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CN 34-1304/R ISSN 1674-3679

2019 Vol. 23, No. 10

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Paying a Tribute to 70 years’ Development of Healthcare
The history, present and prospect of cancer prevention and control in China
WEI Wen-qiang, SHEN Hong-bing
2019, 23(10): 1165-1168, 1180. doi: 10.16462/j.cnki.zhjbkz.2019.10.001
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Cancer is a major chronic disease that seriously harms human health. Cancer prevention and control has become one of the priorities of health strategy for governments around the world. We have gradually explored the way of cancer prevention and control in China and produced many research achievements with Chinese characteristics since the 1950s, which has a major impact in cancer prevention and control in the world. This paper systematically reviewed the major historical events of cancer prevention and control in China since the foundation of the People's Republic of China, and introduced the current situation of cancer prevention and control in modern era, and pointed out the prospect of future work.
Prior development of occupational health for healthy China
CHEN Wei-hong, WU Tang-chun
2019, 23(10): 1169-1172. doi: 10.16462/j.cnki.zhjbkz.2019.10.002
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Since the founding of the People's Republic of China in the past 70 years, occupational health in China has gradually established its distinctive occupational health regulations, personnel training system, scientific research and work models, and has achieved considerable development and progress. This paper reviews the establishment and development of occupational health, affirms the achievements, presents the current problems and looks to the future. Prior development of occupational health will make greater contributions to the implementation of a healthy China strategy and coordinated economic and social development.
Progress and prospect of injury prevention and control in China
WANG Sheng-yong
2019, 23(10): 1173-1175. doi: 10.16462/j.cnki.zhjbkz.2019.10.003
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After a quarter of a century of exploration and practice, injury prevention and control in China has rapidly caught up with the pace of developed countries and formed an injury control mode with Chinese characteristics: there are injury control institutions and professional teams, injury research centers in universities, injury prevention and control professional committees and six specialized committees, eight National Academic Conferences were held, a number of injury monographs and the journal of Injury Medicine were published. A second spring of injury prevention and control in China is coming by the strategic plan for Healthy China deploied at the 19th National Congress of the Communist Party of China (CPC) and the plan for 'Healthy China' released from the CPC central committee and the State Council in October 2016.
New China's public health practice has been brilliant for 70 years
WU Jun, YE Dong-qing
2019, 23(10): 1176-1180. doi: 10.16462/j.cnki.zhjbkz.2019.10.004
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Strive for 70 years, strive for a new era. Under the leadership of the Communist Party of China, China's public health adheres to the System of Socialism with Chinese Characteristics, and always implements the policy of putting prevention first. Since the founding of the People's Republic of China, after the reform and opening up, a public health system with a combination of epidemic prevention and disease prevention with Chinese characteristics has been established, and a public health undertaking with Chinese characteristics has been created. Especially since the 18th National Congress of the Communist Party of China, China's public health has spurred the slogan of "Implementing a Healthy China Strategy" in the new era, and fully promoted the "the Plan for Health China 2030" to lay a solid foundation for the Chinese dream of realizing the great rejuvenation of the Chinese nation.
Behavioral Health
Depression status and influencing factors of empty-nest elderly based on structural equation model
XUE Ya-qing, ZHANG Chi-chen, ZHAO Hui-ning, ZHENG Xiao, CAI Yuan
2019, 23(10): 1181-1185. doi: 10.16462/j.cnki.zhjbkz.2019.10.005
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  Objective   To clarify the depression status of empty-nest elderly in Shanxi Province, to explore the related influencing factors by structural equation model, and to provide scientific basis for the prevention and intervention of depression for empty nesters.   Methods   A questionnaire survey was conducted among 4 901 empty-nest elderly in Shanxi Province by self-rating depression scale and general situation questionnaire, and the model was established.   Results   The prevalence of depressive symptoms among empty nesters in Shanxi Province was 64.21%. The model demonstrated that health status had a direct impact on depressive symptoms (P=0.028), the total effect was -0.978; the effect of economic status on depressive symptoms was 0.086 (P=0.030), and social function had no significant impact on depressive symptoms (P=0.173), which could affect depressive symptoms through affecting health status and economic status. There was a significant correlation between the three latent variables (P < 0.05). Health status had the strongest correlation with social function (r=0.942), followed by economic status (r=0.718), and the correlation between social function and economic status was 0.683.   Conclusions   In this research, most of the empty-nest elderly suffer from depressive symptoms. Health status is the most direct and important influencing factor of depressive symptoms in empty nesters. Social function affects depressive symptoms through influencing health status and economic status.
