中华疾病控制杂志

The progress of epidemiologic method in etiologic research

TAN Hong-zhuan

2017, 21(8): 755-757. doi: 10.16462/j.cnki.zhjbkz.2017.08.001

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Epidemiology is a very important method in etiologic research, and the etiologic research is one of the main field of epidemiologic research. Etiologic research become more and more complicated, which promote the rapidly progress of epidemiologic method. We outlined this progress in concept and model of etiology, confounding control, interaction analysis, combination between epidemiology and omics, concept and development of molecular pathological epidemiology, and the criteria of disease cause.

Analysis of chronic disease prevalence and its equity among working population in four Cities, China

SHEN Yang, LIU Sheng-lan, WANG Yan-ling, JIANG Ying, CHANG Chun

2017, 21(8): 758-761,766. doi: 10.16462/j.cnki.zhjbkz.2017.08.002

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Objective To investigate the prevalence of chronic disease and its influencing factors among employees in urban China and to evaluate the health equity among employees with different socioeconomic status (SES). Methods A total of 3 553 employees were selected from 5 types of workplaces in Beijing, Xiamen, Quanzhou and Hohhot using stratified cluster sampling and investigated by questionnaire. Results The total prevalence rate of chronic disease among participants was 14.8% (16.7% in men and 12.5% in women). The Logistic regression analysis indicated that advancing age (all P<0.05), college and above education (OR=2.020, 95% CI:1.567-2.605), high occupational stress (OR=1.328, 95% CI:1.091-1.617), overweight or obesity (OR=1.530, 95% CI:1.249-1.875), smoking (OR=1.436, 95% CI:1.148-1.798) and drinking (OR=1.976, 95% CI:1.409-2.771) were risk factors for chronic disease, whereas nonlocal census register was the protective factor (OR=0.756, 95% CI:0.604-0.945). Stratified by gender, there was a significant difference in the prevalence of chronic diseases among employees with different SES (all P<0.05), and concentration indexes of chronic diseases were all positive value and highest in income. Conclusions The prevalence rate of chronic disease was relatively low and associated with age, education, occupational stress and lifestyles. Health inequity among the employees with different SES was measured.

Analysis on the metabolic syndrome and the influencing factors in the elderly with prediabetes in rural areas in Yiyang of Hunan

HU Zhao, XU Hui-lan

2017, 21(8): 762-766. doi: 10.16462/j.cnki.zhjbkz.2017.08.003

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Objective To investigate the prevalence and influencing factors of metabolic syndrome (MS) in the elderly with pre-diabetes in rural areas in Yiyang. Methods The background characteristics and laboratory results of the elderly with prediabetes were collected by questionnaire and laboratory testing during April to July 2015. Binary unconditional Logistic regression was used to analyse the influencing factors of metabolic syndrome among the elderly with prediabetes. Results The prevalence of metabolic syndrome in the elderly with prediabetes in rural areas was 31.6% (95% CI:27.2%-36.0%).Results from the binary unconditional Logistic regression indicated that gender, age, body mass index(BMI), physical activity, drinking were influencing factors of metabolic syndrome in the elderly with pre-diabetes (all P<0.05). Conclusions The prevalence of metabolic syndrome in the elderly with pre-diabetes in rural areas in Yiyang is higher than that in general population.We should pay more attention to metabolic syndrome and to improve intervention.

A cross-sectional study on mild cognitive impairment among the elderly in communities of Huangshi City

YANG Yu-huan, CHENG Guang-wen, RONG Shuang, ZHU Hai-lin, CHEN Dan, YANG Bei, LI Wen-fang

