中华疾病控制杂志

Gene-environment analysis in the study of chronic non-communicable diseases

CHANG Jiang, MIAO Xiao-ping

2018, 22(4): 323-325. doi: 10.16462/j.cnki.zhjbkz.2018.04.001

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Chronic non-communicable diseases, such as cancer, cardiovascular diseases and Alzheimer's disease are correlated with both genetic and environmental risk factors. However, we would incorrectly estimate the risk if we only considered the separate contributions of genetic or environmental factors. The gene-environment interaction is needed to be considered. There are many aspects need to be considered when we perform the gene-environment interaction analysis. This paper reviews the study design, method and examples of gene-environment interaction analysis and may help researchers to conduct such study in the future.

Regional characteristics analysis on cardiovascular and cerebrovascular diseases mortality in Qingdao from 2011 to 2016

CAO Yan, SUN Xiao-hui, ZHANG Hua, LI Fei-fei, NING Feng, WANG Shao-jie

2018, 22(4): 326-329. doi: 10.16462/j.cnki.zhjbkz.2018.04.002

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Objective To evaluate the geographical distribution and changing trend of cardiovascular and cerebrovascular diseases mortality in Qingdao from 2011 to 2016, so as to provide theoretical basis on the determination of critical prevention and treatment regions. Methods The cardiovascular and cerebrovascular diseases cause death were collected from the Chronic Disease Monitoring System in Qingdao. The trend-surface and time trend statistical methods were performed using the SPSS 21.0 and SAS 9.4 software. Results A total of 86 277 cardiovascular and cerebrovascular deaths was recorded in Qingdao from 2011 to 2016, with a standardized mortality rate of 115.33 per 100 thousands, of which 128.08 per 100 thousands in men and 102.51 per 100 thousands in women, respectively. The standardized cardiovascular and cerebrovascular mortality rate in men was 1.25 times higher than women. The rural-urban standardized mortality ratio was 1:2.67, and the trend-surface analysis showed that the mortality rate of cardiovascular and cerebrovascular diseases had a moderate trend in Qingdao (all P>0.05).The standardized mortality rate of cardiovascular and cerebrovascular diseases in Qingdao increased by 13.64%from 103.43 per 100 thousands in 2011 to 117.54 per 100 thousands in 2016. Conclusions The mortality rate of cardiovascular and cerebrovascular diseases in Qingdao showed an increasing trend, but there was moderate trend in regional distribution. The current prevention and control work need to emphasize on rural areas and in men.

Study on influencing factors and genotypes of hepatitis C virus infection among 734 drug users in Shanghai compulsory detoxification center

WANG Na, LIU Xiao-feng, SHI Da-qing, LU Yi-han

2018, 22(4): 330-334,362. doi: 10.16462/j.cnki.zhjbkz.2018.04.003

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Objective To understand the influencing factors and genotypes of hepatitis C virus infection among drug users in Shanghai compulsory detoxification center, so as to provide evidence for behavior intervention and clinical treatment. Methods A cross-sectional study was conducted with 734 drug users entering the detoxification center for the first addiction from May to July 2015. Field investigation was used to explore the influencing factors, and the nested reverse transcription-polymerase chain reaction (RT-PCR)was conducted to identify the genotype. The HCV genotype and the regional distribution characteristics were also investigated. Results HCV RNA in 236 of 734 drug addicts under compulsory rehabilitation were positive, and the positive rate was 32.2%. Multivariate unconditional Logistic regression analysis showed that the drug-use time(OR_5-year=2.79,95% CI:1.64-4.75;OR_10-year=9.37,95% CI:5.30-16.54;OR_{15-25 year}=11.22,95% CI:6.26-20.01), heroin use(OR=2.02,95% CI:1.32-3.10)and injection drug-use(OR=6.62,95% CI:4.41-9.94) were risk factors of HCV infection.The education with college and above was the protective factor(OR=0.11,95% CI:0.02-0.63).In 236 drug users with HCV RNA-positive, the predominant subtypes were 3a(24.1%),6a(20.2%) and 1b(19.5%), meanwhile subtypes of 3b, 6n, 1a, 2a, 2b and 6e were also identified. Generally, the regional distribution of HCV genotype was disperse. Conclusions Drug-use time, heroin use and injection drug-use are major risk factors of HCV infection, and the subtype of 3a and 6a are the predominant subtypes.

