中华疾病控制杂志

Epidemiological status, challenge of prevention and control, and response strategy of infectious diseases

YANG Juan, LAI Sheng-jie, YU Hong-jie

2017, 21(7): 647-649,674. doi: 10.16462/j.cnki.zhjbkz.2017.07.001

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During recent several decades, the global disease burden of infectious diseases decreased substantially. However, morbidity and mortality associated with common infectious diseases should not be overlooked. In addition, under the influence of such factors as global climate change, rapid urbanization, and rapid population movement, new emerging infectious diseases become severe threat to global public health. Both the whole world and China are threatened by both common and new emerging infectious diseases. The control and prevention of infectious diseases under new circumstances should strengthen global cooperation, and require interdisciplinary and trans-department collaboration.

A research on the spatial distribution structure and spatiotemporal clustering of A(H7N9) human infections in China during 2013 and 2014

DONG Wen, YANG Kun, XU Quan-li

2017, 21(7): 650-654. doi: 10.16462/j.cnki.zhjbkz.2017.07.002

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Objective To investigate the development of spatiotemporal clustering and spreading characteristics of A(H7N9) human infections from March 2013 to December 2014 in China. Methods Data were collected from processed A (H7N9) infection cases. Descriptive statistics analysis, standard deviation ellipse analysis and space-time scan clustering analysis method were used to study the spatiotemporal distribution characteristic, the spatial distribution structure and spatiotemporal clustering of H7N9 outbreaks in each month in China. Results During the study period, the H7N9 epidemics peaked in winter and spring of each year. The high-risk areas of the outbreak concentrated in the eastern and southeast coastal areas of China (such as Zhejiang, Guangdong, Jiangsu, Fujian and Shanghai). The spatial distribution structure of H7N9 outbreaks originated from the eastern areas of China, spread along eastern areas to the southeast coastal of China and finally expanded to the central and western regions of China. The scan test identified a most likely cluster(P<0.001) and a secondary cluster(P=0.029) of H7N9 outbreaks in April 2013, in addition, there was a most likely cluster in each month of January 2014, February 2014 and April 2014 (all P<0.05). Conclusions Due to the differences between the spatial distribution structure and spatiotemporal clustering pattern of A(H7N9) human infections in China, the spread process of the epidemic presented an unbalanced characteristic with a combination of the overall expansion and the local accumulation, and the outbreak has obvious seasonal epidemic characteristics. Therefore, relevant departments should develop prevention and control strategies scientifically based on the spreading characteristics of H7N9 epidemic.

Time-space study on influenza-like illness in Shenzhen, 2013-2015

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

2017, 21(7): 655-659. doi: 10.16462/j.cnki.zhjbkz.2017.07.003

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Objective To analyze the epidemic and spatial characteristics of influenza in Shenzhen during 2013-2015,and to provide decision-making evidence for the prevention and control of influenza in Shenzhen. Methods Influenza-like illness(ILI)data were collected from sentinel hospital or school in Shenzhen during 2013-2015. Spatial-temporal scan statistic were utilized to analyze the temporal and spatial distribution characteristics of influenza. Results Age 0-14 year group was the main part of ILI patients from 2013 to 2015(accounting for 73.20%).There are two peaks for ILI% in each year,one from March to July,the other from December to February.The incidence of ILI could be detected by temporal-spatial scanning statistics, which the aggregating time was consistent with the descriptive analysis of ILI. Conclusions ILI circulating peak mainly focuses in summer and winter, and 0-year group is the main part of ILI patients.Using spatial-temporal scan statistic can detect the abnormal cluster of ILI in time,which will be great significance to the prevention and control of influenza.

Analysis of the evolution mechanism of intensity of influenza a (H1N1) epidemics in Chengdu

REN Shu-hua, DU Chang-hui, MA Lin, FENG Ge, CHEN Wen-wei, YANG Cai-bin, WANG Zheng-hong, WANG Kai, PAN Zhen-zhen, LIANG Xian

