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CN 34-1304/R ISSN 1674-3679

2022 Vol. 26, No. 1

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Original Articles
Study on morbidity and mortality burden of gastric cancer attributed to excessive sodium intake in Chinese adult residents
FANG Ke-hong, FANG Yue-hui, LIAN Yi-yao, LU Xiao-di, HE Yu-na
2022, 26(1): 1-6. doi: 10.16462/j.cnki.zhjbkz.2022.01.001
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  Objective  To study the burden of gastric cancer attributable to overconsumption of sodium among Chinese adults.  Methods  Based on the data of dietary sodium consumption obtained from the China National Nutrition and Health Surveillance 2012, the dietary sodium intake of adults in each province was estimated by using the method of Cooperative Kriging. Data on the incidence and death of gastric cancer in 2015 were obtained from Annals of the Cancer Registry. According to the proportional risk assessment theory, the Population Attributable Fraction of the incidence and death of gastric cancer attributable to high sodium intake was calculated by province.  Results  In 2015, the Population Attributable Fraction of overconsumption of sodium to the incidence and death of gastric cancer in adult was 29.94% and 28.95%. The number of incidence and death of gastric cancer attributable to overconsumption of dietary sodium were 80 718 and 56 578, and the morbidity and mortality were 8.04/100 000 and 5.64/100 000. Gansu had the highest morbidity and mortality of gastric cancer attributable to overconsumption of sodium (24.85/100 000 and 14.51/100 000 respectively). The lowest morbidity of gastric cancer attributed to high sodium diet was found in Guangdong (2.51/100 000), and the lowest mortality of gastric cancer attributed to high sodium diet was found in Tibet (0.29/100 000).  Conclusion  In 2015, the morbidity and mortality burden of gastric cancer in Chinese adults due to overconsumption of dietary sodium was at a high level, with great differences among provinces.
Analysis and model prediction of disease burden attributable to various risk factors for colorectal cancer in China from 1990 to 2019
HUANG Zhao-wei, XUE Ming-jin, HU Yu-di, PAN Rong-ling, DU Jin-lin, LIN Ke-na, NI Jin-dong, HUANG Zhi-gang
2022, 26(1): 7-13. doi: 10.16462/j.cnki.zhjbkz.2022.01.002
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  Objective  Provide references basis for the accurate prevention and control of colorectal cancer through the analysis of the change trend of disease burden attributed to various risk factors of colorectal cancer in China from 1990 to 2019 and the prediction of changes in the next 10 years.  Methods  Based on the Globad Burden of Disease Study 2019 research data, Joinpoint estimated annual percentage of change (APC) and average annual percentage of change (AAPC) were used to reflect the time trend of disease burden of colorectal cancer. To compare the main risk factors and their change rates of different age groups, we described the disease burden attributed to various risk factors of CRC in China in 1990 and 2019. The autoregressive integrated moving average (ARIMA) model was established by R 4.0.2 to predict the disease burden of colorectal cancer attributed to various risk factors in China in the next 10 years.  Results  The disability adjusted life years (DALYs) rate of colorectal cancer attributed to risk factors in China showed an overall upward trend from 1990 to 2019. The DALYs rate of male was higher than that of female in each year, and the gap increased gradually with the change of time; The burden of disease attributed to various risk factors for colorectal cancer in China basically increased with the increase of age. Diet low in calcium was the primary risk factor for the disease burden of colorectal cancer in China in 1990, while diet low in milk in 2019. During the last 30 years, the corresponding risk factor of the most rapid increase in standardized DALYs rates attributed to various risk factors for colorectal cancer in China was high BMI, while the most rapid decrease was diet low in fiber. The model prediction found that diet low in milk will be still the primary risk factor for the disease burden of colorectal cancer in China in the next 10 years.  Conclusions  From 1990 to 2019, the disease burden of colorectal cancer attributed to various risk factors in China showed an overall upward trend. Diet low in milk is the most critical risk factor for the disease burden of colorectal cancer in China at present and in the next 10 years. Middle-aged and older adults, as well as male people are the key population for prevention and control. It is suggested that intervention is formulated to control the prevalence of risk factors and further measures should be taken to reduce the disease burden of colorectal cancer.