2017, 21(8): 767-771. doi: 10.16462/j.cnki.zhjbkz.2017.08.004

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Objective This study aims at investigating the prevalence, distribution and related risk factors of mild cognitive impairment (MCI) among elderly residents in community of Huangshi City, and providing the scientific basis for MCI prevention and management. Methods The multi-stage random cluster sampling method was used to select the elderly residents (aged 60 years or above) in Huangshi City for prevalence survey. Meanwhile, the cognitive function of elderly were evaluated by montreal cognitive assessment (MoCA) Changsha version and activities of daily living (ADL). Results A total of 1 000 valid questionnaire were obtained. Among them, 296 (29.6%) were diagnosed with MCI. The prevalence of MCI was significantly different among the subjects with different education levels, occupations, income, chronic diseases, stroke, alcohol consumption, drinking tea, interests or hobbies, physical exercise and neighbors (all P<0.05). Multivariate Logistic regression analysis showed that smoking, physical exercise, drinking tea, education levels and stroke were related to MCI. Among them, drinking tea and physical exercise were protective factors, others were risk factors (all P<0.05). Conclusions The prevalence of MCI in the elderly in Huangshi City was higher than average. Drinking tea and physical exercise may reduce the incidence of MCI. The elderly with lower education level, smoking habit, and history of stroke are at high risk of developing MCI, as they will be the focus of MCI prevention. Moreover, suggestions should be put forward to guild elderly reduce smoking, increase tea drinking and take more physical exercise.

Study on effectiveness of falls intervention programs in community-dwelling older people in Shijiazhuang

JIANG Cai-xiao, MA Xin-yan, DUAN Lei-lei, ER Yu-liang, ZHANG Xin-juan, GAO Cong, ZHANG Qing-jian, LI Hua

2017, 21(8): 772-774,779. doi: 10.16462/j.cnki.zhjbkz.2017.08.005

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Objective To study the epidemiological characteristics of falls of the elderly in the community, Shijiazhuang. Methods Through random stratified sampling, an investigation of 836 adults in 2012 was carried out among the elderly of 60 years old and above, who living at least 1 year in Weiming communities of Qiaoxi district, Shijiazhuang. Intervention strategies including giving lectures and distributing free literature on falls-related knowledge,and making personalized programs and health education on falls prevention were provided to the interviewees regularly every year after the time of baseline survey.A follow-up survey was conducted in the same community in 2015. Results The incidence of falls was 11.6% at baseline,while the incidence rate of falls was 5.7% after the intervention.After the intervention,the awareness rate of falls-related knowledge in "falls can be prevented", "the elderly should take medical optometry before buying presbyopic glasses" and "if the elderly should be lift up immediately after the fall" were higher than those before the intervention(all P<0.001), and the rate of relevant behavior in "taking measures to prevent falls" and "you would not reduce your daily activities or sports because of the fearing of falling"were higher than those before the intervention(all P<0.001). Conclusions The comprehensive intervention can improve the knowledge awareness of preventing falls and the rate of related behavior of the elderly in the community, and it can reduce the incidence rate of fall.

An evaluation on effectiveness of intervention for children fall injury in Shanghai

YAN Bei, HUANG Li-mei, PENG Juan-juan, HUANG Cheng-jun, HAO Li-peng, YANG Chen, CHEN Han-yi, YU Yan

2017, 21(8): 775-779. doi: 10.16462/j.cnki.zhjbkz.2017.08.006

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Objective To explore the effect of comprehensive intervention measures on children fall injury prevention, so as to provide experience for the future fall injury prevention promotion programs. Methods Using stratified sampling method, 11 primary schools were randomly selected in Shanghai, then students of 1th grade to 3th grade were recruited from these schools, two years later, questionnaire survey was conducted among these students to understand the condition of their knowledge of children's fall injury. Results After intervention, fall injury prevention awareness rate of the intervention group was increased from 77.53% to 92.78% (χ²=354.50,P<0.001), difference in differences(DID)analysis showed net effect was relatively increased by 45% (Z=4.08,P<0.001), awareness rate warming up before exercise increased from 91.26% to 98.65% (χ²=174.73,P<0.001),the net effect was relatively increased by 46%. Rides risk identify behavior increased from 83.32% to 90.55% (χ²=70.89,P<0.001), the net effect was relatively increased by 44%, dangerous environment improvement increased from 87.62% to 89.42% (χ²=4.97,P=0.022), the net effect was relatively increased by 34%.Before intervention, the fall injury incidence of control group and intervention group was 6.32% and 6.15% respectively, there was no significant difference (χ²=0.08,P=0.770). The fall injury incidence of control group was 8.56% after the intervention, the incidence of intervention group fell to 4.33%, the net effect relatively dropped by 69%. Conclusions It is multi-field and multi-level to effectively reduce the incidence of fall injury, which needs comprehensive interventions, such as health education, environmental transformation, policy innovation, etc.

