中华疾病控制杂志

National strategic demand and key issues of basic frontiers for preventive medicine

QIN Li-qiang, Gu Ai-hua, YU Can-qing, DAI Yu-fei, ZHANG Zuo-wen

2018, 22(1): 1-3. doi: 10.16462/j.cnki.zhjbkz.2018.01.001

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Shuangqing Forum (No. 192) of National Natural Science Foundation of China was held in Beijing. The forum focused on the areas of nutrition and health, epidemiology of chronic disease and environment and health. For nutrition and health, the experts suggested to clarify China-based dietary patterns for preventing chronic diseases and metabolic diseases. For epidemiology, the experts emphasized that large population-based cohort was important for precision prevention and the studies on gene-environment interaction. For environment and health, the experts discussed how can epigenetic regulation by environmental exposure be inherited to the next generation. According to national strategic demand, this forum summarized the key issues of basic frontiers for preventive medicine.

Association of carotid intima-media thickness and metabolic health and obesity status

HUANG Chao, CAO Ya-ying, TIAN Yao-hua, SONG Jing, YANG Yan-fen, XIANG Xiao, SUN Ke-xin, YANG Chao, HUANG Shao-ping, LIU Xiao-fen, QIN Xue-ying, TANG Xun, LI Jin, GAO Pei, WU Tao, CHEN Da-fang, HU Yong-hua

2018, 22(1): 4-8,13. doi: 10.16462/j.cnki.zhjbkz.2018.01.002

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Objective To explore the relationship between carotid intima-media thickness (CIMT) and metabolic health and obesity status. Methods A community-based study was conducted in rural communities in Beijing. Biochemical test, CIMT measurement, physical examination and questionnaire investigation were performed. Participants were divided into four groups according to their metabolic status and body mass index (BMI) to analyze the relationship between CIMT and metabolic health and obesity status. Results A total of 1 648 participants were recruited. The average age was (55.4±11.0) years old and men accounted for 45.8%. Logistic regression analysis showed that after adjusting for age, gender, smoke, drink, education, physical activity, diabetes family history and low-density lipoprotein cholesterol (LDL-C), the CIMT thickening rate were higher in metabolically unhealthy normal weight group (OR=1.61, 95% CI:1.01-2.56, P=0.046) and metabolically unhealthy obesity group (OR=2.10, 95% CI:1.32-3.32, P=0.002) than that in metabolically healthy normal weight group. Conclusion Metabolically unhealthy normal weight and metabolically unhealthy obesity might be risk factors for CIMT thickening, indicating that metabolically unhealthy status might have more influence on the development of atherosclerosis than obesity.

Association between socioeconomic position mobility from childhood to adulthood and depressive symptom in older adults

LUO Ya-nan, LI Mao, WU Chao-chao, JIN Xin, ZHENG Xiao-ying

2018, 22(1): 9-13. doi: 10.16462/j.cnki.zhjbkz.2018.01.003

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Objective To study the relationship between socioeconomic position mobility from childhood to adulthood and depressive symptom and its gender differences in older adults. Methods Using the dataset from China health and retirement longitudinal study, 2013, our study included 2 870 participants aged 60 and over. The survey concluded the general information, socioeconomic position and depressive symptoms of the participants. We used χ² test and Logistic regression to do the statistical analysis. Results In female group, compared with the group with socioeconomic position in stable high, the risk of depression symptom of the group with socioeconomic position in stable low, downward mobility, or upward mobility was increasing. Odds ratio (95% CI) for socioeconomic position in stable low(OR=2.37,95% CI:1.18-4.76,P=0.015), downward mobility(OR=2.19,95% CI:1.03-4.66,P=0.042), and upward mobility(OR=2.27,95% CI:1.04-4.93,P=0.039), respectively. For male, the risk of depression symptom in different socioeconomic mobility group had no statistic significant difference (all P>0.05). Conclusions There is an association between socioeconomic position mobility from childhood to adulthood and the risk of depression symptom in female older adults.

