to HBV reactivation of 852 HBsAg carriers. The spontaneous reactivation incidence was 2 746.8 per one hundred thousand person-years. Different reactivation rate were observed in different gender (χ²=3.901,P=0.048). The male accumulated reactivation rate was 10.39%, which was higher than that of the female (6.62%). Meanwhile, significant differences were also found in different age groups (χ²=6.524,P=0.038). The reactivation rate of 46-59 age group was 11.95%. Besides, when the deoxyribonucleic acid of hepatitis B virus (HBV DNA) level was high, the reactivation incidence was rising (χ²=10.404,P=0.006). Especially in the HBV DNA level >1×10⁵ IU/ml group, the reactivation rate could reach 14.36%. Conclusions The HBsAg carriers may develop to HBV reactivation among community. Male, middle-age period and high baseline HBV DNA load are important risk factors for hepatitis B virus (HBV) reactivation. Therefore, we should enhance the management of HBV carriers, conduct regular follow-up to monitor the condition change, and choose the reasonable time to initiate treatment.

Analysis on hepatitis B infection of pregnant women in Shenzhen City from 2011 to 2014

BAO Xue-qin, SHAN Fu-xiang, LU Yan, LV Qiu-ying, FU Xia, WANG Xing-bao, HONG Lie-cheng, WEI Ya-zhen, CHENG Jin-quan

2017, 21(4): 336-339. doi: 10.16462/j.cnki.zhjbkz.2017.04.004

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Objective To investigate the prevalence of hepatitis B virus (HBV) of pregnant women in Shenzhen City from 2011 to 2014, and to provide scientific evidences for mother-to-child transmission of hepatitis B prevention and control. Methods Pregnant women were advised to screen for HBV serologic markers without charge when they come for a prenatal checkup. The screening results and general demographic information were collected by information management system developed by Division of Information in Shenzhen Center for Disease Control and Prevention and were analyzed by SPSS 19.0. Results The positive rates of hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (Anti-HBs),hepatitis B e antigen (HBeAg), antibody to hepatitis B e antigen (Anti-HBe) and antibody to hepatitis B core antigen (Anti-HBc) in pregnant women were 8.40%, 47.84%, 3.11%, 12.28% and 21.24%, respectively. There were significant differences in positive rates of HBsAg, Anti-HBs, HBeAg, Anti-HBe and Anti-HBc between registered and transient pregnant women, different year, different age, education level and profession (all P<0.001). Conclusions The prevalence of HBV in pregnant women in Shenzhen was higher than the national wide and Anti-HBs was not detected in more than a half of pregnant women, so it is helpful to strengthen normal immune and leakage searching reseed work in pregnant women for controlling the transmission of HBV from mother to child.

Epidemiological characteristics and temporal-spatial clustering of hand, foot and mouth disease in Guangxi from 2008 to 2015

JIANG Li-na, TAN Yi, WANG Jing, PAN Pei-jiang, ZHOU Shu-wu, MO Fei-yu

2017, 21(4): 340-344. doi: 10.16462/j.cnki.zhjbkz.2017.04.005

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Objective To analyze the epidemiological characteristics and temporal-spatial clustering of hand, foot and mouth disease (HFMD) in Guangxi from 2008 to 2015, and to provide evidence for the prevention and control of the disease. Methods Surveillance information of HFMD at the county level was collected from Chinese National Notifiable Infectious Disease Report System. The epidemiological characteristics were described using Excel 2010. SaTScan 9.4.2 was used to detect the potential temporal-spatial clusters. By setting different population percentages as the maximum spatial cluster sizes in the analysis, multiple models were assessed to select the optimal one. Results From 2008 to 2015, all cities in Guangxi had reported HFMD cases, a total of 1 360 857 cases were reported with an annual incidence of 359.61 per 10 000. The main peak incidence was observed from April to July, followed by a second peak from September to November. Incidence rate of male was higher than female, children aged 0-5 years accounted for 92.28% of the total cases. The effect of setting the population percentage as the maximum spatial cluster size varied in different models, among which 10% of the population at risk was the best mode. The counties of Nanning and Liuzhou were the main grade-I gathering areas and grade-Ⅱ gathering areas, respectively. The gathering time were mainly detected from March to July. Conclusions Incidence of HFMD was still high in Guangxi. HFMD had obvious aggregation in space and time. We should strengthen prevention and control of HFMD in Nanning and Liuzhou during gathering time.