The study of college students' physical exercise behavior phase and process of change based on the Transtheoretical model
ZHENG Xiao, ZHANG Chi-chen, JIN Zhen-zhen, LU Jiao, HOU Li-hong, LI Mi-mi, XUE Ya-qing, CAI Yuan
2019, 23(10): 1186-1190, 1223. doi: 10.16462/j.cnki.zhjbkz.2019.10.006
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  Objective  To analyze the stage characteristics in the exercise behavior improvement of college students and explore the role of Process in the exercise behavior change based on the transtheoretical model, providing basis for the stage-matched intervention for the exercise behavior of college students.  Methods  There were 932 students who completed the questionnaires, from 5 universities in Shanxi Province were selected by using a stratified random cluster sampling method. Descriptive analysis was used to describe the exercise behavior of college students. Variance analysis and multivariate Logistic regression model were used to analyze the difference of the process of with stage of change among college students' physical exercise. Multivariate variance analysis was used to analyze how personal characteristics affect process of change.  Results  Among all participants, 89.4% students knew the importance of physical exercise, and 29.4% students were satisfied with their physical exercise condition. The distribution of students' physical exercise stage showed an inverted U-shape with left-side peak, and there was a significant difference between gender(χ2=54.657, P < 0.001). There were significant stage characteristics in the process of students' exercise behavior, gender had a significant main effects on mutual aid relation(F=7.400, P=0.07)and conscious control (F=7.778, P=0.005), gender and grade had interaction effects on social release (F=3.614, P=0.013).  Conclusions  The college students' exercise behavior showed the characteristics of "knowing but not to do", which conformed to the Transtheoretical model. It is essential to develop targeted phased exercise intervention strategies according to the relationship between change of phase and change of procedure.
A comparative study on safe sexual behavior and its intention among college students in Beijing between 2006 and 2016
CUI Jing-chen, ZHANG Xin, CHANG Chun, SUN Xin-ying, FAN Xin-yi, SHI Yu-hui
2019, 23(10): 1191-1195. doi: 10.16462/j.cnki.zhjbkz.2019.10.007
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  Objective  To compare the changes of safe sexual behavior and its intention among college students in Beijing between 2006 and 2016, and to provide evidence for reproductive health education for prevention and control of sexually transmitted diseases (STDs).  Methods  By a stratified random sampling method, a questionnaire survey was conducted among college students in Beijing in 2006 and 2016 respectively.  Results  The rate of sexual behaviors declined (χ2=81.150, P < 0.001), while the percentage of homosexual behavior among respondents in 2016 was higher than that in 2006(χ2=12.115, P < 0.001). Meanwhile, the age of first sexual intercourse (t=12.009, P < 0.001) and the intention of safe sexual behavior declined(χ2=10.375, P < 0.001). In both surveys, the proportion of risk behaviors among students who ever had sexual behavior was higher than that of students never had sexual behavior. Multivariate linear regression analysis showed that the intention of safe sexual behavior among college students was associated with gender, age, self-efficacy of condom use, UNGASS index, visiting entertainment places and browsing pornographic information on the Internet(all P < 0.05).  Conclusions  Compared with 2006, the safe sexualbehavior, intention and their risk factors among college students in Beijing changed greatly in 2016. The contents and approaches of intervention related to STDs and reproductive health should be changed according to the current situation in order to improve the intention of safe sexual behavior among college students and to control the occurrence of STDs.
The association of sedentary lifestyles with cardiometabolic risk factors in children in Guangzhou
LU Shao-min, CAI Li, YANG Jie-wen, TAN Wei-qing, CHEN Ya-jun
2019, 23(10): 1196-1201. doi: 10.16462/j.cnki.zhjbkz.2019.10.008
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  Objective  To evaluate sedentary lifestyles after school in children aged 7 to 12 year-old living in Guangzhou, and to explore the association between sedentary behaviors after school with cardiometabolic risk factors.  Methods  Using the method of stratified cluster random sampling, this study recruited 7 to 12 year-old primary students (n=4 294) in Guangzhou. The physical examination and questionnaire were used to collect the sedentary lifestyles after school and cardiometabolic risk factors, analyzing the impact of different aedentary behavoir time after school on cardiometabolic risk factors.  Results  The average sedentary time after school per day were 194.3 min (boys: 200.3 min; girls: 187.3 min). Inter-quartile ranges of sedentary time after school per day were ≤ 130.0, 131.0-180.0, 181.0-240.0, and ≥ 241.0 min/d. Controlling for confounding factors, the odd ratios (OR) of central obesity, overweight/obesity, high TC status, high TG status and high LDL-C status in the highest compared to the lowest quartile of sedentary time after school per day were 1.39 (95%CI: 1.08-1.80), 1.44 (95%CI: 1.16-1.80), 1.26(95%CI: 1.05-1.51), 1.63(95%CI: 1.34-1.98), 1.28(95%CI: 1.06-1.55), respectively.  Conclusions  Sedentary lifestyles have a positive relationship with childhood central obesity, overweight/obesity and dyslipidemia in primary school children. Therefore, it is essential to strengthen the intervention to the lifestyles of teenagers and reduce the sedentary behavior time of children and teenagers.
New perspective in children and adolescents' physical and mental health study: from positive youth development viewpoint
LI Xiao-yan, CAO Juan, LIN Dan-hua
2019, 23(10): 1202-1207. doi: 10.16462/j.cnki.zhjbkz.2019.10.009
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  Objective  Positive youth development (PYD) perspective provides a new paradigm for children and adolescents' physical and mental health research. It emphasizes children and adolescents's strengths and plasticity, as well as the impact of the interaction between individual and environment on children and adoleseents' physical and mental health. This perspective enriches the comprehensive understanding of children and adolescents' physical and mental health, and provides theoretical support and practical guidance for physical and mental health prevention intervention and interdisciplinary research. It also has an important impact on public policy development. The present paper systematically reviewed the theoretical models, empirical research and future prospects regarding the relationship between PYD and children and adolescents' physical and mental health based on the connotation structure and measurement development.
