中华疾病控制杂志

Epidemiologic features and scientific prevention and control advice of SARS-CoV-2 Omicron variant

WU Yu, LIU Jue, LIU Min, LIANG Wan-nian

2022, 26(5): 497-501. doi: 10.16462/j.cnki.zhjbkz.2022.05.001

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The current COVID-19 pandemic has taken the world by storm. Since the first case of the Omicron variant discovered in South Africa was reported to the WHO, the variant has rapidly spread to many countries and regions and has become the main dominant strain currently circulating globally. Compared with the SARS-CoV-2 wild strain or other variants, the Omicron variant has the characteristics of short incubation period, short series interval, fast virus transmission, high proportion of asymptomatic infections, and low case fatality rate. Practice has proved that China adheres to the anti-epidemic concept of "put people and life first", the general strategy of "guarding against imported cases and a rebound in indigenous cases", and the general policy of "dynamic zero-COVID", and the comprehensive prevention and control measures currently taken can effectively deal with Omicron variant. It is recommended to adhere to the general policy of dynamic zero-COVID at the present stage, strengthen the risk management of imported COVID-19 cases, accelerate the vaccination of the elderly, accelerate the development and marketing of specific drugs, and prepare medical and health resources in advance, so as to make full preparations for future prevention and control decisions and response to the epidemic.

Evaluation of influences of COVID-19 pandemic on body mass index among 6-12 years children in Suzhou: Based on Student Health Monitoring Program from 2016 to 2020

HU Jia, HAN Di, DING Zi-yao, HAI Bo, YIN Jie-yun, YANG Hai-bing, SHEN Hui

2022, 26(5): 559-564. doi: 10.16462/j.cnki.zhjbkz.2022.05.012

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Objective The COVID-19 pandemic has influenced all aspects of children life. This study aims to explore the pandemic-related body mass index (BMI) changes in children. Methods Based on the Health Promotion Program for Children and Adolescents in Suzhou of China, 331 341 BMI data of 40 primary schools were retrospectively collected from 2016 to 2020. The BMI-Z score and overweight/obesity prevalence were compared from 2016 to 2020. Results Mean participants per year was 66 868. Overall mean BMI-Z score increased from 0.427 (highest during 2016 to 2019) to 0.580 in 2020, resulting in a rise of 0.158 (95% CI: 0.144-0.171, P < 0.001). Increases in BMI-Z score were higher among boys, urban areas, and lower age groups (all P < 0.001). From 2016 to 2020, the prevalence of overweight and obesity increased, while thinness prevalence declined (χ_trend²=595.834, P < 0.001). The prevalence of obesity increased from 12.9% (highest during 2016 to 2019) to 15.9% in 2020 (χ²=253.616, P < 0.001), same results were found among different gender and region groups. Compared to 2016, the prevalence of obesity in 2017, 2018, and 2019 did not show significant differences, while a significant increase was found in 2020 (OR=1.323, 95% CI: 1.280-1.366). Conclusions COVID-19 pandemic accelerated BMI gains among 6-12 years old children in Suzhou. Progressively increased prevalence of overweight/obesity should be draw attention when conducting epidemic prevention and control.

Effect of 13-valent pneumococcal conjugate vaccine on serotypes and antibiotic-resistance of streptococcus pneumoniae in children

LIN Wan-jing, SHAO Xue-jun, ZHANG Jun, TAO Yun-zhen, FENG Shuang, ZHANG You-yi, CHEN Qing-hui, TIAN Jian-mei, ZHAO Gen-ming, ZHANG Tao

2022, 26(5): 565-570. doi: 10.16462/j.cnki.zhjbkz.2022.05.013

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Objective To investigate the serotype distribution and antibiotic-resistance of Streptococcus pneumoniae (S. pneumoniae) isolated from medical-visiting children, and to explore the effect of 13-valent pneumococcal conjugate vaccine (PCV13) on pneumococcal isolates. Methods The strains of S. pneumoniae isolated from children with confirmed vaccination information in Soochow University Affiliated Children's Hospital (SCH) from 2017 to 2019 were collected. The strains were grouped according to the vaccination status, used quellung reactions to serotype and employed E-test method to determine the antibiotic resistance of strains, and compared the differences in serotypes and antibiotic-resistance between with and without PCV13 vaccination. Results A total of 692 strains of S. pneumoniae were collected, 20 of which were isolated from children vaccinated with PCV13. Serotypes 19F, 6B, 19A and 23F were prevalent in vaccinated children, while serotypes 19F, 6B, 23F, 19A and 14 were common in unvaccinated children. There was no significant difference between the two groups in serotype distribution (P=0.868), and the PCV13 serotype coverage was 70.0% and 72.4%, respectively (P=0.491). All strains were highly resistant to erythromycin, tetracycline and clindamycin, and the multi-antibiotic resistance rate was 98.5%. The unsusceptible rates of penicillin were 5.0% and 9.1% in the vaccinated and unvaccinated groups, respectively (P=0.804). Conclusions Most S. pneumoniae strains from children in SCH were covered by PCV13 serotypes. The resistance of S. pneumoniae to lactams antibiotics was decreased, but the resistance to other commonly used antibiotics such as erythromycin remained severe, and the multi-antibiotic resistance rate was high. No apparent effect of PCV13 on serotype distribution and antibiotic resistance was observed.