Analysis and prediction of the incidence and mortality trends of cervical cancer in Chinese women from 2003 to 2018
ZHANG Zhong-hua, LIU Chen-ying, REN Hui-ye, LIANG Shao-hui
2022, 26(1): 14-20. doi: 10.16462/j.cnki.zhjbkz.2022.01.003
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  Objective  To study the change tendency of the incidence and mortality of the females with cervical cancer in China from 2003 to 2018, and to predict their trends in the next five years.  Methods  The data between 2003 and 2018 on the incidence and mortality of female cervical cancer cases aged 20-79 years old in China was collected. Then the Joinpoint regression model was used to analyze the regularity of the incidence and mortality on the base of the data, and the age-period-cohort (APC) model was further used to explore the influences of age, period and cohort on the numbers of the incidence and the mortality of females with cervical cancer. The autoregressive integrated moving average model (ARIMA), grey model (GM) (1, 1) and back propagation (BP) neural network model were developed to fit the incidence and mortality, and the model with the high-precision prediction was selected to foresee the incidence and mortality in the next five years.  Results  From 2003 to 2018, the incidence of female cervical cancer shows two turning points, with a rapid increase and then a decline; The mortality has a turning point, and decreases first and then increases. In general, the risk of cervical cancer cases increases with age, and slowly decreases after reaching a peak in their 55- < 60 years old. The risk of mortality keeps rising constantly with respect to age, the period effect increases with period evolving and the cohort effect decreases constantly. The fitting results of different models illustrate that the BP neural network model has better effect.  Conclusions  From 2003 to 2018, the incidence rate and the mortality rate of female cervical cancer cases decrease as a whole, and are more affected by age, but less affected by period and cohort. It is predicted that they will decline in the next five years. Therefore, it is necessity for women to strengthen the screening of cervical cancer and take HPV vaccination.
Prediction of kidney cancer mortality trends and comparison of the two prediction models in China
CHEN Lei, XU Jie-ru, ZHANG Min, XIAO Zhi-li, CHEN Yue, RANG Wei-qing
2022, 26(1): 21-27. doi: 10.16462/j.cnki.zhjbkz.2022.01.004
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  Objective  To build and compare two forecasting models for kidney cancer mortality in China, and choose the best model to predict the mortality rate of kidney cancer in China from 2020 to 2025.  Methods  We collected the mortality data of kidney cancer in China among all ages in the global health data exchange (GHDx) database from 1990 to 2019. R 4.0.2 software were used to establish autoregressive integrated moving average model (ARIMA) model and gray model (GM) (1, 1) model. Based on kidney cancer mortality data from 1990 to 2016, we compared the predicted and actual values from 2017 to 2019 to evaluate the fitting and forecasting performance of the two models. Finally, we selected the optimal model to predict kidney cancer mortality in China from 2020 to 2025.  Results  There was an increasing trend for the crude mortality rate (CMR) of kidney cancer in China from 1990 to 201. The ARIMA (1, 2, 0) model has the best fitting effect among those alternative ARIMA models. The model expression of GM (1, 1) was Y(t+1)=9.267 8e0.050 2(t)-8.771 0. The mean absolute error (MAE), root mean squared error (RMSE) and mean absolute percent error (MAPE) of ARIMA (1, 2, 0) were lower than GM (1, 1) on fitting and forecasting performance. According to the best model prediction results, the mortality of kidney cancer in China will increase by 7.74%in 2025 compared to 2019.  Conclusion  Compared with GM (1, 1) model, ARIMA (1, 2, 0) model had better fitting effect and forecasting performance for kidney cancer mortality in China.
The burden of stroke attributable to risk factors and their trends from 1990 to 2019 in China
WU Qiong, WANG Chen-ran, ZHAO Yan, Han Li-yuan, LIU Shi-wei
2022, 26(1): 28-33, 79. doi: 10.16462/j.cnki.zhjbkz.2022.01.005
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  Objective  To investigate the burden of stroke and its subtypes attributable to risk factors, and their trends from 1990 to 2019 in China.  Methods  Based on the open access data from the 2019 global burden of disease study, we used population attributable-faction (PAF) and disability-adjusted life years (DALYs) to explore the burden of stroke and its subtypes attributable to risk factors, and the changes from 1990 to 2019.  Results  In general, the risk factors of stroke can be classified as environmental, behavioral and metabolic factors, which vary in subtypes of stroke for specific factors. Compared with the 15 risk factors of subarachnoid hemorrhage (SAH) (ambient particulate matter pollution, high temperature, low temperature, lead exposure, household air pollution from solid fuels, diet high in red meat, diet high in sodium, smoking, secondhand smoke, diet low in vegetables, diet low in fruits, diet low in fiber, high BMI, high systolic blood pressure, and high fasting plasma glucose), the factors of alcohol use and kidney dysfunction were also included in intracerebral hemorrhage (ICH) and ischemic stroke (IS), and low physical activity, diet low in whole grains, and high LDL-C in IS. In 2019, 68.91%, 68.83% and 66.35% of the 18.62, 19.89 and 2.04 million person years DALYs caused by IS, ICH and SAH were attributed to metabolic factors. The burden of IS was mainly attributed to high systolic blood pressure (50.94%), ambient particulate matter pollution (26.81%), high LDL-C (20.69%); The burden of ICH and SAH were mainly attributed to high systolic blood pressure (58.18% and 58.01%), ambient particulate matter pollution (28.82% and 30.09%), and diet high in sodium (24.40% and 25.11%). From 1990 to 2019, the DALYs of IS and ICH attributable to ambient particulate matter pollution, high BMI, alcohol use and diet high in red meat significantly increased by 410.46%, 320.48%, 277.03%, 245.41% and 168.93%, 132.07%, 60.01%, 84.58%, respectively, and only ambient particulate matter pollution increased by 4.47% for the DALYs of SAH.  Conclusion  Most of the risk factors of stroke are preventable and controllable, and vary considerably in subtypes of stroke, suggesting tailored measures of preventive interventions with consideration of cost-effectiveness.