The status and influencing factors of domestic violence against married women in Wenzhou area
CHEN Li, WU Wen-ting, Wang Li-jing, CHEN Zi-heng, PAN Ren, GU Yu-lan, ZOU Yuan-zhi
2019, 23(10): 1208-1212. doi: 10.16462/j.cnki.zhjbkz.2019.10.010
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  Objective  To investigate and analyze the prevalence, patterns and associated factors of domestic violence against married women in Wenzhou area.  Methods  a total of 705 married women took part in this cross-sectional study conducted in 2018. Conflict Tactics Scales and several short demographic questions were used in this study to collect basic information and the occurence of domestic violence within 12 months.  Results  Nearly 40% of married women experienced at least one incident of domestic violence during the past 12 months. 33.8% of respondents experiencing one episode of psychological violence in the past 12 months, followed by 19.5% experienced physical violence and 14.9%of sexual violence. The joint occurrence of multiple forms of violence was the most commonly reported features experiencing domestic violence. Some individual (education and Hukou), marital relationship (marital satisfaction, duration of marriage, marital autonomy marital models) and family (family model and sex roles) factors of the respondents, were negatively or positively associated with domestic violence against married women.  Conclusion  The results indicated that there was a high rate of domestic violence among married women in Wenzhou area. Accordingly, there is an obvious need of intervention and treatment activities to prevent and reduce the occurrence of domestic violence among the married women.
Original Articles
The effect of maternal food consumption during pregnancy on infantile eczema: a cohort study
YE Pei-qi, WU Wei-jia, WAN Nian-qing, TAN Min-yi, TANG Nu, CHEN Yu-ming, CHEN Ya-jun, JING Jin, CAI Li
2019, 23(10): 1213-1218. doi: 10.16462/j.cnki.zhjbkz.2019.10.011
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  Objective  To investigate the association between maternal food group intakes during pregnancy and the risk of infantile eczema in a Chinese population.  Methods  A prospective birth cohort study was conducted and 523 women were recruited at 20-28 weeks of pregnancy in Guangzhou from 2017 to 2018. A validated 81-item quantitative food frequency questionnaire was used to assess maternal dietary intakes during the past month. Food items were divided into ten food groups according to the Chinese Dietary Guidelines. Offspring were followed up at 6 months by the symptom questionnaire of eczema. Multivariate Logistic regression model was conducted to evaluate the association between maternal food group intakes during pregnancy and the risk of infantile eczema.  Results  The cumulative incidence of eczema at 6 months was 51.8%. Maternal consumption of poultry was higher in the eczema group (27.62±25.20 g/d) than the control group (22.03±22.63 g/d, P=0.022). Comparing to the lowest quantile (Q1), higher maternal intake of poultry (Q4) and fish (Q3) were significantly associated with an increased risk of infantile eczema (OR=2.71, 95% CI=1.24-4.81; OR=2.38, 95% CI=1.23-4.59, respectively) after multivariate adjustment.  Conclusion  Higher intakes of poultry or fish during pregnancy were associated with an increased risk of infantile eczema in Chinese population.
Anemia prevalence and its influencing factors for the infants aged 6-23 months in poor areas in Gansu Province
LI Fu-yun, GUO Jin-xian, WANG Cheng, HUANG Kui-kui, LIU Xu-dong, WANG Meng, FANG Xiang, YANG Lan
2019, 23(10): 1219-1223. doi: 10.16462/j.cnki.zhjbkz.2019.10.012
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  Objective  To understand the prevalence of anemia and its influencing factors in infants aged 6 to 24 months in poor areas of Gansu Province, and to provide reference for improving the prevalence of anemia in local children.  Methods  A multi-stage sampling method was used to conduct a survey on infant and caregivers, in the 12 children nutrition improvement project counties in Gansu Province. T-test and analysis of variance were used to compare the hemoglobin content, the chi-square test was used to compare the prevalence of anemia, and the Logistic regression model was used to analyze the influencing factors.  Results  Among the 3 188 effective data, the detection rate of anemia was 25.69% (819). The detection rate of anemia among boys and girls was 24.54% and 26.90%, respectively. There was no significant difference in the detection rate of anemia among different sexes (χ2=2.326, P=0.127). The detection rate of anemia between different age groups were statistically significant (χ2=42.339, P < 0.001); The results of multivariate analysis showed that children's age, children's ethnic groups, parents' awareness of feeding knowledge, the feeding method of 6 months after birth and the way of taking nutritional packs were associated with anemia (all P < 0.05).  Conclusions  The prevalence of anemia in infants aged 6 to 24 months in poor areas in Gansu Province was relatively high. Strengthening the education of caretakers' knowledge of guardian feeding and scientific child-rearing, and ensuring the nutrition packages intake can significantly reduce the prevalence of anemia prevalence in poor areas in Gansu Province.
