中华疾病控制杂志

Review and prospect of chronic non-communicable disease control and prevention in China

WANG Zhuo-qun, ZHAO Wen-hua

2019, 23(9): 1025-1028, 1036. doi: 10.16462/j.cnki.zhjbkz.2019.09.001

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With the industrialization, urbanization, population aging and the constant change of disease spectrum, ecological environment and lifestyle, chronic diseases have become the biggest threat to the lives and health of Chinese residents. Since the 1990s, our government, professional institutions, and the whole society have given great attention and made unremitting efforts, thus have made great achievements. This article will comprehensively review the construction of chronic disease control and prevention system, control and prevention policies, surveillance, comprehensive intervention and scientific research to provide a basis for the formulation of future chronic disease control and prevention policies in China.

Review of the brilliant achievements of nutrition and health in China

SUN Chang-hao, NIU Yu-cun

2019, 23(9): 1029-1031. doi: 10.16462/j.cnki.zhjbkz.2019.09.002

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Focus on the 70 years since the founding of New China, especially since the 40 years of reform and opening-up, Chinese nutrition has developed rapidly and achieved fruitful results in terms of treatment and prevention of nutritional deficiency diseases, nutrition improvement action, chronic disease improvement programme and nutrition education. It is believed that with the strengthening of the national emphasis on nutrition and the rapid development of nutrition science and technology, the extensive application of a large number of new nutrition technologies and methods will greatly promote human health.

Seventy Years of Progress of Food Safety in China

ZHANG Lishi

2019, 23(9): 1032-1036. doi: 10.16462/j.cnki.zhjbkz.2019.09.003

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Food safety has become the essential issue for national well-being and the people's livelihood. Since the founding the People's Republic of China (PRC), food safety has made great progress in all aspects of laws and regulations, surveillance and supervision. Currently, the overall status of food safety in China is moving towards the upside, but still tough and facing great challenges. This paper reviews the changes and progress in laws and regulations, surveillance and management, science and technology in food safety since the founding the PRC, as well as proposes several current challenges, to provide some thoughts to wrap up the past and move forward to improve the food safety in China.

Review and enlightenment of the China's new round of healthcare reforms

WEI Zi-ning, WANG Ya-dong

2019, 23(9): 1037-1040. doi: 10.16462/j.cnki.zhjbkz.2019.09.004

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This paper reviews and summarizes the background, stages, tasks, achievements and experiences of the China's new round of healthcare reforms. Lessons gained from the reforms are valuable for deepening the healthcare reforms of China.

Trends and risk factors of overweight and obesity among Chinese middle school students

GAO Li-wang, ZHAO Li, SUN Xiao-min, WANG You-fa

2019, 23(9): 1041-1045, 1056. doi: 10.16462/j.cnki.zhjbkz.2019.09.005

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Objective To investigate the trends and risk factors of overweight and obesity in Chinese middle school students. Methods Data from the China Education Panel Survey conducted in 2014, 2015 and 2016 were used (8 616, 8 762, 7 614; age range 11-18 years old). Overweight and obesity were defined according to Chinese sex-age-specific body mass index (BMI) cutoffs. Relationships between risk factors and BMI, overweight and obesity were tested, using linear regression and logistic regression models. Results The overall prevalence of overweight and obesity in 2016 was 15.3% (17.9% in boys, 12.6% in girls). From 2014 to 2016, the prevalence of overweight and obesity was increasing steadily. After adjusting for age and sex in 2016, being only-child, self-perceived being overweight or obese, or living in urban area were associated with higher BMI (β(SE)=0.23(0.10), β(SE)=2.83(0.14), β(SE)=0.23(0.11), respectively). Self-perceived being overweight or obese was associated with overweight and obesity (OR=4.20, 95% CI: 2.97-5.40). Conclusions Overweight and obesity rates among Chinese middle school students increased steadily from 2014 to 2016. Efforts should be made on childhood obesity prevention and control, especially target at those being only-child, living in urban areas.

Cohort study on determinants of mental health of migrant adolescents in junior high schools

LI Long, SONG Yue-ping, HU Yi-song

2019, 23(9): 1046-1050. doi: 10.16462/j.cnki.zhjbkz.2019.09.006

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Objective To analyze the status, changing trends and determinants of mental health of migrant adolescents in junior high schools. Methods All of the data came from China Education Panel Survey (CEPS). CEPS baseline survey was conducted during the 2013-2014 school year by using a stratified multistage probability sampling design. 10 279 nationally representative adolescents from the seventh grade in junior high schools were enrolled in the base school year of data collection and 9 449 participants were followed up at the second wave of data collection during the 2014-2015 school year. Our analytic sample (n=1 645) included all the migrant adolescents who had valid data on mental health. Based on CEPS self-reported mental health scale, t-test method and multivariate linear regression model were used to examine the determinants of mental health of migrant adolescents by performing univariate analysis and multivariate analysis. Results The baseline mental health score of migrant adolescents was (8.33±3.31), higher than that of non-migrant adolescents, and significantly increased to (8.60±3.79) in the follow-up school year. 43.3% of participants had negative mental status at higher frequency as time went on. Sex, cognitive skills, co-residence arrangements, numbers of siblings and school rankings were significant influencing factors for mental health score of migrant adolescents. Conclusions The mental health status of migrant adolescents are more vulnerable than that of non-migrant adolescents and continue deteriorating. Among migrant adolescents, female, those with weak cognitive skills, those who do not live with both parents, those who are not only children and those in schools ranking medium and above are more likely to have a poor mental health state.