Prevalence and influencing factors of chronic diseases among residents in Zhuhai

LI Hui, YE Hao-sen, XU Yu, TENG Yong-yong, LI Jing, YANG Ting-ting, LU Zu-xun

2018, 22(1): 14-18. doi: 10.16462/j.cnki.zhjbkz.2018.01.004

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Objective To investigate the prevalence and influencing factors of non-communicable chronic diseases among residents in Zhuhai, and to provide reference for the prevention and management of chronic diseases. Methods By multi-stage cluster random sampling method, 3 205 residents aged 15 and older from 7 districts and counties in Zhuhai were randomly selected and conducted a questionnaire survey, physical examination. Results Among residents surveyed, the total prevalence of self-reported chronic diseases was 27.6%. The top three diseases were hypertension (16.7%), diabetes (4.1%), coronary heart disease (3.5%). Multivariate Logistic regression analysis showed that older than 35 years, overweight, obesity, physical exercise were risk factors of hypertension (all P<0.05) and the medium level of culture, the mild taste of eating food were protective factors of hypertension (all P<0.05). Older than 50 years, per capita monthly income of ≥ 1 000 yuan, overweight and obesity were risk factors of diabetes(all P<0.05). Besides, older than 50 years was risk factor of coronary heart disease, the daily intake of vegetables ≥ 300 g (all P<0.05) was protective factor of coronary heart disease. Conclusions Hypertension, diabetes, coronary heart disease were the major chronic diseases among residents in Zhuhai. It is a key henceforth works for the prevention and control of chronic diseases that relevant departments should do well in the management of chronic diseases while should carry out the targeted health education and community intervention.

Analysis of the prevalence and influencing factors of diabetes mellitus among adults in Liaoning Province

YOU Yi, LU Chun-ming, PAN Lei-lei, MA Ying-shun, GAO Qing, LI Ning

2018, 22(1): 19-22,28. doi: 10.16462/j.cnki.zhjbkz.2018.01.005

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Objective To describe the prevalence of diabetes mellitus, explore its risk factors in adults of Liaoning Province, and provide scientific evidence for the intervention of diabetes mellitus. Methods Using a multistage stratified and cluster random sampling method,17 857 adults were investigated with a standard questionnaire and physical examination. The Logistic regression was applied to explore the influencing factors of diabetes mellitus prevalence. Results In the province of Liaoning, diabetes mellitus prevalence was 13.00%, with the rate of awareness, treatment and control being 61.84%, 71.31% and 35.16%, respectively. The risk factors of diabetes mellitus prevalence were age(45-years old subgroup:OR=1.824, 95% CI:1.526-2.181, ≥ 60 years old subgroup:OR=2.077,95% CI:1.730-2.492), body mass index (BMI) classification(over weight:OR=1.213,95% CI:1.096-1.343; obesity:OR=1.547, 95%CI:1.338-1.787), dyslipidemia(OR=2.686,95% CI:2.308-3.126) and hypertension(OR=1.807, 95% CI:1.630-2.004). The protective factors of diabetes mellitus were rural residents(OR=0.866, 95% CI:0.788-0.952),high level of education(senior middle school:OR=0.859,95% CI:0.756-0.975; college education or above:OR=0.678,95% CI:0.576-0.798),middle income level(OR=0.738, 95% CI:0.585-0.931) and drinking(OR=0.779,95% CI=0.682-0.890). Conclusions The prevalence and awareness rate of diabetes mellitus are high in adults,but the rates of treatment and control are low. According to the situation, effective measures should be taken to actively intervene in population at high risk for diabetes mellitus.

