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CN 34-1304/R ISSN 1674-3679

2022 Vol. 26, No. 4

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Literature Review
Humble thoughts and opinions on construction of high-level public health schools
HE Na
2022, 26(4): 373-375. doi: 10.16462/j.cnki.zhjbkz.2022.04.001
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Construction of high-level public health schools is going to be initiated. This article attempts to share the author's humble thoughts and opinions on the construction of high-level public health schools from three perspectives: construction ideas of international top schools of public health, current construction situations of selected domestic high-level schools of public health, and construction paths to national high-level public health schools.
Original Articles
Spatial aggregation and prediction model of other infectious diarrhea in China from 2010 to 2017
LI Xin, JIN Jin, SHI Xue-ning, WEI Sheng-nan, YANG Fan, ZHANG Hui-ling, WANG Juan, LI Zhuo-lin
2022, 26(4): 376-379. doi: 10.16462/j.cnki.zhjbkz.2022.04.002
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  Objective  To investigate the spatiotemporal distribution of other infectious diarrhea incidences in China from 2010 to 2017, and to establish the prediction model for the incidence of other infectious diarrhea.  Methods  Based on other infectious diarrhea data reported by the China Public Health Science Data Center Platform (https://www.phsciencedata.cn/Share) from 2010 to 2017, spatial autocorrelation analysis was performed and autoregressive integrated moving average model (ARIMA) was constructed.  Results  According to the global autocorrelation results, the incidence of other infectious diarrhea in China in 2014, 2015, and 2016 showed a global spatial positive correlation. Local autocorrelation results showed that there were high-high regions in China in 2010-2014 and 2016-2017. The model test results showed that the seasonal ARIMA (0, 1, 2) (0, 1, 1)12 model was suitable for the prediction of model construction. ARIMA model had a good effect on the short-term prediction of the disease.  Conclusions  The incidence of other infectious diarrhea in China shows an upward trend, the spatial distribution of the incidence is clustered, and the incidence has obvious seasonality. It is necessary to strengthen the prevention and control of this disease in the region.
Analysis of the results of HIV survey among men who have sex with men by online recruitment from 2016 to 2020 in Fuzhou City
ZHANG Hong, CHEN Jian-hui, CHEN Chuan-gang, XUE Hong-hong, XU Shao-yi, LIU Mei-yan, HE Ding-sheng, LIN Chun-zhong
2022, 26(4): 380-385. doi: 10.16462/j.cnki.zhjbkz.2022.04.003
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  Objective  To understand the HIV infection status and its related factors of men who have sex with men (MSM) in Fuzhou City from 2016 to 2020, and to provide a basis for formulating intervention strategies.  Methods  The MSM survey in Fuzhou City from 2016 to 2020 was carried out by online recruitment. The content of the survey was conducted according to the Requirements of the National AIDS Sentinel Monitoring Program, which including demographic information, behavioral characteristics and antibody screening. Trend χ2 test and multivariate Logistic regression were used to analyze influencing factors.  Results  A total of 11 864 people were surveyed from 2016 to 2020. The cumulative HIV infection rate of the MSM population monitored was 3.82% (453/11 864). And the HIV infection rates in 2016-2020 were 4.48%, 4.24%, 3.27%, 5.01% and 2.36%, respectively. The HIV infection rate of the MSM population monitored every year showed a downward trend (χ2=9.802, P < 0.001). In the last 6 months, the rate of condom use in the most recent anal sex decreased from 89.45% to 79.21%, the rate of commercial sex with the same sex increased from 0.38% to 2.05%, and the awareness rate of AIDS knowledge decreased from 97.51% to 94.53%, with statistically significant results of trend χ2 tests (all P < 0.05). Multivariate Logistic regression analysis showed that having high school degree or above, living in the local area for more than 1 year, no anal sex or condom use in the last 6 months, persistent using condoms for anal sex, receiving AIDS intervention services in one year and having AIDS knowledge were all protective factors for the HIV infection in MSM population; While drug addiction and having sexually transmitted diseases in recent one year would increase the risk of the HIV infection in MSM population.  Conclusions  There is a downward trend in the HIV epidemic among MSM population in Fuzhou City. However, the AIDS awareness rate and the rate of condom use for anal sex with the same sex both show downward trends. We should focus on MSM population with low education and high mobility on strengthening the comprehensive intervention measures to promote the condom use and HIV testing, for which can effectively control the HIV epidemic in MSM population.
