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CN 34-1304/R ISSN 1674-3679

2020 Vol. 24, No. 10

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Literature Review
Insist on prevention first and help the well-off society in an all-round way with the health of the whole people
Bureau of Disease Control and Prevention, National Health Commission
2020, 24(10): 1117-1119, 1236. doi: 10.16462/j.cnki.zhjbkz.2020.10.001
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Abstract:
Physical health is the guarantee of life, and people's health is the foundation of a powerful country. Prevention is the most economical and effective health strategy. In this article, we reviewed the achievements of immunization program and the prevention and control of infectious disease, parasitic and endemic diseases of poor areas, chronic diseases and mental health, environmental health and school health, and puts forward the prospects. Building a strong public health system is the solid health foundation for achieving the "two Centenary Goals" and great rejuvenation of the Chinese nation. And the key lies in adhering to the prevention-oriented health policy, reforming and improving the disease prevention and control system, persist in being unremitting and nip in the bud.
The patriotic health movement is a great pioneering work of public health in new China and an important support for an all-round well-off
MAO Yan-mei, WU Jun, PAN Hai-feng, FAN Yin-guang, YE Dong-qing
2020, 24(10): 1120-1123. doi: 10.16462/j.cnki.zhjbkz.2020.10.002
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Under the leadership of the Communist Party of China (CPC), public health in the new China after 1949 has always adhered to the work policy focusing on prevention, and carried out patriotic public health movement to constantly improve Chinese public health. The patriotic health movement led by the CPC is a great pioneering work of public health in the new China and an important support for an all-round well-off. Up to now, the patriotic health movement still plays an important role in the process of interrupting the spread of diseases and builds a solid fortress for the health cause of Chinese people. Vigorously promoting the fine tradition of the patriotic health movement has extremely important practical significance and far-reaching historical significance for the implementation of the Healthy China Strategy.
Original Articles
The severity and influencing factors of injuries among patients attending hospitals due to falls in China, 2018
LU Zhi-ming, WANG Yuan, YE Peng-peng, ER Yu-liang, DUAN Lei-lei
2020, 24(10): 1124-1128. doi: 10.16462/j.cnki.zhjbkz.2020.10.003
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  Objective  To analyze the epidemiological characteristic and influencing factors of injury severity among patients attending hospitals due to falls in China, so as to provide the evidence for the work of preventing falls and the formulation of policies.  Methods  Descriptive analysis was applied by using the data from National Injury Surveillance System (NISS). Multivariate logistic regression was used for analysis on influencing factors of injury severity.  Results  In total, 500 621 cases of falls were collected by NISS. The injury severity was mainly mild (76.00%), and moderate and severe injury accounted for 24.00%. Results of univariate analysis showed that gender, age, urban-rural, season, time, places, drinking condition before falls, and activities when falls occurred were influencing factors of injury severity. The multivariate analysis showed that male (OR=1.056, 95% CI:1.041-1.071), age group of 5-years old (OR=1.412, 95% CI:1.366-1.460), 15-years old (OR=1.382, 95% CI:1.337-1.427), 30-years old (OR=1.844, 95% CI:1.787-1.903), 45-years old (OR=2.746, 95% CI:2.666-2.829) and 65 years old and older (OR=4.524, 95% CI:4.390-4.663), occurring in summer (OR=1.097, 95% CI:1.077-1.118), autumn (OR=1.110, 95% CI:1.089-1.131) and winter (OR=1.137, 95% CI:1.116-1.159), places where falls occurred were home (OR=1.169, 95% CI:1.143-1.196), school and school-related area (OR=1.102, 95% CI:1.069-1.136), sports and athletics area (OR=1.066, 95% CI:1.016-1.119), industrial and construction area (OR=1.800, 95% CI:1.727-1.877) and farm/farmland (OR=1.257, 95% CI:1.196-1.320), activity when falls occurred was walking (OR=1.084, 95% CI:1.045-1.126), and drinking condition before falls (OR=1.318, 95% CI:1.257-1.381) were risk factors of injury severity for falls.  Conclusions  Moderate and severe injuries account for a certain proportion of patients treated for falls and the influencing factors are various. Relevant departments should carry out targeted falls prevention and control.
Association between early-onset family history and stroke prevalence in high-risk populations of cardiovascular disease
CHENG Ting-ting, SU Jian, QIN Yu, CUI Lan, DING Shuai, MIU Wei-gang, ZHOU Jin-yi, WU Ming
2020, 24(10): 1129-1133. doi: 10.16462/j.cnki.zhjbkz.2020.10.004
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  Objective  To investigate how the early-onset family history of stroke influences the stroke in high-risk populations of cardiovascular disease.  Methods  Based on the China Patient-centered Evaluative Assessment of Cardiac Events Million Persons Project (China PEACE-MPP) from 2015 to 2019, a total of 22 552 persons at high-risk for cardiovascular disease (CVD) were selected from eight project areas in Jiangsu. Logistic regression analysis model was used to research the impact of early-onset family history on stroke prevalence, and further analyses of the interaction between early-onset family history and hypertension or diabetes were carried on.  Results  Compared with people without early-onset family history, people with early-onset family history of stroke had a higher risk of stroke, with an OR value of 2.04 (95% CI:1.70-2.44). For the risk of ischemic stroke, people whose only male relatives, only female relatives and bisexual relatives suffering from stroke had a higher risk of stroke than those without early onset family history, with OR values of 2.18 (95% CI:1.68-2.84), 1.76 (95% CI:1.31-2.37) and 3.12 (95% CI:1.80-5.42), respectively. For the risk of hemorrhagic stroke, only female relatives type was not significant. No interaction between early-onset family history or hypertension and diabetes was found.  Conclusions  People at high risk of CVD with the early-onset family history have a higher risk of stroke. Lifestyle intervention and disease management should be carried out opportunely.