Association between daily temperature range and cardiovascular mortality in Yinchuan: a time-series study

ZHANG Hui-ling, WANG Qing-an, YANG Yi, ZHANG Yin-e, XIE Fan, ZHAO Yu, ZHAO Yi, SANG Jian-ren, ZHANG Yu-long, ZHANG Ya-juan, ZHANG Yu-hong

2018, 22(1): 23-28. doi: 10.16462/j.cnki.zhjbkz.2018.01.006

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Objective To explore the relationship between daily temperature range (DTR) and cardiovascular disease (CVD) mortality in Yinchuan. Methods The total death data and meteorological data, in the course of Jan 1, 2010 and Dec 31, 2015, were obtained from relevant local authorities. A poisson regression with distributed lag non-linear model (DLNM) was adopted to analyze the relationship between DTR and daily cardiovascular mortality. Results The relationship between DTR and daily cardiovascular mortality presented a "J" shape curve, the mortality increased with the rise of DTR, and 20℃ was an inflection point. The extreme high DTR sustained its effect on mortality of cardiovascular disease only in 2 day, reached its maximum at lag 1 day(RR=1.054,95% CI:1.006-1.104), in particularly, males and younger than 65 age group might be more susceptible to be affected by DTR. In warm seasons, the overall effects of extreme DTR reached its maximum at lag 2 days (RR=1.105, 95% CI:1.034-1.182), in which the effects on mortality were larger than that of annual. Additionally, males and each age group might be susceptible to DTR. In cold seasons, the extreme DTR only had a dangerous effect on the group younger than 65 year olds (RR=1.144, 95% CI:1.005-1.303). Conclusions In Yinchuan, the effects of DTR on cardiovascular mortality were nonlinear and had delay effects. When DTR approached 20℃, the mortality of CVD significantly increased. Males and people younger than 65 years were more sensitive to the extreme high DTR. Those results indicate that formulating intervention strategy for sensitivity sub-groups is one of the effective methods, which can prevent the mortality of CVD caused by high DTR.

Association of high sensitive C-reactive protein with stroke: a prospective follow-up study

REN Zhan-yun, TANG Wu-zhuang, FAN Yao, SHEN Chong, ZHAO Yan-ping

2018, 22(1): 29-32,51. doi: 10.16462/j.cnki.zhjbkz.2018.01.007

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Objective To investigate an optimal cut-off value of high sensitivity C-reactive protein (hs-CRP) for the prediction of ischemic stroke in Yixing population and to explore the association between hs-CRP level and the risk of ischemic stroke. Methods A total of 2 238 participants over 35 years old were investigated in a rural area (Guanlin, Yixing, Jiangsu; from May to September 2009) using an epidemiological cluster sampling approach. A total of 2 211 participants were followed (median follow-up time was 5.07 person years) after excluding those who had history of ischemic stroke or cardiovascular disease and those whose disease history was incompleted and those who failed to be detected hs-CRP level. Fitted with survival receiver operator characteristic (ROC) curve in which hs-CRP level predicts the incidence of stroke, the optimal cut-off point was determined according to the maximum Youden's index. Cox proportional hazard model was applied to detect the association between hs-CRP level and the incidence of stroke. Results A total of 96 participants developed ischemic stroke in the period of follow-up. The Youden's index reached the maximum (0.270) when the area under ROC curve was 0.647 and the level of hs-CRP was 1.17 mg/L accordingly. The result of symmetric measure showed that predictive incidences of stroke based on the levels of hs-CRP ≥ 1.17 mg/L and ≥ 1.00 mg/L were consistent. Cox regression analyses showed a significant association of high hs-CRP(≥ 1.00 mg/L) with the risk of incident ischemic stroke even after adjusting for the covariates including age, gender, BMI, GLU, HDL-C, LDL-C, TC, TG, smoking and drinking, and hypertension and T2DM (HR=2.238, 95% CI:1.388-3.608,P=0.001). Conclusions Hs-CRP ≥ 1.00 mg/L is appropriate for predicting the incidence of stroke and intervening with the high risk population in Yixing population.