Disease progression and influencing factors of newly HIV-infected patients in Liuzhou City from 2005 to 2020
CHU Qin-shu, LIANG Jia-jia, WEI Tao, LAN Jian-guo, ZHANG Si-chen, WANG Ting, FU Yuan-sheng, XIE Chang-ping, FAN Yin-guang
2022, 26(4): 386-391. doi: 10.16462/j.cnki.zhjbkz.2022.04.004
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  Objective  To understand the progress of newly HIV infected people into AIDS in Liuzhou City, and to explore factors that may have effects on the progress of the disease.  Methods  A retrospective cohort study was conducted. Newly reported HIV-infected patients with highly active anti-retroviral therapy (HAART) in Liuzhou City from January 1, 2005 to December 31, 2020 were selected from the National Comprehensive AIDS Prevention and Control Information System, and relative data were obtained. The mean incubation period was calculated by Kaplan-Meier. Life table method was used to calculate the incidence and cumulative non-incidence of AIDS. Furthermore, multivariate Cox proportional-hazards model was performed on the influencing factors of HIV disease progression.  Results  The mean incubation period of 9 905 HIV-infected cases was 6.01(95% CI: 5.86-6.16) years. The cumulative non-incidence of AIDS in 1, 3, 5, 10 years were 57.03%, 46.64%, 39.45% and 27.39%, respectively. Multivariate Cox proportional-hazards model analysis showed that male (HR=1.10, 95% CI: 1.03-1.17, P=0.003), age of onset ≥40 years (40-<60 years old: HR=1.50, 95% CI: 1.20-1.88, ≥ 60 years old: HR=1.57, 95% CI: 1.24-1.98, all P < 0.05), CD4+T lymphocyte count at first diagnosis < 200 cells/μl (HR=5.51, 95% CI: 5.10-5.95, P < 0.001), married (HR=1.10, 95% CI: 1.02-1.18, P=0.010) and heterosexual transmission (HR=1.84, 95% CI: 1.47-2.31, P < 0.001) increased the risk of AIDS.  Conclusions  Newly HIV-infected patients in Liuzhou develop into AIDS rapidly. Therefore, corresponding public health and medical services should be improved to slow down the disease progression.
A survey of childhood maltreatment and drug use among 1 173 patients with methamphetamine use disorder in compulsory isolation
CHEN Yan-ling, ZHANG Jun-jie, GU Qiong, YU Hai-bo, XU Sheng, SUN Ye-huan
2022, 26(4): 392-396. doi: 10.16462/j.cnki.zhjbkz.2022.04.005
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  Objective  The study aims to investigate the prevalence of childhood maltreatment among methamphetamine (MA) addicts and its relationship with drug use behavior.  Methods  A cross-sectional survey was conducted in seven adult compulsory isolation centers in Anhui Province, and 1 173 patients were recruited with MA use disorder. All participants were investigated with the general demographic characteristics and drug use behavior questionnaire, and childhood trauma questionnaire short form (CTQ-SF). General descriptive analysis, Chi square test and binary Logistic regression analysis were used for statistical analysis.  Results  The detection rates of five types of childhood maltreatment experiences from high to low were 26.5% for emotional neglect, 24.6% for physical neglect, 18.0% for sexual abuse, 7.5% for physical abuse, 5.5% for emotional abuse and 44.6% for total childhood maltreatment experiences. The detection rates of emotional abuse and emotional neglect in women were higher than those in men, and the detection rate of sexual abuse in men was higher than that in female (all P < 0.05). Binary Logistic regression analysis showed that sexual abuse and emotional neglect were risk factors for low age of the first drug use (< 18 years old), while sexual abuse was a risk factor for high average frequency of MA use (>15 days per month) (all P < 0.05).  Conclusion  The possible influence of childhood maltreatment experiences on the age of the first drug use and the average frequency of MA should be noticed by the drug treatment department.
The influence of blood pressure and overweight or obesity on diabetes mellitus among residents aged 40 years and above in Guangdong Province
MA Shu-li, XU Yan-jun, MENG Rui-lin, ZHENG Xue-yan, XU Xiao-jun, XIA Liang, LI Chuan, XIAO Ni, ZHOU Shao-en, ZENG Zhuan-ping
2022, 26(4): 397-400. doi: 10.16462/j.cnki.zhjbkz.2022.04.006
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  Objective  To explore the influence of hypertension, overweight/obesity, and their interaction effects on diabetes, so as to provide reference for preventing the occurrence of diabetes.  Methods  A multi-stage cluster random sampling method was adopted in this study, and 8 991 residents from September to November 2015, were selected for questionnaire survey, medical examination and venous blood collection. Logistic regression model and linear regression model were constructed based on complex sampling to analyze the data, and the additive model was used to analyze the interaction effect of hypertension and overweight/obesity on the prevalence of diabetes.  Results  Logistic regression results showed that hypertension and overweight/obesity were risk factors for diabetes in people aged ≥40 years. The results of the additive model showed that hypertension and overweight/obesity had a synergistic effect on diabetes, with the OR value of 4.45 (95% CI: 2.75-7.20). The interaction effect on fasting blood glucose and glycosylated hemoglobin was also greater than that of individuals with hypertension or overweight/obese alone.  Conclusions  Hypertension and overweight/obesity were independent risk factors for diabetes in people aged 40 years and over in Guangdong Province. Hypertension and overweight/obesity had additive interaction effects on diabetes.