Analysis of epidemiologic characteristics about hand-foot-mouth disease in Changsha from 2006 to 2013 based on GIS

ZHA Wen-ting, WANG Ling, ZHENG Jian, CHEN Tian-mu, LUO Qing-hong, LV Yuan

2017, 21(4): 345-348. doi: 10.16462/j.cnki.zhjbkz.2017.04.006

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Objective To explore the epidemiologic characteristics of hand-foot-mouth disease in Changsha from 2006 to 2013 with geographic information system (GIS) and provide scientific evidence for optimizing the public health resources distribution. Methods The information about hand-foot-mouth disease in Changsha from 2006 to 2013 was collected, SPSS 18.0 and ArcGIS 10.2 were used to analyze its epidemiologic characteristics. Results The hand-foot-mouth disease incidence in Changsha was 181.55/100 000 from 2006 to 2013, 95.2% were under 5 and 75.1% were scattered children. The overall incidence of disease raised first and then falled in 2006-2013, mostly were concentrated from April to July (69.8%). The GIS map showed that Xingsha, Yuhua pavilion, Dongjing, Zuojiatong street, Lituo village of Changsha were the high-risk areas of hand-foot-mouth disease. The autocorrelation analysis showed that the hand-foot-mouth disease cases existed spatial autocorrelation in 2008-2013 (all P<0.05), the hot region were mainly in the central of Changsha. The trend surface analysis also showed that hand-foot-mouth disease incidence was the highest in the central region of Changsha. Conclusions Most hand-foot-mouth disease patients in Changsha were children under age 5, the highest prevalence month were from April to July, and the highest prevalence region was in the central of Changsha. The key prevention people, time, areas of hand-foot-mouth disease should be confirmed according to the findings, in order to carry out the optimal allocation of public health resources.

Epidemic characteristics and genotypes of norovirus in Hubei Province, 2015

LI Jing, ZHANG Ting, XU Jun-qiang, ZHAN Jian-bo, GUAN Xu-hua, XING Xue-sen, MA Jing, QIU De-zhi, HUANG Jing, GUO Pei-ge, SONG Yi

2017, 21(4): 349-352,361. doi: 10.16462/j.cnki.zhjbkz.2017.04.007

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Objective To describe the epidemiologic characteristics and genotypes of norovirus (NV) infection surveillance in Hubei Province in 2015. Methods 687 stool samples from children and adults with diarrhea were collected from January to December in 2015. NV was detected using real-time reverse transcription-polymerase chain reactions (real-time RT-PCR). Positive samples of NV GⅡ were amplified to obtain the N/S region products by RT-PCR. The PCR products were sequenced for genotype identification and phylogenetic analysis. Results The infected male and female were 93 and 56 respectively and there was no significant difference between men and women (χ²=1.193,P=0.275). The infected population was mainly under 5 years old. NV infections occurred through 2015 and the epidemic peak was in September. The main genotype of NV was GⅡ in Hubei and only 2 strains was GI. The phylogenetic analysis showed that NV GⅡ strains were identified as 5 subgenotypes, GⅡ.17, GⅡ.4 Sydney 2012, GⅡ.3, GⅡ. 6 and GⅡ.13. The different genetic subtype predominated by months in turn. Conclusions There were various subgenotypes of NV among infected population in Hubei Province, 2015. Enhancing the molecular epidemiological surveillance was crucial for NV scientific prevention.

Current situation of drug resistance of 236 mycobacterium tuberculosis from Qinghai

SHEN Xiu-li, JIANG Ming-xia, WANG Zhao-fen, LI Bin, MA Bin-zhong, WEN Guo-ying, YAO Xue-qiong, LI Ting-ting, DU Wen-qi, SONG Xin-yi