Historical trends in suicide risk for the rural residents of China: age-period-cohort modeling of the archived national suicide mortality rates from 2004 to 2019
HOU Hao, PEI Yi-fei, YU Bin, GAO Xiu-yin, WANG Wei
2022, 26(1): 34-39, 111. doi: 10.16462/j.cnki.zhjbkz.2022.01.006
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  Objective   To analyze the trend of suicide mortality among rural population aged 10-84 years from 2004 to 2019, in order to provide scientific basis for the suicide prevention.   Methods   Data of suicide death among rural population aged 10-84 years were collected from China Health Statistics Yearbook from 2005 to 2020. The parameters of age, period and cohort effect were estimated by using age-period-cohort (APC) model and itrinsic estimator.   Results   The suicide rate of rural residents in China was gradually declined. APC model analysis results showed that the age effect of suicide death increased with age, especially in adolescents. The risk of suicide death was higher for females than males in all age except in middle age. The period effect showed that the risk of suicide death decreased slowly with period advances, and the decrease speed of the suicide death was significantly higher for female than for male. Cohort effect of suicide death decreased before 1979, followed by steady between 1980 and 1994, and increased sharply after 1995.   Conclusions   The changes of the risk of suicide death may be closely related to the major historical events. APC model can describe the trend of suicide mortality well.
Characteristics of spatiotemporal distribution among young male students who were reported HIV infection by homosexual transmission in China from 2010 to 2019
LING Qian, MA Kai-fang, ZHANG Xiao-ting, LI Pei-long, LI Dong-min
2022, 26(1): 40-45. doi: 10.16462/j.cnki.zhjbkz.2022.01.007
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  Objective  To understand the spatial and temporal distribution characteristics and trends of HIV among young male students aged 18 to 24 who were reported by homosexual transmission in China from 2010 to 2019, and to provide fundamental research for AIDS prevention and control measures towards young students.  Methods  The subjects were young male students aged 18 to 24 who reported HIV infection through homosexual transmission. ArcGIS 10.3 software was used for distribution description and hot spot analysis. SaTScan 9.6 software was used for space-time scanning analysis to explore the clustering area and the clustering period.  Results  A total of 16 918 cases were included in the study. In China, the number of young male students aged 18 to 24 who were infected with HIV through homosexual transmission had shown an increasing trend, from 488 cases in 2010 to 2 481 cases in 2019. The number of reported cases in Chongqing, Sichuan and Beijing were relatively high. The number of cities where HIV infection ratio among young male students between 18 and 24 years old infected with HIV through homosexual transmission in the same period and same age of the male accounted for more than 1 per 10 000 increased from 1 in 2010 to 17 in 2019. From 2010 to 2019, there were 16 clusters. Among them, the first clustering area included Chongqing, Chengdu, Xi 'an and other areas, and the clustering period was from 2015 to 2019 (RR=2.66, P < 0.001).  Conclusion  In China, there is a certain spatial and temporal clustering among young male students aged 18 to 24 who were reported HIV infection by homosexual transmission. Targeted prevention and control measures should be carried out in these hot spots and clustering areas, so as to reduce the prevalence of HIV among young students.
