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CN 34-1304/R ISSN 1674-3679

2020 Vol. 24, No. 2

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The situation and responses of emerging infectious diseases in China
LI Qun
2020, 24(2): 125-127. doi: 10.16462/j.cnki.zhjbkz.2020.02.001
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Since the 1990 s, emerging infectious diseases have been found in the world. After SARS in 2003, there have been several domestic and imported emerging infectious diseases in China, indicating a not optimistic situation. The associated and driven factors of occurrence or spreading of emerging infectious diseases come from biological, natural and social fields. Therefore, the world health organization and the international community focus on the establishment of effective regional and international monitoring and response systems. Although the emerging infectious diseases response capacity in China has been systematically improved since the SARS epidemic in 2003, there still has deficiencies on mechanism and system. Considering the current emerging infectious diseases situation and challenge, the key area or pathogens and the tasks of capacity building on surveillance, early warning and response need to be clarified and strengthened in China.
Epidemiological characteristics of acute lower respiratory tract infection in children in Gansu Province
CAO Wen-pei, MA Jing, LI Juan-sheng, REN Xiao-wei, SHEN Xi-ping, LIU Xiao-ning
2020, 24(2): 128-133. doi: 10.16462/j.cnki.zhjbkz.2020.02.002
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  Objective   To analyze the pathogenic epidemiological characteristics of acute lower respiratory tract infection(ALRTI) in children in Gansu Province from 2012 to 2015.   Methods   The surveillance data of 458 children infected with ALRTI in 10 sentinel hospitals in Gansu province from 2012 to 2015 were collected, and infection status and epidemiological characteristics of each virus and bacteria were analyzed by descriptive study methods.   Results   The male to female ratio of the 458 children with ALRTI was 1.81:1, and the positive detection rate of the virus was 33.62%(95% CI:29.28%-37.97%), among which the positive detection rate of respiratory syncytial virus was the highest(12.23%).The positive detection rate of bacteria was 24.84%(95% CI:20.04%-29.65%), among which the positive detection rate of streptococcus pneumoniae was the highest(18.47%).There was significant no difference in the positive detection rate of virus and bacteria between children of different genders(P > 0.05).There was significant no difference in the positive detection rate of virus among children of different age groups(χ2=5.980, P=0.050), but the positive detection rate of bacteria was different(χ2=12.078, P=0.002).Positive detection rates of virus infection and bacterial infection were different in distinct seasons(all P < 0.05). By using logistics regression analysis, season, age and sentinel hospital were the influencing factors of ALRTI virus infection in children(allP < 0.05), and sentinel hospital and years were the influencing factors of ALRTI bacterial infection in children(allP < 0.05).   Conclusion   Respiratory syncytial virus, influenza virus and parainfluenza were the main causes of ALRTI virus infection in children aged 0-14 years in Gansu province, and the main bacterial infections were streptococcus pneumoniae and haemophilus influenzae, the number of virus infection was more than that of bacterial infection. Viral and bacterial infection had the same peak incidence.
Epidemiological characteristics and trend prediction of scarlet fever in Hubei Province from 2010 to 2018
CAI Jing, HUANG Shu-qiong, YANG Wen-wen, ZHANG Peng, XIE Cong, WU Ran
2020, 24(2): 134-138. doi: 10.16462/j.cnki.zhjbkz.2020.02.003
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  Objective   To provide reference for formulating scarlet fever prevention and control strategies by analyzing the epidemiological characteristics and predicting the incidence trend of scarlet fever.   Methods   Spearman correlation analysis, clustering analysis, seasonal index model and seasonal ARIMA model were used for analysis and prediction.   Results   The average annual incidence of scarlet fever in 2010-2018 was 1.37/100 000, and there was a positive correlation between annual incidence and year(rs=0.817, P=0.007). April-June and November-December were high incidence months. The clustering analysis was significant(F=4795.30, P < 0.001), showing that the high-incidence areas are Shennongjia, Yichang, Enshi, Wuhan. Reported cases were concentrated in 1-14 years old, mainly for students, child care children and scattered children. The incidence rate of males was higher than that of females. The optimal model is ARIMA(0, 1, 1)(0, 1, 0)12. The prediction showed that the monthly incidence characteristics of 2019 were consistent with previous years, and the annual incidence rate was 10.22/100 000(95% CI:2.33/100 000-30.43/100 000), which was higher than the incidence of 2018.   Conclusions   The incidence of scarlet fever in Hubei Province is generally on the rise from 2010 to 2018. The incidence is bimodal. Students are the main disease group. The incidence rate of males is higher. The incidence is mainly concentrated in the mountainous areas of southwest and capital cities. The ARIMA model has a good applicability in the prediction of scarlet fever. The incidence level will continue to rise in 2019, and it is necessary to strengthen monitoring and control measures with reference to epidemiological characteristics.