Bayesian analysis of influencing factors for the misclassification of blood glucose stability

WU Yao-yao, CHENG Lu-yao, YU Xiao-jin, GUO Hai-jian, XU Jin-shu, MIN Jie

2022, 26(5): 571-575. doi: 10.16462/j.cnki.zhjbkz.2022.05.014

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Objective The Bayesian Logistic method was used to explore the influencing factors of the misclassification of blood glucose stability in diabetic patients, and compared with the traditional Logistic method, to provide a research method with misclassification of outcome for the clinicians. Methods The stratified sampling method was used to select patients at the monitoring sites of diabetes complications in Jiangsu Province. The expert before the sensitivity and specificity of blood glucose stability was given using glycosylated hemoglobin as the gold standard. Univariate and multivariate analyses were carried out using the Bayesian and traditional methods. The selection of the regression model was based on the minimum deviance information criterion or Akaike information criterion and the least parameters. Results A total of 509 subjects were investigated, with an age of (62.32±9.29) years old. Bayesian Logistic regression analysis showed that short course of diabetes (OR=0.299, 95% CI: 0.093-0.840) and high education level (OR=0.348, 95% CI: 0.130-0.914) were protective factors for blood glucose stability. High frequency of consumption of preserved food (OR=4.310, 95% CI: 1.369-22.131) and abnormal BMI (OR=2.912, 95% CI: 1.196-9.865) were risk factors for blood glucose stability. Traditional Logistic regression analysis also reached the same result, but the OR (95% CI) values of preserved food consumption and BMI were underestimated, which were 1.671 (1.100-2.538) and 1.650 (1.115-2.440), respectively. Conclusions The Bayesian and the traditional Logistic regression method concluded that the course of the disease, educational level, frequency of consumption of preserved food and BMI were the factors affecting blood glucose stability. The Bayesian method could correct the classification error of dependent variables, and the results obtained were more reliable.

Assessment on the validity and reliability of the WHOQOL-BREF among HIV cases

XU Di, DUAN Qiong-li, PAN Ling, HUANG Neng-mei, HAN Jing, LI Jian

2022, 26(5): 576-582. doi: 10.16462/j.cnki.zhjbkz.2022.05.015

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Objective The objective of the study was to assess the reliability and validity of the World Health Organization quality of life scale-brief form questionnaire (WHOQOL-BREF) and compare the quality of life among HIV cases, providing a basis for evaluating the quality of life and formulating effective measures of HIV cases. Methods HIV cases were recruited through convenience sampling method in Honghe Hani-Yi Autonomous Prefecture, Yunnan Province. Reliability was assessed by using Cronbach's α and split-half reliability, while exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess its validity. ANOVA were used to compare the scores of different characteristics. Results A total of 410 valid questionnaires were obtained. Cronbach's α of WHOQOL-BREF and physical, psychological, social relationships, environment of WHOQOL-BREF were 0.901, 0.779, 0.819, 0.729, 0.743 respectively. The related correlation coefficients of split half were 0.798, 0.716, 0.822, 0.736, 0.697 respectively. Exploratory factor analysis obtained four communal factors, with a contribution of 54.542% to the overall variance. The results of the confirmatory factor analysis showed that the main indicators of the fitted model were χ²/df and the root-mean-square error of approximation (RMSEA), and the value were 2.169 and 0.076 respectively. Goodness of fit index (GFI), comparative fit index (CFI) and Tucker-Lewis index (TLI) were 0.820, 0.861 and 0.844 respectively. All value were closed to 0.900, indicating an accepted level. ANOVA results showed that there were different quality of life among HIV cases with different characteristics such as receiving antiretroviral therapy or not, ethnicity, occupation, education and last CD4⁺T lymphocyte count. Conclusion The reliability and validity of the WHOQOL-BREF are good, and quality of life varied by different characteristics of HIV cases prompting the intervention strategies pertinently.