Vitamin D status and determinants among children aged 6 to 23 months in 4 poverty-stricken ethnic minority areas of Yunnan Province
LI Yan-hong, ZHANG Xian, LI Yan, ZHAO Meng-ru, ZHAO Lin, LI Lin-xia
2019, 23(10): 1224-1229. doi: 10.16462/j.cnki.zhjbkz.2019.10.013
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  Objective  To investigate the vitamin D (VD) level and determinants among young children aged 6 to 23 months in 4 poverty-stricken ethnic minority areas of Yunnan Province.  Methods  Multistage stratified cluster sampling method was used. 1 255 young children aged 6-23 months from 3 to 4 towns of Jianchuan County, Yiliang County, Mojiang County and Lushui County. Questionnaires on caregivers, physical and serum 25(OH)D measure were achieved. VD level and influencing factors were described and analyzed.  Results  Overall VD level was 20.6(16.3, 25.4) ng/ml. The proportion of VD deficiency, VD insufficiency and VD sufficiency were 7.1%, 39.2% and 53.7% respectively. The risk of VD insufficiency elevated with children'age increasing or no VD supplement (P < 0.05). Hani minority can decrease the risk of VD deficiency and insufficiency (all P < 0.05). Thus, the risk of VD deficiency and insufficiency in children of female, Lisu or Bai minority, or in children who had no nutritional package supplement would increase (all P < 0.05).  Conclusions  The VD level of children aged 6-23 months in poverty-stricken ethnic minority areas of Yunnan Province was low. VD insufficiency was dominating. The intervention of VD deficiency and insufficiency may focus on the children of female, Lisu minority, Bai minority or older than 18 months. This study highlight that enhancing caregivers' knowledge of VD nutrition, adding VD and nutritional package supplement actively are beneficial to improve VD nutrition of young children in minority poverty areas of Yunnan.
Relationship between self-reported chronic disease and smoking behavior in men aged 18 to 69 in Jiangsu Province
GUAN Fang, QIN Yu, SU Jian, LV Shu-rong, PAN Xiao-qun, TAO Ran, ZHOU Jin-yi, WU Ming
2019, 23(10): 1230-1233, 1239. doi: 10.16462/j.cnki.zhjbkz.2019.10.014
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  Objective  To explore the relationship between self-reported chronic disease and smoking behavior among adult males in Jiangsu Province.  Methods  In 2007, 2010, and 2013 respectively, a multistage stratified cluster sampling method was used to select residents from 14 adult chronic diseases and their risk factor surveillance sites in Jiangsu Province to investigate the relationship between the prevalence of chronic diseases, smoking and smoking cessation behaviors among men aged 18 to 69 years.  Results  A total of 8 313 men aged 18 to 69 years had a self-reported prevalence of 1.5%, 1.1%, 1.5%, and 2.8% for cardiovascular and cerebrovascular diseases, malignancies, asthma, and chronic obstructive pulmonary disease (COPD), respectively.The self-reported prevalence of all four chronic diseases was higher in ex-smokers than in current smokers and non-smokers (all P < 0.05).Multivariate analysis showed that the quit rate was of those suffering from cardiovascular and cerebrovascular diseases, malignancies, asthma, and COPD, respectively 3.356 times (95% CI: 1.966-5.728), 3.864 times (95% CI: 2.277-6.555), 2.103 times (95% CI: 1.321-3.345), and 2.586 times (95% CI: 1.872-3.573) higher, than those without.  Conclusion  Smoking cessation rates were significantly higher of those with chronic disease than those without, suggesting that illness would promote smoking cessation behaviors among smokers.
Study on alzheimer's disease-related behavior of residents in Ma'anshan City by PRECEDE-PROCEED model
CHIN Mei-ting, ZHAO Yi-ru, TANG Qi-qiang
2019, 23(10): 1234-1239. doi: 10.16462/j.cnki.zhjbkz.2019.10.015
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  Objective  In order to study the behaviors of Ma'anshan residents on alzheimer's disease (AD), by using the three factors of PRECEDE-PROCEED model, this paper analyzed their correlation with behaviors, explored the influence of three factors on AD related behavior.  Methods  The study used snowball sampling method to conduct questionnaire survey, 761 valid questionnaires were collected in total. SPSS 21.0 software was applied to analyze the data, and AMOS 21.0 modeling was used to analyse the predisposing factors and behaviors, structural equation model (SEM) was used to analyze the correlation. Spearman and Pearson were used to analyze the relativity among enabling factors, reinforcing factors and the behaviors.  Results  It was found that about predisposing factors, attitude affected behavior with a general influence coefficient of 0.562, and knowledge had an indirect effect on behavior with an influence coefficient of 0.243. Among the enabling factors, medical quality (r=-0.073, P=0.045), hierarchical medical treatment (r=0.146, P < 0.001) and policy support on elderly diseases (r=0.099, P=0.006) were all correlated with behaviors. The self-health assessment (r=0.110, P=0.002) of reinforcing factors, the frequency of obtaining AD related information through organization health communication (r=0.191, P=0.035) or mass health communication (r=0.115, P=0.011) channels and the frequency of elderly health issue transmission in interpersonal health communication (r=0.274, P < 0.001) or organization health communication (r=0.177, P < 0.001), which were positively correlated with behaviors.  Conclusions  It is conducive to promote people's positive behaviors toward AD through health communication sharing on AD and other elderly diseases, the improvement of local medical conditions, the implementation of hierarchical medical treatment and the formulation of relevant policies of elderly diseases.