Evaluation on quality of life among patients with diabetes before and after community self-management activities in Nanjing

ZHOU Hai-rong, HONG Xin, WANG Chen-chen, QI Sheng-xiang, XU Fei

2018, 22(1): 33-37. doi: 10.16462/j.cnki.zhjbkz.2018.01.008

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Objective To explore the influencing factors of the quality of life in patients with diabetes, and to evaluate the quality of life before and after community self-management activities. Methods Diabetes patients recruited from communities of Nanjing were interviewed with a structured questionnaire designed by center for disease control and prevention (CDC) of China before and after they participated in health self-management activity. The medical outcomes study 36-item short form health survey (SF-36) was applied to measure the scores of life quality and to analyze the related influencing factors for patients. Results A total of 521 patients were recruited. 494 completed the 6-session activities, with the respond rate of 94.8%. The scores of general health (GH), physical functioning (PF), role physical (RP), role emotional (RE), social functioning (SF) in 494 subjects were lower than those of Chinese general population (all P<0.05). Stepwise regression analysis showed that complications (t=-3.235,P=0.001), other chronic disease (t=-3.197,P=0.002), blood glucose monitoring (t=2.303,P=0.022), dietary habit (t=2.341,P=0.020), physical exercise(t=-5.643,P<0.001) were main factors that influenced the patients' quality of life. Statistically significant improvement on the scores of the quality of life were observed in all eight dimensions after community self-management activities (all P<0.001). Conclusions Communtiy self-management activities are effective in improving the quality of life among patients with diabetes.

Analysis of pathogenic detection results of influenza sentinel surveillance in Hunan Province from 2014 to 2017

HUANG Yi-wei, ZHANG Hong, ZHANG Si-yu, LI Wen-chao, ZENG Ge, HUANG Chao-yang, ZHANG Heng-jiao, CAI Liang, DENG Zhi-hong, ZHAN Zhi-fei

2018, 22(1): 42-45. doi: 10.16462/j.cnki.zhjbkz.2018.01.010

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Objective To analyze the epidemiological characteristics and regularity of influenza by analyzing the influenza sentinel surveillance data in Hunan Province during the 14th week of 2014 and the 13th week of 2017. Methods Throat swabs from 20 influenza-like cases were collected every week in the outpatient department of 23 sentinel hospitals in all the 14 cities of the province. The samples were tested by virus isolation. And the hemagglutination assay and the hemagglutination inhibition assay were used to identify and classify influenza viruses. Test results were described and analyzed by using statistical software for calculations. Results A total of 78 909 respiratory specimens of influenza-like cases were detected in Hunan Province from 2014 to 2017. 4 061 influenza strains were isolated and identified, with a positive rate of 5.15%. H3N2 subtype influenza viruses accounted for the highest proportion, with 42.28% (1 717/4 061).Victoria lineage of type B and H1N1 subtype accounted for the second and third proportions, with 21.08% (856/4 061) and 20.46% (831/4 061), respectively. The 1-4 years old group had the largest proportion of the age group ratio of influenza confirmed cases, accounting for 35.34% (1 434/4 058). The number of male cases was more than that of females, and the male to female ratio was 1.27:1 (2 270:1 788). There were five major peaks in the time distribution. The cities with the highest positive rates in three years were Changsha (9.75%), Zhuzhou (11.59%) and Xiangtan (8.12%), respectively. Conclusions The seasonal characteristics of the influenza in Hunan Province in 2014-2017 are obvious. The dominant strains are different each year. The children under 15 years may be the high incidence group.

Study on molecular evolution characteristics of influenza A(H1N1)pdm09 virus in Zhenjiang from 2014 to 2016