A study on the status quo and influencing factors of falls among the elderly in China

ZHANG Tian-tian, FENG Zhi-qiang, WANG Wan-chen, LI Qiu-sha, YUAN Mei, MENG Cui-xiang, SUN Yan, ZHANG Yu-jie, YAN Yu, LI Cui-yu, YIN Wen-qiang

2022, 26(5): 502-507. doi: 10.16462/j.cnki.zhjbkz.2022.05.002

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Objective To understand the status and influencing factors of falls among the elderly in China, and to provide a reference for preventing falls among the elderly. Methods The data of 7 070 elderly people over 60 years old were obtained from the China Health and Retirement Longitudinal Study (CHARLS) in 2018. The chi-square test and binary Logistic regression were used to analyze the status and influencing factors of falls in the elderly. Results A total of 1 652 people had fallen in the past two years, and the incidence of falls was 23.4%. There were 714 people with serious conditions after falls that required medical attention, and the rate of falls medical treatment was 10.9%. Binary Logistic regression results showed that no spouse, fair and poor self-rated health status, chronic diseases, depressive symptoms, activity of daily living disability, poor vision, poor hearing, and use of supporting tools (OR=1.187, 1.319, 1.435, 1.154, 1.433, 1.730, 1.230, 1.488, 1.503) were risk factors for falls in the elderly (P < 0.05). Conclusions Falls in the elderly are caused by a variety of factors. The risk factors should be comprehensively evaluated, and comprehensive prevention should be taken to prevent and reduce the potential risks leading to falls and protect the health of the elderly.

Study on the prevalence of hypertension and diabetes mellitus and risk factors of comorbidities in the disabled persons over 50 years old in Shanghai

WU Heng-jing, ZHANG Zi-yan, NIU Wen-xin, ZHOU Zhi-tong, WU Jing

2022, 26(5): 508-512. doi: 10.16462/j.cnki.zhjbkz.2022.05.003

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Objective To explore the prevalence, comorbidity characteristics and risk factors of hypertension and diabetes among disabled population over 50 years old in Shanghai. Methods A cluster sampling method was used to retrospectively investigate and analyze the health examination information of 6 195 cases of disabled persons over the age of 50 from a designated health care hospital for the disabled in Shanghai from February to December 2018. The subjects' general demographic information, disability type, disability grade, prevalence of hypertension and diabetes mellitus, and blood biochemical indicators were investigated. Subjects were divided into three levels according to the prevalence of hypertension and diabetes. The risk factors of the morbidity of hypertension and diabetes mellitus were analyzed by using the ordered multi-classification Logistic regression model. Results The age of the 6 195 disabled peoples was (63.9±6.9) years. Among them, 3 313 (53.5%) were males and 3 735 (60.3%) were physical disabilities. The standardized prevalence rate of hypertension was 48.0%, and the standardized prevalence rate of diabetes was 13.4%. There were 565 (9.12%) patients with hypertension and diabetes comorbid. According to the classification of comorbidities, the differences in gender, age, education level, disability type, BMI, triglyceride, cholesterol, uric acid and creatinine levels were statistically significant (all P < 0.05). The results of multi-class Logistic regression analysis showed that male, elderly, physical disability, overweight or obesity, excessive triglycerides, abnormal uric acid and creatinine levels, were risk factors for hypertension and diabetes comorbidities. Conclusions The prevalence of comorbidities of hypertension and diabetes is higher among the disabled, especially those with physical disabilities. Attention should be paid to the changes in indicators such as body weight, lipid metabolism, and uric acid, and precise prevention and control strategies should be formulated for different types of disabilities.

The mediating effect of diabetic distress on depressive symptoms and self-efficacy in elderly patients with T2DM

LI Sha-sha, HUANG Yi-xuan, HUANG An-li, LUO Zhi-hua, XU Min, CAO Xiu-jing

2022, 26(5): 513-516. doi: 10.16462/j.cnki.zhjbkz.2022.05.004

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Objective To explore the influence of depression on self-efficacy in elderly patients with type 2 diabetes mellitus (T2DM) in the community and the mediating role of diabetic distress. Methods By convenience sampling, the 248 elderly T2DM patients managed by a community service center were investigated with questionnaire. The general demographic characteristics, diabetes-related information, self-efficacy, depression, and diabetic distress were collected. Multiple linear regression model was used to analyze the influence of depression on self-efficacy, and Bootstrap method was used for mediation analysis. Result Depression (β=-0.272, P < 0.01) and diabetes distress (β=-0.345, P < 0.01) were associated risk factors of self-efficacy, and diabetes distress played a mediating role between depression and self-efficacy (Boot CI: -2.460 2~-0.783 9, P < 0.05). Conclusion An important way to enhance the level of self-efficacy of elderly patients with T2DM in the community may be improving emotional disorder.

