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CN 34-1304/R ISSN 1674-3679

2022 Vol. 26, No. 3

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Literature Review
Striving for the construction of high-level public health schools
LI Li-ming, YE Dong-qing
2022, 26(3): 249-250. doi: 10.16462/j.cnki.zhjbkz.2022.03.001
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Abstract:
To deeply serve the national strategy of innovative development of medical education, and to promote the construction of new medicine, colleges and universities around the country should actively carry out the construction of high-level public health schools. At present, a public health system with Chinese characteristics has initially formed. Based on the system, concerted efforts should be made to promote the construction of high-level public health schools.
Original Articles
Diet and physical activity in Chinese people with different risks of cardiovascular disease
CUI Qing-mei, LI Jian-xin, CAO Jie, LIU Fang-chao, HUANG Ke-yong, CHEN Shu-feng, CHEN Ji-chun, HUANG Jian-feng, GU Dong-feng, LU Xiang-feng
2022, 26(3): 251-256. doi: 10.16462/j.cnki.zhjbkz.2022.03.002
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  Objective  To describe the distribution of two ideal health behaviors: diet and physical activity in Chinese adults with cardiovascular disease (CVD) risks, and to further provide evidence for CVD prevention.  Methods  The study included 22 220 adults aged 35 to 74 years without CVD from 14 Provinces or cities in China. The 10-year CVD risks for all participants were estimated using the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) equations, and participants were subsequently divided into low (< 5%), moderate (5- < 10%) and high risk (≥10%) groups. Sex-specific distribution of five ideal diet metrics (vegetables and fruits, fish, red meat, soybean products, and tea) and physical activity were compared among participants at different CVD risk groups.  Results  Among Chinese population aged 35-74 years, there were 75.6%, 14.9% and 9.4% of participants with low, moderate, and high risk of 10-year CVD, respectively. Compared with women, the ideal proportion of male diet (56.6% vs. 75.6%) physical activity (46.2% vs. 57.6%) was higher(all P < 0.05). Ideal intake of vegetable, fruits and fish decreased with the 10-year CVD risk (P < 0.05) in both sexes. Inadequate intake of fruit and fish among participants with high CVD risk was the most serious problem. A decreasing trend was observed for the ideal physical activity with the 10-year CVD risk (P < 0.001). Women with high CVD risk had substantial difference of ideal physical activity than those with low CVD risk (28.7% vs. 48.4%).  Conclusion  Low prevalence of ideal diet and physical activity occurred in population with high 10-year CVD risk in China, especially in women. It is imperative to implement healthy lifestyle measures among high-risk population, such as enhancing intake of vegetable, fruits, fish and promoting physical activity.
The combined effects of BMI, waist circumference, and sleep quality on the prevalence of hypertension in adults
WANG Si-jia, LI Li, SUN Dong-han, WU Wen-wen
2022, 26(3): 257-262. doi: 10.16462/j.cnki.zhjbkz.2022.03.003
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  Objective  To evaluate the combined effects of BMI, waist circumference (WC) and sleep quality on the prevalence of hypertension in adults.  Methods  A questionnaire survey was conducted among 3 195 adult residents in Shiyan City from October to December, 2020 by convenience sampling method. The Logistic regression model was used to estimate the combined effects of BMI, WC and sleep quality on hypertension prevalence.  Results  The prevalence of hypertension was 18.22%. Multivariate Logistic regression analysis showed that compared to those with normal BMI/good sleep quality, the subgroup with BMI < 18.5kg/m2/good sleep quality (OR=4.049), with overweight/good sleep quality (OR=1.172), with general obesity/good sleep quality (OR=4.625), with BMI < 18.5kg/m2/poor sleep quality (OR=4.581), with normal BMI/poor sleep quality (OR=1.166), with overweight/poor sleep quality (OR=5.476), and with general obesity/poor sleep quality (OR=8.230) had increased the risk of hypertension. In addition, compared to those with normal WC/good sleep quality, the subgroup with abdominal obesity/good sleep quality (OR=4.017), with normal WC/poor sleep quality (OR=3.074), and with abdominal obesity/poor sleep quality (OR=7.495) also had increased the risk of hypertension.  Conclusion  The co-existence of poor sleep quality and general or abdominal obesity increase the risk of hypertension, suggesting that the control of BMI and WC in people with poor sleep quality is beneficial to the prevention of hypertension.