The physical development and associated factors of ninth grade students in China

XU Mei-mei, ZHAO Li, Wang Wei-dong, YU Fei, LU Dong-yun, GAO Li-wang, WANG You-fa

2019, 23(9): 1051-1056. doi: 10.16462/j.cnki.zhjbkz.2019.09.007

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Objective To analyse the status and related factors of physical development of ninth grade students in China, so as to provide reference and scientific basis for the development of adolescent' physical health promotion programs. Methods Multiple linear regression and binomial Logistic regression models were used to analyse the data from 7 840 ninth grade students in the 2016 China Education Panel Survey. Results There were differences in the distribution of height and weight between urban and rural and between boys and girls.From the age of 14 to 16, boys were taller and heavier than girls(height cm: 171.69±6.95 vs 161.54±5.58, weight kg: 60.43±13.19 vs 53.21±11.69), and urban students were taller and heavier than rural students(height cm: 167.93±8.16 vs 165.80±7.94;weight kg: 58.18±13.16 vs 55.94±12.78). The rate of physical fitness of boys was lower than that of girls(51.8% vs 87.8%), and that of urban boys was lower than that of rural boys(45.7% vs 58.9%), and that of urban girls was higher than that of rural girls(92.0% vs 84.6%). The average age of first spermatorrhea was 13.62±1.23 years for boys and 12.87±1.07 years for girls. Sexual development of urban students appeared earlier than rural students. Multivariate linear regression analysis showed that height and weight were related to bring single-child and sleep time. Height was also related to parents'height, nationality, family economic level and exercise time, weight was also related to parents' weight (all P < 0.05). Binomial Logistic regression analysis showed that physical fitness level was related to gender, nationality, nutritional status, weight, high calorie intake, exercise time, etc (all P < 0.05). Correlative factors of male first spermatorrhea were nationality, urban residence, singleton, sleep time, physical fitness level, while female menarche was related to exercise time, lunch spot and nutritional status (all P < 0.05). Conclusions Comprehensive efforts and cooperation are needed to promote the normal development and physical health of the students.

Prevalence and influencing factors of myopia for the Chinese junior high school students

WANG Wei-dong, YAO Ya-nan, TANG Li-na, HU Yi-song

2019, 23(9): 1057-1061, 1106. doi: 10.16462/j.cnki.zhjbkz.2019.09.008

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Objective To analyze the mechanism of the influencing factors of myopia for junior high school students in China. Methods Based on the follow-up to 7 119 students in the 3 waves of questionnaire survey of the Chinese Education Panel Survey in junior high school stage, and the variables on students' myopia status, myopia influencing factors, and two kinds of risk behaviors of myopia including near visual activities and outdoor activities, the mediation effects of the myopia risk behaviors were tested by Logistic regression model. Results The myopia prevalence of 9th graders before junior high school graduation was 66.36%. Time on writing homework significantly increased the risk of myopia, the odds ratio (OR) was 1.17, the 95% confidence interval (CI) was 1.13-1.21, and the time on outdoor sports significantly decreased the risk of myopia (OR=0.80, 95% CI: 0.75-0.86). Before and after including the risk behaviors into the model, the myopia risk OR(95% CI) of female centralized from 1.84(1.66-2.04) to 1.69(1.51-1.88), the myopia risk OR(95% CI) of urban students'centralized from 1.19(1.03-1.37) to 1.16(1.00-1.34), the myopia risk OR(95% CI) of only children'centralized from 1.20(1.06-1.36) to 1.18(1.04-1.33). With reference to not myopic for both parents, the myopia risk OR(95% CI) of students having one myopic parent centralized from 2.47(2.12-2.88) to 2.44(2.09-2.85), the myopia risk OR(95% CI) of students having parent without myopic centralized from 4.25(3.09-5.86) to 4.13(3.00-5.69). Conclusions Gender, urban and rural, only child, and myopic parents are influencing factors of myopia. These factors have effects on myopia via two kinds of risk behaviors including outdoor activities and near visual activities.

Current situation and influencing factors of abnormal glucose metabolism in junior middle school students in Yanqing District, Beiing

WANG Shao-hua, ZHANG Zhen-quan, WAN Di, WANG Yun, SHI Zhi-hong, GUO Xiu-hua

2019, 23(9): 1062-1066. doi: 10.16462/j.cnki.zhjbkz.2019.09.009

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Objective To understand the current situation and influencing factors of abnormal glucose metabolism in junior middle school students in Yanqing District, Beijing. Methods With the mothod of stratified cluster random sampling, the questionnaire, physical examination and fasting capillary blood glucose were conducted in 2 493 students from 4 junior high schools. Results The prevalence of diabetes, impaired fasting glucose, and abnormal glucose metabolism were 2.5%, 11.4%, and 13.9%, respectively. The prevalence of abnormal glucose metabolism varied significantly among different ages, grades, regions, obesity, central obesity and hypertension (all P < 0.05); Unconditional multiple Logistic regression analysis showed that urban, centripetal obesity, and hypertension were positively associated with the risk of abnormal glucose metabolism in middle school students in Yanqing District; daily breakfast was negatively associated with the risk of abnormal glucose metabolism. Conclusion The prevalence of abnormal glucose metabolism is high among junior middle school students, urban, central obesity, high blood pressure and daily breakfast are influencing factors of abnormal glucose metabolism in Yanqing District of Beijing.