Association between alcohol consumption pattern and health-related quality of life in individuals with high cardiovascular disease risk in Inner Mongolia, China
CAO Ning, XI Yun-feng, NIU Li-wei, ZHANG Nan, BAO Han, ZHU Hao, YAN Tao, ZHANG Xing-guang
2022, 26(4): 401-405. doi: 10.16462/j.cnki.zhjbkz.2022.04.007
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  Objective  To investigate the relationship between alcohol use and health-related quality of life (HRQoL) in people who were at high risk of cardiovascular disease (CVD).  Methods  From 2015 to 2017, permanent residents of 6 villages or settlements in Inner Mongolia were chosen as the research site, using a multi-stage stratified cluster random selection method. The study contents included questionnaire, physical examination and laboratory testing. Participants with a predicted risk of CVD more than 10% were identified as having a high CVD risk. Alcohol use disorders identification test and EuroQol Five-Dmensions Guestionnaire (EQ-5D) scale were used to investigate drinking patterns and HRQoL in high CVD risk groups. Multivariate Logistic regression was used to investigate the relationship between drinking patterns and HRQoL.  Results  Of 12 454 participants with high CVD risk, 76.8% were reported as nondrinkers. Compared with non-drinkers, the OR values of the risk of pain/discomfort and anxiety/depression among men who were low risk drinkers were 1.652 (95% CI: 1.437-1.901, P < 0.001) and 1.758 (95% CI: 1.507-2.049, P < 0.001); the OR values of risk of pain/discomfort and anxiety/depression of hazardous drinkers were 1.520 (95% CI: 1.262-1.831, P < 0.001) and 1.693 (95% CI: 1.382-2.073, P < 0.001). Compared with non-drinkers, the OR values of the risk of pain/discomfort and anxiety/depression among women who were low risk drinkers were 1.536 (95% CI: 1.223-1.930, P < 0.001) and 1.566 (95% CI: 1.237-1.982, P < .001).  Conclusion  It is suggested that those who have high risk of CVD should refrain from alcohol in order to enhance their health-related quality of life.
A cross-section study of the correlations between BMI and sleep duration or sleep quality based on Hainan cohort study
YAN You-xuan, CHEN Jun-cai, LIN Liu-ting, HE Li-min, WU Ling, GU Xing-bo, ZHANG Fan
2022, 26(4): 406-411. doi: 10.16462/j.cnki.zhjbkz.2022.04.008
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  Objective  To explore the correlation of BMI and sleep duration or sleep quality in middle-aged and elderly population in Hainan, and to provide reference for prevention and control of overweight and obesity.  Methods  Physical examination and questionnaire survey were conducted on 5 169 physical examination cohort population in 18 Cities and Counties of Hainan Province in 2018. All participants were permanent residents who had been living in Hainan for more than 5 years, aged 35-75 years, and without severe physical disability or mental illness. The influencing factors of BMI were analyzed by descriptive and univariate analysis. The correlations of BMI and sleep duration or sleep quality were analyzed by ordered Logistic regression model.  Results  There were significant differences in gender, education, income level, age, smoking, tea drinking, noon-nap, sleep quality and sleep duration among different BMI groups (all P < 0.05).The further ordered Logistic regression analysis results showed that longer sleep duration, poor and very poor sleep quality were risk factors of higher BMI level (all P < 0.05). The risk of higher BMI in longer sleep duration was 1.336 times higher than normal sleep duration(95% CI: 1.094-1.632), and the risks of poor and very poor sleep quality groups were respectively 1.294 times higher(95% CI: 1.082-1.548)and 1.948 times higher (95% CI: 1.131-3.357)than good sleep quality group.  Conclusion  Longer sleep hours and poor sleep quality can increase the risk of overweight and obesity in middle-aged and elderly population in Hainan.
Urinary incontinence prevalence and determinants among old population in nursing homes in Changsha City
TAI Hong-yan, HE Gui-xiang, LI Yan-qun, ZHANG Hui, PENG Lei, TAN Hong-zhuan
2022, 26(4): 412-416. doi: 10.16462/j.cnki.zhjbkz.2022.04.009
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  Objective  To study the prevalence of urinary incontinence(UI) and its determinants among old population in nursing homes in Changsha City.  Method  A cluster sampling was used to conduct a questionnaire survey on all eligible paticipants who lived in nursing homes with ≥200 beds in six Districts and two Counties of Changsha City from June 1 to December 31, 2018.  Results  The UI prevalence was 24.01%, among them, the moderate and severe UI accounted for 66.24%. Cardiovascular disease (OR=2.13, 95% CI: 1.37-3.31, P=0.001), surgical history (OR=1.68, 95% CI: 1.14-2.50, P=0.010), reduced mobility [immobility (OR=7.32, 95% CI: 3.22-16.69, P < 0.001), wheelchair dependent walking (OR=4.76, 95% CI: 2.37-9.56, P < 0.001), assistance dependent walking (OR=1.90, 95% CI: 1.03-3.52, P=0.040)] and constipation (OR=1.96, 95% CI: 1.30-2.95, P=0.001) were significant risk factors for UI. Impaired walking ability [wheelchair dependent walking (OR=6.09, 95% CI: 2.11-17.55, P=0.001), assistance dependent walking (OR=4.34, 95% CI: 1.46-12.92, P=0.008)], and anxiety or depression (OR=2.22, 95% CI: 1.09-4.51, P=0.029) increased UI severity.  Conclusion  It's of great significant to treat constipation and cardiovascular disease, and keep mobility function and mental health in older population, which may prevent or remedy UI.