Mortality and premature mortality in trends of variance in major chronic diseases in Jinchang Cohort during ten-year follow-up

LI Si-yu, ZHANG De-sheng, HU Yu-jia, WANG Ruo-nan, CHEN Ya-rong, LI Jing, LI Na, XU Lu-lu, BAI Zhao, ZHANG Rui, BAI Ya-na

2022, 26(5): 517-522. doi: 10.16462/j.cnki.zhjbkz.2022.05.005

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Objective To identify the core diseases which affect population health, and to provide basic data for public prevention and treatment of chronic diseases through analyzing mortality rate, probability of premature mortality, and trends in chronic diseases from 2011 to 2020. Methods A total of 48 001 participants from the baseline in the Jinchang cohort were included in this study. Follow-up lasted for ten years to gain the outcome. Leading indicators for chronic diseases like proportionate mortality rate, crude mortality rate, age-standardized mortality rate, probability of premature death, and annual percent change (APC) were calculated using the abbreviated life table method and joinpoint regression model. Results The average proportionate mortality rate of major chronic diseases in the Jinchang cohort was 80.26%. The crude mortality rate of the four major chronic diseases showed an upward trend (APC=6.48%) during the observation period. The crude mortality rate of cardiovascular and cerebrovascular diseases was also on the rise (APC=10.02%). Except for women with cardiovascular and cerebrovascular diseases whose probability of premature mortality increased (APC=12.92%), probability of premature mortality in other major chronic diseases remained unchanged. The mortality rate and probability of premature mortality of major chronic diseases in men was higher than that in women. The top three average mortality rates of different major chronic diseases were lung cancer, stroke, and coronary heart disease. Conclusions The four major chronic diseases were the main causes of death in the Jinchang cohort, with lung cancer and stroke as the core diseases. Public prevention and treatment of chronic diseases need to focus more on males. Additionally, females are at a higher risk of cardiovascular and cerebrovascular diseases, which requires early prevention to reduce premature mortality from chronic diseases.

Mediating effect of body mass index and waist circumference on the relationship between obstructive sleep apnea and type 2 diabetes

CHEN Shu-ting, WANG Jia-le, WANG Ju-ping, GAO Qian, LIANG Jie, WANG Tong

2022, 26(5): 523-528. doi: 10.16462/j.cnki.zhjbkz.2022.05.006

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Objective To evaluate the mediating effect of BMI and waist circumference (WC)on the relationships between obstructive sleep apnea (OSA) and type 2 diabetes and continuous measures of glucose metabolism. Methods A total of 1 615 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) were included in this cross-sectional study. OSA severity was assessed by apnea-hypopnea index (AHI), which was measured by polysomnography. Continuous measures of glucose metabolism were FPG and glycated hemoglobin (HbA1c). And obesity indexes used in this study included general obesity (BMI) and abdominal obesity (WC). Results OSA was significantly associated with type 2 diabetes. With increasing the severity of OSA, there was a significant increase in the risk of type 2 diabetes (P < 0.001). Mediation analysis showed that BMI and WC mediated the association between severe OSA and type 2 diabetes, respectively. The indirect effect mediated by WC and BMI were 1.296 (95% CI: 1.182-1.466) and 1.291 (95% CI: 1.173-1.479), and the proportion of mediation were 56.397% and 55.400%, respectively. Similarly, BMI and WC mediated the associations between OSA and FPG and HbA1c. Conclusions These findings show that the associations between OSA and type 2 diabetes, FPG and HbA1c are mediated by obesity indexes to a large proportion. It is suggested that weight control, especially reducing abdominal obesity, may have an important role for OSA patients in decreasing the risk of type 2 diabetes and related cardiovascular complications.

An analysis in the prevalence and influencing factors of COPD among people aged 40 years and above in Guizhou Province

HUANG Lu, WANG Yi-ying, LIU Tao, LI Ling, YANG Jing-yuan

2022, 26(5): 529-534. doi: 10.16462/j.cnki.zhjbkz.2022.05.007

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Objective To explore the gender comparison in prevalence and influencing factors of chronic obstructive pulmonary disease (COPD) among people aged 40 years and above in Guizhou Province, to provide basis for risk stratification and prevention of COPD. Methods A total of 2 599 residents aged 40 years and over in the COPD monitored area of Guizhou Province was selected according to a multi-stage stratified cluster sampling method. And all participants were underwent a questionnaire survey, physical examination, and lung function test. Results The total prevalence of COPD in the monitored area of Guizhou Province was 10.7%. The prevalence of male (13.0%) was higher than that of female (7.6%) (χ²=16.951, P < 0.001). Unconditional multivariate Logistic regression analysis suggested that age, smokers, tuberculosis, and history of chronic bronchitis were significantly associated with COPD in male population; While age, cerebrovascular diseases, history of emphysema, history of chronic bronchitis, and rhinitis were significantly associated with COPD in the female. Conclusions The prevalence and influencing factors of COPD were different between male and female. In order to reduce the incidence of COPD, smoking control and respiratory disease screening are main measures for men, and respiratory disease screening is the main measure for women.