Epidemic trend of hepatitis B in 18 ethnic minorities of Yunnan Province from 2009 to 2018
DONG Zhe, KANG Wen-yu, YU Wen, XU Lin, HU Xiao-ting, ZHAO Zhi-xian, LI Qiong-fen
2020, 24(2): 139-144. doi: 10.16462/j.cnki.zhjbkz.2020.02.004
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  Objective   To analyze the epidemic trend of hepatitis B virus(HBV) in 18 minority nationalities in Yunnan Province from 2009 to 2018, so as to explore the ethnic differences in the incidence of HBV in Yunnan Province.   Methods   Based on the reported incidence data of hepatitis B in China's disease prevention and control information system from 2009 to 2018, descriptive epidemiology method was used to describe and analyze the incidence of hepatitis B in different ethnic groups, and K-means clustering method was used to explore and analyze the annual average incidence of hepatitis B in different ethnic groups.   Results   From 2009 to 2018, the average incidence of hepatitis B in Yunnan Province was 44.26/100 000, which was much lower than the overall level of China every year; the average incidence of hepatitis B in ethnic groups was 41.27/100 000, slightly lower than the overall level of Yunnan every year. The prevalence of hepatitis B was different in different ethnic groups. The average incidence of Wa was significantly higher than others(95.26/100 000), and Jingpo was the lowest(22.51/100 000). According to the incidence of hepatitis B, different ethnic groups were divided into three categories: high incidence ethnic group, middle incidence ethnic group and low incidence ethnic group.   Conclusion   There are ethnic differences in the incidence of hepatitis B in Yunnan Province. The incidence of hepatitis B in some ethnic groups is higher than that in the whole country all the year round, which is the key population in the prevention and control of hepatitis B.
Molecular characteristics of the hemagglutinin 1 and neuraminidase genes of influenza B viruses isolated in Yancheng city from 2015 to 2017
CHEN Guo-qing, LI Chun-xiang, WANG Yao, LI Feng, XU Shi-lin, LI Zhang-cheng, SHAO Rong-biao
2020, 24(2): 145-150. doi: 10.16462/j.cnki.zhjbkz.2020.02.005
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  Objective   To analyze the genetic characteristics of the hemagglutinin(HA) and neuraminidase(NA) genes of influenza B viruses isolated in Yancheng City from 2015 to 2017.   Methods   The throat swab specimens of influenza-like illness(ILI) from sentinel surveillance hospital and outbreak sites were collected and sent to Yancheng CDC for virus nucleic acids and virus isolation testing. After validation with serological tests, eighteen strains of influenza B virus isolates were selected to amplify their HA1 and NA genes through RT-PCR assay. Their molecular characteristics of the obtained viral HA1 and NA gene sequences were analyzed using bioinformation software from three aspects, including nucleic acid level, amino acid level and molecular evolution level.   Results   Basically, the clustering relationships and the branche patterns between HA1 and NA genes from the 18 Yancheng influenza B virus strains were similar. The Yamagata lineage strains in 2015 were distributed in the Yamagata Clade 3 branch, belonging to Phuket/3073 strains. The Victoria lineage strains in 2016-2017 were distributed in the Victoria Clade 1 A branch, belonging to Brisbane/60 strains. D196 N substitution was detected on HA1 protein in all of Yamagata lineage strains at 190-helix epitope; Amino acid substitutions of victoria lineage strains involved two antigenic epitopes, 117 and 129 sites of 120-loop epitope and 197 and 199 sites of 190-helix epitope. No Intra-lineage or inter-lineage rearrangements occurred in Yancheng strains. Eighteen influenza B strains had no mutations in catalytic residues and drug resistant sites of NA genes.   Conclusion   The Yamagata strains well matched with vaccine strain B/Phuket/3073/2013. The HA1 and NA genes of victoria lineage strains circulated in Yancheng City during 2016 to 2017 are changing gradually. The accumulation of these mutations will result in antigenic drift of victoria lineage strains and increase the mismatch of the IFV field stains with the available vaccine strains, which may reduce the protective effect of flu vaccine.
Phylogenetic analysis of influenza B hemagglutinin and neuraminidase gene in Binzhou City from 2013 to 2018
ZHANG Li-fang, ZHANG Jing, SUN Hui, HUANG Ying, YIN Xiu-sheng, HAN Feng-chan
2020, 24(2): 151-154. doi: 10.16462/j.cnki.zhjbkz.2020.02.006
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  Objective   To investigate the mutation of hemagglutinin(HA), neuraminidase(NA) gene and amino acid variation of influenza B.   Methods   Throat swab specimens were taken from patient with influenza-like illness(ILI) and were investigated for the influenza virus identification from 2013 to 2018, and 29 strains of influenza B viruses were selected. HA, NA gene sequencing of the viruses were performed and were aligned using molecular evolutionary genetics analysis software. The phylogenetic tree was constructed.   Results   During the influenza seasons from 2013 to 2018, the detection rates of influenza B virus were 47.0%, 23.0%, 31.0%, 7.2% and 65.1%, respectively. Statistically significant differences between the proportion of influenza B viruses were observed(χ2=1 485.143, P < 0.001). The isolates from 2013 to 2014 did not correspond to vaccine strain, which was recommended by world health organization for the influenza season.   Conclusions   The evolution of influenza B virus was achieved through interlineal gene recombination, co-prevalence of different lineages, and continuous replacement of different antigenic lineages in Binzhou from 2013 to 2018.