Study on viral etiology of hospitalized children with acute respiratory infection in Suzhou

SHAN Wei, YAN Yong-dong, CHEN Li-ling, CHEN Zheng-rong, CHEN Kai-le, LIU Chang-peng, ZHANG Jun, ZHAO Gen-ming, ZHANG Tao

2018, 22(4): 335-339. doi: 10.16462/j.cnki.zhjbkz.2018.04.004

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Objective To investigate the viral etiology of hospitalized children with acute respiratory infection in Suzhou. Methods A prospective study of hospitalized patients in the respiratory department of Soochow University affiliated children's hospital from November 2016 to May 2017 was conducted. We enrolled the patients based on strict inclusion criteria, such as local residents, disease occurred within 7 days and without admission in the previous 30 days. The nasopharyngeal secretions were collected for detection of influenza virus A and B (InfA & InfB) by Real-time fluorescence RT-PCR, respiratory syncytial virus (RSV), adenovirus (ADV), parainfluenza virus (PIV) and rhinovirus (RV) by direct immunofluorescence (DFA), as well as bocavirus (BoV) by Real-Time PCR. We also collected the demographic and clinical information, and analyzed the epidemiological characteristics of tested respiratory viruses. Results A total of 479 samples were collected, and the grant positive rate of respiratory virus was 49.1% (235/479). RSV was the most common virus (26.1%), followed by influenza virus (7.7%), RV (7.3%), BoV (5.2%), PIV (4.6%) and ADV (1.5%). The positive rate of respiratory virus was highest in children aged >6 to ≤ 12 months old (59.6%), followed by ≤ 6 months of age (55.8%). The positive rate of respiratory virus decreased with age ((口恶)_Trend²=13.541,P=0.001). Conclusions RSV was the most common virus and influenza virus also played an important role in acute respiratory infections among children in Suzhou. Influenza A/H3N2 and influenza B/Victoria was prevalent at this season. The very young children were more susceptible to respiratory viral infection. Significant differences in age and time were observed in some respiratory virus infections.

Temporal and spatial distribution of tuberculosis in Qinghai Province based on GIS

MA Yong-cheng, WANG Zhao-fen, LI Bin, MA Bin-zhong, MA Cheng-qiang, SHEN Xiu-li, ZHANG Yuan-yuan, WANG Hai-jing, JIANG Ming-xia, WANG Wei-jun

2018, 22(4): 340-344,353. doi: 10.16462/j.cnki.zhjbkz.2018.04.005

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Objective To understand the tuberculosis(TB) spatial distribution characteristics and trends of Qinghai Province and to explore the distribution of hot type and the onset of aggregation, so as to provide evidence for the prevention and control of tuberculosis in Qinghai Province. Methods Data of tuberculosis from 2011 to 2015 in Qinghai were collected and spatial correlation analysis, high/low clustering analysis, hotspot analysis and Kriging interpolation prediction were conducted by spatial epidemiological techniques. Results The results based on five-year average morbidity showed that geographical areas with high incidence of TB in Qinghai were counties of Qumalai, Maduo, Zaduo, Jiuzhi. Low incidence areas were Golmu City, Wulan County, Ping'an, Huangzhong and Huzhu. Trend figures showed that high incidences of TB in Qinghai existed in both east-west direction and the north-south direction, which were consistent with the geographical distribution. Spatial autocorrelation analysis showed that:Moran's I index was 0.32, Z=7.22, P=0.001; High/Low clustering analysis showed that the Getis Gi coefficient was -0.13, Z=-2.00, P=0.045; hot spot analysis showed that most hot spots of TB in Qinghai were concentrated in counties of Zaduo, Qumalai, Chengduo, Dari, Maqing and Banma. Conclusions The geographical distribution of TB in period of 2011 to 2015 in Qinghai was uneven and appeared a positive spatial autocorrelation and displayed a low-low model and a hot spot.

Analysis on seasonal distribution characteristics of hand foot and mouth disease in Qinghai Province based on the concentration and circular distribution method

RAO Hua-xiang, SHI Yan, CAI Zhi-feng, LI Yong-hong, ZHAO Jin-hua, ZHANG Hua-yi, XU Li-li