2017, 21(7): 660-664. doi: 10.16462/j.cnki.zhjbkz.2017.07.004

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Objective To analyze the temporal-spatial transmission mechanism of influenza A (H1N1) in Chengdu. Methods The space-time permutation scan statistic and the small world network model were conducted by using the data of the H1N1 collected from Chengdu in 2009 to explore the evolution mechanism of epidemic intensity of the H1N1. Results Most of hot spots of the H1N1 occurred in the early and mid-September. The number of hot spots reduced gradually from the Chengdu center to the outer circle direction, of which the most were in the six districts, constituting the main city area. Units in the detection of hot spots are mostly schools, accounting for 51.85% of the total number; The small world network model of the spread of the H1N1 had the following features:The flow of the H1N1 cases flowed roughly from the more remote outer layer to the central area of the city; The input flows(imported cases) mainly occurred at the six districts, constituting the central area of the city, where most imported cases were clustered into, while the output flows(export cases) appeared in the third circle sections of the city and the second circle sections far away from the central area of the city, where most exported cases were clustered;The spread-network of the H1N1 among the six districts located in the center was a strongly interconnected network, the mean of the imported and exported cases between which was relatively larger. The six districts, Wenjiang and Shuangliu played a central role in the process of the spread of the H1N1, which were the core of the small world network. Conclusions The counties located in different circle sections of the city had a big difference in the transmission risk of the H1N1,in which main urban districts,as being the core of the small world network, were the highest;As for the aspects of the specific institutional unit, schools were at a higher risk of clusters of the H1N1 occurrence than other units; So it is of great significance for emphasis placed on prevention and control measures in these high risk areas at the time of the arrival of infectious diseases to control infectious disease outbreaks in Chengdu.

Epidemiological characteristics analysis of influenza in Nanjing City from 2006 to 2015

WANG Wei-xiang, HONG Lei, FENG Luo-ju, SU Jing-jing, LI Wei, LIU Pei

2017, 21(7): 665-669. doi: 10.16462/j.cnki.zhjbkz.2017.07.005

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Objective To investigate the epidemiologic characteristics of influenza in Nanjing from 2006 to 2015 in order to provide scientific evidence for developing strategies on the influenza prevention and control. Methods Data was collected from China information system for diseases control and prevention, including influenza-like illness(ILI) case report, pathogen surveillance, and influenza outbreak report. Data analysis was conducted by SPSS 16.0. Results From 2006 to 2015, in average, 5 823 ILI cases were reported annually, and the average annual ILI% was 5.0%. Among different age groups, children under the age of 5 accounted for the highest percentage(64.8%), whereas people aged 60 years and older had the lowest percentage (2.1%). From 2006 to 2015, a total of 31 644 throat swab specimens were collected and tested for ILI, in which 4 762 cases were tested positive (15.0%). The positive rate varied among different years, and different age groups (all P<0.05). Among the 4 762 cases, 1 944 H3N2 types, 1 374 B types, 1 243 H1N1(09pdm) types, and 201 seasonal H1N1 types were identified with the percentage of 40.8%, 28.9%, 26.1%,and 4.2%, respectively. The percentages of virus subtypes were significantly different among different age groups (χ²=317.19,P<0.001). Conclusions The percentage of ILI in children under the age of 5 was the highest. Different influenza subtypes altered to become the dominant strain. The main subtypes of influenza were different among different age groups.

Sequence analysis of C2-V4 region of HIV-1env genes in intravenous drug users in Kunming City

ZOU Sen, GAO Zhan, QI Zhong-wei, REN Li, HU Yuan-yuan, WANG Zheng, HONG Kun-xue

2017, 21(7): 670-674. doi: 10.16462/j.cnki.zhjbkz.2017.07.006

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Objective To investigate the sequence characteristics of C2-V4 region of HIV-1 env genes and to analyze the epitope variation of representative broadly monoclonal neutralizing antibodies (bmNAbs) in intravenous drug users in Kunming City. Methods 165 HIV-1 infected plasma samples were collected from intravenous drug users in Kunming. RNA was extracted and the cDNA was obtained by reverse transcription. The C2-V4 region of the HIV-1 env genes was amplified by nested PCR and analyzed by bioinformation software such as BioEdit and MEGA, etc. And the epitope variation of bmNAbs such as 2G12, PGT135, PGT128, b12 and VRC01 were analyzed. Results The 165 sequences of C2-V4 region were mainly CRF08_BC (74.55%) and CRF07_BC (23.03%) recombinant strains. The diversity degree of the variable loops was as follows:V3 region < C3 region < V4 region;And the gene divergence of C2-C4, V3, C3 and V4 regions of CRF08_BC strains was greater than that of CRF07_BC, respectively. The crown tetrapeptide of V3 loop existed in 5 types:GPGQ (95.76%), GPGR(1.82%), GPRQ(1.21%), GPGL(0.61%) and RPGQ(0.61%), and the majority of strains utilize CCR5 as co-receptor (97.58%). Over 90% CRF08_BC and CRF07_BC recombinant strains had deletions of glycosylation sites associated with 2G12 recognition, while mutations at the sites recognized by b12, VRC01, PGT135 and PGT128 were low. Conclusions CRF08_BC and CRF07_BC are the main circulating strains in intravenous drug users in Kunming, and the gene divergence of CRF08_BC is higher than that of CRF07_BC. Sequence analysis demonstrate that V3 region is more conservative than C3 and V4 regions. Varying degrees of epitope variation among representative bmNAbs such as 2G12, PGT135, PGT128, b12 and VRC01 exist in CRF08_BC and CRF07_BC strains.