2017, 21(4): 353-356. doi: 10.16462/j.cnki.zhjbkz.2017.04.008

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Objective Through 236 strains of mycobacterium tuberculosis(M.tb) insolation and cultivation to explore drug resistance situation of mycobacterium tuberculosis which circulating in Qinghai area, so as to provide reference for TB prevention and control in this area. Methods A total of 236 strains of mycobacterium tuberculosis isolated in Qinghai were cultured with L-J medium.Drug resistance was tested by using the proportional method.The relationship between TB drug resistance and the demographic characteristics were analyzed. Results The results showed that drug resistance rate of 236 mycobacterium tuberculosis was 55.93% (132/236). Resistance rates of four first-line drugs from high to low were 43.22% for isoniazid, 38.14%for streptomycin, 37.29% for rifampin and 28.81% for ethambutol. MDR-TB and XDR-TB were 30.93% (73/236) and 1.27% (3/236) respectively. The ratio of SDR-TB was 12.71%. This drug-resistance TB were associated with regions and ages (all P<0.05), but were not associated with gender and ethnicity (all P>0.05). Conclusions The drug-resistance TB of Qinghai is higher than the national level.Measures of prevention and standardized treatment of tuberculosis patients should be strengthened in this area.

The relationship between serum low high-density lipoprotein cholesterol and diet among Chinese middle-aged and older adults

SONG Peng-kun, JIA Shan-shan, MAN Qing-qing, LI Hong, ZHANG Jian

2017, 21(4): 357-361. doi: 10.16462/j.cnki.zhjbkz.2017.04.009

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Objective To analyze the relationship between serum low high-density lipoprotein cholesterol(HDL-c) and dietary intake among Chinese middle-aged and older adults. Methods Data were collected from Chinese Nutrition and Health Surveillance in 2010-2012. A total of 28 092 participants aged 45y and older were collected in 150 surveillance sites of urban and rural in China. Questionnaire on general information and consecutive three days 24-hour dietary survey was conducted by qualified staff. Fasting serum HDL-c was tested by direct method and low HDL-c was evaluated by Guidelines on Prevention and Treatment of Blood Lipid Abnormality in Chinese Adults 2016 revised edition. Results The total prevalence of serum low HDL-c in male middle-aged and older adults was more than that in female (χ²=202.144, P<0.001).The prevalence of low HDL-c decreased with age (χ²=9.782, P=0.002) while increased with family average income (χ²=16.143, P<0.001) and educational levels (χ²=95.129, P<0.001). The difference among four regional types was significant (χ²=7.314, P=0.007), which was 36.5% in big city, 32.4% in small and medium-sized city, 33.5% in ordinary rural areas and 34.0% in poverty rural areas respectively. Among male participants with low HDL-c and normal HDL-c, difference of dietary fruit intake, eggs intake and milk intake were statistically significant both in urban and rural areas (all P<0.05). When comparing the dietary intake difference between low HDL-c and normal HDL-c among female participants, difference of red meats intake and poultry intake were significant both in urban and rural areas (all P<0.05). Logistic regression by adjustment of confounding factors showed that cereals, fruits and red meats were associated with low HDL-c, their OR and 95% CI were 1.06(1.03-1.09), 1.12(1.06-1.19) and 0.91(0.89-0.93). Conclusions The low HDL-c prevalence was high among middle-aged and older adults both in urban and rural areas of China; low HDL-c was related with cereals, fruits and red meats consumption.

Study on the relationship between triglyceride-glucose (TyG) index and the clustering of risk factors for cardiovascular disease

SONG Jian, CHEN Xue, ZHANG Jie, WU Xue-sen

2017, 21(4): 362-365,374. doi: 10.16462/j.cnki.zhjbkz.2017.04.010

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Objective To explore the relationship between triglyceride-glucose (TyG) index and clustering of cardiovascular risk factors in adolescents. Methods A total of 1 777 residents from Longzihu area in Bengbu, Anhui Province were selected by random sampling. Questionnaires, physical examination and laboratory measurements were used to collect general and clinical information. TyG index was grouped by quartiles. Logistic regression analysis was performed to analyze the relationship between TyG index and cardiovascular risk factors clustering. Using ROC curve analysis, the cut-off value and clinical significance of cardiovascular risk factors clustering prediction by TyG index were calculated for comparison with other indicators. Results The survey included total 748 males (42.09%) and 1 029 females (57.91%) with the average age of (60.82±11.24) years. Spearman correlation analysis showed that TyG index were significantly correlated with cardiovascular disease risk factors (all P<0.001). Indeed, multivariate Logistic analysis showed that TyG index was a risk factor for cardiovascular disease risk factors clustering (OR=2.930, 95% CI:2.625-3.272). When the TyG index was 8.78, the Youden index of cardiovascular disease risk factors clustering determination by TyG index was the maximum. The area under the receiver operator characteristic curve (ROC) curve of TyG index was significantly different from that of fasting blood glucose, triglycerides and body mass index (BMI) (all P<0.05). However, no significant difference was observed when compared with waist-to-height ratio (WHtR) (Z=0.117, P=0.907). Conclusions There is a significant correlation between TyG index and clustering of cardiovascular risk factors, suggesting that TyG index may be applied as a simple marker for identifying adolescents with clustering of cardiovascular risk factors.