Association of plasma n-6 polyunsaturated fatty acids with gestational diabetes mellitus in the second trimester
WANG Fan, LIU Yan, WANG Yi, YE Yi-xiang, HUANG Yi-chao, CHEN Da, PAN Xiong-fei, PAN An
2022, 26(4): 417-422. doi: 10.16462/j.cnki.zhjbkz.2022.04.010
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  Objective  The study aims to explore the association of plasma n-6 polyunsaturated fatty acids (PUFAs) with gestational diabetes mellitus (GDM) in the second trimester of pregnant women in southwest China.  Methods  In the Tongji-Shuangliu Birth Cohort, 6 143 women with a singleton pregnancy (aged 18-40 years) were enrolled at the clinics of perinatal care in the Shuangliu Maternal and Child Health Care Hospital in Chengdu from 2017 to 2019. Basic information of participants was collected by questionnaire and physical examinations were performed at enrollment, and blood samples were collected in the second trimester. A total of 269 pregnant women were diagnosed as having GDM based on the 75 g oral glucose tolerance test during 24-28 weeks. The GDM cases were matched individually to 538 non-GDM controls at a 1∶2 ratio on maternal age (±3 years) and baseline gestational week (±4 weeks). Plasma n-6 PUFAs were determined by gas chromatography-mass spectrometry in the second trimester. The associations of individual n-6 PUFAs and total n-6 PUFAs with GDM were evaluated using multivariable conditional Logistic regression models, and false discovery rate (FDR) was used for the correction of multiple comparison. Sensitivity analysis was used to test the robustness of the associations.  Results  Of the 807 participants, maternal age was (27.8±3.9) years, and gestational age was (24.8±1.1) weeks, and pre-pregnancy BMI was (21.5±3.1) kg/m2. Odds ratios (ORs) for GDM in relation to each 1-SD increase in plasma linoleic acid (LA), gamma-linolenic acid (GLA), eicosadienoic acid (EDA), and arachidonic acid (AA) were 0.83 (95% CI: 0.69-0.99, P=0.039), 0.82 (95% CI: 0.69-0.99, P=0.037), 0.63 (95% CI: 0.50-0.79, P < 0.001) and 1.20 (95% CI: 1.02-1.42, P=0.032), respectively; however, the associations of LA, GLA, and AA with GDM became not significant after FDR correction (all P > 0.05). The association of EDA with GDM were robust in sensitivity analyses.  Conclusion  Plasma EDA in the second trimester was associated with GDM, which needs to be further validated in other populations.
Attitude towards breast feeding and its influencing factors among postpartum women 3 days after delivery in Shanghai
LI Wen-xian, LI Bing-ying, CUI Meng-qing, DU Li, FAN Chong-chun, XU Biao, ZHU Li-Ping
2022, 26(4): 423-429. doi: 10.16462/j.cnki.zhjbkz.2022.04.011
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  Objective  To investigate the newborn feeding attitude among postpartum women three days after delivery in Shanghai, and to analyze the effect of physiological and psychological factors and health care services on breastfeeding intention.  Methods  From June to July 2020, a cross sectional study involving 43 hospitals throughout Shanghai was performed. Postpartum women within three days hospitalization stay were asked to complete the self-designed scale including demographics, health information, Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder 7-item Scale (GAD-7) and simplified Chinese version of the Iowa Infant Feeding Attitude Scale (IIFAS). One-way analysis of variance, t test, multiple linear regression and multiple Logistic regression were used as statistical methods.  Results  In total, 991 postpartum women within 3 days hospitalization stay were investigated. The average score of IIFAS was (59.85±7.22) points. Mothers with IIFAS score >61 points were 1.645 times more likely to breastfeed exclusively than those with IIFAS score < 55 points (95% CI: 1.148-2.357). In the univariate analysis, the following variables were related to IIFAS scores: education degree, type of hospital, anxiety, depression and postpartum breastfeeding guide (all P < 0.05). The multiple linear regressions showed that IIFAS scores were associated with EPDS and hospital category.  Conclusions  The hospitalized postpartum women with positive attitudes towards breastfeeding are more likely to be breastfeeding exclusively. Early recognition and intervention for pregnant and postpartum women with symptoms of depression could improve infant feeding attitude. It is necessary to promote breastfeeding support service in third-grade general hospitals and second-grade women and children's specialized hospitals, including health education about breastfeeding knowledge, individualized counseling and guiding, to cultivate positive attitude of breastfeeding.
Changing trend concerning the burden of cancer between 1990 and 2019 in China
GAO Bei, CHU Hai-chao, LU Wen-li, WANG Yuan
2022, 26(4): 430-436. doi: 10.16462/j.cnki.zhjbkz.2022.04.012
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  Objective  To analyze the status and temporal trend on the burden of cancer between 1990 and 2019 in China, so as to provide evidence for formulating strategies for preventing and treating cancer.  Methods  Using the Global Burden of Disease Study 2019 (GBD2019) results, the incidence, mortality and their corresponding standardized rates were used to evaluate the morbidity and mortality level of cancer. Years of life lost (YLLs), years of lived with disability (YLDs) and disability-adjusted life years (DALYs) related to cancer were collated, and analysis of trend in these indicators were used to assess the burden of cancer between genders and age groups from 1990 to 2019.  Results  Comparing to 1990, the numbers of new cases and deaths of cancer in China increased by 170.07% and 86.10%, and the crude rates of incidence and mortality increased 124.76% and 54.87%, respectively in 2019. After age standardization, incidence increased by 24.18%, while mortality decreased by 19.06% in 2019. The standardized YLDs rate was at a medium level but YLLs and DALYs rates were at a high level among other socio-demographic index(SDI) countries. From 1990 to 2019, the overall standardized YLDs rate (AAPC=1.56%, P < 0.001) of cancer in China showed an increasing trend, while the overall standardized YLLs and DALYs rates (AAPC1=-1.15%, AAPC2=-1.10%, all P < 0.05) showed a decreasing trend. Compared with females, the average annual increase was faster of standardized YLDs rate in males whereas decline was smaller of standardized YLLs and DALYs rates. Similarly, the average annual increase was faster of standardized YLDs rate in 15- < 50 age group whereas decline was smaller of standardized YLLs and DALYs rates in≥70 age group. Moreover, the proportion of YLDs, YLLs and DALYs in males and 50- < 70 age group accounted for the largest. As for the composition in DALYs, YLLs appeared much larger than YLDs and decreased slowly.  Conclusions  The disease burden of cancer was higher in males and the middle-aged and elderly; YLLs was the leading cause of overburden. Therefore, to reduce the occurrence of YLDs and YLLs, effective measures should be taken for management and prevention.