2018, 22(4): 345-348. doi: 10.16462/j.cnki.zhjbkz.2018.04.006

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Objective To analyze the seasonal distribution of incidence of hand foot and mouth disease (HFMD) in Qinghai Province, so as to provide the scientific basis evidence for the establishment of prevention and controlling strategies of HFMD. Methods The HFMD incident cases who lived in Qinghai Province were collected from the China Information System for Disease Control and Prevention by month during 2012-2016. We used the concentration and circular distribution method to depict the characteristics of HFMD incidence in Qinghai Province. Results There was a significant seasonal periodicity in the incidence of HFMD in Qinghai Province (M=0.613), and the peak of incidence was generally happened from May to August every year (r=0.610,a=181.322°, s=57.004°). The results from Watson-Williams analysis showed that the average angle of peak time was changed every year (F=31.492, P<0.001), which indicated a changeable peak time of HFMD incidence. Conclusions We found a statistically significant seasonal periodicity in the incidence of HFMD in Qinghai Province. Therefore, the prevention and control strategies should be carried out before the high-risk season as soon as possible, which would be efficiently reduce the occurrence of severe cases and prevent the possibility of epidemic outbreak.

Evaluation of comprehensive health management by community hospital of the elderly type 2 diabetic patients in Nanjing

DENG Lin, CHAO Jian-qian, XU Hui, YU Qing, CHEN Huang-hui, GU Jia-yi, ZHANG Rui-zhi, HE Ting-ting

2018, 22(4): 349-353. doi: 10.16462/j.cnki.zhjbkz.2018.04.007

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Objective To explore the effect on the community hospital comprehensive health management of the elderly type 2 diabetic patients about habits, physiological and biochemical indicators, health knowledge for the further community diabetes health management. Methods A total of 336 elderly patients with type 2 diabetes mellitus in a community hospital in Nanjing were selected and self-assessment status, health knowledge score, lifestyle and physiological and biochemical indicators were analyzed by Wilcoxon test and chi-square test between the two groups before and after management from March 2013 to December 2016. Results The management group were better than the control group in the pain discomfort, anxiety and depression, healthy self-assessment score, health knowledge scores, monitor fast plasma glucase (FPG) regularly, healthy diet score, three kinds of exercise, daily sitting time and FPG after management by community hospital(all P<0.05). The health knowledge score difference of management group(6.66±6.46)before and after management is higher than the control group(4.64±6.91), the moderate intensity and low intensity exercise increased time of management group ((0.39±218.46,81.51±351.10) min/week) is longer than control group ((-47.77±230.38,18.40±327.75) min/week), and the sitting time difference of management group ((-10.40±139.07) min/day) is better than control group ((28.30±115.93)min/day) (all P<0.05).Conclusions Comprehensive health management such as health lectures, regular follow-up and personalized counseling can effectively improve the elderly type 2 diabetes patients with health status and lifestyle, control blood sugar levels, ameliorate the psychological status and improve the quality of life.

Burden of disease attributable to cigarette smoking in Qingdao in 2015

QI Fei, XU Zhen-shi, JIA Xiao-rong, LIN Peng, GENG Mei-yun, WANG Ya-ni, LI Shan-peng

2018, 22(4): 354-357,385. doi: 10.16462/j.cnki.zhjbkz.2018.04.008

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Objective To estimate the burden of cancers attributable to smoking among the Qingdao population in 2015 and provide scientific basis for further tobacco control strategy. Methods According to the characteristics of different diseases, we calculated the population attributable fractions of different diseases, death and impact of life expectancy which caused by smoking, using smoking impact ratio as exposure levels. The sex-age-specific mortality attributable to smoking was collected from Qingdao Municipal Center for Disease Control and Prevention by the online report system. The population was obtained from the Qingdao Municipal Bureau of Statistics. Results In 2015, tobacco smoking caused an estimated 4 148 cancer deaths (3 195 in male and 953 in female), accounting for 29.13% of total cancer deaths (33.00% in male and 20.92% in female). The mortality increased with age, and increased significantly at age of 45-years. It reached the peak at age of 60-years. Lung cancer showed the greatest PAF (60.04%), followed by nasopharynx cancer (37.95%), oral cancer (35.41%), esophageal cancer (35.14%) and bladder cancer (14.93%). The leading cancers due to smoking in terms of mortality were lung (3 122), liver (339), esophageal (293) and stomach (185), and pancreatic cancer (55). The loss of life expectancy caused by cancer deaths attributable to smoking was 0.87 years (1.19 years in male and 0.45 years in female). Conclusions The burden of cancers attributable to smoking in Qingdao reached a high level. Tobacco control measures such as reducing the smoking rate and protecting non-smokers from secondhand smoke pollution are imperative.

