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CN 34-1304/R ISSN 1674-3679

2022 Vol. 26, No. 6

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Literature Review
Construct high-level public health schools and cultivate first-class public health talents
WANG Jian-ming, SHEN Hong-bing
2022, 26(6): 621-623. doi: 10.16462/j.cnki.zhjbkz.2022.06.001
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The foothold of constructing high-level public health schools is personnel training. It is necessary to take what kind of people to cultivate, how to cultivate and for whom to cultivate as the fundamental issue, aiming to benchmark world-class universities, build first-class disciplines, cultivate first-class talents and pursue first-class scientific research achievements. We should pay attention to interdisciplinary integration, attach importance to the theoretical teaching and practical training of response to the emerging infectious diseases and public health emergencies, and emphasize the integration of medical institutions and public health institutions to train public health talents in the whole chain.
Original Articles
Epidemiological trends and characteristics of major respiratory infectious diseases in China from 2004 to 2018
ZHENG Ze-yang, WANG Zhong-kai, WANG Lian-ke, LIU Dan-dan, ZHANG Bai-yu, ZHOU Qian-yu, JIA Shan-qun, SHEN Jun-ru, LIU Hui-min, LIU Xi-yu, SUN Chang-qing
2022, 26(6): 624-630. doi: 10.16462/j.cnki.zhjbkz.2022.06.002
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  Objective  To analyze the epidemic trends and characteristics of measles, tuberculosis, pertussis, influenza, mumps, rubella and scarlet fever in China from 2004 to 2018, so as to provide evidence for defining the prevention and control priorities of respiratory infectious diseases in China.  Methods  The incidence data of 7 respiratory infectious diseases in China from 2004 to 2018 were summarized, and the trend of incidence rate was analyzed by the Joinpoint regression model.  Results  A total of 23 903 628 cases of 7 respiratory infectious diseases were reported in China from 2004 to 2018, with an average annual incidence of 117.96/100 000. The incidence was higher in males than in females, mainly in teenagers and children, with a higher incidence in spring and winter.In 2004-2016, the overall incidence of major respiratory infectious diseases in China declined significantly. (APC=-2.00%, P < 0.001). However, it increased from 2016 to 2018(APC=15.00%, P=0.30). The incidence of tuberculosis and measles decreased, but the incidence of influenza, whooping cough and scarlet fever increased.  Conclusions  The incidence of respiratory infectious diseases in China has been rising since 2016. How to deal with the epidemic of seasonal influenza and the outbreak of new influenza, the high disease burden of tuberculosis, and the resurgence of whooping cough and scarlet fever will be the focus of prevention and control of respiratory infectious diseases in China in the future.
A comparative study of three models for syphilis incidence trend analysis in China from 2011 to 2020
ZHU Xiao-xia, CHEN Liang, LI Xiu-yang
2022, 26(6): 631-638. doi: 10.16462/j.cnki.zhjbkz.2022.06.003
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  Objective  This study was aimed to compare the effects of the autoregressive integrated moving average (ARIMA) model, nonlinear autoregressive neural network (NAR) model and long-short term memory neural network (LSTM) model applied to predict the reported incidence of syphilis to optimize the epidemic prediction model.  Methods  Based on the fitting dataset of the monthly reported incidence of syphilis in 31 provinces, autonomous regions and municipalities (excluding Taiwan, Hong Kong and Macao) in China from 2011 to 2019, the ARIMA model, NAR model and LSTM model were established to compare the fitting effects of these models. Data on the incidence of syphilis in 2020 was used to compare the prediction effects of these models.  Results  The mean absolute deviations (MAD) of the ARIMA model, NAR model and LSTM model fitting effect were 0.013, 0.011 and 0.002, respectively. The root mean squared errors (RMSE) were 0.015, 0.018 and 0.003, respectively. The mean absolute percentage errors (MAPE) were 4.266%, 3.810% and 0.692%, respectively. The MADs of the forecasting effect were 0.064, 0.049 and 0.044, the RMSEs were 0.069, 0.068 and 0.060 and the MAPEs were 23.310%, 17.629% and 18.575%, respectively.  Conclusions  The LSTM model has better fitting and forecasting effects than the ARIMA and NAR models in predicting the reported incidence of syphilis, which could provide data support for the prevention and control of syphilis.