Population size estimation of men who have sex with men in Nanjing using multiplier method based on social software
XU Yuan-yuan, ZHU Zheng-ping, ZHANG Min, WU Su-shu, GUO Lu, LI Xin, SHI Hong-jie
2022, 26(1): 46-50. doi: 10.16462/j.cnki.zhjbkz.2022.01.008
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  Objective  The study aimed to estimate the population size of men who have sex with men (MSM) in Nanjing, to provide valuable information for estimating the AIDS epidemic, and to develop HIV prevention strategy.  Methods  An innovative approach to population size estimation grounded on the principles of the multiplier method and social app technology, and location-based surveys and internet-based surveys were undertaken among MSM. The number of MSM (r) is the average person-times of logging in Blued App in Nanjing region within 7 days. Meanwhile, a survey was conducted among MSM to obtain the proportion of MSM who had logging in the Blued APP during the given period and the reciprocal of the proportion was the multiplier (m). The MSM population size can be estimated by r multiplied by m.  Results  The population of MSM in Nanjing was estimated to be 35 138 (95% CI: 33 847-36 429) and corresponded to 1.12% of the adult male population aged from 15 to 59 years in Nanjing (95% CI: 1.08%-1.16%). There were significant differences in ways of finding sexual partners, monthly income, the proportion of anal intercourse in the past 6 months, frequency of condom uses during anal sex and the proportion of recreational drug use among MSM population in different investigation methods (all P < 0.05).  Conclusion  The method to population size estimation grounded on the principles of the multiplier method and social app technology, and using field surveys and internet-based surveys facilitates reaching the network of MSM including hidden pockets of the group and seems to be feasible and credible.
A study of online intervention and mobilization for offline HIV testing among men who have sex with men by using social networking applications
LIANG Jun, CHEN Zhan-yuan, LIAO Bin, FU Mei-yan, YANG Yao, LI Jie, LI Yi
2022, 26(1): 51-55. doi: 10.16462/j.cnki.zhjbkz.2022.01.009
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  Objective  To understand the effectiveness of the online intervention to mobilize men who have sex with men (MSM) to participate in offline HIV testing through social networking applications, and to investigate and analyze the characteristics of offline test participants.  Methods  We analyzed and compared the number of MSM online contacted through different social networking applications with the number actually tested offline. Then, we characterized the MSM tested offline as well as to compare the differences in the characteristics of MSM in high and low risk groups of infection.  Results  The online intervention mobilized 23.78% of MSM to participate in offline testing (229/963), with a higher percentage of offline testing recruited using Blued than other social networking applications (χ2=3.958, P=0.047). The total recruitment ratio was 100:2.4, and A total recruitment efficiency was 1.01 persons/day. A total of 220 MSM who had anal sex were divided into a high-risk behavior group (n=96) versus a low-risk behavior group (n=124) based on whether or not they consistently used condoms. The percentage of qualified syphilis knowledge in the high-risk group was lower than in the low-risk group (χ2=6.308, P=0.009), while the percentage of positive HIV test results was higher than in the low-risk group (χ2=11.299, P=0.001).  Conclusions  Using social networking applications to mobilize MSM to participate in offline testing were effective in reaching groups at higher risk of HIV infection, as well as in detecting infected cases timely. When communicating and intervening with the target population online, proactive contact increased the proportion of MSM responding more than passive reply.
Analysis of the status quo of exercise behavior in type 2 diabetic patients and the influencing factors analysis based on the health action process approach model
GUO Yi, SUN Xin, LI Ze-ming, CHEN Ping, GAO Min, CHEN Xue-ying, SUN Xin-ying
2022, 26(1): 56-60, 98. doi: 10.16462/j.cnki.zhjbkz.2022.01.010
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  Objective  The purpose of this study is to use the health action process approach (HAPA) and structural equation model to explore the influencing factors of exercise behavior in patients with type 2 diabetes, and to provide references for future interventions.  Methods  Totally 819 patients with type 2 diabetes mellitus in four community health service centers in Beijing were investigated using a self-compiled questionnaire. The reliability and validity of the questionnaire were good. The structural equation model was used to analyze the influencing factors and potential mediating effects of exercise behavior.  Results  53.7% of patients were over 60 years old, and 77.2% of patients were in the action or maintenance phase of exercise behavior. HAPA can effectively explain the exercise behavior of patients (R2=0.466). Behavioral intentions was affected by task self-efficacy (β=0.645) and  result  expectation (β=0.153). Behavioral intention (β=0.783) and maintenance self-efficacy (β=0.177) had direct effects on implementation intention, while implementation intention (β=0.340) and restoration of self-efficacy (β=0.403) directly affected exercise behavior. Task self-efficacy also affected Maintenance Self-efficacy (β=0.802). Maintenance self-efficacy affected recovery self-efficacy (β=0.450), and behavioral intentions also had a positive effect on maintenance self-efficacy (β=0.483).  Conclusions  The exercise status of T2DM patients is good, but it still needs to be further improved. HAPA can well explain the patients' exercise behavior. Promoting patients' exercise should focus on interventions that improve their self-efficacy.