Expression of long non-coding RNA MALAT1, NEAT1 and NEAT2 in peripheral blood of tuberculosis patients
LI Hong-miao, CHEN Shuang-shuang, BAO Xun-di, ZHANG Gen-you, SHI Si-jiu, LIU Xiao-ning, ZHANG Xin-li, LIU Shuang, WANG Hua, LI Ye
2020, 24(2): 155-159. doi: 10.16462/j.cnki.zhjbkz.2020.02.007
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  Objective   To analyze the differences in the expression levels of the lncRNA MALAT1, NEAT, NEAT2 in peripheral blood mononuclear cell(PBMC) from tuberculosis patients and healthy controls.   Methods   We detected the lncRNA expression levels in PBMC from 79 tuberculosis patients and 82 healthy controls by quantitative reverse transcription polymerase chain reaction, and analyzed the correlation between lncRNA expression levels and some clinical features and laboratory indicators in tuberculosis patients.   Results   The expression levels of MALAT1, NEAT1 in PBMC of tuberculosis patients were significantly higher than healthy controls(Z=-4.386, P < 0.001;Z=-10.175, P < 0.001). There was no significant difference in the expression of NEAT2 between tuberculosis patients and healthy controls(Z=-0.203, P=0.839). The correlation results of lncRNA levels and some clinical features, laboratory indicators in tuberculosis patients suggested that the NEAT2 level in PBMC of newly treated tuberculosis patients was higher than recurrent tuberculosis patients, while the NEAT2 level in PBMC of sputum smear positive tuberculosis patients was lower than that of sputum smear negative tuberculosis patients(all P < 0.05). There was a negative correlation between MALAT1 level and erythrocyte sedimentation rate(rs=-0.256, P=0.034).   Conclusion   MALAT1 and NEAT1 are abnormally expressed in PBMC of tuberculosis patients, and may be involved in the pathogenesis of pulmonary tuberculosis.
Antibiotic resistance, serotype and molecular typing of Listeria monocytogenes from foods in Shandong Province from 2013 to 2016
HOU Pei-bin, CHEN Yu-zhen, LI Xin-peng, LI Wen, LIU Jing, DONG Hai-yan, WANG Mei, ZHANG Hua-ning
2020, 24(2): 160-163. doi: 10.16462/j.cnki.zhjbkz.2020.02.008
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  Objective   To understand the main serotypes, antibiotic resistance profiles and molecular typing characteristics of Listeria monocytogenes(LM) isolated from foods in Shandong Province from 2013 to 2016.   Methods   The antibiotic sensitivity of LM was tested by broth microdilution method. The serotypes were determined by slide agglutination and PCR, and the molecular typing was carried out by pulsed field gel electrophoresis(PFGE) and multilocus sequence typing(MLST).   Results   Most of 191 LM strains were sensitive to the eight antibiotics tested. Tetracycline resistance was most prevalent(15/191, 7.85%). There was no significant difference in the 8 antibiotic resistance monitored for 4 years(P=1.000). The serotype 1/2 a, 1/2 b and 1/2 c accounted for 38.82%(66/170), 18.82%(32/170), and 42.36%(72/170), respectively. The patterns of SDSRZXDZ016, S2014 L031 and SDSRZX030, totally accounted for 33.78%, were the dominant types. The main ST types were ST9, ST8 and ST121, which accounted for 81.18%(69/85). The clinical common types, ST3, ST7 and ST87 accounted for 8.23%(7/85), mainwhile new ST type was not found.   Conclusion   The LM strains isolated in Shandong Province from 2013 to 2016 were sensitive to most antibiotics, but some strains were resistant to tetracycline and erythromycin. The dominant serotypes were 1/2 c and 1/2 a. Serotype 4 b, prone to outbreaks of listeriosis, was not found. The main PFGE types were SDSRZXDZ016, S2014 L031 and SDSRZX030, which were continuously found from 2013 to 2016. The main ST types were ST8, ST9 and ST121. The clinical types, ST3, ST7 and ST87 were isolated from food and should be paid seriously attention to.