Analysis on the incidence of injury proneness and its influencing factors among pupils in Daguan County

TANG Ying, XUE Zhong-yu, HE Zheng-yan, HU Rui-jie, MA Zi-fang, XING Yu-mei, WANG Li

2017, 21(8): 780-783,788. doi: 10.16462/j.cnki.zhjbkz.2017.08.007

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Objective To investigate the current status on the incidence of unintentional injury proneness among pupil in Daguan county, analyze its influencing factors, and to provide the theoretical basis for the personalized intervention of high-risk groups. Methods Totally 1 084 students of grade 4-6 from 5 primary schools in Daguan county were selected by using stratified random cluster sampling method and surveyed with questionnaire. Results Totally 114 students had injury proneness in 1 084 respondents and the incidence rate was 10.5%. The sharp instrument injury ranked highest among all types of children unintentional injury proneness. The passing rate of injury knowledge score was 50.9%. Multivariate Logistic regression analysis indicated that the protective factors related to unintentional injury were primary school in town (OR=0.655,95% CI:0.450-0.953), maternal level of education for the university(OR=0.483,95% CI:0.295-0.790); the risk factors of unintentional injury were male (OR=1.706,95% CI:1.314-2.215) and left-behind students (OR=1.646,95% CI:1.216-2.228); the protective factors of unintentional injury proneness were maternal level of education for the university(OR=0.406, 95% CI:0.223-0.739), high school and secondary vocational school(OR=0.388,CI:0.155-0.972). Conclusions The risk factors of unintentional injury is relatively clear among pupils in Daguan county, in the course of injury intervention, we should pay attention to high-risk groups, and increase the investment from government of Daguan county especially in economically underdeveloped areas.

The effect of comprehensive interventions for metabolic syndrome patients

WANG Ya-sha, XIAO Xiao, FANG Tao, LI Yong-hui, TIAN Feng-shi

2017, 21(8): 784-788. doi: 10.16462/j.cnki.zhjbkz.2017.08.008

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Objective To explore the effect and feasibility of comprehensive interventions majoring in healthy diet, physical activity, smoking cessation and appropriate alcohol use for patients with metabolic syndrome (MS). Methods Patients who work in the government organizations and institutions diagnosed with MS according to the International Diabetes Federation Criteria were included in the study and given intervention for 12 months. All patients received relevant health courses every 2 months. Intervention group patients received additional comprehensive interventions including healthy diet, physical activity, smoking cessation and appropriate alcohol use with self-management method. Physical examination and biochemical indicators testing were performed before, 6 months and 12 months after the intervention respectively. Questionnaire investigations on MS related knowledge were implemented before and after the intervention. Results MS related knowledge awareness rate was higher in intervention group than control group after 12 month intervention. Intervention group patients' body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, triglyceride, total cholesterol, low-density lipoprotein cholesterol, fasting plasma glucose levels and high-density lipoprotein cholesterol level were significantly different with control group (all P<0.05). Conclusions Comprehensive intervention measures majoring in healthy diet, physical activity, smoking cessation and appropriate alcohol use are effective for MS patients.

Investigation on the dietary and nutrient intakes and the associated factors of 263 Uyghur women during the third trimester in southern Xinjiang Province

YANG Yan-qiong, KAMILA-Tursunjan, TURSUNJAN-Memetimin, YANG Yan-qiong, WANG Xiao-jun, WANG Li

2017, 21(8): 789-791. doi: 10.16462/j.cnki.zhjbkz.2017.08.009

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Objective To investigate the dietary and nutrient intakes and the associated factors of 263 Uyghur women during the third trimester in southern Xinjiang and to improve dietary habits in pregnant women and promote maternal and child health in Xinjiang. Methods The Uyghur pregnant women of Kashi maternal and child health care hospital in Xinjiang as a whole group. A cluster sampling method was used to select 263 Uyghur pregnant women from the southern Xinjiang. 24 hour dietary survey was conducted. Results The daily intakes of phosphorus, vitamin B1 and sodium among Uyghur pregnant women compared to dietary reference intakes(DRIs) were 181.63%, 120.67%and 466.90%, respectively. The daily intakes of calcium, vitamin B2, vitamin C and iron compared to DRIs were 42.62%, 66.00%, 70.12% and 89.59%, respectively. The daily intakes of folic acid and iodine were only 15.96% and 14.39% of DRIs. The proportion of fat intake was slightly lower. There were positive correlations between the non first pregnancy of Uyghur pregnant women and the intakes of protein(r=0.209,P=0.001) and carbohydrate (r=0.203, P=0.001). Conclusions During the third trimester, the Uyghur women have excessive intakes of phosphorus, vitamin B1and sodium,but insufficient intakes of calcium, iron, vitamin B2 and vitamin C, and an extreme lack of iodine and folic acid.