YANG Jing, WU Xiao, XU Hong, ZHANG Xiao-dan, SHEN Li, CHEN Yong-chang

2018, 22(1): 46-51. doi: 10.16462/j.cnki.zhjbkz.2018.01.011

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Objective To study the epidemiological characteristics and variation of the influenza A(H1N1)pdm09 virus. Methods The throat swabs were collected from patients with influenza-like illness(ILI) in sentinel surveillance hospital in Zhenjiang from 2014 to 2016. These throat swabs were collected for influenza virus RNA detection and isolation. 13 strains of A(H1N1)pdm09 virus were randomly selected in the epidemic period,then specific primers were designed to sequence the hemagglutinin (HA) and neuraminidase (NA) genes and the genetic characterization of these 13 isolates were analyzed. Results Compared to the vaccine strain A/California/07/2009, the 13 isolated strains shared high nucleic acid sequence similarity in HA and NA genes(97.3%-100.0% and 95.6%-97.5%, respectively), and high amino acid sequence similarity (96.6%-100.0% and 93.8%-96.6%, respectively). The phylogenetic analysis showed that the HA and NA genes of 13 isolated strains were divided into different evolutionary lineages. The molecular characteristics indicated at Sa antigenic site in HA1 domain, 12 isolates had mutations of K173Q,while one had the mutation of K181E. At Ca1 antigenic site in HA1 domain, three isolates had mutations of V183I. Sequence analysis indicated there was no mutation in the receptor binding sites and glycosylation sites. Conclusions Though the HA and NA genes of 13 isolated showed varying degrees of genetic variation compared those of vaccine strain,the antigenicity characteristic remained unchanged. The further monitoring for influenza virus in Zhenjiang is very necessary.

Molecular genotyping of the enterovirus for non-enterovirus 71 and non-coxsackievirus A16 in Yancheng area in 2016 and analysis of the characteristics of VP1 gene of coxsackievirus A6

CHEN Guo-qing, LI Chun-xiang, SHAO Rong-biao, WANG Yao, LI Feng, XU Shi-lin, LI Chang-cheng

2018, 22(1): 52-56. doi: 10.16462/j.cnki.zhjbkz.2018.01.012

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Objective To study the pathogenic spectrum of the enterovirus for non-enterovirus 71 (non-EV71) and non-coxsackievirus A16(non-CVA16) for hand, foot and mouth disease (HFMD)in the city of Yancheng in 2016, and characterize the molecular epidemiology of the VP1 gene of coxsackievirus A6 strains. Methods The serotype of coxsackievirus A6 strains were identified by molecular subtyping. The sequences of the VP1 gene of coxsackievirus A6 strains were amplified through one step reverse transcription polymerose chain reaction (RT-PCR) method and the PCR products were sequenced. The sequences of nucleotide and amino of the VP1 gene of coxsackievirus A6 were analyzed and the evolutional tree was generated using bioinformatics software. Results There was significant difference among the three positive rates in EV71,CVA16 and non-EV71, non-CVA16(χ²=87.72,P<0.001).The strains of the enterovirus for non-EV71 and non-CVA16 were classified into seven genotypes (CVA4,CVA6,CVA10,Echovirus 3(E-3),E-9,E-13,Coxsackievirus B4(CVB4)) and belonged to human enterovirus A group and human enterovirus B group. Phylogenetic tree analysis showed that 56 strains of enterovirus coxsackievirus A6 in Yancheng area belonged to D3,D4 evolutionary sub-branches. Among them, 54 strains belonged to D4 evolutionary sub-branch, which was the mainstream sub-branch in china. Within the D4 sub-branch, 54 strains were clustered into numerous small sub-branches and away from the prototype Gdula strain. Conclusions The spectrum of pathogens causing HFMD epidemics in Yancheng area in 2016 was multifarious and the genotype of coxsackievirus A6 was the prevalent pathogen. D4 sub-branch of strains was the dominant evolutionary branch and formed multiple transmission chains.

The prognostic and predictive value of serum CA199 and CEA in colorectal cancer metastasis

ZHANG Xin-dong, GE Xiao-lei, LIU Sheng-cun, ZHENG Wei-qing, SHEN Tong

2018, 22(1): 57-61. doi: 10.16462/j.cnki.zhjbkz.2018.01.013

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Objective To determine the prognostic and predictive value of serum CA199 and CEA in colorectal cancer metastasis. Methods Clinical characteristics of 1 064 patients with colorectal cancer were collected. Serum CA199 and CEA were tested. All participants were followed-up in term of prognosis. Results CA199 exhibited higher predictive accuracy index for predicting lymph node metastasis, whereas serum CEA was more accurate for the prediction of liver metastasis. Patients with negative levels of CA199/CEA had significantly prolonged survival than those with either single positive CA199/CEA or double positive indicators (all P<0.05). Cox proportional hazards regression showed that the risk of death from positive serum CEA was 1.50 times of that from negative group (HR=1.50, 95% CI:0.89-1.83, P=0.020). Conclusions Serum CA199 and CEA levels are risk factors of poor prognosis in colorectal cancer patients, which may be utilized to predict metastasis.