Construct auxiliary diagnosis model of diabetic retinopathy based on deep neural network
WU Tian-zhu, WU Xue-sen
2022, 26(1): 61-67, 85. doi: 10.16462/j.cnki.zhjbkz.2022.01.011
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  Objective  To construct a diabetic retinopathy (DR) assisted diagnosis model based on the principle of deep neural network by grading the fundus images of DR, providing a convenient and fast method for the screening of this type of disease in the population.  Methods  The image enhancement technique was used to pre-process the image data. Then, deep convolutional neural network Inceptionv4 and SENet154 were optimized using a mixture of Focal Loss, Cosine Annealing, weighted random sampling, and image Gaussian filtering weighting methods to construct a grading model for fundus images of DR. The model was further validated using fundus images of DR and diabetic macular edema (DME) contained in the publicly available Messidor dataset. Finally, a class activation map (CAM) was used to mark the lesion areas to visualize the grading and assist doctors in rapid diagnosis.  Results  In the DR grading model, the area under curve (AUC) for classes 0, 1, 2 and 3 were 0.925 (95% CI: 0.898-0.952), 0.738 (95% CI: 0.711-0.764), 0.873 (95% CI: 0.848-0.898) and 0.977 (95% CI: 0.957-0.997) respectively after using various optimization methods. In the DME grading model, the AUC for classes 0, 1 and 2 were respectively 0.965(95% CI: 0.948-0.981), 0.881(95% CI: 0.852-0.909) and 0.963(95% CI: 0.941-0.985). And the CAM of fundus images were output.  Conclusion  The DR and DME models were constructed in a variety of optimized ways to achieve high AUC values, and the model plots the class activation mapping to accurately locate the suspected lesion area, which can visually assist the doctor to diagnose easily and quickly.
Risk factors and its quantitative evaluation for hypertension in urban area of Qingdao
LIU Lei, TIAN Xiao-cao, LI Xue-dan, ZHENG Xiao-yan, LIU Shi-tao, GUO Yu, WANG Shao-jie, GAO Ru-qin, PANG Zeng-chang, CHEN Zheng-ming, LI Li-ming
2022, 26(1): 68-73. doi: 10.16462/j.cnki.zhjbkz.2022.01.012
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  Objective  To investigate the related risk factors for hypertension among residents in urban area of Qingdao, and perform quantitative evaluation analysis on the risk factors.  Methods  We analyzed the baseline data of participants who were aged 30-79 years and had been enrolled into the CKB study from Qingdao City. Multivariate Logistic regression model was used to analyze the risk factors of hypertension, and the risk scores and individual risk were calculated.  Results  A total of 35 509 participants were investigated in the baseline survey. Ratio of male to female was 1∶1.27, and the average age was (50.32±10.18) years. The prevalence of hypertension in residents aged 30-79 years old in urban area of Qingdao was 36.55%. Multivariate Logistic regression analysis showed that older, low family income, frequent drinking, infrequent consumption of fruit, excessive BMI, and large waist-to-hip ratio were risk factors for male hypertension, and higher risk factors (excluding age) were BMI≥28.0 kg/m2 (OR=3.42), frequent drinking (OR=1.41), and waist-to-hip ratio≥0.9 (OR=1.37). Older, infrequent consumption of fruit, excessive BMI, and large waist-to-hip ratio were risk factors for female hypertension. The OR values of BMI≥28.0 kg/m2, waist-to-hip ratio≥0.85, and infrequent consumption of fruit were 3.11, 1.46, and 1.28, respectively.  Conclusions  Higher BMI, frequent drinking, and large waist-to-hip ratio were main risk factors for hypertension in male residents in Qingdao City. Higher BMI, large waist-to-hip ratio and infrequent consumption of fruit were main risk factors for hypertension in female residents. Community health education and follow-up intervention should be carried out in accordance with the characteristics of risk factors for hypertension in different populations.