The mediating effect of psychopathological symptoms between mothers' parenting style and non-suicidal self-injury in college students

TANG Han-mei, FU Yan-yan, MAO Shao-ju, CHEN Xiao-long, LI Jian-ni, QIU Hong-heng, ZHU Jin-yun, HUANG Peng

2017, 21(8): 792-795. doi: 10.16462/j.cnki.zhjbkz.2017.08.010

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Objective To explore the mediating effect of psychopathological symptoms between mothers' parenting style and non-suicidal self-injury(NSSI) in college students.Methods Multidimensional sub-health questionnaire of adolescents (MSQA), egna minnen av barndoms uppfostran (EMBU) and some entries from the ottawa self injury scale (OSI) were used to survey 4 000 university students.Results 10.20% of college students reported to engage in NSSI. Both mothers' parenting style and psychopathological symptoms had significantly positive correlation with non-suicidal self-injury(all P<0.05). Logistic regression analysis showed that mothers' parenting style (OR=3.56, 95% CI:2.71-4.67, P<0.001) and psychopathological symptoms (OR=1.71, 95% CI:1.56-1.88, P<0.001) could positively predict the occurrence of NSSI. The results of Bootstrap test showed that the mediating effect of psychological symptoms between mothers' parenting style and NSSI accounted for 41.75% of the total effect. Conclusions Poor mothers' parenting styles may affect the occurrence of NSSI through psychological symptoms. Helping the self-injury people deal with the psychopathological problems may be favourable to prevent and control NSSI.

Anxiety, depression and related factors of 184 HIV patients newly admitted to antiretroviral treatment in Guangzhou

ZHOU Kai, DU Zhi-cheng, DU Xuan, WANG Ling-yu, RE Mi-na, XU Hui-fang, LI Ling-hua, GU Jing, HAO Yuan-tao

2017, 21(8): 796-800. doi: 10.16462/j.cnki.zhjbkz.2017.08.011

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Objective To investigate the prevalence and factors of anxiety and depression among human immunodeficiency virus (HIV) patients who were newly admitted to antiretroviral treatment in Guangzhou. Method Patients were recruited by using convenient sampling from May to August 2016 from Guangzhou No. Eight Hospital, and were interviewed by using face-to-face interviews. Multivariate Logistic regression was used to analyze the data. Results A total of 184 HIV patients were included. The prevalence of anxiety was 51.6%, average score:(5.04±4.25), while the prevalence of depression was 66.3%, average score:(7.01±4.92). Duration of infecting more than six months (OR=0.344,95%CI:0.170-0.695,P=0.003), level of self-efficacy (OR=0.814, 95%CI:0.682-0.973, P=0.024) and social support (OR=0.955, 95%CI:0.930-0.982, P=0.001) were protective factors for anxiety; level of self-efficacy(OR=0.790, 95%CI:0.646-0.966, P=0.022)and social support (OR=0.955, 95%CI:0.928-0.983, P=0.002)were also protective factors for depression. HIV/AIDS related symptoms (OR=3.168, 95%CI:1.570-6.394,P=0.001) were a risk factor for depression. Conclusions Affected by multiple factors, there was a high prevalence of anxiety and depression among HIV patients who were newly admitted to HIV antiretroviral treatment in Guangzhou.