Analysis on prevalence of metabolic syndrome and its influencing factors among middle-aged and above in Hebei Province
ZHAO Jing-jing, CAO Ya-jing, SHAN Guang-liang, TANG Li-juan, PAN Li, ZHANG Ling, LI Mei, SHI Wei-wei, GAO Jin-chai, SUN Ji-xin
2020, 24(10): 1134-1138. doi: 10.16462/j.cnki.zhjbkz.2020.10.005
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  Objective  To understand the prevalence of metabolic syndrome (MS) and its influencing factors among middle-aged and above in Hebei Province.  Methods  Using data from the chronic disease cohort study of natural populations in living communities in the Beijing-Tianjin-Hebei region, the prevalence of MS among 4 546 residents aged 40-80 years old in seven districts or counties of Hebei Province was analyzed, and the multivariate logistic regression model was used to explore the related influencing factors of MS prevalence.  Results  The prevalence of MS was 25.30%. Among them, the prevalence of men was 28.59%, and that of women was 23.09%; the prevalence of Han was 28.15%, and the Manchu was 21.07%. Among the components of MS, the prevalence of overweight/obesity, hypertension, hyperglycemia and dyslipidemia were 50.99%, 46.70%, 22.06% and 43.16%, respectively. Multivariate logistic regression results showed that females (OR=0.69, 95% CI:0.57-0.83, P ＜ 0.001), Manchus (OR=0.68, 95% CI:0.59-0.79, P ＜ 0.001), and higher education levels (compared to those with primary school and below, the odds ratio for high school/junior high school and college or above were 0.83 and 0.75, respectively) were protective factors, and the advanced age (compared with 40-49 years old age group, the odds ratio for 50-59 years old, 60-69 years old and 70-80 years old age group were 1.81, 1.76 and 1.50, respectively) was risk factors.  Conclusions  The prevalence of metabolic syndrome in Hebei is relatively high, especially among elderly, male, Han and low-education people. When carrying out targeted prevention and control of the crowd, active measures should be taken to control weight.
Investigate frailty status and analysis its influencing factors of the elderly in Qiannan rural minority arears of Guizhou
ZHOU Quan-xiang, SHE Fu-qiang, YANG Jing-yuan, YANG Xing, SONG Wen-jun, CHEN Hao, HE Shao-qian, LI Zhong-yan
2020, 24(10): 1139-1143. doi: 10.16462/j.cnki.zhjbkz.2020.10.006
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  Objective  To investigate the frailty status and to analyze its influencing factors of elderly in Qiannan rural minority areas, in order to provide reference for improving health condition and the life of quality of elderly.  Methods  Multilevel sampling investigation was used. 1 352 elderly were selected from 10 villages of 3 towns in Qiannan. Chi square test and logistic regression analysis were used.  Results  The prevalence of elderly frailty was 36.76% in Qiannan minority areas. Logistic model showed that ethnic(β=0.40, OR=1.49, 95% CI:1.16-1.91, P < 0.001), age (β=0.27, OR=1.31, 95% CI:1.09-1.57, P < 0.001), annual family income (β=-0.28, OR=0.76, 95% CI:0.67-0.86, P < 0.001), diet type (β=0.29, OR=1.33, 95% CI:1.17~1.52, P < 0.001), living conditions (β=-0.76, OR=0.47, 95% CI:0.32~0.69, P < 0.001), chronic diseases (β=1.01, OR=2.75, 95% CI:2.10-3.60, P < 0.001) and daily living function (β=0.78, OR=2.17, 95% CI:1.66-2.85, P < 0.001) were the main influencing factors of the frailty in Qiannan minority areas.  Conclusions  The frailty status are relatively serious of elderly in this areas. The elderly who are ethnic minorities, have chronic disease and dis-function of daily living ability are high risk groups. Health education, healthy lifestyle education and chronic disease management should be carried out by the primary medical institutions, so as to promote their health level and quality of life.
Analysis on disease economic risk and influencing factors of chronic obstructive pulmonary disease among Na Xi ethnic minority in Yunnan Province
LIU Ying-nan, CAI Le, WANG Xu-ming, CUI Wen-long, SHEN Jing-rong, ZUO Chun-mei, HE Lian-ju
2020, 24(10): 1144-1148. doi: 10.16462/j.cnki.zhjbkz.2020.10.007
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  Objective  The aim of this study was to analyze the disease economic risk and influencing factors of chronic obstructive pulmonary disease (COPD) among Na Xi ethnic minority in Yunnan Province.  Methods  A multi-stage stratified random sampling method was used to conduct on-site questionnaire survey and lung function tests among Na Xi ethnic minority residence aged ≥ 35 years in Yulong County, Yunnan Province.  Results  The prevalence of COPD among Na Xi ethnic minority in Yunnan Province was 17.66%. The economic risk of COPD patients was 1.53 times higher than that of the observed population (RR=1.53), and the incidence of catastrophic health care expenditures and poverty due to illness among households with COPD patients was 13.49% and 18.58%, respectively. The results of multivariate logistic regression analysis showed that households with COPD patients (OR=2.378, 95% CI:1.681-3.363, P < 0.001) and households with lower per capita annual income (OR=0.467, 95% CI:0.332-0.656, P < 0.001) were more likely to experience catastrophic health care expenditure. Households with lower per capita annual income (OR=0.028, 95% CI:0.016-0.047, P < 0.001) and households without toilets (OR=0.561, 95% CI:0.402-0.784, P < 0.001) were more likely to experience poverty due to illness.  Conclusions  The economic risk of COPD is relatively high among Na Xi ethnic minority in Yunnan Province. We should enhance economic and medical support for households with COPD patients and households with low income.