The epidemiological investigation on risk factors of nicotine dependence among the smokers in Beijing

ZHAO Jie-wen, YAO Peng-tao, LIU Li-xiang

2018, 22(4): 358-362. doi: 10.16462/j.cnki.zhjbkz.2018.04.009

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Objective To identify the risk factors of nicotine dependence by conducting an epidemiological investigation in smokers beyond 15 years in Beijing. Methods A household questionnaire survey was carried out on whom were selected by multi-stage stratified and proportional random sampling method. Kruskal-Wallis test and multivariable unconditional Logistic regression analysis were performed to identify the influencing factors of moderate and severe nicotine dependence, compared with mild dependence. Results A total of 1 280 smokers were recruited, in which 1 176 smokers were males (91.9%).The smokers with mild, moderate and severe nicotine dependence accounted for 53.5%, 33.3% and 13.2% respectively. Multivariable unconditional logistic regression analysis showed that compared with the mild nicotine dependence, older(OR=3.643,95% CI:1.467-9.045),often smoking in indoor workplaces(OR=2.539,95% CI:1.553-4.149),in indoor public places(OR=2.621,95% CI:1.581-4.346)and at home smokers(OR=3.304,95% CI:1.782-6.126)had higher risk to become severe nicotine dependence. While higher education level (OR=0.172,95% CI:0.062-0.480),occupation(OR=0.314,95% CI:0.138-0.714), fewere alcohol consumption (OR=0.567,95% CI:0.434-0.742)and fewer everyday smoking number(OR=0.056,95% CI:0.034-0.093)were protective factors. Conclusions From the perspective of demographic information and factors affecting nicotine dependence, strengthen public care and tobacco control policy supervision on public place and that family members' discourage against smoking within the family at the same time. Encourage people start with less smoking and alcohol.

Current situation of smoking behavior and the relationship with family socioeconomic status on secondary vocational school students in Hunan

FENG Yong-hui, LIU Yu-pin

2018, 22(4): 363-366. doi: 10.16462/j.cnki.zhjbkz.2018.04.010

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Objective To examine smoking prevalence and impacts of family socioeconomic status on the secondary vocational school student's smoking behavior in Hunan, and provide scientific references for prevention and reduction of secondary vocational school student's smoking behavior. Methods A total of 1 086 students were recruited from two secondary vocational schools in Loudi and Changde in Hunan Province with the questionnaire of family socioeconomic status and the questionnaire of middle school students smoking behavior. Results The students smoking rate were 32.1%, of which there were 23.8% students smoked more than 6 cigarettes a day. There were significant differences in parents' occupation, subjective family social status and subjective school social status between students smoking and non-smoking (all P<0.05). The results of regression analysis showed that family monthly income (OR=1.129,95% CI:1.024-1.245, P=0.015) and the subjective school social status (OR=0.895, 95% CI:0.820-0.976, P=0.012) can predict the secondary vocational school students smoke or not. Family monthly income (OR=1.062,95% CI:1.010-1.122, P=0.047), parents' occupation (OR=0.951,95% CI:0.908-0.996, P=0.034), and the subjective school social status (OR=0.932,95% CI:0.890-0.984, P=0.010) were predictors of the smoking amount among the students. Conclusions It is serious of secondary vocational school students smoking in Hunan province. Higher family monthly income and lower subjective family socioeconomic status of secondary vocational school students are more likely to be a smoker.

The mediating and moderating effects of emotional dysregulation and left-behind experiences for college freshmen's self-injurious behavior

ZHANG Lian-sheng, ZHU Shuang-shuang, CHANG Wei

2018, 22(4): 367-370. doi: 10.16462/j.cnki.zhjbkz.2018.04.011

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Objective To explore the mediating effect of emotional dysregulation and moderating effect of left-behind experiences on depression and self-injurious behavior. Methods From April to July 2016, 326 college students who have had self-injurious behaviors and left-behind experiences were selected by cluster sampling method. Investigations were conducted using self-injury scale for the adolescent, self-rating depression scale and emotional dysregulation scale. Results The mediating effect of emotional dysregulation was significant on depression and self-injurious behavior, the coefficient of depression scores (X)→emotional dysregulation scores (M) was 0.259 (t=7.642, P<0.001); the coefficient of M→self-injurious behavior scores (Y) was 0.092 (t=2.653, P=0.008). The direct moderating effect of left-behind experience was significant on depression and self-injurious behavior,the coefficient of X*left-behind experience (W)→Y was 0.133 (t=3.954, P<0.001). The moderating effect of left-behind experience on emotional dysregulation was also significant, the coefficient of X*W→M was 0.071 (t=5.017, P<0.001); the coefficient of M*W→Y was 0.124 (t=3.510, P<0.001). Conclusions Emotional dysregulation plays a mediating role and the left-behind experience serves as a moderating role between depression and self-injurious behavior.