The relationship between the activities of daily living and death in the elderly aged 65 and over in China
KOU Shuo, LU Zhao-jun, ZHENG Wei-jun, WANG Jun-ping, RONG Chao
2022, 26(3): 263-268. doi: 10.16462/j.cnki.zhjbkz.2022.03.004
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  Objective  To explore the relationship between disability in activities of daily living and death in the elderly.  Methods  Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which is a nationally representative study. The analysis included 37 173 subjects, all of whom were new entrants in the year of the interview. The survival outcome was derived from the first follow-up after 2-4 year. And disability was measured using the scale of Activities of Daily Living (ADL). By calculating and grouping the ADL scores, several statistical models were used to analyze the relationship between disability and death in the elderly.  Results  After adjusted for confounding factors such as demographics, health behaviors, and dietary intake characteristics, a statistical association was observed between ADL total score and the risk of death in the population (RR=1.09, 95% CI: 1.08-1.09, P < 0.001). Compared scored of 6, death for people with scores >6 increased by 69% (RR=1.69, 95% CI: 1.65-1.74, P < 0.001). Compared normal group, the risk of death in the low-grade disability group and the high-grade disability group increase by 52% and 92%, respectively (RR=1.52, 95% CI: 1.47-1.56, P < 0.001; RR=1.92, 95% CI: 1.86-1.97, P < 0.001).  Conclusion  In the CLHLS sample, disability increases the risk of death in the elderly, and short-term follow-up and low-age disabled elderly are at greater risk of death.
An analysis of influencing factors of diabetic retinopathy among type 2 diabetic patients: a nested case-control study
CHEN Jia-xian, WAN Ya-nan, SU Jian, ZHU Zheng, PAN En-chun, SHEN Chong, WEN Jin-bo, WANG Kai, YU Hao, QIN Yu, CUI Lan, ZHOU Jin-yi, WU Ming
2022, 26(3): 269-273. doi: 10.16462/j.cnki.zhjbkz.2022.03.005
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  Objective  To investigate the influencing factors of diabetic retinopathy (DR) in type 2 diabetic patients.  Methods  This nested case-control study was based on a prospective cohort study: Comprehensive Research on the Prevention and Control of the Diabetes, including type 2 diabetic patients over 35 years old at communities in Huai'an City in 2013-2014. Standardized questionnaires, anthropometric measurement and biochemical blood tests were used to collect baseline information. For this study, 1 544 patients diagnosed with DR during follow-up were recruited as cases, controls were randomly selected and were 1∶1 matched with case by age (±4 years) and sex. The relationship between DR and glycated hemoglobin, diabetes duration, systolic blood pressure and other influencing factors were analyzed using Logistic regression model. In addition, multinominal Logistic regression was performed to analyze the influencing factors of mild-moderate and severe DR.  Results  The mean age of cases and controls was (58.09±8.55) and (58.15±8.50) years, respectively, and the median of follow-up was 6 years. Logistic regression model found that insulin use (OR=2.26, 95% CI: 1.75-2.92), triglyceride (OR=1.06, 95% CI: 1.02-1.11), waist-hip ratio (per 0.1-unit increase) (OR=1.28, 95% CI: 1.15-1.43), glycated hemoglobin (OR=1.65, 95% CI: 1.57-1.73), systolic blood pressure (OR 1.01 (95% CI: 1.00-1.01), diabetes duration [5-10 y vs. < 5 y, OR =1.69 (95% CI: 1.42-2.01); ≥10 y vs. < 5 y, OR=2.38, (95% CI: 1.94-2.91)] were associated with the risk of DR.  Conclusions  Insulin use, triglyceride, waist-hip ratio, glycated hemoglobin, systolic blood pressure and diabetes duration are the influencing factors of DR among type 2 diabetic patients. It is important to strengthen screening for DR among type 2 diabetic patients.
Association of sleep with chronic comorbidities of young and middle-aged people in a plateau area
LI Ya-jie, HE Rui-feng, SUOLANG De-ji, WANGQING Ping-cuo, CIREN Zhuo-ga, LABA Ci-ren, SILANG Yang-zong, NIMA Qu-cuo
2022, 26(3): 274-279. doi: 10.16462/j.cnki.zhjbkz.2022.03.006
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  Objective  To investigate the relationship of sleep duration, sleep quality, and snoring with chronic comorbidities in young and middle-aged people at high altitude.  Methods  From May 2018 to August 2019, people aged 30 and above in Chengguan District of Lhasa City were selected by multi-stage random cluster sampling method for questionnaire survey. Multivariate Logistic regression model was used to analyze the correlation between sleep and chronic comorbidities.  Results  A total of 5 505 young and middle-aged people aged 30-59 years old were included in the study. The average age was (44.70 ± 8.50) years old, and 29.5% of them were defined with chronic comorbidities. Multivariate Logistic regression models showed that shorter sleep duration, poor sleep quality, and snoring were risk factors for chronic comorbidities in young and middle-aged people after adjusting for potential confounding factors. Compared with participants with 8 hours of sleep duration daily, the OR (95% CI) of chronic comorbidities for those with sleep duration ≤6 h was 1.57(95% CI: 1.21-2.04). The OR (95% CI) of chronic comorbidities was 1.59(95% CI: 1.39-1.82) in the poor sleep quality group compared with those with good sleep quality. Compared with those who did not snore during sleep, the OR (95% CI) of chronic comorbidities in those who snored occasionally and frequently during sleep were 1.20 (95% CI: 1.02-1.41) and 1.64 (95% CI: 1.37-1.97), respectively.  Conclusions  Shorter sleep duration (≤6 h), poor sleep quality, and snoring are associated with chronic comorbidities in young and middle-aged people at high altitude. The middle-aged people in plateau area should not only ensure the proper sleep time, but also control the snoring behavior and improve the sleep quality.