Study on relation of body mass index and waist-to-height ratio to blood pressure in middle-aged community groups

YUE Na-na, LI Juan-sheng, PU Hong-quan, LI Hai-yan, XIA Ting, LIU Jian-zheng

2017, 21(4): 366-369. doi: 10.16462/j.cnki.zhjbkz.2017.04.011

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Objective To explore the correlation of body mass index(BMI) and waist-to-height ratio(WHtR) with blood pressure as well as to assess the efficacy of the two obesity index in the prediction of hypertension in a middle-aged community groups. Methods Total 4 088 middle-aged residents from one community of Jinchuan area in Jinchang City were included in this study. Basic health information was collected using a health-behavior factors survey. Linear regression model analysis was carried out on the relationship between blood pressure(systolic and diastolic) and BMI, WHtR. The efficacy and appropriate cut-off values of BMI and WHtR in the prediction of hypertension were assessed using receiver operating characteristic curve (ROC). Results Systolic and diastolic pressures increased with increasing BMI and WHtR. The effect of BMI on blood pressure was greater than that of WHtR. The prediction efficacy of BMI on hypertension were better than that of WHtR no matter male (Z=2.06,P=0.020) or female (Z=1.77, P=0.038). Conclusions BMI has a stronger correlation with blood pressure than that of WHtR in this middle-aged community residents. People with BMI ≥ 24.0 kg/m² and/or WHtR ≥ 0.5 should be the key residents for hypertension prevention and control.

Study on the cut off value of serological markers in screening gastric cancer in Fujian Province

WU Si-han, ZHENG Kui-cheng, WANG Wen, LIN Lan, LIU Dan-feng, SHI Hong, HUANG Liang-xiang, WU Bing-shan, CHEN Tie-hui, LI Xiao-qing, CAI Lin

2017, 21(4): 370-374. doi: 10.16462/j.cnki.zhjbkz.2017.04.012

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Objective To conduct the investigation on the optimism cut off value on serological markers of gastric cancer, including PG I, PG I/PG Ⅱ ratio (PGR) and G-17 among Fujian population, and to improve the early detection and diagnosis rate. Methods The study participants were assigned to normal control group, atrophic gastritis group and gastric cancer group in accordance with the result of gastroscopy and pathological analyses. ELISA technique was employed to determine the fasting serum level of PG I, PG Ⅱ and G-17, and qualitative analysis on Hp-IgG antibody was also performed. The PGR was calculated for further analysis. Receiver operating characteristic curve was generated to estimate the optimism cut off value of above-mentioned serological markers. Results The serum level of PG I and PGR were significantly lower in gastric cancer cases when comparing with atrophic gastritis group and normal controls (all P<0.05). Similar difference were also observed in atrophic gastritis group when comparing with normal controls (all P<0.05). As for PG Ⅱ, the significant elevation in gastric cancer group when comparing with normal controls (Z=3.016, P=0.008), however, no significant difference was found when comparing with atrophic gastritis group (Z=0.115, P=0.909). In addition, significant elevation on PGI, PGⅡ and G-17 was observed in subjects with H.pylori infection when comparing with those free of H.pylori (all P<0.05), on the other hand, significant reduction on the PGR was also found in subjects with H.pylori infection (Z=10.135, P<0.001). The cut off value of PG I, PGR and G-17 for screening gastric cancer were 98.63 μg/L, 8.13 and 5.68 pmol/L, respectively.Conclusions The reduction on serum level of PG I and PGR and the elevation on G-17 are associated with the development of gastric cancer. The optimism cut off value of serum PG I, PGR and G-17 in the diagnosis of gastric cancer in different regions should be established.