Disease burden and trend of HIV/AIDs among the elderly in China during 1990-2019
REN Ning-jun, LI Yuan-sheng, ZHANG Wen-xin, WANG Ruo-lan, FAN Song, LI Ai-ling
2022, 26(6): 639-644. doi: 10.16462/j.cnki.zhjbkz.2022.06.004
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  Objective  To describe and analyze the prevalence, morbidity rate, mortality rate, and disability-adjusted life years (DALYs) rate of HIV/AIDS among the elderly in China from 1990 to 2019.  Methods  Data was collected from the Global Burden of Disease Study 2019(GBD 2019). Statistical description was used to analyze disease burden indicators by age, gender, and year. Temporal trend analysis was conducted by Joinpoint regression models. Annual percentage change (APC) and average annual percentage change (AAPC) were calculated for prevalence, morbidity rate, mortality rate, and DALYs rate.  Results  From 1990 to 2019, the age-standardized prevalence of HIV/AIDS among the elderly in China increased from 7.56/105 to 48.90/105. The age-standardized morbidity rate increased from 1.03/105 to 1.89/105.The age-standardized mortality rate increased from 0.35/105 to 2.97/105. The DALYs rate increased from 11.01/105 to 90.51/105. According to the Joinpoint results, from 1990-2019, there was an overall increasing trend in the standardized prevalence, mortality rate, morbidity rate, DALYs rate of HIV/AIDS among the elderly in China, with AAPC of 6.71%, 1.91%, 7.65%, and 7.52% respectively. The differences were all statistically significant with P < 0.05.  Conclusions  The disease burden of HIV/AIDS among the elderly in China is still severe. The disease burden index is on the rise. Early HIV/AIDS screening and health education should be strengthened, and targeted preventive measures should be formulated according to the HIV/AIDS burden characteristics among the elderly.
First-year mortality after antiretroviral therapy initiation among people living with HIV/AIDS in Guangdong from 2016 to 2018
CHEN Xiu-yuan, ZHANG Yu-qin, ZHANG Jing, JIA Wei-dong, XIE Jin-zhao, CAI Wei-ping, GU Jing, LI Ling-hua, HAO Yuan-tao
2022, 26(6): 645-650. doi: 10.16462/j.cnki.zhjbkz.2022.06.005
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  Objective  To estimate the trends in first-year mortality among HIV/AIDS patients newly receiving antiretroviral therapy (ART) in Guangdong Province from 2016 to 2018. To compare the differences in mortality among HIV/AIDS patients from different regions in Guangdong during the"Guangdong AIDS Community Integrated Prevention and Treatment Research Project".  Methods  We estimated the annual first-year mortality after ART and standardized mortality ratio (SMR) of HIV/AIDS patients receiving ART at Guangzhou Eighth People's Hospital. And we analyzed the changes in patients'treatment characteristics using Cochran-Armitage tests. Finally, we explored the differences in first-year mortality of HIV/AIDS patients from different regions using Cox regressions.  Results  During 2016-2018, a total of 6 447 HIV/AIDS patients newly started ART. The number of patients in Guangzhou demonstration districts, other districts in Guangzhou and other cities in Guangdong Province were 976, 3 921, and 1 550, among that 152 people died. From 2016 to 2018, first-year mortality in Guangzhou demonstration districts decreased by 79.7%. The mortality in other districts in Guangzhou did not decline significantly, and the mortality of patients in other Cities in Guangdong increased by 18.8%. After standardization, SMR of three groups of patients all decreased.Among three groups, the early-diagnosis rates increased by year. But only HIV/AIDS patients living in Guangzhou had significant improvement in treatment outcome over the year. Cox regressions showed that after adjusting for baseline characteristics and factors being well controlled during the program implementation, differences in mortality rates no longer existed among patients in the three residence groups.  Conclusions  The first-year mortality of HIV/AIDS patients receiving ART in Guangzhou was well-controlled, especially patients from demonstration districts. But patients in other cities in Guangdong had high mortality, which could be explained by their poor physical conditions. For patients with HIV/AIDS receiving ART in Guangzhou but living in other cities in Guangdong Province, to focus on the poor ART outcomes and actively promote early treatment are crucial in reducing their first-year mortality.
Interaction effect of hypertension family history and dyslipidemia on the prevalence of hypertension
DU Jin-ling, ZHOU Nan, SONG Ying-qian, WANG Wei-wei, HONG Xin
2022, 26(6): 651-656. doi: 10.16462/j.cnki.zhjbkz.2022.06.006
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  Objective  To explore the effect of the interaction of family history of hypertension and dyslipidemia on the prevalence of hypertension.  Methods  Based on the Chronic Disease and Risk Factor Surveillance in Nanjing City from 2017 to 2018, a representative sample of 61 098 residents aged over 18 years were surveyed. All participants completed face-to-face questionnaires, anthropometric measurements and relevant laboratory examinations. A logistic regression model of complex sampling was utilized to analyze the influence of the family history of hypertension and dyslipidemia on the prevalence of hypertension. The multiplicative and additive models were applied to analyze the interaction effect of family history of hypertension and dyslipidemia.  Results  Finally, a total of 60 283 subjects were included in this study. Among them, there were 15 686 hypertensive patients with a standardized prevalence rate of 29.8%;33.8% of participants had a family history of hypertension, and the standardized rate of dyslipidemia was 29.8%. After adjusting for confounding factors by multivariate Logistic regression, participants with a family history of hypertension and dyslipidemia had a significantly higher risk of hypertension compared with those without a family history of hypertension and dyslipidemia (OR=4.881, 95% CI: 4.381-5.438). There was a multiplicative interaction between a family history of hypertension and dyslipidemia (OR=1.107, 95% CI: 1.015-1.208). The additive interaction model showed a synergistic effect between a family history of hypertension and dyslipidemia, the S, RERI, API% was 1.603(95%CI: 1.447-1.775), 1.460(95%CI: 1.212-1.707), and 29.9%(95%CI: 24.8-35.0), respectively.  Conclusion  Family history of hypertension and dyslipidemia has synergistic impact on risk of hypertension, and the simultaneous presence of both increases the risk of hypertension.