Survey results and comparative analysis of residents' health literacy among Beijing, Shanghai and Taipei

CHIN Mei-ting, LUO Yan, CHIN Yi-ping

2018, 22(1): 62-65,69. doi: 10.16462/j.cnki.zhjbkz.2018.01.014

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Objective This study aims to examine the level and differences of health literacy (HL) of permanent residents in Beijing, Shanghai and Taipei, so as to provide scientific basis for further behavioral intervention. Methods By using triangulated sampling investigation method, from Feb. to Apr. 2015, 985 residents in Beijing, Shanghai and Taipei were taken as respondents in the investigation of HL. Results The average score of HL of residents in Beijing, Shanghai and Taipei was (14.74±2.77) out of 21. The average health literacy of Beijing residents was (15.20±2.19), which was higher than the residents of Taipei (15.03±2.58) and Shanghai (13.94±3.30). According to the definition of health literacy level in this article, Beijing and Taipei residents ranked upper-middle level of health literacy, while Shanghai residents in the middle and lower health level. Conclusions The medical "graphic and text information literacy" level indicator of Beijing, Shanghai and Taipei residents are low. The appropriate intervention measures should be taken to improve lack of health literacy of the residents.

An analysis of lower grade students' state of sub-health and correlative factors in a university of Chinese medicine

LI Bai-kun, ZHAN Yu-can, LI Jing, WU Song, YANG Jie, WANG Ting-ting, ZHU Ji-min

2018, 22(1): 66-69. doi: 10.16462/j.cnki.zhjbkz.2018.01.015

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Objective To explore the prevalence of lower grade students' sub-health and correlative factors in medical colleges with the purpose to formulate reference data for popularizing healthy lifestyle and scientific intervention of sub-health among college students. Methods A total of 4 952 students were surveyed by Questionnaire, SPSS 21.0 software was used for statistical analysis. Results The sub-health score was 14(7,27), with a detection rate of 38.1%, and the healthy status of students from towns was better than those from rural areas(Z=-3.599, P<0.001). The common symptoms of sub-health among college students were fatigue (36.6%), low concentration (29.6%) and poor memory (28.1%), which was even worse especially among those with higher sub-health score. The scores of diet(Z=-11.264, P<0.001), physical activities(Z=-7.172, P<0.001) and adverse events(Z=-14.207, P<0.001) of healthy people were better than those of sub-health. The results of multiple Logistic regression analysis showed that 4 factors influenced the sub-health status among the students, including academic achievement (OR=1.647, 95% CI:1.149-2.363, P=0.007), body mass index(OR=1.117, 95% CI:1.006-1.240, P=0.038), adverse events (OR=1.470, 95% CI:1.154-1.874, P=0.002) and physical activities (OR=0.882, 95% CI:0.790-0.985, P=0.026). Conclusion Universities should pay more attention to the health state of college students as well as actively conduct targeted intervention activities.

Survey on health trails use and its effects

ZHU Xiao-lei, ZHANG Xiao-chang, WU Ming, ZHAI Yi, SHEN Tao, ZHOU Jin-yi, PAN Xiao-qun, WU Jing, LI Yuan

2018, 22(1): 70-74. doi: 10.16462/j.cnki.zhjbkz.2018.01.016

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Objective To explore the development of the health trail and its service condition, physical activity and influencing factors among the health trail users. Methods In August 2015, a self-administered questionnaire was conducted among 1 615 health trail users in four health trails in three districts (Jingkou, Runzhou and Dantu) in Zhenjiang Municipality in Jiangsu Province. The users' socio-demographic characteristics, exercise behaviors, activities were obtained. A chi-square test was used to evaluate differences in the trails and different populations. Results The percentages of the health trail users of 6-7 days per week and of 3-5 days per week were 50.56% (816/1 614) and 31.91% (515/1 614), respectively. The percentages of users went for a stroll in three age groups (under 45, 45-59 and over 60) were higher than those went for walking, brisk walking and slow jogging. 67.58% (1 090/1 613) users considered that there was an increased exercise amount. The majority of users (96.65%, 1 557/1 611) went to health trails from home, between which, the distance range was 1.26 to 2.11 km. 44.67% (720/1 612) and 22.21% (359/1 612) users preferred that the health trail should locate in parks and squares, respectively. The top two reasons for willing to use health trails were safety and beauty of environment. Conclusions The health trail is a good channel to build up the people's health. Healthy lifestyle can be improved by using health trails.