Relationship between the intake of salt and salted food and the infection of Helicobacter pylori in 40-69 years old local residents in a county with high gastric cancer risk in Anhui Province
WU Han-han, WANG Chen, WANG Guang-jun, ZHAO Qi-hong, LI Li, CHEN Wen-jun, BO Qing-li, HU Chuan-lai, HU An-la
2020, 24(2): 164-169. doi: 10.16462/j.cnki.zhjbkz.2020.02.009
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  Objective   The aim of the present study was to investigate the relationship between the intake of salt and salted food and the infection of Helicobacter pylori(Hp) among 40-69 years old local residents in a county with high gastric cancer risk in Anhui province.   Methods   From July 2015 to August 2018, we conducted a questionnaire and a serological test for Hp among 40-69 years old local residents in Lujiang county, Anhui province. The questionnaire focused on the consumptions of salt and salted food. The relationship between Hp infection and risk factors was analyzed by gender. Univariate and multivariate logistic regression analysis were used to analyze the relevant influencing factors.   Results   The Hp infection rate of total local residents was 50.07%. Among male subjects, age, body mass index(BMI), marital status, educational level, job, labor intensity and income had no link to Hp infection(allP > 0.05). But among female subjects, BMI was associated with Hp infection(χ2=13.454, P=0.001). Besides, alcohol consumption was a risk factor for Hp infection in male subjects(OR=1.789, 95% CI:1.188-2.694, P=0.003). But, high intake of salt and salted food had no effect on Hp infection after adjustment for alcohol consumption variable in men using multivariate analysis(all P > 0.05). After adjusted for BMI variable among female individuals, high salt intake(≥9 g/day)(OR=1.462, 95% CI:1.060-2.015, P=0.021) and the high salted food intake(≥1 times/day) were risk factors for Hp infection in women(OR=1.560, 95% CI:1.021-2.383, P=0.040).   Conclusions   In one county with high gastric cancer risk in Anhui province, high salt intake(≥9 g/day) and high salted food intake(≥1 times/day) are risk factors for Hp infection among 40-69 years old female local residents.
Associations of body mass index, waist circumference, waist height ratio and hypertension in the elderly
SUN Zhuo-yu, LI Yi-jun, DU Zhuo, LIU Qian, FU Jing-zhu, ZHOU Dong-tao, HUANG Guo-wei, WANG Guang-shun, SUN Zhang-qing
2020, 24(2): 170-175. doi: 10.16462/j.cnki.zhjbkz.2020.02.010
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  Objective   To explore the associations of body mass index(BMI), waist circumference(WC), waist height ratio(WHtR) and the prevalence of hypertension in elderly residents over 60 years in Baodi district, Tianjin.   Methods   Residents over 60 who underwent medical examinations in the Koudong Health Center, Baodi district, Tianjin, were all invited to participate in the study from April to May, 2018. Participants were asked to fill out structured questionnaires and undergo physical examinations. Stratified analysis and logistic regression analysis were applied to examine joint effects and interactions of BMI and WC(or WHtR) on the risk of hypertension.   Results   A total of 1 417 residents(83.75%) out of 1 692 residents participated in the study. The prevalence of hypertension in the participants was 46.36%. 66.50% of the participants were BMI overweight or obese. Participants with central obesity accounted for 74.66%(measured by the WC) and 75.38%(by the WHtR). Compared to the normal weight measured by the BMI or the WC, BMI overweight(OR=1.65, 95%CI: 1.19-2.30) or obesity(OR=3.41, 95%CI: 2.23-5.20) and WC central obesity(OR: 1.49, 95%CI: 1.00-2.23) were associated with increased risk of hypertension. The joint effects of BMI and WC(OR=2.49, 95%CI: 1.78-3.46), or BMI and WHtR(WHtR overweight: OR=2.05, 95%CI: 1.41-2.99; WHtR obesity: OR=2.37, 95%CI: 1.50-3.76) were greater than the single effect of the latter(WC overweight/obesity: OR=1.39, 95%CI: 0.90-2.15; WHtR overweight: OR=1.02, 95%CI: 0.62-1.66; WHtR obesity: OR=1.44, 95%CI:0.55-3.81).   Conclusions   Of the three indices, BMI is strongly correlated with the risk of hypertension. BMI overweight or obesity has enhanced the association of WC or WHtR and the risk of hypertension, suggesting that weight control in the normal range, especially measured by the BMI index, may prevent and control hypertension.
Effect of sleep duration and quality on hypertension incidence in Chinese middle-aged and elderly people
ZHU Ling-yuan, FANG Yuan, CAO Zhi-xian, WANG Yang, HE Yu-hua, WANG Yu-zheng
2020, 24(2): 176-182. doi: 10.16462/j.cnki.zhjbkz.2020.02.011
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  Objective   To investigate the incidence of hypertension among Chinese middle-aged and elderly people, and to explore the association of sleep duration and sleep quality with the incidence of hypertension.   Methods   Our data were collected from the 2011 and 2015 China health and retirement longitudinal study(CHARLS), a total of 6 047 middle-aged and elderly individuals aged 45 years and over were included in this study, sleep duration were measured as self-reported average sleep time in the past month. Sleep quality was evaluated using the self-made questionnaire. The association of sleep duration and sleep quality with the incidence of hypertension was analyzed using multivariate logistic regression analysis.   Results   After four years of follow-up, 1 151 peoples developed hypertension, and the cumulative incidence rate was 19.03%. Logistic regression analysis showed that abnormal sleep time or poor sleep quality had no effect on the incidence of hypertension. The results remained unchanged in the subgroup analysis of sex and age. Further investigation of the association of different combinations of sleep duration and quality in relation to hypertension indicated that the combined effect of sleep time and sleep quality on hypertension was not statistically significant(all P > 0.05).   Conclusion   There is no sufficient evidence supporting correlation between sleep time and sleep quality with the incidence of hypertension in the middle-aged and the elderly in China, and age and sex had no effect on the correlation.