A preliminary study on the dose-response relationship between egg consumption and cardiovascular diseases in the Bouyei ethnic group of Guizhou Province
WANG Qiao-rong, LIU Lei-lei, MA Na-na, XU Zi-xuan, PENG Lian, ZHANG Lin-yuan, HONG Feng
2022, 26(6): 657-662. doi: 10.16462/j.cnki.zhjbkz.2022.06.007
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  Objective  The study aimed to evaluate the potential dose-response relationship between egg consumption and the risk of cardiovascular diseases among the Bouyei ethnic group in Guizhou Province.  Methods  Based on the China Multi-Ethnic Cohort Study, a cross-sectional assessment was conducted among 5 908 Bouyei adults aged 30-79 years from Guizhou Province. The age-standardized prevalence of cardiovascular diseases was calculated according to 2010 China Census data. A restricted cubic splines model based on a multivariable Logistic regression model was applied to assess the dose-response association.  Results  The age-standardized prevalence of cardiovascular diseases was 3.19%. There was a non-linear dose-response association between the frequency and amount of egg intake per week and the risk of cardiovascular diseases risk (Pnonlinearity < 0.001). Moreover, lower cardiovascular diseases risk was identified when the frequency of eggs consumed per week was less than 7 times and the intake was less than 500 grams. Our results also indicated that the risk of cardiovascular diseases can be decreased by 60% when the frequency of eggs consumed per week was between 4 and 7 times and the intake was between 200 and 500 grams.  Conclusion  A non-linear dose-response association of egg consumption with cardiovascular diseases was observed among Bouyei adults in Guizhou Province. These findings suggest that keeping optimal egg consumption may have a protective effect on cardiovascular diseases.
Analysis of characteristics of injury-induced death and life loss among Shenzhen residents, 2017-2020
ZHANG Zhuo-jie, ZHANG Zhen, WEI Lan, FU Ying-bin, WU Yong-sheng
2022, 26(6): 663-667. doi: 10.16462/j.cnki.zhjbkz.2022.06.008
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  Objective  To analyze characteristics of the main injury-induced death and life loss among Shenzhen residents during 2017-2020 and provide a scientific basis for the targeted formulation of strategies and measures for injury prevention and control.  Methods  Injury-induced death characteristics and life loss were assessed using composition ratio, mortality rate, standardized mortality rate, potential years of life lost (PYLL), potential years of life lost rate (PYLLR), and average years of life lost (AYLL). Joinpoint regression was also applied to compare the age-specific mortality rates of significant injury death causes in different years and genders.  Results  The number of injury-induced deaths among Shenzhen residents in 2017-2020 was 7 199, with an average annual crude mortality rate of 12.73/100 000 and an average annual standardized mortality rate of 20.70/100 000, the mortality rate of males was higher than females. The top three causes of injury-induced death and injury-induced PYLL were suicide, traffic accident and accidental fall. The overall change in the age-specific mortality rate of all injury-induced in the whole population was a mean increase of 4.9% per year (t=5.2, P < 0.001);the overall suicide mortality rate was a mean increase of 3.1% per year (t=3.8, P < 0.001);the overall change of mortality rates for traffic accidents was a mean increase of 2.7% per year (t=2.8, P=0.005);the overall change in mortality rates for falls was a mean increase of 6.1% per year (t=6.8, P< 0.001). The mortality turning points of males and females were different, the mortality curves were not parallel, and the trends were not the same. The total PYLL caused by injuries during the 4-year period was 269 093.5 person-years, the AYLL was 37.38 years/person, and the PYLLR was 4.76 per 1 000.  Conclusion  Suicide is the primary cause of injury-induced death among Shenzhen residents, and the mortality rates of each cause of injury-induced death for men and women show different age trends. Targeted measures should be taken according to critical populations. Injuries lead to serious life loss and have a significant impact on families and society. All sectors of society need to strengthen the prevention of injuries and reduce the occurrence of injuries, especially fatal injuries.