Association between hospital visit and self-rated treatment effect among rural stroke patients at high risk of returning to poverty
CUI Niu-niu, ZHANG Lei
2022, 26(4): 437-441. doi: 10.16462/j.cnki.zhjbkz.2022.04.013
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  Objective  To examine the situation of hospital visits and its association with self-rated treatment effect among rural stroke patients aged ≥40 years at high risk of returning to poverty in China.  Methods  From the database of national system for dynamic management on rural health poverty alleviation, we extracted the information about 14 614 rural stroke patients aged ≥40 years at high risk of returning to poverty. Descriptive analysis and multivariate Logistic regression analysis were conducted to explore the association between hospital visits and self-rated treatment effect among the participants.  Results  Of the 14 614 stroke patients, self-rated improvement of stroke after medication were reported by 62.5% of the participants. The proportion of patients who visited primary medical institutions and medical institutions in the county for treatment and hospitalization, and only visited hospital once or twice in five years was high. The median annual medical cost of patients was 4 646.53 Yuan. The results of multivariate Logistic regression analysis showed that patients who visited the primary medical institutions (OR=1.10, 95% CI: 1.02-1.19), were hospitalized (OR=2.01, 95% CI: 1.83-2.21), and had higher annual medical expenditure had better self-rated treatment outcomes. Patients with 3-5 visits (OR=0.77, 95% CI: 0.70-0.84), patients with ≥6 visits (OR=0.59, 95% CI: 0.51-0.67) during 2016-2020 had worse self-rated treatment outcomes than patients with 1-2 visits.  Conclusion  The self-rated treatment effect is closely related to the situation of hospital visits among stroke patients aged ≥40 years in rural areas at high risk of returning to poverty.
Association between combined trajectories of cardiac structure and function indicators and prognosis of chronic heart failure
MENG Bing-xia, TIAN Jing, YANG Hong, LI Jing, HE Hang-zhi, HAN Qing-hua, ZHANG Yan-bo
2022, 26(4): 442-448. doi: 10.16462/j.cnki.zhjbkz.2022.04.014
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  Objective  To explore the potential value of the longitudinal trajectory groups of cardiac structure and function indicators for the prognosis of patients with chronic heart failure.  Methods  A total of 277 patients who were hospitalized in two tertiary hospitals in Shanxi Province from January 2012 to January 2019 and met the criteria were included. The cardiac structure and function indicators of multiple hospitalizations were used to establish the group-based multi-trajectory model to identify patient groups with similar trajectory changes. The Cox proportional hazards regression model was used to analyze the influence of trajectory group on the risk of death of patients.  Results  Three trajectory groups with different changes in trajectory indicators and baseline feature distributions were identified. Among them, patients in trajectory group 1 were balanced between men and women, New York Heart Association (NYHA) functional class was concentrated in grades Ⅱ-Ⅲ, the overall ejection fraction (EF) was relatively stable, which was higher than the other two groups, and more patients had unstable angina. The proportion of men and patients with old myocardial infarction in trajectory group 2 were high, and the EF was steadily decreasing. Trajectory group 3 had a high proportion of males and NYHA grade IV patients, EF presented a fluctuated decline state, ischemic cardiomyopathy, valvular heart disease and atrial fibrillation were more common. The results of the Cox proportional hazards regression model showed that the trajectory group were an influencing factor for the death of patients with chronic heart failure under the three conditions of individual inclusion, adjustment of baseline characteristics, and adjustment of comorbidity.  Conclusion  The trajectory groups identified based on the longitudinal changes of cardiac structure and function indicators can stratify the death risk of patients with chronic heart failure and help identify high-risk patients.
Analysis of the epidemiological characteristics and incidence prediction of tuberculosis in Xinjiang Production and Construction Corps from 2008 to 2020
LING Xi, ZHANG Ze-wen, ZHAO Peng-shan, LIU Xin-wen, MA Xiao-ling, LI Fan-ka, DAI Jiang-hong
2022, 26(4): 449-454. doi: 10.16462/j.cnki.zhjbkz.2022.04.015
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  Objective  The study aims to explore the epidemic characteristics of pulmonary tuberculosis in Xinjiang Production and Construction Corps, and establishing an autoregressive integrated moving average (ARIMA) model to predict the future trend of morbidity, to provide support for pulmonary tuberculosis prevention and control.  Methods  We collected pulmonary tuberculosis data from the infectious disease epidemic information network direct reporting system from January 1, 2008 to December 31, 2020, and analyzed the time, region, and population distribution characteristics using traditional descriptive epidemiological methods. R 4.0.3 was performed to build a model based on the data from January 2008 to June 2020, and also the validated model with the data from July to December 2020. The established model was used to predict the incidence trend in the next two years.  Results  From 2008 to 2020, the incidence of tuberculosis in the Xinjiang Production and Construction Corps showed an overall downward trend, with an average annual reported incidence rate of 70.68 per 100 000, with the peak incidence in March. The third, eighth, and thirteenth divisions have higher average annual morbidity rates. The ratio of male to female cases was 1.77∶1, with the largest proportion between 65 and 75 years old. The patients were mainly retired personnel and farmers. The ARIMA(1, 1, 1)(0, 1, 1)12 was the optimal model, and the actual number of cases from July to December 2020 all fall within the 95% confidence interval of the model simulation data. Using the ARIMA model, the number of reported cases of pulmonary tuberculosis in 2021 and 2022 will be 1 301 and 1 219.  Conclusion  In view of the characteristics of pulmonary tuberculosis in Xinjiang Production and Construction Corps, key populations and key areas should strengthen prevention and control. The forecasting ablity of the ARIMA is good, which is suitable for short-term forecasting and dynamic analysis, therefore, it can provide reference for the disease prevention and control.