Preoperative albumin-globulin ratio and prognosis of patients with esophageal squamous cell carcinoma
WANG Jing-wen, LIN Zheng, LIU Shuang, YANG Hui-min, XIE Qian-wen, CHEN Hui-lin, CHEN Yuan-mei, HU Zhi-jian
2019, 23(10): 1240-1245. doi: 10.16462/j.cnki.zhjbkz.2019.10.016
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  Objective  To investigate the relationship between albumin/globulin ratio (AGR) and postoperative survival among patients with esophageal squamous cell carcinoma(ESCC) undergoing radical oesophagectomy, to establish an effective prognostic nomogram for ESCC and to provide a reference for prognosis prediction of ESCC.  Methods  From February 2014 to September 2017, 390 ESCC patients who underwent surgery were retrospectively enrolled from the tumor hospital in Fujian Province. The receiver operating characteristic curves(ROC) were applied to establish optimal cutoff points. Chi-square test was used to estimate the relationship between the AGR and the clinical features. Cox proportional hazards model was used to estimate the HR and 95% CI for the associations between AGR and Prognosis of ESCC patients. A nomogram model was established to predict the outcome of ESCC patients.  Results  The ROC demonstrated the best cutoff value for AGR was 1.16. A total of 356 patients were recruited in the final analysis, who were divided into the high AGR group (≥ 1.16) and the low AGR group (< 1.16) by the best cutoff value. Both 1-year and 3-year survival rates in the high AGR group were higher than those detected in the low AGR group(all P < 0.05). Multivariate analysis showed that the T stage, N stage, and AGR were independent prognostic factors of overall survival(all P < 0.05). The HR of T stage was 1.87 (T3-T4 vs T1-T2, 95% CI: 1.04-3.35); The HR of N stage was1.89 (N+ vs N0, 95% CI: 1.13-3.17); The HR of AGR was 0.57(the high AGR group vs the low AGR group, 95%CI: 0.36-0.90). The concordance index(C-index) of the nomogram to predict overall survival was 0.68 (95% CI: 0.62-0.73, P < 0. 001).  Conclusions  The AGR was an independent prognosis factor for operated ESCC patients. The prognosis of ESCC in the high AGR group was better than that in the low AGR group and the prognostic nomogram provides individualized risk estimate of survival in ESCC patients after surgery.
Analysis on status and disease burden of injury deaths in Guangxi from 2014 to 2015
QIN Qiu-lan, MAO Wei, MENG Jun
2019, 23(10): 1246-1249, 1278. doi: 10.16462/j.cnki.zhjbkz.2019.10.017
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  Objective  To analyze the death and disease burden of injury in Guangxi from 2014 to 2016, so as to provide scientific basis for making policy strategies on injury prevention.  Methods  Datas from the Death Monitoring Network in Guangxi from 2014 to 2016 were analyzed. Descriptive statistics and Chi square were used to describe the mortalities. The potential years of life lost (YPLL) and average years of potential life lost(AYPLL) were assessed.  Results  A total of 29 288 deaths were reported in Guangxi. The mortality rate was 42.77/100 000. The overall mortality rate decreased over the past three years. Traffic accident, accidental fall, drowning, suicide and sequela, accidental poisoning were the top five causes of injury deaths. The leading cause of injury death in the 0 to 14 age group was drowning, traffic accident in the 15 to 64 age group and accidental fall in the 65 years old and above group. The AYPLL was 29.11 years and, which was higher in male than in female and there was no significant difference between urban and rural. Suicide and sequela had become the biggest average disease burden.  Conclusions  The average mortality rate decreased in Guangxi from 2014 to 2016. It is necessary to take effective measures to prevent and control injury.
Time series analysis and spatial autocorrelation analysis of dengue data in China from 2011 to 2018
YANG Hui-xin, ZHAO Chen-hao, LUO Jing-jing, HU Fang-fang, ZHANG Si-wen, WANG Tai-jun, ZHEN Qing
2019, 23(10): 1250-1254. doi: 10.16462/j.cnki.zhjbkz.2019.10.018
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  Objective  To understand the spatial and temporal distribution characteristics of dengue fever in China from 2011 to 2018, and predict the incidence of dengue fever in China in 2019.  Methods  Based on the case data of dengue fever in China from 2011 to 2018 in the Chinese Disease Prevention and Control Information System, the trend of dengue fever was described and predicted by using the autoregressive integrated moving average model (ARIMA) with R 3.6.0 software. Based on the data of the incidence of dengue fever in the country, provinces and cities from 2011 to 2016 provided by the national scientific data sharing platform for population and health, global and local spatial autocorrelation analysis was performed using GeoDa 1.12 software to determine the dengue fever hotspots.  Results  The incidence of dengue fever was 14 302 in 2019, showing no disease outbreaks. The incidence of dengue fever in 2012(Moran's I=-0.088, P=0.037), 2013(Moran's I=-0.121, P=0.040) and 2014(Moran's I=-0.076, P=0.045) showed a global spatial negatively correlaton. In 2016(Moran's I=0.078, P=0.048), the incidence of dengue fever was positively correlated with global space. The results of local autocorrelation analysis showed that the high incidence of dengue fever was mainly in the southeast coastal areas of China.  Conclusions  In 2019, the epidemic of dengue fever in China showed no obvious fluctuation trend, and the epidemic situation showed spatial clustering distribution.