Quantile regression model-based analysis of influencing factors on quality of life of inpatients with type 2 diabetes
ZHANG Jing, SUN Xian, ZHANG Wen-ling, LI Jin-xia, TIAN Xiao-li
2020, 24(2): 183-188. doi: 10.16462/j.cnki.zhjbkz.2020.02.012
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  Objective   This study aimed to understand the status of health-related quality of life(HRQOL) among the hospitalized patients with type 2 diabetes(T2 DM) in Yinchuan, so as to analyze the factors associated with HRQOL of hospitalized T2 DM patients. The applied value of quantile regression in analysis of HRQOL was explored.   Methods   A cross-sectional study was conducted to obtain data of 480 hospitalized T2 DM patients. The Chinese Normal Audit of Diabetes-Dependent Quality of Life(CN-ADDQoL) scale was used to assess the HRQOL status of patients. Traditional linear regression and quantile regression were used to analyze the influencing factors of HRQOL in hospitalized T2 DM patients.   Results   The average weight impact(AWI) of hospitalized T2 DM patients was-2.7(-3.6, -1.9), and the items with lowest score were in the dimension of "work life"(AWI, -4(-6, -2)), "eat" AWI, -4(-6, -2)) and "Anything of Drinking"(AWI, -4(-6, -2)). Linear regression results showed that 18-59 years old or the renal and circulatory complications were risk factors for HRQOL in T2 DM hospitalized patients. Quantile regression further found that the better the quality of life, the weaker the effect on age(β1=0.931, P1=0.001; β2=0.699, P2=0.001; β3=0.370, P3=0.012; β4=0.313, P4=0.035), the rural residents(β5=-0.421, P5 < 0.001), insulin treatment(β3=-0.325; P3=0.024), the ocular(β1=-0.546, P1=0.008; β5=-0.352, P5=0.008), renal(β5=-0.358, P5=0.025) and circulatory complications(β1=-0.803, P1 < 0.001; β5=-0.302, P5=0.011) had effect on HRQOL at different quantiles.   Conclusions   Age, urban and rural residence, whether receive insulin therapy and complications are the influencing factors of HRQOL in hospitalized T2 DM patients. The quantile regression model can show different factors affecting the quality of life of patients at different quintiles. The results from quantile regression can provide the targeted and reasonable recommendations for improvement of HRQOL of T2 DM patients.
Analysis on incidence and death trend of breast cancer in adult women from 1999 to 2016 in Haimen, Jiangsu Province
QIAN Jun-hua, WANG Ying-ying, YANG Yan-lei, HUANG Pei-xin, JIANG Feng, WANG Na, JIANG Qing-wu
2020, 24(2): 189-193. doi: 10.16462/j.cnki.zhjbkz.2020.02.013
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  Objective   To analyze the incidence and mortality of female breast cancer from 1999 to 2016 in Haimen City.   Methods   Data of female breast cancer from 1999 to 2016 in the Haimen Tumor Registry Reporting System were used to calculate the crude incidence and mortality, standardized incidence and mortality, age-specific incidence and mortality, percentage change of rate(PC) and annual percentage change of rate(APC).   Results   There were 2 977 cases from 1999 to 2016. The crude incidence and age-standardized incidence by Chinese standard population were 39.29/100 000 and 20.65/100 000, respectively; APC were 5.87% and 4.71%, respectively. There were 938 deaths, the crude mortality and standardized mortality by Chinese standard population were 12.38/100 000 and 6.07/100 000, respectively; APC were 3.87% and 2.43%, respectively. The incidence increased with age, with a sharp increase occuring in 30-years old and two peaks occuring in 55-years old(65.05/100 000) and 70-years old(60.77/100 000). The mortality gradually increased with age and the peak was at age 80(29.68/100 000).   Conclusion   The incidence and mortality of female breast cancer in Haimen City had a upward trend with year and age. The age-standardized incidence and mortality by world standard population were higher than provincial and national levels. The work for prevention and control of female breast cancer in this region should be strengthened.