Analysis on factors influencing the infection status of human intestinal parasites among the ethnic minorities living in the rural areas in Guangxi Province by multi-level and multi-factor model

YANG Ping, SHI Wu-xiang, KANG Min, MO Gang, FENG Le-ping, NONG Zi-jun, MAI Hao, LI Tian-xue

2017, 21(8): 801-804. doi: 10.16462/j.cnki.zhjbkz.2017.08.012

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Objective To investigate the factors influencing the infection status of human intestinal parasites among the ethnic minorities living in the rural areas in Guangxi Province. Methods A cross-sectional household survey was conducted by a self-designed questionnaire, pecies of instestinal parasites were detemined using Kato's thick smear method, multi-level and multi-factor model analysis was used to investigate the effect of demographic characteristics, eating habits, life habits, family level factors and village level factors on infection status of human intestinal parasites. Results It was showed that the factors influencing human intestinal parasites infection among the ethnic minorities living in the rural areas in Guangxi province included sex, years of education, personal eating habits, personal hygiene habits, annual per capital income,status of human and animal cohousing, status of having the family toilets and status of having family hygienic cabinet for food, etc. (all P<0.05). After controlling for individual and family characteristics by multilevel model, the community contextual variables in the natural village level such as the status of the village with the pipeline water supply public toilets, and village environmental hygiene condition were also associated independently with the intestinal parasitic infection (all P<0.05). Conclusions The residents with higher level of education, healthy personal eating habits and life habits have the lower rate of intestinal parasitic infection. The households having the higher economic incomes, personal toilets and family hygienic cabinet for food also have the lower risk of the infection of intestinal parasites. Social and economic environmental variables in the village level such as the status of the pipeline water supply, public restrooms and improved community hygiene environment have independently impacted on the infection of intestinal parasitic.

Identifying the high-risk areas of the incidence of hepatitis C by using SaTScan and FleXScan

LI Si, ZHU Wei-ping, LU Yi-han, XIA Cong-cong, HU Yi, WU Hong-yan, ZHANG Zhi-jie

2017, 21(8): 805-808,817. doi: 10.16462/j.cnki.zhjbkz.2017.08.013

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Objective To detect the spatial clusters and identify the high-risk areas of the incidence of Hepatitis C (HC) in Pudong New Area of Shanghai in 2015, as well as to compare the effects of applying SaTScan and FleXScan to detect the disease spatial clusters. Methods By means of collecting the incidence data of HC from the surveillance system in the unit of subdistrict or town, and then conducting the Poisson model in SaTScan 9.4.4 and FleXScan 3 for detecting HC spatial clustering areas of Pudong New Area in 2015. The changes of clusters locations and scopes in the two scanning methods under different parameter settings was compared. Results The incidence rate of HC in Pudong new district was 12.72 per 100 000 in 2015. Both SaTScan and FleXScan detected only one cluster significantly (P<0.05) in Pudong New Area, covering 10 towns (Chuansha new town, Datuan, Heqing, Huinan, Zhuqiao, Xuanqiao, Zhoupu, Xinchang, Laogang and Wanxiang) and 4 towns (Chuansha new town, Zhangjiang, Caolu and Heqing) in each cluster respectively. Both of the scanning results provided by the two methods included Chuansha new town and Heqing town. Only one town was reduced, a result from the change of window proportion ranging from 50% to 25% in SaTScan, while the clustering scope detected by FleXScan was a bit larger when different K values were set. Conclusions The spatial clustering of HC existed in Pudong New Area of Shanghai in 2015, and the results provided by SaTScan and FleXScan displayed that Chuansha new town and Heqing town are the high-risk regionsand key areas for theprevention and control of HC.

Spatio-temporal characteristics analysis of hand, foot and mouth disease in Chaohu City

SUN Mei-lan, SONG Yu-hua, TANG Ji-hai, DU-jiang, NIE Jin-tao

2017, 21(8): 809-812. doi: 10.16462/j.cnki.zhjbkz.2017.08.014

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Objective To assess the spatio-temporal clustering of HFMD in Chaohu City from 2009 to 2015. Methods Epidemiological data of HFMD were collected from 2009 to 2015,and the relevant GIS databases were established. The global and local indicators of spatial autocorrelation analysis was carried out with GeoDa 1.6 software, and SaTScan 9.4 was used to describe the retrospective space time scan.Results A total of 6 960 cases were reported in Chaohu city from 2009 to 2015.The HFMD cases were aggregated in Chaohu City, and local indicators of spatial association analysis explored 14 regions of high-incidence clusters in 2011,2013 to 2015.Three statistically significant HFMD clusters were identified. HFMD mostly occurred in urban area. Conclusions HFMD is clustered geographically in Chaohu City. This study may provide clues about HFMD risk factors and provide theoretical basis for further prevention and control in Chaohu City.