A study on epidemic model of hepatitis B virus in migrant workes in Guizhou minority areas
SONG Wen-jun, HUANG Wen-yong, YANG Jing-yuan, JIANG Zhi-yue, WANG Jun-hua, GUAN Zhi-zhong
2019, 23(10): 1255-1259. doi: 10.16462/j.cnki.zhjbkz.2019.10.019
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  Objective  To research the prevalence model of hepatitis B virus in the minority areas of Guizhou and to provide reference for the prevention and control virus of hepatitis B virus.  Methods  Using multi-stage cluster simple random sampling, four villages were selected from Leishan and Libo counties in minority areas of Guizhou. Questionnaires were investigated by trained investigators and serum hepatitis B virus five-item test results were collected from the subjects.  Results  A total of 1 629 participants were surveyed, the outcome showed that migrant workers' infection rate of hepatitis B was 44.8%, and the carrying rate of HBsAg was 8.4%. The positive rates of anti-HBs and anti-HBc were 28.0% and 25.6% respectively. The infection model rate of migrant workers was 19.8%, which was lower than that of non-migrant workers (23.2%) (P>0.05).The detection rate of susceptible model in migrant workers (52.2%) was higher than that in non-migrant workers (43.4%), while the detection rate of immune mode migrant workers (28.0%) was lower than that in non-migrant workers (33.4%), which the difference was statistically significant (all P < 0.05). After adjusted related factors by multivariate Logistic regression analysis model, migrant workers were still the influencing factors of vulnerability model (OR=1.568, 95% CI: 1.206-2.039) compared with non-migrant workers.  Conclusion  There was a high susceptibility to hepatitis B virus among migrant workers in minority areas of Guizhou, In order to reduce the infection and prevalence of hepatitis B virus, we should strengthen the immunization of hepatitis B vaccine to migrant workers and to improve their specific immunity.
Characteristic of sexual behavior and their associated factors among male and female partners of men who have sex with men
DAI Se-ying, CHENG Xiao-li, LIU Ai-wen, XIAO Yong-kang, SU Bin
2019, 23(10): 1260-1264. doi: 10.16462/j.cnki.zhjbkz.2019.10.020
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  Objective  To understand the characteristic of sexual behavior and their associated factors among male and female partners of men who have sex with men in Anhui province.  Methods  Cross-sectional studies were conducted among MSM in Hefei, Wuhu and Liuan in Anhui province. MSM were recruited through "snowball sampling" and "internet-based recruiting", and eligible participant received an anonymous survey. Multivariate Logistic regression analysis model was used to identify risk factors associated with having sex with women in the last 6 months among MSM.  Results  Of the 1 200 MSM interviewed, 78.3% had anal sex with men, and 20.9% had vaginal intercourse with women, and 16.5% had sexual intercourse with both men and women in the past 6 months. Less MSM reported using condom every time with women (29.9%) in the past 6 months than with men (53.0%), and less reported using condom with women (52.2%) during the last sexual intercourse than with men(79.6%) (all P < 0.05). The results of mutivariate Logistic regression analysis showed that MSM who were married(including currently married/cohabitating/divorced/widowed), lived more than 2 years in the surveyed city, and had commercial sex with men were more likely to have sex with women.  Conclusions  There was a high proportion of bisexual behavior and low rate of condom use among MSM. It should strengthen the sexual health education, risk perception education and behavioral intervention among MSM.
rs12252 polymorphism of IFITM3 gene and influenza susceptibility in Chinese population: a study-based sequential Meta-analysis
ZHANG Tian-chen, LIU Xiao-qing, PAN Huan-hong, ZHAO Yu-qin
2019, 23(10): 1265-1272. doi: 10.16462/j.cnki.zhjbkz.2019.10.021
Abstract(382) HTML (191) PDF(31)
Abstract:
  Objective  To systematically and quantitatively evaluate the relationship of rs12252 polymorphism in IFITM3 gene and susceptibility to influenza in Chinese population.  Methods  The databases of Medline, PubMed, Embase, Web of Science, China National knowledge infrastructure (CNKI), Wanfang and VIP were searched to retrieve the articles which focused on the topic of relationship between the rs12252 polymorphism and susceptibility to influenza in Chinese population. Meta-analysis method was used to comprehensively and quantitatively analyze the enrolled articles.  Results  Seven papers with a total of 919 influenza cases were involved in this article. Influenza virus involved influenza A (H7N9, H1N1 pmd09, H3N2) and influenza B. Study-based sequential meta-analysis of the study showed that the total sample size of this study have achieved the required sample size to obtain stable positive results. The results of this meta-analysis showed that the rs12252 polymorphism was associated with susceptibility to influenza in Chinese population and that the rs12252C polymorphism in IFITM3 gene was more susceptible to have influenza in Chinese people (C vs T: OR=1.67, 95% CI: 1.45-1.92; CC vs TT: OR=2.61, 95% CI: 1.97-3.46; TC vs TT: OR=1.55, 95% CI: 1.20-2.00; CC vs TC+TT: OR=2.01, 95% CI: 1.49-2.72; CC+TC vs TT: OR=8.90, 95% CI: 4.94-16.06).  Conclusion  the rs12252 polymorphism of IFITM3 gene was a risk factor for influenza in Chinese population.