Effects of age and influenza virus exposure on the cross-reaction of post-immune serum with H3N2 subtype mutants
ZENG Zhao-zhun, LI Jing-xin, CAO Jia-qian, YU Qiu-fan, ZHANG Li, ZHU Feng-cai
2020, 24(10): 1149-1153. doi: 10.16462/j.cnki.zhjbkz.2020.10.008
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  Objective  To evaluate the effect of age and previous influenza exposure history on the cross-reaction of post-immune serum with H3N2 subtype mutants.  Methods  750 subjects were vaccinated with the test influenza virus subunit vaccine and the control influenza virus split vaccine at a ratio of 1:1, and were grouped according to age and influenza virus exposure history. Through the hemagglutination inhibition(HI)test, the serum hemagglutination inhibition titer of the subject before and after immunization against the vaccine strain, and the antibody titer of the immunized serum against the four H3N2 subtype variant influenza strains that were circulating in that year were measured. Calculate the geometric mean antibody titer(GMT)and the ratio of the antibody GMT ratio between the variant strain and the vaccine strain. The Kruskal-Wallis rank sum test was used to compare the difference in GMT odds ratio between different age groups and between different previous influenza exposure groups.  Results  In the population vaccinated with influenza virus subunit vaccine, subjects exposed to both H1 subtype and B lineage virus strains before immunization had higher post-immunization antibody levels against A/Jiangsu-Nanchang/11926/2014(H3N2)than those without exposed to H1/B (t=3.913, P=0.001). Among the people vaccinated with influenza virus split vaccine, adults aged 19-59 years faced A/Jiangsu-Haizhou/11044/2015 (H3N2)post-immunization cross-reactivity levels higher than those aged 3-18 years (t=3.198, P=0.008).  Conclusions  Previous exposure to H1 subtype or B lineage influenza viruses may affect the cross-reactivity of antibody responses after H3 immunity to varying degrees, and therefore may affect vaccine efficacy. There are age-specific differences in human post-immunization responses.
Typing and antimicrobial resistance analysis of diarrheogenic Escherichia coli in Anhui Province from 2015 to 2019
LI Chun, CHEN Guo-ping, MENG Zhao-qian, WANG Li, CHEN Qing-qing, SUN Yong, ZHANG Zhu-hui
2020, 24(10): 1154-1159. doi: 10.16462/j.cnki.zhjbkz.2020.10.009
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  Objective  To understand the epidemic characteristics and drug resistance trend of diarrheogenic Escherichia coli (DEC) in Anhui area, so as to provide an important basis for prevention and treatment of DEC diarrhea in Anhui Province.  Methods  Fecal samples of diarrhea patients were collected and inoculated with McConkey culture medium in Anhui from 2015 to 2019. Suspicious colonies were identified and typed by multiple fluorescence quantitative PCR, and drug sensitivity test was carried out by microbroth dilution method.  Results  557 strains were isolated from 6 120 stool samples. The main pathotypes were 191(34.29%) a typical enteroaggregative Escherichia coli (aEAEC), 153(27.47%) enterotoxigenic Escherichia coli (ETEC), 108(19.39%) a typical enteropathogenic Escherichia coli (aEPEC), 77(13.82%) typical enteroaggregative Escherichia coli (tEAEC), 11(1.97%) enteroinvasive Escherichia coli (EIEC) and 3(0.54%) typical enteropathogenic Escherichia coli (tEPEC). Multidrug resistant bacteria accounted for 45.78%. The statistically significant resistance difference of the same pathotype in different years were as follows:a typical EAEC:ampicillin/sulbactam (AMS), nalidixic acid (NAL), cefoxicillin (CFZ); typical EAEC:AMS, CFZ, azithromycin (AZM); EPEC:ampicillin (AMP), AMS, CFZ; ETEC:NAL, AZM, ciprofloxacin (CIP). The antibiotics with statistically significant differences in drug resistance among different pathotypes were AMP, AMS, tetracycline(TET), NAL, erythromycin (ERY), chloramphenicol (CHL), cefotaxime (CTX), CFZ, gentamicin (GEN), trimethoprim/sulfamethoxazole (SXT), AZM and CIP. The resistance of tEAEC to CFZ, EPEC to AMP, AMS and CFZ, ETEC to NAL and CIP showed an increasing trend from 2015 to 2019.  Conclusions  The mainly epidemic pathotypes in Anhui area were aEAEC, ETEC, aEPEC and tEAEC. The resistances of antibiotics (AMP, AMS, NAL, CFZ and CIP) were significantly different among different years and pathotypes. The results of resistance analysis can provide reference for rational use of antibiotics and prevention of the increase of antimicrobial resistance.