Association between dietary patterns and overweight/obesity among adolescents in Luzhou
LIU Xiao-yan, QIU Ming, KANG Jia-hao, XU Wang-dong, MA Ling
2022, 26(3): 280-284. doi: 10.16462/j.cnki.zhjbkz.2022.03.007
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  Objective  This study aimed to analyze the association between dietary patterns and overweight/obesity among adolescents in Luzhou City and providing a theoretical basis for adolescents' dietary intervention.  Methods  A total of 3 869 adolescents in Luzhou City were recruited by multi-stage stratified cluster sampling. The basic information and dietary habits of the respondents was collected through questionnaire, and the frequency and amount of various food intakes by the respondents in the past year was obtained by diet frequency method. Factor analysis was used to extract the dietary patterns of adolescents in Luzhou. Multivariate Logistic regression analysis was used to examine the correlation between dietary patterns and overweight/obesity of adolescents.  Results  Three dietary patterns (vegetable-fruit dietary pattern, fast-food dietary pattern and staple-meat dietary pattern)were found among adolescents in Luzhou. The results of Logistic regressive model analysis showed that comparing with the highest score group of fast-food dietary pattern, the risk of obesity increases as the score decreasing after adjusting the confounding factors (the higher group OR=0.59, 95% CI: 0.36-0.97, P=0.041; the lower group OR=0.60, 95% CI: 0.36-0.99, P=0.046).  Conclusions  There is a correlation between adolescents' dietary patterns and obesity. Health education and dietary interventions should be strengthened by relevant departments to optimize the dietary patterns of adolescents and promote them to grow healthily.
Evaluating the influential factors of multidrug-resistant tuberculosis using a propensity score matching method
XU Ke, DING Song-ning, YANG Chen, WANG Rong, MIAO Rui-fen, ZHANG Da-wei, ZHANG Hong-ying, LI Chen
2022, 26(3): 285-289. doi: 10.16462/j.cnki.zhjbkz.2022.03.008
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  Objective  The aim of present study is to evaluate the influential factors of multidrug-resistance tuberculosis (MDR-TB) in Nanjing, and to provide scientific evidence for reducing the incidence rate of MDR-TB.  Methods  To screening 6 649 suspected MDR-TB cases who registered and managed in Nanjing from January 1, 2013 to December 31, 2020. The general information of the patients was checked through the Tuberculosis (TB) management system of the Chinese Center for Disease Control and Prevention, and the treatment management conditions of the patients were tracked through electronic medical records and telephone investigation. A total of 279 MDR-TB and 6 370 non-MDR-TB were described from general demographic characteristic. A total of 279 non-MDR-TB with 1∶1 matched were select using a propersity score matching method. Conditional Logistic regression model was used to analyze single and multiple factors influential of MDR-TB.  Results  Conditional Logistic regression results showed that previous history of second-line drugs and adverse reactions of anti-tuberculosis drugs were risk factors for MDR-TB (OR=2.39, 95% CI: 1.46-3.93, P < 0.001; OR=3.90, 95% CI: 2.45-6.21, P < 0.001), Initial treatment patient and regular medication were protective factors for MDR-TB (OR=1.55, 95% CI: 1.02-2.34, P=0.038; OR=2.63, 95% CI: 1.69-4.07, P < 0.001).  Conclusions  MDR causes a huge of harm to patients, their families and the society. Clinical medical institution and CDC should strengthen cooperation to improve the detection rate of TB and the standard treatment management rate of patients, so as to control the spread of MDR epidemic.
Time series analysis of the association between air pollution and daily outpatient visits for eczema in Zhengding
SUN Cheng-yao, TANG Da-jing, CHANG Hui-yun, CHEN Feng-ge, ZHAO Chuan, GUAN Ming-yang
2022, 26(3): 290-296. doi: 10.16462/j.cnki.zhjbkz.2022.03.009
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  Objective  This study investigates the impact of atmospheric pollutants on the daily number of outpatient visits for eczema in Zhengding County, Shijiazhuang City.  Methods  Outpatient information of eczema, atmospheric pollutants concentration data (PM10, PM2.5, SO2, and NO2), and meteorological data (daily average temperature, and relative humidity) in Zhengding from January 1, 2017 to December 31, 2019 were collected. Generalized additive model was chosen to construct single-pollutant models, and double-pollutant models to analyze the association between atmospheric pollutants and daily outpatient visits for eczema. A stratified analysis was performed based on sex and age.  Results  In single-pollutant models, a 10 μg/m3 increase in PM10, PM2.5, SO2, and NO2 were associated with 0.60% (95% CI: 0.16%-1.05%), 0.71% (95% CI: 0.04%-1.39%), 4.45% (95% CI:  1.51%-7.47%), and 2.75% (95% CI: 0.24%-5.32%) increase in outpatient visits for eczema. In double-pollutant models, the effects of PM10, PM2.5, and NO2 disappeared, and the effect of SO2 declined slightly. Stratification analysis showed that males, people aged less than 15 years, and more than 65 years were relatively more sensitive to atmospheric pollutants.  Conclusion  The increase in the concentration of PM10, PM2.5, SO2, and NO2 may lead to an increase in the number of outpatient visits for eczema.