Health literacy and associated factors among college students in a medical university

HOU Ya-jie, HAN Xu, LIU Yang, CAI Su-zhou, WANG Ye, ZHANG Yan-fang

2019, 23(9): 1067-1071. doi: 10.16462/j.cnki.zhjbkz.2019.09.010

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Objective To understand the current health literacy level of students in a medical university and its influencing factors, so as to provide references for health education of medical college students. Methods By means of random stratified cluster sampling, health literacy questionnaire survey was conducted among 1 428 students in three grades of a medical university. Ratio and constituent ratio were used to describe the resuls. Chi-square test was used fot comparison among groups. Logistic regression was used to analyze the influencing factors. Results The percentage of sampled undergraduates in Hebei who had met the health literacy criteria was 57.18%.The percentages of students who had met the health literacy criteria on health concepts and the basic knowledge, and on healthy lifestyles and behaviors, and on the basic health skills were 58.68%, 30.88%, 65.48%, respectively. The health literacy of female college students was higher than that of males. There were statistically significant differences in health literacy among subjects of different grades, majors, fathers with education and fathers with different occupations (χ²=27.748, 46.525, 19.327, 30.779, all P < 0.01). Logistic regression analysis showed that girls' health literacy was higher than boys' (OR=1.521, 95% CI: 1.160-1.993). The health literacy level of students from different majors was in order of clinical medicine, nursing, pharmacy and other majors; The health literacy of the children with highly educated mothers was higher than that of the children with less educated mothers. Conclusions Overall level of health literacy of students in this school is higher than that of undergraduates nationwide. Medical colleges should focus on cultivating healthy lifestyles of medical students, so as to improve the overall health literacy of college students.

A case-control study on the risk factors of unintentional injuries among internal-migrant children

LI Xin-yu, YANG Ya-ming, FEI Gao-qiang, ZHOU Yi-xi, GAO Liu-wei, SUN Qian-nan, QIAN Yi-ning, ZHANG Xu-jun

2019, 23(9): 1076-1080. doi: 10.16462/j.cnki.zhjbkz.2019.09.012

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Objective To explore risk factors of unintentional injuries among internal-migrant children. Methods A 1:1 matched case-control study was conducted between 332 internal-migrant children with unintentional injuries, based on the principle that same class, same gender and age was no more than two years old. The survey was based on the unified questionnaire. Epi Data 3.1 was used to establish database and SPSS 23.0 was used for univariate analysis and multi-conditional Logistic regression analysis. Results Multi-conditional Logistic regression analysis model indicated that caregiver put pressure on children before exam and the adjusted odd ratio (OR) was 2.086 and 95% confidence interval (CI) was 1.263-3.444, caregiver's character was extravert type (OR=2.074, 95% CI: 1.275-3.372) or middle type (OR=1.796, 95% CI: 1.158-2.784), caregiver's educational background was illiteracy (OR=1.867, 95% CI: 1.280-2.722) or primary school (OR=2.458, 95% CI: 1.169-5.168), the neurotic behaviors of children (OR=1.466, 95% CI: 1.012-2.124) were risk factors of unintentional injuries among internal-migrant children. Conclusions The characteristics related to internal-migrant children's caregiver and children's neurotic behaviors are associated with the occurrence of unintentional injuries. Immediate and effective measures should be taken to ease the high injury prevalence and prevent the unintentional injuries among internal-migrant children.

Association of obesity and brachial-ankle pulse wave velocity among type 2 diabetes patients

HUANG Zhe, XU Bei-bei, WANG Xiao-wen, YAO Shan-shan, CAO Gui-ying, LI Man, CAO Ya-ying, TIAN Yao-hua, WU Yao, HUANG Shao-ping, LIU Xiao-fen, QIN Xue-ying, TANG Xun, LI Jin, WU Tao, CHEN Da-fang, HU Yong-hua

2019, 23(9): 1086-1091. doi: 10.16462/j.cnki.zhjbkz.2019.09.014

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Objective The aim of this study was to investigate associations of overall obesity (OO) and abdominal obesity (AO) with brachial-ankle pulse wave velocity (baPWV) among type 2 diabetes(T2DM) patients. Methods A community-based study for T2DM patients was conducted in rural communities in Beijing.Every patient completed a questionnaire to collect demography, lifestyle and diseases history, and underwent physical examinations, baPWV assessments and blood biochemical tests. Multivariate linear regression was used to assess the relationship between obesity index and baPWV. Abnormal baPWV was defined as patients with baPWV ≥ 1, 700 cm/s. Logistic regression model was performed to explore the risk of abnormal baPWV after adjusting for poetential confounders step by step. Results A total of 2 048 T2DM patients were recruited. The average age was (59.2±8.3) years and total prevalence of abnormal baPWV was 49.7%. After multivariable adjustment, linear regression showed that there was a negative correlation between body mass index(BMI) and baPWV and a positive correlation between waist-to-hip ratio (WHR) and baPWV. Compared to normal weight group, those with BMI ≥ 28 kg/m² had lower risk of abnormal baPWV (OR=0.59, 95% CI: 0.44-0.78, P < 0.001), but there was an increased risk of 46% among patients with obesity in WHR (OR=1.46, 95% CI: 1.07-2.00, P=0.018). Compared to those without OO and AO, patients without OO but with AO had a 1.67-fold increasesd risk of abnormal baPWV (OR=1.67, 95% CI: 1.19-2.35, P=0.003). Conclusions Abdominal obesity is related with arterial stiffnening among T2DM patients, and it is critical to evaluate arterial stiffness of T2DM patients with abdmonal obesity and normal BMI in order to reduce future risk of cardiovascular diseases.