Current status of hepatitis B virus infection among children and adolescents in the model area of comprehensive prevention and treatment of hepatitis B in Luohu district in Shenzhen
ZHU Fang, LIAO Yi, LIU Gang, ZHOU Xiao-hong, LUO Yi, FANG Qing, LIU Wei-min, CHEN Guo-cui, LI Xiao-yan, CHENG Jin-quan
2020, 24(10): 1160-1164. doi: 10.16462/j.cnki.zhjbkz.2020.10.010
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  Objective  To investigate the status of hepatitis B virus (HBV) infection among adolescents and children in the model area of comprehensive prevention and treatment of viral hepatitis B in Luohu district in Shenzhen, that provide scientific evidence for the prevention and control of viral hepatitis B.  Methods  A total of 9 599 subjects were selected from 14 kindergartens, 12 primary schools, 2 middle schools and 1 high school in Luohu demonstration area by multi-stage cluster sampling. Venous blood was collected and serum markers were detected by enzyme linked immunosorbent assay (ELISA).  Results  There were no statistically significant differences in the positive rate of hepatitis B serum markers between different genders, but there were significant differences in hepatitis B surface antigen (anti-HBs) (χ2=196.038, P < 0.001) and hepatitis B virus surface antigen (HBeAg) (χ2=9.925, P=0.019) among different school age groups. Among different kind of the kindergarten children, serum markers positive rate of hepatitis B were no statistically difference. Only hepatitis B surface antigen positive rate has statistically differences(χ2=9.487, P=0.002) among different primary school students, and the positive rate of private schools were higher (0.67%) than public schools (0.04%). Between public and private middle school students, only the positive of anti-HBs was statistically difference (χ2=25.390, P < 0.001), and public school (58.85%) had higher positive rate than private schools (45.43%).  Conclusions  The comprehensive prevention and treatment of hepatitis B in the demonstration area is effective. But more attention should be paid to hepatitis B immunization among senior students and children of migrant workers in the future.
Analysis and prediction of the epidemiological characteristics of hepatitis A in Hubei Province from 2004 to 2019
LI Li-na, LI Ning, HU Ying, LIU Na, YU Chuan-hua, WANG Lei, WANG Xu-yan
2020, 24(10): 1165-1169. doi: 10.16462/j.cnki.zhjbkz.2020.10.011
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  Objective  To analyze the epidemiological characteristics of hepatitis A in Hubei Province from 2004 to 2019, so as to provide scientific evidence for the evaluation and formulation of hepatitis A prevention and control strategies.  Methods  A descriptive epidemiological study was conducted to analyze the data of hepatitis A in Hubei Province from 2004 to 2019. Auto regression integrated moving (ARIMA) average seasonal model was used to predict the occurrence of hepatitis A in the future.  Results  A total of 25 080 cases of hepatitis A were reported in Hubei Province from 2004 to 2019, and the average annual incidence rate was 2.71/100 000. The incidence rate of hepatitis A dropped from 5.88/100 000 in 2004 to 1.43/100 000 in 2019. The majority of patients were farmers (59.13%). The age of onset was mainly 35-65 years old (56.80%). The ratio of male to female was 2.03:1 in 2014, and decreased to 1.06:1 in 2019. The reported cases were mainly sporadic. During the study period, there were 6 outbreaks. All outbreaks were related to educational organizations. From 2010 to 2017, the hepatitis A vaccination rate of children in Hubei Province was over 90%. The number of hepatitis A new cases predicted by ARIMA model continued to decline, and it reduced to 484 cases in 2030, with a predicted incidence rate below 1/100 000.  Conclusions  From 2004 to 2019, the prevention and control measures of hepatitis A are effective. In the future, it is necessary to strengthen the comprehensive prevention and control measures for the rural population, especially for the middle-aged farmers, while doing a good job in the immunization plan of children. The occurrence of hepatitis A cannot be eliminated in 2030, but current prevention measures can further reduce the harm of the disease.
The crowd characteristics of uterine fibroids detection among Dong ethnic women aged 30-79 in Guizhou Province
TANG Mei, HONG Feng, GUAN Han, ZHANG Yan, WANG Zi-yun, TANG Xue-jie, YIN Chao-hui, YUAN Wei, WANG Jun-hua
2020, 24(10): 1170-1174, 1201. doi: 10.16462/j.cnki.zhjbkz.2020.10.012
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  Objective  By using the statistical method of latent class analysis(LCA) to analyze the crowd characteristics of uterine fibroids detection among Dong ethnic women aged 30-79 in Guizhou Province.  Methods  Stratified multi-stage sampling method was used to study 3790 Dong ethnic women in Qiandongnan Miao and Dong Autonomous Prefecture, Guizhou province. B-ultrasound (Apogee 1200, China) was used to detect whether they had uterine fibroids. Variables with statistical significance by Chi square test were salected as the risk characteristics of uterine fibroids. The potential category analysis was used to classify Dong women, the detection rate of uterine fibroids in different groups were compared, then the high-risk group was identified.  Results  There were statistically significant differences in the detection rate of uterine fibroids among women with different living types, educational level, menarche age, abortion history, age, BMI, abortion history, birth frequency and menstrual status (all P < 0.05). According to the latent class analysis, the crowd characteristics of Dong ethnic women's uterine fibroids were divided into five types:rural elderly type, rural middle-aged type, rural youth type, urban middle-aged type and urban young middle-aged type. The detection rate of rural youth type was the highest (4.43%), followed by the urban elderly type (3.89%), and the rural elderly type was the lowest (0.79%).  Conclusions  The high-risk groups of uterine fibroids in Dong ethnic women in Guizhou province are different between urban and rural areas. Young people are the majority in rural areas, while old people are the majority in urban areas. Common crowd characteristics are higher abortion rates and high school and middle school education.