Correlation between the infants of large for gestational age and the age interval of delivery age and menarche age
LIAO Qian, LIANG Jun, HUANG Dong-ping, LIU Shun, GUO Xiao-jing, QIU Xiao-qiang
2022, 26(3): 297-301. doi: 10.16462/j.cnki.zhjbkz.2022.03.010
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  Objective  To explore the correlation between the infants of large for gestational age(LGA) and the age interval of delivery age and menarche age.  Methods  A total of 2 032 pregnant women were enrolled from June 2015 to April 2018 in the five Maternal and Child Health Care Institutions in Baise City, Guangxi. The association between the infants of LGA risk and maternal interval age was analyzed, and the efficiency of maternal interval age in predicting LGA was analyzed by receiver operating characteristic (ROC) curve.  Results  During the follow-up of 2 032 pregnant women, the number of 67 cases had LGA, the incident rate was 3.3%. The delivery age, interval age and BMI of pregnant women in LGA group were higher than those in non-LGA group (all P < 0.05). In correlation analysis, after adjusting for confounding factors, there was no association between maternal interval age and birth weight (P=0.178), but the risk of LGA in pregnant women with maternal interval age ≥ 30 years was 29.214 times higher than that with maternal interval age < 10 years (P=0.018). The ROC curve analysis showed that the AUC of the overall prediction of maternal interval age and the delivery of female infants were 0.585 and 0.644, respectively, and the best cutoff point for the prediction of LGA by maternal interval age was 13 years old.  Conclusion  The longer the interval between delivery age and menarche age is, the higher the risk of LGA. The interval between delivery age and menarche age is a good predictor of LGA in female infant.
Association of KCNQ1 gene polymorphism with the risk of gestational diabetes
GUO Meng-zhu, YANG Fei-fei, HAN Tian-bi, REN Qing-wen, ZHAO nan, ZHANG Ya-wei, FENG Yong-Liang, WANG Su-ping, WU Wei-wei
2022, 26(3): 302-308. doi: 10.16462/j.cnki.zhjbkz.2022.03.011
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  Objective  This study aims to investigate the relationship between KCNQ1 (potassium voltage-gated channel, subfamily Q, member 1)gene polymorphism and the risk of gestational diabetes mellitus (GDM), and to provide clues for the study of the GDM mechanism.  Methods  We used a matched nested case-control study design, individuals including 334 gestational diabetes patients and 334 healthy controls. Confirmed 334 gestational diabetes cases and age and residence matched controls (1∶1) were enrolled. We examined 13 candidate single-nucleotide polymorphisms in the KCNQ1 gene and the risk of gestational diabetes. The associations were estimated in Co-dominant, Dominant, Recessive, and Alleles models. HaploView software was used to analyze the relationship between haplotype and gestational diabetes.  Results  After adjusting for family history of diabetes, pre-pregnancy body mass index, and multiple comparisons using false discovery rate method, in the co-dominant model, compared with AA genotype carriers, GG genotype carriers at rs4930000 had a higher risk of GDM (OR=3.37, 95% CI: 1.3-8.73, P=0.013). However, pregnant women who carried the rs163171GA genotype (OR=0.70, 95% CI: 0.50-0.98, P=0.037), rs2074196CA genotype (OR=0.65, 95% CI: 0.46-0.91, P=0.012), rs2237888 GA genotype (OR=0.69, 95% CI: 0.49-0.98, P=0.037) and rs72847583 CG genotype (OR=0.69, 95% CI: 0.49-0.98, P=0.017)had reduced risk of GDM. The haplotype Block1 AA phenotype is composed of rs11023996 and rs7924946 and the Block2 CGACG phenotype is composed of rs233446, rs2237893, rs151293, rs16318, rs163183, and rs234852 within the KCNQ1 gene were associated with the risk of gestational diabetes.  Conclusions  The polymorphisms of KCNQ1 (rs4930000、rs163171、rs2074196、rs2237888、rs72847583), the Block1 AA phenotype and Block2 CGACG phenotype are relevant genetic factors in a Chinese population with gestational diabetes.