Study on intention to quit smoking and influencing factors among current smokers aged 15 to 69 years in Gansu Province

LU Yi-ming, LU Pei-jun, ZHU Ze-shan, KANG Guo-rong, LI Jin-fang

2019, 23(9): 1092-1096, 1113. doi: 10.16462/j.cnki.zhjbkz.2019.09.015

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Objective To understand the intention to quit smoking and its influencing factors among current smokers in Gansu Province, so as to provide scientific basis for tobacco control. Methods A multi-stage sampling method was used to extract current smokers aged 15-69 years, and a face-to-face survey was conducted using the questionnaire on smoking among residents in China. Intention to quit smoking between current smokers with different characteristics was analyzed. Logistic regression was used to explore influencing factors of intention to quit smoking. Results The intention of current smokers to quit smoking in Gansu Province was 16.4% (95% CI: 15.5%-17.3%). Multivariate logistic regression analysis showed that current smokers who were in rural areas (OR=1.199, 95% CI: 1.022-1.408, P=0.026); family smoking prohibited (OR=1.767, 95% CI: 1.273-2.454, P=0.001), medical staff discouraged smoking within 12 months (OR=1.599, 95% CI: 1.359-1.842, P < 0.001), visited smoking clinics (OR=3.089, 95% CI: 2.031-4.698, P < 001), higher educational level of junior high school, senior high school and college or above (OR=1.383, 95% CI: 1.101-1.736; OR=1.627, 95% CI: 1.252-2.116; OR=1.374, 95% CI: 1.009-1.873, all P < 0.05), tobacco hazards knowledge with higher scores of 1-, 3- and 5-6 (OR=1.248, 95% CI: 1.030-1.514; OR=1.574, 95% CI: 1.289-1.922; OR=2.288, 95% CI: 1.879-2.786, all P < 0.05) were more likely to quit smoking; furthermore, smokers aged 20-, 30- years or smoking 20-, 30- years had a lower chance of quit smoking (all P < 0.05). Conclusions The intention of current smokers to quit smoking in Gansu province is generally not high. In the future, knowledge of tobacco hazards should be further promoted, medical staff should provide more smoking cessation services during the treatment process, and more smoking cessation clinics should be established.

Spatiotemporal analysis of esophageal cancer incidence in Huai'an: a study based on geographic information system

MIAO Dan-dan, ZHANG Qin, SUN Zhong-ming, TANG Yong, WEN Jin-bo, PAN En-chun

2019, 23(9): 1097-1101. doi: 10.16462/j.cnki.zhjbkz.2019.09.016

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Objective To explore the spatiotemporal distribution pattern, and identify risk cluster of esophageal cancer in Huai'an City so as to provide evidence for control and prevention of esophageal cancer. Methods Data of esophageal cancer incidence at township level in Huai'an City from 2011 to 2015 was collected. Spatial autocorrelation and local indications of spatial autocorrelation (LISA) were implemented to evaluate the spatial pattern of esophageal cancer incidence. Spatial scan statistics was used to examine spatio-temporal clustering of risk areas. Results The average incidence of esophageal cancer in Huai'an from 2011 to 2015 was 67.12/10 million, the incidence of male was significantly higher than that of female. The results of Moran's I values implyed the spatial autocorrelation at township level. The results of LISA indicated that there were local hot spots and cold spots. The significant high-risk clusters included townships in Huai'an County, Huaiyin County and Jinhu County. The low-risk clusters were located in the main urban area and Xuyi County. Conclusions There are significant spatio-temporal aggregation for the distribution of incidence of esophageal cancer in Huai'an City and same spatiotemporal high-risk clusters between male and female. Our findings have a foundation to explore the multi-factorial etiology of esophageal cancer and have vital practical value for health services and policies implementation.

Temporal and spatial distribution characteristics of NSCLP in Gansu Province from 2010 to 2016

LEI Jie, YUAN Jing-yan, SHEN Xi, ZHAO Si-xuan, LIU Rui-min, YANG Lan, DU Hong-liang, XIE Xiao-dong