The moderated mediating effect of stressful life events on non-suicidal self-injury in Chinese adolescents
HAO Yang, LYU Hang, AN Xian-li, YU Liang-ming, FANG Xu
2022, 26(6): 668-672. doi: 10.16462/j.cnki.zhjbkz.2022.06.009
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  Objective  To explore the moderating role of negative reinforcement in the process of adolescent's non-suicidal self-injury (NSSI) stimulated by stressful life events through negative affect.  Methods  A questionnaire survey was conducted among 4 634 adolescents by using general situation questionnaire, adolescent self-rating life events checklist (ASLEC), positive affect and negative affect scale (PANAS), adolescent non-suicidal self-injury assessment questionnaire (ANSAQ), and using structural equation modeling to test the moderated mediating effect.  Results  The detection rate of adolescents'NSSI was about 29.80%. Stressful life events, negative affect and NSSI were positive correlated with each others (all P < 0.01), negative reinforcement was positively correlated with NSSI (P=0.002). Negative affect played a mediating role between stressful life events and NSSI (IE=0.116, 95% CI: 0.090-0.143). Negative reinforcement not only positively moderate the relationship between negative affect and NSSI (β=0.165, 95% CI: 0.101-0.227), but also positively moderate the mediating effect of negative affect between stressful life events and NSSI[95%CI of Indirect effects comparison are (0.090-0.241), (0.049-0.217), (0.090-0.241)].  Conclusion  There is a moderated mediating effect between stressful life events and NSSI, negative affect is the mediator, negative reinforcement not only exacerbate the impact of negative affect on NSSI, but also exacerbate the impact of stressful life events on NSSI through negative affect.
Analysis on the trend of myopia prevalence and its influencing factors among students in Liaoning Province from 2018 to 2020
GAO Qing, LIU Yi-qing, YE Qian-wen, SUN Wei, WU Ming
2022, 26(6): 673-678. doi: 10.16462/j.cnki.zhjbkz.2022.06.010
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  Objective  To investigate and evaluate the prevalence of myopia and its development trend in students in Liaoning Province from 2018 to 2020, and analyze its influencing factors, to further provides the scientific basis for further formulating the strategy and the measure of preventing myopia.  Methods  The data of myopic physical examination among students in Liaoning Province from 2018 to 2020 were collected by multistage stratified random cluster sampling, the sample size of three surveys were 33 238, 49 381 and 52 083, respectively. To analyze the prevalence and trend of myopia among students in Liaoning Province from 2018 to 2020, and analyze its influencing factors by Logistic regression.  Results  The overall myopia detection rate decreased gradually in the students of Liaoning Province from 2018 to 2020, which was 56.15%, 54.0% and 53.9%, respectively. Multiple Logistic regression analysis found that the main factors affecting myopia were economic classification, urban and rural classification, gender, type of school, year, daily breakfast, moderate to high intensity exercise, regular replacement of class seats, height adjustment of desks and chairs, and daily eye exercises (P < 0.05). Among them, gender (OR=0.731, 95% CI: 0.711-0.751, P < 0.001), senior grade (primary school OR=0.255, 95% CI: 0.235-0.276, P < 0.001; junior high school OR=0.060, 95% CI: 0.055-0.065, P < 0.001; senior high school OR=0.031, 95% CI: 0.029-0.034, P < 0.001; vocational high school OR=0.092, 95% CI: 0.083-0.101, P < 0.001), year (OR=0.936, 95% CI: 0.909-0.963, P < 0.001), do 1-2 eye exercises every day (once OR=0.929, 95% CI: 0.887-0.974, P=0.002; twice OR=0.943, 95% CI: 0.898-0.991, P=0.020), change seats at least once a week(twice a week OR=0.892, 95% CI: 0.842-0.945, P < 0.001; once a week OR=0.915, 95% CI: 0.866-0.966, P=0.001), once a semester chair height adjustment (OR=0.942, 95% CI: 0.899-0.988, P=0.014; 4 days OR=0.910, 95% CI: 0.856-0.969, P=0.003; 7 days OR=0.936, 95% CI: 0.892-0.982, P=0.007) were protective factors for myopia, while poor economic condition (moderate OR=1.261, 95% CI: 1.213-1.312, P < 0.001; poor OR=1.127, 95% CI: 0.084-1.172, P < 0.001), rural area (OR=1.239, 95% CI: 1.203-1.275, P < 0.001) and occasional breakfast (OR=1.041, 95% CI: 1.006-1.077, P=0.022) were risk factors for myopia.  Conclusions  The detection rate of myopia among students in Liaoning Province was relatively high, but it decreased gradually. At the same time, preventive strategies should be taken according to its influencing factors so as to avoid the myopia occurrence.