Study on the association of three TC/HDL-C, TG/HDL-C and LDL-C/HDL-C lipid ratios with insulin resistance, diabetes and pre-diabetes

XIN Peng, LI Jing, LI Chang-kun, FAN Li-li, ZHENG Wen-long, WANG De-zheng

2022, 26(5): 535-540. doi: 10.16462/j.cnki.zhjbkz.2022.05.008

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Objective To study the association between the ratios of lipid TC/HDL-C, TG/HDL-C and LDL-C/HDL-C and insulin resistant diabetes and pre-diabetes in adults in Tianjin City, in order to explore the evaluation value of lipid ratios levels in public health prevention, clinical diagnosis and disease prediction of diabetes. Methods According to the Chinese adult chronic disease and nutrition surveillance program, inhabitants aged 18 years and above were investigated in 7 Districts including Hexi District in Tianjin City. And their fasting venous blood was collected to detect four blood lipids, fasting plasma glucose and insulin. TC/HDL-C, TG/HDL-C, LDL-C/HDL-C levels were Divided into four groups according to the quartile method, and the OR value, 95% CI with insulin resistance, diabetes and pre-diabetes were analyzed use binary Logistic regression analysis model. Results The prevalence of diabetes combined with pre-diabetes in the investigated population in Tianjin was 46.6% (2 030/4 356). The elevation of TC/HDL-C and TG/HDL-C increased the risk of insulin resistance in the participants, but limited to the LDL-C/HDL-C ≥2.86 group, the risk of insulin resistance increased by 1.78 (95% CI: 1.21-2.63) times when compared with the ratio < 1.78 group. With the increase of TC/HDL-C and TG/HDL-C, the risk of diabetes and pre-diabetes increased in both men and women, and the correlation was strong, and the correlation with LDL-C/HDL-C was lower than that of TC/HDL-C and TG/HDL-C. In addition, it was found that the increase of TC/HDL-C, TG/HDL-C and LDL-C/HDL-C had a stronger effect on increasing the risk of diabetes and pre-diabetes in females compared to males. Conclusions The increase of TC/HDL-C and TG/HDL-C can increase the risk of insulin resistance, diabetes and pre-diabetes. LDL-C/HDL-C is weakly associated with the risk of insulin resistance, diabetes and pre-diabetes.

Temporal-spatial distribution of AIDS epidemic in China, 2010-2019

HE Jia-jin, YUAN Lu, WU Chao

2022, 26(5): 541-546. doi: 10.16462/j.cnki.zhjbkz.2022.05.009

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Objective This study aims to explore the temporal-spatial distribution of AIDS incidence in China from 2010 to 2019. Methods Data were extracted from the China Health Statistical YearBook and the Science Center of Public Health, and population data were derived from the National Bureau of Statistics. The epidemic trend of AIDS was analyzed by linear chi-square test and hierarchical map. The global and local spatial autocorrelation analyses were conducted by using software GeoDa 1.18. The software of SaTScan 9.7 was used for spatial-temporal scanning analysis. Results The result of Chi-square Test was 30.432 (P < 0.001); The maps exhibited that the geographical distribution of incidence rate was quite different in China, showed a spatial pattern of being higher in Southwest and lower in Northeast China. Moran's value was from 0.196 in 2010 to 0.383 in 2019. The global spatial autocorrelation indicated that AIDS incidence was positively auto-correlated and the degree of correlation was strengthening. Local spatial autocorrelation showed that Guangxi and Yunnan had been in high-high cluster mode. In 2012, Guizhou changed from low-high cluster to high-high cluster. In 2014, Henan changed from high-low cluster to low-low cluster. And Hunan, Sichuan, and Chongqing added to high-high clustering areas from 2016 to 2019. The spatial-temporal scanning identified three cluster areas, which had certain aggregation in time and space. Conclusions The epidemic of AIDS existed obvious regional differences and spatial aggregation had increased in China. The high-high cluster area in Southwest China was constantly expanding. The targeted prevention and control strategy should be formulated according to the analysis of temporal-spatial characteristics, so as to achieve regional cooperation and rational allocation of resources.