Analysis on impact of meteorological factors on incidence of hand, foot and mouth disease based on path analysis model in Xiamen City

YAN Yu-bing, YU Xin-lian

2017, 21(8): 813-817. doi: 10.16462/j.cnki.zhjbkz.2017.08.015

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Objective To investigate the impact of meteorological factors on the incidence of hand, foot and mouth disease(HFMD) in Xiamen City. Methods Path analysis model was used to analyze the direct and indirect effects of meteorological factors and intestinal virus activity on the incidence of HFMD. The Path parameters were estimated and tested by using the maximum likelihood method. The model was evaluated and modified by absolute indices, relative indices and parsimony indices. Results Meteorological factors had lag effect on the incidence of HFMD in about 5 days. Relative humidity, large evaporation, atmospheric pressure, intestinal virus activity and long vacation directly affect the incidence of HFMD, whereas temperature, precipitation, large evaporation, water vapor pressure, relative humidity, air pressure, maximum wind speed and wind direction had indirect effect on that. There was no significant correlation between wind speed and the incidence of HFMD. Conclusions Meteorological factors are closely related to the HFMD, the path analysis model can verify their relationship.

Epidemic situation analysis of human brucellosis in Fujian Province, 2011-2015

ZHU Han-song, XIE Zhong-hang, XU Zhi-bin, HUANG Wen-long, CHEN Guang-min

2017, 21(8): 818-821. doi: 10.16462/j.cnki.zhjbkz.2017.08.016

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Objective To explore epidemic features of human brucellosis in Fujian Province from 2011 to 2015 and to provide scientific basis for the development of strategies for the prevention and control of human brucellosis. Methods The data of human brucellosis that reported by health institutions through national disease surveillance in Fujian Province, 2011-2015, were analyzed descriptively. Results The number of brucellosis cases reported increased from 15 in 2011 to 115 in 2015, and total 249 cases were reported in these five years with an incidence rate of 0.13/100 000, which also increased rapidly year by year(Z=10.45, P<0.001). Incidence rate in Zhangzhou (0.42/100 000) and Nanping (0.18/100 000) were higher than that in other regions. The number of districts in which brucellosis were reported from 10 in 2011 to 37 in 2015 (Z=25.86, P<0.001). Incidence rate of rural and country were 0.29/100 000 and 0.03/100 000, respectively, and increased significantly in these years. The incidence of brucellosis peaked from May to August. The incidence in males (0.19/100 000) was significantly higher than that in females (0.07/100 000)(χ²=57.27, P<0.001). The highest incidence was in 60 age group with 0.40/100 000. Farmers and herdsmen were high-risk population, accounting for 65.46% of total cases. 30.52% cases were diagnosed in less than 7 days and no significant decrease trend was observed in these years (Z=2.19,P=0.701). During 2011-2015, 14 brucellosis outbreaks were reported in Fujian Province, of which 23 people were infected without reported death. Conclusions Epidemic situation of brucellosis remained a serious public health issue in Fujian Province due to the lack of timely and accurate diagnosis. Therefore, the relevant departments should take effective measures to prevent and control this disease.

Logistic regression analysis on the influencing factors of cognitive dysfunction in elderly patients with acute ischemic stroke

FENG Qing-chun, HUANG Da, HU Shao-min, WANG Xing-wen, LIANG Fu, WU Bi-ying, PENG Mei-juan, WANG Ping-ming

2017, 21(8): 822-826. doi: 10.16462/j.cnki.zhjbkz.2017.08.017

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Objective To investigate the incidence and influencing factors of cognitive dysfunction in elderly patients with acute ischemic stroke(AIS). Methods From January 2013 to September 2016, 725 patients with AIS in the third people's Hospital of Haikou were selected and 426 patients were included in the analysis of cognitive dysfunction using mini mental state examination (MMSE). Accordingly, the total 426 cases were divided into cognitive dysfunction group with 201 cases and normal cognitive function group with 225 cases. The influencing factors of cognitive impairment in patients with acute ischemic stroke were analyzed by single factor and multiple Logistic regression analysis. Receiver operating characteristic(ROC)curve was used to evaluate the effect of the logistic regression model. Results Single factor and multivariate Logistic regression analysis showed that history of hypertension, hyperlipidemia, hyperhomocystinemia, physical exercise, exchange frequency and ability of daily life were independent influencing factors for stroke patients with cognitive dysfunction (all P<0.05). The area under the curve(AUC) was 0.853(95% CI:0.781-0.926) under the effect of the logistic regression model by the ROC curve. MMSE score of groups with more than three independent risk factors was significantly lower than that of groups with less than three independent risk factors (t=4.183,P=0.016). Conclusions The incidence of cognitive dysfunction in elderly patients with acute ischemic stroke is high. There are a large number of risk factors for cognitive dysfunction. Preventive measures should be taken to reduce or delay the occurrence of cognitive impairment.