Clinical study of effectiveness and safety of Iguratimod in treating primary Sjögren's syndrome

WANG Xue, YUAN Xiang, WANG Qi-kai, ZHOU Ying-bo, LI Xiang-pei, WANG Guo-sheng, TAO Jin-hui, MA Yan, LI Xiao-mei

2018, 22(1): 75-78,84. doi: 10.16462/j.cnki.zhjbkz.2018.01.017

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Objective To explore the effectiveness and safety of Iguratimod on the patients with primary Sjögren's syndrome (pSS). Methods A total of 30 patients with primary Sjögren's syndrome were enrolled in a single-center,open,and self-controlled study for 16 weeks. Percentage of CD19⁺CD27⁺ memory B cells in peripheral blood was analyzed by flow cytometry. The clinical symptoms and signs of patients with laboratory indexes were observed, the European league against rheumatism(EULAR) Sjögren's syndrome disease activity index (ESSDAI)score and EULAR Sjögren's syndrome patient reported index (ESSPRI) score were evaluated. At the same time, 36 7-week-old nod mice were randomly divided into empty vector solution group, 10 mg/kg iguratide group, 20 mg/kg iguratide group respectively, 12 rats in each group. After 1 week of adaptation, the rats were treated with different doses of intragastric administration per day for 8 weeks. The percentage of CD19⁺CD27⁺ memory B cells in the spleen of mouse was detected by flow cytometry. Results After the treatment of Iguratimod for 16 weeks,the ESSDAI score and ESSPRI score were improved in pSS patients. The percentage of CD19⁺CD27⁺ memory B cells in peripheral blood,the level of IgG,IgA,IgM in serum,erythrocyte sedimentation rate (ESR)and rheumatoid factor (RF)were reduced respectively (all P<0.05). There were 5 cases of side effects,including 2 cases of gastrointestinal discomfort, 2 cases of mild hepatic dysfunction, and 1 case of generalized body rash, nevertheless, there were no serious adverse reactions, such as peptic ulcer, granulocyte deficiency, infection, etc. Meanwhile, the animal experiment further confirmed that the proportion of CD19⁺CD27⁺ memory B cells in the spleen of mice after 8 weeks of intragastric administration in 10 mg/kg iguratide group and 20 mg/kg iguratide group was significantly lower than that of empty vector group (all P<0.05). Conclusion These findings indicate that Iguratimod could improve the condition of patients with pSS, reduce the level of immunoglobulin, regulate the B cell subsets, and have good tolerability and high safety.

The effects of medical abortion and surgical abortion on subsequent pregnancy outcome among nulliparas in China: a systematic review and meta-analysis

LI Fang, YIN Lei, YANG Hai-dong, CHEN Li-zhang

2018, 22(1): 79-84. doi: 10.16462/j.cnki.zhjbkz.2018.01.018

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Objective To evaluate the effects of medical abortion (MA) and surgical abortion (SA) on subsequent pregnancy outcome among nulliparas in China, so as to provide some reference suggestions for the selection of miscarriages for pregnant women. Methods Systematical search was conducted using PubMed, Cochrane Library, Web of Science, Ovid, Embase, CNKI, China biomedical literature database, Wanfang Database and CQVIP Database. Studies were screened according to the predefined inclusion and exclusion criteria. Review Manager 5.3 software was used for statistical analysis. Results Seven cohort studies with 2 946 cases were included. The incidences of miscarriage, postpartum hemorrhage, placental praevia, placental adhesion and placental remnant occurred in MA group were significantly lower than those occurred in SA group, and their OR(95% CI) were 0.38(0.28-0.52), 0.35(0.25 -0.48), 0.53(0.31-0.90), 0.33(0.23-0.48) and 0.22(0.14-0.35), respectively. No other significant differences were observed between the two artificial abortions groups (all P>0.05). Conclusions Although MA is safer than SA on subsequent pregnancy and is considered a preferred option for nulliparas to terminate their unwilling pregnancy, abortion associated injury still existed for nulliparas in regardless of the type of abortion selected. Thus unnecessary abortion should be avoided.