Study on the association between exposure of environmental risk factors and childhood acute lymphoblastic leukemia

ZHAO Liang, ZENG Qiang, ZHANG Li, ZHANG Dan-dan, ZHANG Lei, WANG Rui, FU Gang, FENG Bao-jia, LIU Xiao-ming

2017, 21(4): 375-378. doi: 10.16462/j.cnki.zhjbkz.2017.04.013

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Objective To explore the association between environmental risk factors and childhood acute lymphoblastic leukemia (ALL). Methods Children with ALL from Tianjin Blood Disease Hospital in 2015 were enrolled in this case-control study. Controls were randomly selected from health children during the same period. Information was collected by one-on-one questionnaire. Chi-square test and non-conditional Logistic regression model were used to analyze the association between environmental risk factors and ALL. The adjusted population attributable risk percent (PARP) for the related risk factors were calculated. Results Single factor analysis showed that children with history of contacting with the paints and coatings(χ²=7.146,P=0.008), eat less vegetables and fruits(χ²=47.070,P<0.001) and exposure to home decoration(χ²=9.030,P=0.003) in case group were more than those in control group. Results from multivariate analysis also showed these three factors were significantly associated with ALL, with odds ratios of 2.174(1.031-4.583), 4.990(3.017-8.253) and 2.831(1.361-5.889) respectively, and the PARP of the three factors were 11.2%, 25.2% and 11.7% respectively. Conclusions Contacting with the paints and coatings, partiality for a particular kind of food and exposure to home decoration could be risk factors for childhood ALL.

An investigation of life quality in 121 cured leprosy patients, Linyi City

SONG Hong-guang, MA Ai-guo, LIN Rui-han, Guo Yu-mei

2017, 21(4): 379-382,408. doi: 10.16462/j.cnki.zhjbkz.2017.04.014

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Objective To investigate the life quality of cured leprosy patients in Linyi City, China, and provide scientific suggestions for improving patients' life quality and health condition. Methods A total of 121 cured leprosy patients in Linyi City were selected as subjects by random sampling method. Using the modified version 2 of the SF-36 health survey (SF-36v2), the subjects were surveyed face to face for analysis and evaluation in 8 dimensions. The data were compared with those of Chinese equivalent norm to analyze the factors affecting quality of life. Results The average age of 121 subjects was 68.7 years old, and 80.2% of them were 60 years old or above. In total, 65 leprosy patients were disabled. Survey analysis showed that the quality of physical health score (PCS) was 35.8 and mental health scores (MCS) was 37.1, both being lower than the China norm (all P<0.05). Transformed scores of 8 dimensions in the SF-36 v2 questionnaire of the leprosy patients were lower than those of China norm (all P<0.05). The physical health score (PCS) of subjects living in the leprosy villages and those scattering across the society were 31.6 and 38.1 respectively, and PCS of subjects scattering across the society was significantly better than those in the leprosy villages (t=-2.276, P=0.025). The physical functioning, role-physical, general health, social functioning and role-emotional dimensions transformed scores of the patients in healthy subjects were higher than those of disabled patients (all P<0.05). Conclusions The cured leprosy patients are very old in Linyi City. Disability, non-divorced and psychological pressure are the major factors that affect the patients' quality of life after cure. The cured leprosy patients deserve more attention.

Study on the construction and evaluation of social function of aging measurement scale (SFAMS) in healthy Chinese

ZENG Ni, DENG Peng-fei, LIN Fei, HUANG He-lang

2017, 21(4): 383-386. doi: 10.16462/j.cnki.zhjbkz.2017.04.015

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Objective A index system was established to evaluate social function of aging of healthy life from the perspective of epidemiology, sociology and elderly health care with guide of modern medical model. Methods Social function of aging evaluation index system and weight coefficient were established by literature collection, modified Delphy (Delphi) and analytic hierarchy process (AHP). The reliability and validity of the scale were evaluated through internal consistency reliability analysis, correlation analysis, and exploratory factor analysis as well as indicator extraction. Results Three aspects and 13 indicators were ultimately included according to the mean and coefficient of variation of importance and feasibility score. The Cronbach's α coefficient of the scale was 0.873. The test-retest reliability coefficient was 0.848 (P<0.001), and CVI (content validity index) was 0.836. Three common factors were extracted through the construct validity analysis which accounted for 53.69% of the variance of the original indicators with factor analysis, the communality of the indicators were 0.573-0.776. Conclusions Those indexes are of good representation and recognition. Indicators included reliability, content validity index, and construct validity are also good. The dispersion of index score, the correlation coefficient of index score with total score and load of each factor are basically reached the related standard. It can provide the judgment of aging for any one and had good value and prospect.