A novel prognostic index for gingival cancer in Fujian Province
CHEN Min-min, BAO Xiao-dan, DENG Qing-rong, ZHANG Ze-yun, HE Bao-chang, LIU Feng-qiong, WANG Jing, CHEN Fa
2020, 24(10): 1175-1180. doi: 10.16462/j.cnki.zhjbkz.2020.10.013
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  Objective  To evaluate the prognostic factors and to further develop an applicable prognostic index (PI) for patients with gingival cancer in Fujian Province.  Methods  From January 2005 to June 2017, a total of 198 patients with pathologically confirmed gingival cancer were recruited from the First Affiliated Hospital of Fujian Medical University. The clinical and follow-up data of all the patients were collected by medical records and telephone interviews, respectively. COX regression analysis model was used to calculate the hazard ratio (HR) as well as 95% confidence interval (95% CI) and to assess independent factors for the prognosis of gingival cancer. Subsequently a prognostic index was developed based on β value of each significant variable obtained from the multivariate COX hazards regression analysis model. PI was divided into low-, medium- and high- risk groups according to the optimal cutoff points obtained by the X-tile software. The Akaike information criterion (AIC) and Harrell's C-statistic (C-index) were used to evaluate the predictability of PI.  Results  Among the patients with gingival cancer, the patients aged ≥ 60 years (HR=1.668, 95% CI:1.002-2.777, P=0.049), and patients with recurrence and metastasis (HR=3.996, 95%CI:2.295-6.959, P < 0.001) had poorer prognosis. The prognosis of patients with clinical stage Ⅳ was worse than that of those with clinical stage Ⅰ (HR=3.002, 95%CI:1.134-7.947, P=0.027); Patients with surgical treatment had better prognosis than those without surgical treatment (HR=0.246, 95%CI:0.118-0.511, P < 0.001). In addition, the PI prognosis prediction model has a good predictability (AIC=611.605, C-index=0.747, AUC=0.765).  Conclusions  This study suggests that age (≥ 60 years), high clinical stage, no surgery treatment as well as recurrence and metastasis were the risk factors for the prognosis of gingival cancer patients and the PI developed had a relatively high predictive ability.
Effects of daily worries and mood state on body sub-health of college students
WANG Xiao-feng, HE Li-ping, XIAO Qi-peng, JIANG Yan, LIU Yu, MENG Yan-bin, XI Jun-yan, QIN Yang-fen
2020, 24(10): 1181-1184, 1214. doi: 10.16462/j.cnki.zhjbkz.2020.10.014
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  Objective  To understand the sub-health, daily worries and mood state of college students, so as to explore the relationship and interaction of daily worries and mood state on sub-health.  Methods  A multi-stage random sampling method was used, and 1 346 college students were selected asthestudy objects. Recent Life Experience of College Students Questionnaire, Profile of Mood States and Multidimensional Sub-health Questionnaire of Adolescents were used for field investigation, and SPSS 24.0 software was used for statistical analysis.  Results  The total detection rate of sub-health of college students was 13.3%, and there were significant differences among students with different residences (χ2=4.390, P=0.036). The total mood disturbance Score (TMD) score was (100.75±18.89), which was lower than the norm (104.7±16.3), and the difference was statistically significant (t=-7.665, P < 0.001). The detection rate of physical sub-health in subjects with higher TMD than norm was higher than that in subjects with lower TMD than norm (χ2=106.819, P < 0.001). The detection rate of physical sub-health was higher in the group with high score of daily hassles than that in the group with low score (χ2=42.278, P < 0.001). The effects of daily worries and state of mind on the physical sub-health of college students were multiplicative and additive, 52.9% of the physical sub-health of college students could be attributed to the interaction between daily worries and state of mind.  Conclusions  Daily worries and mood state have multiplicative and additive effects on sub-health of college students.
The mediating effect of income level between health literacy and self-assessed health
WANG Zhi-fan, ZHANG Zhi-zhong, MA Li-yang, WAN Qiao-ying
2020, 24(10): 1185-1189. doi: 10.16462/j.cnki.zhjbkz.2020.10.015
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  Objective  To analyze the mediating effect of income level between health literacy and self-assessed health among peasants, so as to provide scientific basis for health education and health promotion.  Methods  Using stratified multistage random sampling, we conducted a questionnaire survey among 16 349 peasants.  Results  The health literacy level was 9. 7% among peasants in Gansu. Multiple regression analysis showed that nationality, education level and per capita income were main factors affecting farmers' health literacy. The higher the education and income level, the higher the level of health literacy (all P < 0.05). It showed a linear correlation between health literacy and self-assessed health. The total effect of health literacy on self-assessed health was 0.028 3; The mediating effect of literacy through income was 0.003 9, and the relative mediating effect was 13.78%.  Conclusions  The level of health literacy of peasants in Gansu is at a low level; Health literacy can affect health status through income level.
