中华疾病控制杂志

Development and thinking of Chinese radiation medicine

RAN Xin-ze, CHENG Tian-min

2019, 23(11): 1305-1308, 1424. doi: 10.16462/j.cnki.zhjbkz.2019.11.001

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In this paper, we reviewed the initiation and development of radiation medicine in China, field researches on the health effects of nuclear test and the great leap from the final reports, advance in clinical diagnosis and treatment of radiation injury, and research of radiation combined injuries. Nowadays, China makes great efforts to move up further in development and peaceful use of nuclear energy as one nuclear power. So, nuclear development and nuclear safety have ushered in new opportunities and challenges. To this end, we must maintain a clear understanding, grasp new opportunities, meet new challenges, and be prepared for danger. Thus, a bright future for research in radiation medicine will come.

Influential factors of leisure exercise among patients with type 2 diabetes mellitus based on the planned behavior theory

GAO Min, CHEN Xue-ying, SUN Xin, WANG Feng-bin, SHEN Ying, WANG Tao-tao, ZHAO Li-hua, GAN Jing-wen, YUE Rong-fang, SUN Xin-ying

2019, 23(11): 1309-1312, 1322. doi: 10.16462/j.cnki.zhjbkz.2019.11.002

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Objective This study applied the theory of planned behavior to investigate the leisure exercise situation among patients with type 2 diabetes mellitus (T2DM) and its influencing factors. Methods The questionnaire was self-designed based on the theory of planned behavior, which had good reliability and validity. Structural equation modeling was used to estimate the determinants of leisure exercise and the potential intermediate effect. Results 774 patients with T2DM were enrolled in this study. 52.6% were over 60 years old. The median amount of leisure exercise was 0.0 thousand-step equivalent with quartile of (0.0, 2.0). Structural equation modeling showed that the effects of attitude (β=0.080) and intention (β=0.277) on leisure exercise were significant. Besides, perceived behavioral control (β=0.180) had an indirect effect on exercise through intention. Conclusions In general, most patients with type 2 diabetes have insufficient amount of exercise. Improving attitude, control and intention to exercise would be one crucial part of exercise health education among patients with T2DM.

Prediction of 3-mouth glycemic control in type 2 diabetes mellitus based on machine learning algorithm

QIN Wei, GAO Min, SHEN Ying, SHI Yu-hui, WU Tao, ZHAO Ai, SUN Xin-ying

2019, 23(11): 1313-1317. doi: 10.16462/j.cnki.zhjbkz.2019.11.003

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Objective To evaluate the efficiency of Logistic regression algorithm and random forest algorithm in prediction of blood glucose control in patients with type 2 diabetes mellitus (T2DM) after 3 months, and explore the influencing factors of blood glucose control. Methods The data was extracted from baseline survey and follow-up information of patients with T2DM in Shunyi and Tongzhou Districts. The patient's 3-month glycosylated hemoglobin which was more than 6.5% was chosen as the outcome categorical variable. The random forest algorithm and Logistic algorithm were used to establish the prediction model. The predictive efficiency was evaluated with the area under receive operating characteristic curve (AUC) and accuracy rate. Results Factors affecting the patient's glycemic control included baseline fasting plasma glucose(P < 0.001), duration of disease(P < 0.001), smoking(P=0.026), static activity time(P=0.006), body mass index(overweight P=0.002, obesity P=0.011), bracelet use(P=0.028), and diabetes diet(P=0.002).The Logistic regression prediction model had an AUC of 0.738, a sensitivity of 72.9%, a specificity of 68.1%, and an accuracy of 71.2%. The random forest model had an AUC of 0.756, a sensitivity of 74.5%, a specificity of 69.5%, and an accuracy of 72.8%. Conclusions The efficiency of random forest is better than Logistic regression model, which can be applied to the prediction of blood glucose control and assist the management of diabetic patients.