Theoretical thinking and method of cognition of human aging and test index (scale) construction

HUANG He-lang, LIU Xing, LI Xiang, HE Zi-qiang, YE Xing, WU Lei

2018, 22(1): 85-88,103. doi: 10.16462/j.cnki.zhjbkz.2018.01.019

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On the basis of the comparison of different human life states or different methods of judging aging, this article analyzed the theory of mechanism and influencing factors of aging, it combined the new results of multidisciplinary research, under the guide of the modern medical model and great health view, and it based on the dialectical materialism and big data view, used the biomedical, psychological, sociological and biologic statistics and other multi-disciplinary knowledge exploringly and proposed the different ways of measuring aging and index creatively, and this article focuses on the series of ideas and methods for the research of aging scale and aging judgment scale.

Research progress on the relationship between bullying victimization and non-suicidal self-injury in adolescents

TANG Han-mei, FU Yan-yan, CHEN Xiao-long, HU Wang, HUANG Peng

2018, 22(1): 89-93. doi: 10.16462/j.cnki.zhjbkz.2018.01.020

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Abstract:
In recent years, frequent campus safety incidents put adolescents' behavior problems in sharp focus. Bullying and non-suicidal self-injury (NSSI) have been investigated. Bullying, as a negative behavior, belongs to a sub-type of aggressive behaviors, including bullying perpetration to others, bullying victimization, and bully-victim. NSSI occurs frequently in adolescents, which is an independent risk factor for suicide. At present, most scholars believe that bullying victimization is positively correlated with NSSI, and there may be mediating or moderating effects between them. However, the relationship between bullying perpetration to others and NSSI is still uncertain due to the lack of researches. This paper summarizes the relationship between bullying and NSSI to provide clues or new thoughts for preventing and controlling non-suicidal self-injury in adolescents.

The father of clinical epidemiology: Pierre Charles Alexandre Louis

QIAN Liu-yu, WU Jun, YE Dong-qing

2018, 22(1): 94-96. doi: 10.16462/j.cnki.zhjbkz.2018.01.021

Abstract(1276)

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Abstract:
Pierre Charles Alexandre Louis(1787-1872),a French doctor in nineteenth century, is an important figure in the history of medicine,he pioneered the use of simple observation and statistical analysis to research tuberculosis, typhoid fever and pneumonia. He applied the numerical method to medicine, and established clinical epidemiology.Louis, a clinician and pathologist, has been remembered as a famous clinical epidemiology pioneer by people.

Pathogen spectrum analyzation of severe hand-foot-mouth disease and VP1 genetic analysis of EV71 in Changsha, during 2013-2015

OU Xin-hua, HUANG Zheng, LI ling-zhi, YE wen, YAO dong

2018, 22(1): 97-99. doi: 10.16462/j.cnki.zhjbkz.2018.01.022

Abstract(255)

PDF(19)

Abstract:

Analysis on the status and related factors of high risk behaviors of sexually transmitted diseases/HIV among clients of female sex workers in Guangdong Province

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

2018, 22(1): 100-103. doi: 10.16462/j.cnki.zhjbkz.2018.01.023

Abstract(1243)

PDF(94)

Abstract:

Study on the correlation between mental health and psychological stress among imigrants in Danjiangkou reservoir area

KE Pan, WU Dong-mei, JIANG Feng-bo, LIN Zi, LIU Bing

2018, 22(1): 104-106. doi: 10.16462/j.cnki.zhjbkz.2018.01.024

Abstract(322)

PDF(32)

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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