The value of neutrophil-to-lymphocyte ratio as prognosis factor in small cell lung cancer

ZHOU Yi-xin, HAO Ji-qing

2017, 21(8): 827-829,834. doi: 10.16462/j.cnki.zhjbkz.2017.08.018

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Objective To assess the association of neutrophil-to-lymphocyte ratio (NLR) with the prognosis of small-cell lung cancer in patients who received the standard treatment. Method A total of 50 cases of small-cell lung cancer pathologically diagnosed without surgery at the first affiliated hospital of Anhui medical university between January 2013 and March 2015 were included in this study. All patients were classified into two groups based on the median value of NLR. Various factors that might influence the prognosis of patients were analyzed. Results A total of 47 patients were followed up. The 1-year survival rate was 53.2%. In the low NLR group, 1-year survival rate was 83.3%. In the high NLR group, 1-year survival rate was 21.7%. Univariate analysis showed that clinical stage, ECOG, and the level of NLR were associated with survival (all P<0.05). Multivariate analysis identified clinical stage and NLR as independent prognostic factors of patients (all P<0.05). Conclusion NLR may be an independent prognostic factor of small-cell lung cancer patients.

Gastroenteropancreatic neuroendocrine neoplasms:a clinical analysis of 97 cases

JIANG Lei, LIU Yi

2017, 21(8): 830-834. doi: 10.16462/j.cnki.zhjbkz.2017.08.019

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Objective To investigate the clinical characteristics, treatments and relationship with survival of gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN), so as to provide knowledge for further understanding of this disease. Methods The clinical data of the 97 GEP-NEN patients admitted in the First Affiliated Hospital of Anhui Medical University from December 2011 to December 2015 were retrospectively analyzed. Results Of the 97 patients, 64 cases were males and 33 were females,the male-to-female ratio was 1.9:1. There were 39 cases (40.2%) occurred in the stomach and 25 cases (25.8%) in rectum. Of all the 97 cases, non-functional symptom accounted for 95.9% (93/97), while functional symptom accounted only for 4.1% (4/97). The positive rate of immunohistochemical diagnosis of chromogranin A and synaptophysin were 87.6%, 96.9%, respectively. The multivariate analysis showed that risk factors of reducing survival rate include pathological grading,infiltrating extent and lymph node metastasis (all P<0.05), as well as surgical methods and gender (all P<0.05). Conclusions GEP-NEN may be found at any part of digestive system. Preoperative diagnosis is difficult and a lot of confirmed cases is already late. The treatment of this tumor mainly depends on the operation. The overall prognosis is good. The 1-and 3-year survival rates were 81.9% and 63.4%, respectively.

Economic burden of liver cancer in China during 1996-2015:a systematic review

YANG Jun, WANG Le, SHI Chun-lei, HUANG Hui-yao, WANG Yu-ting, LI Jiang, ZHAO Jian-jun, QU Chun-feng, DAI Min, YANG Li, SHI Ju-fang