Analysis of eHealth literacy and its influencing factors among the elderly

LI Shao-jie, XU Hui-lan, CUI Guang-hui

2019, 23(11): 1318-1322. doi: 10.16462/j.cnki.zhjbkz.2019.11.004

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Objective To investigate the current status and influencing factors associated with the health literacy of the elderly. Methods 24 communities were randomly selected from Jinan City, and 1 201 elderly people were surveyed by the eHealth literacy scale. Univariate analysis was performed using the Chi-square test and multivariate analysis was performed using binary Logistic regression. Results The qualification rate of eHealth literacy among 1 201 older adults was 11.1%. Multivariate analysis showed that primary school education and below (OR=4.50, 95% CI: 1.924-10.530, P=0.001), family pension (OR=3.08, 95% CI: 1.326-7.165, P=0.009), poor self-rated health (OR=2.12, 95% CI: 1.022-4.406, P=0.044), great self-rated life pressure (OR=4.09, 95% CI: 1.686-9.938, P=0.002) were risk factors for eHealth literacy in the elderly; urban household registration (OR=0.52, 95% CI: 0.337-0.815, P=0.004), the main person to taking care of grandchildren (OR=0.43, 95% CI: 0.273-0.682, P < 0.001), urban basic medical insurance or NCMS medical insurance (OR=0.22, 95% CI: 0.047-0.998, P=0.05), commercial medical insurance (OR=0.10, 95% CI: 0.019-0.552, P=0.008) and the parents being alive (OR=0.44, 95% CI: 0.264-0.719, P=0.001) were protective factors for the elderly eHealth literacy. Conclusion The type of household registration, the level of education, the type of medical insurance, the way of caring for grandchildren, the way of providing for the elderly, the self-rated of health status, with the parents being alive, and the self-rated life pressure are the influencing factors of the eHealth literacy of the elderly.

Elder abuse and mental health: the modifying effect of social support

XU Jin-yan

2019, 23(11): 1323-1327, 1337. doi: 10.16462/j.cnki.zhjbkz.2019.11.005

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Objective To explore the relationship between elder abuse and mental health, and the modifying effect of social support between them in rural area. Methods A multi-stage stratified random sampling method was used to select 1 418 elderly people aged 60 years and above from rural areas of Changsha, Zhuzhou and Xiangtan in Hunan Province. Logistic regression model was established to test the relationship among the variables. Results After controlling the basic characteristic variables, when the abuse experience, mental abuse, care neglected, chronicity and multiplicity of abuse increased by one unit, the level of mental health decreased by 21.4%(OR=2.14, 95% CI: 1.49-2.83, P=0.001)、34.2%(OR=3.42, 95% CI: 1.53-4.26, P < 0.001)、17.8%(OR=1.78, 95% CI: 1.36-2.41, P=0.001)、25.4%(OR=2.54, 95% CI: 1.68-2.93, P < 0.001) and 13.7%(OR=1.37, 95% CI: 1.15-2.37, P=0.001), respectively. After social support variables were added, the negative impact coefficient of abuse on mental health decreased. However, it had no statistical significance among the male elderly. Subjective support had greater moderating effect than objective support. Conclusions Abuse is a risk factor for mental health among the elderly. High level of social support can reduce the negative impact of abuse on the mental health among female elderly.

A review of the mobile phone addiction research

LAN Yu-kun, DING Jiao-er, ZHU Xiao-yi, JIA Ying-nan, LI Jiang, FU Hua

2019, 23(11): 1328-1333. doi: 10.16462/j.cnki.zhjbkz.2019.11.006

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Since 1990s, mobile phones have been becoming popular around the world at all ages, and it provides more and more functions. In recent years, with the development of information technology, various mobile phone applications owning billions of users spring up continuously. At the same time, the frequency of mobile phone use is higher and higher than that in the era of functional phones. Additionally, mobile phone-related addiction problems have shown high prevalence in surveys around the world. In this paper, after integrating the different descriptions of relevant scholars for mobile phone addiction, we adopted the suitable definition of mobile phone addiction for the comprehensive description of the mobile phone addiction. Thereby, we summarized prevalence, risk factors, hazard, and interventions of mobile phone addiction around the world, providing integrated data for the analysis of the mobile phone addiction mechanism, the formulation of effective intervention strategies, and the exploration of future research direction.

Several issues in research on suicide behavior

XIAO Shui-yuan

2019, 23(11): 1334-1337. doi: 10.16462/j.cnki.zhjbkz.2019.11.007

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This paper summarized and discussed current problems in research on suicide behavior, including conceptualization of suicide behavior and reporting of suicide rate, risk and protective factors of suicide behavior, as well as prediction and prevention of suicide behavior. The author also provided some suggestions for further research.

Preliminary study on the risk of macrosomia using Bayesian discriminant analysis based on prenatal records

WU Liu-yu, LAN Jing-you, HUANG Dan-dan, QIU Xiao-qiang, LIU Mei-liang, LIANG Qiu-li, ZHANG Di, ZENG Xiao-yun