Review
The risk factors for death in chronic obstructive pulmonary disease patients: a systematic review and Meta-analysis of cohort studies
ZHU Lin, GAO Jing, BAI Ding-xi, WU Chen-xi, YOU Qian
2022, 26(4): 455-462. doi: 10.16462/j.cnki.zhjbkz.2022.04.016
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  Objective  To systematically review the risk factors for death in chronic obstructive pulmonary disease (COPD) patients.  Methods  PubMed, Cochrane Library, Web of Science, Embase, CNKI, CBM, VIP and WanFang databases were searched to query the original studies. Then two researchers further screened the studies simultaneously, extracted the data and assessed study quality, and performed Meta-analysis.  Results  A total of 15 studies were included with Newcastle-Ottawa Scale (NOS) score were among 7 to 9. Meta-analysis showed that elderly people (HR=1.074, 95% CI: 1.048-1.101, P < 0.001), had a high Charlson comorbidity index (CCI) score (HR=1.191, 95% CI: 1.096-1.294, P < 0.001), low BMI (HR=1.434, 95% CI: 1.190-1.727, P < 0.001), smoking (HR=1.390, 95% CI: 1.298-1.490, P < 0.001), had a high modified British medical research council (mMRC) score (HR=1.597, 95% CI: 1.550-1.646, P < 0.001), had Ⅳ COPD (HR=2.114, 95% CI: 1.681-2.658, P < 0.001) were related to the mortality in COPD patients. There was no statistically significant difference between women (HR=1.091, 95% CI: 0.781-1.522, P=0.610), low fat free mass index (FFMI) (HR=3.025, 95% CI: 0.268-34.203, P=0.371) and COPD mortality. Descriptive analysis results showed that high N-terminal pro-brain nitric peptide (NT-proBNP), positive pseudomonas aeruginosa (PA) might be involved in the deaths of COPD patients.  Conclusions  Among COPD patients, those with advanced age, low BMI, had high CCI and mMRC index score, smoking and those with ⅣCOPO were more likly to have mortality outcomes. And the relationship between high NT-proBNP, PA infection and the mortality in COPD patients still needed further research.
Short Reports
Analysis on the spatial distribution and influencing factors of pulmonary tuberculosis among students in Nanning from 2015 to 2018
PAN Meng-hua, LI Yan-ning, CHEN Wen-cai
2022, 26(4): 463-466. doi: 10.16462/j.cnki.zhjbkz.2022.04.017
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Abstract:
  Objective  To understand the epidemiological characteristics of pulmonary tuberculosis among students in Nanning, and to analyze the mechanism of the influencing factors under the influence of spatial effects, and to provide reference for the development of pulmonary tuberculosis prevention and control measures.  Methods  The reported incidence of pulmonary tuberculosis among students in Nanning at the township level was statistically analyzed by spatial scan to describe the spatial clustering of the disease. And the Spatial Durbin Model was established to analyze the spatial effects and influencing factors based on the spatial panel data at the district and county levels in Nanning.  Results  The reported incidence of pulmonary tuberculosis among students in Nanning showed an overall increasing trend from 2015 to 2018. The age of the cases was mainly between 16 and 22 years old. The peak periods of reported cases were from March to May and from September to November, and the trough periods were February and from June to July. Spatial scan analysis revealed that the high incidence of pulmonary tuberculosis among students was distributed in the urban center and its surrounding areas, such as Chaoyang Street, Jianzheng Street, and Huaqiang Street. The spatial distribution pattern was centered on the junction of the six urban areas as the center spreading to the surrounding areas, and the heat of gathering gradually decreasing from the center to the surrounding areas. The analysis of influencing factors found that the influence of each factor on reported incidence was subject to spatial effects. Among them, population density of college students had a positive effect, per capita health financial expenditure had a negative effect, per capita GDP had an indirect effect, and number of health technicians per 1 000 had both a direct and an indirect effect.  Conclusions  There is a spatial clustering of pulmonary tuberculosis among students in Nanning, mainly located in and around the urban center. The reported incidence rate is subject to spatial effects.