Analysis of the trend of total delay among pulmonary tuberculosis patients with positive etiology in Yunnan Province

LYU Tong, YANG Rui, CHEN Jin-ou, LI Ling, QIU Yu-bing, XU Lin

2022, 26(5): 547-553. doi: 10.16462/j.cnki.zhjbkz.2022.05.010

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Objective To analyze the trend of total delay of tuberculosis patients with positive etiology in Yunnan Province during the 11th five-year Plan, 12th five-year Plan and 13th five-year Plan for tuberculosis prevention and control, and to obtain the influencing factors of total delay, so as to provide the basis for reducing the occurrence of total delay. Methods Via the tuberculosis management information system(TMIS), we collected medical records of patients with pathogen-positive pulmonary tuberculosis registered in Yunnan Province in 2005, 2010, 2015 and 2020. The demographic characteristics and delay characteristics of the study participants were described. χ² trend test was used for the time trend test of rate and composition ratio, and the Kaplan-Meier method was used to compare the total delay between groups, and the survival probability was estimated and drawn as a survival function curve. Cox proportional hazard model was used for multivariate analysis of total delay. Results The total delay of positive etiology pulmonary tuberculosis patients in Yunnan Province has declined, and the declining trend was similar to patient delay. The median total delay was reduced from 94 days in 2005 to 33 days in 2020. The probability of patients with pathogenic positive pulmonary tuberculosis being found and receiving treatment in 2020 increased by 2.359 times compared with 2005, and the total delay days of patients with different characteristics showed a downward trend. Multivariate regression analysis showed that besides years, women, older age, farmers, ethnic minorities, floating population and retreatment patients were also risk factors for the total delay. Conclusions With the implementation of tuberculosis prevention, and control measures in Yunnan Province, the total delay days of patients with positive pathogenic tuberculosis decreased significantly, which effectively controlled the development of tuberculosis epidemic. To further control the development of the tuberculosis epidemic, we should pay attention to the risk groups with long total delay days, and seek cost-effective active screening methods to reduce the patient delay of dangerous people.

Effects of outdoor gaseous pollutant exposure on the risk of pulmonary tuberculosis

XU Dong-mei, LU Feng, WANG Wen-mei

2022, 26(5): 554-558. doi: 10.16462/j.cnki.zhjbkz.2022.05.011

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Objective To explore the relationship between outdoor exposure to gaseous pollutants sulfur dioxide (SO₂) and nitrogen dioxide (NO₂) and the risk of pulmonary tuberculosis. Methods We collected the daily number of pulmonary tuberculosis cases reported in Nantong from 2014 to 2018, and the data of air pollutant concentration, meteorological factors and socio-economic indicators during the same period. We constructed the distributed lag nonlinear model (DLNM) to estimate the effects of SO₂ and NO₂ exposure on the risk of pulmonary tuberculosis. Results Between 2014 and 2018, a total of 15 799 pulmonary tuberculosis cases was reported in Nantong. During this period, the weekly average concentration of SO₂ and NO₂ in Nantong was 21.14 (16.43, 28.35) μg/m³ and 35.57 (25.07, 46.29) μg/m³, respectively. In the single-and double-pollutant model, for each 10 μg/m³ increase in NO₂, the cumulative RR of pulmonary tuberculosis was 1.41 (95% CI: 1.02-1.96, P=0.040) and 1.56 (95% CI: 1.02-2.39, P=0.042), respectively, at lag 24 weeks. Conclusions Outdoor NO₂ exposure increased the risk of pulmonary tuberculosis. Reducing the concentration of outdoor NO₂ will help control the epidemic of pulmonary tuberculosis.

Association between gestational weight gain and the risk of overweight/obesity in adult offspring: a systematic review and meta-analysis

LIU Xiao-ling, CHEN Yan, YE Chang-xiang, CHEN Li-zhang, WANG Ting-ting

2022, 26(5): 583-588. doi: 10.16462/j.cnki.zhjbkz.2022.05.016

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Objective To evaluate the association between gestational weight gain (GWG) and the risk of overweight/obesity in adult offspring by systematically reviewing and Meta analyzing. Methods A systematic literature search was performed in the PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang, and Weipu databases from inception to June 2, 2021, for relevant articles on the association between GWG and the risk of overweight/obesity in adult offspring, complementing with a perusal of bibliographies of retrieved articles. The overall risk ratio (RR) and 95% confidence intervals (CI) were calculated using a random-effects model. Subgroup and sensitivity analyses were performed to explore possible sources of heterogeneity and assess the robustness of the results. Results Six studies with a total of 31 968 individuals were included in this study. Results showed that a statistically significant association was found between excessive GWG and the risk of overweight and obesity in adult offspring (RR=1.37, 95% CI: 1.24-1.52, P < 0.001). No significant association was obtained between inadequate GWG and the risk of overweight and obesity in adult offspring (RR=0.93, 95% CI: 0.78-1.11, P=0.430). Conclusions Excessive GWG will increase the risk of overweight and obesity in adult offspring. Therefore, pregnant women should pay attention to a balanced diet and exercise moderately to avoid excessive weight gain during pregnancy.