2019, 23(11): 1338-1341, 1347. doi: 10.16462/j.cnki.zhjbkz.2019.11.008

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Objective To explore the clinical effect of Bayesian discriminant analysis in predicting the risk of macrosomia. Methods 169 fetal macrosomia and 169 non-macrosomia were enrolled in a 1:1 matched case-control study. Conditional Logistic regression was used to select the discriminant indexes, and the discriminant indexes were put into the Bayesian discriminant model to obtain the Bayesian discriminant function. The discriminant function was the retrospectively examined and externally tested. Results The results of conditional Logistic regression model indicated that mother's height, early pregnancy body mass index (BMI), gestational diabetes, gestational weeks, the height of uterine and abdominal circumference were associated with the birth of fetal macrosomia. The Bayesian discriminant function were established: Fetal macrosomia: y1=-27.802+8.420×Mother's height+8.719×early pregnancy BMI+10.485×gestational weeks+3.375×gestational diabetes+2.862×height of uterine and abdominal circumference; Non-macrosomia y2=-17.477+7.161×Mother's height+7.217×early pregnancy BMI+7.862×gestational weeks+2.036×gestational diabetes-0.085×height of uterine and abdominal circumference. Wilks' Lambda λ=0.489, P < 0.001, the Bayesian discriminant function was statistically significant. The internal and external conformity rates of the Bayesian discriminant model were all more than 80%. Conclutions The birth of fetal macrosomia is related to many factors. The Bayesian discriminant model in the present study is valuable to discriminate macrosomia and provide an objective reference for more accurate identification of macrosomia in the future.

Association between unhealthy diets and depression in early pregnancy

ZHAN Yong-le, CHEN Yun-li, SHI Ying-jie, SHEN Zhong-zhou, MA Shuai, FENG Ya-hui, WU San-san, WANG Ya-wen, CAI Shu-ya, MA Liang-kun, JIANG Yu

2019, 23(11): 1342-1347. doi: 10.16462/j.cnki.zhjbkz.2019.11.009

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Objective To explore the association between unhealthy diets and depression in early pregnancy. Methods 7 976 women in early pregnancy were recruited and analyzed in this study from the Chinese Pregnant Women Cohort Study (CPWCS) from July 25th, 2017 to July 24th, 2018. Differences of baseline characteristics between the two groups were conducted by a chi-square test. The qualitative food frequency questionnaire and the edinburgh postnatal depression scale were used to assess depression status and food intake frequency during the first trimester respectively. Log-binomial regression was used to analyze the relationship between unhealthy diets and depression in early pregnancy. Prevalence ratio (PR) and its 95% confidence interval (95% CI) were calculated. Results Eating regularly (PR=0.45, 95% CI: 0.38-0.54, P < 0.001) and eating breakfast frequently (PR=0.80, 95% CI: 0.72-0.90, P < 0.001) were related to the low incidence of depression while frequent consumption of fried food (PR=1.25, 95% CI: 1.03-1.53, P=0.027), Western-style fast food (PR=1.36, 95% CI: 1.06-1.74, P=0.015) and puffed food (PR=1.37, 95% CI: 1.11-1.70, P=0.003) as well as drinking sugar-sweetened beverage (PR=1.37, 95% CI: 1.17-1.61, P < 0.001), wine (PR=1.60, 95% CI: 1.26-2.01, P < 0.001) and liqueur (PR=1.26, 95% CI: 1.00-1.59, P=0.047) were linked with the high incidence of depression. Conclusions There might be an association between unhealthy diets and depression in early pregnancy. Pregnant women should take the initiative to better understand what are healthy diets and reduce the frequency of unhealthy diets consumption to decrease the incidence of depression during pregnancy.

The effect of ambient temperature on the activity influenza like illness andlaboratory-confirmed influenza in Wuxi City

LIU Juan, SHI Chao, ZHANG Qi, SHI Ping, GAO Yu-meng, CHEN Yu-jun, WANG Li-hua, BAO Jing, SHEN Yuan

2019, 23(11): 1389-1393, 1419. doi: 10.16462/j.cnki.zhjbkz.2019.11.018

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Objective To evaluate the effect of ambient temperature on the activity influenza like illness (ILI) and laboratory-confirmed influenza (LAB) in Wuxi City. Methods Daily data of meteorological, ILI and detected influenza virus from 31 December 2012 to 31 December 2017 were collected. Distributed lag non-linear model (DLNM) was used to evaluate the exposure-lag-response of ILI and LAB activity to daily ambient temperature. Results During the period, the overall ILI% was 4.96% and influenza detection positive rate was 12.28% in Wuxi city. The overall cumulative association analysis suggested non-linear relationship between ambient temperature and influenza: U-shaped for ILI, while L-shaped relationship for LAB. Low temperature (<10℃) had strong and longer delay effect than hightemperature (>20℃) for ILI. The cold effect for LAB was stronger and longer delay, and the low temperature (<10℃) was risk factor for LAB. Conclusions The ambient temperature significant correlates with ILI and LAB, and low temperature might be risk factor with lag effect.