A case-control study on risk factors of severe fever with thrombocytopenia syndrome in Chuzhou City, Anhui Province

CHEN Wei-guo, HU Jian-li, BAO Chang-jun, GENG Shou-yan, ZHANG Yong, XIA Zheng-yan, YE Jun, LI Zhi-feng

2017, 21(7): 675-678. doi: 10.16462/j.cnki.zhjbkz.2017.07.007

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Objective To explore the risk factors for severe fever with thrombocytopenia syndrome (SFTS) and to provide evidence for the prevention and control of the disease. Methods A 1:4 matched case-control study was conducted among SFTS cases and controls matched by sex, age and address. Standardized questionnaires were used to collect detailed information about their demographics and risk factors for severe fever with thrombocytopenia syndrome virus (SFTSV) infection. Risk factors for SFTS were identified using univariate and multivariable conditional Logistic regression models. Results In the univariate conditional Logistic regression model, the following factors were associated with SFTSV infection:contacting with SFTS patients, exposure to dogs with ticks, tick bites, living areas surrounded by ticks and sitting on the lawn during break times at work(all P<0.05). The results of the multivariable conditional Logistic regression model showed that contacting with SFTS patients (OR=5.44, 95% CI:1.56-19.04, P=0.004), exposure to dogs with ticks (OR=12.81, 95% CI:3.20-51.25, P<0.001) and tick bites (OR=47.25, 95% CI:6.94-321.53, P<0.001) were risk factors for SFTSV infection. Conclusions Contacting with SFTS patients, exposure to dogs with ticks,and tick bites were risk factors for SFTSV infection. It is necessary to strengthen health education on personal protective behaviors among the high-risk population.

Effect of famine exposure in the early life on risk of metabolic syndrome in adulthood

ZHAO Hou-yu, LI Hai-long, SUN Feng, ZHAN Si-yan

2017, 21(7): 679-683. doi: 10.16462/j.cnki.zhjbkz.2017.07.008

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Objective To examine whether exposure to the Chinese famine during fetal life or early childhood is associated with the risk of metabolic syndrome(MS) in adulthood. Methods A data of 2 854 adults born between 1956 and 1964 from the 2011 Chinese Health and Retirement Longitudinal Survey (CHARLS) was used.Three groups were defined as pre-famine(born in 1956-1958),famine exposure(born in 1959-1961) and non-exposed group(post-famine,born in 1962-1964). The Chinese Diabetes Society(CDS) criteria were used for the definition of metabolic syndrome. Difference in difference model(DID) and disease risk score(DRS) matching approach based on conditional logistic regression were utilized to adjust the effects of age and other potential confounders. Results The prevalence of MS were 16.00%,16.47% and 14.86% among participants of pre-famine,famine and post-famine groups respectively. But after adjusting covariates by DRS matching,the interactions in the DID models were not significant(all P>0.05),meaning the odds ratio (OR) was not significantly bigger than one and that the two famine exposed groups of participants didn't have a significantly higher risk of developing metabolic syndrome. Conclusions There is no significant evidence in our study to support that famine exposure in early life will increase the risk of MS in adulthood. Further studies with larger sample size are needed to confirm the hypothesis.