Prospective study of the relationship between diabetes and the risk of stroke
CHEN Ya-rong, YIN Chun, HUANG Pei-yao, LI Na, XU Lu-lu, HUANG Wen-ya, LIU Nian, LI Si-yu, LI Jing, HU Yu-jia, BAI Ya-na
2022, 26(1): 74-79. doi: 10.16462/j.cnki.zhjbkz.2022.01.013
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  Objective  To analyze the incidence of stroke in the population of Jinchang Cohort, and explore the relationship of diabetes and fasting plasma glucose (FPG) with the risk of stroke, to provide a scientific basis for the control and prevention of stroke.  Methods  The prospective cohort study was used to analyze the relationship of diabetes and blood glucose levels with the risk of stroke in Jinchang Cohort. The restriction spline method was used to analyze the dose-response relationship between FPG and the risk of stroke.  Results  A total of 32 736 people were included in this study. After an average follow-up of 2.2 years, the cumulative incidence of stroke was 8.77‰, among which the incidence of stroke in the diabetic group was 23.38‰, which was 6.67‰ higher than that in the control group. After adjusting for confounding factors, the risk of stroke in diabetes group and pre-diabetes group was 2.257 times that of the control group (HR=2.257, 95% CI: 1.658-3.072, P < 0.001) and 1.396 times (HR=1.396, 95% CI: 1.039-1.877, P=0.027), respectively. After controlling for confounding factors, compared with FPG < 5.6 mmol/L, the risk of stroke in the FPG≥5.6 mmol/L group and FPG≥7.0 mmol/L group increased by 48% (HR=1.481, 95% CI: 1.040-2.108) and 49% (HR=1.493, 95% CI: 1.044-2.136) among the total population, respectively; when FPG ≥ 7.0 mmol/L, the risk of stroke in men and women was 1.614 times (HR=1.614, 95% CI: 1.068-2.438) and 2.742 times (HR=2.742, 95% CI: 1.355-5.547) then that of the control group, respectively. There was a nonlinear dose-response relationship between FPG and the risk of stroke among the total population and women. In addition, there was a linear dose-response relationship between FPG and the risk of stroke among men.  Conclusion  Diabetes is an independent risk factor for stroke, and there is a dose-response relationship between PFG and the risk of stroke.
Spatiotemporal clustering analysis of influenza in Jiangxi Province from 2017 to 2019
FU Wei-jie, DING Sheng, CHENG Hui-jian, HU Mao-hong, ZHANG Cheng-feng
2022, 26(1): 80-85. doi: 10.16462/j.cnki.zhjbkz.2022.01.014
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  Objective  To analyze the epidemiological characteristics and spatiotemporal aggregation of influenza in Jiangxi Province, and to provide the basis for influenza outbreak and epidemic early warning.  Methods  Descriptive epidemiological analysis and spatiotemporal clustering analysis were conducted on the influenza case information reported in Jiangxi Province from 2017 to 2019 in the "China Infectious Disease Surveillance and Management Information System".  Results  From 2017 to 2019, there was an epidemic peak in winter and spring every year in Jiangxi Province, with the highest incidence in southern Jiangxi Province. The annual incidence was more than twice of the provincial average; the proportion of people under 15 years old increased year by year, from 53.90% in 2017 to 72.24% in 2019.Retrospective spatiotemporal scanning analysis detected four types of spatiotemporal aggregation regions: the first type of agglomeration areas 16 counties and districts in southern Jiangxi Province on December 19, 2018 solstice on April 25, 2019 (RR=9.72, LLR=15 061.27, P < 0.001), the second type of clustering area were the 13 counties in the north of Jiangxi Province (RR=20.68, LLR=3 867.86, P < 0.001); the third type of clustering areas were 18 counties and districts in the northeast of Jiangxi Province (RR=3.13, LLR=1 297.439, P < 0.001); the foreh type of clustering region were 17 counties and districts in western Jiangxi on December 2, 2019 (RR=5.09, LLR=1 233.47, P < 0.001).  Conclusion  From 2017 to 2019, the incidence of influenza in Jiangxi Province showed obvious spatiotemporal clustering, but the clustering time was different among different regions. Influenza was mainly in the late winter and spring.
Reviews
Research progress on risk communication of public health emergencies
SHI Xin-ling, WANG Jian-ming
2022, 26(1): 86-90. doi: 10.16462/j.cnki.zhjbkz.2022.01.015
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Risk communication is essential in dealing with public health emergencies. By collecting relevant literature at home and abroad, this paper summarized the development history, communication process and theoretical models of risk communication, focusing on the application of risk communication in public health emergencies. Theoretical research and practical experience have shown that risk communication should follow a specific process and adopt corresponding communication strategies according to the characteristics before, during, and after the public health event. After the outbreak of SARS in 2003, the risk communication mechanism in China has been continuously improved, and it has shown a good effect on coping with the epidemic of influenza A and COVID-19. However, public health emergencies frequently occur in the world, and the demand for risk communication is increasing. There are still deficiencies in the theory and practice of risk communication in China, which needs continuous improvement.