Analysis on reported incidence of pulmonary tuberculosis in Anhui Province from 2016 to 2020
BAO Fang-jin, LIU Jie, YAO Song, ZHANG Yong-zhong
2022, 26(4): 467-472. doi: 10.16462/j.cnki.zhjbkz.2022.04.018
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Abstract:
  Objective  To clarify the incidence and epidemic trends of pulmonary tuberculosis in Anhui Province from 2016 to 2020.  Methods  Data were derived from National Notifiable Disease Report System, and the reported cases of pulmonary tuberculosis in Anhui Province from 2016 to 2020 were retrieved. Joinpoint regression model was used to plot the time trends, and changes of reported incidence along with time were also calculated. The geographical and demographic distribution of the disease were described. Statistical analysis was performed in SPSS 22.0 software.  Results  The incidence of pulmonary tuberculosis in Anhui Province from 2016-2020 were 59.41/100 000 (36 503/61 440 000), 58.78/100 000 (36 418/61 960 000), 54.40/100 000 (34 028/62 550 000), 51.46/100 000 (32 543/63 240 000) and 43.81/100 000 (27 891/63 660 000), respectively. Compared to incidence in 2016, the incidence in 2020 decreased by 26.26%, and the mean declining rate was 7.15% per year (t=-5.10, P=0.015). The incidence was higher in central district than southern and northern district of Anhui Province (all P < 0.05). The 15- < 60 years old group accounted for the most of patients (55.91%). For those age less than 15 years old, the incidence increased year by year (χ2 trend=12.03, P=0.001). In all reported cases, male accounted for 72.03%, and female accounted for 27.97% (male∶female, 2.58∶1). For occupational distribution, most of the patients were farmer (71.78%), and the proportions of medical staffs increased year by year (χ2 trend=7.64, P=0.006). The proportion of patients with evidence of pathogen was also increased (χ2 trend=4 773.54, P < 0.001).  Conclusions  The reported incidence from 2016 to 2020 in Anhui Province has a decreased trend. Incidence is higher in central district. More attention should be paid on prevention and control of pulmonary tuberculosis in farmer and medical staffs.
HIV self-testing, testing strategy and related factors among men who have sex with men in two cities in Shanghai and Suzhou
XIE Yan, WEI Wei, HOU Yong-chun, LIU Yan, ZHENG Yi-hui
2022, 26(4): 473-476. doi: 10.16462/j.cnki.zhjbkz.2022.04.019
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Abstract:
  Objective  To understand HIV self-testing behaviors, test strategies and related factors among men who have sex with men (MSM) in Shanghai and Suzhou.  Methods  MSM aged ≥18 with no HIV/AIDS history in Shanghai and Suzhou were recruited and investigated online from February to May, 2021. Frequencies were used to describe self-testing behaviors and test strategies, and χ2 test and Logistic regression were used in analyses of related factors.  Results  A total of 759 MSM were recruited. 71.4%(542/759) had self-testing history. Among them, 148 reported having observed a positive result of whom 140 identified it false positive through another test. The rate of adopting test strategy including self-testing, strategy with only facility-based test and no-testing strategy in the last year was 69.4%、10.0% and 20.6%, respectively. Compared to strategy including self-testing, living in Suzhou (OR=1.85, 95% CI: 1.08-3.17), inserting sexual role (OR=0.34, 95% CI: 0.14-0.80), having 2-4(OR=0.51, 95% CI: 0.32-0.81) or 5-9(OR=0.31, 95% CI: 0.14-0.68) sexual partners in the last year, seeking partners offline (OR=0.44, 95% CI: 0.23-0.86) or offline & online(OR=0.51, 95% CI: 0.31-0.84), drug abuse (OR=0.54, 95% CI: 0.36-0.83), STD history (OR=0.41, 95% CI: 0.24-0.69), having difficulties in accessing or using kits (OR=2.52, 95% CI: 1.53-4.15;OR=1.93, 95% CI: 1.22-3.07) were factors relating to choice of no-testing strategy; aged 18- < 25 (OR=0.26, 95% CI: 0.10-0.71) or 25- < 45 (OR=0.38, 95% CI: 0.15-0.95), having 2-4 sexual partners in the last year (OR=0.42, 95% CI: 0.23-0.78) and having difficulties in accessing kits (OR=2.58, 95% CI: 1.33-4.99) were factors relating to choice of only facility-testing strategy (all P < 0.05).  Conclusions  MSM in Shanghai and Suzhou have a relatively high uptake of HIV self-testing and an imperative demand for specific health care. Choice of test strategy among MSM relates to age, residence, sexual behaviors, drug abuse, accessibility and operability of self-testing kits.
The impact of inclusive education which integrated home, school and health care institutions on the injury outcome of students in Guangming District, Shenzhen
ZHU Zhong-ping, GUAN Xin-yan, HUANG Li-ping
2022, 26(4): 477-482. doi: 10.16462/j.cnki.zhjbkz.2022.04.020
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Abstract:
  Objective  To understand the impact of inclusive education which integrated home, school and health care institutions on the occurrence and outcome of injuries among primary and middle school students, and to provide a scientific basis for the development of student injury prevention and intervention policies.  Methods  A stratified cluster sampling was used to select 11 439 primary and secondary school students who had adopted the inclusive education model in 2019 from 3 sentinel schools in Guangming District of Shenzhen City. The injury data of 8 056 students from 3 schools in 2014 before the implementation of the intervention model were used for comparison. Qualitative data are described by frequency, and the chi-square test was used for comparison between groups. The nonparametric test was used for the comparison of hierarchical data between groups. SPSS 21.0 software was used for statistical analysis.  Results  In 2019, the average incidence of injuries reported by schools in Guangming District was 19.86%. The incidence of injuries in boys (24.54%) was higher than in girls (13.89%). The primary school had the highest injury rate (35.01%). The most common injuries were recreation/play/leisure (60.40%). The main injury types were fall/fall injury (57.39%) and blunt injury (30.85%). The main injury sites were the knee (19.76%) and head (15.76%). Contusions and abrasions (64.13%) were the main injury consequences. Compared with 2014, the proportion of students with mild injuries increased in 2019, while the proportion of moderate and severe injuries decreased, with statistical significance (Z=-51.88, P < 0.001).  Conclusions  The inclusive education model promotes effective coordination among families, schools and health institutions in school health work, and improves the sensitivity and response of injury monitoring for primary and secondary school students.