The distribution of psychological aging and its correlation with age among people from elder care institutions

YE Xing, TIAN Ting, ZHOU Yue-ping, HUANG He-lang

2018, 22(4): 371-373,379. doi: 10.16462/j.cnki.zhjbkz.2018.04.012

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Objective To explore the distribution characteristics of psychological aging and its correlation with age among people from elder care institutions,so as to provide guidance for geriatric care management. Methods A self-constructed questionnaire of three dimensional aging scale was used to collect psychological aging information among people from elder care institutions. The fluctuation characteristics of psychological aging scores and its correlation with age were analyzed by statistical software. Results Of total 500 distributed questionnaires, 477 were retrieved, with a response rate of 95.20%. The total score of psychological aging ranged from 7.76 to 18.81. The range of scores on dimension of cognition, emotion, personality, motivation and needs was 1.69-7.77, 1.25-5.00, 1.66-3.32, and 1.55-4.90, respectively. Psychological aging score varied significantly among people with different ages, showing an positive correlation with age (r=0.409, P<0.001). The scores of each dimension showed a slow rising trend, the 60-age and the 70-age groups increased significantly. Conclusions Psychological aging score increases with age and its fluctuation characteristics can provide valuable reference for studying the aging of human psychology.

Analysis on the status and influencing factors of anxiety and depression in Iatrogenic multiple pregnancy women

LUO Gui-ying, WANG Chun-yan, WEI Zhao-lian, CONG Lin, PAN Fa-ming

2018, 22(4): 374-379. doi: 10.16462/j.cnki.zhjbkz.2018.04.013

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Objective To investigate the status of anxiety and depression in iatrogenic multiple pregnancy, and to analyze the relevant factors which affect their mental health. Methods The multiple pregnancy patients with IVF-ET (in vitro fertilization-embryo transfer) were selected from a reproductive center in Hefei, Anhui. And we collected the data with the self-designed General Situation Questionnaire, the pregnancy stress scale (SAS) and Self-rating depression scale (SDS) to evaluate the anxious and despondent status of the patients. Results A total of 240 patients with multiple pregnancy from a reproductive center in Hefei were recruited. According to the patient's infertility type, they were divided into two groups with primary infertility and secondary infertility, and the difference between the two groups in the cause of infertility was statistically significant((口恶)²=7.871,P=0.049). The anxiety and depression detection rate was 47.50% and 66.25% respectively. Multivariate regression analysis showed that SAS score was correlated with and secondary infertility(OR=2.274, 95% CI:1.312-3.941, P=0.003), pay attention to the sex of the fetus(OR=4.591, 95% CI:2.492-8.459, P<0.001). No family history of disease(OR=0.248, 95% CI:0.074-0.832, P=0.024)were protective factors of SDS scores. The average monthly income(OR=4.105, 95% CI:1.204-14.004, P=0.024)and pay attention to the sex of the fetus (OR=2.303, 95% CI:1.161-4.568, P=0.017)was risk factor of SDS scores. Conclusions Secondary infertility and eagering to give birth with boys may be a risk factor of iatrogenic sexual anxiety in patients with multiple pregnancy. A high level of income, eagering to give birth with boys are important risk factors for depression.

Analysis of trends of birth weight, and incidence of adverse birth outcomes and relevant factors from 2002 to 2015

DING Hai-yan, XIAMUSIYE Muyiduli, LI Min-chao, JIANG Shu-ying, MO Min-jia, SHAO Bu-le, WANG Shuo-jia, YU Yun-xian