Influencing factors of self-injury behavior among undergraduates by two-level binary Logistic regression model

CHEN Fei, HUANG Jing, ZHANG Lian-sheng

2017, 21(4): 387-390. doi: 10.16462/j.cnki.zhjbkz.2017.04.016

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Objective To explore the influencing factors of self-injury behavior among undergraduates. Methods A total of 19 662 undergraduates were selected based on stratified random cluster sampling from 10 universities at various levels in Wuhan. Self-injurious behavior questionnaire, emotion adjustment difficulties scale and Eysenck personality questionnaire were conducted among subjects. Binary logistic regression and two-level binary logistic regression model were used to analyze the school-level factors influencing self-injury behavior incidence. Results The incidence of self-injurious behavior among undergraduates was 1.8%. Scores on emotional adjustment difficulties and personality in self-injury group were higher than those in non self-injury group (all P<0.05). The self-injury behavior among undergraduates revealed an aggregation in university-level. The two-level binary logistic regression model showed that gender, origin of student, left-behind experience, emotion dysregulation and personality disorder were predictive factors for self-injurious behavior (all P<0.05). Conclusions It is necessary to build positive coping strategies and improve psychological health level among undergraduates. Peer education intervention plays an important role in the prevention and control of self-injury behavior.

Analysis on the knowledge and risk factors for child sexual abuse among school children in rural area

XIANG Bing, LI Yan, GUO Qing, WANG Shu-ming, ZHENG Nian-xiang, HUANG Ju-fen

2017, 21(4): 391-394. doi: 10.16462/j.cnki.zhjbkz.2017.04.017

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Objective To evaluate the knowledge and risk factors for child sexual abuse (CSA) among school aged children in rural area and to provide basic information for CSA prevention education in school. Methods 1 252 school-aged children were recruited from 4 schools by random cluster sampling, and non-condition Logistic regression was executed to analyze the knowledge and risk factors for CSA. Results Three factors related to CSA had the lowest rate of correct knowledge among school-aged children:children who were secually assaulted are right in the event (54.6%), children can be sexual assaulted by people with the same sex (54.2%), women can sexually abuse children (51.3%). Multivariate analysis results indicated that male, non-single child, non-resident, junior high school educational level and below, the low score of adaptability, aged 10 to 12 and aged 13 to 16 were risk factors (all P<0.05). Conclusions The school-aged children in rural area lack basic CSA prevention knowledge. It is necessary to promote CSA prevention education in school children, more attention should be paid to the left-behind children in rural area.

Study on the relationship between 5-HT, 5-HTP levels in peripheral blood and drivers' accident proneness

DENG Yu, YANG Jia-li, WANG Xiao-min, HUANG Kai-yong, ZENG Xi, YANG Jun, YANG Li

2017, 21(4): 395-398. doi: 10.16462/j.cnki.zhjbkz.2017.04.018

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Objective To investigate the relationship between 5-hydroxytryptophan (5HT), 5-hydroxytryptophan (5-HTP) level in peripheral blood and the drivers' accident proneness. Methods A case-control study was applied to this study. The motor vehicle drivers who had 3 or more times the same responsibility of road traffic accidents from January 2008 to December 2012 were selected as the cases, and other drivers who had not happened road traffic injuries during the same period with similar gender, vehicle type, age and driving years less than 2 years old as the control group. Results The levels of 5-HT and 5-HTP in the case group were lower than those in the control group (all P<0.05). Multivariate logistic regression analysis showed that the low level of 5-HT and the low level of 5-HTP were related to motor vehicle drivers' accident proneness (all P<0.05). Conclusions The driver accident proneness is related to the level of 5-HT and 5-HTP. 5-HT and 5-HTP levels were protective factors of drivers' accident proneness.