The influencing factors of vaccination willingness in pneumococcal vaccine in Chinese senior citizen: a Meta-analysis
ZHU Lin, GAO Jing, BAI Ding-xi, CHEN Xin-yu
2022, 26(1): 91-98. doi: 10.16462/j.cnki.zhjbkz.2022.01.016
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  Objective  To systematically review the influencing factors of the pneumococcal vaccine (PV) vaccination willingness of the elderly in China.  Methods  PubMed, Cochrane Library, Web of Science, EMbase, CBM, CNKI, VIP and WanFang were searched to query the original studies. Two reviewers then screened the studies, extracted the data and assessed the quality. A Meta-analysis was then performed.  Results  A total of 16 studies eventually fulfilled the eligibility criteria. The pooled findings of this Meta-analysis demonstrated that family income (OR=1.94, 95% CI: 1.21-3.09, P=0.006), situation of PV information (OR=1.93, 95% CI: 1.12-3.33, P=0.019), history of pneumonia (OR=2.09, 95% CI: 1.00-4.36, P=0.050), recommended by doctors (OR=2.80, 95% CI: 1.18-6.62, P=0.019)were statistically significant in relation to influencing factors of the PV vaccination willingness of the elderly in China. There was no statistically significant difference between degree of education (OR=1.17, 95% CI: 0.81-1.70, P=0.408), history of PV vaccination (OR=1.06, 95% CI: 0.14-8.13, P=0.957), and whether to suffer from chronic disease (OR=1.22, 95% CI: 0.76-1.97, P=0.409).  Conclusion  Family income, situation of PV information, history of pneumonia, and recommended by doctors are promoters of PV vaccination willingness among the elderly in China; It is not proved that education level, history of PV vaccination, and chronic disease were the influencing factors of PV vaccination willingness among Chinese elderly.
Short Reports
Longitudinal trajectories of lifestyle index and their association with blood pressure changes among middle-aged and older adults
ZHANG Guan-rong, LIN Ai-hua
2022, 26(1): 99-104. doi: 10.16462/j.cnki.zhjbkz.2022.01.017
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Abstract:
  Objective  To investigate trajectories of lifestyle index and their association with blood pressure change in the middle-aged and older adults.  Methods  A community-based lifestyle intervention trial for adults aged 50-79 was conducted in two communities in Guangzhou from January 2010 to March 2012. Data of lifestyle factors (including smoking, alcohol drinking, diet, physical activity and BMI) and blood pressure (BP) were collected at baseline and 6, 12 and 24 months. Lifestyle indicators were used to generate a healthy lifestyle index (HLI). Trajectories of HLI were identified using a group-based trajectory modelling approach. Linear mixed models were performed to examine the association between HLI trajectories and blood pressure change after adjusting for covariates.  Results  A total of 393 individuals were included, of which 130 were males (33.1%) and the mean age was (58.6±7.3) years. Three distinct HLI trajectories were identified: persistently low (Group 1, 26.7%), moderate and slightly improved (Group 2, 52.7%) and high and rapidly improved (Group 3, 20.6%). Compared with Group 1, there was no apparent change in blood pressure in Group 2 (all P >0.05) during follow-up. While significant reductions in SBP (6 months: -5.2 mm Hg; 12 months: -8.2 mm Hg; 24 months: -6.7 mm Hg; all P < 0.01) and DBP (12 months: -4.7 mm Hg; 24 months: -2.9 mm Hg; all P < 0.05) were observed in Group 3.  Conclusions  Three distinct HLI trajectories (high, medium and low) were identified in the middle-aged and older adults. BP reductions during intervention period were greater in the high-level trajectory group compared with the medium- and low-level group. Specific lifestyle intervention measures targeting different trajectory groups should be developed.