2018, 22(4): 380-385. doi: 10.16462/j.cnki.zhjbkz.2018.04.014

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Objective To describe the trends of birthweight from 2002 to 2015, and analyze the incidence of adverse birth outcomes and to explore their relevant factors. Methods Datasets were obtained from decoded Electronic medical recorder system (EMRS) of Zhoushan, trends of birthweight were described, incidence of adverse birth outcomes were analyzed. Multivariate Logistic regression was used to analyze relevant factors. Results Mean birth weight of 37 141 newborns were (3 388±462) g, and incidence of low birth weight, macrosomia, preterm birth were 2.34%, 9.42% and 3.61%, respectively. Girls had higher risk of low birth weight than boys. Pre-pregnancy underweight or overweight, high risk pregnancy (OR=1.80, 95% CI:1.42-2.28) were risk factors of low birth weight. High levels of maternal education reduced the risk of low birth weight; girls had lower risk of macrosomia than boys. Pre-pregnancy overweight and obese increased the risk of macrosomia. Born in summer or fall, maternal age <25 and pre-pregnancy underweight reduced the risk of macrosomia. Girls had lower risk of preterm birth than boys. Maternal age <25 reduced the risk of preterm, maternal age >30 (OR=1.38, 95% CI:1.19-1.60), born in winter (OR=1.24, 95% CI:1.06-1.45), pre-pregnancy overweight or obese and high risk pregnancy (OR=1.95, 95% CI:1.66-2.29) increased risk of preterm birth. Conclusions During 2002-2015, mean birth weight tends to decrease, incidence of low birth weight and preterm birth tend to increase. Incidence of macrosomia or low birth weight and preterm birth were relevant with newborn's gender, maternal age, pre-pregnancy body mass index (BMI) and high risk pregnancy.

Effects of arsenic in Keap1 inhibiting HaCaT cells apoptosis and antioxidant levels

BAI Xue, MA Yao, LI Yu, CHEN Rou-jin, WU Jun, ZHENG Yu-jian

2018, 22(4): 386-389,410. doi: 10.16462/j.cnki.zhjbkz.2018.04.015

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Objective Based on the inhibition of Keap1(Kelch-like ECH-associated protein 1)gene, we studied the effects of arsenic exposure on the apoptosis and antioxidant capacity of human immortalized keratinocyte (HaCaT) cells. Methods The cells were cultured for 72 h and was divided into 5 groups including blank control, negative control (Keap1 gene inhibition of untouched arsenic) and Keap1 gene inhibition+low-dose arsenic group (2.9 μmol/L), Keap1 gene inhibition +medium-dose arsenic group (5.8 μmol/L) and Keap1 gene inhibition +high-dose arsenic group (29.0 μmol/L); The apoptosis rate was detected by flow cytometry. The expression of Nrf2 and Keap1 mRNA was detected by Real-Time Quantitative PCR. The expressions of GSH, HO-1, COX-2, SAM and HCY were detected by ELISA. Results The expression of Nrf2 and Keap1 mRNA was not equal in each groups (all P<0.05). Compared with the negative control group, the expression of SAM and HCY protein in low-dose arsenic group was significantly increased (all P<0.05); The protein expression of COX-2 was increased in medium-dose and high-dose arsenic groups (all P<0.05); GSH protein expression was increased in high arsenic group (F=7.24,P=0.001). Conclusions In the case of Keap1 gene inhibition, the arsenic exposure increased the antioxidant enzyme activity, increased the level of antioxidation and decreased the apoptosis rate. With the increasing of arsenic dose, the expression of Nrf2 was down-regulated and the antioxidant level was imbalanced and death increased.

Protective effect of bicyclol on anti-tuberculosis drug-induced hepatotoxicity:a Meta-analysis

HAO Hai-bo, WANG Xian-hua, ZHAO Shan-liang, WANG Qiu-zhen, MA Ai-guo

2018, 22(4): 390-395. doi: 10.16462/j.cnki.zhjbkz.2018.04.016

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Objective To evaluate the efficacy of bicyclol in the treatment of anti-tuberculosis drug-induced hepatotoxicity. Methods Data related to the efficacy of bicyclol in the treatment of anti-tuberculosis drug-induced liver injury were searched from databases including CBM, CNKI, WanFang, VIP Data, PUBMED, EMbase, Central, etc. The randomized controlled trials (RCT) were chosen based on the inclusion and exclusion criteria. Meta-analysis was performed using Stata 11.0 software. Results A total of 1 847 patients from 9 ramdomized controlled trial (RCT) were included, of which 998 were test cases and 849 were control cases. The meta-analysis results showed that the total effective rate of liver function improvement was higher in bicyclol group than that in control group(RR=1.277,95% CI:1.082-1.506,P=0.004). What's more, subgroup analysis showed that the total effective rate of the improvement of liver function within 2 weeks in the experimental group was better than that in control group (RR=1.224,95% CI:1.128-1.329,I²=0.0%,P=0.579); the total effective rate of the improvement of liver function within 4 weeks in the test group was significantly higher than that in control group (RR=1.337,95% CI:0.862-2.074,I²=97.4%,P<0.001). Finally, there was no significant difference between two groups in side effect (RR=0.921,95% CI:0.483-1.938,P=0.828). Conclusions Bicyclol is effective in improving liver injury induced by anti-tuberculosis drugs in tuberculosis (TB) patients.