2019, 23(9): 1102-1106. doi: 10.16462/j.cnki.zhjbkz.2019.09.017

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Objective To investigate the temporal and spatial distribution characteristics of non-syndromic cleft lip with or without palate (NSCLP) who born in Gansu Province from 2010 to 2016, and to establish a predictive model for developing the strategies for the prevention and control of NSCLP. Methods Spatial epidemiological research method and geographical information systems (GIS) were used to conduct thematic mapping, spatial correlation analysis, high/low clustering analysis, hotspot analysis and Kirging interpolation prediction for NSCLP patients in Gansu Province from 2010 to 2016. Results From 2010 to 2016, the aggregation trend of NSCLP incidence in 89 counties in Gansu Province was different obviously, the southeast area was high and the northwest was low. Based on the data of the cumulative incidence of NSCLP from 2010 to 2016 in Gansu, the spatial distribution of NSCLP presented positive spatial correlation (Moran'I=0.274, Z=7.814, P < 0.001) and the aggregation type was high-high cluster(Getis Gi=0.000 003, Z=4.381, P < 0.001), with 22 hot spots. The Kirging interpolation prediction results showed that the main prevalence trend of NSCLP in Gansu extended from Longdong to Longxi and Longnan areas. Conclusions The geographical distribution of NSCLP had a positive spatial correlation and a high-high aggregation type in Gansu from 2010 to 2016. The high aggregation area is concentrated in Longdong, Longxi and Longnan of Gansu, which suggest that it is essential to focus on prevention and control in these areas.

Study on genotyping drug resistance of HIV/AIDS patients with antiviral failure from 2014 to 2016 in Yunnan Province

LI Jian-jian, PAN Xiao-man, ZHANG Mi, LIU Jia-fa, YANG Cui-xian, YANG Bi-hui, LI Hui-qin, DONG Xing-qi

2019, 23(9): 1107-1113. doi: 10.16462/j.cnki.zhjbkz.2019.09.018

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Objective To investigate and analyze the prevalence, variation and mutations of genotyping drug resistance of human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS) patients with treatment failure from 16 prefectures in Yunnan Province from 2014 to 2016. Methods A cross-sectional study was conducted and epidemiological information collected from subject investigated. Reverse transcription-polymerase chain reaction(RT-PCR) was used to amplify HIV-1 pol gene fragments adopt In-house method, the alignment analysis was underway after sequencing, elucidated the resistant state of the three types of antiviral drugs. Results Based on the total patients treated from 2014 to 2016, 1 368 cases (58.8%) with drug-resistant mutations occurred all over province. A rough estimate of the overall resistance rate of HIV-1 was 1.6% (1 368/84 146). Drug-resistant strains were found in 16 cities. The highest overall drug resistant rate was 4.5% of Zhaotong, and among treatment failure population was Dehong's 72.9%(100/145). The mutations rates of nucleoside reverse transcriptase inhibitors(NRTIs), non-nucleoside reverse transcriptase inhibitors(NNRTIs) and protease inhibitors(PIs) in viral failure patients were 51.1% (699/1 368), 91.2% (1 248/1 368), 9.6%(132/1 368);The mutation sites with the highest frequency of the three kinds of drugs were NRTIs-M184V (71.1%), NNRTIs-K103N (43.7%), PIs-K20I (24.2%). Conclusions At present, HIV-1 drug resistance in Yunnan shows a low prevalence level, and there is a certain difference of resistant rate distribution in various cities. NNRTIs and NRTIs give priority to the drug resistance among the three kinds of drugs, the overall situation is significantly different from results of 2008-2012. We should strengthen the management of antiviral therapy and the detection of genotypic resistance, reduce the incidence of drug resistance, and control the occurrence and spread of drug-resistant strains.

Molecular evolution of influenza A/H3N2 viruses HA and NA genes circulating in Shenzhen in 2017

FAN Ying, LI Xue-yun, FANG Shi-song, PENG Bo

2019, 23(9): 1114-1120. doi: 10.16462/j.cnki.zhjbkz.2019.09.019

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Objective To investigate the molecular evolution of the Hemagglutinin (HA) and Neuraminidase (NA) genes of influenza A/H3N2 viruses in Shenzhen in the first half of 2017, so as to provide scientific basis for predicating influenza epidemic and variation. Methods A total of 40 influenza A/H3N2 viruses strains were selected and the molecular phylogenetic trees were constructed by bioinformatics software DNAStar, MEGA 7.0, etc. Then, the genetic characteristics and variation of HA and NA genes along with corresponding amino acids were analyzed. Results The homology of Shenzhen isolates reached 97.8%-100.0%, which located in the human-derived branch of Asia and North America. Compared with the vaccine strains A/Switzerland/9715293/2013(H3N2) and A/Hong Kong 14801/2014(H3N2) recommended by world Health Oraganication (WHO), there was a higher sequence similarity. Compared with the vaccine strain, HA and NA proteins had a number of amino acid sites replaced, of which HA 6 antigen sites and 2 receptor binding sites change; NA had a mutation of D151N/G located in enzyme activity sites. Potential N-glycosylation sites for HA and NA also changed. Conclusions The influenza A/H3N2 viruses in Shenzhen in the first half of 2017 has not yet formed a new subtype in the epidemic. Currently, the recommended vaccine strains still have some protective effects on the population. The replacement mutation of multiple amino acids sites of HA and NA suggests that the dynamic monitoring of molecular level of influenza A/H3N2 viruses need to be strengthened.