The prognostic effects of treatment on oral cancer patients with T1-4N0M0 stage
LU Mei-qi, BAO Xiao-dan, ZHANG Yan-wei, CAI Chao-qun, LIN Qi-ling, CHEN Chen-yi, CHEN Jing-ting, LIN Jing, WANG Jing, CHEN Qing, CHEN Lin, WANG Rui, CHEN Fa, LIU Feng-qiong, QIU Yu, HE Bao-chang
2020, 24(2): 194-199. doi: 10.16462/j.cnki.zhjbkz.2020.02.014
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  Objective   To investigate the effects of treatments for the prognosis of T1-4N0M0 stage oral cancer patients.   Methods   Patients with new oral cancer confirmed by pathology in the department of oral and maxillofacial surgery, the First Affiliated Hospital of Fujian Medical University from October 2010 to June 2017 were recruited in the study. The pathological diagnosis of lymph nodes was negative, and no distant metastasis occurred in all patients. The univariate and multivariate Cox proportional risk model was used to analyze the prognostic factors of oral cancer.   Results   A total of 454 subjects were included in this study. The results showed that patients receiving surgery combined with chemotherapy(HR=1.792, 95% CI: 1.025-3.134, P=0.041) and patients receiving surgery combined with chemoradiotherapy(HR=2.111, 95% CI: 1.275-3.495, P=0.004) had worse prognosis compared with those receiving surgery alone. Stratified analysis showed that among the patients with the total number of lymph node was 10-31 or BMI ≥ 24.0 kg/m2: patients receiving surgery combined with radiotherapy have a worse prognosis compared with those receiving surgery alone. Among the patients with the total number of lymph node was 32-87 or clinical staging Ⅰ-Ⅱ and BMI < 18.5 kg/m 2: patients receiving surgery combined with chemotherapy had a worse prognosis compared with those receiving surgery alone. Among the patients with the total number of lymph node was 10-31, clinical staging Ⅰ-Ⅱ or BMI < 18.5 kg/m 2: patients receiving surgery combined with chemoradiotherapy had a worse prognosis compared with those receiving surgery alone.   Conclusion   Among the T1-4N0M0 patients with oral cancer, receiving surgery combined with radiotherapy, the patients receiving surgery combined with chemotherapy or receiving surgery combined with chemoradiotherapy have a worse prognosis compared with those receiving surgery alone.
Association of mild cognitive impairment with incidence of falls in communities aged 55 and over
SUN Xiao-ya, HE Zhi-qiang, WANG Li-qun, WANG Zhi-zhong
2020, 24(2): 200-203. doi: 10.16462/j.cnki.zhjbkz.2020.02.015
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  Objective   To explore the association between mild cognitive impairment(MCI) and the risk of falls in community populations, so as to provide a reference for preventing falls in the elderly.   Methods   826 community residents aged 55 years and older were enrolled in Wuzhong, Ningxia; cognitive function was assessed during the participants attending the basic public health examination, and self-report falling events were observed through telephone call survey after half a year. The incidence of falls among different populations was compared using unconditional Logistic regression model.   Results   A total of 521 participants completed the follow-up study, and 127 of them met criteria of MCI at baseline. 32 participants reported falling occurred during follow-up with a incidence of 6.1%(32/521), and the incidence of falls was higher(8.85%, 23/260) in females than that of males(3.45%, 9/261)(RR=2.56, P=0.010). The incidence among MCI group(9.45%, 12/127) was 1.86 times of that among non-MCI group(RR=1.86, P=0.073). Under the controlling of demographic variables(gender, age and education level), there was no association between MCI and falls(RR=1.41, P=0.382).   Conclusions   The incidence of falls in the elderly communities is common, and females has higher risk of falls than males. There is no statistical association between MCI and risk of falls. Further validation is needed with large-sample studies in the future.
Association of the behaviors of playing mahjong and watching mobile phone with depression in rural women in Hubei Province
WANG Xiao-yu, WANG Yu-fan, LIU Nan-nan, DAI Guo-hong, SHEN Min, WANG You-jie, LIANG Yuan
2020, 24(2): 204-209. doi: 10.16462/j.cnki.zhjbkz.2020.02.016
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  Objective   To analyze the association of the behaviors of playing mahjong and watching mobile phone with depression in rural women in Hubei Province, so as to provide suggestions for improving their physical and mental health.   Methods   A stratified cluster sampling method was used to investigate 1367 adult women in 8 administrative villages of 7 counties/cities in Hubei Province. The depression status was measured by the Center for Epidemiological Studies Depression Scale-10(CESD-10) and the percentage conversion was carried out. The higher the score was, the lower the degree of depression was, and the better the mental health status was.   Results   The CESD-10 scores of 15-44 years old women(77.63±13.95)were higher than those of 45-64 years old(73.17+17.01) and over 65 years old(69.25+18.16)(P < 0.001). The results of multiple linear regression showed that there was a correlation between the time spent on mobile phone and depression in rural women(allP < 0.05), in particular, there was a statistical significance on depression of women aged 45-64(allP < 0.05), and the longer the time spent on mobile phone, the higher the degree of depression was; there was no significant difference in the effect of mahjong on depression of women of all ages(allP > 0.05).   Conclusions   There is a correlation between watching mobile phone and depression of rural women in Hubei Province, reducing the use of mobile phones by rural women, especially middle-aged women, is worthy of attention in the future work of health education and Women's Federation.