The current status of metabolic syndrome among adults aged 35 years and above in Xinjiang

DONG Ying, WANG Xin, ZHANG Lin-feng, CHEN Zuo, NIE Jing-yu, WANG Jia-li, ZHENG Cong-yi, SHAO Lan, TIAN Ye, WANG Zeng-wu, ZHOU Ling, LI Nan-fang

2017, 21(7): 684-687,692. doi: 10.16462/j.cnki.zhjbkz.2017.07.009

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Objective To understand the prevalence and influential factors of metabolic syndrome in Xinjiang adults aged 35 years and above. Methods Using a multistage stratified random sampling method, investigations including questionnaire, physical examination and blood test, was conducted among inhabitants aged 35 years and above in Xinjiang on 2015. MS was diagnosed according to the US National Cholesterol Education Program Adult Treatment Panel Ⅲ (NCEP ATP Ⅲ) criteria with modification for Asian population. Prevalence of MS was standardized by 2010 general population and non-conditional logistic regression analysis was followed to analyze the risk factor. Results The prevalence of MS was 26.40% (aged-standardized prevalence 25.46%),24.66% (age-adjusted prevalence 24.49%) for males, and 28.00% (age-adjusted prevalence 26.18%) for females. Among participants with MS, 34.95% were with central obesity, high blood pressure and dyslipidemia. The prevalence of MS was highest in the Uygur (41.18%). People who have family history of hypertension had higher risk of MS than their counterpart (OR (95% CI):1.230 (1.037-1.459), P=0.017). Conclusion The prevalence of MS was higher in Xinjiang adults, family history of hypertension was one of the risk factors of MS.

Investigation of the correlative factors for osteoporosis among elderly male patients with type 2 diabetes

MA Hong-yan, YE Shan-dong

2017, 21(7): 688-692. doi: 10.16462/j.cnki.zhjbkz.2017.07.010

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Objective To explore the related factors for osteoporosis(OP) among elderly male patients with type 2 diabetes(T2DM). Methods A total of 288 elderly male patients with T2DM were divided into 3 groups according to the diagnosis standards of OP:normal group(n=72), ostepenia group(n=118)and osteoporosis group(n=98). Body height, weight were measured and body mass index(BMI) was calculated.Fasting blood glucose(FBG), glycosylated hemoglobinA1c (HbA1c), parathyroid hormone(PTH), serum calcium(Ca), serum phosphonium(P), serum 25-hydroxyvitamin D(25-OH-VD) and urinary albumin/creatinine ratio(ACR) were detected. Diabetic course, diabetes specific therapy and diabetic chronic complications were recorded. Results Compared with normal group, ostepenia and osteoporosis groups had longer diabetic course, higher HbA1c levels, and lower BMI (all P<0.05). Correlation analysis showed that bone mineral density(BMD) value of femoral neck, Ward's triangle region, greater trochanter and lumbar spine L2-4 were positively correlated with BMI(all P<0.05), but negatively correlated with HbA1c(all P<0.05). The incidences of diabetic nephropathy, diabetic retinopathy were higher in osteoporosis group than in normal and ostepenia groups (all P<0.05),and the incidence of diabetic neuropathy was higher in osteoporosis group than in normal group (χ²=6.168, P=0.013). Logistic regression analysis showed that BMI, HbA1c and diabetic nephropathy were correlated with diabetetic osteoporosis(all P<0.05). Conclusions Low BMI, poor blood glucose control and diabetic nephropathy were the risk factors for OP in elderly male patients with T2DM.

Association study of SLC22A12 gene rs893006 and SLC2A9 gene rs11942223 with hyperuricemia

ZHAO Li, ZHANG Fan-di, ZHANG Ya-di, DU Jian-cai, WANG Yun, GUO Zhong-qin

2017, 21(7): 693-697. doi: 10.16462/j.cnki.zhjbkz.2017.07.011

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Objective To explore the association of SLC22A12 gene rs893006 and SLC2A9 gene rs11942223 with hyperuricemia and provide the evidences for the population genetics research and hyperuricemia prevention and treatment. Methods 364 subjects were selected in a certain medical institution as case group, meanwhile, 364 subjects were selected as control group matching for the gender, ethnicity and age. Sequenom Mass ARRAY iPLEX GOLD technology was used to analyze the single nucleotide polymorphisms (SNPs) site genotype of case and control groups, multifactor dimensionality reduction (MDR) was used to analyze the interaction relationship between genetic polymorphisms of rs893006, rs11942223 and body mass index (BMI) in hyperuricemia population. Results The creatinine, total cholesterol, triglyceride, systolic blood pressure and BMI of case group were and allele frequency higher than control, there were significant difference in two groups (all P<0.05). rs893006 SNPs site genotype frequency and allele frequency were significantly different in two groups among male (χ₁²=6.372, P=0.041;χ₂²=4.935,P=0.026). In the different genetic model of male group, G allele of rs893006 SNP site was a protective factor, the hyperuricemia incidence of GT and GG carriers was 0.405 times than TT carrier. The interaction analysis between genes and BMI showed weak synergy effect between rs893006, rs11942223 and BMI, while an obvious antagonistic effect existed between rs893006 and rs11942223, high-risk genotype carriers had higher risk for hyperuricemia than low-risk genotype (OR=1.99, χ²=12.499,P<0.001). Conclusions SLC22A12 gene rs893006 SNP site was associated with the incidence of hyperuricemia in male group. There was an interaction effect between rs893006, rs11942223 and BMI.