Sequence analysis of pol gene of HIV-1 strains in Kunming, Yunnan Province
QIU Yu-ting, LI Jian-jian, LIU Jia-fa, WANG Jia-li, ZHANG Mi, DONG Xing-qi
2022, 26(3): 309-314. doi: 10.16462/j.cnki.zhjbkz.2022.03.012
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  Objective  To investigate the distribution of human immunodeficiency virus type 1(HIV-1) subtypes and the variation of pol gene in Kunming, Yunnan Province.  Methods  Randomly selected 390 samples with HAART for more than half a year in Kunming from 2015 to 2019, and collected the epidemiological information. Purified the HIV-1 RNA from plasma and amplified the HIV-1 pol gene by nested polymerase chain reaction. Online analysis tools like Genotyping, BLAST and MEGA 6.06 software were used to determine strain subtypes. Distance program of MEGA was used to calculate the gene distance, and Entropy program was used to analyze the amino acid polymorphism, so as to analyze the pol gene sequence characteristics of HIV-1 strains.  Results  A total of 318 pol gene sequences were successfully amplified. The major subtypes of HIV-1 strains in Kunming were B subtype(3.1%), C subtype(4.4%), CRF01_AE(26.1%), CRF07_BC(20.4%), CRF08_ BC(42.8%) and other subtypes (3.1%). There were statistically significant differences in the distribution of HIV-1 genotypes in sex, age and infection routes (all P < 0.001).The genetic distances of pol gene for CRF01_AE, CRF07_BC and CRF08_BC were (0.018±0.008), (0.015±0.006) and (0.006±0.004) bp (all P < 0.01). In CRF01_ AE, there were 45 different sites in amino acid sequences between intravenous drug addicts and sexual contacts and 156 different sites between hetrosexual contacts and homosexual contacts, and the differences were sitatistically significant (P < 0.05).  Conclusion  There are complex and diverse HIV-1 subtypes in Kunming, and CRF08_BC is the predominant epidemic subtype. The main route of infection is heterosexual transmission. CRF01_ AE subtype is an epidemic strain with high degree of variation in Kunming. There are differences in amino acid mutation sites of strains from different infection routes, which should be closely monitored.
Prognostic molecular subtyping of clear cell renal cell carcinoma based on multi-omics data
WEI Yi-fang, LI Ling-mei, LI Zhi, FANG Rui-ling, CAO Hong-yan, CUI Yue-hua
2022, 26(3): 315-324. doi: 10.16462/j.cnki.zhjbkz.2022.03.013
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  Objective  This work is to explore the application of association-signal-annotation boosted similarity network fusion (ab-SNF) method in clear cell renal cell carcinoma (ccRCC) molecular subtyping based on multi-omics data integration, to identify patients with poor prognosis of ccRCC, and to detect potential pathogenic genes, pathways and related immune infiltrating cells of patients with different subtypes.  Methods  The miRNA/mRNA expression and DNA methylation data of ccRCC were downloaded from The Cancer Genome Atlas (TCGA) database. We applied ab-SNF to integrate multiple omics data of ccRCC to identify subtypes. Cox regression was conducted to evaluate the prognostic risk of different subtypes. Differentially expressed mRNAs (DEmRNAs), miRNAs (DEmiRNAs) and differentially methylated genes (DMGs) were screened following subtyping. Correlation analysis and gene ontology (GO) enrichment analysis were performed for the overlapping genes. Finally, the immune cell infiltration analysis and pathway activity analysis of patients with different subtypes were carried out.  Results  ccRCC patients were divided into high-risk and low-risk groups. ccRCC patients in the high-risk group were 1.903 times more likely to die than the low-risk group. A total of 5 218 DEmRNAs, 107 DEmiRNAs and 2 625 DMGs were identified. Among them, 20 DEmRNAs were regulated by DEmiRNA, 567 DEmRNAs were accompanied by abnormal methylation, and 588 overlapping genes were enriched in 10 GO items. In addition, 6 immune filtrating cells and 9 pathways showed statistical significance.  Conclusion  ab-SNF can effectively identify the subtypes of ccRCC, and can identify potential pathogenic genes, important pathways and related immune infiltrating cells of ccRCC. The result of this study can provide new strategies for targeted therapy of ccRCC patients.
Review
Research progress of propensity score and Mendelian randomization in China
HE Si-min, ZHANG Yu, PENG Liu-qing, JING Jia-rui, CHEN Shu-ting, WANG Wen-jie, GAO Rong-rong, GAO Xue, GAO Qian, WANG Tong
2022, 26(3): 325-330. doi: 10.16462/j.cnki.zhjbkz.2022.03.014
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Confounding bias is a common source of bias in non-randomized studies, and the control of confounding factors is an important guarantee for reliable results. In this article, we briefly introduce two types of commonly used methods on confounding control: propensity scoring and Mendelian randomization. We reviewed the current research in recent years in China, with a view to provide recommendations for propensity score and Mendelian randomization research applications.