Comparison analysis of European quality of life-5 dimensions with three-level and five-level based on four types of people in China
CAI Yi-fan, WU Hong-yan, Yang Zhi-hao
2020, 24(10): 1190-1194. doi: 10.16462/j.cnki.zhjbkz.2020.10.016
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  Objective  To compare the difference of EQ-5D-3L and EQ-5D-5L in patients with hypertension, diabetes, chronic hepatitis and the general population.  Methods  Four groups of people were investigated by using two scales to compare the consistency, redistribution inconsistency and information discrimination.  Results  In the four types of people, the intra-group correlation coefficients of the utility value of the two scales were greater than 0.7. The ceiling reductions of EQ-5D-5L compared to the EQ-5D-3L were 5.8%, 8.3%, 9.2% and 17.3%. The average redistribution rates of the EQ-5D-3L to EQ-5D-5L in the five dimensions were 5.5%, 7.6%, 5.7% and 2.2%. The inconsistency mainly focused on the two dimensions of pain or discomfort and anxiety or depression. Among the four groups of people, Shannon index of EQ-5D-5L was superior to that of EQ-5D-3L in all dimensions except for the self-care dimension of the general population. In terms of the Shannon uniformity index, the value of the EQ-5D-5L scale was larger in the four types of people in the mobility dimension, and the two scales had different values in the other four dimensions.  Conclusions  In the disease population, the additional level of EQ-5D-5L reflects its advantages and improves the ability of the respondents to identify the health status, while in the general population, the EQ-5D-3L has been able to meet the research needs.
Lambda-mu-sigma method(LMS) study on the physical growth reference standard of low birth weight infant
SHAO Zi-yu, SUN Yu, LI Pei-pei, WEI Hua-zhang, DUAN Yu-wen, LI Lin, WANG Hong-xin, XU Xiu-qin
2020, 24(10): 1195-1201. doi: 10.16462/j.cnki.zhjbkz.2020.10.017
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Abstract:
  Objective  To investigate the physical growth status of low birth-weight infants (LBWI) from 0 to 12 months in main urban area of Hefei City, so as to obtain the growth trajectory of premature low birth-weight infants and mature low birth-weight infants in Hefei.  Methods  A birth cohort was established, totally 228 LBWI entered the cohort, 161 normal birth weight infant (NBWI) from the same center were selected as control group. The physical growth indicators were monitored during 0-12 months, the percentile values of weight and length for age and gender were calculate by using lambda-mu-sigma(LMS) method, and LMS curves were drew.  Results  The body weight and length of LBWI group were significantly lower than those of NBWI group during the infancy stage, and the difference was statistically significant (all P < 0.001). The weight of LBWI was 2.5 times heavier at 3 months than at birth, 4.3 times heavier at 12 months than at birth, and the length of LBWI was 1.6 times longer at 12 months than at birth.In general, the LBWI group showed a catch-up growth trend on weight and length in the first year, especially under 6 months. The catch-up growth rate of premature low-birth-weight infants was faster than that of mature low birth-weight infants.  Conclusions  There is catch-up growth of LBWI during 0-12 months. The growth curves by LMS method of premature low birth weight infants and mature low birth-weight infants can objectively describe their different physical growth characteristics and trajectories.
Estimation of the agreement between different molecular detection strategies for diagnosing Enterovirus in hospitalized children with hand, foot and mouth disease
ZHANG Tian-chen, YANG Jun-mei, LI Yu, YANG Jian-li, ZHOU Yong-hong, KANG Di, QIU Qi, LI Peng, LIANG Lu, SHEN Yuan-fang, CUI Peng, CUI Ya-jie, GUO Chun, SONG Chun-lan, ZENG Meng-yao, WANG Fang, LONG Lu, CHENG Yi-bing, YU Hong-jie
2020, 24(10): 1202-1208. doi: 10.16462/j.cnki.zhjbkz.2020.10.018
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Abstract:
  Objective  The aim of this study was to understand the diagnostic yield of fluorescence-based quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR) only and qRT-PCR combined with several nested polymerase chain reaction (nested PCR) sequencing for detecting enterovirus in hospitalized children with hand, foot and mouth disease (HFMD), furthermore to analyze the agreement and its associated factors of the two testing strategies.  Methods  A hospital-based prospective HFMD cohort was established in Henan from February 2017 to February 2018. The relevant information and biological specimens of the participants were collected. According to the detection strategies, qRT-PCR and qRT-PCR combined with several nested PCR sequencing were performed both for enterovirus diagnosis independently.  Results  The agreement between the two testing strategies in the detection for enterovirus-A71 (EV-A71), coxsackievirus-A16 (CV-A16) and other enterovirus (EVs) were good (kappa>0.60). Sampling types and with EV-A71 vaccination, the time of sample collection after onset, age and disease severity were related to detection yield. The sampling days after onset of specimens for qRT-PCR combined with nested PCR sequencing ≥ 4 d and the sampling time interval of different detection strategies more than 2 d would reduce the chance-corrected agreement between the two testing strategies in EV-A71 detection. Severe disease was associated with higher chance-corrected agreement in EV-A71 detection. Specimen type (P=0.033) and disease severity (P=0.020) were independent factors related to the chance-corrected agreement of CV-A16 detection.  Conclusions  The agreement between the two detection strategies of qRT-PCR and qRT-PCR combined with nested PCR sequencing is relative well. The individual condition of the child and the time of specimen collection would affect the detection yields and consistency of molecular detection.