Study on the association between P2X7R gene rs1621388 polymorphism and gout susceptibility

TAO Jin-hui, TANG Jiang-ping, CHENG Miao, LI Xiang-pei, LIU Qin, WANG Ya-ling

2017, 21(7): 698-701,736. doi: 10.16462/j.cnki.zhjbkz.2017.07.012

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Objective To analyze the association between Purinergic receptor P2X ligand-gated ion channel 7 (P2X7R) gene single nucleotide polymorphism of rs1621388 and gout susceptibility. Methods The typical site rs1621388 of P2X7R was determined through genetic linkage analysis. The peripheral venous blood and DNA of 114 gout patients (experimental group) and 93 hyperuricemia patients (control group) were collected,TaqMan method was used to detect P2X7R gene rs1621388 genotype of two groups, then the association between different alleles or genotypes and gout susceptibility were analyzed. Results The frequency of rs1621388 genotype AA,AG and GG was 10.5%,49.1% and 40.4% respectively in gout patients, 3.2%,28.0% and 68.8% in hyperuricemia patients, the genotype distribution was significantly different in two groups (χ²=17.369,P<0.001). Allele A and G frequency was 35.1% and 64.9% in gout patients, 17.2% and 82.8% in hyperuricemia patients. Allele A may be the susceptibility gene of gout (OR=2.601, 95% CI:1.629-4.154, P<0.001). There was a statistically significant difference between the distribution of dominant model genotype (AA+AG vs GG) (OR=3.262, 95% CI:1.833-5.807, P<0.001). Conclusions P2X7R gene single nucleotide polymorphism of rs1621388 was associated with gout susceptibility.

Study on the association between MTHFR gene polymorphism and the hyperhomocysteinemia among pregnant women in Shanghai

FANG Qi-wen, LIU Zhen-qiu, WANG Jun, ZHANG Zhi-jie, WANG Yong-quan, ZHANG Tie-jun

2017, 21(7): 702-705. doi: 10.16462/j.cnki.zhjbkz.2017.07.013

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Objective To investigate the distribution of MTHFR gene polymorphism among pregnant women in Shanghai and to explore the relationship between MTHFR gene C677T polymorphism and hyperhomocysteinemia, providing references for genetic screening of high-risk pregnant women and individual folate supply during periconceptional care. Methods A total of 1 000 pregnant women from 5 community hospitals in Shanghai for archiving from January to June in 2015 were enrolled in the present study. The data of their basic information, risk factors during pregnancy and folate intake were collected. MTHFR genotypes and concentration of Hcy were detected using blood samples. Results The genotype frequency of CC,CT and TT was 33.0%, 49.2%, 17.8%, respectively, and the allele frequency of C and T was respectively 57.6% and 42.4%. The concentration of serum Hcy was 11.22 (IQR, 9.15, 13.52) μmol/L, among which 84(8.4%) were mild hyperhomocysteinemia. Multivariate analysis indicated a significant association between T allele and hyperhomocysteinemia (OR_CT=2.18,95% CI:1.11-4.25; OR_TT=6.26, 95% CI:3.13-12.53). Conclusions The polymorphism of MTHFR C677T are associated with hyperhomocysteinemia among pregnant women in Shanghai. Women with T allele should be regarded as high-risk and take more folate during periconceptional care.