Short Reports
Main risk factors and clustering of cardiovascular diseases in Sichuan Province based on a multi-level model
ZHA Yu-xin, DENG Ying, ZUO Ming-liang, WANG Zhuo, ZHANG Yan, XU Wei, CUI Jian-lan, HE Yu-jin, HE Jun
2022, 26(3): 331-336. doi: 10.16462/j.cnki.zhjbkz.2022.03.015
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  Objective  To investigate the distribution and aggregation of high risk types of cardiovascular diseases (CVD) in different areas of Sichuan Province.  Methods  A total of 10 counties (districts) in Sichuan Province were randomly selected by multi-stage cluster sampling. A total of 29 300 permanent residents aged 35 to 75 years were included in this study during 2015 to 2019. Multi-level Logistic regression model was used to analyze the aggregation of CVD high-risk types in different regions of Sichuan Province.  Results  A total of 29 300 patients with high-risk of CVD were detected, and the standardized detection rate was 17.64%, among Patients the male was higher than the female, the rural was higher than the urban, high school education or above, and the family annual income ≥ 50 000 was higher. The detection rate of high-risk population was the highest in western Sichuan and the lowest in southern Sichuan. The standard detection rate increased with age. The average age of high-risk group was (58.45±12.47) years old, and there were statistical differences in basic characteristics, self-reported disease history, risk factors and health indicators by region (P<0.001). The influence of different regions on the aggregation risk of high-risk types could be ignored. The aggregation degree of ≥2 high-risk types in males was higher than that in females (P<0.001), and the concentration of high-risk types of CVD increased with age. Living in city (OR=0.770, 95% CI: 0.717-0.828, P<0.001) was the protective factor for the aggregation degree of two high-risk types. High school degree and below (OR=1.125, 95% CI: 1.011-1.252, P=0.030) and annual household income<50 000 (OR=1.121, 95% CI: 1.008-1.247, P=0.036) were the risk factors for aggregation degree of two high-risk types.  Conclusion  The influence of the different regions of Sichuan Province for high-risk type gathering risk negligible. The prevention and control of high-risk types of CVD aggregation risk should focus on the male, high school age, culture level, rural residents, family income,<50 000 people, and for risk factors of different areas in Sichuan Province to take targeted measures, in order to obtain better control effect.
Analysis on major chronic diseases on the probability of premature death in Shaanxi Province, 2015-2020
QIU Lin, WANG Wei-hua, LIU Rong, SA Ri-na
2022, 26(3): 337-342. doi: 10.16462/j.cnki.zhjbkz.2022.03.016
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  Objective  The study aimed to analyze the mortality, probability of premature death and change trend of four major chronic diseases (cardiovascular and cerebrovascular diseases, malignant tumors, chronic respiratory diseases and diabetes) in Shaanxi Province from 2015 to 2020, and predicting the realization of the goal of "Healthy China 2030" for major chronic diseases on probability of premature death.  Methods  Using the monitoring data of death causes in Shaanxi Province from 2015 to 2020, the crude mortality rate, standardized mortality rate, constituent ratio, probability of early death, average growth rate, predicted value of probability of early death and target value of probability of early death were calculated. χ2 test was used for comparison of mortality rates, and annual percentage change (APC) was used for analysis of trends.  Results  From 2015 to 2020, the death rate of four major chronic diseases accounted for more than 83.00% of the total death rate and more than 94.00% of the death rate of chronic diseases in Shaanxi Province. The crude mortality of the four major chronic diseases in the total population, male and female subgroup showed an upward trend (APC=2.02%, male APC=2.12%, female APC=1.92%), and the standardized mortality showed a downward trend (APC=-2.96%, male APC=-2.47%, female APC=-3.54%), with statistical significance (all P < 0.05). The crude mortality of four major chronic diseases in male was higher than that in female over the years, with statistical significance (all P < 0.001). From 2015 to 2020, the probability of premature death of four major chronic diseases in the total population, male and female showed a decreasing trend (total population APC=-1.78%, male APC=-1.19%, female APC=-3.05%), and the trend test showed statistical significance (all P < 0.05). In the past 6 years, the probability of premature death of the total population, male and female in Shaanxi Province decreased by 1.98%, 1.34% and 3.43%, respectively. According to the prediction of the decline rate, the probability of premature death of the total population and male in Shaanxi Province will not reach the target value of "Healthy China 2030" by 2030, but female can reach the target.  Conclusions  From 2015 to 2020, the standardized mortality rate and the probability of premature death of four major chronic diseases in Shaanxi Province had declined. The probability of premature death of the total population and male cannot achieve the target value. It is suggested to further strengthen the comprehensive prevention and control of chronic diseases, targeted intervention measures, to promote "Healthy China 2030" goal.