Analysis of prevalence and related factors of pre-diabetes mellitus in Gansu Province
CHANG Xing-yu, FU Song-bo, TANG Xu-lei, LIU Jing-fang, MA Cheng-xu, ZHU Guo-mao, JING Gao-jing, ZHAO Nan, MA Li-hua, NIU Qiang-long, JIAO Cai-hong, GUO Qiang, WANG Xiao-lin, TENG Wei-ping, SHAN Zhong-yan
2022, 26(4): 483-489. doi: 10.16462/j.cnki.zhjbkz.2022.04.021
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  Objective  To investigate the prevalence and related influencing factors of pre-diabetes mellitus (PDM) patients in Gansu Province.  Methods  By using the method of multi-stage stratified cluster random sampling, 2 866 adult residents in Gansu Province were investigated, and the standardized prevalence rate was calculated by direct standardized method. χ2 test was used to analyze the prevalence difference of PDM. Pearson correlation analysis were used to analyze the fasting blood glucose (FPG) and oral glucose tolerance test (OTGG) 2 h blood glucose (2 h PBG) related influencing factors. Logistic regression analysis was used to analyze the risk factors of PDM population.  Results  The total prevalence rate of PDM in Gansu Province was 15.07%, among which the prevalence rate of impaired glucose tolerance (IGT) was the highest, and there was a statistically significant difference in the prevalence rate of PDM among different age groups (all P < 0.05). Age, BMI, SBP, DBP, waist circumference, TC, TG, LDL-C and uric acid (UA) in PDM group were higher than those in normal group, while Vitamin D and urinary iodine were lower than those in normal group (all P < 0.05). The level of FPG in PDM population was positively correlated with age, BMI, SBP, DBP, waist circumference, TG, TC, LDL-C and UA, but negatively correlated with HDL-C, serum calcium and Vitamin D (all P < 0.05). The 2 h PBG was positively correlated with age, BMI, SBP, DBP, waist circumference, TG, TC, LDL-C and UA, but negatively correlated with Vitamin D (all P < 0.05). Logistic regression analysis showed that the risk factors of PDM were aging, high level of BMI, SBP, TG, TC, UA and thyroid nodules, while the appropriate levels of HDL-C and thyroid-stimulating hormone (TSH) were protective factors.  Conclusions  The prevalence rate of PDM in middle-aged and elderly people in Gansu area is relatively high, so attention should be paid to the monitoring of glucose tolerance level of PDM high-risk population; PDM people should pay more attention to UA level and Vitamin D level, and timely regulation and intervention should be carried out; people with thyroid nodules should be alert to abnormal glucose regulation status, pay attention to thyroid function status, and adjust diet and lifestyle to prevent PDM.
Prevalence trend of metabolically unhealthy overweight and impact of educational levels on Chinese adults of Shanghai
YANG Yi-hui, CHENG Min-na, Yeerzhati Yeerjiang, SHI Yan, XU Wang-hong, LI Yan-yun
2022, 26(4): 490-496. doi: 10.16462/j.cnki.zhjbkz.2022.04.022
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  Objective  Metabolically unhealthy overweight (MUO) is more harmful for human health than metabolically healthy overweight (MHO). This study aims to investigate the prevalence trend of MUO in Chinese adults in Shanghai, and to evaluate the impact of education attainment of the populations.  Methods  The study was based on three sampling surveys performed in residents aged 35-74 years in Shanghai in 2002-2003 (n=12 302), 2009 (n=7 400) and 2017 (n=19 023). All participants were classified into three groups according their educational levels: primary school or below, middle or high school and college or above, and categorized as four phenotypes based on the presence or absence of overweight and metabolic syndrome (MS): metabolically healthy, normal weight (MHNW), metabolically unhealthy, normal weight (MUNW), MHO and MUO. Multinomial Logistic regression and generalized estimating equation were employed to analyze the association between education level and four phenotypes.  Results  Both crude and age-standardized prevalence of MUO significantly increased in men and women (P < 0.001). The increase in age-standardized prevalence of MUO was observed in each subgroup of educational level and was the most substantial in the group of primary school or below. The age-standardized prevalence of MUO decreased along with increasing educational attainment in women in the three surveys, whereas the prevalence increased among men in the 2002-2003 and 2009 surveys (all P < 0.05). In the three surveys, after adjusting for age and other confounders, men with middle or high school educational level had a higher risk of MUO than those with educational level of primary school or below, whereas the risk was lower in women with educational levels of middle or high school and college or above (all P < 0.05).  Conclusion  The prevalence of MUO shows an upward trend in Chinese adults in Shanghai, and increases most among those with low educational levels. Interventions should be addressed in the population, particularly in women with lower educational levels.

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