Analysis of health literacy and influencing factors of primary school teachers in Jiangsu Province

MAO Tao, QU Chen, ZHANG Feng-yun, LI Xiao-ning, GUO Hai-jian

2017, 21(7): 706-709. doi: 10.16462/j.cnki.zhjbkz.2017.07.014

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Objective To investigate the health literacy level and influencing factors of primary school teachers in Jiangsu Province. Methods A total of 3 518 primary school teachers from 6 cities of Jiangsu Province were selected by multi-stage stratified sampling and were investigated with health literacy questionnaire. Results A total of 3 518 questionnaires were distributed and 3 514 were valid, the effective rate was 99.89%. The health literacy level of primary school teachers in Jiangsu Province was 66.6%. The Exhaustive chi-squared automatic interaction detector classification tree model showed that the most important factor affecting the health literacy level of primary school teachers was age (χ²=83.634,P<0.001), teachers of 44 years old and less were higher than those above 44 years old. In addition, the health literacy level of teachers in town and rural areas was higher than urban areas in ≤ 44 age group (all P<0.05). In (44-49] age group, teachers who had higher education level would have higher health literacy level (χ²=8.660,P=0.020). In > 49 age group, female teachers' health literacy level was higher than male (χ²=8.439,P=0.011). Conclusions The health literacy level of primary school teachers in Jiangsu Province was high, but there was still much room for improvement. The main factor affecting the health literacy level was age, the other influencing factors of health literacy in different age groups were various and it required targeted attention.

The status of health literacy and its influencing factors among freshmen from Jiangsu Province

DU Guo-ping, YAN Wen-juan, LI Xiao-shan, JI Yu, GE You, ZHANG Yue-jin, WEI Ping-min, GAO Rong

2017, 21(7): 710-713. doi: 10.16462/j.cnki.zhjbkz.2017.07.015

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Objective To study the status of health literacy and its influencing factors among freshman in Jiangsu province, and to provide scientific basis for school health education. Methods A total of 7 560 freshmen were selected by using multi-stage stratified random cluster sampling from 14 colleges in Jiangsu Province. A self-developed questionnaire was administered to investigate the status of health literacy. Chi-square test and multiple Logistic regression model was used to analyze the influencing factors of the health literacy. Results The total rate, basic knowledge, lifestyles and behaviors as well as basic skills of health literacy were 40.4%, 56.9%, 34.2% and 76.1%, respectively. The health literacy rates of freshmen in undergraduate universities and vocational colleges were 44.2% and 32.2%, respectively (χ²=98.302, P<0.001). Female (OR=1.7), only child (OR=1.5), Han nationalities (OR=1.8), liberal arts students (OR=1.5) and science students (OR=1.5) as well as those with father graduated from college (OR=1.3) were identified as higher health literacy rates, while using male, non-only child, minority nationality, art and music majors students and those with father graduated from primary school. Conclusions The health literacy rates of freshmen in Jiangsu were higher than that of national level. However, the phenomenon of imbalanced developing of health literacy among different demographics students was existed, so targeted health promotion activities should be conducted to improve the health literacy level.

Comparative study on body morphological growth among primary and middle school students in Lanzhou

LIU Wei, WANG Yan, GUO Ke, SU Jun-hai, WANG Er-ping, WANG Yu

2017, 21(7): 714-717. doi: 10.16462/j.cnki.zhjbkz.2017.07.016

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Objective To investigate the current status of physical development among school students in Lanzhou 2014,in order to provide the basis for the improvement of their physical quality. Methods The data of height, sitting height, weight, chest circumference and skin-fold thickness were obtained from the cross sectional study of Lanzhou Student Physical Health of 2014 and 2010 and vervaeck index were calculated. T-test was used for data analysis. Results Height, sitting height, weight, chest circumference of the students in Lanzhou all increased with age(all P<0.05). No matter students in urban or rural areas, height, sitting height, weight and chest circumference of boys were significantly higher than girls (all P<0.05). Arm skin-fold thickness and scapular skin-fold thickness of boys was lower than girls (all P<0.05). Compared with 2010, arm skin-fold thickness, scapular skin-fold thickness and vervaeck index had no obvious change. Conclusions The patterns of growth and development of students in Lanzhou are in line with the general trend. It is necessary to take steps to eliminate the urban-rural gap in Lanzhou.