Review
Research progress of social media in coronavirus disease 2019 (COVID-19)
LYU Jin-liang, WANG Wan-zhou, ZHANG Yun-jing, ZHOU Jiang-jie, WANG Sheng-feng
2020, 24(10): 1209-1214. doi: 10.16462/j.cnki.zhjbkz.2020.10.019
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Abstract:
In March of 2020, the World Health Organization (WHO) announced the occurrence of a global pandemic of coronavirus disease 2019 (COVID-19). As a real-time and widely accessible information sharing platform, social media not only provides an important data source for surveillance during the COVID-19 epidemic, but also serves as an important way for information acquisition, medical services and public opinion surveillance. Social media has shown great values in prevention and control of the disease, however, there are still many limitations in related areas, such as limited application of the prediction model and propagation of misinformation. In the context of globalization, making full use of social media's advantages of immediacy, sensitivity and interactivity can provide beneficial ways for prevention and control of COVID-19, and emerging infectious diseases. Further researches are recommended to center around themes of formulation of social media-based forecasting paradigm and elimination of data-sharing barriers. Much more efforts still needed for optimizing analysis techniques and methods, so as to provide guarantee for epidemic prevention and control.
Short Repoets
Correlation between depression and low back pain of elderly women in rural areas of China
WANG Xiao-hui, ZHAO Shuai-xiang, CAO Jin, ZHAO Si-ya
2020, 24(10): 1215-1218. doi: 10.16462/j.cnki.zhjbkz.2020.10.020
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Abstract:
  Objective  To explore the correlation between depression and low back pain of elderly females in rural areas of China.  Methods  Data comes from China Health and Retirement Longitudinal Study (CHARLS) in 2015. All women aged 60 years old and over in rural areas were included in the study. The subjects were divided into depression group and non-depression group by the scores of the 10-item center for experimental studies depression scale (CESD-10). The covariates related to depressive symptoms were balanced by the propensity score matching (PSM), and the correlation between low back pain and depression was analyzed by univariate unconditional Logistic regression.  Results  A total of 1 668 subjects were enrolled, with an average age of (67.51 ±5.90) years. The prevalence of low back pain and depressive symptoms were 30.22% (95% CI:28.02%-32.48%) and 46.04% (95% CI:43.63%-48.47%), and the average score of depressive symptoms were (10.13 ±7.00) points. After using PSM 1:1 to match the covariates, the results of univariate unconditional Logistic regression analysis showed that there was a correlation between depression and low back pain of elderly women in rural areas of China (OR=2.901, 95% CI:2.002-4.203, P < 0.001).  Conclusions  There is an association between low back pain and the risk of depression in elderly females of rural areas in China.
Survey of access and demands of health information in patients with rare bone diseases and their families
LIU Li-li, HE Bing-jie, CHEN Wei-ye, SUN Yue, SHAN Wei-ru, ZHANG Zhi-jun, WANG Sheng-feng, ZHAN Si-yan
2020, 24(10): 1219-1223. doi: 10.16462/j.cnki.zhjbkz.2020.10.021
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Abstract:
    Objective   To describe the current status and needs of patients with rare bone diseases and their families in obtaining health information.    Methods   We developed a self-designed questionnaire by Wenjuanxing, and conducted an online survey through a non-profit organization of rare bone diseases. The information collected included access and needs/recommendations about health information related to rare bone diseases.    Results   A total of 199 valid questionnaires were collected, with 10 rare bone diseases involved. 76.38% of the questionnaires were filled out by family members of patients. The patients or their families who chose online platforms (mobile phones, computers, etc.) to obtain health information accounted for 84.92%, and the search engine (66.86%) and WeChat Official Accounts (63.31%) were used most frequently. 85.05% of the patients or their families followed 1 to 3 WeChat Official Accounts of rare disease. The top three health information focus on WeChat Official Accounts were diagnosis and treatment knowledge (91.59%), related policies (83.18%), and public welfare activities (73.83%), in turn, and the top three that patients most wanted to increase were related policies (82.24%), diagnosis and treatment knowledge (75.70%), and cutting-edge information (74.77%).    Conclusions   Patients with rare bone diseases and their families mainly obtain health information through online platforms, with greater needs on policies, diagnosis and treatment knowledge and the cutting-edge information, and providers should focus more precisely on these three aspects in the future.
Accuracy of self-reported body height, weight and excess body weight among school students in Nanjing City
YE Qing, QIN Zhen-zhen, WANG Na, WANG Zhi-yong, XU Fei
2020, 24(10): 1224-1227. doi: 10.16462/j.cnki.zhjbkz.2020.10.022
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Abstract:
  Objective  To assess the accuracy of self-reported body height and weight as well as body weight status among school students in Nanjing, and further to explore the factors affecting the accuracy.  Methods  With a multistage cluster sampling approach, students of grade four to twelve were randomly selected from 12 districts of Nanjing. All the data were gathered via face-to-face interview and physical examination. Cohen's kappa and Bland Altman plots were used to assess the agreement between self-reported and objectively-measured body height and weight as well as body weights status.  Results  The proportion of objectively-measured overweight and obesity was 16.70% and 10.97%, respectively, among these students. Participants' body height was significantly over-estimated with an average of 1.33 cm by self-report, while their body weight and body mass index (BMI) value were significantly under-estimated with 1.16 kg and 0.76 kg/m2 (all P < 0.05), respectively. The accuracy of self-reported body height and weight might be influenced by participant's gender, grade, parent's educational level, residence location and body weight status. The concordance rate between self-reported and objectively-measured BMI categories was 83.89% (κ=0.662). For each anthropometric characteristic, fewer than 5% of subjects were out of 95% confidence interval of agreement based on Bland-Altman analysis.  Conclusions  The accuracy of self-reported body height and weight as well as body weight status was acceptable for primary and high school students in Nanjing. It suggests that self-reported anthropometric measurements could be used for population-based epidemiologic surveys among school-aged children and adolescents.