Research progress of free radical induced aging

YANG Shan-lan, WU Lei, TU Jia-xin, DENG Li-fang, HUANG He-lang

2022, 26(5): 589-594. doi: 10.16462/j.cnki.zhjbkz.2022.05.017

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The theory of free radical-induced aging (FRTA), first proposed by Denham Harman in 1954, believes that free radicals generated in the environment and from internal metabolism can damage cell components, thus damaging human function and accelerating aging. The research of human aging has developed rapidly, there are many theories and great debates, but the free radical theory has drawn wide attention. Most works of literature have given this theory some academic support as they affirm the fact that free radicals can cause aging and induce some chronic diseases. This paper summarizes the connotation and pathogenesis of free radicals from the aspects of biomedicine, molecular epidemiology and epidemiology, focuses on the progress of research on free radical in recent years and reveals the gap between the traditional understanding. At the same time, the paper puts forward a possible path of free radical-induced aging: free radicals act on the body continuously, dynamically and circularly. Aging can only occur when a certain cyclic balance is broken. This path brings opportunities and thoughts on preventing aging, reducing chronic diseases and delaying aging.

Analysis of quality of life and inflection point age of the elderly in rural areas of Anhui Province based on ROC curve

ZHU Wei-zheng, ZHANG Min, HE Xin-ran, SUN Qian, LIU Yu-yang, DING Hong

2022, 26(5): 595-599. doi: 10.16462/j.cnki.zhjbkz.2022.05.018

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Objective To evaluate the quality of life of the elderly in rural areas of Anhui Province and the gender differences of their inflection point age, to provide a reference for improving the quality of life of the elderly in rural areas. Methods A total of 3 336 older adults were investigated in 18 villages in Anhui Province by using a multistage stratified cluster random sampling method. The quality of life of the elderly was assessed by the five-dimensional European quality of health scale (EQ-5D), and the inflection point age of quality of life of the elderly in different genders was predicted by the receiver operator characteristic (ROC) curve. A binary Logistic regression analysis model was used to verify the predictive ability of inflection point age on quality of life. Results The health utility value of men was (0.774±0.200) and that of women was (0.721±0.205), which was higher in men than in women (t=7.500, P < 0.001); Whether male or female, the proportion of difficulty in the dimension of "pain and discomfort" was the highest; The inflection point age of quality of life was 72.5 years for men and 70.5 years for women; Logistic regression analysis model showed that inflection point age had a predictive value for the change of quality of life. Conclusions The quality of life of the elderly men in rural areas of Anhui Province is better than that of women, and the inflection point age of all dimensions of the quality of life of women is earlier than that of men. We should pay attention to the chronic pain and mental health of the elderly to improve the quality of life.

Association of neighborhood greenness exposure and diabetes mellitus among adults in Bengbu: the mediation of body mass index

SHI Heng-yuan, XIAO Li-ping, LIU Ting, HE Fen-fen, DONG Yi-lin, LYU Heng, CHU Yi-fan, JIA Xian-jie, GAO Huai-quan

2022, 26(5): 600-603. doi: 10.16462/j.cnki.zhjbkz.2022.05.019

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Abstract:
Objective This study aims to evaluate the association between neighborhood greenness exposure and diabetes mellitus (DM) among adults in Longzihu District, Bengbu City, and to explore the mediating effect of BMI on neighborhood greenness exposure with DM. Methods In 2015, 3 354 adult residents in Longzihu District were recruited. Basic information was obtained by questionnaire survey. Normalized difference vegetation index (NDVI) and soil adjusted vegetation index (SAVI) values with 1000 m buffers were used to evaluate neighborhood greenness exposure. Binary Logistic regression was conducted to assess the association between neighborhood greenness exposure and DM. In addition, this study assessed the mediating effects of BMI on neighborhood greenness exposure with DM. Results There were significant differences in the prevalence of DM among different groups in NDVI-1 000m (χ²=36.39, P < 0.001) and SAVI-1 000m (χ²=20.14, P < 0.001). In the fully adjusted model, the prevalence of DM in the Q3 group was 0.538 (OR=0.538, 95% CI: 0.388-0.745) and 0.605 (OR=0.605, 95% CI: 0.440-0.833) compared to the Q1 group under NDVI-1 000 m and SAVI-1 000 m, respectively. The BMI mediated 6.42% (95% CI: 1.83%-16.00%) on NDVI-1 000m with DM and 7.43% (95% CI: 2.36%-19.00%) on SAVI-1 000 m with DM. Conclusion The higher the neighborhood greenness exposure, the lower the prevalence of DM. BMI was a mediating factor between neighborhood greenness exposure with DM.