Analysis of the current status and increase rate trend of poor eyesight among Han ethnic group students aged 7-18 in Jiamusi City
ZHU Li-ling, DING Ling-ling, YANG Di
2022, 26(6): 679-683. doi: 10.16462/j.cnki.zhjbkz.2022.06.011
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  Objective  To understand the current status and trend of the increasing rate of poor eyesight with age among students in Jiamusi City, so as to provide a basis for the prevention and control of poor eyesight.  Methods  Data were collected from the investigation of students' physical constitution and health status in Jiamusi City in 2019. Students aged 7 to 18 with complete information of gender, age, urban/rural areas, and poor eyesight were selected as subjects. A total of 37 544 students were selected, including 19 177 boys and 18 367 girls. Curve fitting was adopted to construct the increase rate model of poor eyesight, so as to analyze the differences and characteristics in the increase rate of poor eyesight between male and female students in urban and rural areas.  Results  (1) The poor eyesight rate of Han ethnic group students aged 7 to 18 in Jiamusi was 71.89%. Female students had higher overall and severe poor eyesight rates than those of male ones, and urban students had higher overall and all degrees of poor eyesight rates than those of rural ones. The overall and severe poor eyesight rates tended to increase with age, while mild poor eyesight rate tended to decrease. (2) Urban boys had a greater increasing rate than that of rural boys before age 12, which crossed over at age 12 and then showed an opposite trend. Urban girls had a higher increasing rate than that of rural ones before age 10, which crossed over at age 10 and then showed an opposite trend. (3) Urban girls had higher increasing rate of poor eyesight than that of urban boys before age 13, with an opposite trend after age 13. Rural girls had higher increasing rate of poor eyesight than that of rural boys before age 14, with an opposite trend after age 14.  Conclusions  There is an effective control for the trend of forward shift of the peak age of the increasing rate of poor eyesight in urban and rural boys and girls in Jiamusi City, and the increasing rate of poor eyesight crosses in adolescence.
Analysis on the status and trend of dementia burden in China based on the global perspective
LU Tian-huan, YU Chuan-hua
2022, 26(6): 684-690. doi: 10.16462/j.cnki.zhjbkz.2022.06.012
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  Objective  Analyzing the disease burden and its changing trend of dementia in China from 1990 to 2019 to provide a scientific basis for the prevention and control of dementia.  Methods  Based on the Global Burden of Disease (GBD) 2019 data, to obtain the incidence, mortality and disability adjusted life year (DALY) rates and corresponding standardized indexes of dementia in China, USA, Japan, India, Malaysia, and the global in 1990-2019. Using Joinpoint to calculate annual percent change (APC) and average annual percent change (AAPC) of standardized incidence and mortality rate of dementia and compare the characteristics and trends of the burden of dementia with the development of years.  Results  In 2019, the incidence, mortality and DALY rate of dementia in China were higher in females than in males and higher in senior age groups than in lower age groups. From 1990 to 2019, the incidence, mortality and disability adjusted life year rate of dementia in China increased from 43.32/100 000, 7.88/100 000, 155.95/100 000 in 1990 to 126.57/100 000, 22.55/100 000, 420.22/100 000 in 2019, respectively. In 2019, the standardized incidence, standardized mortality and standardized DALY rate were higher than those in the global but lower than those in Japan. The standardized incidence rate of dementia in China has increased by 0.47% per year, and the standardized mortality rate has not changed significantly. The main risk factors of dementia in men and women were smoking, high BMI and high fasting plasma glucose in 2019.  Conclusions  Since 1990, the burden of dementia in China has been on the rise. Health education should be conducted to improve the public knowledge about the prevention of dementia, especially paying attention to the prevention and control of the elderly. People should formulate reasonable policies and control risk factors to further reduce the burden of dementia in China.
Interaction analysis of factors influencing high-risk behaviors among registered schizophrenic patients in Bao'an District of Shenzhen City
CHEN Qing, LIU Cheng-feng, CHENG Juan, LU Chu-hong, QING Li, SU Hai-yun, WANG Yong-jun, HU Dong-sheng, GUO Yan-fang
2022, 26(6): 691-695. doi: 10.16462/j.cnki.zhjbkz.2022.06.013
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  Objective  To understand the influencing factors and interaction of high-risk behaviors in patients with schizophrenia.  Methods  A self-designed risk behavior questionnaire was carried out among registered schizophrenic patients in Bao'an District of Shenzhen City using the census method. Their risk status was evaluated face-to-face by the psychiatrist.  Results  The incidence of high-risk behavior was 1.06% among 4 731 registered schizophrenic patients. Multivariate Logistic regression analysis showed that the risk factors of high-risk behavior in schizophrenia patients were had 1 or more than 2 times previous hospitalizations, previous risk behaviors, poor interpersonal skills, and low learning abilities (OR values were 2.55, 2.73, 16.21, 3.59 and 4.01, all P < 0.05). There was an additive interaction between previous hospitalization and previous risk behaviors, and the related indexes relative excess risk of interaction (RERI), attributable proportion of interaction (API) and synergy index (S) were 33.59, 0.78 and 4.96, respectively. However, there was no multiplicative interaction among the factors.  Conclusions  People with schizophrenia who have had previous hospitalizations, previously risky behaviors, poor interpersonal skills, and low learning abilities have significant risk factors of high-risk behaviors, which are worth evaluating. It is possible to identify the key factors involved in the prevention and management of schizophrenia through the community's practical work, including characteristics such as previous hospitalizations and risk behaviors, and timely monitoring and early warning can be implemented.