The mental health of 1 031 drug addicts under compulsory rehabilitation in Chongqing

ZHAO Meng-xue, YANG Guo-yu, ZHANG Ying, ZHANG Jing-xuan, WANG Fei-fei, YANG Chun-li, WANG Wan-xi, XU Wen-jia

2017, 21(4): 399-403. doi: 10.16462/j.cnki.zhjbkz.2017.04.019

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Objective To explore the mental health of drug addicts under compulsory rehabilitation. Methods Self-reporting inventory, state-trait anxiety inventory (STAI) and self-rating depression scale were used to evaluate the psychological condition of 1 031 subjects. Results The incidence of psychological problems was 53.73%. Except for interpersonal sensitivity, scores of rest items were significantly higher than the norm (all P<0.05). Hostility, STAI and paranoid ideation scores of males were significantly higher than females (all P<0.05). The lower level of education, the higher scores in somatization, obsessive-compulsive, anxiety, STAI and depression. Except for trait anxiety, there were significant differences in each dimension among addicts on different age groups (all P<0.05). The detoxification stage scores were the highest, STAI scores were getting lower with the progress of rehabilitation. Trait anxiety scores of addicts for the above-third-time and above rehabilitation were the highest. Except for hostility, phobia anxiety, paranoid ideation and psychoticism dimensions, the scores of injecting drug addicts were significantly higher than suction mouth drug users (all P<0.05). Conclusions The incidence of psychological problems of drug addicts under compulsory rehabilitation is higher and more severe than the norm. Mental health and emotion were affected by gender, age, culture level, rehabilitation stage, rehabilitation times and drug-taking patterns.

The study of mitochondrial pathway that mediated by oxidative stress involved cardiomyocytes apoptosis induced by N, N-dimethylformamide mitochondrial pathway

MA Xiao-li, YANG Yong-jian, WANG Juan, RONG Qing-xiu, WANG Lu-lu, SUN Wen-jing, XIANG Mei

2017, 21(4): 404-408. doi: 10.16462/j.cnki.zhjbkz.2017.04.020

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Objective To explore whether N, N-dimethylformamide (DMF) can induce apoptosis in H9c2 cardiomyocytes through mitochondrial pathway and its potential mechanism preliminarily. Methods H9c2 Cardiomyocytes were cultured in vitro and divided into groups with different treatments:control group, NAC group (4 mmol/L), DMF group (200 mmol/L), NAC (4 mmol/L)+DMF (200 mmol/L) group. After treating with 24 h, the location of Cyt-c was detected by immunofluorescence cytochemistry (IFC) and the levels of Cyt-c, Bcl-2, Cleaved caspase-3 were detected by western blotting. Results IFC showed that the control and NAC group of Cyt-c were distributed in spotted or patchy shape in the cytoplasm, and the DMF group of Cyt-c was distributed in the cytoplasm diffusely, while NAC could inhibit the effect induced by DMF. Western blotting showed that the levels of Cyt-c different groups were significantly different (F=26.14, P<0.001). Comparing with the control group, as for the level of Cyt-c, the DMF group was significantly increased and the NAC+DMF group was significantly decreased than DMF group (all P<0.001); as for the level of Bcl-2 among different groups were significantly different (F=28.92,P<0.001). Compare with control group, the DMF group was significantly decreased and the NAC+DMF group was significantly increased than DMF group (all P<0.001); as for the level of Cleaved caspase-3, there were significantly different (F=28.98,P<0.001) among different groups. Compare with control group, the DMF group was significantly increased and the NAC+DMF group was significantly decreased than DMF group (all P<0.001). Conclusions DMF can induce apoptosis in H9c2 Cardiomyocytes through mitochondrial pathway. Oxidative stress may be involved in the pathogenesis.

Health economics evaluation of syphilis intervention strategy in syphilis integrated prevention and control area of Guangdong Province

ZOU Ya-ming, LIU Feng-ying, CHEN Lei, SHEN Hong-cheng, HUANG Shu-jie, ZHENG He-ping, YANG Bin, HAO Yuan-tao