Study on the association between prenatal examinations of Tibetan pregnant women and low birth weight infants

DE Qiong, WU Yu, ZHANG Yu-tong, LIU Jue, LIU Min

2019, 23(11): 1348-1352. doi: 10.16462/j.cnki.zhjbkz.2019.11.010

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Objective To understand the relationship between the number of prenatal examination during pregnancy in Tibetan mothers and low birth weight infants, and to provide reference for improving the quality of antenatal care and reducing the incidence of low birth weight infants. Methods Tibetan women and newborns who gave birth in a hospital in Lhasa, Tibet from January 2012 to December 2018 were selected as research objects. The basic data, delivery materials and newborn data of all single births were collected. Logistic regression models were used to analyze the relationship between the number of maternal prenatal examinations and the birth weight of the newborn. Results In 5 563 pregnant women, the prenatal check-up rate was 10.48%. Among the newborns, low birth weight accounted for 11.32%. With the increase in the number of maternal births, the neonatal low birth weight rate showed a downward trend (χ²=14.57, P=0.002). Multivariate Logistic regression model showed that after controlling for maternal age, fetal gender, mode of delivery, fetal asphyxia and other confounding factors, the number of low prenatal examinations was still related to the occurrence of low birth weight infants. The incidence of low birth weight infants who gave birth to antenatal check-ups and 1-2 prenatal visits was 1.41 times (95% CI: 1.00-1.98) and 2.34 times (95% CI: 1.09-5.02) higher than those who received standardized prenatal checkups. Conclusions Tibetan pregnant women receive a lower proportion of standardized prenatal examination and there is a higher risk of low birth weight infants. It is recommended to strengthen the quality of maternal and child health care work in minority areas to ensure maternal and child safety.

Dose-response relationship between light at night and nonalcoholic fatty liver in steel workers

WANG Zhen-de, WANG Han, YANG Li, XUE Chao, WANG Yong-bin, ZHANG Sheng-kui, YUAN Ju-xiang

2019, 23(11): 1353-1357, 1363. doi: 10.16462/j.cnki.zhjbkz.2019.11.011

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Objective To explore the relationship between light at night (LAN) and nonalcoholic fatty liver (NAFLD) in steel workers. Methods Relevant information was collected through questionnaires, physical examinations and blood biochemical analysis. Using restricted cubic spline (RCS) and mutiple Logistic regression model to explore the relationship between LAN and NAFLD based on a cross-sectional study. Results The prevalence of NAFLD was 33.8% (2 594/7 664) in steel workers. After adjusting for age, sex, marriage, educational level, smoking, drinking, body mass index, luminous intensity in life, liver enzyme metabolism, blood lipid level, physical activity, diet, sleep duration, shift work, high temperature, noise, dust, and carbon monoxide exposure, the RCS model showed a nonlinear dose-response relationship between LAN and NAFLD (χ²=71.59, P < 0.001 for overall association test and χ²=16.92, P < 0.001 for nonlinear test); Multivariate Logistic regression model showed that after adjusting for all confounding factors, when the LAN in the 1 178 d~2 017 d and 2 017 d~group, the prevalence of NAFLD increased by 21.7% (OR=1.217, 95% CI: 1.027-1.441) and 47.9% (OR=1.479, 95% CI: 1.240-1.763), respectively, when compared with the group LAN < 1 178 d. Conclusion There is a nonlinear dose-response relationship between LAN and NAFLD in steel works.

Correlation between metabolic syndrome component aggregation and nonalcoholic fatty liver disease in a certain district of Urumqi's check-up population

GULISIYA Hailili, YAO Hua, WANG Shu-xia, WANG Yu-shan, LIU Tao, CHEN Zhen, LUO Tao, DAI Jiang-hong

2019, 23(11): 1358-1363. doi: 10.16462/j.cnki.zhjbkz.2019.11.012

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Objective The relationship between metabolic syndrome(MetS), metabolic syndrome score (MSS) and non-alcoholic fatty liver disease(NAFLD) in Urumqi was investigated by the MSS, reflecting the aggregation of MetS components. Methods The subjects were divided into non-NAFLD and NAFLD group by abdominal B ultrasound. The results of physical examination and blood biochemical examination were analyzed. The MSS was calculated and the relationship between the different aggregation of MSS and NAFLD was analyzed by Log-binomial regression. Results A total of 20 569 subjects were included in the study. The detection rate of MetS was 16.7%, the detection rate of NAFLD was 32.4%. Compared with non-NAFLD group, the systolic blood pressure, diastolic blood pressure, body mass index (BMI), waist circumference, fasting plasma glucose, triglyceride, total cholesterol, and low-density lipoprotein cholesterol were all increased in the NAFLD group, and the difference was statistically significant (P < 0.05). After adjusting for gender, age, ethnicity and education level, Log-binomial regression analysis showed high BMI, hypertension and hyperglycemia. High triglycerides and low-density lipoproteins are the main risk factors for NAFLD (PR values were 3.194, 1.331, 1.623, 1.981, 1.254, respectively); the risk of NAFLD increased corresondingly when MSS, MSS0, MSS1, MSS2, MSS3, and MSS4 increased. The PR were 3.127, 4.983, 6.437, and 7.331, respectively. Conclusions The formation of NAFLD is not a single accumulation of liver fat, combined with abnormalities such as blood lipids, blood pressure, and blood sugar. The detection rate of male MetS and NAFLD was higher than that of female, but women with two abnormal metabolic indicators were more likely to develop into NAFLD. BMI as the obesity index has the strongest relationship with NAFLD, and NAFLD prevention should focus on obese people.