Composition and source apportionment differences of daytime and nighttime samples of PM_2.5 in the community of suburb in Tianjin during different heating periods

ZHAO Yan, FENG Li-hong, JIANG Chang-cheng, LI Jian-ping, SHANG Bo-dong, WU Ying-hong, LV Guang

2019, 23(9): 1121-1125, 1131. doi: 10.16462/j.cnki.zhjbkz.2019.09.020

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Objective To study the pollution and source apportionment differences of different periods PM_2.5 in the residential community of suburb in Tianjin City during heating and non-heating periods. Methods From 2015 to 2016, daytime and nighttime PM_2.5 samples were collected at a community in the suburb of Tianjin. The mass concentration of PM_2.5 samples and major chemical components in PM_2.5, including metal elements, polycyclic aromatic hydrocarbons (PAHs) and inorganic water-soluble ions were monitored. Positive matrix factorization (PMF) model was used to apportion potential sources of metal elements, PAHs and inorganic water-soluble ions in daytime and nighttime PM_2.5. Results In the heating period, the concentrations of some metal elements of suburban residential community were higher in the daytime than in the nighttime. In the non-heating period, the concentrations of some PAHs and inorganic water-soluble ions of suburban residential community were higher in the nighttime than in the daytime. Meanwhile, the concentrations of some metal elements were greater in the daytime than in the nighttime. When in heating period, the main source of PM_2.5 in the suburban residential community was coal combustion during daytime and its source contribution rate was 50.1% while secondary aerosol and fuel combustion emissions of gasoline and diesel vehicles were main sources during nighttime and their source contribution rates were 41.0% and 35.9%. The principal source of daytime PM_2.5 in the suburban residential community was indoor activity emissions during non-heating period, and secondary aerosol was main source during nighttime and their source contribution rates were 29.8% and 31.1%. Conclusions The pollution status of PM_2.5 in residential communities of suburban is serious, and the source apportionment of day and night PM_2.5 samples has different in different heating periods.

Study on the relationship between meteorological factors and the number of hypertension outpatients based on CNN-LSTM

ZHANG Zhong-lin, FEI Shan-shan, REN Xiao-lan, ZHANG Jing

2019, 23(9): 1126-1131. doi: 10.16462/j.cnki.zhjbkz.2019.09.021

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Objective To study the effect of meteorological factors on the number of hypertension outpatients in four areas of Gansu Province, then predict and analyze the trend of the number of hypertension outpatients, so as to provide reference for the prevention and control of hypertension diseases. Methods On the basis of controlling the confounding factors such as long-term trends, date effects, meteorological information and contaminant influence, a mixed model of convolutional neural network (CNN) and long-short term memory (LSTM) was constructed for the number of hypertension outpatients in the four regions of Baiyin, Chengxian, Qingcheng and Liangzhou by Python programming language. Results The root mean square errors of the CNN-LSTM model for the number of hypertensive outpatients in the four regions was 6.330 9, 6.814 2, 6.393 6 and 6.867 6. The mean absolute percentage error was 74.082 2, 78.508 2, 56.618 3 and 50.235 4. And the average absolute errors was 4.875 7, 5.431 1, 4.542 0 and 6.460 8. All the results was superior to those of support vector machine (SVM), autoregressive integrated moving average model (ARIMA), random forest (RF), CNN and LSTM. Conclusion The CNN-LSTM model can accurately predict the number of hypertension outpatients in Gansu. The hospital can rationally allocate medical resources according to the needs of hypertension for medical treatment at different times.

Clinical comparative analysis of acute kidney injury caused by scrub typhus in Guangxi from 2014 to 2018

LI Bai-cheng, ZHU Jie-yun, WANG Xiao-ling, ZHANG Jian-feng

2019, 23(9): 1132-1136. doi: 10.16462/j.cnki.zhjbkz.2019.09.022

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Objective To retrospectively analyze the clinical data of patients with acute kidney injury (AKI) caused by scrub typhus in Guangxi, to evaluate the incidence of AKI, and to search for the prediction indicators of AKI. Methods Data of 211 patients from The First Affiliated Hospital of Guangxi Medical University from 2014 to 2018 were collected and divided into AKI group (58 cases) and non-acute kidney injury (NAKI) group (153 cases). The auxiliary examination, treatment measures and complications of the two groups were compared. Regression analysis was used to analyze the risk factors associated with AKI. Results There were 58 cases (27.49%, 95% CI: 1.66-1.76, P < 0.001) with AKI and 166 cases were all negative in the field test. Compared with the NAKI group, the incidence and need rate of AKI were higher than NAKI group, and the differences were statistically significant (all P < 0.05). Multivariate Logistic regression analysis showed that blood system damage (OR=4.536, 95% CI: 1.262-16.308), the use of hormones (OR=3.261, 95% CI: 1.259-8.446) and diuretics (OR=3.870, 95% CI: 1.186-12.633) were risk factors for AKI. Low direct bilirubin (OR=0.952, 95% CI: 0.915-0.991) was a protective factor. Conclusion The incidence of scrub typhus induced AKI in Guangxi is in the middle level at domestic and abroad. Patients with scrub typhus who have complications of blood system damage and have to be treated with hormones and diuretics are risk factors for AKI.