2017, 21(4): 409-413,427. doi: 10.16462/j.cnki.zhjbkz.2017.04.021

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Objective To evaluate the intervention strategies in Guangdong initiative for comprehensive control of syphilis (GICCS) from the aspect of health economics, and to provide the scientific basis for optimization and formulation of syphilis prevention and control strategy. Methods Two kinds of syphilis intervention strategies were considered:one was 80 percent coverage of syphilis screening (Strategy 1) and the other was 85 percent coverage of syphilis screening (Strategy 2). A Markov model for syphilis screening was applied based on the results of field surveys in GICCS and published literature. Cost-effectiveness analysis and sensitivity analysis were conducted through simulating the total costs and expected health outcomes of 10 000 syphilis high-risk people during the time horizon of 20 years under strategy 1 and Strategy 2 respectively from the societal perspective. Results Compared to strategy 1, strategy 2 would cost 3 998.88 million yuan more but avert 28 primary syphilis, 34 secondary syphilis, 337 latent syphilis and 8 tertiary syphilis cases and 392 disability adjusted life years (DALYs) at the same time. The incremental cost effectiveness ratio was 101.95 thousand yuan per DALYs. Sensitivity analyses showed that syphilis screening programme would have more cost effectiveness when the incidence of syphilis and the probability of late latent syphilis progressing to tertiary syphilis increased and the treatment rates of secondary syphilis and late latent syphilis decreased. Conclusion The syphilis intervention strategies GICCS adopts have cost effectiveness and can be popularized.

Study on the import and export of hepatitis B cases reported in Tianjin

WU Wei-shen, CHEN Jing, HE Hai-yan, ZHAO Ying, LI Chao, WANG Wen-quan

2017, 21(4): 414-417. doi: 10.16462/j.cnki.zhjbkz.2017.04.022

Abstract(422)

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Abstract:
Objective To explore the Hepatitis B epidemic characteristics and distribution in the import and export cases of Tianjin and to provide basis for the regional integration. Method Hepatitis B cases data were derived respectively from "China information system for disease control and prevention" among 2005-2015 by current address and reported regions Tianjin. Then studies of gender, age, reported region, occupation and reporting agency were performed according to the category of imported or exported cases. Results The rate of export and import cases respectively was 14.96% (6 311/42 190) and 3.28%(1 218/37 097) (χ²=3 130.935, P<0.001). Hebei Province got both the first import and export rate (57.47%, 57.96%), among which males (63.79-75.93%), aged 20-49 and farmers were the major population. The export number and constituent ratio of children, students aged 0-19 was larger than those imported. Conclusions Hepatitis B cases addressed in Tianjin are mainly reported by local hospitals. The export or import cases are closely related with Hebei and Beijing, which regional integration should be strengthened for Hepatitis B management and control.

The burden of disease and vaccine prevention of influenza in the elderly, patients with chronic diseases and health personnel

HUANG Yu-kai, ZHANG Tao, ZHAO Gen-ming

2017, 21(4): 418-421. doi: 10.16462/j.cnki.zhjbkz.2017.04.023

Abstract(493)

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Abstract:
Influenza, a highly contagious viral infection, affects mainly the nose, throat, bronchi and lungs. It is easily transmitted via droplets through coughing or sneezing. Most will recover within one to two weeks without medical care after infection. For older people and those with certain health conditions, however, it may result in hospitalization or even death. Receiving an annual vaccination is the best way to prevent influenza. This study aims to describe the burden of disease and vaccine prevention among these higher risk groups.

The research actuality and characteristics of health-related quality of life assessment for tumor patients in China

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

2017, 21(4): 422-424. doi: 10.16462/j.cnki.zhjbkz.2017.04.024

Abstract(454)

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Health-related quality of life (HRQOL) assessment for tumor patient has been getting increased attention in recent years. Relevant assessment methods have applied widely overseas.The article introduces the measurement method, actuality, application and development of HRQOL for tumor patient. The characteristics of these studies are also discussed.

Curve regression analysis between EV71 positive rate among HFMD normal case and morbidity of severe cases in Hunan Province

ZHANG Si-yu, HUANG Wei, LUO Kai-wei, ZHANG Hong, GAO Li-dong, CHEN Yu, DENG Zhi-hong, ZHOU Shuai-feng, ZHANG Fan, HU Shi-xiong

2017, 21(4): 425-427. doi: 10.16462/j.cnki.zhjbkz.2017.04.025

Abstract(212)

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Investigation of a family clustering of human infection with avian influenza A (H7N9) virus in Taihe, Jiangxi

ZENG Zhi-li, ZHU Meng-man, YUAN Hui, LIU Xiao-qing

2017, 21(4): 428-430. doi: 10.16462/j.cnki.zhjbkz.2017.04.026

Abstract(241)

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Editor

Editor-in-Chief Ye Dongqing M.D.

Assistant editor Fan Yinguang M.D.

Assistant editor Pan Haifeng M.D.

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