Analysis on the associated factors of hyperuricemia: based on classification tree model

WANG Xue-ying, LI Nan, GUO Jia-tong, LENG Song

2019, 23(11): 1364-1369. doi: 10.16462/j.cnki.zhjbkz.2019.11.013

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Objective To explore the associations between physiological factors, psychosocial factors, dietary habits, lifestyles and hyperuricemia (HUA) and provide the evidence for hyperuricemia intervention. Methods From 2016 to 2017, adults during their checkup in the health management center of the Second Affiliated Hospital of Dalian Medical University were interviewed with self-designed questionnaire and received the health examinations. To determine the influence of socio-economic data, life style habits and psychological factors on the risk of HUA, the classification tree model was adopted. Results A total of 4 118 subjects were enrolled in the study, with an average age of (52.8±7.9) years. The results showed that the prevalence of HUA was higher among people under 30 years old and 40-50 years old who are smoking, drinking and doing the sedentary work, who unsatisfied with their work and under a great mental stress. Factor analysis model identified three dietary patterns, traditional model, fried and smoked food and dessert model and high quality protein model, the cumulative variance contribution rate was 53.886%. In multivariate model, it was found that high-quality protein pattern, physical exercise and fasting plasma glucose (FPG) were negatively associated with HUA. Male, smoking, drinking, having dyslipidemia, higher body mass index (BMI) were risk factors for HUA. Subgroup analysis showed that in both male and female, the high-quality protein patterns were negatively associated with HUA. The pattern of fried and smoked food and dessert patterns was the independent risk factors for HUA in female. Classification tree model showed that male, dyslipidemia, higher BMI grade, and the fried and smoked food and dessert pattern were the risk factors for HUA. Conclusions The influencing factors of HUA in different gender were different, which indicate the individualized health management should be adopted. Male who is overweight or obese should quit smoking and drinking. Women should pay more attention to avoid of the excess intake of fried and smoked food and dessert. Meanwhile, a high-quality protein diet and more physical exercise should be encouraged.

Interactive effect of Hyperglycemia and Hyperuricemia on abnormal alanine aminotransferase

ZHAI Wen-hai, LI Xue-mei, WANG Jun-zhi, LIN Wen-yuan

2019, 23(11): 1370-1374. doi: 10.16462/j.cnki.zhjbkz.2019.11.014

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Objective To investigate interaction effect of hyperglycemia and hyperuricemia on the patients with abnormal alanine aminotransferase(ALT). Methods From March to November 2018, 5 223 cases with complete and suitable data were enrolled in the physical medical examination in Yichang, Hubei Province of China. The metabolic characteristics of the two groups (508 ALT anomaly cases and 513 normal cases) were compared and analysed, Logistic regression model was used to study the independent effects of risk factors, and the interaction between risk factors was analyzed by additive model and multiplicative model. Results Levels of uric acid, triglyceride, total cholesterol, low density lipoprotein-cholesterol, fasting blood glucose, systolic blood pressure, diastolic blood pressure, body mass index, aspartate aminotransferase were significantly higher than that of the control group(all P < 0.05). After adjusting some confounding factors, multivariate Logistic regression analysis showed that risk of abnormal ALT was 5.62 times higher in subjects with hyperglycemia and hyperuricemia than in subjects without them(95% CI: 1.65-19.73, P=0.004). Interaction analysis of risk factors for abnormal ALT showed that there was no multiplicative interaction between hyperglycemia and hyperuricemia, but with additive interaction, the synergy index was 3.02, the relative excess risk due to interaction was 3.09, the attributable proportion due to interaction was 54.98% and pure factor attribution interaction was 66.87%. Conclusions There are several abnormal metabolic indices in individuals with abnormal ALT. The positive interaction between hyperglycemia and hyperuricemia are among the important risk factors for abnormal ALT patients. They can significantly increase the risk of illness.