The analysis of Human Papillomavirus infection and subtype distribution in 8 744 females in Anhui Province
YE Hong, CHANG Zhong-bao, TONG Lin, YU Juan-ping, ZHANG Shuang, WANG Qian-qian, LI Xiao-hua, XU Qing-hua
2019, 23(10): 1273-1278. doi: 10.16462/j.cnki.zhjbkz.2019.10.022
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Abstract:
  Objective  To investigate the genotypes of Human Papillomavirus (HPV) infection and distribution characteristics of women in Anhui, and to provide reference for HPV molecular epidemiology research and promotion of vaccine in Anhui.  Methods  The flowcytometry fluorescence hybridization method were used to eaxm 8 744 samples of women HPV Subtype.  Results  The high-risk and low-risk infection rate of HPV were 16.10% and 6.38% respectively. The rate of single and multiple subtype were 13.85% and 5.58% respectively. HPV positive detectable rates were higher in HPV16, HPV52 and HPV58, HPV16 was the highest. The defection rate was significantly different among southern, central and northern in Anhui (χ2=13.790, P=0.008). The infection rates of high risk subtype 51 and 56 in northern were higher than those in the other two regions, and the difference was statistically significant (χ2=17.323, P < 0.001; χ2=9.643, P=0.008). Age distribution results showed that the age group with high infection rate was 10-age group (37.50%), 20-age group (23.19%) and ≥ 60 age group (22.16%), and the difference was statistically significant (χ2=61.855, P < 0.001). The infection rates of HPV subtypes in different years were significantly different (χ2=59.479, P < 0.001). The infection rate was the highest in 2015.  Conclusions  The high risk and single genotypes of infection were dominant in Anhui. HPV positive detectable rates were higher in HPV16, HPV52 and HPV58. There was significant difference in different regions (all P < 0.05) and there were some subtypes with higher infection rates. The age distribution of HPV infection showed a trend of high in youngest and oldest group and low in the middle. The infection rate in different years showed a downward trend year by year.
Direct medical expenses and its influencing factors of patients with pulmonary tuberculosis in Wuhan
ZHANG Fan, SHEN Li-jun, LIU Zhao, LIU Yue-hua
2019, 23(10): 1279-1283, 1292. doi: 10.16462/j.cnki.zhjbkz.2019.10.023
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Abstract:
  Objective  To analyze the direct medical expenses and its influencing factors of patients with pulmonary tuberculosis (TB) from 2011 to 2018 in Wuhan, so as to provide references for improving the TB derating policy.  Methods  A total of 1 258 953 medical records were studied, the direct medical expenses and its influencing factors were analyzed by rank sum test, multivariable linear regression and generalized estimated equation.  Results  The average direct medical expense of TB outpatients was 147.51 yuan each time, while that of TB inpatients was 8 849.57 yuan; and the average direct medical expenses of each year was 9 607.01 yuan per person. The average reimbursement ratio for TB outpatients was 6.36%, and 67.56% for inpatients. Analysis on the influencing factors showed that the direct medical expenses were related with patients' age, sex, year, health care insurance, medical institution and whether they had surgery and Chinese traditional medicine or not (all P < 0.01).  Conclusions  The current direct medical expenses of TB inpatients are relatively affordable, but low-income patients and patients still have heavy financial burden. TB treatment cycle is long and the outpatient medical service B also safficient. Improved derating policy is in need.
Evaluation of individualized medication under the guidance of genetic testing in the management of hypertension patients in rural areas
NI Xiao-li, TANG Quan-qi, ZOU Shi-gui, LI Lun-lan, ZHANG Sheng-quan
2019, 23(10): 1284-1288. doi: 10.16462/j.cnki.zhjbkz.2019.10.024
Abstract(311) HTML (174) PDF(33)
Abstract:
  Objective  This study combined genotyping with family doctors' contracting model to assess the application of precision medicine in rural patients with essential hypertension.  Methods  In this study, 209 hypertensive patients from 3 villages in Lujiang County, Hefei City, Anhui Province were selected as subjects and randomly divided into experimental group(n=105) and control group(n=104). The medication regimen of observation group was guided by genetic testing for gene sensitivity to antihypertensive drugs, and the control group was implemented routine pharmacy. All the patients were managed by family doctors. Adverse drug reaction rate, treatment compliance, blood pressure, body mass index (BMI), fasting blood glucose (FBG), cholesterol (TC), and triglycerides (TG) of the two groups were analyzed, respectively, during the 6-month intervention.  Results  After 6-month of intervention, the medication compliance of the experimental group were significantly higher than that of the control group, and the blood pressure and adverse drug reaction rate were significantly lower than that of the control group. After 3 months of intervention, there was no significant decrease in BMI, FBG, TC and TG in the two groups. After 6 months of intervention, the FBG, TC and TG of the experimental group were significantly decreased, while only the FBG value of the control group was significantly decreased. There were no significant changes in body mass index (BMI) values in both groups.  Conclusions  Individualized medication guided by genotyping can improve the treatment compliance, reduce the adverse drug reaction rate, and improve the treatment efficiency of patients with essential hypertension.
Epidemiological characteristics of rabies in Shaanxi Province from 1953 to 2017
CHEN Sa, ZHAO Bin, ZHANG Yi, NING Shao-qi, ZHOU Ti-cao, CAO Lei, LIU Feng
2019, 23(10): 1289-1292. doi: 10.16462/j.cnki.zhjbkz.2019.10.025
Abstract(725) HTML (376) PDF(52)
Abstract:
  Objective  To analyze the epidemiological characteristics of rabies in 1955-2016 and the third epidemic period in shaanxi province, and to provide scientific basis for prevention and control of rabies.  Methods  The historical epidemic data from 1853 to 2003, the rabies surveillance data from Chinese diesase prevention and control information system from 2004 to 2017, and the rabies patient case survey data from 2009 to 2017 were collected to conduct the analysis.  Results  From 1953 to 2017, there were three epidemics of human rabies in Shaanxi Province. In 2009-2017, 270 cases of rabies were reported, and rabies cases occurred every month. Cases were mainly concentrated in Guanzhong and southern Shaanxi, and occasional cases were reported in northern Shaanxi. The male-female ratio is 2.51:1, and the occupational composition was dominated by farmers (84.4%). Injured dogs were mainly domesticated dogs, the ratio of domestic and stray dogs was 13.07:1. The exposure level was mainly grade Ⅲ (84.23%). The wounds of 60% cases were not treated after the injury, and the rabies vaccination rate and immunoglobulin utilization rate were both low.  Conclusions  The public's awareness of the dangers of rabies was still insufficient, so that there was no standard treatment after canine bite, which causes disease. It is necessary to increase the publicity of rabies prevention and control knowledge. The focus should be placed on remote areas and rural areas, and the public should be advocated to take the initiative to use the reimbursement policy for medical treatment.