Comparative efficacy and safety of first-line EGFR-TKIs for advanced non-small cell lung cancer:a network meta-analysis
ZHANG Hui-fang, MA Jin-sha, LI Lu, GAO Qian, WANG Tong
2020, 24(2): 210-216. doi: 10.16462/j.cnki.zhjbkz.2020.02.017
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  Objective   To compare the efficacy and safety of gefitinib, erlotinib, and afatinib in the first-line treatment of advanced non-small cell lung cancer(NSCLC).   Methods   PubMed, EMBASE, and The Cochrane Library were searched to identify the relevant literatures published from December 2008 to December 2018. Bayesian network meta-analysis was carried out to rank the three treatments.   Results   A total of ten eligible studies involving 2275 patients were enrolled. In terms of efficacy, the surface under the cumulative ranking(SUCRA) indicated that erlotinib performed best in progression-free survival(PFS)(0.88), afatinib performed best in objective response rate(ORR)(0.82) and disease control rate(DCR)(0.86), gefitinib performed worst in PFS(0.45), ORR(0.42), and DCR(0.45). For safety, the differences of grade 3 or 4 adverse events rate(OR=0.29, 95%CI:0.08-0.98) and discontinuation rate(OR=0.14, 95%CI:0.01-0.8) between erlotinib and the platinum-based doublet chemotherapy were statistically significant. The ranking results also supported that erlotinib was the safest. SUCRA results suggested that gefitinib(0.31) had a lower grade 3 or 4 adverse events rate than afatinib(0.57), and the possibility of discontinuation in gefitinib(0.44) was similar to that of afatinib(0.41).   Conclusion   Erlotinib might be the preferred first-line treatment for advanced NSCLC after weighing and balancing the benefits and risks.
Current situation on the global distribution of hepatitis B virus subtypes
WU Ming-shan, LIU Zhen-qiu, CHEN Xing-dong, ZHANG Tie-jun
2020, 24(2): 217-221. doi: 10.16462/j.cnki.zhjbkz.2020.02.018
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Abstract:
Hepatitis B virus(HBV) infection is an important global public health concern and a major cause of chronic hepatitis, cirrhosis and liver cancer. Many studies have shown that different genotypes and subtypes have significant differences in pathogenicity, thus affecting the disease progression and prognosis of infected individuals. So far, a total of 10 HBV genotypes and more than 40 subtypes have been reported across the world, and these subtypes have shown distinct distribution characteristics. In the present review, we systematically summarized the current situation on the global distribution of HBV genotypes.
A systematic review on the association between meteorological factors with traffic accident injury
LIANG Ming-ming, ZHANG Yun, WANG Yuan, YE Peng-peng, SHI Ting-ting, MIN Min, XING Xiu-ya, DUAN Lei-lei, SUN Ye-huan
2020, 24(2): 222-227. doi: 10.16462/j.cnki.zhjbkz.2020.02.019
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Abstract:
In recent years, the impact of meteorological factors on health and injury has been paid more and more attention. Severe weather events were considered to be an important risk factor for traffic accident injuries. Evidence from a large number of epidemiological studies suggests that meteorological factors, including high temperatures, rainfall, snowfall, wind and visibility, might be related to the occurrence of traffic accidents. This systematic review attempts to summarize the current research status of meteorological factors on traffic accident injury, systematically review the relationship between meteorological factors and traffic accident injury, and discuss how to further carry out related research.
Expression profile and prognostic value of linc00346 and E2F2 in liver cancer
ZHU Yu, LIU Hao-han, DING Lei, LIANG Ya-li, WEN Yu-feng
2020, 24(2): 228-232. doi: 10.16462/j.cnki.zhjbkz.2020.02.020
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Abstract:
  Objective   To investigate the expression pattern of linc00346 and E2 F2, and its prognostic value on liver cancer.   Methods   Gene expression profile data of patients with liver cancer was downloaded from the cancer genome atlas(TCGA) database. Paired t test was used to evaluate the differential expression of linc00346 and E2 F2 from tissues and matched adjacent normal tissues. Co-expression analysis of linc00346 and E2 F2 was performed using Pearson correlation. Log-Rank test and Cox proportional hazards regression were used to estimate prognostic value of linc00346 and E2 F2.   Results   linc00346 and E2 F2 expression were upregulated in liver cancer tissue specimens(all P < 0.05), and fold change was 2.24 and 3.72, respectively. Pearson coefficient was 0.20(P < 0.001). Patient with linc00346 and E2 F2 high expression had a 1.77(95 %CI: 1.23-2.55) and 2.19(95 % CI: 1.51-3.17) times higher hazard of death than those with linc00346 and E2 F2 low expression, respectively. However, only E2 F2 was significantly associated with the prognosis of liver cancer in multiple Cox regression.   Conclusions   linc00346 and E2 F2 expressions are upregulated in liver cancer tissues, and patients with linc00346 and E2 F2 high expressions has poor prognosis. It is of great significance to discover linc00346 and E2 F2 as a novel therapeutic target for liver cancer.