Genetic variations and epidemiological characteristics of influenza B virus in Xinxiang from 2012 to 2019

MA Jian-min, CHENG Dong, LI Hua-feng, SHI Xiao-juan, LUAN Xu-bo, LIU Dan, WANG Mei

2019, 23(11): 1375-1379. doi: 10.16462/j.cnki.zhjbkz.2019.11.015

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Objective To investigate the genetic variation and epidemiological characteristics of influenza B virus in Xinxiang to provide policy basis for local influenza vaccination. Methods The influenza surveillance data in Xinxiang from January 2012 to February 2019 was analyzed. 23 isolated influenza B virus were randomly selected for hemagglutinin (HA) and neuraminidase (NA) gene sequencing. Sequence alignment was conducted by using DNAman software and phylogenetic tree analysis was conducted using Neighbor-Joining method. Results Yamagata (BY) and Victoria (BV) strains of influenza B virus circulated alternately every other year in Xinxiang, mainly among people aged 0-15 years (91.4%). The dominant influenza B lineages from 2015 to 2016 and from 2017 to 2018 did not match the corresponding trivalent vaccine strain of the year. The HA phylogenetic tree revealed that 87.5% (7/8) of BV strains coexisted with the vaccine strain in one branch, while 88.98% (8/9) of BY strains from 2013 to 2015 were not in the same branch as the corresponding vaccine strain, with 5 epitope site mutions N116K, S150L, N165Y, D196N and N202S. No drug-resistant site mutation was identified in the NA gene. A total of 6 intra-lineage reassortants were identified. Conclusions The influenza B lineage in the trivalent vaccine recommended by WHO did not match the dominant circulating B lineage of Xinxiang in some epidemic year. Therefore, quadrivalent vaccines are recommended to use in susceptible population, especially under the age of 15. In addition, there are large variations in HA gene of the epidemic BY strain compared with the corresponding vaccine. Then, a vaccine more sutable for the epidemic strains in China is expected to be developed.

Effectiveness of tobacco-control intervention program among high risk population of chronic non-communicable diseases in institutions from Chongqing

CHEN Ting, BAI Ya-min, DING Xian-bin

2019, 23(11): 1380-1383, 1388. doi: 10.16462/j.cnki.zhjbkz.2019.11.016

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Objective To explore the effect of the classified management intervention model on the smoking status of high risk population of chronic non-communicable diseases in institutions from Chongqing, so as to provide scientific basis for the management of high risk population of chronic non-communicable diseases. Methods Workers from governments and institutions of four districts in Chongqing were sampled by cluster sampling. High risk population of non-communicable disease were screened and enrolled into the intervention group and control group. The intervention group were intervened by classified management. And the control group weren't intervened. To evaluate the change of smoking and smoking hazard cognition in intervention group and control group after one year intervention. Results The result of analysis of the net effect of intervention measures using difference in difference regression model showed that the intervention measures could reduce the smoking rate, the current smoking rate and the daily smoking rate in subjects (OR=0.32, 95% CI: 0.21-0.49; OR=0.31, 95% CI: 0.20-0.48; OR=0.34, 95% CI: 0.21-0.54). The intervention measures could increase the awareness rates of smoking causing serious diseases, stroke and lung cancer in subjects (OR=2.19, 95% CI: 1.08-4.42; OR=1.73, 95% CI: 1.17-2.57; OR=2.17, 95% CI: 1.25-3.77), the difference was statistically significant (all P < 0.05). Conclusion The intervention model of classified management for high risk population of chronic non-communicable diseases in institutions can effectively improve the awareness rate of smoking hazards among the subjects, and then reduce the smoking rate. Therefore, this intervention model is worth popularizing and applying.

WAN An, KE Jie-qi, CHEN Gang, JIANG Lai, CHEN Zheng-zheng, QU Wan-jun, ZHAO Wei-dong

2019, 23(11): 1384-1388. doi: 10.16462/j.cnki.zhjbkz.2019.11.017

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Objective To investigate the related factors of lymph node metastasis and ovary involvement in endometrioid adenocarcinoma. Methods The clinicopathological data of endometrioid adenocarcinoma patients who underwent surgical treatment at the first affiliated hospital of university of science and technology of China from January 2011 to January 2018 were analyzed retrospectively. A total of 189 endometrioid adenocarcinoma were retrieved in the study. Results In the univariate analysis, D-dimer, preoperative plasma fibrinogen and CA125 levels could be elevated in endometrioid adenocarcinoma patients with ovary involvement (all P < 0.05). Endometroid adenocarcinoma patients with lymph node metastasis had lower body mass index (BMI) (t=2.133, P=0.040), preoperative plasma fibrinogen, D-dimer, CA125 levels and BMI were higher in patients with lymph node metastasis (all P < 0.05). In Logistic regression analysis, D-dimer levels(OR=1.448, 95% CI: 1.105-1.898) and preoperative plasma fibrinogen(OR=1.925, 95% CI: 1.018-3.640) were elevated in endometrioid adenocarcinoma patients with ovary involvement; Multiparity was the protective factor(OR=0.498, 95% CI: 0.253-0.982) for endometrioid adenocarcinoma patients with lymph node metastasis, but elevated preoperative plasma fibrinogen (OR=2.191, 95% CI: 1.085-4.422) was the risk factor among the patients. Conclusion Increased preoperative plasma fibrinogen or D-dimer levels could be predictors of lymph node metastasis or ovary involvement in endometrioid adenocarcinoma.