Short Reports
Epidemiological characteristics of co-infection of hepatitis C virus among newly reported HIV infeced patients in Chinese and Burmese from 2016 to 2017 in Dehong Prefecture of Yunnan Province
WANG Ji-bao, CHEN Xiao-chen, DUAN Xing, WANG Yi-kui, YANG Jin, YANG Tao, YE Run-hua, YANG Yue-cheng, YAO Shi-tang, DUAN Song, HE Na
2019, 23(10): 1293-1296, 1300. doi: 10.16462/j.cnki.zhjbkz.2019.10.026
Abstract(381) HTML (167) PDF(26)
Abstract:
  Objective  To understand the prevalence and epidemiological characteristics of hepatitis C virus (HCV) co-infection among newly reported HIV-infected patients from 2016 to 2017 in Dehong Prefecture of Yunnan Province.  Methods  A cross-sectional survey was conducted to detect HCV antibodies in 2 196 newly reported HIV-infected persons in Dehong Prefecture, Yunnan Province, from 2016 to 2017.  Results  A total of 694 cases(31.6%) were detected antibodies against HCV during HIV-infected persents. The prevalence of HCV co-infection among newly reported HIV-infected patients in Chinese and Burmese was 14.4% (112/780) and 41.1% (582/1 416), respectively. Moreover, the prevalence of HCV co-infection was higher in male, ethnic minorities such as Dai and Jingpo minority, primary school and below and farmers in both Chinese and Burmese. Multivariate Logistic regression model showed that HCV infection was associated with male, Dai minority, HIV infection by injecting drug and famers among Chinese and Burmese reported HIV-infected patients.  Conclusions  The prevalence of HCV co-infection was high among newly reported in Dehong Prefecture of Yunnan Province. Meanwhile, the epidemiological characteristics of HIV/HCV co-infections in Chinese and Burmese are different, thus different prevention and control measures are needed for patients of different nationalities.
Carriage prevalence and drug resistance profile of MRSA and MSSA strains isolated from newborns
WANG Ying-ying, ZHOU Xin, WU Chuan-an, ZHENG Hui-jie, ZHENG Hao-qu, YAO Zhen-jiang
2019, 23(10): 1297-1300. doi: 10.16462/j.cnki.zhjbkz.2019.10.027
Abstract(529) HTML (218) PDF(25)
Abstract:
  Objective  To determine the carriage prevalence and antibiotics resistance profile of methicillin-resistant staphylococcus aureus(MRSA) and methicillin-sensitive staphylococcus aureus(MSSA) strains isolated from newborns.  Methods  A cross-sectional study was conducted in two hospitals in Shenzhen from August to November 2015. Cotton swab samples were collected from 1834 newborns. Staphylococcus aureus was identified by general laboratory tests, and antimicrobial-susceptibility profiles was tested.  Results  In total, 3.27% (60/1 834) Staphylococcus aureus (SA) strains were isolated, including 0.82% (15/1 834) MRSA and 2.45% (45/1 834) MSSA. Most MRSA and MSSA strains were resistant to penicillin and erythromycin but less than 10% strains resistant to linezolid. Drugs resistance rates of MRSA to erythromycin, moxifloxacin and clindamycin were all higher than that of MSSA (all P < 0.05). The multidrug-resistant risk of MRSA (80.00%) was 12.36 times higher than that of MSSA (24.44%).  Conclusions  Multidrug-resistant SA especially MRSA strains isolated from newborns had the higher prevalence, the drugs resistance rate of MRSA strains was more serious than that of MSSA.
History of Public Health
Dedicated to scientific research and public service: in memory of Su The Lung, a master of preventive medicine in China
XU Zhi-yi, SU Zhu-jun, JIANG Qing-wu, HE Na
2019, 23(10): 1301-1304. doi: 10.16462/j.cnki.zhjbkz.2019.10.028
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Abstract:
Su Teh Lung(1906-1985), a famous public health scientist, medical educator and thinker, one of the founders of epidemiology in China. Through scientific experiments and field investigations, he first clarified the distribution law of Oncomelania hupensis comprehensively and proposed the method of eliminating Oncomelania hupensis, and his work has made outstanding contributions to the study of the causes and prevention of schistosomiasis in China. He advocated a comprehensive research of every link of epidemiological process with ecological research, attached importance to statistical methods and logical thinking, went deep into the field, combined with reality, and created theoretical system of epidemiology in China. He advocated truth, seek truth from facts, devoted all his life to the practice and research of epidemic prevention and control, which has a far-reaching impact on the development of preventive medicine in China and the world.

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