Drug resistance analysis of influenza virus to neuraminidase inhibitor from 2018 to 2019 in Hebei Province
JIANG Cai-xiao, HAN Guang-yue, LI Yan, LIU Yan-fang, LIU Lan-fen, QI Shun-xiang
2020, 24(2): 233-236. doi: 10.16462/j.cnki.zhjbkz.2020.02.021
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Abstract:
  Objective   To analyze the resistance of influenza virus to neuraminidase inhibitors(NAI) in Hebei province during 2018-2019.   Methods   Virus were collected from the Hebei Influenza Surveillance Network during 2018-2019. A total of 36 confirmed influenza viruses(with 25 H1 pdm09 and 11 H3 N2) were selected to test resistance to oseltamivir and zanamivi with fluorescence(FL).   Results   All 36 influenza viruses tested were sensitive to oseltamivir and zanamivir. The median half maximal inhibitory concentration(IC50) for oseltamivir of H1 pdm09 and H3 N2 were of 0.50 nM(range 0.07-1.14 nM) and 0.25 nM(range 0.09-0.69 nM) respectively, while 0.29 nM(range 0.09-0.85 nM) and 0.87(range 0.17-1.81 nM) for zanamivir, all were within 10 fold IC50 of the reference virus(corresponding type).   Conclusion   All the tested influenza strains isolated in Hebei province during 2018-2019 were sensitive to NAI.
Analysis of epidemiological characteristics and surveillance result of host animal on hemorrhagic fever with renal syndrome in Zibo City from 2015 to 2018
WANG Ling, ZHANG Yan, ZHANG Ling, LIU Fang-ying, SUN Tao, JIANG Xiao-lin, WANG Zhi-qiang, WANG Xian-jun
2020, 24(2): 237-240. doi: 10.16462/j.cnki.zhjbkz.2020.02.022
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  Objective   To analyze the epidemic characteristics of hemorrhagic fever with renal syndrome(HFRS), the distribution and virus-carrying status of host animals in Zibo City from 2015 to 2018, so as to provide references for prevention and control.   Methods   Descriptive epidemiological study was conducted on the incidence data of HFRS collected in Zibo City from 2015 to 2018.   Results   A total of 315 cases including one death were reported in Zibo, with the average incidence of 1.69/100000 and the fatality rate of 0.32%. The cases were distributed mainly in Zichuan District and Yiyuan Coutry, which accounting for 67.62%. The main groups of cases were middle-aged and elderly farmers, and people aged 45-69 accounted for 62.86% of total cases. Two peak seasons were observed in spring(March-May) and autumn-winter(October-December). The average rat density and virus-carrying rate were 3.04% and 3.87% respectively rattus norvegicus was the dominant species of rodents in the residential area, while in the field, apodemus agrarius was the dominant species.The virus-carrying rates of rattus norvegicus and apodemus agrarius were 6.48% and 0.75% respectively, which had significant difference in these two group(χ2=6.694, P=0.01).   Conclusions   The incidence rate of HFRS was declining in Zibo City, while the rat density and the virus-carrying rate were still high in the areas with high incidence, which indicating the outbreak risk of HFRS was existed.It is necessary to strengthen immunization, rodent control and health education in high-endemic areas.
Epidemiolgic characteristics and influencing factors of measles among floating children in Shenzhen:a case-control study
FAN Duo-ji, CHEN Jun-liang, SUN Yang-qing, MO Bo-wei, WANG De-quan
2020, 24(2): 241-244. doi: 10.16462/j.cnki.zhjbkz.2020.02.023
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  Objective   To investigate epidemiological characteristics of measles cases and the influencing factors of transmission of measles among floating children in Shenzhen.   Methods   Descriptive study was conducted in data which were collected from the report system of statutory infectious diseases from 2016 to 2018 in Shenzhen. Case-control study was conducted between 89 cases and relative controls.   Results   A total of 108 measles cases in floating children were reported from 2016 to 2018, and the incidence trend showed a year-on-year decline(χtrend2=68.35, P < 0.001). Analysis showed that nosocomial exposure in 7 to 21 days ago(OR=7.80, 95% CI:3.51-17.35, P < 0.001), having been to the crowded places(OR=3.37, 95% CI:1.52-7.47, P=0.002), having contact history of fever-rash patients(OR=4.57, 95% CI:1.41-14.84, P=0.007) were influencing factors of transmission of measles among floating children, and immunization at the prescribed time(OR=0.12, 95% CI:0.04-0.32, P < 0.001) was a protective factor for measles.   Conclusions   Vaccination must be strengthened for floating children. Medical institutions should avoid becoming a key place for measles transmission, and need to strengthen health education.
The founder of environment and disease theory:Hippocrates
WU Jun, YE Dong-qing
2020, 24(2): 245-248. doi: 10.16462/j.cnki.zhjbkz.2020.02.024
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Abstract:
Hippocrates(460-370 BC) is a famous doctor in ancient Greece and the founder of Western medicine. He is a "landmark" in the long history of human medicine and is considered as the first epidemiologist in history. He created the "Four Body Fluids" theory of medicine, freeing human medicine from theology and entering the natural medical model; His hard work on Airs, Waters, and Places, laid the epidemiological ideological foundation for more than 2 000 years; He was praised for his noble medical ethics, and his "Hippocrates Oath" has been extolled to today; he and his disciples have integrated the masterpiece "Hippocrates Collection" and passed on a generation of doctors. Therefore, Hippocrates is now known as the western "father of medicine".

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