Investigation and analysis of work situation of professional and technical personnel in Beijing Centers for Disease Prevention and Control during the COVID-19 epidemic
YANG Yu-jie, DU Shuai, MENG Yue-li, DONG Pei, ZHAO Min-jie, WANG Kun, YAN Xiao-ling, LIU Xiu-ying, QIU Wu-qi, MAO A-yan
2022, 26(6): 696-702. doi: 10.16462/j.cnki.zhjbkz.2022.06.014
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  Objective  To analyze the work situation of the personnel in Beijing Centers for Disease Prevention and Control during the novel coronavirus disease 2019 (COVID-19) epidemic, and to provide references for improving the construction of the capital's disease control and prevention system.  Methods  Cross-sectional survey and cluster sampling methods were used. A total of 422 municipal-level and 664 district-level professional technicians from CDCs who were mainly involved in epidemic prevention and control in Beijing were included in the study. Self-designed questionnaires were used to collect the basic information, work intensity and satisfaction and other data. The statistical description and test analysis were carried out.  Results  Among professionals, 64.36% had normal workload, and 76.89% had overload during the epidemic prevention and control period. The proportion of disease control personnel expressing dissatisfaction with the usual salary level was 54.51%, and the satisfaction with the professional title promotion was mostly at the average level (45.58%). The proportions of satisfaction with the prevention and control work arrangements and logistical support during the COVID-19 epidemic were 49.08% and 54.42%, respectively. Only 21.73% professionals were satisfied with the temporary work subsidy. From the perspective of population distribution, staffs at the municipal and district levels and in different job positions were mainly dissatisfied with the salary level (all P < 0.05). Most of staffs who undertook different prevention and control responsibilities were satisfied with the work arrangements and logistics support (all P < 0.05), but they were dissatisfied with the temporary work subsidies (H=27.076, P=0.012). Among the survey respondents, 44.48% had thoughts of resigning. Regardless of the municipal and district levels, different professional titles or positions, the willingness to resign was generally high (all P>0.05). The primary reason for wanting to leave was the low salary level, followed by difficulty in promotion of professional titles and poor development prospects which were also major considerations.  Conclusion  It is suggested to improve the stability of CDCs staffs and promote the high-quality and sustainable development of the disease control and prevention system by improving the personnel allocation, strengthening the interdisciplinary talent reserve, improving the salary system and optimizing the professional title appointment mechanism.
Post-traumatic stress disorder prevalence and vulnerable groups after the outbreak of COVID-19 in Chinese adults
WANG Wei-dong, HU Yi-song
2022, 26(6): 703-708. doi: 10.16462/j.cnki.zhjbkz.2022.06.015
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  Objective  To evaluate post-traumatic stress disorder (PTSD) prevalence after the outbreak of COVID-19 in Chinese adults and to explore the vulnerable groups of COVID-19-associated PTSD.  Methods  Random digital dialling sampling method was used based on the national cell phone segment database. Computer assisted telephone interviewing platform was administered to collect 4 206 questionnaires from all prefecture-level cities in China from May 11th to 28th 2020. PTSD score was evaluated with the post-traumatic stress disorder checklist 5th edition (PCL-5).  Results  The total national suspected PTSD rate was 2.06%. The suspected PTSD rate for Wuhan City, other areas in Hubei and other Provinces were 2.88%, 2.54% and 2.03% respectively. The multivariate Logistic regression model showed that middle age, rural location, and lower social-economic status was positively associated with suspected PTSD.  Conclusions  Although the COVID-19-associated PTSD rate was relatively low, more attention should be paid because of the largest population in China. And more consideration should be given to the low SES population for the control and prevention of COVID-19-associated PTSD.