Influencing factors of COVID-19 epidemic on the utilization of Human immunodeficiency virus testing among men who have sex with men
JIANG Shi-qing, CAO He, HU Tian, CHEN Ya-qi, LI Zhi-ming, ZHANG Ke-chun
2022, 26(3): 343-347. doi: 10.16462/j.cnki.zhjbkz.2022.03.017
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Abstract:
  Objective  To analyze the utilization of HIV testing services and related influencing factors among men who have sex with men (MSM) on COVID-19.  Methods  From September to November 2020, an electronic questionnaire survey was conducted on MSM in the AIDS Vct of Longhua CDC and the Third People's Hospital of Shenzhen, The rank sum test was used to compare the changes in the utilization of HIV testing services in different situations of various factors, and ordinal multinomial logistic regression model was established to analyze the influencing factors of the utilization of HIV testing services.  Results  A total of 30.4% MSM were reported reduction in the use of HIV testing services. Logistic regression analysis showed that highly panic of COVID-19 reducing the frequency of anal sex (OR=0.056, 95% CI: 0.021-0.150, P < 0.001), being advised not going to testing agency (OR=0.538, 95% CI: 0.297-0.975, P=0.041), and being infected of COVID-19 (OR=21.979, 95% CI: 4.369-110.559, P < 0.001) had higher chance of reduction in the used of HIV testing services.  Conclusion  The HIV testing service utilization is decreased in MSM during COVID-19. It is necessary to pay more attention to this convenience when formulating and implementing epidemic prevention and control measures.
Prevalence and influencing factors of obesity and abdominal obesity among adults in Shenzhen in 2018
ZHAO Shao-juan, YAN Xin-feng, YU Chuan-ning, YU Xiao-xuan, CHEN Jian-dong, CAO Si-jing, LUO Yi, YANG Li-zhen, LEI Lin, PENG Ji
2022, 26(3): 347-350. doi: 10.16462/j.cnki.zhjbkz.2022.03.018
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Abstract:
  Objective  To examine the prevalence and impact factors of obesity and central obesity among adult residents in Shenzhen City.  Methods  In 2018, a total of 10 046 permanent adult residents in Shenzhen were selected by multi-stage stratified random sampling to investigate chronic diseases and their risk factors. And analyze the epidemiological characteristics and influencing factors of obesity and centripetal obesity were analyzed.  Results  Of all the residents, 8.65% and 38.04% were indentified with obesity and central obesity, respectively. Gender, age and smoking were significantly associated with the prevalence of obesity and central obesity (all P < 0.05). Male gender, middle age and smoking were risk factors for obesity and central obesity (OR=1.411, 95% CI: 1.115-1.725, P=0.001; OR=1.155, 95% CI: 1.010-1.321, P=0.036), while moderate work physical activity was a protective factor against central obesity (OR=0.856, 95% CI: 0.775-0.946, P=0.002).  Conclusion  Although the rate of obesity and central obesity slightly decrease among adult in Shenzhen, targeted preventive measures should be encouraged, especially for central obesity.
Analysis of prevalence, awareness, treatment and disease burden of chronic obstructive pulmonary disease among three ethnics in rural Yunnan Province
LIU Lan, WANG Xu-ming, LI Jin-bo, MO Yi, SUN Cheng-huan, CUI Wen-long, CAI Le
2022, 26(3): 351-356. doi: 10.16462/j.cnki.zhjbkz.2022.03.019
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Abstract:
  Objective  The aim of this study was to analyze the prevalence, awareness, treatment, and disease burden of chronic obstructive pulmonary disease (COPD) among Han majority, Naxi and Bai ethnic minorities in rural areas of Yunnan Province.  Methods  The multi-stage stratified random sampling method was used to select 7 534 rural residents aged ≥35 years from three counties in Yunnan Province. Each participant received questionnaire survey and pulmonary function examination.  Results  The prevalence rate of COPD among Han majority, Naxi and Bai ethnic minorities was 11.51%, 17.66% and 13.23%, awareness rate was 11.11%, 17.45% and 45.92%, and treatment rate was 10.42%, 16.11% and 45.02%, respectively. The highest prevalence of COPD was found in Naxi ethnic minority, whereas the lowest was found in Han majority (P < 0.001). Males had higher prevalence of COPD than females (P < 0.001), and prevalence of COPD increased with age for all three ethnics (P < 0.001). Among the three ethnics, persons with junior middle school educational level or above had higher awareness and treatment rate of COPD than those with primary school educational level or below. The mortality rate per 100 000 population, years of life lost (YLL) /1000 population, years lived with disability (YLD)/1 000 population and DALY/1 000 population (YLL) of COPD was 110.06, 9.75, 44.62 and 54.37 for Han people, 58.51, 17.25, 68.68 and 85.93 for Naxi minority people, and 102.52, 8.22, 51.22 and 59.44 for Bai minority people, respectively. The mortality rate per 100 000 population, YLL/1 000 population, YLD/1 000 population and DALY/1 000 population of COPD were higher in males than in females among the three ethnics. The highest YLL, YLD and DALY rates of COPD were found in Naxi ethnic minority, whereas the lowest was found in Han majority.  Conclusion  The findings indicate disease high prevalence and burden of COPD among the three ethnics and there are ethnic differences in prevalence, awareness, treatment, and burden of COPD in rural Yunnan Province. Ethnically tailed tertiary prevention measures of COPD are needed to reduce the harm of COPD to people's health in rural Yunnan Province.