Investigation on HPV infection status and subtype distribution in women of different ages in Hanzhong area of Shanxi Province

LI Jun, HE Bao-ming, NAN Xing, WANG Yi-yu, WANG Guo-qing, TIAN Xiao-fei, YAN Tao, FU Yu-lan, LIU Ying, YIN Yue, YUAN Rong

2017, 21(7): 718-722. doi: 10.16462/j.cnki.zhjbkz.2017.07.017

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Objective To investigate infection status and distribution of different types of human papillomavirus (HPV) in women of different ages in Hanzhong area of Shanxi Province. Methods Twenty-three HPV genotypes were analyzed by PCR and reverse dot blot hybridization technique. Results The total infection rate, high-risk HPV infection rate, low-risk HPV infection rate and mixed high and low risk infection rate were 29.86%, 26.79%, 1.57% and 1.49% respectively. The infection rate of single high-risk subtype of HPV and multiple subtype of HPV were 21.08% and 5.71% respectively. HPV infection rate was higher for women under 20 years old and over 60 years old groups and the infection rate gradually increased along with women's age in above 21 years old age groups. High-risk HPV subtype infection rate was the highest in 50 -years old group. The most common subtype were 16,58,52,53,33 and 39 in total and single subtype infection and its infection rates were 73.25% and 79.71% in HPV infection respectively and subtype 16 reached 27.11% and 34.41% in all HPV infection respectively. Single and high-risk single type infection rates were 75.66% and 70.59% in total HPV infection respectively. Multiple and high-risk multiple infection rates were 24.34% and 24.13% in total infection respectively. Conclusions The HPV infection rate of women in Hanzhong region of Shanxi province is higher especially in the over 60 years old age group and the most common HPV high and low risk subtypes are 16,58,52,53,33,39 and 6,43. The infection rates of total, high-risk, low-risk and high-low-risk were significantly different in different age groups.

Research on symptom clusters analysis and management strategy for lung cancer patients with chemotherapy

YAN Li, KUANG Da-lin, ZHANG Hui, GUI Shu-yu

2017, 21(7): 723-726. doi: 10.16462/j.cnki.zhjbkz.2017.07.018

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Objective To investigate symptom of patients with lung cancer during chemotherapy and their incidence and severity level, for providing a proper management procedure for the patients. Methods A total of 150 lung cancer patients with chemotherapy were investigated by the Chinese version of the memorial symptom assessment scale (MSAS-Ch). Principal component analysis was performed to conduct the exploratory factor analysis. Results The average age of all the patients was (61.8±9.7) years old, and 66.7% were male. The cultural degree was mainly junior high school and under (85.4%). The highest incidence symptom of patients with chemotherapy was ‘worrying’, and the ‘pain’ was most severe. Five common factors were extracted from the MSAS-Ch, explaining 60.47% variance. The factors were intestinal discomfort symptom cluster, fatigue-related symptom cluster, psychology illness symptom cluster, sickness behavior symptom cluster, adverse reaction symptom cluster. Conclusions Clinical nursing staff should focus on general characteristics of patients and find out the source and key point of symptoms, utilize the synergistic effect of symptoms clusters and do well in recognition work, put forward targeted management procedures to improve life quality of lung cancer patients.

Value and influencing factors of intra-cavity administration of bevacizumab for patients with malignant pleural effusion and ascites

MA Tai, PAN Yue-yin, SUN Guo-ping, DA Jie, LIU Hu, DU Ying-ying, NING Jie, WANG Rong, ZHU Yan-zhe

2017, 21(7): 727-731. doi: 10.16462/j.cnki.zhjbkz.2017.07.019

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Objective To observe the effects and safety of intra-thoracic or intraperitoneal administration of bevacizumab (Bev) in patients with malignant pleural effusion or ascites, and to explore the potential factors that influence the efficiency. Methods Clinical data of sixty-one cases with malignant pleural effusion or ascites who received intra-cavity injection of drugs were retrospectively analyzed, of which twenty-four patients were injected with bevacizumab-contained regimens, and thirty-seven patients were injected with traditional chemotherapy regimens. Paracentesis-free interval (PaFI) of the groups were compared to evaluate efficiency side events after administration of drugs were recorded. Cox regression was used to analyze the clinical characteristics, blood and general effusion test. Results Median PaFI in bevacizumab group was 115.0(55.3, 219.0) days, and was significantly longer than traditional therapy (53.0(32.0, 147.5) days), (Z=2.340, P=0.019). After stratified with effusion site, Kaplan-Meier analysis also demonstrated a significant benefit from bevacizumab therapy (χ²=7.568, P=0.006). Cox regression analysis concluded effusion site and ratio of monocytes and multinucleate cell counting in the effusion had influence on outcomes in addition to bevacizumab injection (all P<0.05). No differences were seen in side events between the two groups, side events rates were 41.67% for bevacizumab group versus 40.54% for traditional therapy group (χ²=0.008, P=0.930). The most common side event was catheter-related complications, not due to drugs. Conclusions Intra-thoracic or intraperitoneal administration of Bev was thought to more effective than traditional regimens in controlling malignant effusion with tolerable side effects. Effusion sites and ratio of monocytes and multinucleate cell counting in effusion may influence the outcomes.