Analysis on monitoring results of iodine deficiency disorders of children aged from 8 to 10 years and pregnant women in Wuhai City in 2017

LIU Fu-sheng, LIU Yan-chao, YANG Chen, WANG Hao-jie, ZHAO Hong, WANG Pei-xia, DAI Gang, LI Hai-ling

2019, 23(9): 1072-1075. doi: 10.16462/j.cnki.zhjbkz.2019.09.011

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Objective To explore current situation of iodine deficiency disorders(IDD) and iodine nutrient level by analyzing monitoring data of IDD from children aged from 8 to 10 and pregnant women in Wuhai City in 2017, so as to provide basis for the prevention and control of IDD. Methods Our surveillance points were located in Haibowan District, Wuda District, Hainan District of Wuhai City. Samples of salt and human urine were collected from 200 children aged 8 to 10 and 100 pregnant women at random. Urine iodine concentration and salt iodine concentration were measured. Thyroid volume was determined by B-ultrasound. Results There were 10 children diagnosed as thyroid goiter. Children's Goiter rate in this area was 1.67%.The averaged covering rate of eating iodine among children reached 99.56%, their acceptance rate of iodized salt was 12.7%. Median of salt-iodine was 21.7 mg/kg. Median of urinary iodine(MUI) for children was 204.5 μg/L. The percentage of children whose urinary iodine was less than 100 μg/L and 50 μg/L was 12.7% and 2.2%, respectively. Median of urinary iodine in boys was 224.0 μg/L, which was higher than in girls(191.5 μg/L), the difference was statistically significant(P=0.004). Median of urinary iodine in pregnant women was 145.8 μg/L. Pregnant women whose urine iodine below 150 μg/L accounted for 51.7%. The MUI in pregnant women during the first trimester was 115.5 μg/L. Pregnant women during the first trimester whose urine iodine below 150 μg/L accounted for 62.0%. Conclusions The iodine nutrition condition in children is basically normal, while iodine nutrition deficiency exist in pregnant women in this area. We should particularly enhance monitoring urinary iodine for pregnant women during the first trimester to reduce iodine deficiency.

Analysis of injury results of hospital outpatient/emergency in Hunan Province injury surveillance system from 2015 to 2017

WU Shan-shan, JIN Dong-hui, LIU Jia-wu, HUANG Yue-long, TAN Hong-zhuan

2019, 23(9): 1081-1085. doi: 10.16462/j.cnki.zhjbkz.2019.09.013

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Objective To analyze the causes and epidemiological characteristics of injury in Hunan Province, so as provide scientific basis for the development of intervention measures of injury. Methods The Excel 2007 software and SPSS 18.0 software were used to organize and analyze the injury surveillance system data. Results A total of 107 754 effective cases were collected in three years, and the male-female ratio was 1.65:1. The top three causes of injury were falls(36.0%), motor vehicle accident (20.6%) and sharp knife injury (11.8%). The locations of injuries were mainly roads (30.9%) and homes (28.3%). The top three activities at the time of injury were leisure activities (24.7%), driving (17.6%) and work (16.4%). 93.2% of injury was unintentional injury, and the degree of injury was mainly mild injury (74.3%). Conclusions The number of injuries is increasing year by year. The number of male injuries is more than that of females. Systematic research and intervention measures should focus on falls and motor vehicle accident.

Application of a support vector regression on prediction of bacillary dysentery combined with meteorological and air pollutants index

HAN Xiao-li, ZHANG Wei, CUI Xu-dong, MA Han-ping, ZHAO Xiang-kai, LIU Yan-chen, ZHANG Xiao-yu, REN Xiao-wei

2019, 23(9): 1137-1142. doi: 10.16462/j.cnki.zhjbkz.2019.09.023

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Objective To explore the application of support vector regression (SVR) model combined with meteorological and air pollutants index in the prediction of the cases of bacillary dysentery in Lanzhou City, so as to provide scientific reference for the prevention and control of bacillary dysentery. Methods Time series data of the reported cases of bacillary dysentery from December 2013 to August 2016, combined with the meteorological and air pollutants data, were used as training set to fit support vector regression model. The data from September 2016 to December 2017 was used as validation set to verify the model and compare the effect in fit and prediction with different models. Results A total of 7 192 bacillary dysentery cases were reported in Lanzhou City from 2013 to 2017. The correlation coefficient of meteorological and pollution factors with the cases of bacillary dysentery was more than 0.4, except air pressure. The parameters of the fit model were selected based on the integrated data, acquiring the three parameters with the smallest test error were C=5, γ=0.02 and ε=0.000 1, respectively. The validation set was used to test the different models, which showed that the integrated data model had the best predictive accuracy and robustness. The root mean squared error (RMSE) was 0.164 7 and the mean absolute percentage error (MAPE) was 16.405%. Conclusion SVR model combined with meteorological and air pollutants index is effective in the prediction of bacterial dysentery.

The predictive model of birth defect risk based on evidence-based medicine

ZHAO Jing-hua, LI Lu, CAO Hong-yan, SONG Chun-ying, GUO Xing-ping, ZHANG Yan-bo

2019, 23(9): 1143-1147. doi: 10.16462/j.cnki.zhjbkz.2019.09.024

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Objective The Rothman-Keller model was used to establish a predictive model for the risk of birth defects on the basis of evidence-based medicine, which so as to provide the basis for pertinent interventions in China. Methods First, the odds ratio (OR) value of risk factors for birth defects was obtained by evaluating the literature of meta-analysis, and the risk score table of the Rothman-Keller model was constructed. Then the simulation data was used to build the model, the risk boundary value of risk prediction, and finally the actual data to was used for verification. Results The main risk factors for 20 birth defects were collected through 17 articles. In the actual data of Shanxi Province, the actual incidence rate of high-risk populations screened by Rothman-Keller model was 10.9%, and it was statistically different from other groups (χ²=147.58, P < 0.001). In addition, the rothman-keller model identified all patients with a family history of birth defects as high-risk. Conclusions Through the meta-analysis literature on birth defects in China, the study find the main risk factors and construct a risk prediction model. It can be used to predict the risk of birth defects and help screen high-risk groups. At the same time, it provides ideas for predicting the risk of other diseases.