Influential factors of sarcopenia in older adults based on random forest and Logistic regression
CHEN Xin-yu, ZHOU Jun-liang, LI Ting-ting, TIAN Tian, WANG Min, JIA Hong
2022, 26(3): 357-361. doi: 10.16462/j.cnki.zhjbkz.2022.03.020
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Abstract:
  Objective  To analyze the influencing factors of sarcopenia in older adults, and providing a reference for sarcopenia intervention.  Methods  The structured questionnaires were used to investigate 439 elder persons admitted to communities and hospitals in Luzhou City. The random forest method was used to sort the importance and reduce the dimension of the independent variables. The Logistic regression model was used to analyze the action direction and relative risk of independent variables.  Results  The results of the random forest analysis showed that the estimated error rate was the lowest when the number of variables was seven, followed by the body mass index, diabetes, age, hypertension, abdominal obesity, alcohol drinking and exercise duration. Logistic regression analysis showed that age, BMI, alcohol drinking, abdominal obesity, diabetes were influencing factors of sarcopenia in the elderly (all P < 0.05).  Conclusion  The top seven influencing factors of sarcopenia were BMI, diabetes, age, hypertension, abdominal obesity, alcohol drinking, and exercise duration. It is recommended to increase the education of healthy lifestyles, and strengthen the detection and control of diabetes and hypertension.
Analysis of Caner Burden in Anhui Province in 2015
LIU Jin-song, WANG Hua-dong, ZHANG Xin-zhou, SU Qing, DAI Dan, ZHA Zhen-qiu, LU Man-man
2022, 26(3): 362-366. doi: 10.16462/j.cnki.zhjbkz.2022.03.021
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  Objective  To analyze the disease burden of cancer in Anhui Province, 2015.  Methods  Based on the cancer registry follow-up data of residents in Anhui Province in 2015, several indicators including incidence, mortality and disability adjusted life year (DALY) were calculated.  Results  In 2015, the crude incidence and crude mortality of cancers in Anhui Province were 272.11/105 and 16.69/105. The DALY and DALY rate caused by cancers in Anhui Province were 1 486 717 person years and 2 139.84/105. The top five cancers of DALY' rates in Anhui Province were lung cancer, stomach cancer, liver cancer, esophagus cancer and colon-rectum cancer, which was 71.75% of total burden for cancers.  Conclusion  The burden of cancers in Anhui Province is higher than the national average level, we should strengthen prevention and treatment for the key cancers.
Analysis of genetic characteristics of B-Victoria strains of influenza virus in Shandong Province during the influenza surveillance year from 2019 to 2020
LYU Jian, WU Ju-long, LIU Ti, YAO Ming-xiao, LI Yan, ZHU Kai, LI Dong, JI Long, KOU Zeng-qiang
2022, 26(3): 367-372. doi: 10.16462/j.cnki.zhjbkz.2022.03.022
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Abstract:
  Objective  The study aims to analyze the prevalence and genetic characteristics of the B-Victoria strain of influenza virus in Shandong Province from 2019 to 2020 monitoring year, and providing a reference for the vaccination of influenza B vaccine.  Methods  The surveillance data of influenza surveillance from 2019 to 2020 were analyzed. B-Victoria strain of influenza were randomly selected by multi-stage sampling method for gene sequence determination, multi sequence alignment was carried out by Muscle method of Mega X software, and phylogenetic analysis was carried out by Neighbor-Joining method.  Results  The B-Victoria line and H3N2 subtype were the main types from 2019 to 2020 monitoring year. The phylogenetic analysis showed that the 20 strain was far from B/Colorado/06/2017, but close to B/Washington/02/2019 in the next year, and clustered on clade1A (Δ3) branch. Compared with B/Colorado/06/2017, there were 13 amino acid changes, of which 5 were located in antigenic determinants, with the maximum variation rate of 1.91%. Glycosylation analysis showed that all the 20 strains had an increase of 209 glycosylation sites, and no mutation was found in the 20 isolates.  Conclusions  The protective effect of the recommended vaccine from 2019 to 2020 may not be ideal, but B-Victoria strain in Shandong Province is still sensitive to neuraminidase inhibitors. We should continue to pay close attention to the prevalence and genetic variation of B-Victoria influenza virus in the future, so as to provide a basis for the recommendation and prevention of influenza B virus vaccine strains in the future.

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