Effects of ozone concentration on allergic skin disease visits in summer in Hefei from 2015 to 2018
FANG Lan-lan, WU Jun, DENG Li-jun, LIAO Tao, YE Dong-qing, PAN Gui-xia
2022, 26(6): 709-714. doi: 10.16462/j.cnki.zhjbkz.2022.06.016
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  Objective  To investigate the relationship between ozone (O3) concentration and allergic skin disease (ASD) visits in summer.  Methods  The daily counts of ASD admissions from January 1, 2015, to December 31, 2018 in summer (every year from June 1st to August 31st) were collected from the First Affiliated Hospital of Anhui Medical University and the First Affiliated Hospital of University of Science and Technology of China, and air pollutants and meteorological data were gathered during the same period. The exposure-lag-response relationship between O3 concentration and ASD admissions was evaluated using the distributed lag non-linear model (DLNM), in which confounding factors, time trend, day of week, and holiday were adjusted.  Results  A total of 31 741 ASD admissions were collected during the study period. O3 concentration was positively correlated with ASD admissions and chronic urticaria admissions but had no statistical significance with atopic dermatitis admissions. When O3 concentration increased by 10 μg/m3, the maximum single-day lagged effect of ASD admissions was 1.007 (RR=1.007, 95% CI: 1.003-1.011, lag 7 d), and the maximum cumulative lagged effect of ASD admissions was 1.078 (RR=1.078, 95% CI: 1.028-1.131, lag 0-14 d). In males, < 18 years and 18- < 65 years ASD patients, the single-day and cumulative lagged effects of O3 concentration increased by 10 μg/m3 on ASD admissions were statistically significant (all P < 0.05).  Conclusions  High concentration O3 is an important risk factor with lagged effect for ASD in summer in Hefei. The relevant departments should intensify the prevention and control of O3 pollution in summer, strengthen the medical service for ASD patients and protect the susceptible population.
The common genetic characteristics and molecular mechanisms of systemic lupus erythematosus and primary Sjogren's syndrome
LING Hua-yun, WU Ling-ling, ZHOU Ying, QIU Li-juan, WANG Hong, XUE Yu, CHEN Hui-juan, WANG Ting-rui, WANG Bin
2022, 26(6): 715-722. doi: 10.16462/j.cnki.zhjbkz.2022.06.017
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Abstract:
  Objective  To initially investigate the common gene expression characteristic and molecular mechanism of systemic lupus erythematosus (SLE) and primary Sjögren's syndrome (pSS).  Methods  The SLE and pSS gene expression datasets were obtained from the Gene Expression Omnibus (GEO) database. Weighted gene co-expression network analysis (WGCNA) and differentially expressed genes (DEGs) were performed on the data to preliminarily identify the common key genes and gene expression characteristics of SLE and pSS.  Results  Both WGCNA and DEGs analysis showed that the common genes of SLE and pSS were mainly enriched in type Ⅰ interferon (IFN) and viral immune-related pathways (all P < 0.05). The analysis identified nine key genes, namely ISG15, IFIT3, OASL, OAS2, SERPING1, GBP1, DDX60, XAF1, and DDX58, most of which were type Ⅰ IFN-related genes.  Conclusion  The findings suggest that the common gene expression signatures of SLE and pSS are mainly related to type Ⅰ IFN and viral immune-related genes and pathways, which will provide some reference for future mechanistic studies.
Review
Progress of health management services for patients with rheumatoid arthritis
XU Yan-hui, DAI Lie, CHEN Jia-ying
2022, 26(6): 723-727. doi: 10.16462/j.cnki.zhjbkz.2022.06.018
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Abstract:
Rheumatoid arthritis (RA) is a common chronic autoimmune disease with inflammation and joint injury. However, in clinical practice, deficiency of medical condition and health management service results in low treatment success rate. Health management provides comprehensive and overall-process health care service for individuals or groups. Among them, chronic health management is effective to improve treatment result. Integrated health service could improve treatment efficiency and quality with no increased total investment or with little incremental investment by adjusting service model and synergy mechanism. This study aims to summarize the progression of RA health management service and experience on integrated health services for chronic diseases. It is expected to develop idea for RA health management service.
Short Reports
Epidemiological characteristics of high-risk population of cardiovascular disease in residents aged 35-75 years in Hunan Province
YIN Li, YIN Lei, LIU Qiong, LIU Yuan, LIU Yi, XIE Xian
2022, 26(6): 728-731. doi: 10.16462/j.cnki.zhjbkz.2022.06.019
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Abstract:
  Objective  To understand epidemiological characteristics of high-risk population of cardiovascular disease in adults aged 35-75 years in Hunan Province, and to provide basis for prevention and treatment of cardiovascular diseases.  Methods  Epidemiological characteristics of high-risk population of cardiovascular disease were analyzed through the data from China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project in Hunan Province. The mixed model was used to analyze the association between individual characteristics and high risk of cardiovascular disease.  Results  Totally, 99 001 participants were enrolled in this study, with an average age of (56.6±9.7) years. In both sexes, 62.2 % of participants were females and 37.8% were males. 12.1% of the participants were the high-risk population for cardiovascular diseases, and among these high-risk population, 96.4% people had been diagnosed with hypertension. Living in rural areas, Han nationality, drinkers and overweight/obesity were positively correlated with the risk of cardiovascular disease, while those with high education, high family income and married were negatively correlated with the risk of cardiovascular disease (all P < 0.001).  Conclusions  The proportion of high-risk population of cardiovascular disease screened in Hunan Province is high. Comprehensive intervention measures should be taken to reduce the risk of cardiovascular disease among high-risk population.