Epidemiological characteristics and pathogen of hand-foot-mouth-disease in Longhua District of Shenzhen in 2015-2016

BAI Jiang-tao, XU Shao-jian, REN Yan, LAI Xiao-ling, LIU Ai-ping, QUAN De-fu, WANG Jin-ming, LIN Qi-hui

2017, 21(7): 732-736. doi: 10.16462/j.cnki.zhjbkz.2017.07.020

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Objective To analyze the epidemiological and etiological features of hand-foot-and-mouth disease (HFMD) in Longhua district, Shenzhen City, in order to provide an important scientific basis for the HFMD prevention and control strategies in this area. Methods HFMD epidemiological data of Longhua district was obtained from China's disease prevention and control information system; The nucleic acid of enteroviurs (EV), enteroviurs 71(EV-A71)and coxsackievirus A16(CV-A16)for 447 cases of HFMD in Longhua district was detected by fluorescent quantitative reverse transcription-polymerase chain reaction(RT-PCR),and VP1 of non EV-A71, non CV-A16 and other EV was performed sequencing to identify the subtype and carry out evolutionary analysis. χ² test was used to analyze the results of HFMD pathogen typing between different age group. Results The high incidence of HFMD in Longhua district of Shenzhen City was Longhua street and Guanlan street. The incidence curve showed a bimodal distribution, the main peak in May-July, the second peak in September-November. Children under 5 years of age was 96.40% among all incidence. There was significant difference in different age groups of HFMD pathogen typing(χ²=25.01,P<0.001). Conclusions CV-A6 is the main pathogen of HFMD in Longhua district of Shenzhen, and there are two main branches in evolutionary relationship in 2015. However, there are multiple branches in CV-A6 in 2016. HFMD prevention and control should focus on children under the age of 5.

Research advance in gene characteristics of soluble guanylate cyclase and the correlation of its polymorphisms with hypertension

CHEN Yan, JIN Yue-long, ZHANG Xiao-yu, YAO Ying-shui

2017, 21(7): 737-740,745. doi: 10.16462/j.cnki.zhjbkz.2017.07.021

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As the only receptor of nitric oxide(NO)and the key metal enzyme in the NO signal transduction pathway, soluble guanylate cyclase (SGC) plays an important intermediation role in the NO-cGMP pathway and the regulation of blood pressure and renal sodium excretion. In recent years, researchers at home and abroad have done much studies on its construction, function, activation mechanism, and roles in physiology and pathology. This article reviews current advances in the gene characteristics of SGC and its correlation with hypertension.

Research progress of the risk factors and nutritional intervention on Alzheimer's disease

DONG Rui-rui, ZHANG Yu-sen, YANG Qian, LI Jing, WU Wen-hui, ZHAO Hai-feng

2017, 21(7): 741-745. doi: 10.16462/j.cnki.zhjbkz.2017.07.022

Abstract(418)

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Alzheimer's disease(AD)has gradually become one of the major disease threatening human health with the social aging.However, there is no effective treatment currently because of the complex mechanisms.It is important to screen the risk factors and to intervene by nutritional intervention for the control of AD.The research progress of the risk factors and nutritional intervention on AD was focused on in this review.

Analysis on epidemiologic feature of pulmonary tuberculosis among students in Yunnan Province, 2005-2015

WEI Die-xin, CHEN Wei, CHANG Li-tao, HUANG Da-feng, AN Wei-wei

2017, 21(7): 746-748. doi: 10.16462/j.cnki.zhjbkz.2017.07.023

Abstract(328)

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Survey on urban and rural residents' satisfaction degree of community health service center in Jiangning District of Nanjing

LIU Ying, ZANG Feng, HUANG Peng, LIU Mei, YU Rong-bin

2017, 21(7): 749-751,754. doi: 10.16462/j.cnki.zhjbkz.2017.07.024

Abstract(387)

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Qualitative evaluation on interventions of the hand hygiene promoting project in kindergartens in Shenzhen

ZHOU Yan, HOU Wan-li, Kylah Jones, Vicki Erasmus, PENG Xiao-dong, CHENG Jin-quan, ZHAO Zhi-guang

2017, 21(7): 752-754. doi: 10.16462/j.cnki.zhjbkz.2017.07.025

Abstract(365)

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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