Spatial point pattern analysis of hemorrhagic fever with renal syndrome in Jingzhou, Hubei Province, 2017

YAO Meng-lei, LIU Tian, HUANG Ji-gui, NIE Xiao-pei, LI Tian-yan, WU Yang, TANG Zhuo

2019, 23(9): 1148-1150, 1154. doi: 10.16462/j.cnki.zhjbkz.2019.09.025

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Objective To analyze the spatial point pattern distribution characteristics of hemorrhagic fever with renal syndrome (HFRS) in Jingzhou city, Hubei province during the two seasons spring- summer and autumn-winter of 2017, to discuss its high incidence area and reason, and to provide basis for the resource allocation of public health. Methods The analytical data was collected from Infectious Disease Reporting Information System in China, and the spring-summer season was from March to August of 2017, while the autumn-winter was from the September of 2017 to the February of 2018. The Ripley's K-function and kernel density estimation were applied to analyze the spatial point pattern distribution and compare the distribution characteristics of spatial point pattern between the two seasons. Results In 2017, 133 cases of HFRS were reported in Jingzhou city, including the spring- summer and autumn-winter two pick incidences. The strongest aggregation distance was 17.77km in spring-summer season, and 14.40 km in autumn-winter season. The spatial gathering center was located in the north of Jianli County in spring-summer, and it moved to the south of Jiangling County and Shashi District in autumn-winter. Conclusions The key areas for the prevention and control of HFRS in Jingzhou City are Jiangling County, the southern part of Shashi District and the northern part of jianli county. The key groups are the residents of the urban-rural junction in the southern part of Shashi City, residents along the route of large-scale projects, and farmers engaged in agricultural planting or crayfish breeding in the gathering areas.

Prevalence of hypertension and its influencing factors in Shigatse area of Tibet

LI Jing, FENG Dan-hong, WU Guo-xiu, WANG Ying-ting, KANG Long-li

2019, 23(9): 1151-1154. doi: 10.16462/j.cnki.zhjbkz.2019.09.026

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Objective To investigate the prevalence of hypertension among residents over 18 years of age in Shigatse, Tibet, and to explore the correlation between different influencing factors and the incidence of hypertension. Methods A questionnaire survey and field blood pressure measurements were used to collect the information of age, education, occupation, smoking, drinking, body mass index (BMI) and salt intake were collected from 391 residents in Shigatse area. Logistic regression analysis of SPSS was used for statistical analysis. Results 391 questionnaires showed that the prevalence of hypertension was 38.36%, of which 39.91% was male and 36.52% was female. The results of multivariate Logistic regression analysis showed that the factors associated with hypertension in Shigatse residents included age, BMI, smoking and drinking, in which age and BMI, smoking were positively correlated with hypertension. Alcohol consumption was negatively correlated with hypertension. Conclusion In Shigatse area, age, BMI and smoking were the risk factors of hypertension, while drinking alcohol was protective factor of hypertension.

Investigation on the infestation and environment tolerance of Ornithonyssus bacoti in stored traditional Chinese herb Semen Coicis

JIANG Feng, LI Chao-pin

2019, 23(9): 1155-1157. doi: 10.16462/j.cnki.zhjbkz.2019.09.027

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Objective To investigate the infestation status and environment tolerance of ornithonyssus bacoti (O. bacoti) in stored traditional Chinese herb Semen Coicis (Coix seed). Methods 800 g of stored Semen Coicis was initially taken, and subjected to passing a 40-mesh sampling sieve. Then 80 g of Coix seed particles was sampled to directly isolate the mites that were made into slide specimen in conventional technique, and identified as the procedures described in previous literature. Results A total of 449 mites were isolated from the 80 g stored Semen Coicis particles, and were identified as O. bacoti. Conclusions O.bacoti was first detected in the stored traditional Chinese medicinal Semen Coicis with which infestation is serious. This status should call out attention to prevent the disease associated with transmission of pathogens from O.bacoti.

Evaluation of the value of immature reticulocyte fraction in the diagnosis of viral diseases in children

WANG Zhi-xian, WANG Ji-feng, WANG Shao-wen

2019, 23(9): 1158-1160. doi: 10.16462/j.cnki.zhjbkz.2019.09.028

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Dr.He Guanqing, an unforgettable master for epidemiology and public health in new China

LIAO Su-su

2019, 23(9): 1161-1164. doi: 10.16462/j.cnki.zhjbkz.2019.09.029

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The article is a brief biography of Prof. and Dr. Guangqing He (Dr. Eutrope A. Ho or Dr. Kuan-Ching Ho), in particular, focusing on his contributions to education and research in epidemiology and medicine after foundation of the People's Republic of China. It also introduces the history of Peking Union Medical College and its influence on development of epidemiology and public health in China.

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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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