The association between military experience and health among older adults aged 60 and above in China
HU Xi-yuan, GUO Chao
2022, 26(1): 105-111. doi: 10.16462/j.cnki.zhjbkz.2022.01.018
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Abstract:
  Objective  To analyze the association between military experience and health among older adults and provide a reference for future policy formulation.  Methods  Data was collected from China Family Panel Studies (CFPS) in 2018. Our study involved 3 706 men aged 60 years and over. Physical health was measured by the presence or absence of chronic disease and self-rated health. Mental health was measured by the Center for Epidemiologic Studies Depression Scale (CES-D) and cognitive ability was measured by self-reported memory. Logistic regression model, linear regression model, and propensity score weighting method were adopted to analyze the relationship of military experience and health of older adults.  Results  After controlling for confounding factors, the odds ratio of suffering chronic disease was 1.27 (OR=1.27, 95% CI: 1.01-1.59) in veterans compared with non-veterans, and the risk of poor self-rated health among older adults with military experience increased by 36% (OR=1.36, 95% CI: 1.09-1.69) compared with those who had no military experience. Veterans scored 0.26 points higher on CES-D than non-veterans, but the difference was not statistically significant (P=0.244). Compared with non-veterans, veterans had a 39% lower risk of poor self-reported memory (OR=0.61, 95% CI: 0.45-0.82). The results were robust after propensity score weighting.  Conclusions  Military experience of older adults in China is negatively correlated with physical health and positively correlated with cognitive ability. The relationship between military experience and mental health is not statistically significant.
Estimation of epidemiological parameters of COVID-19 epidemic caused by Delta variant strain in Guangzhou
ZHANG Kai-xuan, HU Kuan, ZOU Pin-ang, LUO Fang, LUO Dan, CHEN Yue, PENG Wen-hui, WANG Bao-guo
2022, 26(1): 112-115. doi: 10.16462/j.cnki.zhjbkz.2022.01.019
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Abstract:
  Objective  An epidemic of COVID-19 caused by an imported Delta variant strain in Guangzhou was investigated, and the transmission chain, transmission characteristics and infection of each case were analyzed, so as to provide a theoretical basis for predicting disease development and epidemic prevention and control.  Methods  By collecting the information released by Guangzhou government, the confirmed cases with a clear transmission chain were selected, and the infectious disease indicators such as serial interval (SI), basic reproduction number (R0) and time-dependent reproduction number (Rt) were calculated to analyze the epidemiological characteristics.  Results  From May 21 to June 20, 2021, a total of 144 cases of indigenous COVID-19 were confirmed in Guangzhou, among which 67 pairs of cases with a clear transmission chain were selected. SI was calculated to follow the Gamma distribution, with a mean of 4.27 d and a standard deviation of 2.65 d. R0=3.18 (95% CI: 2.197-4.428), and Rt showed an obvious decreasing trend over time. On June 10, Rt=0.97 (95% CI: 0.751 -1.214), which was lower than 1. Since then Rt had been less than 1, and it got smaller and smaller over time.  Conclusion  In this COVID-19 epidemic, the SI was shorter and the R0 was larger, which indicated that the Delta variant strain had a faster transmission rate and stronger transmissibility than the COVID-19 infected in Wuhan in 2020.
Analysis of epidemic characteristics of infectious diseases in Ningxia from 1949 to 2018
SUN Wei, ZHANG Yin-hao, ZHAO Jian-hua, LI Hai-jun, GONG Rui, LI Xi
2022, 26(1): 116-120. doi: 10.16462/j.cnki.zhjbkz.2022.01.020
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Abstract:
  Objective  To understand and grasp the epidemic trend of infectious diseases and the change characteristics of disease spectrum in Ningxia in the past 70 years, so as to provide scientific basis for timely adjustment and formulation of infectious disease prevention and control strategies and guarantee the high-quality development of social economy.  Methods  The reported data of infectious diseases in Ningxia from 1949 to 2018 was collected and analyzed by descriptive epidemiological method.  Results  In the 1949-2018 years, a total of 30 cases of infectious diseases was reported in Ningxia, 2 004 205 cases was reported, 12 202 cases was reported, and the average reported incidence rate was 912.42/10 million, with an average mortality rate of 7.84/10 million. The incidence and mortality of infectious diseases decreased in general, and the annual incidence rate dropped from 5 359.12/10 million in 50s to 299.37/10 million in 90s. The incidence rate of infectious diseases in recent twenty years was basically around 500.00/10 million. The disease spectrum in different periods changed greatly, and the diseases of infectious diseases was different in different periods. (χ2=10 130.997, P < 0.001).  Conclusions  In the past 70 years, the epidemic situation of infectious diseases in Ningxia showed a downward trend, especially in the past 20 years. However, with the changes of epidemic characteristics and patterns, the situation of prevention and control is still grim. It is necessary to adjust the prevention and control strategies in time to effectively prevent the spread of infectious diseases.

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