Relationship between the dietary inflammatory index and gastrointestinal symptoms in middle-aged and elderly residents in a high-incidence-of -gastric-cancer county in Anhui Province
WANG Ke-xin, WANG Ting-ting, LIN Xiao, WANG Li, ZHAO Qi-hong
2022, 26(6): 732-735. doi: 10.16462/j.cnki.zhjbkz.2022.06.020
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Abstract:
  Objective  To explore the relationship between dietary inflammatory index (DII) and gastrointestinal symptoms of middle-aged and elderly residents in a county with high incidence of gastric cancer in Anhui Province.  Methods  In this study, a total of 1 229 residents over 45-year old were randomly selected from Lujiang County, Anhui Province to conduct a questionnaire survey. The relationship between DII and gastrointestinal symptoms was analyzed.  Results  There were residents with gastrointestinal symptoms. For instance, 87 (7.1%) residents had anorexia, 171 (13.9%) had epigastric discomfort, and 18 (1.5%) had emaciation/anemia, respectively. Multivariate analysis showed that, residents with DII of Q4(P75-P100) had a higher risk of epigastric discomfort (OR=2.326, 95% CI: 1.350-4.008, P=0.002) than those with DII of Q1(P0-P25) from lowest to highest according to quartiles.   Conclusion  With the increase of DII scores of middle-aged and elderly residents in that area of Anhui province, the risk of gastrointestinal symptoms increase.
Economic burden and health-related quality of life of herpes zoster disease in rural areas of Jiangsu Province
WANG Fei, JIN Peng-fei, MENG Fan-yue, WEI Ming-wei, LI Jing-xin, ZHU Feng-cai
2022, 26(6): 736-739. doi: 10.16462/j.cnki.zhjbkz.2022.06.021
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Abstract:
  Objective  To analyze the economic burden and health-related quality of life of patients with herpes zoster (HZ) aged 40 years and over in rural areas of Jiangsu Province.  Methods  A prospective follow-up survey was carried out among HZ patients at the age of 40 years and above in the study area. The economic burden of disease, health utility value and Visual analogue scale (VAS) score of European quality of life-5 dimensions (EQ-5D) were obtained by questionnaire.  Results  A total of 310 patients received valid questionnaires. The median direct economic burden, indirect economic burden and intangible economic burden of 310 patients were 351.050 yuan, 582.900 yuan and 2 000.000 yuan, respectively. The health utility value and VAS score of patients were lower in the early follow-up period, and gradually recovered in the later period.   Conclusion  The economic burden of HZ disease in rural areas of Jiangsu province was heavy, and the disease reduced the health-related quality of life of patients.
The complete gene sequence characteristic analysis of coxsackievirus A6 strains isolated from China
DONG Xiao-cong, JI Wang-quan, CHEN Shuai-yin, YANG Hai-yan, DUAN Guang-cai, JIN Yue-fei
2022, 26(6): 740-744. doi: 10.16462/j.cnki.zhjbkz.2022.06.022
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Abstract:
  Objective  To analyze the genetic evolutionary characteristic of coxsackievirus A6 (CVA6) strains reported from 2007 to 2019 of China to provide theoretical basis for disease prevention and development of vaccines.  Methods  The whole information of gene sequences of 454 Chiness CVA6 strains reported up to March 1, 2021 were collected from Genbank, and the isolation year and region of the strains were analyzed. Phylogenetic tree was constructed to reveal the evolutionary character of the strains and gene recombination analysis was conducted.  Results  The information of isolated region showed that the CVA6 strains were mainly originated from coastal areas and south of China. The number of reported CVA6 strains had a significant increase since 2013. The phylogenetic tree revealed that 454 CVA6 strains were mainly clustered into 10 branches. Three strains in Group A isolated from Jiangxi Province was most closely related to the CVA6 prototype strain Gdula (AY421764), with nearly 100% similarity of nucleic acid sequence. Group J isolated from many provinces in China, such as Shandong Province and Guangdong Province, was the most widespread group of strains. Recombination analysis showed that gene recombination of most strains was common. Most representative strains of CVA6 were recombined with some other Enterovirus A strains in P2 and P3 regions.   Conclusion  From 2007 to 2019, the CVA6 strains have been spreading widely in China, and the phenomenon of gene recombination among CVA6 strains is widespread.

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