Long-term effects of early-life disaster exposure on mental health during the whole life cycle

GUO Chao, ZHAO Yi-hao, YANG Fei-fei

2019, 23(11): 1404-1408, 1414. doi: 10.16462/j.cnki.zhjbkz.2019.11.021

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Early nutritional status, lifestyle and life experiences are critical to the health and development of one's whole life. Previous studies on the effect of earthquake, flood, ice storm and hurricane, famine on population health were reviewed and sorted out from a perspective of life cycle. It turned out that catastrophic events exposure during the fetus period could have some adverse effects on the growth and development of fetuses, newborns and children, and also on mental health during the life cycle from newborns to adults. Based on the research results at home and abroad, future research on the long-term impacts of early-life adverse events on mental health could be further explored from such aspects as expanding research objects, improving research methods, and extending research content.

Progress in research of clinical trials of herpes zoster vaccines

LI Juan, LI Jing-xin, JIN Peng-fei, ZHANG Hong-xiu, ZHU Feng-cai

2019, 23(11): 1409-1414. doi: 10.16462/j.cnki.zhjbkz.2019.11.022

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Herpes zoster (HZ) is more common in middle-aged and elderly people, and is caused by varicella-zoster virus (VZV) that is latent in sensory ganglia. In recent years, due to various reasons, especially the aging of China's population has become more serious, the incidence of HZ in China has risen sharply. Although HZ is self-limited, its complications will still reduce the quality of life of patients and increase the economic burden of patients' families and society. In order to reduce the incidence and improve the quality of life of the elderly in their later years, the development of safe and effective HZ vaccine may be an important and effective measure. This article aims to make a brief review of the progress in research for clinical trials of HZ vaccines, so as to provide a reference for the use of HZ vaccine and the prevention and control of HZ disease in China.

Application of the time series model in prediction of incidence of hand-foot-mouth disease from 2008 to 2016 in China

XIONG Yu-yang, REN Jing-chao, DUAN Guang-cai

2019, 23(11): 1394-1398. doi: 10.16462/j.cnki.zhjbkz.2019.11.019

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Abstract:
Objective To predict the monthly incidence of hand-foot-mouth disease (HFMD) in China by using autoregressive integrated moving average (ARIMA) model and provide evidence for prevention and control of HFMD. Methods The monthly incidence data of HFMD in China from 2008 to 2016 were collected from the Public Health Science data Center. The incidence database was established by Excel 2007 and graphed. SAS 9.1 was used to construct the ARIMA model, based on the data of the monthly reported incidence of HFMD in China from January 2008 to December 2015, and then the data in 2016 were used to verify the predicted results. The monthly incidence in 2017 was predicted in the same way.The difference was statistically significant when P<0.05. Result The model predicting monthly incidence of HFMD in China is ARIMA ((12), 2, 0) sparse coefficient and residuals is white noise. The parameters were as follows: moted mean squared error=3.6490, mean absolute error=2.62, mean absolute percentage error=28.24%. Conclusion The sparse coefficient model could well simulate the trend of HFMD case in time series, which has good reference of early warning and prevention of HFMD.

Prediction and analysis of death of children under 5 years old in Lanzhou based on time series model

LIANG Wei-tao, LIANG Fang, JING Guang-zhuang, TAO Sheng-cong, XIE Li-ao, HU Yi-ping, LI Zhi-lan

2019, 23(11): 1399-1403. doi: 10.16462/j.cnki.zhjbkz.2019.11.020

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Objective To analyze the death trend of children under 5 years old in Lanzhou and establish the time series model to predict the mortality and incidence of children under 5 years old in Lanzhou in 2019. Methods Descriptive epidemiological method was used to analyze the mortality of children under 5 years old in Lanzhou from January 2010 to December 2018. SPSS 21.0 software was used to construct time series analysis model, selecting the best model and predict the mortality of children under 5 years old in Lanzhou in 2019. Results A total of 1 650 deaths of children under 5 years old were reported in Lanzhou from 2010 to 2018. The number of deaths reported by boys and girls was 871 and 774 respectively, with an average annual mortality rate of 6.23‰. In recent years, the overall mortality rate of children under 5 years old in Lanzhou had declined. The majority of deaths among children under 5 years old were neonates, accounting for 65.27%. Simple seasonal model was the best model by comparing different models. The model could well fit the monthly death cases of children under 5 years old in Lanzhou from 2010 to 2018. It is predicted that the total number of deaths of children under 5 years old in Lanzhou will be 140 in 2019, which is similar to the number of deaths in 2018. Conclusions The mortality rate of children under 5 years old in Lanzhou is decreasing year by year. Simple seasonal model can better reflect the mortality trend of children under 5 years old in Lanzhou and make short-term prediction.