Mental health status and influencing factors of staffs in the disease control and prevention system under the normalization prevention of COVID-19 epidemic

XIE Yan-xin, QI Hui, PAN Jie, LU Xiang-hua, HAO Li-peng, ZHU Wei-ping

2022, 26(5): 604-610. doi: 10.16462/j.cnki.zhjbkz.2022.05.020

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Abstract:
Objective To investigate the mental status of staffs in disease prevention and control system of Shanghai, and to analyze the relevant factors that may affect the mental status of staffs under the normalized prevention and control period of COVID-19. Methods Stratified cluster sampling was used in the study. A questionnaire survey on 538 staffs in 4 disease control and prevention centers was implemented. Results The scores of depression, anxiety, interpersonal loneliness were listed as 10(3, 20), 7(2, 15), 4(0, 12). Depression scores in different education backgrounds, marital status, occupations, underlying diseases, units, work shifts population were different (all P < 0.05). Anxiety and interpersonal loneliness scores in different education backgrounds, occupations, underlying diseases, units, work shifts population were different (all P < 0.05). The respondents thought that pressure from the routine work and the COVID-19 prevention and control work, uncertainty about the COVID-19 development, et al all contributed to their depression, anxiety, interpersonal loneliness feeling. Results showed that units, underlying diseases, work shifts, education backgrounds, the longest working hour in the last 2 weeks were the main influencing factors of depression scores basing on multi-factor analysis model; units, underlying diseases, work shifts, the longest working hour in the last 2 weeks were the main influencing factors of anxiety scores; units, work shifts were the main influencing factors of interpersonal loneliness scores. Conclusions The scores and influencing factors of depression, anxiety, interpersonal loneliness dimension in the study were separately different. It is suggested that targeted measures should be taken to improve the mental health status of the staffs.

A survey on the willingness and influencing factors of the COVID-19 vaccination among people aged 60 years and above in Zhejiang Province

LIAO Yu-ting, YANG Juan, HUANG Shou-jie, SU Ying-ying

2022, 26(5): 611-614. doi: 10.16462/j.cnki.zhjbkz.2022.05.021

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Abstract:
Objective To understand the willingness and influencing factors of COVID-19 vaccination among people aged 60 years and above in Zhejiang Province. Methods A questionnaire survey was conducted from September to November 2020 using stratified sampling among population aged 60 years and above in Zhejiang Province. Socio-demographic information, willingness to receive COVID-19 vaccine and awareness of the risks of COVID-19 were collected. Chi-square test and multivariate Logistic regression were used to explore the factors associated with vaccination willingness. Results A total of 1 858 participants were completed the questionnaire. The vaccination willingness rate for the free vaccination and self-pay vaccination for COVID-19 vaccine were 88.3% and 66.1%, respectively. Multivariate Logistic regression showed that for free vaccination, those who lived in the country (OR=1.6, 95% CI: 1.2-2.2)、did not go outside(OR=1.6, 95% CI: 1.1-2.3)、had heard of COVID-19 (OR=3.7, 95% CI: 2.4-5.8), and believed that SARS-CoV-2 could cause serious consequences (OR=2.3, 95% CI: 1.6-3.5) had higher willingness of vaccination. For self-pay vaccination, the main reasons for receiving COVID-19 vaccine were their agreement with the safety and efficacy of the COVID-19 vaccine, while the main reasons for reluctance of vaccine were considered with the fee and side effects. Conclusions The willingness of COVID-19 vaccination is at a relatively high level among people aged 60 years and above in Zhejiang Province. However, further education should be concerned for the promotion of the vaccination.

Behavior problems and relevant factors among children aged 3-6 years old in Anhui Province

CHENG Jin, XIE Rui-jin, WANG Jin, XU Ting, WANG Xin, HUANG Yong-ling

2022, 26(5): 615-620. doi: 10.16462/j.cnki.zhjbkz.2022.05.022

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Abstract:
Objective To investigate the prevalence of behavior problems and associated risk factors among children aged 3-6 years old, and to provide support for the early intervention of child behavior problems. Methods A total of 9 541 children aged 3-6 years were selected from the kindergartens by multi-stage stratified cluster random sampling in Anhui Province, and their parents were surveyed by Conners Parent Rating Scales and general information questionnaire. The χ² test was used to analyze the detection rate of behavioral problems in children aged 3-6 years by univariate analysis, and the multivariate unconditional Logistic regression analysis model was used to analyze the influencing factors of behavioral problems in children. Results The prevalence of behavior problems was 14.3% among children aged 3-6 years old. Learning problems and psychosomatic disorder were the two prominent behavior problems. The results of Logistic regression analysis showed that boys, aged 3- < 6 years, only child, living with one of their parents in the past six months, sleep deprivation were the risk factors associated with behavior problems. However, the primary caregivers were their parents was the protective factor. Conclusions The behavioral problems were common among children aged 3-6 years in Anhui Province. The intervention strategies should focus on boys, only child, the children raised by their grandparents/material grandparents and left-behind children. Behavior problem intervention should be carried out at the early stage.

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2022 Vol. 26, No. 5

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Editor

Editor-in-Chief Ye Dongqing M.D.

Assistant editor Fan Yinguang M.D.

Assistant editor Pan Haifeng M.D.

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