Comparative effectiveness of oral pharmacotherapy in the treatment of osteoarthritis:network Meta-analysis

ZHU Xiao-yue, SHEN Jun-jie, SANG Ling-li, JIANG Li-ying

2018, 22(4): 396-401. doi: 10.16462/j.cnki.zhjbkz.2018.04.017

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Objective To compare the efficacy and adverse effect of acetaminophen, celecoxib, glucosamine, chondroitin sulfate, and combination of glucosamine and chondroitin sulfate on the treatment of osteoarthritis. Methods We systematically searched all potential studies published from the inception to October 2017 in electronic database that were randomized control trials design. Bayesian network Meta-analysis and traditional Meta-analysis were used to evaluate and compare the efficacy and safety of these treatments. Results We identified 58 papers that contained 61 randomized controlled trials, including 25 045 patients. Network Meta-analysis demonstrated that celecoxib was significantly superior to other treatments on pain relief (SMD=-0.32,95% CI:-0.38--0.25), followed by the symptomatic slow-acting drugs. For physical function improvement, all interventions were significantly superior to oral placebo except acetaminophen (SMD=-0.14,95% CI:-0.27-0.01). In terms of stiffness, glucosamine (SMD=-0.36,95% CI:-0.67--0.06) and celecoxib (SMD=-0.29,95% CI:-0.51--0.08) outperformed than placebo. Although celecoxib had significant efficacy, it was accused of an increased risk adverse events. Symptomatic slow-acting drugs had shown a significant treatment effect accompanied with remarkable safety. Acetaminophen seemed to be the least efficacious intervention option and the most adverse events. Conclusions Given the effectiveness of these Non-steroidal anti-inflammatory drugs and symptomatic slow-acting drugs, oral celecoxib is significantly superior to other treatments on relieving pain, but it has relatively high incidence rate of adverse effect. Symptomatic slow-acting drugs also performs relatively superb efficacy and has relatively low incidence rate of adverse effect.

Investigation of clinical characteristics and prognosis of severe fever with thrombocytopenia syndrome:69 cases analysis

YANG Min, YE Jun, LI Hui, HUA Tian-feng, ZHENG Yao, LI Jun

2018, 22(4): 402-405. doi: 10.16462/j.cnki.zhjbkz.2018.04.018

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Objective To investigate the clinical characteristics and prognostic factors of severe fever with thrombocytopenia syndrome (SFTS) patients from the Second Affiliated Hospital of Anhui Medical University. Methods Clinical data of SFTS patients from January 2012 to September 2016 were reviewed and compared. According to prognosis, all cases were divided into survival group and death group. The clinical characteristics and prognostic factors of SFTS patients were analyzed. Results A total of 69 SFTS patients were included with 49 cases in survival group and 20 cases in death group. The case fatality rate was 28.99%. The advanced age and symptoms of respiratory system, gastrointestinal system, neurological system and hemorrhage in death group were significantly higher than that in survival group (all P<0.05). There were significant differences between the two groups in neutrophil count, platelet count, aspartate transaminase (AST), MB isoenzyme of creatine kinase (CKMB), and lactate dehydrogenase (LDH) (all P<0.05). The sequential organ failure assessment (SOFA) in death group was significantly higher than that in the survival group (Z=-6.495,P<0.001). Multiple factor Logistic regression analysis showed that the independent prognostic factors included neurological system symptoms and hemorrhage. Conclusions The level of neutrophil count, platelet count, serum creatinine, AST, CKMB and LDH are associated with the prognosis of SFTS. The independent prognostic factors are neurological system symptoms and hemorrhage. SOFA should be recommended during the evaluation and treatment of SFTS patients.

The status and influencing factors of hand hygiene compliance among kindergarten teachers in Shenzhen City

PENG Xiao-dong, HOU Wan-li, ZHOU Yan, XIONG Tian-tian, ZHANG Zhen, XIE Xu, CHENG Jin-quan, ZHAO Zhi-guang