2017, 21(8): 835-840,851. doi: 10.16462/j.cnki.zhjbkz.2017.08.020

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Objective To synthesize available evidence on the economic burden of liver cancer in China to inform future evaluations. Methods Articles were searched in PubMed, CNKI and wanfang literature database during 1996-2015. Description of basic characteristics, analyses of economic burden data and quality assessment were conducted, and all the expenditure data was discounted to the year 2013. Results A total of 32 studies were included for analysis. Only 2 population-level studies reported the economic burden of liver cancer, which was 3 780 million CHY (provincial, direct and indirect) and 600 million (municipal, indirect), respectively. There were 30 individual-level studies reporting direct medical expenditure of liver cancer, in which the median annual expenditure per patient from 21 studies was 11 663 CNY (3 500-70 567), the median annual expenditure per visit from 9 studies was 19 202 CNY (7 005-41 118) and the annual median expenditure per diem from 11 studies was 865 CNY (409-1 275). All the three expenditure indicators showed a slow increase in the past two decades, and drug accounted more than half of the overall expenditure (56.6%). From 5 individual-level studies, the median indirect expenditure was 73 440 CNY (35 815-166 967). The overall reporting quality was poor. Conclusions Current evidence on population-level economic burden of liver cancer is limited in China, and the focus of which is inconsistent with the severity of disease burden in various regions. Expenditure per patient was reported mostly, while results should be interpreted with caution. Lastly, the indirect economic burden of liver cancer should not be ignored in further studies.

Association between steel plant noise and hypertension in China:a Meta-analysis

LIANG Xiao, CHENG Pei-pei, YAN Ying-jie, ZHANG Di, QIAO Ya-mei, PING Zhi-guang, FU Xiao-li, YAO Wu, YAN Zhen

2017, 21(8): 841-845. doi: 10.16462/j.cnki.zhjbkz.2017.08.021

Abstract(404)

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Abstract:
Objective To evaluate the relationship between noise exposure and the risk of hypertension in steel plant of China. Methods Based on the online search for publication, related literatures were collected according to keywords from home and abroad, Stata 12.0 was used to perform Meta-analysis. Results The total identified papers were 3 392 from databases, 12 included articles involving 6 regions of China met the eligibility criteria. A random effects model was used to calculate the OR with 95% confidence intervals (CI) for the effect size. Noise exposure was positively associated with prevalence of hypertension(OR=2.09, 95% CI:1.68-2.60), the OR for < 85 dB(A) group was 1.24(95% CI:0.60-2.54), 85-dB(A) group was 1.74 (95% CI:1.27-2.37), 95-dB(A) group was 3.38 (95% CI:2.61-4.37), and ≥ 105 dB(A) group was 5.51 (95% CI:3.84-7.90). Besides, hypertension risk would increase along with the increasing of noise exposure. The results were stable judged by sensitivity analysis and published bias analysis. Conclusions Noise in the steel plant may increase the risk of hypertension and it may go rising as the noise exposure becoming more severe.

The research progress of the epidemiology on metabolically healthy obesity

HUANG Chao, QIN Xue-ying, HU Yong-hua

2017, 21(8): 846-851. doi: 10.16462/j.cnki.zhjbkz.2017.08.022

Abstract(377)

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Abstract:
Metabolically healthy obesity (MHO) is a special kind of body size phenotype of which the definition and diagnosis has not been universal. The prevalence of MHO differed in studies at home and abroad. Besides, it remains to clarify the mechanisms and the relationship between this phenotype and common health outcomes. This review summarize the epidemiology, mechanisms and prognosis about MHO hoping researchers later could learn it more.

Correlation study of overweight and obesity with frailty among the elderly in Zhengzhou community

SONG Xiao-yue, HUANG Ling-ling, ZHANG Wei-hong, SU Yuan-yuan, SUN Dan, PAN Li-niu, YU Zhen

2017, 21(8): 852-854. doi: 10.16462/j.cnki.zhjbkz.2017.08.023

Abstract(339)

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Relationship between memory impairment and executive function in patients with leukoaraiosis

LIU Wen-chao, HU Pan-pan, LI Xi-lin, ZHANG Wei, WANG Kai

2017, 21(8): 855-856,859. doi: 10.16462/j.cnki.zhjbkz.2017.08.024

Abstract(292)

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Investigation and analysis of KAP among high risk population of stroke

XU Shu-hua, SUN Jing, QIAN Jin-ming, ZHENG De-qun

2017, 21(8): 857-859. doi: 10.16462/j.cnki.zhjbkz.2017.08.025

Abstract(387)

PDF(36)

Abstract:

Analysis of stress urinary incontinence and influencing factors among adult female in Liuzhou City

YING Ting, YANG Fang-hua, WANG Xin-dan, TAO Hua

2017, 21(8): 860-862. doi: 10.16462/j.cnki.zhjbkz.2017.08.026

Abstract(308)

PDF(25)

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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