Genetic characteristics of highly pathogenic avian influenza A(H5N6) virus in Suzhou City

DONG Ze-feng, YA Xue-rong, WANG Di, SHEN Qiang, XIA Yu

2019, 23(11): 1415-1419. doi: 10.16462/j.cnki.zhjbkz.2019.11.023

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Objective To analyze host adaptability and drug resistance variation of highly pathogenic avian influenza (HPAI) A(H5N6) viruses obtained from outbreaks in Suzhou City. Methods Real-time fluorescent quantitative reverse transcription-polymerase chain reaction (RT-PCR) assay was used for influenza virus detection in pharynx or anus swabs of dead birds and suspected cases. Full genome of H5N6 positive samples were sequenced by using Sanger method. Hemagglutinin (HA) and neuramidinase (NA) phylogenetic trees were constructed by MEGA software. Results A child was laboratory confirmed to have A(H5N6) viruses infection in November 2018. A outbreak of avian flu in poultry in W district during the Spring Festival was laboratory confirmed as a A(H5N6) epidemic situation. Avian-origin H5N6 viruses possessed D198N and Q226H resistance mutations. The homology of HA and NA genes of Suzhou strains were 98.01%-100.0% and 98.16%-100.0%, respectively. These H5N6 strains belonged to 2.3.4.4 H5 clad. Multiple basic amino acid at the cleavage site of HA implied the highly pathogenic characteristics of Suzhou H5N6 strains. Conclusion H5N6 is a kind of malti-sourse reassortment virus, which is still evolving. Multiple loci of Suzhou H5N6 strains of this epidemic were identified to have drifted. The prevalence of drug-resistant mutations should be closely monitored in order to timely take effective measures to prevent serious damage to public health and poultry production industries.

Metal elements analysis and risk assessment of carcinogenicity on PM_2.5 samples collected from Shenzhen and Taiyuan

HU Xin-nan, WANG Xun, XU Xin-yun, HUANG Hai-yan, GENG Hong, ZHENG Kai, WANG Bin-yu

2019, 23(11): 1420-1424. doi: 10.16462/j.cnki.zhjbkz.2019.11.024

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Objective To conduct metal elements analysis and risk assessment of carcinogenicity on Particulate Matter 2.5 (PM_2.5) collected from Shenzhen and Taiyuan. Methods PM_2.5 samples were collected in Shenzhen and Taiyuan from 2017 to 2018. Ten heavy metal elements in PM_2.5 samples were detected by inductively coupled plasma mass spectrometry (ICP-MS). Health risk assessment was conducted using the recommended United States Environmental Protection Agency (EPA) model. Results Metal elements found in PM_2.5 samples from Shenzhen included (in decreasing order of concentration) Al, Pb, Mn, Cr, Cu, V, As, Ni, Cd and Co. Their levels were 1 807.67, 31.02, 30.63, 17.37, 17.32, 11.59, 6.98, 4.76, 2.24, 2.20 ng/m³, respectively. Metal elements in PM_2.5 samples from Taiyuan included Al, Mn, Pb, Cr, Cu, As, Ni, V, Cd and Co. Their levels were 2 817.64, 91.04, 63.33, 26.56, 24.69, 11.82, 10.39, 4.46, 3.42, 1.01 ng/m³, respectively. There were significant differences among Pb, Mn, As, Ni levels between Shenzhen and Taiyuan (all P<0.05), but remaining metal element levels did not show significant differences between Shenzhen and Taiyuan. Risk assessment data showed that the total risk from five carcinogenic metal elements in Taiyuan and Shenzhen were more than 1.00×10^-4 and the total risk from five carcinogenic metal elements of Taiyuan(3.79×10^-4) was higher than Shenzhen(2.44×10^-4). Among five carcinogenic metal elements, Cr had the highest carcinogenicity risk (>1.00×10^-4), then followed by As, Ni and Cd (1.00×10^-6-1.00×10^-4). Pb had the lowest risk (<1.00×10^-6). Conclusion Some of the metal elements in PM_2.5 samples collected from Shenzhen and Taiyuan have carcinogenicity risk. Further researches and measures for prevention and control should be considered.

The leader of American public health: Edward Jarvis

LIAO Tao, WU Jun, YE Dong-qing

2019, 23(11): 1425-1428. doi: 10.16462/j.cnki.zhjbkz.2019.11.025

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Edward Jarvis (1803-1884) was a famous clinician of Harvard Medical School, excellent social statistician and outstanding public health leader. He applied social statistics to improve the American census system, changed the status of mental illness in America, and pioneered family group psychotherapy. Jarvis attached great importance to disease prevention, advocated prevention and treatment of diseases from the perspective of disease prevention, strengthen health construction, and promoted the development of public health in America.

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2019 Vol. 23, No. 11

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Editor-in-Chief Ye Dongqing M.D.

Assistant editor Fan Yinguang M.D.

Assistant editor Pan Haifeng M.D.

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