2018, 22(4): 406-410. doi: 10.16462/j.cnki.zhjbkz.2018.04.019

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Abstract:
Objective To investigate the hand hygiene (HH) behavior of kindergarten teachers, and evaluate the intervention effects based on compliance. Methods Stratified cluster random sampling technique was performed in this study. 18 kindergartens were selected from two districts in Shenzhen city, and were then randomly assigned to either intervention group (12 kindergartens) or control group (6 kindergartens). Hand hygiene products, kick off activity, health education materials and health education session were main interventions. Teacher's HH compliance was observed before and one, three, and six months after the intervention, and self-reported questionnaires of HH compliance were completed before and after intervention. Then the intervention effectiveness was evaluated by comparing the HH compliance of intervention group and control group. Results Before the implementation of intervention, observed HH compliance of teachers was 10.4% (23/222), and the self-reported compliance was 9.4±1.5 (scale 0-10). Self-reported HH compliance of intervention group increased from 9.21 to 9.65 after the intervention (Z=-1.951, P=0.051),but the difference of control group had no statistical significance before and after the intervention (Z=-1.531, P=0.126). There was no signifiant difference in observed HH compliance between intervention group and control group before intervention (OR=0.43, 95% CI:0.18-1.02), and observed HH compliance in the intervention group was significantly higher after intervention than that in the control group (OR=11.53, 95% CI:5.71-23.30). Conclusions HH compliance of teachers increased due to the multiple interventions, so dissemination of intervention can be performed in kindergartens in Shenzhen, China.

Characteristics and measurement of physical fitness in older adults

CUI Yi-ke, XIAO Hui, LAI Yu-qing, CHEN Jing-hua, HUANG He-lang, WU Lei

2018, 22(4): 411-415. doi: 10.16462/j.cnki.zhjbkz.2018.04.020

Abstract(540)

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Abstract:
The problems related to an aging population have been exacerbated and are becoming more serious in China. The elder commonly suffer from chronic diseases which result in not only negative effects on their health conditions and the quality of life, but also heavy financial burdens to both family and society. Physical fitness assessment plays an important role in early identification of factors influencing health. Although considerable improvement has been made, indexes and indicators of physical assessment for the elderly still need to be elucidated. In this review, we discussed different methods used for the measurement of physical conditions among China's aged population. Our object is to provide scientific basis for predicting, preventing chronic diseases among the aged population and guiding actions on ageing in China.

Epidemiology of public health emergencies in Shaanxi Province from 2004 to 2016

WANG Shu, ZHANG Yi, ZHANG Zhi-cheng, CHEN Sa, CAO Lei, ZHOU Ti-cao, WANG Wei-hua, NING Shao-qi

2018, 22(4): 416-418. doi: 10.16462/j.cnki.zhjbkz.2018.04.021

Abstract(314)

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Abstract:

Analysis on main death causes and life lost of residents' injury in Suzhou City from 1987 to 2016

HUANG Chun-yan, DENG Yao, WANG Lin-chi, LU Yan, HUANG Qiao-liang, HU Yi-he, LV Da-bing, WANG Hai-tao

2018, 22(4): 419-421. doi: 10.16462/j.cnki.zhjbkz.2018.04.022

Abstract(261)

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Abstract:

The relationship between daily average temperature and non-accidental mortality in Hefei City from 2007 to 2016

TANG Jing, XIAO Chang-chun, ZHANG Jun-qing, GENG Xi-ya, CUI Long-jiang, ZHAI Jin-xia

2018, 22(4): 422-425. doi: 10.16462/j.cnki.zhjbkz.2018.04.023

Abstract(366)

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Abstract:

Clinical effect of combination therapy with entecavir and RuanGanHuaJian granule in patients with hepatitis B virus infection-related fibrosis

YAN Hui-min, LV Ying, LV Zhuo, CUI Mei-lan, LIU Wen-xuan, LI Man, YANG Lei, LIU Dian-wu

2018, 22(4): 426-428. doi: 10.16462/j.cnki.zhjbkz.2018.04.024

Abstract(401)

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Abstract:

2018, 22(4): 429-430. doi: 10.16462/j.cnki.zhjbkz.2018.04.025

Abstract(299)

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Abstract:

The morden epidemiologist with classical medical ideas: Willian Budd

ZHANG Ming-yue, QIAN Liu-yu, WU Jun, YE Dong-qing

2018, 22(4): 431-433. doi: 10.16462/j.cnki.zhjbkz.2018.04.026

Abstract(365)

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Abstract:
William Budd (1811-1880) was one of the most famous British epidemiologists in the 19th century and wrote many articles on the prevention and control of infectious diseases. His main contributions are to clarify that some epidemics are contagious, such as typhoid, cholera, burdock, scarlet fever, tuberculosis, etc. and put forward Ihe way for spreading and prevention strategies of these epidemics, especially typhoid fever and cholera. Those works have made him one of the pioneers of epidemiology and laid the foundation for the development of modern epidemiological microbiological theory.

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2018 Vol. 22, No. 4

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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