The genotypes and sequence characteristics of NS5B region of subtype 1b among hepatitis C viruses in Liuzhou, Guangxi, from 2014 to 2018
YIN Qi, LUO Zhou, CHEN Qin-yan, YANG Qing-li
2020, 24(10): 1228-1232. doi: 10.16462/j.cnki.zhjbkz.2020.10.023
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Abstract:
  Objective  To analyze the genotypes distribution of hepatitis C virus(HCV)and the sequence characteristics of NS5B region of HCV subtype 1b from 2014 to 2018 in Liuzhou, Guangxi.  Methods  HCV RNA was extracted from serum of patients with chronic hepatitis C, and the NS5B gene was amplified by nested PCR after reverse transcription. The genotype and genetic relationship of HCV were analyzed by gene sequencing and constructing gene evolutionary tree. The differences of NS5B gene and protein sequence among local, non-local and reference strains of HCV 1b were compared by cluster analysis.  Results  The genotypes of HCV epidemic in Liuzhou included 1a, 1b, 2a/c, 3a, 3b, 6a, 6c/d and undermined type(NT), which accounted for 3.39%, 43.01%, 0.42%, 13.98%, 6.99%, 28.81%, 3.18% and 0.21%, respectively. The evolutionary distances for 61.6% of the HCV 1b subtype were far away from those of the reference strain. From 2014 to 2018, the proportion of this group accounted for 69.8%, 78.6%, 43.3%, 47.6% and 59.6% of HCV 1b, respectively. Fifteen frequent point mutations of NS5B gene in this group were determined, which caused I2682V and S2755N frequent mutations of NS5B protein.  Conclusions  The dominant genotypes of HCV epidemic in Liuzhou, Guangxi are 1b, 6a and 3a. Most of the subtypes of HCV 1b belong to the local genetic group. The NS5B proteins of this group have characteristic mutational sites and may affect the antiviral effect with direct antiviral drugs.
Prevalence and risk factors of COPD in some areas of Shaanxi Province
HU Zhi-ping, WANG Yan-ping, LI Ya-jun, QIU Lin, LIU Rong, WANG Wei-hua, WU Meng, SA Ri-na
2020, 24(10): 1233-1236. doi: 10.16462/j.cnki.zhjbkz.2020.10.024
Abstract(372) HTML (240) PDF(26)
Abstract:
  Objective  To investigate the prevalence and influencing factors of chronic obstructive pulmonary disease (COPD) in people aged 40 and above in some areas of Shaanxi Province.  Methods  The multi-stage stratified cluster random sampling method was used in this study. A total of 1 800 residents aged 40 and above were selected from three monitoring districts in Shaanxi.Interview survey, physical measurement and pulmonary function were examined. The relevant factors were analyzed by test and binary logistic regression analysis.  Results  A total of 1 638 effective samples were obtained. The prevalence of COPD was 13.8%. Prevalence rate in male (18.5%) was higher than that in female (9.6%)(χ2=27.399, P < 0.001); the prevalence of the age group of 70 years and above (22.5%) was the highest. The prevalence of COPD was 20.4%, 12.9% and 8.5% in 60-, 50- and 40- group respectively. With aging, the prevalence was increasing(χtrend2=31.970, P < 0.001). Multivariate logistic regression analysis showed that the risk factors for COPD were age (OR=2.86, 95% CI:1.52-5.39, P=0.001), smoke (OR=1.60, 95% CI:1.12-2.27, P=0.031) and family history of respiratory diseases (OR=1.83, 95% CI:1.05-3.18, P=0.008).  Conclusions  The prevalence of COPD is high in some areas of Shaanxi Province. The risk factors for COPD are old age, smoking and family history of respiratory diseases.
History of Public Health
The expeditioner of epidemiological causal inference: Robert Koch
ZHANG Qi, WU Jun, YE Dong-qing, FAN Yin-guang
2020, 24(10): 1237-1240. doi: 10.16462/j.cnki.zhjbkz.2020.10.025
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Abstract:
Robert Koch (1843-1910), a German doctor in the 19th century, was the founder and pioneer of world pathogenic bacteriology, as well as an expedition to infer the causes of epidemics. He innovated the technology of mycobacterium tuberculosis staining, developed solid culture medium, microphotography and bacterial microscopy, etc., which laid the foundation for researchers in microbiology; he successively found more than 100 kinds of bacteria, such as anthrax, typhoid, tuberculosis and vibrio cholerae, which opened the mysterious veil of unknown causes diseases; the single cause biological specific causation theory and Koch's law came out, which opened the "golden era" of epidemiological causal inference.

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